Parent and Family Factors Related to Children's Progress in Intensive Behavioural Intervention

The goal of this study was to examine the relationship between parent and family demographic, psychosocial, and involvement factors and the progress of children with Autism Spectrum Disorder (ASD) in Intensive Behavioural Intervention (IBI). Children’s cognitive rates of development and parents’ perceptions of children’s progress were used to measure children’s progress in IBI. Demographic (socioeconomic status, marital status, maternal employment, and having other children with disabilities), psychosocial (parent distress, and coping), and involvement (parent involvement in IBI, and self-efficacy surrounding involvement) factors were related to children’s progress in various ways. Specifically, maternal employment, and parental involvement in IBI were predictors of increased cognitive rates of development, and coping was a predictor of increased parental perceptions of children’s progress. Clinical implications include empirical evidence for encouraging parents to be involved in their children’s treatment, along with evidence supporting maternal employment

Alcohol use during the COVID-19 pandemic: gender, parenthood, intimate partner violence, and stress

Some preliminary work during the COVID-19 pandemic indicates that adult alcohol use increased, particularly for parents. This cross-sectional study examined the quantity and frequency of adults' alcohol use during the early stages of the pandemic. Additionally, the influences of gender, parenthood, COVID-19-related stressors and intimate partner violence (IPV) on alcohol consumption were examined. The sample consisted of 298 adults (98 parents) from across the United States who completed self-report surveys through Qualtrics at the beginning of the pandemic in May 2020. In the present study, all men reported higher levels of drinking compared to all women. Although stress levels did not impact alcohol consumption, findings indicate that increased IPV experiences were associated with higher levels of heavy drinking during the pandemic. Results also suggested that having children in the home particularly impacted drinking levels during the pandemic, above and beyond the influence of gender, IPV, and stress levels. These findings suggest that parenthood may have had a cascading influence on drinking experiences during the COVID-19 pandemic. Implications and recommendations for further research are discussed

Increased posterior default mode network activity and structural connectivity in young adult APOE-ε4 carriers: a multi-modal imaging investigation

Young adult APOE-ε4 carriers show increased activity in posterior regions of the default mode network (pDMN), but how this is related to structural connectivity is unknown. Thirty young adults (one half of whom were APOE-ε4 carriers; mean age 20 years) were scanned using both diffusion and functional magnetic resonance imaging. The parahippocampal cingulum bundle (PHCB)—which links the pDMN and the medial temporal lobe—was manually delineated in individual participants using deterministic tractography. Measures of tract microstructure (mean diffusivity and fractional anisotropy) were then extracted from these tract delineations. APOE-ε4 carriers had lower mean diffusivity and higher fractional anisotropy relative to noncarriers in PHCB, but not in a control tract (the inferior longitudinal fasciculus). Furthermore, PHCB microstructure was selectively associated with pDMN (and medial temporal lobe) activity during a scene discrimination task known to be sensitive to Alzheimer's disease. These findings are consistent with a lifespan view of Alzheimer's disease risk, where early-life, connectivity-related changes in specific, vulnerable “hubs” (e.g., pDMN) lead to increased neural activity. Critically, such changes may reflect reduced network efficiency/flexibility in APOE-ε4 carriers, which in itself may portend a faster decline in connectivity over the lifespan and ultimately trigger early amyloid-β deposition in later life

Design of an Intervention to Minimize Ingestion of Fecal Microbes by Young Children in Rural Zimbabwe.

We sought to develop a water, sanitation, and hygiene (WASH) intervention to minimize fecal-oral transmission among children aged 0-18 months in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial. We undertook 4 phases of formative research, comprising in-depth interviews, focus group discussions, behavior trials, and a combination of observations and microbiological sampling methods. The resulting WASH intervention comprises material inputs and behavior change communication to promote stool disposal, handwashing with soap, water treatment, protected exploratory play, and hygienic infant feeding. Nurture and disgust were found to be key motivators, and are used as emotional triggers. The concept of a safe play space for young children was particularly novel, and families were eager to implement this after learning about the risks of unprotected exploratory play. An iterative process of formative research was essential to create a sequenced and integrated longitudinal intervention for a SHINE household as it expects (during pregnancy) and then cares for a new child

Fish Consumption and Mercury Exposure among Louisiana Recreational Anglers

Ba c k g r o u n d: Methylmercury (MeHg) exposure assessments among average fish consumers in the United States may underestimate exposures among U.S. subpopulations with high intakes of region-ally specific fish. obj e c t i v e s: We examined relationships among fish consumption, estimated mercury (Hg) intake, and measured Hg exposure within one such potentially highlyexposed group, recreational anglers in the state of Louisiana, USA. Me t h o d s: We surveyed 534 anglers in 2006 using interviews at boat launches and fishing tourna-ments combined with an Internet-based survey method. Hair samples from 402 of these anglers were collected and analyzed for total Hg. Questionnaires provided information on species-specific fish consumption during the 3 months before the survey. re s u l t s: Anglers’ median hairHg concentration was 0.81 μg/g (n = 398; range, 0.02–10.7 μg/g);40% of participants had levels >1 μg/g, which approximately corresponds to the U.S. Environmental Protection Agency’s reference dose. Fish consumption and Hg intake were significantly positively associated with hairHg. Participants reported consuming nearly 80 different fish types, many of which are specific to the region. Unlike the general U.S. population, which acquires most of its Hg from commercial seafood sources, approximately 64% of participants’ fish meals and 74% of their estimated Hg intake came from recreationally caught seafood. co n c l u s i o n s: Study participants had relatively elevated hairHg concentrations and reported con-sumption of a wide variety of fish, particularly locally caught fish. This group represents a highlyexposed subpopulation with an exposure profile that differs from fish consumers in other regions of the United States, suggesting a need for more regionallyspecific exposure estimates and public health advisories.ISSN:1552-9924ISSN:0091-676

Measuring wealth in rural communities: Lessons from the Sanitation, Hygiene, Infant Nutrition Efficacy (SHINE) trial.

BACKGROUND: Poverty and human capital development are inextricably linked and therefore research on human capital typically incorporates measures of economic well-being. In the context of randomized trials of health interventions, for example, such measures are used to: 1) assess baseline balance; 2) estimate covariate-adjusted analyses; and 3) conduct subgroup analyses. Many factors characterize economic well-being, however, and analysts often generate summary measures such as indices of household socio-economic status or wealth. In this paper, a household wealth index is developed and tested for participants in the cluster-randomized Sanitation, Hygiene, Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe. METHODS: Building on the approach used in the Zimbabwe Demographic and Health Survey (ZDHS), we combined a set of housing characteristics, ownership of assets and agricultural resources into a wealth index using principal component analysis (PCA) on binary variables. The index was assessed for internal and external validity. Its sensitivity was examined considering an expanded set of variables and an alternative statistical approach of polychoric PCA. Correlation between indices was determined using the Spearman's rank correlation coefficient and agreement between quintiles using a linear weighted Kappa statistic. Using the 2015 ZDHS data, we constructed a separate index and applied the loadings resulting from that analysis to the SHINE study population, to compare the wealth distribution in the SHINE study with rural Zimbabwe. RESULTS: The derived indices using the different methods were highly correlated (r>0.9), and the wealth quintiles derived from the different indices had substantial to near perfect agreement (linear weighted Kappa>0.7). The indices were strongly associated with a range of assets and other wealth measures, indicating both internal and external validity. Households in SHINE were modestly wealthier than the overall population of households in rural Zimbabwe. CONCLUSION: The SHINE wealth index developed here is a valid and robust measure of wealth in the sample

Examining Stress and Coping in Parents of Children with Autism Spectrum Disorder

Parents of children with Autism Spectrum Disorder (ASD) are at risk for experiencing elevated levels of distress; coping has been shown to moderate parents experience of distress, but popular instruments of both stress and coping have not been well-validated in the ASD population. Previous research on a commonly-used measure of parental distress, the Parenting Stress Index – Short Form (PSI-SF), has shown that its three subscale model does not adequately explain data from parents of children with ASD. The goal of the current study was to further examine the psychometric properties of the PSI-SF and to examine the psychometric properties of an instrument that measures coping – namely, the Family Crisis Oriented Personal Evaluation Scales (F-COPES) – using a large, community-based sample of parents of 1,790 children with ASD obtained from archived screening assessments conducted over a decade and a half (2000 – 2016). Further, the large sample provided an opportunity to examine separately the responses of fathers, which has been a gap in the literature. First, the factor structure of each questionnaire was examined in mothers and fathers separately using confirmatory factor analysis (CFA) to evaluate the fit of the model of the questionnaires as published. As expected from previous research with smaller samples, the fit indices differed from the original validation structures published in the test manuals with identified subscales shown to be lacking psychometric verification. Exploratory factor analysis (EFA) was then completed on half of each sample (mothers and fathers separately) to examine other models for improved fit. After new factor structures were developed, these models were examined using CFA on the other half of the sample for cross-validation. Based on these analyses, a 5-factor model was developed for the PSI-SF (General Parental Distress, Behavioural Regulation, Reciprocity, Child Limits, Perceived Disagreeable Behaviour) and a 7-factor model was developed for the F-COPES (Social Support from Friends and Family, Self-Efficacy, Religious Participation/Coping, Passive/Avoidant Coping, Formal Supports, Supports from Neighbours, Acceptance), with the factors defining the same subscale pattern for mothers and fathers. Finally, child and demographic factors (age, sex, adaptive behaviour, autism symptom severity, and socioeconomic status) were evaluated as potential predictors of the newly developed PSI-SF and F-COPES subscale scores in mothers and fathers. The findings of this large clinical sample research have important applications for instrument subscale revisions to improve measurement and have implications for theoretical models of parental stress and coping. Future research might explore some of the preliminary findings of differences between mothers and fathers in predictors arising from newly proposed subscales of family distress and coping

A Text-Based Smoking Cessation Intervention for Sexual and Gender Minority Groups: Protocol for a Feasibility Trial

BACKGROUND: Smoking among sexual and gender minority (SGM) groups, which include lesbian, gay, bisexual, transgender, and queer individuals, has been reported to be highly prevalent. This is attributed to several factors, including minority-specific stress and targeted tobacco marketing. Therefore, this population is at an increased risk for tobacco-related diseases. SMS text messaging programs have been found to be effective for smoking cessation and appeal to traditionally hard-to-reach populations over other interventions. It has also been suggested that targeted and tailored interventions could be more effective among SGM smokers because they can be designed to assure a safe, validating health care environment that enhances receptivity to cessation. OBJECTIVE: The aim of this study is to develop SmokefreeSGM, a text-based smoking cessation program tailored to and tested among SGM smokers. METHODS: The study consists of three phases, culminating in a feasibility trial. In Phase 1, our research team will collaborate with a Community Advisory Board to develop and pretest the design of SmokefreeSGM. In Phase 2, the tailored text messaging program will be beta tested among 16 SGM smokers. Our research team will use a mixed-methods approach to collect and analyze data from participants who will inform the refinement of SmokefreeSGM. In Phase 3, a feasibility trial will be conducted among 80 SGM smokers either enrolled in SmokefreeSGM or SmokefreeTXT, the original text-based program developed by the National Cancer Institute for the general population. Our research team will examine recruitment, retention, and smoking abstinence rates at 1-, 3-, and 6-month follow-up. Additionally, a qualitative interview will be conducted among 32 participants to evaluate the feasibility and acceptability of the programs (SmokefreeSGM and SmokefreeTXT). RESULTS: This study received approval from The University of Texas Health Science Center at Houston Committee for the Protection of Human Subjects to begin research on August 21, 2020. Recruitment for the beta testing of SmokefreeSGM (Phase 2) began in January 2022. We estimate that the feasibility trial (Phase 3) will begin in September 2022 and that results will be available in December 2023. CONCLUSIONS: Findings from this research effort will help reduce tobacco-related health disparities among SGM smokers by determining the feasibility and acceptability of SmokefreeSGM, an SGM-tailored smoking cessation intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05029362; https://clinicaltrials.gov/ct2/show/NCT05029362. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42553