1
|
Potter LN, Schlechter CR, Nahum-Shani I, Lam CY, Cinciripini PM, Wetter DW. Socio-economic status moderates within-person associations of risk factors and smoking lapse in daily life. Addiction 2023; 118:925-934. [PMID: 36564898 PMCID: PMC10073289 DOI: 10.1111/add.16116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 12/07/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Individuals of lower socio-economic status (SES) display a higher prevalence of smoking and have more diffxiculty quitting than higher SES groups. The current study investigates whether the within-person associations of key risk (e.g. stress) and protective (self-efficacy) factors with smoking lapse varies by facets of SES. DESIGN AND SETTING Observational study using ecological momentary assessment to collect data for a 28-day period following a smoking quit attempt. Multi-level mixed models (i.e. generalized linear mixed models) examined cross-level interactions between lapse risk and protective factors and indicators of SES on smoking lapse. PARTICIPANTS A diverse sample of 330 adult US smokers who completed a larger study examining the effects of race/ethnicity and social/environmental influences on smoking cessation. MEASUREMENTS Risk factors included momentary urge, negative affect, stress; protective factors included positive affect, motivation, abstinence self-efficacy; SES measures: baseline measures of income and financial strain; the primary outcome was self-reported lapse. FINDINGS Participants provided 43 297 post-quit observations. Mixed models suggested that income and financial strain moderated the effect of some risk factors on smoking lapse. The within-person association of negative [odds ratio (OR) = 0.967, 95% CI= 0.945, 0.990, P < 0.01] and positive affect (OR = 1.023, 95% CI = 1.003, 1.044, P < 0.05) and abstinence self-efficacy (OR = 1.020, 95% CI = 1.003, 1.038, P < 0.05) on lapse varied with financial strain. The within-person association of negative affect (OR = 1.005, 95% CI = 1.002, 1.008, P < 0.01), motivation (OR = 0.995, 95% CI = 0.991, 0.999, P < 0.05) and abstinence self-efficacy (OR = 0.996, 95% CI = 0.993, 0.999, P < 0.01) on lapse varied by income. The positive association of negative affect with lapse was stronger among individuals with higher income and lower financial strain. The negative association between positive affect and abstinence self-efficacy with lapse was stronger among individuals with lower financial strain, and the negative association between motivation and abstinence self-efficacy with lapse was stronger among those with higher income. The data were insensitive to detect statistically significant moderating effects of income and financial strain on the association of urge or stress with lapse. CONCLUSION Some risk factors (e.g. momentary negative affect) exert a weaker influence on smoking lapse among lower compared to higher socio-economic status groups.
Collapse
Affiliation(s)
- Lindsey N Potter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Chelsey R Schlechter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Inbal Nahum-Shani
- Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, USA
| | - Cho Y Lam
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Paul M Cinciripini
- Department of Behavioral Science, Division of Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Unit 1330, Houston, TX, 77230, USA
| | - David W Wetter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| |
Collapse
|
2
|
Financial strain and electronic nicotine delivery systems use among U.S. young adults: A longitudinal panel analysis, 2013-2018. Addict Behav 2021; 114:106716. [PMID: 33109395 DOI: 10.1016/j.addbeh.2020.106716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/26/2020] [Accepted: 10/13/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Financial strain is associated with an increased likelihood of cigarette smoking, but less is known about its association with electronic nicotine delivery systems (ENDS) use. This study examined longitudinal associations of financial strain with ENDS use behaviors among young adults. METHODS We analyzed in 2020 four waves (2013-2018) of the Population Assessment of Tobacco and Health, a nationally representative longitudinal study. A total of 5740 U.S. young adults (aged 18-24 years at baseline) had matched data for all four waves. We used generalized linear mixed modeling which accounts for correlations between repeated measures. Weighted logistic regressions assessed the association between financial strain and three different types of ENDS use behaviors (i.e., everyday, some-day, and experimental use), adjusting for major confounders including poverty, mental health symptoms, and other substance use behaviors. RESULTS Frequency and proportion of everyday ENDS use showed a linear increase over time whereas some-day and experimental uses showed quadratic trends, increasing with a peak at Wave 2 and then decreasing over time. Financial strain prospectively predicted some-day (adjusted odds ratio [AOR] = 1.32; 95% CI = 1.03-1.69) and experimental (AOR = 1.25; 95% CI = 1.02-1.52) ENDS use, but not everyday use. CONCLUSIONS The findings of the current study indicate the need for distinctly different approaches for non-daily ENDS users from daily users. Our findings further suggest that ENDS use prevention and cessation efforts should consider financial strain of young adults particularly for non-daily users to thwart them from progressing towards nicotine dependence and long-term use.
Collapse
|
3
|
Moderating Roles of Social Support in the Association between Hope and Life Satisfaction among Ethnic Minority College Students in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052298. [PMID: 33652641 PMCID: PMC7956686 DOI: 10.3390/ijerph18052298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 11/17/2022]
Abstract
Ethnic minority college students in China are Chinese students who migrate from ethnic minority-dominant areas to Han-dominant areas to attend college. Acculturative stress would lead to maladjustments for ethnic minority college students in China, such as low levels of life satisfaction. To help improve the life satisfaction of these students, this study adopted resilience theory to explore the beneficial effects of hope and social support and their influencing mechanisms. The participants included 362 ethnic minority college students in Beijing, China, and a questionnaire method was used. The results indicated that Han social support had a promotive effect on life satisfaction, while hope did not have a promotive effect on life satisfaction. Moreover, Han social support moderated the relationship between hope and life satisfaction. Specifically, the effect of hope on life satisfaction was stronger under the condition of a higher level of Han social support compared with those under a lower level of Han social support. In conclusion, Han social support can play a promotive effect individually, while hope only affected life satisfaction when a high level of Han social support existed. Han social support should be strengthened to improve the life satisfaction among ethnic minority college students in China.
Collapse
|
4
|
Komazawa Y, Murayama H, Harata N, Takami K, Parady GT. Role of Social Support in the Relationship Between Financial Strain and Frequency of Exercise Among Older Japanese: A 19-year Longitudinal Study. J Epidemiol 2020; 31:265-271. [PMID: 32307351 PMCID: PMC7940977 DOI: 10.2188/jea.je20190248] [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: 11/24/2022] Open
Abstract
Background Previous studies have reported that financial strain has deleterious effects on healthy behaviors. Moreover, social support is expected to mitigate these effects, but few studies have investigated the effects of exercise; thus, the investigation can deepen our understanding of the relationship between social support and physical activity/exercise. We examined the relationship between financial strain and frequency of exercise, and the role of social support in this relationship in old age. Methods Data came from a 19-year longitudinal study conducted between 1987 and 2006 of Japanese adults aged 60 or more with up to seven repeated observations. Frequency of exercise was assessed using a four-point scale. Financial strain was measured using the responses to three questions related to financial condition. This study considered both emotional and instrumental supports. Covariates included demographic and socioeconomic factors, health behaviors, and health condition. Results The analysis included 3,911 participants. The results of a generalized estimation equation model showed that among females, greater financial strain in the previous wave was associated with reduced frequency of exercise (b = −0.018; 95% confidence interval, −0.032 to −0.004), and that as financial strain increased, those who received more instrumental support engaged in less exercise than those who received less support (b = −0.009; 95% confidence interval, −0.017 to −0.002). These relationships were not observed among males. Conclusion This study provides evidence that financial strain is negatively correlated with frequency of exercise among older females. In addition, instrumental support is negatively correlated with frequency of exercise among females under financial strain.
Collapse
Affiliation(s)
| | | | - Noboru Harata
- Graduate School of Engineering, The University of Tokyo
| | | | | |
Collapse
|
5
|
Strickland JC, Stoops WW, Kincer MA, Rush CR. The impact of financial strain on medication non-adherence: Influence of psychiatric medication use. Psychiatry Res 2019; 271:389-395. [PMID: 30529876 DOI: 10.1016/j.psychres.2018.11.055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/31/2018] [Accepted: 11/24/2018] [Indexed: 10/27/2022]
Abstract
Non-adherence to prescribed medications is a systemic public health concern. Financial strain, the extent to which an individual is unable to afford necessary items, may represent an important factor related to adherence. This study evaluated the association between financial strain and medication adherence as a function of medication type. Participants reporting a daily prescription for psychiatric or other chronic health conditions (N = 231) were sampled from the crowdsourcing website Amazon Mechanical Turk (mTurk). All participants completed measures of financial strain and other individual-difference factors related to adherence. Medication adherence was evaluated using a subjective scale (i.e., ARMS) and past month non-adherence rates. General financial strain showed a modest relationship with subjective scales of adherence, but not past month non-adherence rates. Medication-specific financial strain was associated with greater non-adherence, even after controlling for relevant demographic, socio-economic, and personality factors. Medication-specific financial strain also disproportionately affected individuals taking psychiatric medications relative to those not taking psychiatric medications. These findings emphasize the role that financial strain plays in medication adherence, and in particular, in psychiatric conditions. Future studies could design interventions targeting financial strain to improve clinical adherence, broadly, and psychiatric medication adherence, specifically.
Collapse
Affiliation(s)
- Justin C Strickland
- Department of Psychology, University of Kentucky College of Arts and Sciences, 171 Funkhouser Drive, Lexington, KY 40506-0044, USA
| | - William W Stoops
- Department of Psychology, University of Kentucky College of Arts and Sciences, 171 Funkhouser Drive, Lexington, KY 40506-0044, USA; Department of Behavioral Science, University of Kentucky College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536-0086, USA; Department of Psychiatry, University of Kentucky College of Medicine, 3470 Blazer Parkway, Lexington, KY 40509-1810, USA; Center on Drug and Alcohol Research, University of Kentucky College of Medicine, 845 Angliana Ave, Lexington, KY 40508, USA
| | - Mary A Kincer
- Department of Behavioral Science, University of Kentucky College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536-0086, USA
| | - Craig R Rush
- Department of Psychology, University of Kentucky College of Arts and Sciences, 171 Funkhouser Drive, Lexington, KY 40506-0044, USA; Department of Behavioral Science, University of Kentucky College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building Room 140, Lexington, KY 40536-0086, USA; Department of Psychiatry, University of Kentucky College of Medicine, 3470 Blazer Parkway, Lexington, KY 40509-1810, USA.
| |
Collapse
|
6
|
Gellert P, Häusler A, Suhr R, Gholami M, Rapp M, Kuhlmey A, Nordheim J. Testing the stress-buffering hypothesis of social support in couples coping with early-stage dementia. PLoS One 2018; 13:e0189849. [PMID: 29300741 PMCID: PMC5754077 DOI: 10.1371/journal.pone.0189849] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 12/03/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose To test whether the negative relationship between perceived stress and quality of life (Hypothesis 1) can be buffered by perceived social support in patients with dementia as well as in caregivers individually (Hypothesis 2: actor effects) and across partners (Hypothesis 3: partner effects and actor-partner effects). Method A total of 108 couples (N = 216 individuals) comprised of one individual with early-stage dementia and one caregiving partner were assessed at baseline and one month apart. Moderation effects were investigated by applying linear mixed models and actor-partner interdependence models. Results Although the stress-quality of life association was more pronounced in caregivers (β = -.63, p<.001) compared to patients (β = -.31, p<.001), this association was equally moderated by social support in patients (β = .14, p<.05) and in the caregivers (β = .13, p<.05). From one partner to his or her counterpart, the partner buffering and actor-partner-buffering effect were not present. Conclusion The stress-buffering effect has been replicated in individuals with dementia and caregivers but not across partners. Interventions to improve quality of life through perceived social support should not only focus on caregivers, but should incorporate both partners.
Collapse
Affiliation(s)
- Paul Gellert
- Institute of Medical Sociology, Charité – Universitätsmedizin Berlin, Berlin, Germany
- * E-mail:
| | - Andreas Häusler
- Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Ralf Suhr
- Centre for Quality in Care, Berlin, Germany
| | - Maryam Gholami
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, United States of America
| | - Michael Rapp
- Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Adelheid Kuhlmey
- Institute of Medical Sociology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Johanna Nordheim
- Institute of Medical Sociology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
7
|
Robles Z, Anjum S, Garey L, Kauffman BY, Rodríguez-Cano R, Langdon KJ, Neighbors C, Reitzel LR, Zvolensky MJ. Financial strain and cognitive-based smoking processes: The explanatory role of depressive symptoms among adult daily smokers. Addict Behav 2017; 70:18-22. [PMID: 28161618 PMCID: PMC10041799 DOI: 10.1016/j.addbeh.2017.01.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 01/10/2017] [Accepted: 01/24/2017] [Indexed: 11/29/2022]
Abstract
Little work has focused on the underlying mechanisms that may link financial strain and smoking processes. The current study tested the hypothesis that financial strain would exert an indirect effect on cognitive-based smoking processes via depressive symptoms. Three clinically significant dependent variables linked to the maintenance of smoking were evaluated: negative affect reduction motives, negative mood abstinence expectancies, and perceived barriers for quitting. Participants included 102 adult daily smokers (Mage=33.0years, SD=13.60; 35.3% female) recruited from the community to participate in a self-guided (unaided; no psychological or pharmacological intervention) smoking cessation study. Results indicated that depressive symptoms explain, in part, the relation between financial strain and smoking motives for negative affect reduction, negative mood abstinence expectancies, and perceived barriers for quitting. Results indicate that smoking interventions for individuals with high levels of financial strain may potentially benefit from the addition of therapeutic tactics aimed at reducing depression.
Collapse
Affiliation(s)
- Zuzuky Robles
- Department of Psychology, Roosevelt University, Chicago, IL, United States
| | - Sahar Anjum
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Brooke Y Kauffman
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Rubén Rodríguez-Cano
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Kirsten J Langdon
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, United States
| | - Clayton Neighbors
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Lorraine R Reitzel
- Department of Psychological, Health & Learning Sciences, Houston, TX, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, United States.
| |
Collapse
|
8
|
Murayama H, Liang J, Shaw BA, Botoseneanu A, Kobayashi E, Fukaya T, Shinkai S. Changes in health behaviors and the trajectory of body mass index among older Japanese: A 19-year longitudinal study. Geriatr Gerontol Int 2017; 17:2008-2016. [PMID: 28276623 DOI: 10.1111/ggi.13008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 12/19/2016] [Accepted: 01/09/2017] [Indexed: 11/29/2022]
Abstract
AIM Although the modification of lifestyle factors might facilitate weight control, the effects of health behaviors on the trajectory of bodyweight among older adults have been understudied. We examined the effect of changes in smoking, alcohol use and physical activity on the long-term trajectory of body mass index (BMI) among older Japanese adults. METHODS Data came from a national sample of 4869 Japanese adults aged 60 years and older at baseline, with up to seven repeated observations over a period of 19 years (1987-2006). Hierarchical linear modeling was used to analyze the intrapersonal and interpersonal differences in BMI trajectory. RESULTS The average BMI among older Japanese adults was 22.3 at baseline, and decreased with an accelerating rate over time. Smoking was significantly associated with lower BMI over time, whereas smoking cessation was associated with higher BMI. Drinking and physical activity were not associated with BMI. We found significant interactions between age and smoking status, and between sex and physical activity, on BMI trajectory: the association between smoking and lower BMI was stronger in younger participants compared with older participants. The association between physical activity and higher BMI was more pronounced among men compared with women. CONCLUSION The present findings yield important new information regarding the complex dynamics underlying the linkage between lifestyles factors and BMI trajectory among older Japanese, and suggest that there might be cross-cultural differences in these linkages. Geriatr Gerontol Int 2017; 17: 2008-2016.
Collapse
Affiliation(s)
- Hiroshi Murayama
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan.,Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Jersey Liang
- Department of Health Management and Policy, University of Michigan School of Public Health, New York
| | - Benjamin A Shaw
- Department of Health Policy, Management and Behavior, School of Public Health, State University of New York at Albany, New York
| | - Anda Botoseneanu
- Department of Health and Human Services, University of Michigan, Michigan, USA.,Institute of Gerontology, University of Michigan, Michigan, USA
| | | | - Taro Fukaya
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shoji Shinkai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| |
Collapse
|
9
|
Tomioka K, Kurumatani N, Hosoi H. Association Between Social Participation and Instrumental Activities of Daily Living Among Community-Dwelling Older Adults. J Epidemiol 2016; 26:553-561. [PMID: 27180933 PMCID: PMC5037253 DOI: 10.2188/jea.je20150253] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Population-based data examining the relationship between social participation (SP) and instrumental activities of daily living (IADL) are scarce. This study examined the cross-sectional relationship between SP and IADL in community-dwelling elderly persons. Methods Self-administered questionnaires were mailed to 23 710 residents aged ≥65 years in Nara, Japan (response rate: 74.2%). Data from 14 956 respondents (6935 males and 8021 females) without dependency in basic activities of daily living (ADL) were analyzed. The number, type, and frequency of participation in social groups (SGs) were used to measure SP. SGs included volunteer groups, sports groups, hobby groups, senior citizens’ clubs, neighborhood community associations, and cultural groups. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression models stratified by gender were used. Results After adjustment for putative confounding factors, including demographics, health status, life-style habits, ADL, depression, cognitive function, social networks, social support, and social roles, participation in various SGs among both genders was inversely associated with poor IADL, showing a significant dose-response relationship between an increasing number of SGs and a lower proportion of those with poor IADL (P for trend <0.001). A significant inverse association between frequent participation and poor IADL was observed for all types of SGs among females, whereas the association was limited to sports groups and senior citizens’ clubs among males. Conclusions Our results show that participation in a variety of SGs is associated with independent IADL among the community-dwelling elderly, regardless of gender. However, the beneficial effects of frequent participation on IADL may be stronger for females than for males.
Collapse
Affiliation(s)
- Kimiko Tomioka
- Nara Prefectural Health Research Center, Nara Medical University
| | | | | |
Collapse
|
10
|
Reitzel LR, Langdon KJ, Nguyen NT, Zvolensky MJ. Financial strain and smoking cessation among men and women within a self-guided quit attempt. Addict Behav 2015; 47:66-9. [PMID: 25879712 DOI: 10.1016/j.addbeh.2015.03.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 03/07/2015] [Accepted: 03/29/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Financial strain, defined as an unfavorable asset-to-needs ratio, has been associated with reduced odds of smoking cessation in the context of a structured clinical study providing cessation assistance. This study reports on a secondary data analysis that assessed the association of financial strain and biochemically-verified smoking abstinence within a structured clinical study of smokers making a self-guided cessation attempt. METHODS Participants (N=58; 65.5% men) were enrolled in a study about anxiety sensitivity and smoking cessation whereby they were instructed to initiate a self-guided quit attempt. Relations between financial strain and biochemically-verified smoking abstinence on the quit day and at Days 3, 7, 14, 28, and 90 post-quit were assessed using generalized estimating equations controlling for age, sex, race, education, partner status, pre-quit cigarettes smoked per day, and time. RESULTS Associations between financial strain and abstinence in the whole sample were marginal (aOR=.94, 95% CI=.87-1.01, observations=293; p=.07). However, sex was a significant moderator: greater financial strain was associated with lower odds of abstinence for men (aOR=.90, 95% CI=.80-1.00, observations=201; p=.05), but not women (aOR=1.05, 95% CI=.91-1.21, observations=92; p=.48). CONCLUSIONS Results indicated that financial strain was associated with lower odds of cessation among men undergoing a self-guided quit attempt in the context of a structured clinical study. These data suggest that financial strain may be an important socioeconomic determinant of smoking cessation and support its relevance for better understanding socioeconomic-based smoking-related health disparities. Future work may benefit by exploring sex-specific models of financial strain in the context of smoking cessation.
Collapse
Affiliation(s)
- Lorraine R Reitzel
- The University of Houston, College of Education, Department of Psychological, Health, & Learning Sciences, 491 Farish Hall, Houston, TX 77204-5029, USA.
| | - Kirsten J Langdon
- The National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston University School of Medicine, Boston, MA 02118, USA
| | | | - Michael J Zvolensky
- The University of Houston, College of Liberal Arts and Social Sciences, Department of Psychology, 126 Heyne Building, Suite 104, Houston, TX 77204, USA
| |
Collapse
|
11
|
Spanier AJ, Beck AF, Huang B, McGrady ME, Drotar DD, Peake RWA, Kellogg MD, Kahn RS. Family hardships and serum cotinine in children with asthma. Pediatrics 2015; 135:e416-23. [PMID: 25583915 PMCID: PMC4306794 DOI: 10.1542/peds.2014-1748] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE A better understanding of how poverty-related hardships affect child health could highlight remediable intervention targets. Tobacco smoke exposure may be 1 such consequence of family hardship. Our objective was to explore the relationship between family hardships and tobacco exposure, as measured by serum cotinine, a tobacco metabolite, among children hospitalized for asthma. METHODS We prospectively enrolled a cohort of 774 children, aged 1 to 16 years, admitted for asthma or bronchodilator-responsive wheezing. The primary outcome was detectable serum cotinine. We assessed family hardships, including 11 financial and social variables, through a survey of the child's caregiver. We used logistic regression to evaluate associations between family hardship and detectable cotinine. RESULTS We had complete study data for 675 children; 57% were African American, and 74% were enrolled in Medicaid. In total, 56% of children had detectable cotinine. More than 80% of families reported ≥ 1 hardship, and 41% reported ≥ 4 hardships. Greater numbers of hardships were associated with greater odds of having detectable cotinine. Compared with children in families with no hardships, those in families with ≥ 4 hardships had 3.7-fold (95% confidence interval, 2.0-7.0) greater odds of having detectable serum cotinine in adjusted analyses. Lower parental income and educational attainment were also independently associated with detectable serum cotinine. CONCLUSIONS Family hardships are prevalent and associated with detectable serum cotinine level among children with asthma. Family hardships and tobacco smoke exposure may be possible targets for interventions to reduce health disparities.
Collapse
Affiliation(s)
- Adam J Spanier
- Department of Pediatrics, Penn State Milton S. Hershey Children's Hospital, Hershey, Pennsylvania;
| | - Andrew F Beck
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Ohio; and
| | - Bin Huang
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Ohio; and
| | - Meghan E McGrady
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Ohio; and
| | - Dennis D Drotar
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Ohio; and
| | - Roy W A Peake
- Clinical Epidemiologic Research Laboratory, Boston Children's Hospital, Boston, Massachusetts
| | - Mark D Kellogg
- Clinical Epidemiologic Research Laboratory, Boston Children's Hospital, Boston, Massachusetts
| | - Robert S Kahn
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Ohio; and
| |
Collapse
|
12
|
Usami S, Hayes T, McArdle JJ. On the Mathematical Relationship Between Latent Change Score and Autoregressive Cross-Lagged Factor Approaches: Cautions for Inferring Causal Relationship Between Variables. MULTIVARIATE BEHAVIORAL RESEARCH 2015; 50:676-87. [PMID: 26717126 DOI: 10.1080/00273171.2015.1079696] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The present paper focuses on the relationship between latent change score (LCS) and autoregressive cross-lagged (ARCL) factor models in longitudinal designs. These models originated from different theoretical traditions for different analytic purposes, yet they share similar mathematical forms. In this paper, we elucidate the mathematical relationship between these models and show that the LCS model is reduced to the ARCL model when fixed effects are assumed in the slope factor scores. Additionally, we provide an applied example using height and weight data from a gerontological study. Throughout the example, we emphasize caution in choosing which model (ARCL or LCS) to apply due to the risk of obtaining misleading results concerning the presence and direction of causal precedence between two variables. We suggest approaching model specification not only by comparing estimates and fit indices between the LCS and ARCL models (as well as other models) but also by giving appropriate weight to substantive and theoretical considerations, such as assessing the justifiability of the assumption of random effects in the slope factor scores.
Collapse
|