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Call C, Oran A, O'Shea TM, Jensen ET, Frazier JA, Vaidya R, Shenberger J, Gogcu S, Msall ME, Kim S, Jalnapurkar I, Fry RC, Singh R. Health-related quality of life at age 10 years in children born extremely preterm. J Perinatol 2024:10.1038/s41372-024-01987-3. [PMID: 38760579 DOI: 10.1038/s41372-024-01987-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE To evaluate the association between prenatal maternal health and socioeconomic status (SES) and health-related quality of life (QoL) among 10-year-old children born extremely preterm. DESIGN/ METHODS Retrospective analysis of the Extremely Low Gestational Age Newborns (ELGAN) Study cohort of infants born < 28 weeks gestational age. QoL was assessed at 10 years of age using the Pediatric Quality of Life Inventory. Multivariate regression models were used for analyses. RESULTS Of 1198 participants who survived until 10 years of age, 889 (72.2%) were evaluated. Lower maternal age, lack of college education; receipt of public insurance and Supplemental Nutrition Assistance Program (SNAP) were associated with lower QoL scores. Specific maternal health factors were also associated with lower child QoL scores. CONCLUSIONS Specific, potentially modifiable, maternal health and social factors are associated with lower scores on a measure of parent-reported child QoL across multiple domains for children born extremely preterm.
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Affiliation(s)
- Catherine Call
- Department of Pediatrics, Tufts University School of Medicine, Boston, MA, USA
| | - Ali Oran
- Department of Environmental Sciences & Engineering, Gillings School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - T Michael O'Shea
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth T Jensen
- Department of Epidemiology and Prevention, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jean A Frazier
- Department of Psychiatry and the Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Ruben Vaidya
- Department of Pediatrics, University of Massachusetts Chan Medical School - Baystate, Springfield, MA, USA
| | - Jeffrey Shenberger
- Department of Pediatrics, Connecticut Children's Hospital, Hartford, CT, USA
| | - Semsa Gogcu
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Michael E Msall
- Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities University of Chicago, Chicago, IL, USA
| | - Sohye Kim
- Department of Psychiatry and the Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Isha Jalnapurkar
- Department of Psychiatry and the Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Rebecca C Fry
- Department of Environmental Sciences & Engineering, Gillings School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rachana Singh
- Department of Pediatrics, Tufts University School of Medicine, Boston, MA, USA.
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Overmann KM, Porter SC, Zhang Y, Britto MT. Caregiver Quality of Life During Pediatric Influenza-Like Illness: A Cross-Sectional Study During the COVID-19 Pandemic. J Patient Exp 2023; 10:23743735231188840. [PMID: 37528955 PMCID: PMC10388629 DOI: 10.1177/23743735231188840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
The objective of this study was to quantify the quality of life (QoL) of caregivers with children with influenza-like illnesses (ILI) and to identify factors associated with worse QoL. This was a cross-sectional cohort study of caregivers in a pediatric emergency department with previously healthy young children with ILI. The primary outcome was caregiver QoL. Additional measures included health literacy, social support, and caregiver health status. Two hundred and eighty-one caregivers completed the study. And 41% reported overall QoL was worse during their child's illness. The median QoL score was 3.8 [3.1, 4.6] in a 7-point scale. Illness duration was associated with worse overall QoL score (0.128 worse for each additional day of illness). The median emotions domain score was 2.5 [1.5, 4.0], the worst of any domain. Caregivers who perceived worse illness severity had lower emotions domain scores (2.61 vs 6.00, P = .0269). Caregivers with adequate literacy had lower mean QoL scores (3.08 vs 4.44, P < .0001). Childhood illnesses worsen caregiver QoL. Factors associated with worse QoL were perception of illness severity and duration. Addressing caregiver QoL could mitigate the impact of childhood acute illnesses on caregiver wellbeing.
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Affiliation(s)
- Kevin M Overmann
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Stephen C Porter
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Yin Zhang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Maria T Britto
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
- Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Sanmarchi F, Scheier LM, Dallolio L, Ricci M, Longo G, Ceciliani A, Masini A. Association of Socioeconomic Factors and Physical Activity with Health-Related Quality of Life in Italian Middle School Children: An Exploratory Cross-Sectional Study. Healthcare (Basel) 2023; 11:2092. [PMID: 37510533 PMCID: PMC10379006 DOI: 10.3390/healthcare11142092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Health-related quality of life (HRQoL) provides a broad assessment of an individual's well-being and can serve as a good prognosticator of life's outcomes later for children and adolescents. Understanding the factors associated with HRQoL is crucial for promoting better health and life satisfaction. This study investigated the cross-sectional association of socioeconomic status, cardio fitness, and physical activity levels with HRQoL in 224 Italian early adolescents attending secondary school in the Emilia-Romagna region located in Northern Italy. In a multivariate path regression model, younger students and females reported a higher quality of life (β = -0.139, p = 0.015, 95% CI: -0.254--0.023 and β = 0.142, p = 0.019, 95% CI: 0.011-0.273, respectively). Having both parents employed and having a higher familiar educational status were also associated with a higher quality of life (β = 0.142, p = 0.013, 95% CI 0.027-0.257 and β = 0.133, p = 0.017, 95% CI 0.022-0.244, respectively). Greater engagement in routine physical activity levels from moderate to vigorous intensity was positively associated with quality of life (β = 0.429, p < 0.001, 95% CI: 0.304-0.554). Endurance (speed) was positively associated with quality of life (β = 0.221, p = 0.001, 95% CI: 0.087-0.355), and students with longer times on the shuttle run reported less quality of life (β = -0.207, p = 0.002, 95% CI: -0.337--0.077). These relations remained intact even when controlling for socioeconomic factors. The current findings reinforce the importance of promoting regular physical activity among younger children and also addressing socioeconomic status disparities to improve children's well-being. Future studies may want to consider expanding the array of measures used to assess physical activity and include additional measures assessing nutrition, cultural factors, and family functioning, all of which can influence a child's willingness to engage in physical activity and their well-being. The emphasis on fitness and physical activity and their contribution to a child's well-being should be the prime focus for stakeholders who work in the education, public health, and health policy sectors.
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Affiliation(s)
- Francesco Sanmarchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Lawrence M Scheier
- LARS Research Institute, Inc., Sun City, AZ 85351, USA
- Prevention Strategies, Greensboro, NC 27410, USA
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Matteo Ricci
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Giulia Longo
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Andrea Ceciliani
- Department of Life Quality Studies, University of Bologna, Campus of Rimini, 47921 Rimini, Italy
| | - Alice Masini
- Department of Translational Medicine, University of Eastern Piedmont (UNIUPO), Via Solaroli, 17, 28100 Novara, Italy
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Morgan PL, Hu EH, Woods AD, Gloski CA, Wang Y. Disparities in Family-Centered Care Among US Children and Youth with Special Healthcare Needs. J Pediatr 2023; 253:297-303.e6. [PMID: 36152688 PMCID: PMC10635424 DOI: 10.1016/j.jpeds.2022.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 11/20/2022]
Abstract
Cross-sectional analyses of 4 nationally representative samples indicate disparities in family-centered care occur among US children and youth with special healthcare needs by race and ethnicity, family income and composition, insurance coverage, and healthcare setting. Measured confounds including children's health and impairment severity do not explain the disparities.
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Affiliation(s)
- Paul L Morgan
- Department of Education Policy Studies, Penn State University, University Park, PA; Population Research Institute, Penn State University, University Park, PA.
| | - Eric Hengyu Hu
- Department of Education Policy Studies, Penn State University, University Park, PA; Population Research Institute, Penn State University, University Park, PA
| | - Adrienne D Woods
- Center for Learning and Development, SRI International, Menlo Park, CA
| | - Cecelia A Gloski
- Department of Education Policy Studies, Penn State University, University Park, PA; Population Research Institute, Penn State University, University Park, PA
| | - Yangyang Wang
- Department of Education Policy Studies, Penn State University, University Park, PA; Population Research Institute, Penn State University, University Park, PA
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Akinboboye O, Williams JS, Olukotun O, Egede LE. Differences by race in the associations between neighborhood crime and violence and glycemic control among adults with type 2 diabetes. PLoS One 2022; 17:e0279234. [PMID: 36520857 PMCID: PMC9754268 DOI: 10.1371/journal.pone.0279234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Limited data exist on the differential association between neighborhood characteristics such as crime and violence and diabetes outcomes by race. OBJECTIVE To examine racial differences in the relationship between neighborhood characteristics (crime and violence) and glycemic control in a sample of adults with type 2 diabetes (T2DM). DESIGN A cross-sectional study. PARTICIPANTS 601 adults with T2DM from the Southeastern United States. MEASUREMENTS Outcome was glycemic control. Neighborhood violence and crime were the primary independent variable, and previously validated scales and indices were used to assess neighborhood crime and violence. Covariates included age, gender, education, marital status, income, hours of work per week, duration of diabetes, comorbidity, health status, and site of recruitment. Multiple linear regression was used to assess the relationship between neighborhood characteristics (violence and crime) and glycemic control adjusting for relevant covariates. RESULTS Approximately 66% of the sample population was Black with ages ranging between 49-71 years. The unadjusted mean hemoglobin A1c (HbA1c) was significantly higher for Black adults compared to White adults (8.0 ± 2.0 vs. 7.8 ± 1.6; p = 0.002). In the fully adjusted stratified model, glycemic control was significantly associated with neighborhood crime (β-coefficient: 0.36; 95% CI 0.07, 0.65) and neighborhood violence (β-coefficient: 0.14; 95% CI 0.003, 0.28) for White adults in the fully adjusted model; these relationships were not significant for Black adults. CONCLUSION In this sample of adults with T2DM, neighborhood crime and violence were significantly associated with glycemic control for White adults, but not for Black adults. Additional research is needed to understand perceptions of neighborhood crime and violence between White adults and Black adults with T2DM.
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Affiliation(s)
- Olaitan Akinboboye
- Department of Public and Community Health, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Joni S. Williams
- Division of General Internal Medicine, Department of Medicine, Froedtert & The Medical College of Wisconsin, Milwaukee, WI, United States of America
- Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Oluwatoyin Olukotun
- School of Nursing, University of Portland, Portland, OR, United States of America
| | - Leonard E. Egede
- Division of General Internal Medicine, Department of Medicine, Froedtert & The Medical College of Wisconsin, Milwaukee, WI, United States of America
- Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, United States of America
- * E-mail:
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Demographic and Disease-Related Predictors of Socioemotional Development in Children with Neurofibromatosis Type 1 and Plexiform Neurofibromas: An Exploratory Study. Cancers (Basel) 2022; 14:cancers14235956. [PMID: 36497438 PMCID: PMC9737030 DOI: 10.3390/cancers14235956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
Individuals with neurofibromatosis type 1 (NF1) and plexiform neurofibromas (PNs) have a higher risk for socioemotional problems. The current study aims to identify the socioemotional developmental pattern and its predictors across childhood and adolescence in individuals with NF1 and PNs. Participants included 88 children with NF1 and PNs (aged 6-18 years old, M = 12.05, SD = 3.62, 57% male) in a natural history study. Neuropsychological assessments were administered three times over six years. There are large variabilities in socioemotional development in the study participants. Developmental patterns varied across socioemotional domains, respondent type (parent-report [PR] vs. child-report [CR]), demographic factors, and NF1 disease-related factors. For instance, lower parental education was associated with a greater decline in internalizing problems (PR) but a greater increase in school disconnectedness (CR) over time. Non-White (vs. White) children were more likely to experience increased adaptive skills (PR) but decreased personal adjustment (CR). Children with more visible tumors experienced a greater decrease in school disconnectedness (CR). Children with more NF1 complications experienced a greater decrease in externalizing problems (PR). These findings indicate the necessity of using multi-informants and investigating subdomains of socioemotional functions. They also highlight the importance of developing individualized approaches to patient care and interventions.
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DeSousa M, Rego K. Perceived Scarcity Across Sociodemographic Backgrounds Predicts Self-Reported Health. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2022. [DOI: 10.1027/2512-8442/a000122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract. Background: Perceived scarcity shows promise as an indicator of physical and mental health and a possible predictor of health disparities; however, a systematic investigation of how perceived scarcity is experienced across racial and ethnic, gender, and socioeconomic groups is imperative. Moreover, it is necessary to unpack the unique predictive power of each scarcity domain. Aims: First, differences in the experience of perceived scarcity by various sociodemographic groups in overall perceived scarcity and each of its three dimensions were explored using a cross-sectional sample. Next, using self-reported health outcome data collected from participants at a second time point, the direct and mediating role of perceived scarcity in the relationship between sociodemographic indicators and self-reported health was examined. Method: Participants included a racially and socioeconomically diverse online sample. One-way analyses of variance (ANOVAs) and t-tests were used to assess whether perceived scarcity, overall and by domain, varied by sociodemographic factors. PROCESS macro for SPSS v 3.5 was used to analyze the proposed direct effects and mediations. Results: Results indicate that sociodemographic differences do exist in perceived scarcity and in a variety of ways that may not be reflected when solely examining overall perceived scarcity. Dimensions of perceived scarcity were found to mediate the relationship between some sociodemographic factors and self-reported health. Limitations: Future research should address the limitations of the current study’s sample insofar as recruiting a wider sample of participants to include those experiencing the most extreme forms of scarcity. Conclusion: Findings support the importance of considering the unique experience of perceived scarcity by domain across sociodemographic groups when using it as a predictor or mediator of health.
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Affiliation(s)
- Maysa DeSousa
- Department of Psychology, Springfield College, Springfield, MA, USA
| | - Kaitlyn Rego
- Department of Psychology, Springfield College, Springfield, MA, USA
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8
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Klages KL, Berlin KS, Cook JL, Keenan ME, Semenkovich K, Banks GG, Rybak TM, Ankney RL, Decker KM, Whitworth JR, Corkins MR. Examining Risk Factors of Health-Related Quality of Life Impairments Among Adolescents with Inflammatory Bowel Disease. Behav Med 2021; 47:140-150. [PMID: 34048329 DOI: 10.1080/08964289.2019.1676193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Inflammatory Bowel Disease (IBD) is a chronic, costly, and burdensome disease that is typically diagnosed during adolescence. Despite the use of effective treatments, rates of relapse and intestinal inflammation remain high and put patients at risk for long term physical and psychosocial health complications. Given the costs associated with IBD, it is critical to examine potential risk factors of poor health-related quality of life (HRQoL) among patients for the enhancement and further development of interventions. As such, the aim of the current study was to examine how sociodemographic and disease characteristics, psychosocial problems, and adherence behaviors impact HRQoL among a sample of youth with IBD. 107 adolescents with IBD and their caregiver completed self- and parent-report measures as part of a psychosocial screening service. Medical records were reviewed to obtain information regarding diagnosis, insurance, medication use, illness severity, and disease activity. Results revealed lower HRQoL scores among adolescents with more psychosocial problems (Est. = -3.08; p < .001), greater disease severity (Est. = -.40; p = .001), and those who identified as Black (Est. = -.38; p < .05). Greater disease severity (Est. = .13 p = .004), use of nonpublic insurance (Est. = .32 p = .004), and fewer psychosocial problems (Est. = -.13 p = .04) were associated with greater adherence behaviors. These findings suggest that implementing individually tailored, evidence-based psychological interventions focused on coping with psychosocial problems and symptoms may be important in enhancing adherence behaviors and HRQoL among adolescents with IBD.
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Affiliation(s)
| | - Kristoffer S Berlin
- Department of Psychology, The University of Memphis.,Department of Pediatrics, University of Tennessee Health Sciences Center
| | | | | | | | | | | | | | | | - John R Whitworth
- Department of Pediatrics, University of Tennessee Health Sciences Center
| | - Mark R Corkins
- Department of Pediatrics, University of Tennessee Health Sciences Center
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Martin-Gutierrez G, Wallander JL, Yang YJ, Depaoli S, Elliott MN, Coker TR, Schuster MA. Racial/Ethnic Differences in the Relationship Between Stressful Life Events and Quality of Life in Adolescents. J Adolesc Health 2021; 68:292-299. [PMID: 32747050 DOI: 10.1016/j.jadohealth.2020.05.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 05/26/2020] [Accepted: 05/29/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Stressful life events (SLEs) increase allostatic load and require adaptation. Experiencing SLEs has been associated with decreased health-related quality of life (HRQOL) among adolescents. This study examined racial/ethnic and developmental differences in the relationship between SLEs and HRQOL from preadolescence to midadolescence. METHODS Data were from 4,824 participants in the Healthy Passages project, a population-based prospective longitudinal survey of fifth, seventh, and 10th grade adolescents in the U.S. HRQOL was measured with Pediatric Quality of Life Inventory and SLEs with items addressing family-related SLEs (e.g., the parent's death, separation, and divorce; family member's injury/illness; residential change; new child in the household). RESULTS Adolescents, regardless of race/ethnicity, reported the highest SLEs and the lowest HRQOL in early adolescence. Analysis of an autoregressive model with cross-lagged effects showed that the concurrent relationships between SLEs and HRQOL were significantly negative across preadolescence, early adolescence, and midadolescence in African-American, Latinx, and white groups. Furthermore, adolescents had a negative cross-lagged association from SLEs in early adolescence to HRQOL in pre adolescence, but this was not the case among the other racial/ethnic groups. CONCLUSIONS Because the negative relationship between family-related SLEs and HRQOL persisted throughout stages of adolescent development, health services targeting adolescents should provide comprehensive family-centered care to alleviate the impact of family-related life stress. Relationships between family life stress and HRQOL varied by racial/ethnic groups, which should be considered by health professionals, teachers, and parents, and in prevention efforts. Latinx adolescents may be particularly vulnerable to time-lagged effects of such family-related stress.
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Affiliation(s)
- Geraldy Martin-Gutierrez
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, California
| | - Jan L Wallander
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, California.
| | - Yuzhu June Yang
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, California
| | - Sarah Depaoli
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, Merced, California
| | | | - Tumaini R Coker
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington; Seattle Children's Research Institute, Seattle, Washington
| | - Mark A Schuster
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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Sprague NL, Ekenga CC. The impact of nature-based education on health-related quality of life among low-income youth: results from an intervention study. J Public Health (Oxf) 2021; 44:394-401. [PMID: 33415330 DOI: 10.1093/pubmed/fdaa243] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 11/20/2020] [Accepted: 11/21/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Nature experiences have been shown to promote physical, emotional, mental and overall health. However, low-income youth often face inequities in access to nature. The purpose of this study was to evaluate the impact of a 15-week nature-based education (NBE) intervention on health-related quality of life (HRQoL) of low-income youth. METHODS A total of 362 low-income youth (ages 9-15) in St. Louis, MO, USA, participated in this study. Study participants completed a pre- and post-intervention survey that included validated measures of six HRQoL domains (Physical Activity, Emotional Health Functioning, School Functioning, Social Functioning, Family Functioning and overall HRQoL). Random effects analysis of covariance was used to test for significant differences in HRQoL scores between the intervention and control groups, after adjusting for school, age, previous nature exposure, and Science, Technology, Engineering and Mathematics capacity. RESULTS After the intervention period, youth in the NBE intervention group experienced improvements in all HRQoL domain scores (P < 0.001), whereas youth in the control group experienced declines in HRQoL domain scores (P < 0.001). CONCLUSIONS NBE may have a positive impact on the HRQoL of low-income youth. Further investigations examining the influence of nature-based activities on youth health outcomes are warranted.
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Affiliation(s)
- Nadav L Sprague
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY 10032, USA
| | - Christine C Ekenga
- Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA
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11
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Health-related quality of life scores of typically developing children and adolescents around the world: a meta-analysis with meta-regression. Qual Life Res 2020; 29:2311-2332. [DOI: 10.1007/s11136-020-02519-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2020] [Indexed: 12/17/2022]
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Kan K, Fierstein J, Boon K, Madeleine Kanaley, Zavos P, Volerman A, Vojta D, Gupta RS. Parental quality of life and self-efficacy in pediatric asthma. J Asthma 2020; 58:742-749. [PMID: 32072838 DOI: 10.1080/02770903.2020.1731825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: Self-efficacy is the personal belief that a behavior can produce a desired result; and in asthma, self-efficacy in asthma care has been related to improvements in asthma outcomes and children's quality of life. To appreciate the full burden of asthma on families, the relationship between parental self-efficacy and quality of life also needs further study. We aim to characterize this relationship.Methods: Secondary analysis of measurements of parents of children with persistent asthma (n = 252; ages 4-17 years) from a large urban area were identified from a randomized trial; the association between baseline assessments of parental quality of life, measured by the Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), and parental self-efficacy, measured through the Parental Asthma Management Self-Efficacy Scale (PAMSES), were examined through multivariable linear regression.Results: Parental self-efficacy in asthma was positively associated with quality of life among parents of racially and ethnically diverse children (p = 0.01). Confidence in using medications correctly (p = 0.03), having inhalers during a child's serious breathing problem (p = 0.02), and knowing which medications to use during a child's serious breathing problem (p = 0.04) were associated with a clinically meaningful difference in parental quality of life. Other significant factors associated with parental quality of life included Hispanic/Latino ethnicity (p < 0.01) of the child and Asthma Control Test scores (p < 0.01).Conclusion: The findings suggest that improving parental confidence on when and how to use their child's asthma medications, particularly during an asthma attack, might be clinically meaningful in enhancing parent's quality of life.
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Affiliation(s)
- Kristin Kan
- Division of Academic General Pediatrics and Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Jamie Fierstein
- Feinberg School of Medicine, Institute for Public Health and Medicine, Northwestern University, Chicago, IL, USA
| | - Kathy Boon
- Feinberg School of Medicine, Institute for Public Health and Medicine, Northwestern University, Chicago, IL, USA
| | - Madeleine Kanaley
- Feinberg School of Medicine, Institute for Public Health and Medicine, Northwestern University, Chicago, IL, USA
| | - Patricia Zavos
- Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Anna Volerman
- Department of Medicine and Pediatrics, University of Chicago Medicine, Chicago, IL, USA
| | - Deneen Vojta
- Global Research & Development, United Health Group, Minnetonka, MN, USA
| | - Ruchi S Gupta
- Division of Academic General Pediatrics and Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Feinberg School of Medicine, Institute for Public Health and Medicine, Northwestern University, Chicago, IL, USA
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Youth Victims of Violence Report Worse Quality of Life Than Youth With Chronic Diseases. Pediatr Emerg Care 2020; 36:e72-e78. [PMID: 29489599 DOI: 10.1097/pec.0000000000001423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Measuring health-related quality of life (HRQOL) provides the patient's perspective of his/her well-being and offers a unique outcome measure to demonstrate the impact of violence on the victim. To date, no study has described HRQOL in youth victims of violence in the United States. The purpose of this study was to describe HRQOL in youth victims of violence as compared with healthy youth and youth with chronic disease. METHODS We conducted an exploratory cross-sectional study of the HRQOL of victims of violence aged 8 to 18 years. Descriptive statistics were reported for participant and injury demographics. One sample t tests were used to compare the sample population's HRQOL to known HRQOL of healthy populations and specific disease populations. RESULTS Fifty-eight victims of violence participated in the study. Youth victims of violence had significantly worse mean HRQOL scores (mean, 71.4) compared with healthy youth in overall functioning (mean, 83.9), P < 0.001. Youth victims of violence reported worse psychosocial (mean, 67.6), emotional (mean, 62.9), and school (mean, 63.8) functioning than youth with obesity (mean, 72.1, 68.6, 75.0, respectively) and cancer (mean, 72.1, 72.2, 68.3, respectively). Mean Patient-Reported Outcomes Measurement Information System T scores for youth victims of violence were significantly worse in anxiety (T = 51.9) and depression (T = 52.4) compared with youth with obesity (T = 48.3, 49.2), cancer (T = 47.7, 47.6), and sickle cell disease (T = 43, 44). CONCLUSIONS Youth victims of violence suffer significant impairment in HRQOL compared with healthy populations and youth with specific disease burdens. Future studies into violence prevention effectiveness should use HRQOL as a comparative outcome measure to better tailor post injury management and interventions.
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Lion KC, Zhou C, Ebel BE, Penfold RB, Mangione-Smith R. Identifying Modifiable Health Care Barriers to Improve Health Equity for Hospitalized Children. Hosp Pediatr 2020; 10:1-11. [PMID: 31801795 PMCID: PMC6931033 DOI: 10.1542/hpeds.2019-0096] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Children from socially disadvantaged families experience worse hospital outcomes compared with other children. We sought to identify modifiable barriers to care to target for intervention. METHODS We conducted a prospective cohort study of hospitalized children over 15 months. Caregivers completed a survey within 3 days of admission and 2 to 8 weeks after discharge to assess 10 reported barriers to care related to their interactions within the health care system (eg, not feeling like they have sufficient skills to navigate the system and experiencing marginalization). Associations between barriers and outcomes (30-day readmissions and length of stay) were assessed by using multivariable regression. Barriers associated with worse outcomes were then tested for associations with a cumulative social disadvantage score based on 5 family sociodemographic characteristics (eg, low income). RESULTS Of eligible families, 61% (n = 3651) completed the admission survey; of those, 48% (n = 1734) completed follow-up. Nine of 10 barriers were associated with at least 1 worse hospital outcome. Of those, 4 were also positively associated with cumulative social disadvantage: perceiving the system as a barrier (adjusted β = 1.66; 95% confidence interval [CI] 1.02 to 2.30), skill barriers (β = 3.82; 95% CI 3.22 to 4.43), cultural distance (β = 1.75; 95% CI 1.36 to 2.15), and marginalization (β = .71; 95% CI 0.30 to 1.11). Low income had the most consistently strong association with reported barriers. CONCLUSIONS System barriers, skill barriers, cultural distance, and marginalization were significantly associated with both worse hospital outcomes and social disadvantage, suggesting these are promising targets for intervention to decrease disparities for hospitalized children.
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Affiliation(s)
- K Casey Lion
- Department of Pediatrics and
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington; and
| | - Chuan Zhou
- Department of Pediatrics and
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington; and
| | - Beth E Ebel
- Department of Pediatrics and
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington; and
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, Washington
| | - Robert B Penfold
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Rita Mangione-Smith
- Department of Pediatrics and
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington; and
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Harnett NG, Wheelock MD, Wood KH, Goodman AM, Mrug S, Elliott MN, Schuster MA, Tortolero S, Knight DC. Negative life experiences contribute to racial differences in the neural response to threat. Neuroimage 2019; 202:116086. [PMID: 31401241 PMCID: PMC6819267 DOI: 10.1016/j.neuroimage.2019.116086] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 07/11/2019] [Accepted: 08/07/2019] [Indexed: 12/12/2022] Open
Abstract
Threat-related emotional function is supported by a neural circuit that includes the prefrontal cortex (PFC), hippocampus, and amygdala. The function of this neural circuit is altered by negative life experiences, which can potentially affect threat-related emotional processes. Notably, Black-American individuals disproportionately endure negative life experiences compared to White-American individuals. However, the relationships among negative life experiences, race, and the neural substrates that support threat-related emotional function remains unclear. Therefore, the current study investigated whether the brain function that supports threat-related emotional processes varies with racial differences in negative life experiences. In the present study, adolescent violence exposure, family income, and neighborhood disadvantage were measured prospectively (i.e., at 11-19 years of age) for Black-American and White-American volunteers. Participants then, as young adults (i.e., 18-23 years of age), completed a Pavlovian fear conditioning task during functional magnetic resonance imaging (fMRI). Cued and non-cued threats were presented during the conditioning task and behavioral (threat expectancy) and psychophysiological responses (skin conductance response; SCR) were recorded simultaneously with fMRI. Racial differences were observed in neural (fMRI activity), behavioral (threat expectancy), and psychophysiological (SCR) responses to threat. These threat-elicited responses also varied with negative life experiences (violence exposure, family income, and neighborhood disadvantage). Notably, racial differences in brain activity to threat were smaller after accounting for negative life experiences. The present findings suggest that racial differences in the neural and behavioral response to threat are due, in part, to exposure to negative life experiences and may provide new insight into the mechanisms underlying racial disparities in mental health.
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Affiliation(s)
- Nathaniel G Harnett
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Muriah D Wheelock
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kimberly H Wood
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adam M Goodman
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Mark A Schuster
- Harvard Medical School, Boston, MA, USA; Boston Children's Hospital, Boston, MA, USA; Kaiser Permanente School of Medicine, Pasadena, CA, USA
| | - Susan Tortolero
- Health Science Center, University of Texas, Houston, TX, USA
| | - David C Knight
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
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Gu X, Zhang T, Chu TLA, Wang J, Zhang X, Nelson L, Brown K. Exploring Racial Disparities in Physical Activity and Quality of Life Through an Expectancy-Value Perspective. J Racial Ethn Health Disparities 2019; 6:973-980. [PMID: 31098952 DOI: 10.1007/s40615-019-00598-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/29/2019] [Accepted: 05/03/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Alleviating racial/ethnic disparities in physical activity (PA) and health outcomes during childhood becomes an important public health priority as the nation's populace continues to diversify. Guided by expectancy-value model, the purposes of this study were (a) to examine the potential differences in expectancy-value beliefs, PA and health-related quality of life (HRQOL) between African-American (AA) children and their American-Caucasian (AC) peers, and (b) to determine how the relationships among these variables might differ between the two racial groups. METHOD Participants were 321 (152 boys; 189 AC) children from three schools who completed a previously validated questionnaire assessing their expectancy-value beliefs in physical education, leisure-time PA (PAQ-C), and HRQOL. RESULTS Students' PA was positively associated with HRQOL among AC and AA children (p < .01). AA children had significant higher expectancy-value beliefs but lower HRQOL than AC children. The regression results revealed that both racial groups had a nearly identical effect of expectancy beliefs on their self-reported PA (β = .34 in AA group, β = .33 in AC group, respectively). The regression analysis also suggests that expectancy-value belief was a significant predictor of HRQOL while controlling for all other variables (β = .36; p < .001) for the AC group, but not the AA group. CONCLUSIONS The growing health disparities across racial/ethnic subgroups are of great public health concern. Thus, this study provided valuable insights regarding how to promote AA children's PA and HRQOL through an expectancy-value approach.
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Affiliation(s)
- Xiangli Gu
- University of Texas at Arlington, 500 W. Nedderman Dr., Arlington, TX, 76019, USA.
| | - Tao Zhang
- University of North Texas, 1155 Union Circle #310769, Denton, TX, 76203, USA
| | - Tsz Lun Alan Chu
- University of Wisconsin-Green Bay, 2420 Nicolet Drive, Green Bay, WI, 54311, USA
| | - Jing Wang
- University of Texas at Arlington, 500 W. Nedderman Dr., Arlington, TX, 76019, USA
| | - Xiaoxia Zhang
- University of Texas at Arlington, 500 W. Nedderman Dr., Arlington, TX, 76019, USA
| | - Larry Nelson
- University of Texas at Arlington, 500 W. Nedderman Dr., Arlington, TX, 76019, USA
| | - Kyrah Brown
- University of Texas at Arlington, 500 W. Nedderman Dr., Arlington, TX, 76019, USA
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Wallander JL, Fradkin C, Elliott MN, Cuccaro PM, Tortolero Emery S, Schuster MA. Racial/ethnic disparities in health-related quality of life and health status across pre-, early-, and mid-adolescence: a prospective cohort study. Qual Life Res 2019; 28:1761-1771. [PMID: 30927145 DOI: 10.1007/s11136-019-02157-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine (1) racial/ethnic disparities in health-related quality of life (HRQOL) and overall health status among Black, Latino, and White youth during adolescence; (2) whether socioeconomic status (SES) and family contextual variables influence disparities; and (3) whether disparities are consistent from pre- to early- to mid-adolescence. METHODS A population sample of 4823 Black (1755), Latino (1812), and White (1256) youth in three US metropolitan areas was prospectively assessed in a longitudinal survey conducted on three occasions, in 5th, 7th, and 10th grades, when youth reported their HRQOL using the PedsQL™ short-form Total, Physical and Psychosocial scales and youth and parents separately reported on youth's overall health status. Parents reported their education and household income to index SES, family structure, and use of English at home. RESULTS Based on analysis conducted separately at each grade, marked racial/ethnic disparities were observed across all measures of HRQOL and health status, favoring White and disfavoring Black, and especially Latino youth. More strongly present in 5th and 7th grade, HRQOL disparities decreased by 10th grade. Most disparities between White and Black youth disappeared when adjusting for SES. However, even after adjusting for SES, family structure, and English use, overall health status disparities disfavoring Latino youth remained across all three assessments. CONCLUSIONS Racial/ethnic disparities in adolescent HRQOL and health are substantial. These disparities appear consistent from pre- to early-adolescence but diminish for HRQOL by mid-adolescence. As disparities appear influenced by SES and other family contextual variables differently in different racial/ethnic groups, efforts to reduce health disparities in youth should address culturally specific conditions impinging on health.
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Affiliation(s)
- Jan L Wallander
- Psychological Sciences and Health Sciences Research Institute, SSHA, University of California, 5200 N. Lake Rd, Merced, CA, 95343, USA.
| | - Chris Fradkin
- Psychological Sciences and Health Sciences Research Institute, SSHA, University of California, 5200 N. Lake Rd, Merced, CA, 95343, USA.,Departamento de Psicologia, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Paula M Cuccaro
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, USA
| | - Susan Tortolero Emery
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, USA
| | - Mark A Schuster
- Kaiser Permanente School of Medicine, Pasadena, CA, USA.,Division of General Pediatrics, Boston Children's Hospital, Boston, USA.,Department of Pediatrics, Harvard Medical School, Boston, USA
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Quality of life in children and adolescents in Central Kenya: associations with emotional and behavioral problems. Qual Life Res 2019; 28:1271-1279. [PMID: 30656535 PMCID: PMC6470276 DOI: 10.1007/s11136-019-02099-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2019] [Indexed: 01/09/2023]
Abstract
Purpose To assess the quality of life (QoL) of children and adolescents in Kenya as rated by parents and youth themselves, and examine how QoL is related to emotional and behavioral problems (EBP). Method QoL and EBP reports were obtained from 1022 Kenyan parents and 533 adolescents living in the country’s Central Province. Parents with children between 6 and 18 years completed the Pediatric Quality of Life Inventory (PedsQL) and the Child Behavior Checklist, while the adolescents (12–18) completed the PedsQL and the Youth Self-Report. Results Parent-reported QoL in Kenyan youth was somewhat above that of US standardization samples, while levels of adolescent self-reports were well within the range of those from most high- and middle-income countries. Average adolescent girls’ self-reports were lower on all QoL scales than boys. QoL in children/adolescents with clinical to borderline levels of EBP (cf. multicultural norms, Achenbach and Rescorla, 2007) was lower than QoL in agemates with normal levels of EBP. Regression analyses indicated unique associations of QoL with parent-reported withdrawn/depressed, somatic complaints, attention problems, and aggressive behavior, and with adolescent self-reported somatic complaints, attention problems, and rule-breaking behavior. Conclusion QoL levels were well within ranges of other countries. Moreover, associations of QoL with EBP indicated that those with borderline/clinical levels of EBP had a much lower QoL most notable for those with somatic complaints and attention problems. Mental health providers might focus on interventions that reduce EBP in Kenyan children and adolescents and simultaneously reduce the risk of lowered QoL.
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Kim KW, Wallander JL, Peskin M, Cuccaro P, Elliott MN, Schuster MA. Associations Between Parental SES and Children’s Health-Related Quality of Life: The Role of Objective and Subjective Social Status. J Pediatr Psychol 2017; 43:534-542. [DOI: 10.1093/jpepsy/jsx139] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 10/27/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kay W Kim
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced
| | - Jan L Wallander
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced
| | - Melissa Peskin
- Prevention Research Center, University of Texas School of Public Health
| | - Paula Cuccaro
- Prevention Research Center, University of Texas School of Public Health
| | | | - Mark A Schuster
- Division of General Pediatrics, Boston Children’s Hospital
- Department of Pediatrics, Harvard Medical School
- Kaiser Permanente School of Medicine, Pasadena, CA, USA
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20
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Health-Related Issues in Latina Youth: Racial/Ethnic, Gender, and Generational Status Differences. J Adolesc Health 2017; 61:478-485. [PMID: 28712595 DOI: 10.1016/j.jadohealth.2017.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 03/08/2017] [Accepted: 04/20/2017] [Indexed: 11/21/2022]
Abstract
PURPOSE Few studies have examined the early development of a broad range of health issues of importance in adolescence in Latina (female) youth, despite their being potentially a vulnerable group. This study compared suicide and depressive symptoms, substance use, violence exposure, injury prevention, obesity, and health-related quality of life among Latina, African-American, and white females as well as Latino (male) youth in fifth grade, as well as differences related to immigrant generational status for Latinas. METHODS Data were from the Healthy Passages study, including 3,349 African-American, Latina, and white females as well as Latino male fifth graders in three U.S. metropolitan areas. Self-report items and scales were used to compare status on health-related issues. Generational status was classified based on the parent report of birth location. Logistic and linear regression analyses were conducted, including adjustment for sociodemographic differences. RESULTS Latinas showed higher vulnerability than white females for several health issues, whereas few remained after adjustments for sociodemographic differences (higher obesity, lower bike helmet use, and lower physical health-related quality of life). Latina's lower vulnerability compared with African-American females generally persisted after adjustments. Third generation Latinas, after adjustments, reported lower prevalence of alcohol use and fewer friends using alcohol, yet higher future intentions of alcohol use, than first and second generation Latinas. There were few differences between Latina and Latino youth. CONCLUSIONS Latina youth generally report low vulnerability across health issues in preadolescence. To the extent they appear at higher vulnerability than white females, this may be related to their disadvantaged sociodemographic status.
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Racial and Ethnic Disparities in Unmet Need for Pediatric Therapy Services: The Role of Family-Centered Care. Acad Pediatr 2017; 17:27-33. [PMID: 27368126 DOI: 10.1016/j.acap.2016.06.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/20/2016] [Accepted: 06/21/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine whether individual elements of family-centered care (FCC) mediate racial/ethnic disparities in parent-reported unmet therapy need. METHODS We conducted a secondary data analysis using the 2009-2010 National Survey of Children With Special Health Care Needs. A total of 6478 black, Hispanic, and white children ages 0 to 5 years had complete data on parent-reported unmet need and FCC. Five measured indicators of FCC included whether the child's health care provider spent enough time with the child (time), listened carefully to the child's parents (listening), was sensitive to family culture and values (sensitivity), delivered information specific to the child's health (information), and helped parents feel like partners (partnership). We performed staged multivariate logistic regression to test the association between race/ethnicity and parent-reported unmet therapy need, and to explore whether this association was mediated by elements of FCC using the Baron-Kenny mediation framework. RESULTS Eighteen percent of children with special health care needs 0 to 5 years old with reported therapy need experienced unmet need. Black and Hispanic children were more likely than white children to have parent-reported unmet therapy need (adjusted odds ratio 1.59, 95% confidence interval 1.08-2.36). This disparity was no longer significant after adjustment for the FCC elements of time, sensitivity, or partnership. CONCLUSIONS The provision of FCC is likely an important factor in meeting the therapy needs of children with developmental delay and in reducing racial/ethnic disparities in parent-reported unmet therapy need. Interventions aimed at fostering parent-provider relationships through improved cultural sensitivity and engagement of parents as partners are necessary to ensure equitable utilization of these services.
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Montgomery L, Marinos D. The influence of potentially traumatic household characteristics on blunt use among Black youth. J Prev Interv Community 2016; 44:101-11. [DOI: 10.1080/10852352.2016.1132827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wallander JL, Koot HM. Quality of life in children: A critical examination of concepts, approaches, issues, and future directions. Clin Psychol Rev 2015; 45:131-43. [PMID: 26911191 DOI: 10.1016/j.cpr.2015.11.007] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Abstract
The quality of children's life is important both as an investment in the future of our society and because children constitute an important group of themselves and deserve to experience well-being presently. Quality of life (QOL) has been conceptualized and studied in children for several decades, but with disparate approaches that have rarely been discussed jointly with application to children in general. Here we describe and critically examine the three main approaches to children's QOL: health-related QOL (HRQOL), social indicators, and subjective well-being (SWB). Although this is not a review of instruments per se, we illustrate these approaches by describing their most prominent measures. Issues and opportunities in research on children's QOL are then discussed related to conceptual clarity, content specification, range of experience, subjective and objective perspectives, development in childhood, reporting source, and malleability of QOL. Finally, directions for advancing children's QOL are considered. We highlight the benefits of focusing on social indicators and SWB, rather than HRQOL, when representing this concept for children in general, the need for applying more sophisticated research strategies, and using QOL as a universal indicator of success whenever we intend to advance the well-being of children through intervention, programs, and policy.
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Affiliation(s)
- Jan L Wallander
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, United States.
| | - Hans M Koot
- Department of Developmental Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
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Wallander JL. Commentary: Dennis D. Drotar Distinguished Research Award: Reflections on People and Contexts Influencing a Research Career. J Pediatr Psychol 2015; 40:1001-7. [PMID: 26384218 DOI: 10.1093/jpepsy/jsv089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 08/19/2015] [Indexed: 11/15/2022] Open
Affiliation(s)
- Jan L Wallander
- Psychological Sciences and Health Sciences Research Center, University of California, Merced
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Crerand CE, Rosenberg J, Magee L, Stein MB, Wilson-Genderson M, Broder HL. Parent-Reported Family Functioning Among Children With Cleft Lip/Palate. Cleft Palate Craniofac J 2014; 52:651-9. [PMID: 25405543 DOI: 10.1597/14-050] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To examine family functioning related to sociodemographic and clinical characteristics in youth with cleft lip and/or palate (CL/P). DESIGN Cross-sectional, multi-site investigation. SETTING Six U.S. cleft centers. PATIENTS/PARTICIPANTS A diverse sample of 1200 children with CL/P and their parents. MAIN OUTCOME MEASURE Parents completed the Family Environment Scale (FES), which assesses three domains of family functioning: cohesion (or closeness), expressiveness (open expression of feelings), and conflict. Demographic and clinical characteristics were also assessed including race, ethnicity, type of insurance, and surgical recommendations. RESULTS The FES scores for families seeking team evaluations for their youth with CL/P (mean age = 11.6 years) fall within the average range compared with normative samples. Families receiving surgical recommendations for their youth also had FES scores in the average range, yet families of children recommended for functional surgery reported greater cohesion, expressiveness, and less conflict compared with those recommended for aesthetic surgery (P < .05). For cohesion and expressiveness, significant main effects for race (P = .012, P < .0001, respectively) and ethnicity (P = .004, P < .0001, respectively) were found but not for their interaction. No significant differences were found on the conflict domain. Families with private insurance reported significantly greater cohesion (P < .001) and expressiveness (P < .001) than did families with public insurance. CONCLUSIONS Family functioning across domains was in the average range. However, observed differences by race, ethnicity, type of insurance, and surgical recommendation may warrant consideration in clinical management for patients and families.
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Wallander JL, Kerbawy S, Toomey S, Lowry R, Elliott MN, Escobar-Chaves SL, Franzini L, Schuster MA. Is obesity associated with reduced health-related quality of life in Latino, Black and White children in the community? Int J Obes (Lond) 2013; 37:920-5. [PMID: 23478424 PMCID: PMC3705583 DOI: 10.1038/ijo.2013.31] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 01/10/2013] [Accepted: 01/28/2013] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Few studies have examined the impact of obesity on health-related quality of life (HRQOL) in non-clinical community samples of children, and methodological limitations have hindered drawing firm conclusions, especially whether the impact is similar across racial/ethnic groups. The present aims were to examine at what levels of non-normal weight, school-aged children experience lower HRQOL and whether this differs among racial/ethnic groups, when controlling for socioeconomic status (SES) differences. DESIGN Cross-sectional community cohort survey. SUBJECTS AND METHODS Data are from the Healthy Passages, reporting on 4824 Latino, black and white 5th graders in a population-based survey conducted in three United States metropolitan areas. Children's weight status was classified from measured weight and height into underweight (1%), normal weight (52%), overweight (19%), obese (13%) and extremely obese (14%). Children reported their own HRQOL using the Pediatric Quality of Life Inventory and additional scales addressing global self-worth, physical appearance and body satisfaction. Parents reported children's overall health status. RESULTS Each increment in higher non-healthy weight class-overweight to obese to extremely obese-was associated with significantly lower scores in more domains of psychosocial HRQOL compared with that in normal weight. However, only extremely obese children reported significantly lower physical HRQOL. Differences among weight classes remained when adjusting for SES and were independent of race/ethnicity. Underweight children generally reported HRQOL that was not significantly different from normal weight children. CONCLUSIONS Overweight, obese and extremely obese 5th graders on average experience worse HRQOL than normal weight children, especially in psychosocial domains including self-worth and peer relationships, regardless of race/ethnicity. If messages can be conveyed in a sensitive and supportive manner, the desire to improve HRQOL could provide additional motivation for children and their parents in addressing unhealthy weight.
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Affiliation(s)
- J L Wallander
- Department of Psychological Sciences, Center of Excellence on Health Disparities, Health Sciences Research Institute, University of California, Merced, Merced, CA 95343, USA.
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