A social support and social strain measure for minority adolescent mothers: a confirmatory factor analytic study

An observational cohort study to investigate the impact of dolutegravir in pregnancy and its obesogenic effects on the metabolic health of women living with HIV and their children: Study protocol

INTRODUCTION

Dolutegravir (DTG)-based antiretroviral therapy is the World Health Organization's preferred first-line regimen for all persons with HIV, including pregnant women. While DTG has been implicated as an obesogen associated with greater weight gain compared to other antiretrovirals, there is a paucity of data in pregnant women and their children. The Obesogenic oRigins of maternal and Child metabolic health Involving Dolutegravir (ORCHID) study is investigating associations between DTG, weight gain, and metabolic outcomes in the context of HIV.

MATERIALS & METHODS

ORCHID is a prospective observational study taking place in Cape Town, South Africa (NCT04991402). A total of 1920 pregnant women with and without HIV infection are being followed from ≤18 weeks gestational age to 24 months postpartum with their children. Participants attend eleven study visits: 3 antenatal, delivery, and 7 postnatal visits. Several embedded sub-studies address specific scientific aims. Primary outcome measurements in mothers include anthropometry, blood pressure, body composition, dysglycemia, insulin resistance (IR), and dyslipidemia. Other maternal measures include demographics, resting energy expenditure, viral load, physical activity, dietary intake, hepatic steatosis, and repository specimens. Sub-study measurements include markers of adipose inflammation, gut integrity, and satiety/hunger, subcutaneous adipose tissue morphology and mitochondrial function, and metabolomics. Primary outcome measurements in children include anthropometry, adipose tissue mass, dysglycemia, IR, and dyslipidemia. Other variables include fetal growth, birth outcomes, medical/breastfeeding history, caloric intake, neurodevelopment, and repository specimens. Sub-study measurements include metabolites/lipid subspecies in umbilical cord blood, as well as breast milk composition and DTG exposure.

DISCUSSION

ORCHID will play a pivotal role in defining obesogenic mechanisms and clinical consequences of DTG use in pregnancy in women with HIV and their children. It will provide insights into metabolic disease risk reduction in the context of HIV/DTG, identify intervention targets, and inform public health approaches to diminish chronic metabolic co-morbidities for women and children.

Measurement of Social Strain in People with Dementia: A Preliminary Study of the Reliability and Validity of the Negative Relationship Quality Questionnaire in Indonesia

People with dementia (PWD) may exhibit symptoms that negatively affect their relationships with their families or friends which could cause social strain. The Negative Relationship Quality (NRQ) questionnaire can be used to measure social strain in PWD. There has never been an Indonesian adaptation of the NRQ. This preliminary study aimed to measure the validity and reliability of the NRQ among PWD in Indonesia (NRQ-INA). This study used a cross-sectional design. Forward−backward translation methods were conducted first. Pearson’s correlation and factor analysis were employed for the validity test. Cronbach’s alpha and test−retest were used to determine reliability. The NRQ-INA has four parallel items related to social strain that are divided into three subscales and asked to spouse/partner, family members, and friends, leading to a total of 12 questions. The results of validity testing from 60 respondents showed that all items in the NRQ-INA were strongly valid with correlation coefficients (r) of >0.8 (p < 0.01). Factor analysis showed a convergence with the variance explained of more than 50% for all items in each subscale, which also indicated that NRQ-INA had acceptable construct validity to measure social strain. Cronbach’s alpha values (α) were 0.926, 0.942, and 0.938 for the subscales of spouse, friends, and family members, respectively. The correlations of test−retest reliability for all items were >0.7 (p < 0.01), demonstrating a reliable NRQ-INA measurement. In conclusion, NRQ-INA had a good validity and reliability to measure social strain in PWD. Further study of the concurrent validity among PWD is still needed.

Friend Support and the Parenting of Latina Adolescent Mothers: The Moderating Role of Maternal Age

OBJECTIVES

This study examined the role of maternal age in the relation between social support from friends and parenting adjustment in a sample of young Latina mothers and their 18-month-old children (N=168).

METHODS

Hierarchical multiple regression analyses tested friend social support types (emotional, socializing, child care) as differential predictors of maternal behavior (sensitivity, cognitive growth-fostering, detachment) displayed during mother-child play interactions. To consider maternal development, the moderating role of maternal age on these associations was tested.

RESULTS

The relations between friend emotional and child care support and parenting were moderated by maternal age. Emotional support was related to the use of more growth-fostering parenting behaviors for older (≥ 19.5 yrs.), but not for younger Latina mothers. Child care support from friends was related to the display of more detachment and less cognitive growth-fostering behaviors among the younger (≤ 18.7 yrs.) mothers only. Immigrant mothers reported significantly less overall friend support and emotional support than mothers born in the mainland U.S.

CONCLUSIONS

The findings emphasize the importance of assessing the types of friend support as separate measures in an ecological context that takes into account mothers' generational and developmental level.

Adaptation of the Sexuality Scale for Women with Gynecologic Cancer for Turkish Patients

Objective:

Diagnosis and treatment of gynecologic cancers can have a negative impact on sexuality. Identification of sexual problems and concerns is key to enable appropriate management. Therefore, there is a need for a valid and reliable instrument for evaluating the sexuality of patients. This study aimed to adapt the sexuality scale for women with gynecologic cancer for Turkish patients with gynecologic cancer.

Methods:

A cross-sectional study of 150 volunteer patients with gynecologic cancer was undertaken in Turkey. The patients completed a semi-structured demographic data form and the sexuality scale for women with gynecologic cancer. We assessed the reliability, language accuracy, and content and construct validities of the Turkish version of the scale.

Results:

Exploratory and confirmatory factor analyses showed that the scale had four factors. In the exploratory factor analysis, seven items were discarded from the scale because their load values were <0.3. In the confirmatory factor analysis, the coefficients were higher than 0.3. The total Cronbach's α was 0.72.

Conclusions:

The sexuality scale for women with gynecologic cancer (Turkish version) is a valid and reliable instrument for evaluating the sexuality of Turkish patients with gynecologic cancer.

Social Support, Parenting, and Social Emotional Development in Young Mexican and Dominican American Children

This study focused on social support and its association with child developmental outcomes, indirectly through parenting practices, in families of 4-5 year old Latino children. Data were collected from mothers and teachers of 610 Mexican American (MA) and Dominican American (DA) children. Mothers reported on perceived social support, parenting practices and children's problem and adaptive behavior functioning at home, and teachers reported on mothers' parent involvement and children's problem and adaptive behavior functioning in the classroom. Results showed that support received from family was higher than support received from school networks for both ethnic groups. Moreover, familial support was associated with child behavior, mediated by positive parenting practices, whereas support from school networks was not associated with child outcomes. During early childhood, social support from family members may be an important protective factor that can promote positive behavioral functioning among Latino children.

Psychological Adjustment among Young Puerto Rican Mothers: Perceived Partner Support and the Moderating Role of Latino Cultural Orientation

Adolescent mothers face multiple stressors and are at risk for experiencing high levels of depressive symptoms and parenting stress. This study examined the interplay of Latino cultural orientation and perceived support from romantic partners in protecting the adjustment of young, low-income, Puerto Rican mothers (N = 103; M age = 18.0 yrs; SD = 1.2) during the second year postpartum. In multivariate analyses, perceived partner support was uniquely and negatively associated with both maternal depressive symptoms and parenting stress. However, in the case of parenting stress, this association was moderated by mothers' Latino cultural orientation. Perceived partner support was related to less parenting stress when mothers endorsed a relatively strong Latino cultural orientation; perceived partner support was no longer protective at low levels of Latino orientation. The implications for intervention and for the understanding of the role of culture in social support processes within close relationships are discussed.

A Longitudinal Examination of Support, Self-esteem, and Mexican-origin Adolescent Mothers' Parenting Efficacy

Guided by a risk and resilience framework, this study used a prospective longitudinal, multiple-reporter design to examine how social support from a mother figure during pregnancy interacted with Mexican-origin adolescent mothers' self-esteem to inform their parenting efficacy when their children were 10 months old. Using reports of perceived social support by adolescent mothers (Mage = 16.24, SD =099) and their mother figures (Mage = 40.84, SD = 7.04) in 205 dyads, and controlling for demographic factors (i.e., adolescent age, adolescent nativity, family income, mothers' educational attainment, adolescent-mother coresidence) and adolescents' social support from a significant other, findings indicated that social support during pregnancy was positively associated with adolescent mothers' future parenting efficacy when adolescent mothers had relatively lower self-esteem. Findings were consistent for adolescents' and mothers' reports, and emphasize the value of social support from a mother figure among adolescent mothers with lower self-esteem. Implications for interventions are presented.

Maternal Depressive Symptoms and Child Behavior Problems among Latina Adolescent Mothers: The Buffering Effect of Mother-reported Partner Child Care Involvement

We examined the relations between maternal depressive symptoms and child internalizing and externalizing problems in a sample of 125 adolescent Latina mothers (primarily Puerto Rican) and their toddlers. We also tested the influence of mother-reported partner child care involvement on child behavior problems and explored mother-reported partner characteristics that related to this involvement. Results suggested that maternal depressive symptoms related to child internalizing and externalizing problems when accounting for contextual risk factors. Importantly, these symptoms mediated the link between life stress and child behavior problems. Mother-reported partner child care interacted with maternal depressive symptoms for internalizing, not externalizing, problems. Specifically, depressive symptoms related less strongly to internalizing problems at higher levels of partner child care than at lower levels. Participants with younger partners, co-residing partners, and in longer romantic relationships reported higher partner child care involvement. Results are discussed considering implications for future research and interventions for mothers, their children, and their partners.