Search

Background: Investigations of chronic physiological stress measured by hair cortisol are rapidly expanding among community samples of adolescents and adults. However, research examining physiological stress among youth experiencing homelessness is nascent despite the youth's increased risk for adverse exposures and subsequent impaired mental health. Objective: This article aimed to examine the feasibility of collecting hair formeasuring cortisol among diverse youth experiencing homelessness and gain an understanding of variation in participation. Methods: Analysis of survey and hair participation data from three pilot studies among youth experiencing homelessness was conducted. Survey measures included sociodemographic characteristics (age, race and ethnicity, sex assigned at birth, and sexual orientation) and reasons for nonparticipation. Descriptive analysis examined participation rates in hair collection for cortisol measurement, including sociodemographic differences in participation. Results: Participation in the hair sampling for cortisol was high for the combined sample (88.4%), with some variation across the three pilot studies. Insufficient hair for cutting was the most common reason for not participating; Black andmultiracial youth, as well as male youth, had a higher prevalence of nonparticipation. Discussion: The collection of hair for cortisol research among youth experiencing homelessness is feasible, and integration of physiological measures of stress into research with this vulnerable population should be considered, given their high risk for adversity and death by suicide and drug overdose. Methodological considerations and avenues for potential research are discussed. [ABSTRACT FROM AUTHOR]

Background: Mass incarceration of Black fathers and mothers in the United States has had an undeniably negative effect on the health and well-being of their children, families, and communities. Nearly 1 in every 9 Black youth in the United States has had an incarcerated parent compared to 1 in every 17 White youth. To mitigate the consequences of such historical and structural racism, family and community protective factors that promote health and flourishing in Black youth need exploration. Objectives: The aim of this study was to understand the associations of protective family, school, and neighborhood factors of overall health and flourishing in Black youth ever exposed to parental incarceration. Methods: Using the 2016-2019 National Survey of Children's Health, secondary data analyses were conducted of Black youth ages 6-17 years exposed to parental incarceration (n = 839). Multivariable logistic regression models predicted the associations among protective family and community factors and two child outcomes of interest: overall good health status and flourishing. Overall good health status was measured dichotomously comparing children in "good, very good, or excellent" health to children in "fair or poor" health. Flourishing was measured as a count score using three survey questions designed to assess the child's curiosity and discovery about learning, resilience, and self-regulation. Protective factors of interest included family resilience and connectedness, neighborhood support and safety, and school safety. Other child and caregiver demographics and health characteristics were also included as covariates. Results: Across all models, higher levels of family connectedness were associated with greater odds of having overall good health and flourishing in Black youth exposed to parental incarceration after adjusting for covariates and neighborhood and school protective characteristics. No significant associations were found between neighborhood or school protective factors and either outcome. Discussion: To achieve health equity and maximize opportunities for all youth, we must remove the obstacles and consequences of mass incarceration. Improving the health and flourishing of Black youth who have had incarcerated parents requires greater investment in structural supports to bolster family connectedness and better evidence on how to support families affected by mass incarceration and structural racism. [ABSTRACT FROM AUTHOR]

Few studies have examined the effects of parental incarceration (PI) on outcomes above and beyond other risk and adverse childhood experiences (ACEs). The objectives of this study were to (1) the associations between PI and mental health problems (attention, externalizing, internalizing, and total behavioral problems) and (2) the mediating role of current socioeconomic status and cumulative ACEs. An observational and cross-sectional design was employed. Analyses included hierarchical multivariable linear regression modeling. The analytic sample included 613 adolescents (11-17 years). On average, youth exposed to PI experienced three times as many ACEs compared with youth unexposed. Youth exposed to PI were more likely to have behavioral problems than their unexposed peers. The main effect for all models was attenuated by current economic hardship as well as exposure to increasing numbers of ACEs. Exposure to PI can be viewed as a marker of accumulative risk for intervention since youth impacted by PI are more likely to experience behavioral difficulties and associated adverse childhood experiences. Due to the associated adversity that impact youth exposed to PI, mental health providers need to be able to identify and screen for symptoms associated with trauma. [ABSTRACT FROM AUTHOR]

Objective: Medical care alone cannot adequately improve population health or eliminate inequities; social determinants of health (SDH) must be addressed. This study's purpose was to describe the research, teaching, service, and clinical practice activities implemented by RWJF Nurse Faculty Scholars to act on the SDH. Design: A cross-sectional survey design was used with a sample of RWJF Nurse Faculty Scholars, chosen because they were provided specialized mentoring, grants, and other support that allowed them to explore SDH. Results: Respondents (n = 57) addressed SDH in their research (86.0%), teaching (68.4%), service (66.7%), and clinical practice (33.3%). Leading research foci were quality of health care (56.1%), social and physical environmental stressors (54.4%), and access to health care services (49.1%). Leading SDH areas in teaching were discrimination in society against vulnerable populations (54.4%), quality of health care received by vulnerable populations (50.9%), and vulnerable populations' access to health care services (50.9%). Service activities included addressing discrimination against diverse populations. Leading SDH areas in clinical practice were quality of health care received by vulnerable populations (28.1%), vulnerable populations' access to health care services (22.8%), and discrimination in society against vulnerable populations (19.3%). Respondents also addressed SDH through personal mentoring (71.9%); efforts to recruit and/or retain underrepresented faculty (59.6%); developing a diverse pipeline of nurses (59.6%); and participation on a diversity committee (40.4%). Conclusion: The RWJF Nurse Faculty Scholars were able to leverage their awards to address SDH; however, further research is needed to assess the impact of the SDH work conducted. Knowledge from this study can be used as a road map for SDH elements and areas of professional work that nurses and other health professionals could address SDH in research, teaching, service, and practice. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To examine racial and ethnic disparities in human papillomavirus (HPV) awareness and vaccination among young adult females aged 18-24 years. Design and Sample: Descriptive correlational study. One thousand nineteen women aged 18-24 years who self-identified as Hispanic, non-Hispanic Black, or non-Hispanic White. Measures: Descriptive and multivariate logistic regression analyses using data from the 2007-2008 National Survey of Family Growth. Results: Approximately 90% of non-Hispanic White women, 80% of non-Hispanic Black women, and 56-60% of Hispanic women reported an awareness of HPV infection and vaccination, and yet, vaccine receipt across racial and ethnic groups was 23%, 8%, and 6%, respectively. In multivariate analyses, Hispanic and non-Hispanic Black women were less aware than non-Hispanic White women of HPV infection (OR=0.10, 95% CI=0.05, 0.19; OR=0.23, 95% CI=0.13, 0.40) and vaccination (OR=0.13, 95% CI=0.07, 0.27; OR=0.27, 95% CI=0.14, 0.52) and also less likely to report vaccine receipt (OR=0.44, 95% CI=0.21, 0.90; OR=0.16, 95% CI=0.07, 0.35). Conclusions: Despite moderate to high levels of awareness, HPV vaccination rates were low among this national population of young adult women. Continued surveillance is imperative to monitor vaccine uptake, including racial and ethnic disparities. Further research exploring HPV knowledge and vaccination barriers across diverse cultural groups is needed to inform the development of more effective public health interventions. [ABSTRACT FROM AUTHOR]

Objectives. We examined relationships between neighborhood social disorganization and trichomoniasis among young US adults. Methods. We employed multilevel logistic regression modeling with secondary data from wave III of the National Longitudinal Study of Adolescent Health (2001-2002). The dependent variable-trichomoniasis-was measured via urine testing. The measures for neighborhood social disorganization were derived from the 2000 US Census-racial and ethnic composition, concentrated poverty, and residential instability. The sample comprised 11370 individuals across 4912 neighborhoods. Results. Trichomoniasis was more likely in neighborhoods with higher concentrations of Black residents (adjusted odds ratio [AOR]=1.16; 95% confidence interval [CI]=1.03, 1.30). However, this association was mediated by neighborhood concentrated poverty. Furthermore, young adults who lived in neighborhoods with higher concentrations of poverty were significantly more likely to have trichomoniasis (AOR=1.25; 95% CI=1.07, 1.46). Neither immigrant concentration nor residential instability was significantly associated with trichomoniasis. Conclusions. These findings strengthen the evidence that neighborhood structural conditions are associated with individual sexually transmitted infection (STI) acquisition. Research is needed to explore the mechanisms through which these conditions influence STI. In addition, STI-prevention programs that include structural interventions targeting neighborhood disadvantage are needed. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study examined the relationships among nurse fatigue, individual nurse factors, and the practice environment in the inpatient setting. BACKGROUND: Nurse fatigue affects the quality of care provision on inpatient units. Scant literature exists regarding how aspects of the practice environment relate to nurse fatigue. METHODS: A cross-sectional, correlational design was used in this survey study of 175 neonatal intensive care unit nurses from multiple hospitals. Data were collected using the Checklist Individual Strength questionnaire and the Practice Environment Scale of the Nursing Work Index. Hierarchical regression analysis was performed to examine the relationships. RESULTS: Higher fatigue was significantly associated with more hours worked, fewer hours of sleep, a physical or mental contributor to fatigue, and a recent distressing patient event. Lower fatigue was significantly associated with better nurse manager ability, leadership, and support. CONCLUSIONS: Nurse fatigue may be diminished with organizational and individual strategies. Developing tactics for nurse managers to better support staff members after a recent distressing patient event is indicated. [ABSTRACT FROM AUTHOR]