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Ramos SD, Vincent W, Siconolfi DE, Pollack LM, Horvath KJ, Campbell CK, Tebbetts S, Kegeles SM, Storholm ED. Differential Associations of Depressive Symptomology to HIV Care Engagement Among Young Black Sexual Minority Men with HIV (YBSMM+) in the US South: A Multi-Group Analysis of Mood, Intimate Partner Violence, and Alcohol Use. AIDS Behav 2024; 28:774-785. [PMID: 37796375 DOI: 10.1007/s10461-023-04186-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/06/2023]
Abstract
Young Black Sexual Minority Men with HIV (YBSMM+) in the US South encounter multiple socio-structural challenges that contribute to disproportionately poor HIV-related outcomes across the care continuum. Depression, anxiety, intimate partner violence (IPV), and alcohol use are prominent factors that negatively impact engagement with HIV care. Syndemic theory posits that these multiple factors interact synergistically to promote poor outcomes; however, depression itself is highly heterogeneous in presentation, which may pose issues when examining associations to HIV care engagement. This study sought to better understand the associations of specific depressive symptomology subtypes, generalized anxiety, experienced IPV, and alcohol use on HIV care engagement for YBSMM+. Results showed that interpersonally oriented depressive symptomatology was associated with increased HIV care engagement among YBSMM + who abstained from alcohol. On the other hand, among YBSMM + who frequently binge drank, combined negative affect and somatic components of depressive symptomatology and frequency of IPV experiences were associated with decreased HIV care engagement while generalized anxiety was associated with increased HIV care engagement. The findings suggest that the negative affect and somatic components of depression may be particularly salient for HIV care engagement among YBSMM + who binge drink frequently. Developing targeted interventions that address these specific conditions while accounting for the nuances of mood-based symptomatology could improve intervention efforts geared towards improving HIV care engagement among YBSMM+.
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Affiliation(s)
- Stephen D Ramos
- Department of Medicine, Division of Infectious Disease and Global Public Health, University of California San Diego, 6475 Alvarado Road, Suite 118, San Diego, CA, 92120, USA.
- SDSU Research Foundation, San Diego State University, San Diego, CA, USA.
| | - Wilson Vincent
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | | | - Lance M Pollack
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Keith J Horvath
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | | | - Scott Tebbetts
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Susan M Kegeles
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Erik D Storholm
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
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STOLT M, KOTTORP A, SUHONEN R. The use and quality of reporting of Rasch analysis in nursing research: a methodological scoping review. Int J Nurs Stud 2022; 132:104244. [DOI: 10.1016/j.ijnurstu.2022.104244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 11/24/2022]
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Zhu J, Chiu MM. Gender- and age-bias in CES-D when measuring depression in China: A Rasch analysis. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01991-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gutman SA, Precin P, LaForest ML, Chu A, Diaz M, Engel R, Epino K, Gotlieb R, Hart L, Plaus N, Xing S, Zimmer A. The Association between LGBTQIA+ Self-Identification and Factors Facilitating Homelessness: A Scoping Review of the Occupational Therapy Peer-Reviewed Literature. Occup Ther Health Care 2021; 35:138-181. [PMID: 33761821 DOI: 10.1080/07380577.2021.1901171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The purpose of this paper was to perform a scoping review examining the occupational therapy peer-reviewed literature regarding the LGBTQIA+ community to (a) determine what types of scholarship have been generated and (b) whether the association between LGBTQIA+ self-identification and homelessness has been identified and addressed in occupational therapy practice. A database search of seven peer-reviewed, health care publication indexes, with 19 key search terms was performed. The database search targeted articles published prior to January 2020. Fifty-three articles were identified within the occupational therapy literature and addressing the LGBTQIA+ community. The majority of this literature (n = 40) was exploratory studies through which researchers sought to better understand the unique needs of subgroups within the LGBTQIA+ community. Only three articles addressed the link between LGBTQIA+ self-identification and homelessness with no articles that addressed evaluation and intervention of the factors predisposing this population to homelessness. As occupational therapists have a unique skill set that could be used to help LGBTQIA+ community members transition from and remain free from homelessness, occupational therapy researchers must develop and assess interventions that target these factors. Occupational therapy educators should develop and assess curricular programming to heighten student comfort and preparedness in service delivery to this community.
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Affiliation(s)
- Sharon A Gutman
- Occupational Therapy Doctorate Program, Department of Rehabilitation and Movement Science, Rutgers University, Newark, New Jersey
| | - Pat Precin
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | | | - Alison Chu
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Maria Diaz
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Rena Engel
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Katarina Epino
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Rachel Gotlieb
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Lara Hart
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Nicole Plaus
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Susan Xing
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
| | - Alana Zimmer
- Occupational Therapy, Columbia University Medical Center, New York, NY, USA
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Miller AP, Kintu M, Kiene SM. Challenges in measuring depression among Ugandan fisherfolk: a psychometric assessment of the Luganda version of the Center for Epidemiologic Studies Depression Scale (CES-D). BMC Psychiatry 2020; 20:45. [PMID: 32024472 PMCID: PMC7003345 DOI: 10.1186/s12888-020-2463-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 01/24/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Depression is a prevalent and serious mood disorder and a major source of disability adjusted life years (DALY) in Uganda. Furthermore, evidence from Uganda and other countries throughout sub-Saharan Africa suggests that nearly a third of persons living with human immunodeficiency virus (HIV) suffer from depression and it adversely affects healthcare seeking behavior. The high burden of disease attributable to depression makes data on the prevalence of depression in Uganda, a country with a generalized HIV epidemic, a public health priority. This paper describes the psychometric properties of the Center for Epidemiologic Studies-Depression (CES-D) measure when administered to men and women residing in three fishing communities along the shore of Lake Victoria. METHODS We applied methods based on item response theory and classical test theory approaches to assess individual item characteristics, conducted exploratory factor analysis and assessed internal reliability, and construct and content validity of the measure. All analyses were performed in R Studio. RESULTS The study sample consisted of 300 residents of fishing communities in Wakiso District, Uganda. Fifty-six percent of the sample was female and 19.7% reported being HIV positive. Seven items of the measure that did not perform well, either because they could not differentiate between levels of the latent trait or because they did not map onto the primary factor, were removed from the scale. A single factor structure best fit our final set of 13-items and we found an overall coefficient alpha of 0.89, indicating high internal consistency in this population. CONCLUSIONS Based on our findings, we recommend that future use of the CES-D in this population utilize our revised scale with the final set of 13-items. The addition of other measures that can improve the rigor of CES-D validation efforts, such as inclusion of a clinical depression measure and administration in both a clinical and a general population sample in this setting are needed.
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Affiliation(s)
- Amanda P. Miller
- Division of Infectious Disease and Global Public Health, University of California, San Diego, La Jolla, CA USA ,0000 0001 0790 1491grid.263081.eDivision of Epidemiology and Biostatistics, San Diego State University School of Public Health, 5500 Campanile Drive (MC-4162), San Diego, CA 92182 USA
| | - Michael Kintu
- Wakiso Integrated Rural Development Association, Entebbe, Uganda
| | - Susan M. Kiene
- 0000 0001 0790 1491grid.263081.eDivision of Epidemiology and Biostatistics, San Diego State University School of Public Health, 5500 Campanile Drive (MC-4162), San Diego, CA 92182 USA ,0000 0004 1936 9094grid.40263.33Alcohol Research Center of HIV, Brown University School of Public Health, Providence, RI USA
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Radusky PD, Rodriguez VJ, Kumar M, Jones DL. Differential Item Functioning by HIV Status and Sexual Orientation of the Center for Epidemiological Studies-Depression Scale: An Item Response Theory Analysis. Assessment 2019; 28:1173-1185. [PMID: 31718240 DOI: 10.1177/1073191119887445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Center for Epidemiological Studies-Depression Scale (CES-D) is the most widely used instrument to assess depressive symptoms in people living with HIV. However, its differential item functioning (DIF) by HIV status and sexual orientation has yet to be explored. This study examined DIF and measurement invariance of the CES-D using an item response theory (IRT) framework, and a more traditional factor analytic approach. Data from 841 HIV-infected and HIV-uninfected individuals, from Miami, Florida, were analyzed. Uniform DIF by HIV status was detected in Items 4, 12, and 16 from the Positive Affect factor. Nonuniform DIF was detected in Items 13 and 17. Uniform DIF by sexual orientation was detected in Items 2, 15, and 19, two of them from the Interpersonal factor. Nonuniform DIF was detected in Item 2. Using a factor analytic approach, the CES-D was invariant at the configural and metric levels by HIV and sexual orientation. These findings indicate that overall, however, using IRT, the magnitudes of DIF were negligible, the CED-D was somewhat invariant using factor analytic methods; the CES-D may be reliably used to compare by HIV status or sexual orientation.
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Affiliation(s)
- Pablo D Radusky
- Universidad de Buenos Aires, Buenos Aires, Argentina.,Fundación Huésped, Buenos Aires, Argentina
| | - Violeta J Rodriguez
- University of Miami Miller School of Medicine, Miami, FL, USA.,University of Georgia, Athens, GA, USA
| | - Mahendra Kumar
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Deborah L Jones
- University of Miami Miller School of Medicine, Miami, FL, USA
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Métral M, Darling K, Locatelli I, Nadin I, Santos G, Brugger P, Kovari H, Cusini A, Gutbrod K, Tarr PE, Calmy A, Lecompte TD, Assal F, Monsch A, Kunze U, Stoeckle M, Schwind M, Schmid P, Pignatti R, Di Benedetto C, Du Pasquier R, Cavassini M. The Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study: baseline participant profile. HIV Med 2019; 21:30-42. [PMID: 31589807 PMCID: PMC6916574 DOI: 10.1111/hiv.12795] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2019] [Indexed: 02/05/2023]
Abstract
Objectives The aim of the study was to examine baseline neurocognitive impairment (NCI) prevalence and factors associated with NCI among patients enrolled in the Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study. Methods The NAMACO study is an ongoing, prospective, longitudinal, multicentre and multilingual (German, French and Italian) study within the Swiss HIV Cohort Study. Between 1 May 2013 and 30 November 2016, 981 patients ≥ 45 years old were enrolled in the study. All underwent standardized neuropsychological (NP) assessment by neuropsychologists. NCI was diagnosed using Frascati criteria and classified as HIV‐associated or as related to other factors. Dichotomized analysis (NCI versus no NCI) and continuous analyses (based on NP test z‐score means) were performed. Results Most patients (942; 96.2%) had viral loads < 50 HIV‐1 RNA copies/mL. NCI was identified in 390 patients (39.8%): 263 patients (26.8%) had HIV‐associated NCI [249 patients (25.4%) had asymptomatic neurocognitive impairment (ANI)] and 127 patients (13%) had NCI attributable to other factors, mainly psychiatric disorders. There was good correlation between dichotomized and continuous analyses, with NCI associated with older age, non‐Caucasian ethnicity, shorter duration of education, unemployment and longer antiretroviral therapy duration. Conclusions In this large sample of aging people living with HIV with well‐controlled infection in Switzerland, baseline HIV‐associated NCI prevalence, as diagnosed after formal NP assessment, was 26.8%, with most cases being ANI. The NAMACO study data will enable longitudinal analyses within this population to examine factors affecting NCI development and course.
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Affiliation(s)
- M Métral
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - Kea Darling
- Service of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - I Locatelli
- Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
| | - I Nadin
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland.,Service of Neurology, University Hospital of Geneva, Geneva, Switzerland
| | - G Santos
- Service of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - P Brugger
- Neuropsychology Unit, Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - H Kovari
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - A Cusini
- Department of Infectious Diseases and Hospital Epidemiology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - K Gutbrod
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - P E Tarr
- University Department of Medicine, Kantonsspital Bruderholz, University of Basel, Bruderholz, Switzerland
| | - A Calmy
- HIV Unit, Infectious Diseases Division, Medicine Department, University Hospital of Geneva, Geneva, Switzerland
| | - T D Lecompte
- HIV Unit, Infectious Diseases Division, Medicine Department, University Hospital of Geneva, Geneva, Switzerland
| | - F Assal
- Service of Neurology, University Hospital of Geneva, Geneva, Switzerland
| | - A Monsch
- Memory Clinic, Felix Platter Hospital, University Center for Medicine of Aging, Basel, Switzerland
| | - U Kunze
- Memory Clinic, Felix Platter Hospital, University Center for Medicine of Aging, Basel, Switzerland
| | - M Stoeckle
- Infectious Diseases Unit, Basel, Switzerland
| | - M Schwind
- Neurology Clinic, St Gallen, Switzerland
| | - P Schmid
- Infectious Diseases and Hospital Epidemiology Division, Kantonsspital St Gallen, St Gallen, Switzerland
| | - R Pignatti
- Department of Neurology, Neurocentre of Southern Switzerland, Lugano Regional Hospital, Lugano, Switzerland
| | - C Di Benedetto
- Infectious Diseases Unit, Lugano Regional Hospital, Lugano, Switzerland
| | - R Du Pasquier
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - M Cavassini
- Service of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland
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Getnet B, Alem A. Validity of the Center for Epidemiologic Studies Depression Scale (CES-D) in Eritrean refugees living in Ethiopia. BMJ Open 2019; 9:e026129. [PMID: 31064806 PMCID: PMC6528005 DOI: 10.1136/bmjopen-2018-026129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 02/28/2019] [Accepted: 03/04/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Depression is among the top mental health problems with a major contribution to the global burden of disease. This study aimed at identifying the latent factor structure and construct validity of the Center for Epidemiologic Studies Depression (CES-D) Scale. PARTICIPANTS AND SETTING A cross-sectional survey of 562 adults aged 18 years and above who were randomly selected from the Eritrean refugee community living in the Mai-Aini refugee camp, Ethiopia. MEASURES The CES-D Scale, Primary Care PTSD (PC-PTSD) screener, premigration and postmigration living difficulties checklist, Oslo Social Support Scale (OSS-3), Sense of Coherence Scale (SoC-13), Coping Style Scale and fast alcohol screening test (FAST) were administered concurrently. Confirmatory factor analysis was employed to test prespecified factor structures of CES-D. RESULT First-order two factors with second-order common factor structure of CES-D (correlated error terms) yielded the best fit to the data (Comparative Fit Index =0.975; root mean square error of approximation=0.040 [90% CI 0.032 to 0.047]). The 16 items defining depressive affect were internally consistent (Cronbach's α=0.932) and internal consistency of the 4 items defining positive affect was relatively weak (Cronbach's α=0.703). These two latent factors have a weaker standardised covariance estimate of 33% (24% for women and 40% for men), demonstrating evidence of discriminant validity. CES-D is significantly associated with measures of adversities, specifically, premigration living difficulties (r=0.545, p<0.001) and postmigration living difficulties (r=0.47, p<0.001), PC-PTSD (r=0.538, p<0.001), FAST (r=0.197, p<0.001) and emotion-oriented coping (r=0.096, p˂0.05) providing evidence of its convergent validity. It also demonstrated inverse association with measures of resilience factors, specifically, SoC-13 (r=-0.597, p<0.001) and OSS-3 (r=-0.319, p<0.001). The two correlated factors model of CES-D demonstrated configural, metric, scalar, error variance and structural covariance invariances (p>0.05) for both men and women. CONCLUSIONS Unlike previous findings among Eritreans living in USA, second-order two factors structure of CES-D best fitted the data for Eritrean refugees living in Ethiopia; this implies that it is important to address culture for the assessment and intervention of depression.
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Affiliation(s)
- Berhanie Getnet
- Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychology, University of Gondar, Gondar, Ethiopia
| | - Atalay Alem
- Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- Consultant Psychiatrist, Amanuel Hospital, Addis Ababa, Ethiopia
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Psychometric properties and validity of the Center for Epidemiological Studies Depression Scale (CES-D) in a population attending an HIV clinic in Cali, Colombia. BIOMEDICA 2019; 39:33-45. [PMID: 31021545 DOI: 10.7705/biomedica.v39i1.3843] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Depression in people living with HIV/AIDS is associated with poor health outcomes. Despite this, assessment of depressive symptoms is not a routine clinical practice in the care of people with HIV in Colombia. One reason could be the lack of validated depression screening scales for this population. OBJECTIVE To test the reliability and construct validity of the 20- and 10-item-Center for Epidemiological Studies Depression Scale in patients attending an HIV clinic in Cali, Colombia. MATERIALS AND METHODS A non-random sample of 105 adults was enrolled. The 20 item-CES-D (CES-D-20) scale was administered twice: At baseline and 2-4 weeks later. We calculated the Cronbach's alpha coefficient and the intraclass correlation coefficient. In addition, we used an exploratory and confirmatory factorial analysis, as well as the item response theory to assess the validity of the scale. RESULTS Most participants were men (73%), with a mean age of 40 years, 53% of whom had not completed high school. Cronbach's coefficients were 0.92 and 0.94 at baseline and at the second interview, respectively. The intraclass correlation was 0.81 (95% CI: 0.72-0.88). Although all 20 items loaded distinctly in 4 factors, 5 items did not load as expected. The structure factor of the CES-D-20 was not confirmed, as 4 items had poor goodness of fit. The CES-D-10 appeared to perform better in this population. CONCLUSIONS These results support the reliability and validity of the CES-D-10 instrument to screen for depressive symptoms in people living with HIV in Colombia.
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Beam CR, Collins EM. Trajectories of Depressive Symptomatology and Loneliness in Older Adult Sexual Minorities and Heterosexual Groups. Clin Gerontol 2019; 42:172-184. [PMID: 30321105 PMCID: PMC6375292 DOI: 10.1080/07317115.2018.1518283] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This article examines whether sexual minority men and women experience greater increases in depressive symptoms and loneliness with age compared to heterosexual men and women. METHODS Using three waves of data from sexual minority (nMen = 87 and nWomen = 62) and heterosexual (nMen = 1,297 and nWomen = 1,362) older adults in the National Social Life, Health, and Aging Project, we used latent growth curve modeling to test whether change in depressive symptoms and loneliness varies across sexual orientation and whether annual household income and family support accounted for this change. RESULTS Although differences in the growth trajectories of depressive symptoms and loneliness across sexual orientation were not observed, gender differences were. Annual household income and family support more strongly influenced initial depressive symptoms and loneliness in sexual minority men and women than in heterosexual men and women. CONCLUSIONS Trajectories of depressive symptoms and loneliness in older adulthood do not vary by sexual orientation. Economic and family resources may allow sexual minorities to cope effectively with depressive symptoms and loneliness. CLINICAL IMPLICATIONS Clinicians should be cautious about assuming that older sexual minority group members are more susceptible to depressive symptoms and loneliness than heterosexual groups by virtue of their sexual preference.
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Affiliation(s)
- Christopher R Beam
- a Psychology , University of Southern California Dana and David Dornsife College of Letters Arts and Sciences , Los Angeles , USA
| | - Emma M Collins
- a Psychology , University of Southern California Dana and David Dornsife College of Letters Arts and Sciences , Los Angeles , USA
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Tuthill EL, Sheira LA, Palar K, Frongillo EA, Wilson TE, Adedimeji A, Merenstein D, Cohen MH, Wentz EL, Adimora AA, Ofotokun I, Metsch L, Kushel M, Turan JM, Konkle-Parker D, Tien PC, Weiser SD. Persistent Food Insecurity Is Associated with Adverse Mental Health among Women Living with or at Risk of HIV in the United States. J Nutr 2019; 149:240-248. [PMID: 30753638 PMCID: PMC6698636 DOI: 10.1093/jn/nxy203] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/04/2018] [Accepted: 08/02/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Food insecurity and mental health negatively affect the lives of women in the United States. Participants in the Women's Interagency HIV Study (WIHS) provided the opportunity to understand the association of food insecurity with depression and mental well-being over time. OBJECTIVE We investigated the association between current and persistent food insecurity and depression among women at risk of or living with HIV in the United States. METHODS We used longitudinal data from the WIHS, a prospective cohort study in women at risk of or living with HIV from multiple sites in the United States. Participants completed 6 semiannual assessments from 2013 to 2016 on food security (FS; high, marginal, low, and very low) and mental health (i.e., depressive symptoms and mental well-being). We used multiple regression analysis to estimate the association between these variables. RESULTS Among 2551 participants, 44% were food insecure and 35% reported depressive symptoms indicative of probable depression. Current marginal, low, and very low FS were associated with 2.1-, 3.5-, and 5.5-point (all P < 0.001) higher depression scores, respectively. In models adjusting for both current and previous FS, previous marginal, low, and very low FS were associated with 0.2-, 0.93-, and 1.52-point higher scores, respectively (all P < 0.001). Women with very low FS at both time points (persistent food insecurity) had a 6.86-point higher depression score (P < 0.001). In the mental health models, there was a dose-response relation between current FS and worse mental health even when controlling for previous FS (all P < 0.001). Previous low FS was associated with worse mental health. These associations did not differ by HIV status. CONCLUSIONS Food insecurity placed women at risk of depression and poor mental well-being, but the risk was substantially higher for women experiencing persistent food insecurity. Future interventions to improve women's mental health call for multilevel components that include addressing food insecurity.
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Affiliation(s)
- Emily L Tuthill
- Department of Community Health Systems, School of Nursing, San Francisco, San Francisco, CA
| | - Lila A Sheira
- Division of HIV, Infectious Disease, and Global Medicine, San Francisco, San Francisco, CA
| | - Kartika Palar
- Division of HIV, Infectious Disease, and Global Medicine, San Francisco, San Francisco, CA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC
| | - Tracey E Wilson
- Department of Community Health Sciences, State University of New York Downstate Medical Center, School of Public Health, Brooklyn, NY
| | - Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Daniel Merenstein
- Department of Family Medicine, Georgetown University Medical Center, Washington, DC
| | | | - Eryka L Wentz
- Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Baltimore, MD
| | - Adaora A Adimora
- School of Medicine and Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Ighovwerha Ofotokun
- School of Medicine, Emory University, Atlanta, GA
- Grady Healthcare System, Atlanta, GA
| | - Lisa Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Margot Kushel
- Division of General Internal Medicine at San Francisco General Hospital, University of California, San Francisco, San Francisco, CA
| | - Janet M Turan
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Deborah Konkle-Parker
- Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Phyllis C Tien
- Department of Medicine, San Francisco, San Francisco, CA
- Medical Service, Department of Veteran Affairs Medical Center, San Francisco, CA
| | - Sheri D Weiser
- Division of HIV, Infectious Disease, and Global Medicine, San Francisco, San Francisco, CA
- Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA
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12
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East African HIV care: depression and HIV outcomes. Glob Ment Health (Camb) 2019; 6:e9. [PMID: 31258923 PMCID: PMC6582461 DOI: 10.1017/gmh.2019.6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/05/2019] [Accepted: 04/22/2019] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE Depression is a common co-morbidity for people living with HIV (PLWH) and is associated with elevated plasma HIV RNA levels. While depression correlates with deficits in antiretroviral (ARV) adherence, little data exist to inform the relationship between depression and HIV vial load more broadly. OBJECTIVE To examine the relationship between depression and viral load in the African Cohort Study (AFRICOS) independently of ARV adherence. DESIGN PLWH in Kenya, Uganda and Tanzania underwent screening for depression using the Center for Epidemiologic Studies Depression Scale (CESD) upon enrollment at AFRICOS HIV care sites. SETTING AFRICOS is an ongoing prospective longitudinal cohort study enrolling HIV-infected adults at HIV care centers including sites in Kenya, Tanzania and Uganda. These sites are administered by President's Emergency Plan For AIDS Relief programs. PARTICIPANTS HIV+ individuals were eligible if they were at least 18 years old, receiving HIV care at the enrolling clinic and consented to data and specimen collection. MAIN OUTCOME MEASURE CESD. RESULTS Among 2307 participants, 18-25% met the CESD threshold for depression. Depression was associated with decreased ARV adherence (OR 0.59, p = 0.01). Higher scores on three CESD items were significantly associated with 209-282% higher viral load, independently of ARV adherence among participants on ARVs ⩾6 months. CONCLUSIONS PLWH had high prevalence of depression on the CESD. Diverse depression symptoms were independently associated with increases in viral load, underscoring the need for comprehensive treatment of depression.
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Reyes CC, Anderson KO, Gonzalez CE, Ochs HC, Wattana M, Acharya G, Todd KH. Depression and survival outcomes after emergency department cancer pain visits. BMJ Support Palliat Care 2018; 9:e36. [PMID: 30171043 DOI: 10.1136/bmjspcare-2018-001533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 07/30/2018] [Accepted: 08/08/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Pain and depression frequently co-occur in patients with cancer. Although pain is a common reason for emergency department (ED) presentation by these patients, depression frequently goes unrecognised during an ED visit. In this study, we assessed the risk for depression in patients with cancer presenting to the ED for uncontrolled pain and assessed the extent to which the risk for depression was associated with survival in this population. METHODS Participants were consecutive patients with cancer taking Schedule II opioids (n=209) who presented to the ED of a tertiary cancer centre for uncontrolled pain. Risk for depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), excluding the somatic symptoms. Survival was calculated from date of ED visit to date of death/last follow-up. RESULTS The CES-D was completed by 197 of 209 participants (94.3%); of these, 81 of 197 (41.1%) had high risk for depression (CES-D ≥10). The mean survival time for the entire sample was 318 days (SD=33), with 84 deaths. Cox proportional hazards regression modeling showed that risk for depression and disease stage (CES-D ≥10: HR=1.75, 95% CI 1.11 to 2.78, p=0.016; disease stage: HR=2.52, 95% CI 1.20 to 5.30, p<0.001) were significant factors for survival. CONCLUSIONS Risk for depression was prevalent and associated with survival outcomes in patients with cancer presenting to the ED with uncontrolled pain. Screening for risk for depression in the ED may identify patients who need referral for clinical assessment of depression. Diagnosis and adequate treatment could improve health outcomes and survival rates for these patients.
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Affiliation(s)
- Cielito C Reyes
- Departments of Emergency Medicine and Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Karen O Anderson
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carmen E Gonzalez
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Haley Candra Ochs
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Monica Wattana
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Gyanendra Acharya
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Knox H Todd
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Alexandrowicz RW, Jahn R, Wancata J. Assessing the dimensionality of the CES-D using multi-dimensional multi-level Rasch models. PLoS One 2018; 13:e0197908. [PMID: 29799866 PMCID: PMC5969764 DOI: 10.1371/journal.pone.0197908] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 05/10/2018] [Indexed: 11/19/2022] Open
Abstract
Objectives The CES-D is a widely used depression screening instrument. While numerous studies have analysed its psychometric properties using exploratory and various kinds of confirmatory factor analyses, only few studies used Rasch models and none a multidimensional one. Methods The present study applies a multidimensional Rasch model using a sample of 518 respondents representative for the Austrian general population aged 18 to 65. A one-dimensional model, a four-dimensional model reflecting the subscale structure suggested by [1], and a four-dimensional model with the background variables gender and age were applied. Results While the one-dimensional model showed relatively good fit, the four-dimensional model fitted much better. EAP reliability indices were generally satisfying and the latent correlations varied between 0.31 and 0.88. In the analysis involving background variables, we found a limited effect of the participants’ gender. DIF effects were found unveiling some peculiarities. The two-items subscale Interpersonal Difficulties showed severe weaknesses and the Positive Affect subscale with the reversed item wordings also showed unexpected results. Conclusions While a one-dimensional over-all score might still contain helpful information, the differentiation according to the latent dimension is strongly preferable. Altogether, the CES-D can be recommended as a screening instrument, however, some modifications seem indicated.
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Affiliation(s)
| | - Rebecca Jahn
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Johannes Wancata
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Kelso-Chichetto NE, Okafor CN, Cook RL, Abraham AG, Bolan R, Plankey M. Association Between Depressive Symptom Patterns and Clinical Profiles Among Persons Living with HIV. AIDS Behav 2018; 22:1411-1422. [PMID: 28593404 DOI: 10.1007/s10461-017-1822-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
To describe patterns of depressive symptoms across 10-years by HIV status and to determine the associations between depressive symptom patterns, HIV status, and clinical profiles of persons living with HIV from the Multicenter AIDS Cohort Study (N = 980) and Women's Interagency HIV Study (N = 1744). Group-based trajectory models were used to identify depressive symptoms patterns between 2004 and 2013. Multinomial logistic regressions were conducted to determine associations of depression risk patterns. A 3-group model emerged among HIV-negative women (low: 58%; moderate: 31%; severe: 11%); 5-groups emerged among HIV-positive women (low: 28%; moderate: 31%; high: 25%; decreased: 7%; severe: 9%). A 4-group model emerged among HIV-negative (low: 52%; moderate: 15%; high: 23%; severe: 10%) and HIV-positive men (low: 34%; moderate: 34%; high: 22%; severe: 10%). HIV+ women had higher odds for moderate (adjusted odds ratio [AOR] 2.10, 95% CI 1.63-2.70) and severe (AOR 1.96, 95% CI 1.33-2.91) depression risk groups, compared to low depression risk. HIV+ men had higher odds for moderate depression risk (AOR 3.23, 95% CI 2.22-4.69), compared to low risk. The Framingham Risk Score, ART use, and unsuppressed viral load were associated with depressive symptom patterns. Clinicians should consider the impact that depressive symptoms may have on HIV prognosis and clinical indicators of comorbid illnesses.
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Affiliation(s)
- N E Kelso-Chichetto
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, PO Box 100231, CTRB 4233, Gainesville, FL, 32610, USA.
| | - C N Okafor
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - R L Cook
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, PO Box 100231, CTRB 4233, Gainesville, FL, 32610, USA
| | - A G Abraham
- Department of Ophthalmology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - R Bolan
- Los Angeles LGBT Center, Los Angeles, CA, USA
| | - M Plankey
- Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
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Beaulieu T, Ti L, Milloy MJ, Nosova E, Wood E, Hayashi K. Major depressive disorder and access to health services among people who use illicit drugs in Vancouver, Canada. Subst Abuse Treat Prev Policy 2018; 13:3. [PMID: 29351757 PMCID: PMC5775557 DOI: 10.1186/s13011-018-0142-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/12/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND People who use illicit drugs (PWUD) are commonly diagnosed with major depressive disorder (MDD). However, little is known about whether PWUD living with MDD experience additional barriers to accessing health services compared to those without MDD. We sought to identify whether MDD symptoms were associated with perceived barriers to accessing health services among people who use illicit drugs (PWUD) in Vancouver, Canada. METHODS Data were collected through prospective cohorts of PWUD in Vancouver, Canada between 2005 and 2016. Using multiple logistic regression, we examined the relationship between MDD symptoms, defined as a Centre for Epidemiologic Studies Depression (CES-D) scale total score of ≥16, and barriers to access health services. We also used descriptive statistics to examine common barriers among participants who reported any barriers. RESULTS Among a total of 1529 PWUD, including 521 (34.1%) females, 415 (27.1%) reported barriers to accessing health services, and 956 (62.5%) reported MDD symptoms at baseline. In multiple logistic regression analyses, after adjusting for a range of potential confounders, MDD symptoms (adjusted odds ratio [AOR] = 1.40; 95% confidence interval [CI]: 1.03-1.92) were positively and significantly associated with barriers to accessing health services. Among those who reported MDD symptoms and barriers to access, commonly reported barriers included: long wait lists/times (38.1%); and treated poorly by health care professionals (30.0%). CONCLUSION These findings show that the likelihood of experiencing barriers to accessing health services was higher among PWUD with MDD symptoms compared to their counterparts. Policies and interventions tailored to address these barriers are urgently needed for this subpopulation of PWUD.
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Affiliation(s)
- Tara Beaulieu
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Lianping Ti
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - M-J Milloy
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- British Columbia Centre on Substance Use, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - Ekaterina Nosova
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- British Columbia Centre on Substance Use, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- British Columbia Centre on Substance Use, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - Kanna Hayashi
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
- British Columbia Centre on Substance Use, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
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Depression, evening salivary cortisol and inflammation in chronic fatigue syndrome: A psychoneuroendocrinological structural regression model. Int J Psychophysiol 2017; 131:124-130. [PMID: 28918107 DOI: 10.1016/j.ijpsycho.2017.09.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 09/05/2017] [Accepted: 09/12/2017] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Chronic Fatigue Syndrome (CFS) is a poorly understood illness that is characterized by diverse somatic symptoms, hypothalamic pituitary adrenal (HPA) axis dysfunction and heightened inflammatory indicators. These symptoms are often exacerbated and accompanied by psychological distress states and depression. Since depression is known to be associated with HPA axis dysfunction and greater inflammation, a psychoneuroendocrinological (PNE) model of inflammation was examined in persons diagnosed with CFS in order to uncover underlying biopsychosocial mechanisms in this poorly understood chronic illness. METHODS Baseline data were drawn from two randomized controlled trials testing the efficacy of different forms of psychosocial intervention, and included psychological questionnaires, di-urnal salivary cortisol, and blood samples. Data were analyzed with structural equation modeling (SEM). RESULTS The sample (N=265) was mostly middle-aged (Mage=49.36±10.9, range=20-73years), Caucasian (67.7%), female (81.7%), highly educated (85.5% completed some college, college, or graduate program), and depressed (CES-D M=23.87±12.02, range 2-57). The SEM supporting a psychoneuroendocrinological model of immune dysregulation in CFS fit the data χ2 (12)=17.725, p=0.1243, RMSEA=0.043, CFI=0.935, SRMR=0.036. Depression was directly related to evening salivary cortisol and inflammation, such that higher evening cortisol predicted greater depressive symptoms (β=0.215, p<0.01) and higher pro-inflammatory cytokines (interleukin-2 [IL-2], IL-6, and tumor necrosis factor-alpha [TNF-α] levels (β=0.185, p<0.05), when controlling for covariates. DISCUSSION Results highlight the role of depression, cortisol and inflammation in possible biological mechanisms involved in the pathophysiology of CFS. Time-lagged, longitudinal analyses are needed to fully explore these relationships.
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The Effect of Small Sample Size on Measurement Equivalence of Psychometric Questionnaires in MIMIC Model: A Simulation Study. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7596101. [PMID: 28713828 PMCID: PMC5496316 DOI: 10.1155/2017/7596101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 05/21/2017] [Indexed: 11/17/2022]
Abstract
Evaluating measurement equivalence (also known as differential item functioning (DIF)) is an important part of the process of validating psychometric questionnaires. This study aimed at evaluating the multiple indicators multiple causes (MIMIC) model for DIF detection when latent construct distribution is nonnormal and the focal group sample size is small. In this simulation-based study, Type I error rates and power of MIMIC model for detecting uniform-DIF were investigated under different combinations of reference to focal group sample size ratio, magnitude of the uniform-DIF effect, scale length, the number of response categories, and latent trait distribution. Moderate and high skewness in the latent trait distribution led to a decrease of 0.33% and 0.47% power of MIMIC model for detecting uniform-DIF, respectively. The findings indicated that, by increasing the scale length, the number of response categories and magnitude DIF improved the power of MIMIC model, by 3.47%, 4.83%, and 20.35%, respectively; it also decreased Type I error of MIMIC approach by 2.81%, 5.66%, and 0.04%, respectively. This study revealed that power of MIMIC model was at an acceptable level when latent trait distributions were skewed. However, empirical Type I error rate was slightly greater than nominal significance level. Consequently, the MIMIC was recommended for detection of uniform-DIF when latent construct distribution is nonnormal and the focal group sample size is small.
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Kelso-Chichetto NE, Plankey M, Abraham AG, Ennis N, Chen X, Bolan R, Cook RL. Association between alcohol consumption trajectories and clinical profiles among women and men living with HIV. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017. [PMID: 28621562 DOI: 10.1080/00952990.2017.1335317] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Alcohol use is common among persons living with HIV (PLWH). It is unclear how alcohol consumption changes over time and if these changes are associated with clinical profiles. OBJECTIVE We aimed to describe the association between longitudinal patterns of alcohol consumption and the clinical profiles of PLWH. METHODS Data from the Women's Interagency HIV Study (n = 1123 women) and Multicenter AIDS Cohort Study (n = 597 men) from 2004 to 2013 were utilized. Group-based trajectory models were used to assess alcohol consumption patterns across 10 years. Generalized estimating equations were used to identify associations between clinical factors and alcohol consumption. All analyses were stratified by sex. RESULTS Four trajectories of alcohol use were identified in women and men (women: abstinent 38%, low: 25%, moderate: 30%, heavy: 7%; men: abstinent 16%, low: 69%, moderate: 9%, heavy: 5%). The Framingham Risk Score (women: adjusted odds ratio [AOR] 1.07, 95% confidence interval [CI] 1.04-1.09), years on ART (women: AOR 1.02, CI 1.00-1.05; men: AOR 1.05, CI 1.01-1.09), suboptimal ART adherence (men: AOR 1.23, CI 1.07-1.42), and unsuppressed viral load (women: AOR 1.82, CI 1.56-2.13; men: AOR 1.36, CI 1.17-1.58) were associated with increased odds for moderate drinking. The Framingham Risk Score (women: AOR 1.10, CI 1.07-1.14; men: AOR 1.12, CI 1.06-1.20), suboptimal adherence (women: AOR 1.25, CI 1.04-1.51), and unsuppressed viral load (women: AOR 1.78, CI 1.42-2.24) were associated with increased odds for heavy drinking. CONCLUSIONS Clinicians should consider screening patients for alcohol consumption, particularly if patients have comorbid medical conditions, suboptimal antiretroviral adherence, and/or detectable viral load.
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Affiliation(s)
- Natalie E Kelso-Chichetto
- a Department of Epidemiology , Colleges of Public Health and Health Professions and Medicine, University of Florida , Gainesville , FL , USA
| | - Michael Plankey
- b Department of Medicine , Georgetown University Medical Center , Washington , DC , USA
| | - Alison G Abraham
- c Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Nicole Ennis
- d Department of Clinical and Health Psychology , College of Public Health and Health Professions, University of Florida , Gainesville , FL , USA
| | - Xinguang Chen
- a Department of Epidemiology , Colleges of Public Health and Health Professions and Medicine, University of Florida , Gainesville , FL , USA
| | | | - Robert L Cook
- a Department of Epidemiology , Colleges of Public Health and Health Professions and Medicine, University of Florida , Gainesville , FL , USA
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Coleman CL. Health related quality of life and depressive symptoms among seropositive African Americans. Appl Nurs Res 2016; 33:138-141. [PMID: 28096007 DOI: 10.1016/j.apnr.2016.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 10/25/2016] [Accepted: 11/10/2016] [Indexed: 12/24/2022]
Abstract
The primary aim of this descriptive correlational study was to determine which domains of health related quality of life (HRQOL) after controlling for demographic correlates predict depressive symptoms among N=70 seropositive African American men and women on Active Antiretroviral Therapy (ART). A demographic questionnaire, the Center for Epidemiological Studies Depression Scale (CESD-D), and the SF-36 Health Related Quality of Life (HRQOL) scale were administered. The regression analyses resulted in three models. The first model indicated that emotional well-being explained 38% of the variance in depressive symptoms (P=0.000) and in model two, emotional well-being and role limitations on emotional health explained 50% of the variance (P=0.000) and in the final and best fitting model emotional well-being, role limitations on emotional health and pain explained 53% of the variance in depressive symptoms (P=0.000) respectively. The findings underscore the need to explore the impact of HRQOL on mental health, and to also screen and treat seropositive African American men and women on (ART) for depressive symptoms.
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Affiliation(s)
- Christopher Lance Coleman
- University of Pennsylvania School of Nursing, Room 222 NEB 418 Curie Blvd, Philadelphia, PA 19104-4217, United States.
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Kamwesiga JT, von Koch L, Kottorp A, Guidetti S. Cultural adaptation and validation of Stroke Impact Scale 3.0 version in Uganda: A small-scale study. SAGE Open Med 2016; 4:2050312116671859. [PMID: 27746913 PMCID: PMC5046200 DOI: 10.1177/2050312116671859] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 09/01/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Knowledge is scarce about the impact of stroke in Uganda, and culturally adapted, psychometrically tested patient-reported outcome measures are lacking. The Stroke Impact Scale 3.0 is recommended, but it has not been culturally adapted and validated in Uganda. OBJECTIVE To culturally adapt and determine the psychometric properties of the Stroke Impact Scale 3.0 in the Ugandan context on a small scale. METHOD The Stroke Impact Scale 3.0 was culturally adapted to form Stroke Impact Scale 3.0 Uganda (in English) by involving 25 participants in three different expert committees. Subsequently, Stroke Impact Scale 3.0 Uganda from English to Luganda language was done in accordance with guidelines. The first language in Uganda is English and Luganda is the main spoken language in Kampala city and its surroundings. Translation of Stroke Impact Scale 3.0 Uganda (both in English and Luganda) was then tested psychometrically by applying a Rasch model on data collected from 95 participants with stroke. RESULTS Overall, 10 of 59 (17%) items in the eight domains of the Stroke Impact Scale 3.0 were culturally adapted. The majority were 6 of 10 items in the domain Activities of Daily Living, 2 of 9 items in the domain Mobility, and 2 of 5 items in the domain Hand function. Only in two domains, all items demonstrated acceptable goodness of fit to the Rasch model. There were also more than 5% person misfits in the domains Participation and Emotion, while the Communication, Mobility, and Hand function domains had the lowest proportions of person misfits. The reliability coefficient was equal or larger than 0.90 in all domains except the Emotion domain, which was below the set criterion of 0.80 (0.75). CONCLUSION The cultural adaptation and translation of Stroke Impact Scale 3.0 Uganda provides initial evidence of validity of the Stroke Impact Scale 3.0 when used in this context. The results provide support for several aspects of validity and precision but also point out issues for further adaptation and improvement of the Stroke Impact Scale.
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Affiliation(s)
- Julius T Kamwesiga
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Occupational Therapy School, Institute of Allied Health and Management Sciences-Mulago, Kampala, Uganda
| | - Lena von Koch
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Kottorp
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Susanne Guidetti
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Assari S, Moazen-Zadeh E. Confirmatory Factor Analysis of the 12-Item Center for Epidemiologic Studies Depression Scale among Blacks and Whites. Front Psychiatry 2016; 7:178. [PMID: 27872599 PMCID: PMC5098257 DOI: 10.3389/fpsyt.2016.00178] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 10/13/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The Center for Epidemiologic Studies Depression (CES-D) scale is one of the most widely used tools to measure depressive symptoms in epidemiological studies. Given the importance of cross-racial measurement equivalence of the CES-D scale for research, we performed confirmatory factor analysis (CFA) of the 12-item CES-D in a nationally representative sample of Black and White adults in the United States. METHODS We used data from the National Survey of American Life (NSAL), 2001-2003. A total number of 3570 Blacks (African-Americans) and 891 non-Hispanic Whites were included in the present study. CFA was carried out on the 12-item CES-D scale using multi-group structural equation modeling. RESULTS For both Blacks and Whites, the best fitting model was found to be the 3-factor model, indicating invariance of factor structure between Blacks and Whites. A statistically different fit of the models with and without constraints indicated lack of invariance of factor loadings between Blacks and Whites. Some of the positive (i.e., "as good" and "hopeful") and interpersonal (i.e., "people were unfriendly") items showed poor loadings, even in the 3-factor solution that allowed separate domains for positive affect, negative affect, and interpersonal problems. Despite the good fit of our final model, more items (i.e., "as good," "hopeful," "keeping mind," and "everything effort") had poorer loadings in Blacks than Whites (i.e., "as good"). CONCLUSION There is invariance in factor structure but lack of invariance in factor/item loadings between Blacks and Whites. These findings have implications for cross-racial studies of depressive symptoms using CES-D scale among Blacks and Whites. Further research is warranted to scrutinize the role of socioeconomics and culture in explaining the lack of invariance of the CES-D scale between Blacks and Whites.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Ehsan Moazen-Zadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran; Mental Health Research Center, Tehran Psychiatric Institute, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
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