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In the U.S., cigarette smoking is increasingly concentrated in disadvantaged and vulnerable populations, such as populations with lower income and with mental health needs. Food insecurity is linked with psychological distress and is an independent risk factor for smoking. We prospectively examined how cigarette smoking, food insecurity, and psychological distress operate as risk factors for one another in a 2-year longitudinal analysis of U.S. adults from the 2015 and 2017 Panel Study of Income Dynamics, a nationally representative household survey (N = 7946). Using cross-lagged panel analysis, cross-lagged regression coefficients were estimated simultaneously with direct-effect paths, controlling for covariates. Results showed significant bidirectional associations between smoking and food insecurity: 2015 smoking predicted 2017 food insecurity, and 2015 food insecurity predicted 2017 smoking. Food insecurity and psychological distress also had significant bidirectional associations. However, the association between smoking and psychological distress was unidirectional: 2015 psychological distress predicted 2017 smoking, but not vice versa. The findings suggest a cyclical possibility that smoking exacerbates food insecurity, food insecurity exacerbates psychological distress, and psychological distress exacerbates smoking. There is a need to replicate with more timepoints, but our results highlight the importance of examining the overlapping health burdens of smoking, food insecurity, and psychological distress.

IntroductionSmoking prevalence is disproportionately high among Asian American immigrant men with limited English proficiency. Understanding the role of family support may provide insights on culturally acceptable strategies to promote smoking cessation.AimsThis study examined how family support was associated with readiness to consider smoking cessation among Chinese and Vietnamese American male daily smokers.MethodsWe analyzed baseline data (N=340) from a cluster randomized trial of a family-based healthy lifestyle intervention. We assessed the frequency of receiving family support in various forms (encouraging use of cessation resources; praising efforts; checking-in; reminding of familial role). Multiple regression analysis was used to determine associations between family support areas and readiness to consider smoking cessation, controlling for covariates.Results/findingsReporting a higher frequency of receiving praise and encouragement for one's efforts to quit was positively associated with readiness to consider cessation. Other areas of family support were not significant.ConclusionsThese findings provide evidence to explore specific areas of family support in enhancing Asian American smokers' readiness to consider cessation. As there is high interest from Asian American family members to support their smokers for quitting, culturally specific and acceptable strategies are needed to promote smoking cessation among Asian Americans.

Youth Leaders Program (YLP) is a health intervention implemented in a rural Alaskan school district, which utilizes natural helpers and peer leaders to increase protective factors such as school engagement and personal/cultural identities, and to reduce risks associated with drug/alcohol abuse, violence, and bullying. Through these means, the program aims to ultimately decrease the disproportionately high rates of indigenous youth suicide in the region. This paper describes process and outcome evaluation findings from the program during the 2013-2014 school year. Data collected include a survey for program participants done at the beginning and end of the study year (n = 61, complete pairs); pre- and post-intervention school data (attendance, GPA, and disciplinary actions) (n = 86); an all-school survey asking students at the participating schools about their experience with YLP and participating youth (n = 764); interviews with program advisors (n = 11) and school principals (n = 2); and focus groups with participating students at all eleven participating schools at the end of the year. Outcomes included increased school attendance (mean attendance increased from 146 to 155 days) and improved academic performance (mean GPA of 8th, 9th, and 10th graders increased from 3.01 to 3.14) of program participants; positive peer reviews of participating student interventions in cases of bullying, depression, and suicidality; and a reported increase in the sense of agency, responsibility, and confidence among participating youth. The YLP appears to improve school climate and increase school and other protective factors for participating students. Recommendations for program implementation in the future and implications for school health will be discussed.

HIV infection has been linked to selenium deficiency and chronic inflammation. Both selenium deficiency and inflammation have been associated with poor health outcomes among individuals with HIV. However, the role of serum selenium levels in inflammation has not been studied among individuals with HIV. We assessed the relationship of serum selenium levels to C-reactive protein (CRP), a marker of inflammation, in individuals with HIV in Kathmandu, Nepal. In this cross-sectional study, we measured the normal serum CRP and selenium levels of 233 individuals with HIV (109 women and 124 men) using the latex agglutination turbidimetric and atomic absorption methods, respectively. We used multiple linear regression analysis in examining the association of serum selenium levels with CRP adjusting for sociodemographic and clinical parameters, including antiretroviral therapy, CD4+ T cell count, chronic diseases, and body mass index. The geometric means of CRP and selenium levels were 1.43 mg/liter and 9.65 μg/dL, respectively. Overall, serum selenium levels were inversely associated with CRP levels (β for one unit change in log selenium; β = −1.01, p = .06). Mean CRP levels significantly decreased with increasing selenium across selenium tertiles (p for trend = .019). The mean serum CRP levels were 40.8% lower in the highest selenium tertile than in the lowest. Our study suggests that high serum selenium levels may reduce serum CRP levels in individuals with HIV, although a longitudinal study is warranted to establish causality. [ABSTRACT FROM AUTHOR]

Objectives Appropriate infant and young child feeding (IYCF) for children aged 6-23 months includes adequate dietary diversity, appropriate meal frequency, and continued breastfeeding. Mothers receiving antenatal care (ANC) and postnatal care (PNC) may adopt better IYCF. This study examined the association of ANC or PNC attendance with IYCF and child nutrition status. Methods A cross-sectional study was performed on 400 mother-child pairs in rural Nepal. Mothers were interviewed about their history of ANC and PNC attendance and IYCF; the height and weight of their children were measured. IYCF was measured with infant and child feeding index (ICFI) aggregating scores of dietary diversity, meal frequency, continued breastfeeding, and dietary variety. Lower ICFI scores indicated poorer IYCF practices. Multiple regression and logistic regression examined the association of ANC and PNC attendance with ICFI scores and undernutrition, respectively. Results Absence of ANC ([beta] = -1.01, P = 0.011) and absence of PNC ([beta] = -1.01, P = 0.011) were negatively associated with ICFI scores. Additionally, absence of ANC was positively associated with underweight (AOR 3.37; 95 % CI 1.42-9.92 for children 6-11 months, AOR 3.43; 95 % CI 1.41-8.32 for children 12-23 months) and stunting (AOR 6.51; 95 % CI 2.11-20.10 for children 6-11 months, AOR 3.32; 95 % CI 1.50-7.31 for children 12-23 months). Similarly, children tended to be underweight and stunted if their mothers did not receive any PNC. Conclusion Absence of ANC and PNC were associated with poor IYCF, underweight, and stunting in children., Author(s): Khem Pokhrel[sup.1] , Keiko Nanishi[sup.1] , Krishna C. Poudel[sup.2] , Kalpana Gaulee Pokhrel[sup.3] , Kalpana Tiwari[sup.4] , Masamine Jimba[sup.1] Author Affiliations: (1) Department of Community and Global Health, Graduate [...]

Comparative studies are lacking on intimate partner violence (IPV) between urban poor and general populations. The objective of this study is to identify the prevalence and risk factors of physical IPV among the general and poor populations in urban Nepal. A cross-sectional study was conducted by structured questionnaire interview. Participants included 905 ever-married women in Kathmandu aged 15 to 49 years. Of the 905 participants, 680 were randomly selected from general population and 225 were recruited from urban poor population, who lived in purposively selected two communities. The prevalence and association between ever experiencing physical IPV and sociodemographic variables were examined. Results showed that the prevalence of physical IPV was 33.8% among the urban poor population (n = 225) and 19.9% among the general population (n = 680; p less than 0.01). Several factors were significantly associated with physical IPV in both populations: the frequency of the husband's drinking, polygyny, and lower household economic status. However, two factors were associated with physical IPV only among the general population: the husband's lower educational level and early marriage. The conclusions of this study are that compared to the general population, the urban poor population showed a significantly higher prevalence of physical IPV and differences in the associated risk factors. The urban poor population requires focused data collection as well as tailored interventions to reduce IPV. (Contains 2 tables and 2 figures.)

The authors conducted a community based, cross-sectional study to describe the prevalence of intimate partner violence (IPV) by husbands and the association between wives' attitudes toward gender roles and their experience of IPV in Central Province, Sri Lanka. This article included a representative sample of 624 wives between 15 and 49 years of age and examined the prevalence of physical, psychological, and sexual abuse. Then, using multivariate logistic regression analysis, the authors examined the association between wives' attitudes toward gender roles and IPV. Of the 624 wives, 36% had experienced at least one episode of physical, psychological, or sexual abuse by their husbands during their life time (ever abuse), and 19% had experienced such abuse during the past 12 months (current abuse). The wives were less likely to experience current abuse by husbands if they believed that "outsiders should not intervene to protect abused wives." They were more likely to experience ever and current isolated psychological abuse by husbands if they did not believe that "a good wife always obeys her husband." This study suggests that the prevalence of IPV is high in Sri Lanka. Although several published studies on IPV suggest that traditional gender role attitudes tend to increase women's vulnerability to IPV, this study suggests that in Sri Lanka, the wives who respect cultural norms tend to experience less IPV by husbands. (Contains 2 tables and 1 figure.)

This longitudinal observational study evaluated whether admission priorities given to children on waiting lists for out-of-home day-care centres (DCCs), determined as being either an early or late admission to DCCs, are determined by actual childcare needs and are assigned to children of disadvantaged families, in public DCCs in Pokhara, Nepal, between November 2003 and February 2006. Multivariate logistic regression analysis showed high caste, low household weekly income, and father's absence from the home were associated with children's early admission to DCCs; but maternal employment and availability of childcare support were not associated with admission priorities. Priorities given to children on DCC waiting lists were not fully based on deprivation and childcare need; caste/ethnicity may influence the prioritisation. Policies should explicitly prioritise those most in need and most deprived, possibly with regulations to reserve seats for those from low-caste/ethnic groups. (Contains 2 tables.)

Family‐centred interventions addressing sociocultural and emotional stressors promise to prevent mental health problems among refugees in the United States. Peer‐led strategies are highly valued, as they engage communities and promote the sustainability of interventions. We assessed the effects of a peer‐led family‐centred Social and Emotional Well‐being (SEW) intervention on preventive (coping, social networking and conflict resolution) and mental health outcomes (stress, anxiety and depression) among resettled Bhutanese adults in Massachusetts. We conducted a SEW intervention with a pre‐intervention versus post‐intervention (7‐day) and follow‐up (3‐month) evaluation among 103 adults (50 families). The SEW is a culturally tailored 5‐weekly session program that included health education, problem‐solving and mind–body exercises to increase knowledge and skills regarding stress management and conflict resolution. We measured anxiety and depression using the Hopkins Symptom Checklist‐25 and stress using Cohen Perceived Stress scales. Health‐promoting behaviours were measured using validated scales. We used paired t‐tests for continuous and McNemar tests for categorical variables. Mean scores significantly decreased from pre‐intervention to post‐intervention and follow‐up for stress by 15% and 13.9%, anxiety by 20.9% and 25.1% and depression by 18.7% and 20.4% (all p's < 0.01). Mean scores increased from pre‐intervention to post‐intervention and follow‐up for coping by 10% and 17.2%, and for community networking by 28% and 36.8% (all p's < 0.01). Generalised estimating equations showed a significant reduction in stress, anxiety, depression and improved coping, self‐efficacy, family and community networking scored from baseline to follow‐ups (all p's < 0.01). Our peer‐led family‐centred SEW intervention was associated with improved preventive and mental health outcomes among Bhutanese adults. [ABSTRACT FROM AUTHOR]

Limited studies have examined the role of a parent's involvement in their child's daily life as it relates to cigarette smoking among adolescents in low- and middle-income countries (LMICs). We examined the role of parental involvement with current smoking among 6,105 adolescents using a nationally representative sample from the 2015– 2016 Global School-based Students Health Survey in Nepal. Using the adolescents' perceptions of daily parental involvement, a composite variable was created to include parents (a) checking to see if the child's homework was done, (b) understanding the child's problems and worries, and (c) knowing what the child was doing with their free time. Our analysis utilized a multiple logistic regression to calculate adjusted odds ratios (aOR) accounting for significant covariates. Overall, an increase in parental involvement was associated with a 15% less (aOR = 0.86) likelihood of their child smoking. Additionally, being 15 years or older (aOR =1.55), being bullied (aOR =1.72), drinking alcohol (aOR =20.63), and having missed school without permission (aOR =2.29) were all associated with cigarette smoking. Further, girls were almost 70% less (aOR = 0.33) likely to be cigarette smokers than boys. Future longitudinal studies should examine parental involvement as a protective factor against cigarette smoking. [ABSTRACT FROM AUTHOR]