1
|
Perng W, Galai N, Zhao Q, Litonjua A, Geiger S, Sauder KA, O'Shea TM, Hivert MF, Oken E, Dabelea D, Aris IM. Sociodemographic Correlates of High Cardiovascular Health Across Childhood and Adolescence: A Prospective Study Among 2 Cohorts in the ECHO Consortium. J Am Heart Assoc 2024; 13:e036279. [PMID: 39082419 DOI: 10.1161/jaha.124.036279] [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: 04/26/2024] [Accepted: 06/25/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND This study seeks to characterize cardiovascular health (CVH) from early childhood to late adolescence and identify sociodemographic correlates of high CVH that serve as levers for optimizing CVH across early life. METHODS AND RESULTS Among 1530 youth aged 3 to 20 years from 2 cohorts in the ECHO (Environmental Influences on Child Health Outcomes) consortium, we first derived CVH scores on the basis of the Life's Essential 8 construct comprising 4 behavioral (nicotine use/exposure, physical activity, sleep, and diet) and 4 health factors (body mass index, blood pressure, non-high-density lipoprotein cholesterol, and fasting glucose) during early childhood (mean age, 3.5 years), middle childhood (8.0 years), early adolescence (13.3 years), and late adolescence (17.8 years). Next, we used generalized regression to estimate the probability of high (versus not high) CVH with respect to sociodemographic characteristics. Overall CVH score was stable across life stages: 81.2±7.6, 83.3±8.0, and 81.7±8.9 of 100 possible points in early childhood, middle childhood, and early adolescence, respectively. Accordingly, during these life stages, most children (63.3%-71.5%) had high CVH (80 to <100). However, CVH declined by late adolescence, with an average score of 75.5±10.2 and 39.4% high CVH. No children had optimal CVH (score=100) at any time. Correlates of high CVH include non-Hispanic White race and ethnicity, maternal college education, and annual household income >$70 000. These associations were driven by behavioral factors. CONCLUSIONS Although most youth maintained high CVH across childhood, the decline by late adolescence indicates that cardiovascular disease prevention should occur before the early teen years. Disparities in high CVH over time with respect to sociodemographic characteristics were explained by behavioral factors, pointing toward prevention targets.
Collapse
Affiliation(s)
- Wei Perng
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center University of Colorado Anschutz Medical Campus Aurora CO
- Department of Epidemiology Colorado School of Public Health University of Colorado Anschutz Medical Campus Aurora CO
| | - Noya Galai
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Qi Zhao
- Department of Preventive Medicine College of Medicine University of Tennessee Health Science Center Memphis TN
| | - Augusto Litonjua
- Department of Pediatrics University of Rochester Medical Center Rochester NY
| | - Sarah Geiger
- Department of Kinesiology and Community Health College of Applied Health Sciences University of Illinois at Urbana-Champaign Champaign IL
| | - Katherine A Sauder
- Department of Implementation Science Wake Forest University School of Medicine Winston-Salem NC
| | - T Michael O'Shea
- Department of Pediatrics University of North Carolina School of Medicine Chapel Hill NC
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center University of Colorado Anschutz Medical Campus Aurora CO
- Department of Epidemiology Colorado School of Public Health University of Colorado Anschutz Medical Campus Aurora CO
- Department of Pediatrics School of Medicine University of Colorado Anschutz Medical Campus Aurora CO
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Boston MA
| |
Collapse
|
2
|
Lee SL, Wu LM, Lin SY, Chen TH, Lin WT. Cross-cultural translation and validation of the Chinese version Distress Tolerance Scale for adolescents with chronic physical disease. Child Care Health Dev 2024; 50:e13270. [PMID: 38706405 DOI: 10.1111/cch.13270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/18/2024] [Accepted: 03/31/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Chronic physical disease (CPD) makes life filled with many negative events in adolescents, but not all adolescents experiencing negative life events proceed to develop emotional distress, only those with low emotional distress tolerance (EDT). A valid and reliable scale to measure EDT in CPD adolescents is important for caring for their emotional distress. Therefore, the purpose of this study is to translate the 15-item English version Distress Tolerance Scale (DTS) into a Chinese version and then validate the scale for measuring EDT of adolescents with CPD. METHODS The 15-item English version DTS was translated into a Chinese version using the translation guidelines for cross-cultural research. Two cohorts of adolescents with CPD were recruited from four hospitals in southern Taiwan, with the first cohort including 124 adolescents with CPD employed to conduct exploratory factor analysis, corrected item-total correlation and reliability testing, while the second cohort, consisting of 238 adolescents with CPD, was utilized to examine confirmatory factor analysis and concurrent validity. RESULTS The two-factor nine-item Chinese version DTS for Adolescents with CPD (C-DTS-A) was developed. Lower scores of the C-DTS-A were significantly associated with higher diabetes distress, poorer self-management, and worse glycaemic control; their correlation coefficients sequentially were -.40, .17 and -.23. Cronbach's α and the test-retest reliability of the two-factor C-DTS-A ranged from .81 to .87 and from .79 to .89, respectively. CONCLUSION The two-factor nine-item C-DTS-A with good cross-cultural translation quality was a reliable and valid scale to assess EDT for adolescents with CPD.
Collapse
Affiliation(s)
- Shu-Li Lee
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Li-Min Wu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shu-Yuan Lin
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tzu-Han Chen
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neonatal Intensive Care Unit, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wei-Ting Lin
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| |
Collapse
|
3
|
Xiong JM, Su J, Ke QQ, Li YX, Gong N, Yang QH. Psychosocial adaptation profiles in young and middle-aged patients with acute myocardial infarction: a latent profile analysis. Eur J Cardiovasc Nurs 2024; 23:267-277. [PMID: 37503729 DOI: 10.1093/eurjcn/zvad071] [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: 11/07/2022] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 07/29/2023]
Abstract
AIMS We sought to explore the latent classifications of psychosocial adaptation in young and middle-aged patients with acute myocardial infarction (AMI) and analyse the characteristics of different profiles of AMI patients. METHODS AND RESULTS A cross-sectional study was performed in 438 Chinese young and middle-aged patients with AMI. The investigation time was 1 month after discharge. Three different self-report instruments were distributed to the participants, including the Psychosocial Adjustment to Illness Scale, the Perceived Stress Scale, and the Social Support Rating Scale. The seven dimensions of the Psychosocial Adjustment to Illness Scale were then used to perform a latent profile analysis. All participants signed informed consent forms in accordance with the ethical principles of the Declaration of Helsinki. Finally, a total of 411 young and middle-aged AMI patients were enrolled. Three distinct profiles were identified, including the 'well-adapted group' (44.8%), 'highlight in psychological burdens group' (25.5%), and 'poorly adapted group' (29.7%). The influencing factors included stress perception, social support, occupational type, and marital status (P < 0.05). CONCLUSION The psychosocial adaptation of young and middle-aged AMI patients can be divided into three profiles. Clinical nurses can carry out individualized psychological interventions according to the characteristics of patients in different potential profiles to improve the psychosocial adaptation of patients and the prognosis of their disease.
Collapse
Affiliation(s)
- Jia-Ming Xiong
- School of Nursing, Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou 510632, China
| | - Jin Su
- School of Nursing, Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou 510632, China
| | - Qi-Qi Ke
- School of Nursing, Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou 510632, China
| | - Yao-Xia Li
- School of Nursing, Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou 510632, China
| | - Ni Gong
- School of Nursing, Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou 510632, China
| | - Qiao-Hong Yang
- School of Nursing, Jinan University, 601 Huangpu Avenue West, Tianhe District, Guangzhou 510632, China
| |
Collapse
|
4
|
Wang J, Xie Y, Zhang Y, Xu H, Zhang X, Wan Y, Tao F. The relationship between cumulative ecological risk and health risk behaviors among Chinese adolescents. BMC Public Health 2024; 24:603. [PMID: 38403637 PMCID: PMC10895731 DOI: 10.1186/s12889-024-17934-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 01/30/2024] [Indexed: 02/27/2024] Open
Abstract
OBJECTIVES To explore the relationship between cumulative ecological risk and individual risky behavior and multiple forms of aggregated behaviors among adolescents, and examine the gender differences. METHODS A large-scale, nationally representative, and students-based investigation was conducted in rural and urban areas of eight provinces in China from October to December 2021. A total of 22 868 adolescents with an average age of 14.64 years completely standardized questionnaire in which the sociodemographic characteristics, socio-ecological risk factors and risky behaviors were used to analyze. RESULTS Of included students, 48.4% encountered the high level of social-ecological risk. The prevalence of breakfast intake not daily, alcohol use (AU), smoking, physical inactivity, prolonged screen time (ST) on weekdays and weekends, suicidal ideation, suicidal plan, suicidal attempt, and non-suicidal self-injury (NSSI) was 41.0%, 11.9%, 3.4%, 61.9%, 15.1%, 51.1%, 27.7%, 13.9%, 6.5% and 27.0% respectively. 22.2% of participants engaged in high-risk behaviors. All were significantly influences of increased cumulative ecological risk on individual behavior and low-risk clustering behaviors separately. The odds ratio of breakfast intake not daily, AU, smoking, physical inactivity, prolonged ST in weekday and weekend, suicidal ideation, suicidal plan, suicidal attempt, and NSSI for the adjusted model in low versus high level of cumulative ecological risk was respectively significant in both boy and girls, and the ratio of odds ratios (ROR) was separately 0.95 (p = 0.228), 0.67 (p < 0.001), 0.44 (p < 0.001), 0.60 (p < 0.001), 0.78 (p = 0.001), 0.83 (p = 0.001), 0.80 (p = 0.001), 0.83 (p = 0.022), 0.71 (p = 0.005), 0.75 (p = 0.001). Girls encountering a high level of cumulative ecological risk were more likely to engage in multiple forms of clustering risky behaviors than boys (RORs: 0.77, p = 0.001). CONCLUSIONS Research and effective inventions at the social-ecological environment, based on the view of cumulative risk, are needed to promote the healthy development of behaviors in adolescence, and pay more attention to decreasing the occurrence of risky behaviours in girls than boys.
Collapse
Affiliation(s)
- Jiaojiao Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yang Xie
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
- Moe Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
| | - Yi Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
- Moe Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
| | - Huiqiong Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
- Moe Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
| | - Xianglin Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yuhui Wan
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
- Moe Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China.
- Moe Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China.
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China.
| |
Collapse
|
5
|
Wang Y, Kim E, Yi Z. Robustness of Latent Profile Analysis to Measurement Noninvariance Between Profiles. EDUCATIONAL AND PSYCHOLOGICAL MEASUREMENT 2022; 82:5-28. [PMID: 34992305 PMCID: PMC8725055 DOI: 10.1177/0013164421997896] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Latent profile analysis (LPA) identifies heterogeneous subgroups based on continuous indicators that represent different dimensions. It is a common practice to measure each dimension using items, create composite or factor scores for each dimension, and use these scores as indicators of profiles in LPA. In this case, measurement models for dimensions are not included and potential noninvariance across latent profiles is not modeled in LPA. This simulation study examined the robustness of LPA in terms of class enumeration and parameter recovery when the noninvariance was unmodeled by using composite or factor scores as profile indicators. Results showed that correct class enumeration rates of LPA were relatively high with small degree of noninvariance, large class separation, large sample size, and equal proportions. Severe bias in profile indicator mean difference was observed with intercept and loading noninvariance, respectively. Implications for applied researchers are discussed.
Collapse
Affiliation(s)
- Yan Wang
- University of Massachusetts Lowell, Lowell, MA, USA
| | | | - Zhiyao Yi
- Chongqing Technology and Business University, Chongqing, China
| |
Collapse
|
6
|
Liu F, Yang D, Liu Y, Zhang Q, Chen S, Li W, Ren J, Tian X, Wang X. Use of latent profile analysis and k-means clustering to identify student anxiety profiles. BMC Psychiatry 2022; 22:12. [PMID: 34986837 PMCID: PMC8728926 DOI: 10.1186/s12888-021-03648-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/07/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Anxiety disorders are often the first presentation of psychopathology in youth and are considered the most common psychiatric disorders in children and adolescents. This study aimed to identify distinct student anxiety profiles to develop targeted interventions. METHODS A cross-sectional study was conducted with 9738 students in Yingshan County. Background characteristics were collected and Mental Health Test (MHT) were completed. Latent profile analysis (LPA) was applied to define student anxiety profiles, and then the analysis was repeated using k-means clustering. RESULTS LPA yielded 3 profiles: the low-risk, mild-risk and high-risk groups, which comprised 29.5, 38.1 and 32.4% of the sample, respectively. Repeating the analysis using k-means clustering resulted in similar groupings. Most students in a particular k-means cluster were primarily in a single LPA-derived student profile. The multinomial ordinal logistic regression results showed that the high-risk group was more likely to be female, junior, and introverted, to live in a town, to have lower or average academic performance, to have heavy or average academic pressure, and to be in schools that have never or occasionally have organized mental health education activities. CONCLUSIONS The findings suggest that students with anxiety symptoms may be categorized into distinct profiles that are amenable to varying strategies for coordinated interventions.
Collapse
Affiliation(s)
- Fang Liu
- grid.412449.e0000 0000 9678 1884School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New District, Shenyang, 110122 Liaoning China
| | - Dan Yang
- Nanchong Physical and Mental Hospital (Nanchong Sixth People’s Hospital), No.99 Jincheng Street, Yingshan County, Nanchong, 637000 Sichuan China
| | - Yueguang Liu
- Nanchong Physical and Mental Hospital (Nanchong Sixth People’s Hospital), No.99 Jincheng Street, Yingshan County, Nanchong, 637000 Sichuan China
| | - Qin Zhang
- grid.412449.e0000 0000 9678 1884School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New District, Shenyang, 110122 Liaoning China
| | - Shiyu Chen
- Nanchong Physical and Mental Hospital (Nanchong Sixth People’s Hospital), No.99 Jincheng Street, Yingshan County, Nanchong, 637000 Sichuan China
| | - Wanxia Li
- Nanchong Physical and Mental Hospital (Nanchong Sixth People’s Hospital), No.99 Jincheng Street, Yingshan County, Nanchong, 637000 Sichuan China
| | - Jidong Ren
- Nanchong Physical and Mental Hospital (Nanchong Sixth People’s Hospital), No.99 Jincheng Street, Yingshan County, Nanchong, 637000 Sichuan China
| | - Xiaobin Tian
- Nanchong Physical and Mental Hospital (Nanchong Sixth People's Hospital), No.99 Jincheng Street, Yingshan County, Nanchong, 637000, Sichuan, China. .,Department of Preventive Medicine, North Sichuan Medical College, No.234 Fujiang Road, Nanchong, 637000, Sichuan, China.
| | - Xin Wang
- School of Health Management, China Medical University, No.77 Puhe Road, Shenyang North New District, Shenyang, 110122, Liaoning, China.
| |
Collapse
|