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Scroggins JK, Hulchafo II, Topaz M, Cato K, Barcelona V. Addressing bias in preterm birth research: The role of advanced imputation techniques for missing race and ethnicity in perinatal health data. Ann Epidemiol 2024; 94:120-126. [PMID: 38734192 DOI: 10.1016/j.annepidem.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/24/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES To evaluate the effectiveness of Bayesian Improved Surname Geocoding (BISG) and Bayesian Improved First Name Surname Geocoding (BIFSG) in estimating race and ethnicity, and how they influence odds ratios for preterm birth. METHODS We analyzed hospital birth admission electronic health records (EHR) data (N = 9985). We created two simulation sets with 40 % of race and ethnicity data missing randomly or more likely for non-Hispanic black birthing people who had preterm birth. We calculated C-statistics to evaluate how accurately BISG and BIFSG estimate race and ethnicity. We examined the association between race and ethnicity and preterm birth using logistic regression and reported odds ratios (OR). RESULTS BISG and BIFSG showed high accuracy for most racial and ethnic categories (C-statistics = 0.94-0.97, 95 % confidence intervals [CI] = 0.92-0.97). When race and ethnicity were not missing at random, BISG (OR = 1.25, CI = 0.97-1.62) and BIFSG (OR = 1.38, CI = 1.08-1.76) resulted in positive estimates mirroring the true association (OR = 1.68, CI = 1.34-2.09) for Non-Hispanic Black birthing people, while traditional methods showed contrasting estimates (Complete case OR = 0.62, CI = 0.41-0.94; multiple imputation OR = 0.63, CI = 0.40-0.98). CONCLUSIONS BISG and BIFSG accurately estimate missing race and ethnicity in perinatal EHR data, decreasing bias in preterm birth research, and are recommended over traditional methods to reduce potential bias.
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Affiliation(s)
| | | | - Maxim Topaz
- Columbia University School of Nursing, New York, NY, United States; Data Science Institute, Columbia University, New York, NY, United States; Center for Home Care Policy & Research, VNS Health, New York, NY, United States
| | - Kenrick Cato
- University of Pennsylvania School of Nursing, Philadelphia, PA, United States
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Estrada LV, Barcelona V, Dhingra L, Luchsinger JA, Dick AW, Glance LG, Stone PW. Potentially Avoidable Hospitalizations Among Historically Marginalized Nursing Home Residents. JAMA Netw Open 2024; 7:e249312. [PMID: 38696169 PMCID: PMC11066698 DOI: 10.1001/jamanetworkopen.2024.9312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 03/04/2024] [Indexed: 05/04/2024] Open
Abstract
Importance Nursing home (NH) transfers to hospitals are common and have been associated with cognitive decline; approximately 45% of NH hospital transfers are potentially avoidable hospitalizations (PAHs). Objective To determine PAH incidence for historically marginalized NH residents with severe cognitive impairment compared with non-Hispanic White residents. Design, Setting, and Participants This cross-sectional study merged 2018 Centers for Medicaid & Medicare Services datasets and LTCFocus, a public dataset on US NH care, for US NH residents aged 65 years and older who had a hospitalization. Analyses were performed from January to May 2022. Exposure Race and ethnicity of NH residents. Main Outcomes and Measures Racial and ethnic differences in resident-level annual rates of PAHs were estimated for residents with and without severe cognitive impairment (measured using the Cognitive Function Scale), controlling for resident characteristics, comorbidities, dual eligibility, and time at risk. PAHs were defined as NH hospital transfers that resulted from neglectful NH care or for which NH treatment would have been appropriate. Results Of 2 098 385 NH residents nationwide included in the study, 7151 (0.3%) were American Indian or Alaska Native, 39 873 (1.9%) were Asian, 229 112 (10.9%) were Black or African American, 99 304 (4.7%) were Hispanic, 2785 (0.1%) were Native Hawaiian or Pacific Islander, 1 713 670 (81.7%) were White, and 6490 (0.3%) were multiracial; 1 355 143 (64.6%) were female; 128 997 (6.2%) were severely cognitively impaired; and the mean (SD) age was 81.8 (8.7) years. PAH incidence rate ratios (IRRs) were significantly greater for residents with severe cognitive impairment compared with those without. In unadjusted analyses comparing historically marginalized residents with severe cognitive impairment vs non-Hispanic White residents with severe cognitive impairment, American Indian or Alaska Native residents had a 49% higher PAH incidence (IRR, 1.49 [95% CI, 1.10-2.01]), Black or African American residents had a 64% higher incidence (IRR, 1.64 [95% CI, 1.48-1.81]), and Hispanic residents had a 45% higher incidence (IRR, 1.45 [95% CI, 1.29-1.62]). Higher incidences persisted for historically marginalized residents with severe cognitive impairment vs non-Hispanic White residents with severe cognitive impairment in adjusted analyses. Asian residents had a 24% higher PAH incidence (IRR, 1.24 [95% CI, 1.06-1.45]), Black or African American residents had a 48% higher incidence (IRR, 1.48 [95% CI, 1.36-1.60]), and Hispanic residents had a 27% higher incidence (IRR, 1.27 [95% CI, 1.16-1.39]). Conclusions and Relevance In this cross-sectional study of PAHs, compared with non-Hispanic White NH residents, historically marginalized residents had increased PAH incidence. In the presence of severe cognitive impairment, incidence rates increased significantly compared with rates for residents without severe cognitive impairment. These results suggest that identification of residents with severe cognitive impairment and proper NH care may help prevent further cognitive decline by avoiding PAHs.
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Affiliation(s)
- Leah V. Estrada
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Lara Dhingra
- MJHS Institute for Innovation in Palliative Care, New York, New York
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - José A. Luchsinger
- Departments of Medicine and Epidemiology, Columbia University Irving Medical Center
| | | | - Laurent G. Glance
- RAND Corporation, Boston, Massachusetts
- Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, New York
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Millender E, Harris RM, Bagneris JR, Marks LR, Barcelona V, Wong FY, Crusto CA, Taylor JY. The Cumulative Influence of Perceived Discrimination, Stress, and Coping Responses on Symptoms of Depression Among Young African American Mothers. J Am Psychiatr Nurses Assoc 2024; 30:322-332. [PMID: 35833679 PMCID: PMC9839894 DOI: 10.1177/10783903221105281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND African American women have an elevated risk for experiencing depressive symptoms, and discrimination, stress, and coping contribute to symptoms of depression. AIMS We aimed to examine the associations between discrimination, stress, and coping on symptoms of depression among young African American mothers. METHODS In this retrospective study, we utilized a hierarchical linear regression to explore the effects of perceived racial discrimination, stress, and general and discrimination-related coping responses on depressive symptoms in a sample of African American mothers (N = 250). The data were drawn from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure study (InterGEN), a study conducted between 2014 and 2019 and based in Connecticut. RESULTS After accounting for maternal age, level of education, and income, greater perceived racial discrimination (p = .03), higher levels of stress (p < .001), greater engagement in avoidance coping (p < .001), and use of passive coping responses to discrimination (p = .04) were uniquely associated with increased depressive symptoms. Other forms of coping, specifically, problem-solving and support seeking, did not appear to influence depressive symptoms in this sample. CONCLUSION The findings highlight the negative impact of discrimination, heightened stress, and maladaptive coping on the emotional health of young African American mothers.
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Affiliation(s)
- Eugenia Millender
- Center of Population Sciences for Health Equity, Florida State University, Tallahassee, FL, USA
| | | | | | | | | | - Frank Y. Wong
- Center of Population Sciences for Health Equity, Florida State University, Tallahassee, FL, USA
| | | | - Jacquelyn Y. Taylor
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY, USA
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Barcelona V, Scharp D, Moen H, Davoudi A, Idnay BR, Cato K, Topaz M. Using Natural Language Processing to Identify Stigmatizing Language in Labor and Birth Clinical Notes. Matern Child Health J 2024; 28:578-586. [PMID: 38147277 DOI: 10.1007/s10995-023-03857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 12/27/2023]
Abstract
INTRODUCTION Stigma and bias related to race and other minoritized statuses may underlie disparities in pregnancy and birth outcomes. One emerging method to identify bias is the study of stigmatizing language in the electronic health record. The objective of our study was to develop automated natural language processing (NLP) methods to identify two types of stigmatizing language: marginalizing language and its complement, power/privilege language, accurately and automatically in labor and birth notes. METHODS We analyzed notes for all birthing people > 20 weeks' gestation admitted for labor and birth at two hospitals during 2017. We then employed text preprocessing techniques, specifically using TF-IDF values as inputs, and tested machine learning classification algorithms to identify stigmatizing and power/privilege language in clinical notes. The algorithms assessed included Decision Trees, Random Forest, and Support Vector Machines. Additionally, we applied a feature importance evaluation method (InfoGain) to discern words that are highly correlated with these language categories. RESULTS For marginalizing language, Decision Trees yielded the best classification with an F-score of 0.73. For power/privilege language, Support Vector Machines performed optimally, achieving an F-score of 0.91. These results demonstrate the effectiveness of the selected machine learning methods in classifying language categories in clinical notes. CONCLUSION We identified well-performing machine learning methods to automatically detect stigmatizing language in clinical notes. To our knowledge, this is the first study to use NLP performance metrics to evaluate the performance of machine learning methods in discerning stigmatizing language. Future studies should delve deeper into refining and evaluating NLP methods, incorporating the latest algorithms rooted in deep learning.
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Affiliation(s)
- Veronica Barcelona
- School of Nursing, Columbia University, 560 West 168th St, Mail Code 6, New York, NY, 10032, USA.
| | - Danielle Scharp
- School of Nursing, Columbia University, 560 West 168th St, Mail Code 6, New York, NY, 10032, USA
| | - Hans Moen
- Department of Computer Science, Aalto University, Espoo, Finland
| | | | - Betina R Idnay
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Kenrick Cato
- School of Nursing, Columbia University, 560 West 168th St, Mail Code 6, New York, NY, 10032, USA
- University of Pennsylvania, Philadelphia, PA, USA
| | - Maxim Topaz
- School of Nursing, Columbia University, 560 West 168th St, Mail Code 6, New York, NY, 10032, USA
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Barcelona V, Chen L, Zhao Y, Samari G, Monk C, McNeil R, Baccarelli AA, Wapner R. Associations between individual and structural level racism and gestational age at birth in the Nulliparous Pregnancy Outcomes Study: Monitoring mothers-to-be. Res Sq 2024:rs.3.rs-3898223. [PMID: 38352522 PMCID: PMC10862945 DOI: 10.21203/rs.3.rs-3898223/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
The purpose of this study was to investigate the associations between multilevel racism and gestational age at birth among nulliparous non-Hispanic Black, non-Hispanic White and Hispanic women. We conducted a secondary analysis of data of the nuMoM2b Study (2010-2013) to examine the associations between individual and structural-level experiences of racism and discrimination and gestational age at birth among nulliparous women (n=7,732) at eight sites across the U.S. Measures included the individual Experiences of Discrimination (EOD) scale and the Index of Concentration (ICE) at the Extremes to measure structural racism. After adjustment,we observed a significant individual and structural racism interaction on gestational length (p=0.03). In subgroup analyses, we found that among these with high EOD scores, women who were from households concentrated in the more privileged group had significantly longer gestations (β = 1.07, 95% CI: 0.24, 1.90). Women who reported higher EOD scores and more economic privilege had longer gestations, demonstrating the moderating effect of ICE as a measure of structural racism. In conclusion, ICE may represent a modifiable factor in the prevention of adverse birth outcomes in nulliparas.
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Barcelona V, Abuaish S, Lee S, Harkins S, Butler A, Tycko B, Baccarelli AA, Walsh K, Monk CE. Stress and DNA Methylation of Blood Leukocytes among Pregnant Latina Women. Epigenomes 2023; 7:27. [PMID: 37987302 PMCID: PMC10660842 DOI: 10.3390/epigenomes7040027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
Latinas experience physical and psychological stressors in pregnancy leading to increased morbidity and higher risk for adverse birth outcomes. Epigenetic changes, including DNA methylation (DNAm), have been proposed as markers to create more refined risk stratification, yet few of these studies have examined these changes in Latinas. We conducted a secondary analysis of stored blood leukocytes of Latina women (n = 58) enrolled in a larger National Institutes of Health funded R01 project (2011-2016). We examined DNAm on eight candidate stress genes to compare physically and psychologically stressed participants to healthy (low stress) participants. We found unique CpGs that were differentially methylated in stressed women early- and mid-pregnancy compared to the healthy group, though none remained significant after FDR correction. Both physical and psychological stress were associated with hypomethylation at two consecutive CpG sites on NR3C1 in early pregnancy and one CpG site on NR3C1 in mid-pregnancy before adjustment. Stress was also associated with hypomethylation at two CpG sites on FKBP5 in early and mid-pregnancy but were no longer significant after FDR adjustment. Though we did not find statistically significant differences in DNAm during pregnancy between stressed and healthy women in this sample, signals were consistent with previous findings. Future work in larger samples should further examine the associations between stress and DNAm in pregnancy as this mechanism may explain underlying perinatal health inequities.
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Affiliation(s)
| | - Sameera Abuaish
- Department of Basic Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia;
| | - Seonjoo Lee
- Mental Health Data Science, New York State Psychiatric Institute, New York, NY 10032, USA;
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY 10032, USA
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA;
| | - Sarah Harkins
- Columbia University School of Nursing, New York, NY 10032, USA;
| | - Ashlie Butler
- Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA;
| | - Benjamin Tycko
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, NJ 07110, USA;
| | - Andrea A. Baccarelli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY 10032, USA;
| | - Kate Walsh
- Department of Psychology, University of Wisconsin-Madison, Madison, WI 53706, USA;
| | - Catherine E. Monk
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA;
- Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA;
- New York State Psychiatric Institute, New York, NY 10032, USA
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Taylor JY, Barcelona V, Magny-Normilus C, Wright ML, Jones-Patten A, Prescott L, Potts-Thompson S, Santos HP. A roadmap for social determinants of health and biological nursing research in the National Institute of Nursing Research 2022-2026 Strategic Plan: Optimizing health and advancing health equity using antiracist framing. Nurs Outlook 2023; 71:102059. [PMID: 37863707 PMCID: PMC10803078 DOI: 10.1016/j.outlook.2023.102059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/08/2023] [Accepted: 09/15/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Health equity is essential for improving the well-being of all individuals and groups, and research remains a critical element for understanding barriers to health equity. While considering how to best support research that acknowledges current health challenges, it is crucial to understand the role of social justice frameworks within health equity research and the contributions of minoritized researchers. Additionally, there should be an increased understanding of the influence of social determinants of health on biological mechanisms. PURPOSE Biological health equity research seeks to understand and address health disparities among historically excluded populations. DISCUSSION While there are examples of studies in this area led by minoritized researchers, some individuals and groups remain understudied due to underfunding. Research within minoritized populations must be prioritized to authentically achieve health equity. Furthermore, there should be increased funding from National Institutes of Health to support minoritized researchers working in this area.
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Affiliation(s)
- Jacquelyn Y Taylor
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY.
| | - Veronica Barcelona
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY
| | | | | | | | - Laura Prescott
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY
| | | | - Hudson P Santos
- School of Nursing & Health Studies, University of Miami, Coral Gables, FL
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Barcelona V, Horton RL, Rivlin K, Harkins S, Green C, Robinson K, Aubey JJ, Holman A, Goffman D, Haley S, Topaz M. The Power of Language in Hospital Care for Pregnant and Birthing People: A Vision for Change. Obstet Gynecol 2023; 142:795-803. [PMID: 37678895 PMCID: PMC10510792 DOI: 10.1097/aog.0000000000005333] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/18/2023] [Accepted: 05/25/2023] [Indexed: 09/09/2023]
Abstract
Language is commonly defined as the principal method of human communication made up of words and conveyed by writing, speech, or nonverbal expression. In the context of clinical care, language has power and meaning and reflects priorities, beliefs, values, and culture. Stigmatizing language can communicate unintended meanings that perpetuate socially constructed power dynamics and result in bias. This bias may harm pregnant and birthing people by centering positions of power and privilege and by reflecting cultural priorities in the United States, including judgments of demographic and reproductive health characteristics. This commentary builds on relationship-centered care and reproductive justice frameworks to analyze the role and use of language in pregnancy and birth care in the United States, particularly regarding people with marginalized identities. We describe the use of language in written documentation, verbal communication, and behaviors associated with caring for pregnant people. We also present recommendations for change, including alternative language at the individual, clinician, hospital, health systems, and policy levels. We define birth as the emergence of a new individual from the body of its parent, no matter what intervention or pathology may be involved. Thus, we propose a cultural shift in hospital-based care for birthing people that centers the birthing person and reconceptualizes all births as physiologic events, approached with a spirit of care, partnership, and support.
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Kang JA, Barcelona V. A comparison of conceptual frameworks to examine health inequities in End-of-Life care. J Adv Nurs 2023; 79:2025-2041. [PMID: 35909090 PMCID: PMC9887096 DOI: 10.1111/jan.15393] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/11/2022] [Accepted: 07/20/2022] [Indexed: 02/02/2023]
Abstract
AIMS To discuss existing conceptual frameworks that can be applied to the examination of health inequities in end-of-life care and related health outcomes. We used the Fawcett and Desanto-Madeya evaluation technique modified by the National Institute on Minority Health and Health Disparities Research Framework to include individual, interpersonal, community, and societal levels of influence. DESIGN Discussion paper. DATA SOURCES We performed a systematic review of PubMed, CINAHL and Embase for conceptual frameworks of health inequities in end-of-life care and health outcomes published as of February 2022. IMPLICATIONS FOR NURSING There is a strong need for research that can address multiple factors influencing end-of-life care inequities and health outcomes. To mitigate the complex nature of social determinants of health and structural inequities, researchers, clinicians, educators and administrators should have solid conceptualizations of these multi-level factors. Based on sound and comprehensive frameworks, nurses with interdisciplinary partnerships can promote health equity with a broader health care scope through addressing social determinants of health. CONCLUSION We identified and reviewed three frameworks. We concluded all three frameworks have the potential for use in the examination of health inequities in end-of-life care and health outcomes. However, the Conceptual Framework of Minority Access to End-of-Life Care was more applicable to diverse studies and settings when adapted to include fundamental characteristics such as sex and gender. IMPACT Despite the substantial rise in end-of-life care delivery, health inequities persist in end-of-life care access and utilization. Though some studies have been conducted to promote health equity by addressing social determinants of health, progress is hampered by their complex and multi-faceted nature. Through a concrete conceptual framework, researchers can comprehensively examine multi-level factors influencing health inequities in end-of-life care. NO PATIENT OR PUBLIC CONTRIBUTION This discussion paper focused on reviewing existing evidence.
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Affiliation(s)
- Jung A Kang
- Columbia University School of Nursing, New York, New York, USA
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10
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Barcelona V, Scharp D, Idnay BR, Moen H, Goffman D, Cato K, Topaz M. A qualitative analysis of stigmatizing language in birth admission clinical notes. Nurs Inq 2023:e12557. [PMID: 37073504 DOI: 10.1111/nin.12557] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/20/2023]
Abstract
The presence of stigmatizing language in the electronic health record (EHR) has been used to measure implicit biases that underlie health inequities. The purpose of this study was to identify the presence of stigmatizing language in the clinical notes of pregnant people during the birth admission. We conducted a qualitative analysis on N = 1117 birth admission EHR notes from two urban hospitals in 2017. We identified stigmatizing language categories, such as Disapproval (39.3%), Questioning patient credibility (37.7%), Difficult patient (21.3%), Stereotyping (1.6%), and Unilateral decisions (1.6%) in 61 notes (5.4%). We also defined a new stigmatizing language category indicating Power/privilege. This was present in 37 notes (3.3%) and signaled approval of social status, upholding a hierarchy of bias. The stigmatizing language was most frequently identified in birth admission triage notes (16%) and least frequently in social work initial assessments (13.7%). We found that clinicians from various disciplines recorded stigmatizing language in the medical records of birthing people. This language was used to question birthing people's credibility and convey disapproval of decision-making abilities for themselves or their newborns. We reported a Power/privilege language bias in the inconsistent documentation of traits considered favorable for patient outcomes (e.g., employment status). Future work on stigmatizing language may inform tailored interventions to improve perinatal outcomes for all birthing people and their families.
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Affiliation(s)
| | - Danielle Scharp
- Columbia University School of Nursing, New York City, New York, USA
| | - Betina R Idnay
- Department of Biomedical Informatics, Columbia University, New York City, New York, USA
| | - Hans Moen
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Dena Goffman
- Department of Obstetrics, Columbia University Irving Medical Center, New York City, New York, USA
| | - Kenrick Cato
- Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Maxim Topaz
- Columbia University School of Nursing, New York City, New York, USA
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Barcelona V, Flowers A, Caceres BA, Crusto CA, Taylor JY. Associations between Paternal Co-residence and Child Health among African American Children. West J Nurs Res 2023; 45:201-207. [PMID: 35897162 PMCID: PMC9880248 DOI: 10.1177/01939459221115152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We investigated the associations between paternal co-residence and asthma, obesity, and blood pressure among children aged 3-5 years. Mother/child dyads (N = 250) self-identified as African American or Black. Mothers reported on father's co-residence and child's asthma diagnosis. Height, weight, and blood pressure were measured. Regression models were used to examine paternal co-residence with child health outcomes (i.e., asthma, obesity, and blood pressure). Confounders included maternal and child age, child sex, maternal smoking, and insurance status. Children who lived with their fathers were less likely to have asthma (OR = 0.39, 95% CI 0.18-0.79), though this association was not significant after adjustment for confounders (aOR = 0.47, 95% CI 0.22-1.01). Paternal co-residence was not significantly associated with child obesity (aOR = 0.78, 95% CI 0.35-1.73), systolic (β = 0.57, SE = 1.2, p = .64), or diastolic (β = 1.91, SE = 1.0, p = .07) blood pressure. More research is necessary to understand the diversity of family living situations and how they affect child health.
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Affiliation(s)
- Veronica Barcelona
- Columbia University School of Nursing, New York, NY, USA.,Center for Research on People of Color, Columbia University School of Nursing, New York, NY, USA
| | | | - Billy A Caceres
- Columbia University School of Nursing, New York, NY, USA.,Center for Research on People of Color, Columbia University School of Nursing, New York, NY, USA
| | - Cindy A Crusto
- Yale School of Medicine, New Haven, CT, USA.,University of Pretoria, Pretoria, South Africa
| | - Jacquelyn Y Taylor
- Columbia University School of Nursing, New York, NY, USA.,Center for Research on People of Color, Columbia University School of Nursing, New York, NY, USA
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Taylor JY, Huang Y, Zhao W, Wright ML, Wang Z, Hui Q, Potts‐Thompson S, Barcelona V, Prescott L, Yao Y, Crusto C, Kardia SLR, Smith JA, Sun YV. Epigenome-wide association study of BMI in Black populations from InterGEN and GENOA. Obesity (Silver Spring) 2023; 31:243-255. [PMID: 36479596 PMCID: PMC10107734 DOI: 10.1002/oby.23589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 08/09/2022] [Accepted: 08/22/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Obesity is a significant public health concern across the globe. Research investigating epigenetic mechanisms related to obesity and obesity-associated conditions has identified differences that may contribute to cellular dysregulation that accelerates the development of disease. However, few studies include Black women, who experience the highest incidence of obesity and early onset of cardiometabolic disorders. METHODS The association of BMI with epigenome-wide DNA methylation (DNAm) was examined using the 850K Illumina EPIC BeadChip in two Black populations (Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure [InterGEN], n = 239; and The Genetic Epidemiology Network of Arteriopathy [GENOA] study, n = 961) using linear mixed-effects regression models adjusted for batch effects, cell type heterogeneity, population stratification, and confounding factors. RESULTS Cross-sectional analysis of the InterGEN discovery cohort identified 28 DNAm sites significantly associated with BMI, 24 of which had not been previously reported. Of these, 17 were replicated using the GENOA study. In addition, a meta-analysis, including both the InterGEN and GENOA cohorts, identified 658 DNAm sites associated with BMI with false discovery rate < 0.05. In a meta-analysis of Black women, we identified 628 DNAm sites significantly associated with BMI. Using a more stringent significance threshold of Bonferroni-corrected p value 0.05, 65 and 61 DNAm sites associated with BMI were identified from the combined sex and female-only meta-analyses, respectively. CONCLUSIONS This study suggests that BMI is associated with differences in DNAm among women that can be identified with DNA extracted from salivary (discovery) and peripheral blood (replication) samples among Black populations across two cohorts.
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Affiliation(s)
- Jacquelyn Y. Taylor
- Center for Research on People of ColorColumbia University School of NursingNew YorkNew YorkUSA
| | - Yunfeng Huang
- Department of EpidemiologyEmory University Rollins School of Public HealthAtlantaGeorgiaUSA
| | - Wei Zhao
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | | | - Zeyuan Wang
- Department of EpidemiologyEmory University Rollins School of Public HealthAtlantaGeorgiaUSA
| | - Qin Hui
- Department of EpidemiologyEmory University Rollins School of Public HealthAtlantaGeorgiaUSA
| | | | - Veronica Barcelona
- Center for Research on People of ColorColumbia University School of NursingNew YorkNew YorkUSA
| | - Laura Prescott
- Center for Research on People of ColorColumbia University School of NursingNew YorkNew YorkUSA
| | - Yutong Yao
- Department of EpidemiologyEmory University Rollins School of Public HealthAtlantaGeorgiaUSA
| | - Cindy Crusto
- Department of PsychiatryYale School of MedicineNew HavenConnecticutUSA
| | - Sharon L. R. Kardia
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Jennifer A. Smith
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
- Survey Research CenterInstitute for Social Research, University of MichiganAnn ArborMichiganUSA
| | - Yan V. Sun
- Department of EpidemiologyEmory University Rollins School of Public HealthAtlantaGeorgiaUSA
- Atlanta VA Healthcare SystemDecaturGeorgiaUSA
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Barcelona V, Jenkins V, Britton LE, Everett BG. Adverse pregnancy and birth outcomes in sexual minority women from the National Survey of Family Growth. BMC Pregnancy Childbirth 2022; 22:923. [PMID: 36482391 PMCID: PMC9733239 DOI: 10.1186/s12884-022-05271-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Few studies have examined how multiple marginalized identities are associated with adverse pregnancy and birth outcomes, especially for Black and Hispanic sexual minority women. Sexual minorities are people who identify as lesbian, gay, bisexual or transgender (LGBT). The purpose of this study was to examine differences in adverse pregnancy (i.e., miscarriage) and birth outcomes (i.e., preterm birth, low birthweight, and stillbirth) in a national sample of women by race and ethnicity, and sexual minority status (LGBT identification and same-sex sexual behavior). METHODS We conducted a cross-sectional analysis of the National Survey of Family Growth (NSFG). The unit of analysis was pregnancy, not participants. In this study, we examined pregnancies to participants who identified as heterosexual, lesbian, and bisexual, by race and Hispanic ethnicity. We also studied sexual behaviors to categorize participants as women who have sex with women (WSW) and women who have sex with men (WSM). Outcomes included preterm birth, low birthweight, miscarriage, and stillbirth. We employed logistic and linear regression analyses for analyses using STATA. RESULTS We studied 53,751 pregnancies, and 9% of these occurred in people who identified as heterosexual, but had engaged in sexual activity with a female partner (heterosexual-WSW), 7% in those identifying as bisexual, and 1% to women who identified as lesbian. Pregnancies ended in preterm birth (10.7%) and low birthweight (9.0%), stillbirths (2-4%), and miscarriages (17-21%) in sexual minority women. We observed that pregnancies reported by Hispanic lesbian women had a higher birthweight (β = 10.71, SE = 4.1, p-value = 0.01) compared to infants born to Hispanic heterosexual-WSM. Pregnancies to lesbian women were significantly more likely to end in stillbirth (aRR = 3.58, 95% CI 1.30,9.79) compared to heterosexual-WSM. No significant differences were noted in risk of adverse birth outcomes by sexual orientation for NH Black or Hispanic women. CONCLUSION In this sample, preterm births were less likely to occur among heterosexual-WSW than in heterosexual-WSM. Pregnancies to lesbians and bisexual women were more likely to end in miscarriage or stillbirth than heterosexual WSM. Lesbian Hispanic women reported higher birthweights compared to heterosexual-WSM Hispanic women. More research should be done to further understand these findings.
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Affiliation(s)
- Veronica Barcelona
- grid.21729.3f0000000419368729Columbia University School of Nursing, 560 W 168thStreet, Mail Code 6, New York, NY USA
| | - Virginia Jenkins
- grid.223827.e0000 0001 2193 0096The University of Utah, Salt Lake City, UT USA
| | - Laura E. Britton
- grid.21729.3f0000000419368729Columbia University School of Nursing, 560 W 168thStreet, Mail Code 6, New York, NY USA
| | - Bethany G. Everett
- grid.223827.e0000 0001 2193 0096The University of Utah, Salt Lake City, UT USA
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14
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South K, Bakken S, Koleck T, Barcelona V, Elhadad N, Dreisbach C. Women's Experiences of Symptoms of Suspected or Confirmed COVID-19 Illness During the Pandemic. Nurs Womens Health 2022; 26:450-461. [PMID: 36265561 PMCID: PMC9575040 DOI: 10.1016/j.nwh.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/19/2022] [Accepted: 09/22/2022] [Indexed: 04/13/2023]
Abstract
OBJECTIVE To explore experiences of symptoms of suspected or confirmed COVID-19 illness among women using the CovidWatcher mobile citizen science app. DESIGN Convergent parallel mixed-methods design. PARTICIPANTS Twenty-eight self-identified women consented for follow-up after using CovidWatcher. Participants' ages ranged from 18 to 83 years old. METHODS We collected data via semistructured, virtual interviews and surveys: the COVID-19 Exposure and Family Impact Survey and Patient-Reported Outcomes Measurement Information System measures. We used directed content analysis to develop codes, categories, themes, and subthemes from the qualitative data and summarized survey data with descriptive statistics. RESULTS We derived five themes related to symptom experiences: (a) Physical Symptoms, (b) Mental Health Symptoms, (c) Symptom Intensity, (d) Symptom Burden, and (e) Symptom Trajectories. Subthemes reflected more nuanced experiences of suspected or confirmed COVID-19 disease. For those without COVID-19, anxiety and mental health symptoms were still present. Of those who attested to one of the PROMIS-measured symptoms, all but one had at least mild severity in one of their reported symptoms. CONCLUSION This study demonstrates the cross-cutting impact of the COVID-19 pandemic on individuals who identify as women. Future research and clinical practice guidelines should focus on alleviating physical and mental health symptoms related to the ongoing pandemic, regardless of COVID-19 diagnosis. Furthermore, clinicians should consider how patients can use symptom reconciliation apps and tracking systems.
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15
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Caceres BA, Huang Y, Barcelona V, Wang Z, Newhall KP, Cerdeña JP, Crusto CA, Sun YV, Taylor JY. The Interaction of Trauma Exposure and DNA Methylation on Blood Pressure Among Black Women in the InterGEN Study. Epigenet Insights 2022; 15:25168657221138510. [PMID: 36466626 PMCID: PMC9716582 DOI: 10.1177/25168657221138510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/21/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Despite evidence that trauma exposure is linked to higher risk of hypertension, epigenetic mechanisms (such as DNA methylation) by which trauma potentially influences hypertension risk among Black adults remain understudied. Methods Data from a longitudinal study of Black mothers were used to test the hypothesis that direct childhood trauma (ie, personal exposure) and vicarious trauma (ie, childhood trauma experienced by their children) would interact with DNA methylation to increase blood pressure (BP). Separate linear mixed effects models were fitted at each CpG site with the DNA methylation beta-value and direct and vicarious trauma as predictors and systolic and diastolic BP modeled as dependent variables adjusted for age, cigarette smoking, and body mass index. Interaction terms between DNA methylation beta-values with direct and vicarious trauma were added. Results The sample included 244 Black mothers with a mean age of 31.2 years (SD = ±5.8). Approximately 45% of participants reported at least one form of direct childhood trauma and 49% reported at least one form of vicarious trauma. Epigenome-wide interaction analyses found that no CpG sites passed the epigenome-wide significance level indicating the interaction between direct or vicarious trauma with DNAm did not influence systolic or diastolic BP. Conclusions This is one of the first studies to simultaneously examine whether direct or vicarious exposure to trauma interact with DNAm to influence BP. Although findings were null, this study highlights directions for future research that investigates epigenetic mechanisms that may link trauma exposure with hypertension risk in Black women.
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Affiliation(s)
| | | | | | - Zeyuan Wang
- Rollins School of Public Health, Department of Epidemiology and Biomedical Informatics, Emory University, Atlanta, GA, USA
| | - Kevin P Newhall
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Cindy A Crusto
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Yan V Sun
- Rollins School of Public Health, Department of Epidemiology and Biomedical Informatics, Emory University, Atlanta, GA, USA
| | - Jacquelyn Y Taylor
- Columbia University School of Nursing, New York, NY, USA,Jacquelyn Y Taylor, Columbia University School of Nursing, 560 West 168th Street, New York, NY 10032, USA.
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16
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Kalinowski J, Huang Y, Rivas MA, Barcelona V, Wright ML, Crusto C, Spruill T, Sun YV, Taylor JY. Stress Overload and DNA Methylation in African American Women in the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure Study. Epigenet Insights 2022; 15:25168657221126314. [PMID: 36246163 PMCID: PMC9554129 DOI: 10.1177/25168657221126314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/28/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction: Experiencing psychosocial stress is associated with poor health outcomes such as hypertension and obesity, which are risk factors for developing cardiovascular disease. African American women experience disproportionate risk for cardiovascular disease including exposure to high levels of psychosocial stress. We hypothesized that psychosocial stress, such as perceived stress overload, may influence epigenetic marks, specifically DNA methylation (DNAm), that contribute to increased risk for cardiovascular disease in African American women. Methods: We conducted an epigenome-wide study evaluating the relationship of psychosocial stress and DNAm among African American mothers from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure (InterGEN) cohort. Linear mixed effects models were used to explore the epigenome-wide associations with the Stress Overload Scale (SOS), which examines self-reported past-week stress, event load and personal vulnerability. Results: In total, n = 228 participants were included in our analysis. After adjusting for known epigenetic confounders, we did not identify any DNAm sites associated with maternal report of stress measured by SOS after controlling for multiple comparisons. Several of the top differentially methylated CpG sites related to SOS score (P < 1 × 10−5), mapped to genes of unknown significance for hypertension or heart disease, namely, PXDNL and C22orf42. Conclusions: This study provides foundational knowledge for future studies examining epigenetic associations with stress and other psychosocial measures in African Americans, a key area for growth in epigenetics. Future studies including larger sample sizes and replication data are warranted.
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Affiliation(s)
- Jolaade Kalinowski
- Department of Human Development and Family Sciences, The University of Connecticut, Storrs, CT, USA,Jolaade Kalinowski, Department of Human Development and Family Sciences, The University of Connecticut, 2006 Hillside Rd, Storrs, CT 06279-1248, USA.
| | - Yunfeng Huang
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Martin A Rivas
- Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Veronica Barcelona
- Columbia University School of Nursing and Center for Research on People of Color, New York, NY, USA
| | | | | | - Tanya Spruill
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Yan V Sun
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jacquelyn Y Taylor
- Columbia University School of Nursing and Center for Research on People of Color, New York, NY, USA
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17
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Barcelona V, Huang Y, Caceres BA, Newhall KP, Hui Q, Cerdeña JP, Crusto CA, Sun YV, Taylor JY. Experiences of Trauma and DNA Methylation Profiles among African American Mothers and Children. Int J Mol Sci 2022; 23:ijms23168951. [PMID: 36012217 PMCID: PMC9408935 DOI: 10.3390/ijms23168951] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/18/2022] Open
Abstract
Potentially traumatic experiences have been associated with chronic diseases. Epigenetic mechanisms, including DNA methylation (DNAm), have been proposed as an explanation for this association. We examined the association of experiences of trauma with epigenome-wide DNAm among African American mothers (n = 236) and their children aged 3–5 years (n = 232; N = 500), using the Life Events Checklist-5 (LEC) and Traumatic Events Screening Inventory—Parent Report Revised (TESI-PRR). We identified no DNAm sites significantly associated with potentially traumatic experience scores in mothers. One CpG site on the ENOX1 gene was methylome-wide-significant in children (FDR-corrected q-value = 0.05) from the TESI-PRR. This protein-coding gene is associated with mental illness, including unipolar depression, bipolar, and schizophrenia. Future research should further examine the associations between childhood trauma, DNAm, and health outcomes among this understudied and high-risk group. Findings from such longitudinal research may inform clinical and translational approaches to prevent adverse health outcomes associated with epigenetic changes.
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Affiliation(s)
- Veronica Barcelona
- Center for Research on People of Color, Columbia University School of Nursing, 560 West 168th St., New York, NY 10032, USA
| | | | - Billy A. Caceres
- Center for Research on People of Color, Columbia University School of Nursing, 560 West 168th St., New York, NY 10032, USA
| | - Kevin P. Newhall
- School of Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA
| | - Qin Hui
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Jessica P. Cerdeña
- MD-PhD Program, Yale School of Medicine, 367 Cedar St., New Haven, CT 06520, USA
- Department of Anthropology and Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, 354 Mansfield Rd., Storrs, CT 06269, USA
| | - Cindy A. Crusto
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, USA
- Department of Psychology, University of Pretoria, Private Bag x 20, Hatfield, Pretoria 0028, South Africa
| | - Yan V. Sun
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Jacquelyn Y. Taylor
- Center for Research on People of Color, Columbia University School of Nursing, 560 West 168th St., New York, NY 10032, USA
- Correspondence: ; Tel.: +1-(212)-342-3986
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18
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Gao X, Barcelona V, DeWan A, Prescott L, Crusto C, Sun YV, Taylor JY. Depressive Symptoms and Blood Pressure in African American Women: A Secondary Analysis From the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure Study. J Cardiovasc Nurs 2022; 37:E89-E96. [PMID: 37707976 PMCID: PMC8443694 DOI: 10.1097/jcn.0000000000000800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Depression is a risk factor for hypertension, yet few studies have been conducted in African American women. OBJECTIVE We conducted a secondary analysis of depressive symptoms and high blood pressure among African American women from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure longitudinal study (N = 250). METHODS Logistic regression was used to examine depressive symptoms and blood pressure, adjusting for education, employment, and racism/discrimination. Growth curve modeling was used to investigate longitudinal associations between depressive symptoms and systolic (SBP) and diastolic (DBP) blood pressures at 4 time points (T1-T4). RESULTS Depressive symptoms at baseline were not prospectively associated with hypertension prevalence. Participants with Beck Depression Inventory scores higher than 10 had higher estimated marginal SBP and DBP over time compared with participants with lower scores. CONCLUSION Depressive symptoms were not associated with hypertension prevalence at T4, but they were associated with higher estimated marginal SBP and DBP. Future research is needed to elucidate mechanisms and implications for clinical care and prevention.
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Kalinowski J, Talbert RD, Woods B, Langford A, Cole H, Barcelona V, Crusto C, Taylor JY. Police Discrimination and Depressive Symptoms in African American Women: The Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure Study. Health Equity 2022; 6:527-532. [PMID: 36186618 PMCID: PMC9518801 DOI: 10.1089/heq.2021.0167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jolaade Kalinowski
- Columbia University School of Nursing and Center for Research on People of Color, New York, New York, USA
| | - Ryan D. Talbert
- Department of Sociology, University of Connecticut, Storrs, Connecticut, USA
| | - Brandy Woods
- Morehouse University School of Medicine, Atlanta, Georgia, USA
| | - Aisha Langford
- Department of Population Health, NYU Langone Health, New York, New York, USA
| | - Haile Cole
- Department of Anthropology, University of Connecticut, Storrs, Connecticut, USA
| | - Veronica Barcelona
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Cindy Crusto
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jacquelyn Y. Taylor
- Columbia University School of Nursing and Center for Research on People of Color, New York, New York, USA
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20
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Barcelona V, Wischik DL, Marshall A, Tetrault JM. Integration of medication for opioid use disorder training into graduate nursing education. Nurs Forum 2022; 57:869-873. [PMID: 35616353 DOI: 10.1111/nuf.12753] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 04/20/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
The COVID-19 pandemic has further limited access to treatment for opioid use disorder (OUD). Advanced practice registered nurses can reduce opioid related complications and overdose by obtaining a Drug Enforcement Administration (DEA) regulated X-waiver that allows for prescription of medications for OUD (MOUD) in general medical settings. Graduate nursing education, where advanced practice nurse practitioner (NP) students are educated, has not incorporated this content into standard curricula. We describe an innovative approach to incorporate DEA X-waiver training in a required community health NP in partnership with addiction medicine clinicians. Advanced practice NP students (N = 114) either completed fully online or hybrid (virtual didactic and online) X-waiver training on MOUD. We describe how an interprofessional partnership to incorporate MOUD education into graduate nursing curricula is a feasible method for training students to treat OUD in the context of the pandemic. This approach is responsive to the crucial need for more health care providers to address the opioid overdose crisis.
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Affiliation(s)
| | - Dora L Wischik
- Division of Primary Care, Yale School of Nursing, Orange, Connecticut, USA
| | - Ami Marshall
- Division of Primary Care, Yale School of Nursing, Orange, Connecticut, USA
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21
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Condon EM, Barcelona V, Ibrahim BB, Crusto CA, Taylor JY. Racial Discrimination, Mental Health, and Parenting Among African American Mothers of Preschool-Aged Children. J Am Acad Child Adolesc Psychiatry 2022; 61:402-412. [PMID: 34153495 PMCID: PMC8683578 DOI: 10.1016/j.jaac.2021.05.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/08/2021] [Accepted: 06/11/2021] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Indirect exposure to racism experienced by a caregiver (ie, vicarious racism) is associated with poor outcomes for children, but mechanisms of vicarious racism transmission are poorly understood. The purpose of this study was to examine the relationship between experiences of racial discrimination and parenting among African American mothers and to identify psychological mediators and moderators of this relationship. METHOD African American mothers (N = 250) with young children (mean age = 3.7 years old) reported on perceived racial discrimination (Race-Related Events Scale), parenting (Parenting Stress Index, Parenting Styles and Dimensions Questionnaire), coping (Coping Strategies Index), and mental health (Stress Overload Scale, Beck Depression Inventory). Multivariable linear regression was used to examine associations between perceived racial discrimination and parenting and to test coping as a moderator of these relationships. Ordinary least-squares regression-based path analysis with bootstrapping was used to examine mediation by stress overload and depressive symptoms. RESULTS At least one experience of racial discrimination was reported by 57% of women. Experiences of racial discrimination were associated with increased parenting stress (β = 0.69, p = .02), and this relationship was mediated by stress overload (95% CI [0.35, 1.09]) and depressive symptoms (95% CI [0.27, 1.18]). Racial discrimination was not associated with parenting styles, and coping strategies largely did not moderate the relationships examined. CONCLUSION Racial discrimination has harmful intergenerational effects on African American children and families. Systemic-level interventions are needed, including adoption of policies to promote racial justice and eliminate structural racism in the United States. Future research on coping strategies specific to racism-related stress is needed to inform approaches to intervention.
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Affiliation(s)
| | | | | | | | - Jacquelyn Y. Taylor
- Center for Research on People of Color, Columbia University School of Nursing, New York
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22
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Barcelona V, Montalvo-Ortiz JL, Wright ML, Nagamatsu ST, Dreisbach C, Crusto CA, Sun YV, Taylor JY. DNA methylation changes in African American women with a history of preterm birth from the InterGEN study. BMC Genom Data 2021; 22:30. [PMID: 34482817 PMCID: PMC8418749 DOI: 10.1186/s12863-021-00988-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 08/25/2021] [Indexed: 01/20/2023] Open
Abstract
Background Preterm birth (< 37 weeks’ gestation) is a common outcome of pregnancy that has been associated with increased risk of cardiovascular disease for women later in life. Little is known about the physiologic mechanisms underlying this risk. To date, no studies have evaluated if differences in DNA methylation (DNAm) among women who experience preterm birth are short-term or if they persist and are associated with subsequent cardiovascular sequelae or other health disorders. The purpose of this study was to examine long-term epigenetic effects of preterm birth in African American mothers (n = 182) from the InterGEN Study (2014–2019). In this study, we determine if differences in DNAm exist between women who reported a preterm birth in the last 3–5 years compared to those who had full-term births by using two different approaches: epigenome-wide association study (EWAS) and genome-wide co-methylation analyses. Results Though no significant CpG sites were identified using the EWAS approach, we did identify significant modules of co-methylation associated with preterm birth. Co-methylation analyses showed correlations with preterm birth in gene ontology and KEGG pathways. Functional annotation analysis revealed enrichment for pathways related to central nervous system and sensory perception. No association was observed between DNAm age and preterm birth, though larger samples are needed to confirm this further. Conclusions We identified differentially methylated gene networks associated with preterm birth in African American women 3–5 years after birth, including pathways related to neurogenesis and sensory processing. More research is needed to understand better these associations and replicate them in an independent cohort. Further study should be done in this area to elucidate mechanisms linking preterm birth and later epigenomic changes that may contribute to the development of health disorders and maternal mood and well-being. Supplementary Information The online version contains supplementary material available at 10.1186/s12863-021-00988-x.
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Affiliation(s)
- Veronica Barcelona
- School of Nursing, Columbia University, 560 W. 168th St, New York, NY, 10032, USA.
| | - Janitza L Montalvo-Ortiz
- Department of Psychiatry, Division of Human Genetics, School of Medicine, Errera Community Care Center-Orange Annex, Yale University, 200 Edison Road, Orange, CT, 06477, USA
| | - Michelle L Wright
- School of Nursing & Dell Medical School, Department of Women's Health, University of Texas at Austin, 1710 Red River St., Austin, TX, 78712, USA
| | - Sheila T Nagamatsu
- Department of Psychiatry, Division of Human Genetics, School of Medicine, Errera Community Care Center-Orange Annex, Yale University, 200 Edison Road, Orange, CT, 06477, USA
| | - Caitlin Dreisbach
- Columbia University, Data Science Institute, Northwest Corner, 550 W 120th St #1401, New York, NY, 10027, USA
| | - Cindy A Crusto
- School of Medicine, Department of Psychiatry, Yale University, 389 Whitney Ave, New Haven, CT, 06511, USA
| | - Yan V Sun
- Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Jacquelyn Y Taylor
- Center for Research on People of Color, School of Nursing, Columbia University, 560 W 168th St, Room 605, New York, NY, 10032, USA
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Mudd-Martin G, Cirino AL, Barcelona V, Fox K, Hudson M, Sun YV, Taylor JY, Cameron VA. Considerations for Cardiovascular Genetic and Genomic Research With Marginalized Racial and Ethnic Groups and Indigenous Peoples: A Scientific Statement From the American Heart Association. Circ Genom Precis Med 2021; 14:e000084. [PMID: 34304578 DOI: 10.1161/hcg.0000000000000084] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Historically marginalized racial and ethnic groups and Indigenous peoples are burdened by significant health inequities that are compounded by their underrepresentation in genetic and genomic research. Of all genome-wide association study participants, ≈79% are of European descent, despite this group constituting only 16% of the global population. For underrepresented populations, polygenic risk scores derived from these studies are less accurate in predicting disease phenotypes, novel population-specific genetic variations may be misclassified as potentially pathogenic, and there is a lack of understanding of how different populations metabolize drugs. Although inclusion of marginalized racial and ethnic groups and Indigenous peoples in genetic and genomic research is crucial, scientific studies must be guided by ethical principles of respect, honesty, justice, reciprocity, and care for individuals and communities. Special considerations are needed to support research that benefits the scientific community as well as Indigenous peoples and marginalized groups. Before a project begins, collaboration with community leaders and agencies can lead to successful implementation of the study. Throughout the study, consideration must be given to issues such as implications of informed consent for individuals and communities, dissemination of findings through scientific and community avenues, and implications of community identity for data governance and sharing. Attention to these issues is critical, given historical harms in biomedical research that marginalized groups and Indigenous peoples have suffered. Conducting genetic and genomic research in partnership with Indigenous peoples and marginalized groups guided by ethical principles provides a pathway for scientific advances that will enhance prevention and treatment of cardiovascular disease for everyone.
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Barcelona V, Wang Z, DeWan A, Sun YV, Taylor JY. DNA Methylation, Preterm Birth and Blood Pressure in African American Children: The DPREG Study. J Immigr Minor Health 2021; 24:334-341. [PMID: 33886023 PMCID: PMC8060901 DOI: 10.1007/s10903-021-01201-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 11/28/2022]
Abstract
Preterm birth (< 37 weeks) has been associated with high blood pressure (BP) and cardiovascular disease in adulthood. Epigenetic mechanisms may explain how preterm birth influences later BP. In this study, we examined the association between DNA methylation (DNAm), preterm birth and BP in African American children. We recruited 100 children and collected clinical and birth history data. DNA was extracted from saliva and the Illumina EPIC BeadChip was used for epigenetic analyses. Preterm birth was not associated with systolic or diastolic BP. No significant DNAm sites were associated with preterm birth in candidate gene methylation analyses. Body mass index was associated with systolic BP (p = 0.01). We did not observe an effect of preterm birth on DNAm or BP in early childhood. Our study is one of the few, however, to examine these associations among African Americans.
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Affiliation(s)
- Veronica Barcelona
- Columbia University School of Nursing, 560 West 168th St, New York, NY, 10032, USA.
| | - Zeyuan Wang
- Emory University Rollins School of Public Health, 201 Dowman Drive, 30322, Atlanta, Georgia
| | - Andrew DeWan
- Center for Perinatal, Pediatric and Environmental Epidemiology, Yale University School of Public Health, 1 Church Street, 6th Floor, New Haven, CT, 06510, USA
| | - Yan V Sun
- Emory University Rollins School of Public Health, 201 Dowman Drive, 30322, Atlanta, Georgia
| | - Jacquelyn Y Taylor
- Center for Research on People of Color, Columbia University School of Nursing, 560 W 168th St, New York, NY, 10032, USA
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Caceres BA, Barcelona V, Vo D, Suero-Tejeda N, Jackman K, Taylor J, Corwin E. Investigating the Associations of Everyday Discrimination and Inflammation in Latina Women: A Pilot Study. Biol Res Nurs 2021; 23:311-317. [PMID: 33626923 DOI: 10.1177/1099800421995901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Discrimination is associated with negative health outcomes among Latinos. Research on the link between discrimination and inflammation in adults has focused on pro-inflammatory markers rather than characterizing the more informative balance of pro- and anti-inflammatory markers. The purpose of this cross-sectional study was to examine the associations of everyday discrimination with inflammation ratio (defined as the ratio of pro- to anti-inflammatory cytokines) in a sample of middle-aged and older Latinas. METHODS Latinas were recruited from an existing study in New York City. Participants reported frequency and count of everyday discrimination. Peripheral blood was used to analyze pro- (IL-1B and IL-6) and anti-inflammatory (IL-4 and IL-10) cytokines. The inflammation ratio was calculated by dividing the sum of pro-inflammatory cytokines by the sum of anti-inflammatory cytokines. We used linear regression to assess the link between everyday discrimination and inflammation ratio. RESULTS The final sample included 40 Latinas (mean age = 63.2 years). Approximately 68% had household incomes less than $15,000. More than half (53%) reported experiencing some form of everyday discrimination. Regression models showed everyday discrimination was not associated with individual pro- and anti-inflammatory cytokines. In adjusted regression models, the frequency of everyday discrimination was not associated with inflammation ratios (B[SE] = 0.57[0.30], p = .07). However, a higher count of everyday discrimination was associated with inflammation ratios (B[SE] = 1.15[0.55], p = .04). CONCLUSIONS The count of everyday discrimination was positively associated with inflammation in Latina women. Future studies should replicate these findings using longitudinal assessment of discrimination and inflammatory markers.
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Affiliation(s)
- Billy A Caceres
- Precision in Symptom Self-Management Center, 5798Columbia University School of Nursing, New York, NY, USA.,Center for Research on People of Color, 5798Columbia University School of Nursing, New York, NY, USA
| | - Veronica Barcelona
- Center for Research on People of Color, 5798Columbia University School of Nursing, New York, NY, USA
| | - Danny Vo
- 5798Columbia University Mailman School of Public Health, New York, NY, USA
| | - Niurka Suero-Tejeda
- Precision in Symptom Self-Management Center, 5798Columbia University School of Nursing, New York, NY, USA
| | - Kasey Jackman
- Precision in Symptom Self-Management Center, 5798Columbia University School of Nursing, New York, NY, USA
| | - Jacquelyn Taylor
- Precision in Symptom Self-Management Center, 5798Columbia University School of Nursing, New York, NY, USA.,Center for Research on People of Color, 5798Columbia University School of Nursing, New York, NY, USA
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Caceres BA, Barcelona V, Crusto C, Taylor JY. Exploring Psychosocial Mediators of the Associations of Lifetime Trauma and Body Mass Index in African American Women. Health Equity 2020; 4:542-548. [PMID: 34095701 PMCID: PMC8175258 DOI: 10.1089/heq.2020.0056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2020] [Indexed: 11/22/2022] Open
Abstract
Purpose: This study sought to examine the association between lifetime trauma (i.e., childhood, adulthood, and cumulative) and body mass index (BMI) and if this association was mediated by psychosocial factors (i.e., depressive symptoms and stress) in a sample of African American women. Methods: We examined lifetime trauma among African American women in the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure Study (InterGEN) study. We conducted mediation analyses with bootstrapping to assess the direct and indirect effects of increasing forms of trauma across the lifespan on BMI. Depressive symptoms and stress were examined as mediators of these associations. Results: The analytic sample included 138 women with a mean age of 31.9 years. Approximately half of women reported any childhood trauma (47.8%) and more than half (73.2%) reported any adulthood trauma. The direct effects of all forms of trauma were associated with greater depressive symptoms. Only lifetime trauma was associated with higher stress overload (B=2.40, standard error [SE]=1.12, p<0.05). Higher depressive symptoms were associated with higher BMI in all models. The indirect effects of adulthood trauma (B=0.60, SE=0.20, p<0.01) and lifetime trauma (B=0.53, SE=0.20, p<0.01) on BMI were partially mediated by depressive symptoms. Conclusion: These findings indicate that depressive symptoms mediate the associations between adulthood and lifetime trauma with BMI. Interventions aimed at reducing elevated BMI in African American women should account for the influence of depressive symptoms. Future research should replicate these analyses in other samples of African American women.
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Affiliation(s)
- Billy A Caceres
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY, USA
| | | | - Cindy Crusto
- Yale University School of Medicine, New Haven, CT, USA
| | - Jacquelyn Y Taylor
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY, USA
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Barcelona V, Wang Z, Crusto C, Hui Q, Sun YV, Taylor JY. High blood pressure in pregnancy, DNA methylation, and later blood pressure in African American women enrolled in the InterGEN Study. Birth 2020; 47:290-298. [PMID: 33448462 PMCID: PMC7876779 DOI: 10.1111/birt.12501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Few studies have examined the effects of high blood pressure (BP) in pregnancy, preeclampsia, or eclampsia on later BP, and the epigenetics of this phenomenon is similarly poorly understood, especially among African Americans. The purpose of this study was to examine the association between high BP in pregnancy, epigenomics, and later BP in African American women in the InterGEN Study (n = 250). METHODS In cross-sectional analyses, regression and linear mixed-effects models were employed to examine the effects of high BP in pregnancy on: (a) epigenetic associations (DNA methylation) and (b) BP 3-5 years after birth. The 850K Illumina EPIC BeadChip was used for evaluating epigenome-wide DNA methylation. High BP in pregnancy, preeclampsia, or eclampsia was self-reported by women, and BP was measured 3-5 years after birth, per JNC-7 guidelines. DNA methylation and clinical BP were the main outcomes. RESULTS Mean age of enrolled women was 31.2 years, 21.8% were smokers, 58% had some college or higher education, 46.6% reported an annual income <$15 000, and 13.6% reported high BP in pregnancy. After adjustment for obesity, smoking, and age, women with a history of high BP in pregnancy had significantly higher BP than those who did not report this complication (5.39 ± 2.4 mm Hg, P = .030). Epigenome-wide analysis revealed no significant sites after multiple testing correction. CONCLUSIONS We observed a small, but clinically significant, increase in BP in women who reported high BP in pregnancy 3-5 years after that pregnancy. Future studies with larger sample sizes should examine epigenetic contributions to this finding.
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Affiliation(s)
| | - Zeyuan Wang
- Emory University Rollins School of Public Health, 201 Dowman Drive, Atlanta, Georgia 30322
| | - Cindy Crusto
- Yale University School of Medicine, 300 George St, New Haven, CT, 06511, University of Pretoria, South Africa
| | - Qin Hui
- Emory University Rollins School of Public Health, 201 Dowman Drive, Atlanta, Georgia 30322
| | - Yan V. Sun
- Emory University Rollins School of Public Health, 201 Dowman Drive, Atlanta, Georgia 30322
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Wright ML, Newhall K, Barcelona V, Taylor JY. African American mothers' attitudes towards genetic testing in the InterGEN study. J Community Genet 2020; 11:285-290. [PMID: 31811592 PMCID: PMC7295918 DOI: 10.1007/s12687-019-00440-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022] Open
Abstract
The paucity of representation of people of color, particularly those of African ancestry, is a major issue in contemporary omics research. Metadata summarizing genome-wide association studies from 2005 to 2015 suggest that nearly 80% of participants are of European ancestry and only 2.4% are of African ancestry. Negative attitude towards genetic testing is a commonly cited belief as to why there is low representation of Americans of African ancestry participating in genetic studies. Using the attitudes towards genetic testing survey, administered as part of our parent (epi)genome-wide association study, we characterized the perceptions of genetic research among our cohort of African ancestry women (n = 168). Our data show generally favorable perceptions of genetic testing among our cohort. Further, we demonstrate that more favorable attitudes towards genetic testing correlated with higher levels of income, even when accounting for commonly cited negative predictors such as maternal age, education, country of origin, and religion. Overall, our data characterize generally positive perceptions of genetic testing among women of African ancestry.
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Affiliation(s)
- Michelle L. Wright
- School of Nursing, University of Texas, Austin, TX USA
- Dell Medical School, Department of Women’s Health, Austin, TX USA
| | - Kevin Newhall
- Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, NY USA
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Abstract
The health and well-being of pregnant women during and after natural disasters remains an international concern. In this mixed methods study we described pregnant women's mental health, psychosocial concerns and sources of stress living in New Orleans during long term recovery from Hurricane Katrina. Our survey of 402 pregnant women indicated poor social support was associated with higher levels of depression symptomology, post-traumatic stress disorder, anxiety, and stress. Women were interviewed and described seven common areas of worry. We concluded that pregnant women living in post-disaster communities have stressful lives years after the event, needing innovative models of care to build resilience.
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Affiliation(s)
- Gloria Peel Giarratano
- a Department of Health Sciences, School of Nursing , Louisiana State University , New Orleans , Louisiana , USA
| | - Veronica Barcelona
- b School of Nursing , Yale University , West Haven , Connecticut , USA.,c Department of Epidemiology , Tulane University , New Orleans , Louisiana , USA
| | - Jane Savage
- d College of Nursing and Health , Loyola University , New Orleans , Louisiana , USA
| | - Emily Harville
- c Department of Epidemiology , Tulane University , New Orleans , Louisiana , USA
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Barcelona V, Huang Y, Brown K, Liu J, Zhao W, Yu M, Kardia SLR, Smith JA, Taylor JY, Sun YV. Novel DNA methylation sites associated with cigarette smoking among African Americans. Epigenetics 2019; 14:383-391. [PMID: 30915882 DOI: 10.1080/15592294.2019.1588683] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Cigarette smoking has been associated with adverse health outcomes for mothers and children and is a major contributor to heart disease. Although cigarette smoking is known to affect the epigenome, few studies have been done in African American populations. In this study, we investigated the association between cigarette smoking and DNA methylation (DNAm) among African Americans from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure Study (InterGEN), and the Genetic Epidemiology Network of Arteriopathy (GENOA). METHODS The InterGEN study aims to examine the effects of genetic and psychological factors on blood pressure among African American women and their children. Current cigarette smoking was assessed at baseline. DNAm of saliva was assessed using the 850K EPIC Illumina BeadChip for Epigenome-Wide Association analyses. A replication study was conducted among 1100 participants in the GENOA study using the same BeadChip. RESULTS After controlling for age, body mass index, population structure and cell composition, 26 epigenome-wide significant sites (FDR q < 0.05) were identified, including the AHRR and PHF14 genes associated with atherosclerosis and lung disease, respectively. Six novel CpG sites were discovered in the InterGEN sample and replicated in the GENOA sample. Genes mapped include RARA, FSIP1, ALPP, PIK3R5, KIAA0087, and MGAT3, which were largely associated with cancer development. CONCLUSION We observed significant epigenetic associations between smoking and disease-associated genes (e.g., cardiovascular disease, lung cancer). Six novel CpG sites were identified and replicated across saliva and blood samples.
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Affiliation(s)
| | - Yunfeng Huang
- b Department of Epidemiology , Emory University Rollins School of Public Health , Atlanta , Georgia
| | - Kristen Brown
- b Department of Epidemiology , Emory University Rollins School of Public Health , Atlanta , Georgia
| | - Jiaxuan Liu
- c School of Public Health , University of Michigan, Department of Epidemiology , Ann Arbor , MI , USA
| | - Wei Zhao
- c School of Public Health , University of Michigan, Department of Epidemiology , Ann Arbor , MI , USA
| | - Miao Yu
- c School of Public Health , University of Michigan, Department of Epidemiology , Ann Arbor , MI , USA
| | - Sharon L R Kardia
- c School of Public Health , University of Michigan, Department of Epidemiology , Ann Arbor , MI , USA
| | - Jennifer A Smith
- c School of Public Health , University of Michigan, Department of Epidemiology , Ann Arbor , MI , USA
| | - Jacquelyn Y Taylor
- d New York University Rory Meyers College of Nursing , New York , NY , USA
| | - Yan V Sun
- b Department of Epidemiology , Emory University Rollins School of Public Health , Atlanta , Georgia
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Frisancho AR, Juliao PC, Barcelona V, Kudyba CE, Amayo G, Davenport G, Knowles A, Sanchez D, Villena M, Vargas E, Soria R. Developmental components of resting ventilation among high- and low-altitude Andean children and adults. Am J Phys Anthropol 1999; 109:295-301. [PMID: 10407461 DOI: 10.1002/(sici)1096-8644(199907)109:3<295::aid-ajpa2>3.0.co;2-u] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This paper evaluates the age-associated changes of resting ventilation of 115 high- and low-altitude Aymara subjects, of whom 61 were from the rural Aymara village of Ventilla situated at an average altitude of 4,200 m and 54 from the rural village of Caranavi situated at an average altitude of 900 m. Comparison of the age patterns of resting ventilation suggests the following conclusions: 1) the resting ventilation (ml/kg/min) of high-altitude natives is markedly higher than that of low-altitude natives; 2) the age decline of ventilation is similar in both lowlanders and highlanders, but the starting point and therefore the age decline are much higher at high altitude; 3) the resting ventilation that characterizes high-altitude Andean natives is developmentally expressed in the same manner as it is at low altitude; and 4) the resting ventilation (ml/kg/min) of Aymara high-altitude natives is between 40-80% lower than that of Tibetans.
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Abstract
Despite the widespread use of rigid fixation techniques in craniofacial surgery, there is a paucity of studies in the literature that serve to better define the reasons for the subsequent removal of plates and screws. The current study appears to be the first to attempt to assess these issues among a broad range of craniofacial surgery patients. Fifty-five patients who underwent hardware removal following craniofacial surgery at the University of Michigan Medical Center between 1989 and 1995 were retrospectively studied via an in-depth chart review. Common reasons for hardware removal included palpable/prominent hardware in 19 patients (34.5%), loosening of plates and screws in 14 patients (25.5%), pain in 14 patients (25.5%), infection in 13 patients (23.6%), wound dehiscence/exposure of hardware in 11 patients (20%), and removal at the time of secondary procedures in 5 patients (9.1%). It is hoped that this study will serve as a tool to define more completely the risk of needing subsequent hardware removal among craniofacial surgery patients treated with rigid internal fixation.
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Affiliation(s)
- J S Orringer
- Section of Plastic Surgery, University of Michigan, Ann Arbor, USA
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