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Tavares KL, Tsotsoros CE. The Relation Between Adverse Childhood Experiences and Health Behaviors in Adult Women. Am J Health Promot 2024; 38:778-786. [PMID: 38266029 DOI: 10.1177/08901171241229829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
PURPOSE This study aims to identify whether adverse childhood experiences (ACEs) influence health lifestyles throughout adulthood and examine how ACEs influence dimensions of health lifestyles. DESIGN The data was collected cross-sectionally through an online questionnaire. SETTING Individuals were invited to participate in an online survey for a larger brain health study as a pre-screening measure. SUBJECTS Women in the Midwest between 18-25 and 65-85 who reported either no ACEs or 3 or more ACEs completed the survey, with 233 women answering all questionnaires. MEASURES Demographic indicators, the 10-item ACEs questionnaire, and the Health Promoting Lifestyle Profile (HPLP-II). ANALYSIS Independent sample t-tests revealed significantly lower scores for ACEs group on the HPLP-II and the 6 subcategories (heath responsibility, interpersonal relationships, nutrition, physical activity, spiritual growth, and stress management). A structural equation model using the 3 ACE categories (abuse, neglect, and household dysfunction) and 6 health domains showed substantial differences in the variance captured for each health behavior. RESULTS Findings indicate that abuse predicts physical activity, stress management, and spiritual growth (β = -.21, -.23, -.20); neglect predicts interpersonal relationships and spiritual growth (β = -.17, -.18); and household dysfunction predicts health responsibility, nutrition, stress management, and interpersonal relations (β = -.20, -.22, -.10, -.17). CONCLUSION The present investigation extends research in displaying that ACEs play a significant role in future health behaviors, with household dysfunction being the greatest predictor.
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Affiliation(s)
- Karina L Tavares
- Department of Human Development & Family Science, University of Rhode Island, Kingston, RI, USA
| | - Cindy E Tsotsoros
- Department of Human Development & Family Science, University of Rhode Island, Kingston, RI, USA
- George & Ann Ryan Institue for Neuroscience, University of Rhode Island, Kingston, RI, USA
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Ko E, Kim HK. Parenting experiences of marriage immigrant women in South Korea during the COVID-19 pandemic: a descriptive phenomenological study. WOMEN'S HEALTH NURSING (SEOUL, KOREA) 2024; 30:153-163. [PMID: 38987919 PMCID: PMC11237363 DOI: 10.4069/whn.2024.05.13] [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: 01/08/2024] [Revised: 05/13/2024] [Accepted: 05/13/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE This study aimed to investigate the experiential meaning of child-rearing for marriage immigrant women in Korea in the context of the coronavirus disease 2019 (COVID-19) pandemic. METHODS Using the hermeneutic descriptive phenomenology framework developed by Colaizzi, 10 marriage immigrant women rearing preschool and school-age children were invited through purposive and snowball sampling from two multicultural support centers in Korea. The participants were rearing one or two children, and their original nationalities were Vietnamese, Japanese, Cambodian, and Chinese. Individual in-depth, face-to-face, semi-structured interviews were conducted from September 1 to November 30, 2021. We extracted significant statements from the transcripts, transformed these into abstract formulations, and organized them into theme clusters and themes to authentically capture the essence of the participants' subjective experiences. RESULTS Four theme clusters with 14 themes were derived. The four theme clusters identified were "navigating child healthcare alone," "guilt for not providing a social experience," "worry about media-dependent parenting," and "feelings of incompleteness and exclusion." This study explored the perspectives of mothers raising children as marriage migrant women who experienced physical and emotional health crises due to the COVID-19 pandemic. CONCLUSION The findings underscore that marriage immigrant women encountered heightened challenges in managing their children's health and well-being during the COVID-19 pandemic due to linguistic and cultural barriers limiting access to healthcare and information. Additionally, these women experienced considerable emotional stress from perceived inadequacies in providing a holistic social and developmental environment for their children under extensive social restrictions.
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Affiliation(s)
- Eunjung Ko
- Department of Nursing, U1 University, Youngdong, Korea
| | - Hyun Kyoung Kim
- Department of Nursing, Kongju National University, Gongju, Korea
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Hartmann M, Giovenco D, Zeebari Z, Itzikowitz G, Ekström AM, Nielsen A, Pettifor A, Bekker LG, Kågesten AE. Associations between psychosocial wellbeing and experience of gender-based violence at community, household, and intimate-partner levels among a cross-sectional cohort of young people living with and without HIV during COVID-19 in Cape Town, South Africa. BMC Public Health 2023; 23:2115. [PMID: 37891509 PMCID: PMC10612288 DOI: 10.1186/s12889-023-16945-5] [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: 12/30/2022] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Growing evidence indicates that gender-based violence (GBV) increased during COVID-19. We investigated self-reported impact of the pandemic on GBV at community, household and intimate partner (IPV) levels among young people and its associations with psychosocial wellbeing, i.e., COVID-related stressors and mental health. METHODS Cross-sectional data were drawn from a survey with young people ages 13-24 (N = 536) living with HIV (YPLWH) and without HIV (YPLWoH), in peri-urban Cape Town, South Africa. The survey, conducted February-October 2021, examined the impact of the initial lockdown on experience and perceived changes in GBV at each level, and pandemic-related psychosocial wellbeing. Descriptive statistics and binomial and multinomial regression analyses were conducted to illustrate exposure and perceived changes in GBV since lockdown, and their association with COVID-related stress factors (e.g., social isolation, anxiety about COVID), mental health (e.g., depression, anxiety), and other risk factors (e.g., age, gender, socioeconomic status) by HIV status. RESULTS Participants were 70% women with mean age 19 years; 40% were living with HIV. Since lockdown, YPLWoH were significantly more likely than YPLWH to perceive community violence as increasing (45% vs. 28%, p < 0.001), and to report household violence (37% vs. 23%, p = 0.006) and perceive it as increasing (56% vs. 27%, p = 0.002) (ref: decreasing violence). YPLWoH were also more likely to report IPV experience (19% vs. 15%, p = 0.41) and perception of IPV increasing (15% vs. 8%, p = 0.92). In adjusted models, COVID-related stressors and common mental health disorders were only associated with household violence. However, indicators of economic status such as living in informal housing (RRR = 2.07; 95% CI = 1.12-3.83) and food insecurity (Community violence: RRR = 1.79; 95% CI = 1.00-3.20; Household violence: RRR = 1.72; 95% CI = 1.15-2.60) emerged as significant risk factors for exposure to increased GBV particularly among YPLWoH. CONCLUSIONS Findings suggest that for young people in this setting, GBV at community and household levels was more prevalent during COVID-19 compared to IPV, especially for YPLWoH. While we found limited associations between COVID-related stressors and GBV, the perceived increases in GBV since lockdown in a setting where GBV is endemic, and the association of household violence with mental health, is a concern for future pandemic responses and should be longitudinally assessed.
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Affiliation(s)
- Miriam Hartmann
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
- Women's Global Health Imperative, RTI International, Berkely, CA, USA.
| | - Danielle Giovenco
- Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Zangin Zeebari
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Jönköping International Business School, Jönköping University, Jönköping, Sweden
| | - Gina Itzikowitz
- Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, South General Hospital, Stockholm, Sweden
| | - Anna Nielsen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Audrey Pettifor
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Linda-Gail Bekker
- Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
| | - Anna E Kågesten
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Kang Y, Colson-Fearon D, Kim M, Park S, Stephens M, Kim Y, Wetzler E. Socio-economic and psychosocial determinants of violent discipline among parents in Asia Pacific countries during COVID-19: Focus on disadvantaged populations. CHILD ABUSE & NEGLECT 2023; 139:106059. [PMID: 36805614 PMCID: PMC9933874 DOI: 10.1016/j.chiabu.2023.106059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/11/2023] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Mobility restrictions and economic downfall as a result of the COVID-19 pandemic may increase the risk of child maltreatment, including increased risk for violent discipline use by parents. OBJECTIVE We examined the socio-economic and psychosocial determinants of violent discipline among parents against children in Asia Pacific countries. PARTICIPANTS & SETTINGS This secondary data analysis included 7765 parents with children 6-18 years old in eight Asia Pacific countries. METHODS 24 potential determinants were identified, including household demographic factors, parents' psychosocial status, and livelihood changes. The dependent variable was parental use of violent discipline (physical, severe physical, psycho-social aggression, and any violent discipline). Univariate and multivariable logistic regression analysis was conducted. RESULTS A total of 41 % of households reported violent discipline. Parental demographic characteristics that were positively related to use of violent discipline were living in rural areas, not being a household head, female sex, age younger than 35 years, and large family size. Poor parental mental health status, loss of job or reduced income due to COVID-19, lack of food at household level, parent engagement in petty trade, and owning a business also predicted violent discipline. Mandatory curfew and receiving pandemic-related education materials were also positive predictors. CONCLUSION Some socio-demographic factors, economic hardship due to COVID-19, and poor mental health status of parents are associated with the use of violent discipline against children in the Asia Pacific region. These results highlight several potential target areas for child protection interventions by governmental and non-profit organizations, including economic, social, and mental health interventions.
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Affiliation(s)
- Yunhee Kang
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.
| | - Darien Colson-Fearon
- Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Myungsun Kim
- Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Soim Park
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | | | - Yunseop Kim
- College of Medicine, Korea University, Seoul, South Korea
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Bravo LG, Ahmed C, Choi K. Addressing Social Context in Adverse Childhood Experience Screening Policy: Implications for Children With Special Health Care Needs. J Pediatr Health Care 2023; 37:213-216. [PMID: 36460544 DOI: 10.1016/j.pedhc.2022.11.010] [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: 09/23/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 12/02/2022]
Abstract
Adverse childhood experiences (ACEs) disproportionately affect children with special health care needs, especially racial and ethnic minority children whose ACEs may be less likely to be identified. As awareness and understanding of the health impacts of ACEs have increased, heightened by the COVID-19 pandemic, several areas of the United States have initiated policy efforts to screen for and address ACEs. However, these policies do not always include mechanisms to account for context-specific adversity or contemporary stressors in the lives of children. Stressors most significant in a child's life may include adversities beyond those included in common ACE screening instruments. ACE policy in California will be discussed relative to addressing the social context in ACEs screening. By taking a holistic view of ACEs and thinking beyond deriving ACE scores alone, clinicians can ensure that ACE-related policies are implemented with maximum benefit to diverse children with special health care needs.
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Choudhury S, Yeh PG, Markham CM. Coping with adverse childhood experiences during the COVID-19 pandemic: Perceptions of mental health service providers. Front Psychol 2022; 13:975300. [PMID: 36160597 PMCID: PMC9493451 DOI: 10.3389/fpsyg.2022.975300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/22/2022] [Indexed: 11/21/2022] Open
Abstract
Background Adverse Childhood Experiences (ACEs) have been associated with long-term physical and mental health conditions, toxic stress levels, developing unstable interpersonal relationships, and substance use disorders due to unresolved childhood adversities. Aims This study assessed the perspectives of mental health providers (MHPs) regarding their adult patients’ coping with ACEs during COVID-19 in Houston, Texas. Specifically, we explored how individuals with ACEs are coping with the increased stresses of the pandemic, how MHPs may provide therapeutic support for individuals with ACEs during this pandemic, pandemic-related challenges of accessing and utilizing mental health services for individuals with ACEs, and the awareness and treatment of ACEs among MHPs. Methods Ten in-depth semi-structured virtual interviews were conducted with licensed MHPs from November 2021 to April 2022 in Houston, Texas. Interviews were coded and analyzed for emerging themes through an inductive open coding approach to discover insights regarding coping with ACEs during COVID-19. Results Four key themes experienced by individuals with ACEs emerged from the MHP interviews: (1) Maladaptive emotional dissonance and coping outlets during the pandemic, (2) Difficulties with social connectedness and significance of social support, (3) Heightened daily life stressors and coping with the ongoing disruption of the pandemic, and (4) Changing interactions with the mental health system. Themes from this study highlighted that resilience, seeking treatment, and strong social support can help develop healthy coping strategies among individuals with ACEs. Conclusion This study may help inform best clinical practices to develop interventions and policies regarding ACEs such as a resilience-promotion approach that targets all the socio-ecological levels. In addition, findings highlight the synergy of psychotherapeutic and pharmacological management via tele-health modalities, in helping individuals with ACEs continue receiving the care they deserve and need during a persistent pandemic and an uncertain future.
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Affiliation(s)
- Sumaita Choudhury
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
- *Correspondence: Sumaita Choudhury,
| | - Paul G. Yeh
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, The University of Texas Health Science Center at Houston School of Public Health, Brownsville, TX, United States
| | - Christine M. Markham
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
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Abstract
PURPOSE OF REVIEW This paper reviews the literature on the prevalence, risk factors, and effects of traumatic experiences on the mental health outcomes of minority youth in the USA. RECENT FINDINGS The USA has an increasing number of children and youth from minority backgrounds. Research reveals that traumatic experiences disproportionately affect minority youth. These experiences include historical/generational trauma, immigration and acculturation stressors, natural and manmade disasters, experiences of discrimination, family violence, and community violence. The COVID-19 pandemic has also disproportionately affected minority youth resulting in illness and hospitalizations. Despite the higher incidence of trauma exposure, minority youth are less likely to access medical and mental health care. These disparities are resulting in increasing rates of depression, anxiety, post-traumatic stress, substance use disorders, and suicide in minority youth. Recognizing and understanding the impact of trauma is critical to the healthy development and successful functioning of minority youth, and to the success of our nation.
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Affiliation(s)
- Andres J Pumariega
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Youngsuhk Jo
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Brent Beck
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Mariam Rahmani
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA.
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