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Wang X, Jiang L, Barry L, Zhang X, Vasilenko SA, Heath RD. A Scoping Review on Adverse Childhood Experiences Studies Using Latent Class Analysis: Strengths and Challenges. TRAUMA, VIOLENCE & ABUSE 2024; 25:1695-1708. [PMID: 37594222 DOI: 10.1177/15248380231192922] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Adverse childhood experiences (ACEs) studies reveal the profound impacts of experiencing trauma and hardships in childhood. However, the cumulative risk approach of treating ACEs obscures the heterogeneity of ACEs and their consequences, making actionable interventions impossible. latent class analysis (LCA) has increasingly been used to address these concerns by identifying underlying subgroups of people who experience distinctive patterns of co-occurring ACEs. Though LCA has its strengths, the existing research produces few comparable findings because LCA results are dependent on ACEs measures and indicators, which vary widely by study. Therefore, a scoping review of ACEs studies using LCA that focuses on ACEs measures, indicators, and findings is needed to inform the field. Following Arksey and O'Malley's five-stage scoping review methodological framework, we first identified 211 articles from databases of EBSCOhost, PubMed, and Scopus using "adverse childhood experiences" for title search and "latent class analysis" for abstract search. Based on the inclusion criteria of peer-reviewed articles written in English published from 2012 to 2022 and the exclusion criteria of nonempirical studies and the LCA not analyzing ACEs, we finally selected 58 articles in this scoping review. Results showed LCA has been increasingly endorsed in the ACEs research community to examine the associations between ACEs and human health and well-being across culturally diverse populations. LCA overcame the limitations of the traditional methods by revealing specific ACEs clusters that exert potent effects on certain outcomes. However, the arbitrary nature of selecting ACEs indicators, measures, and the limited use of theory impedes the field from moving forward.
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Liu Q, Wang X, Razza RA, Vasilenko SA. Early adverse childhood experiences and preschoolers' attentional regulation: A latent class analysis. CHILD ABUSE & NEGLECT 2024; 149:106703. [PMID: 38395020 DOI: 10.1016/j.chiabu.2024.106703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/10/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) profoundly disrupt preschoolers' attentional regulation development. Different patterns of ACEs may be associated with different attentional regulation outcomes. OBJECTIVE Drawing from developmental systems theory and attachment theory, this study aimed to identify distinct patterns of early ACEs at age three and examined the associations of these patterns with preschoolers' attentional regulation at age five. PARTICIPANTS AND SETTING This study used the two waves of longitudinal data from the Future of Families and Child Wellbeing Study (N = 4457). METHODS First, this study applied latent class analysis (LCA) across nine indicators of ACEs at age three. Second, class membership was examined for associations with preschoolers' attentional regulation at age five. RESULTS LCA identified four latent classes of ACEs: separation (41.2 %), parental incarceration (33 %), family dysfunction (20.8 %), and child abuse (5 %). Children in the child abuse class exhibited lower levels of attentional regulation than those in the family dysfunction class (0.33 standard deviation difference, p < .01) or separation class (0.48 standard deviation difference, p < .001). Children in the parental incarceration class demonstrated lower levels of attentional regulation than those in the separation class (0.63 standard deviation difference, p < .001). CONCLUSIONS Findings provide implications for the need to prevent early child abuse and incorporate trauma-informed intervention programs to support preschoolers' attentional regulation during school-entry age.
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Affiliation(s)
- Qingyang Liu
- Department of Human Development and Family Science, Syracuse University, United States of America.
| | - Xiafei Wang
- School of Social Work, Syracuse University, United States of America
| | - Rachel A Razza
- Department of Human Development and Family Science, Syracuse University, United States of America
| | - Sara A Vasilenko
- Department of Human Development and Family Science, Syracuse University, United States of America
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Vasilenko SA, Wang X, Liu Q. Longitudinal Patterns of Multidimensional Violence Exposure and Adolescent Early Sexual Initiation. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2881-2896. [PMID: 37154880 PMCID: PMC10630535 DOI: 10.1007/s10508-023-02607-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/02/2023] [Accepted: 04/16/2023] [Indexed: 05/10/2023]
Abstract
Early sexual intercourse is associated with sexually transmitted infections, pregnancy, and depressive symptoms, and delay of intercourse allows adolescents opportunities to practice relationship skills (Coker et al., 1994; Harden, 2012; Kugler et al., 2017; Spriggs & Halpern, 2008). Thus, understanding predictors of early sexual intercourse is crucial. Prior research has suggested that violence exposure is associated with early initiation of sexual intercourse in adolescence (Abajobir et al., 2018; Orihuela et al., 2020). However, most studies have looked only at a single type of violence exposure. In addition, little research has examined longitudinal patterns of violence exposure in order to determine whether there are particular periods when the violence exposure may have the strongest impact on sexual behavior. Guided by life history and cumulative disadvantage theories, we use longitudinal latent class analysis and data from the Future of Families and Child Well-being Study (N = 3,396; 51.1% female, 48.9% male) to examine how longitudinal patterns of multiple types of violence exposures across ages 3 to 15 are associated with early sexual initiation in adolescence. Findings suggest that experiencing persistent physical and emotional abuse across childhood was associated with the greatest prevalence of early sexual initiation. Early exposure to violence was not consistently associated with greater likelihood of sexual initiation; instead, early abuse was more strongly associated with sexual initiation for boys, while late childhood abuse was more strongly associated for girls. These findings suggest that gender-sensitive programs are highly needed to address unique risk factors for boys' and girls' sexual behaviors.
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Affiliation(s)
- Sara A Vasilenko
- Department of Human Development and Family Science, Syracuse University, 144 White Hall, Syracuse, NY, 13244, USA.
| | - Xiafei Wang
- Department of Social Work, Syracuse University, Syracuse, NY, USA
| | - Qingyang Liu
- Department of Human Development and Family Science, Syracuse University, Syracuse, NY, USA
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Jiang Q, Wang D, Yang Z, Choi JK. Bidirectional relationships between parenting stress and child behavior problems in multi-stressed, single-mother families: A cross-lagged panel model. FAMILY PROCESS 2023; 62:671-686. [PMID: 35667879 PMCID: PMC10411985 DOI: 10.1111/famp.12796] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 03/19/2022] [Accepted: 05/02/2022] [Indexed: 06/08/2023]
Abstract
Investigations on the bidirectional relationships between parenting stress and child behavior problems are important to inform intervention strategies; however, prior research has provided inconsistent findings. Using a national sample of multi-stressed single-mother families from the Fragile Families and Child Wellbeing study, the present study examined the bidirectional relationships between maternal parenting stress and children's behavioral problems spanning from early childhood through adolescence at the child's ages 3, 5, 9, and 15. Reciprocal transactions were found between parenting stress and behavior problems in early childhood between the ages 3 and 5. From age 5 to age 15, our findings also suggest that children's behavior problems at an earlier time point predict mothers' parenting stress at a later time point. Unexpectedly, the lagged effects of parenting stress on child behavior problems in school ages were not significant in our sampled data. Early childhood interventions should address mitigating both parenting stress and their toddlers' behavior problems. During middle childhood and adolescence, interventions to directly address children's behavior problems are critical both to the well-being of mothers and to assist in the reduction in levels of behavior problems.
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Affiliation(s)
- Qingyu Jiang
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Dan Wang
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Zhenqiao Yang
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Jeong-Kyun Choi
- Department of Social Work, California Baptist University, Riverside, California, USA
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Bommersbach T, Rhee TG, Jegede O, Rosenheck RA. Mental health problems of black and white children in a nationally representative epidemiologic survey. Psychiatry Res 2023; 321:115106. [PMID: 36791593 DOI: 10.1016/j.psychres.2023.115106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
Black children face more numerous socio-economic disadvantages than White children, but whether they have more adverse mental health problems remains understudied. Using nationally-representative data from the 2018-2019 National Survey of Children's Health, we examined differences in mental health problems between non-Hispanic Black (n = 2,890) and White (n = 30,015) children aged 6-17. Multivariate analyses were used to determine whether differences in mental health conditions could be accounted for by other factors. We found Black children were significantly less likely than White children to have clinically-identified internalizing conditions (especially anxiety) and more likely to be identified with conduct problems. Black children were also substantially more likely to have greater exposure to adverse childhood experiences (ACEs), to be uninsured, experience poverty, and less likely to receive needed mental health services. After adjusting for these potential confounders, Black children remained half as likely to have clinically-recognized internalizing conditions, but were no longer more likely to have clinically-identified conduct problems. Differences in ACEs alone fully accounted for the racial difference in conduct problems. These results point to the potential impact of assessment bias by clinicians and underscore the potential benefit of routine screening for depression/anxiety in racial/ethnic minority children, especially in light of rising suicide rates among Black youth.
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Affiliation(s)
- Tanner Bommersbach
- Department of Psychiatry and Psychology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55901, USA.
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, Connecticut, USA; U.S. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, 950 Campbell Avenue, West Haven, Connecticut, USA; Department of Public Health Sciences, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, Connecticut, USA
| | - Oluwole Jegede
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, Connecticut, USA
| | - Robert A Rosenheck
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, Connecticut, USA; U.S. Department of Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, 950 Campbell Avenue, West Haven, Connecticut, USA
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Zhu Y, Zhang G, Anme T. Adverse Childhood Experiences, Resilience, and Emotional Problems in Young Chinese Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3028. [PMID: 36833720 PMCID: PMC9963758 DOI: 10.3390/ijerph20043028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Resilience plays an important role in the relationship between adverse childhood experiences (ACEs) and children's health. Young children are often neglected in ACEs research and suffer from the negative consequences of ACEs. However, few studies have focused on the relationship between ACEs and emotional problems in young Chinese children and the moderating and mediating effect of resilience on this relationship. This study included young children at the beginning of their kindergarten year (n = 874, 42.80 ± 4.09 months) from Wuhu City, China, to examine the mediation and moderation effects of resilience on early-life ACEs and emotional problems. Our results show a positive direct effect of ACEs on emotional problems. Furthermore, a positive indirect effect of ACEs and emotional problems on resilience was found. A moderating effect of resilience was not observed in this study. Our findings (a) highlight the significance of paying more attention to early ACEs and revealing a better understanding of the effect of resilience on ACEs at an early age and (b) indicate that age-specific interventions should be provided to enhance young children's resilience when exposed to adversity.
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Affiliation(s)
- Yantong Zhu
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba 3058577, Japan
| | - Gengli Zhang
- Faculty of Educational Science, Anhui Normal University, Wuhu 241000, China
| | - Tokie Anme
- Faculty of Medicine, University of Tsukuba, Tsukuba 3058577, Japan
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Wang X, Heath RD, Majewski D, Blake C. Adverse childhood experiences and child behavioral health trajectory from early childhood to adolescence: A latent class analysis. CHILD ABUSE & NEGLECT 2022; 134:105879. [PMID: 36115324 DOI: 10.1016/j.chiabu.2022.105879] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) profoundly influence child development. Different patterns of ACEs among boys and girls may be associated with different developmental trajectories. OBJECTIVE This study aimed to identify patterns of ACEs at age three and tested the associations of these patterns with child behavioral health problems from age three to age fifteen. PARTICIPANTS AND SETTING This study used data (N = 4898) from the Fragile Families Child Wellbeing Study. METHODS First, this study conducted latent class analysis (LCA) across ten indicators of ACEs at age 3. LCA was conducted separately for boys and girls. Second, class membership was tested for associations with child internalizing symptoms and externalizing behaviors (ages three, five, nine, and fifteen years). RESULTS LCA identified five classes of ACEs for girls: low ACEs, parental separation, financial difficulty, chaotic home, and child maltreatment. LCA for boys, however, identified a six-class solution, in which there was a physical abuse-only class, while also a sixth high ACEs class that included both physical and emotional abuse. Classes with the most ACEs often had the highest symptomology (internalizing symptoms ranging from 0.24 to 0.56; externalizing ranging from 0.36 to 1.00; ps < .05). However, differences in behavioral health were detected depending on the patterns of ACES. At ages nine and fifteen, the financial difficulty group also had high symptomatology (internalizing symptoms ranging from 0.23 to 0.43; externalizing from 0.23 to 0.46; ps < .05). CONCLUSIONS Findings provide implications including the need to examine ACEs heterogeneity and address financial difficulty as a substantial ACE.
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Affiliation(s)
- Xiafei Wang
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA.
| | - Ryan D Heath
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Daniel Majewski
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Corinne Blake
- Department of Human Development and Family Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
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Wang X, Wu Q, Phelps BJ. How Do Fathers Help? A Moderation Analysis of the Association between Adverse Childhood Experiences and Child Behavioral Health in Fragile Families. Child Psychiatry Hum Dev 2022; 53:754-764. [PMID: 33830394 DOI: 10.1007/s10578-021-01170-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 01/09/2023]
Abstract
Existing research has built concrete links between trauma exposure and lifelong behavioral health outcomes. However, the ways by which father engagement buffers the detrimental effects of trauma on early childhood behavioral health remains unexplored. Using the data of 3001 mothers from the Fragile Families and Child Well-being Study, we conducted a moderation analysis to examine the associations between adverse childhood experiences (ACEs), child behavioral health, father engagement, and maternal education. We found that ACEs at child age three were positively associated with child externalizing and internalizing behaviors at child age five. Father engagement at child age one buffered the harmful effects of ACEs on child externalizing behaviors, but this effect was only significant for children living with mothers with an education level lower than high school. Child psychiatrists should view father engagement as a critical factor in fostering child resilience, particularly for children living in families with limited resources.
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Affiliation(s)
- Xiafei Wang
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, White Hall 220, 150 Crouse Dr, Syracuse, NY, 13244, USA.
| | - Qiong Wu
- Department of Family and Child Sciences, Florida State University, Tallahassee, FL, USA
| | - Benjamin John Phelps
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, White Hall 220, 150 Crouse Dr, Syracuse, NY, 13244, USA
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Sim A, Georgiades K. Neighbourhood and family correlates of immigrant children's mental health: a population-based cross-sectional study in Canada. BMC Psychiatry 2022; 22:447. [PMID: 35790945 PMCID: PMC9254422 DOI: 10.1186/s12888-022-04096-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Immigrant children exhibit significant variation in their mental health outcomes despite disproportionate exposure to socio-economic adversity compared to their non-immigrant peers. Identifying aspects of neighbourhood and family contexts that are most salient for immigrant children's mental health can help to inform and target interventions to prevent mental disorder and promote mental well-being among this population. METHODS The study analyzed multi-informant data from 943 first- and second-generation immigrant caregiver and child dyads from the Hamilton Youth Study, a representative sample of immigrant and non-immigrant families in Hamilton, Ontario. Multivariate multilevel regression models examined associations between neighbourhood and family characteristics and processes, and parent and child self reports of internalizing and externalizing problems. RESULTS Positive and negative parenting behaviours were significantly associated with internalizing and externalizing problems, with negative parenting demonstrating associations with externalizing problems across both parent and child reports (b = 0.26-1.27). Neighbourhood social disorder and parental trauma exposure were associated with greater internalizing and externalizing problems, and neighbourhood immigrant concentration was associated with fewer externalizing problems for parent reports only. Adding parental distress and parenting behaviour to the models reduced the coefficients for parental trauma exposure by 37.2% for internalizing problems and 32.5% for externalizing problems and rendered the association with neighbourhood social disorder non-significant. Besides the parenting variables, there were no other significant correlates of child-reported internalizing and externalizing problems. CONCLUSIONS Results highlight the importance of parenting behaviour and parental experiences of trauma and distress for immigrant children's mental health. While not unique to immigrants, the primacy of these processes for immigrant children and families warrants particular attention given the heightened risk of exposure to migration-related adverse experiences that threaten parental and family well-being. To prevent or mitigate downstream effects on child mental health, it is imperative to invest in developing and testing trauma-informed and culturally responsive mental health and parenting interventions for immigrant families.
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Affiliation(s)
- Amanda Sim
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, The Offord Centre for Child Studies, Hamilton, ON, Canada.
| | - Katholiki Georgiades
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, The Offord Centre for Child Studies, Hamilton, ON Canada
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Hege A, Bouldin E, Roy M, Bennett M, Attaway P, Reed-Ashcraft K. Adverse Childhood Experiences among Adults in North Carolina, USA: Influences on Risk Factors for Poor Health across the Lifespan and Intergenerational Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8548. [PMID: 33218030 PMCID: PMC7698730 DOI: 10.3390/ijerph17228548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/19/2020] [Accepted: 10/28/2020] [Indexed: 12/22/2022]
Abstract
Adverse childhood experiences (ACEs) are a critical determinant and predictor of health across the lifespan. The Appalachian region of the United States, particularly the central and southern portions, experiences worse health outcomes when compared to the rest of the nation. The current research sought to understand the cross-sectional relationships between ACEs, social determinants of health and other health risk factors in one southcentral Appalachian state. Researchers used the 2012 and 2014 North Carolina Behavioral Risk Factor Surveillance System (BRFSS) for analyses. An indicator variable of Appalachian county (n = 29) was used to make comparisons against non-Appalachian counties (n = 71). Analyses further examined the prevalence of ACEs in households with and without children across Appalachian and non-Appalachian regions, and the effects of experiencing four or more ACEs on health risk factors. There were no statistically significant differences between Appalachian and non-Appalachian counties in the prevalence of ACEs. However, compared with adults in households without children, those with children reported a higher percentage of ACEs. Reporting four or more ACEs was associated with higher prevalence of smoking (prevalence ratio [PR] = 1.56), heavy alcohol consumption (PR = 1.69), overweight/obesity (PR = 1.07), frequent mental distress (PR = 2.45), and food insecurity (PR = 1.58) in adjusted models and with fair or poor health only outside Appalachia (PR = 1.65). Residence in an Appalachian county was independently associated with higher prevalence of food insecurity (PR = 1.13). Developing programs and implementing policies aimed at reducing the impact of ACEs could improve social determinants of health, thereby helping to reduce health disparities.
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Affiliation(s)
- Adam Hege
- Public Health Program, Department of Health and Exercise Science, Appalachian State University, Boone, NC 28608, USA;
| | - Erin Bouldin
- Public Health Program, Department of Health and Exercise Science, Appalachian State University, Boone, NC 28608, USA;
| | - Manan Roy
- Department of Nutrition and Healthcare Management, Appalachian State University, Boone, NC 28608, USA;
| | - Maggie Bennett
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
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