1
|
Royse SK, Snitz BE, Hill AV, Reese AC, Roush RE, Kamboh MI, Bertolet M, Saeed A, Lopresti BJ, Villemagne VL, Lopez OL, Reis SE, Becker JT, Cohen AD. Apolipoprotein E and Alzheimer's disease pathology in African American older adults. Neurobiol Aging 2024; 139:11-19. [PMID: 38582070 DOI: 10.1016/j.neurobiolaging.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/07/2024] [Accepted: 03/22/2024] [Indexed: 04/08/2024]
Abstract
The apolipoprotein-E4 (APOE*4) and apolipoprotein-E2 (APOE*2) alleles are more common in African American versus non-Hispanic white populations, but relationships of both alleles with Alzheimer's disease (AD) pathology among African American individuals are unclear. We measured APOE allele and β-amyloid (Aβ) and tau using blood samples and positron emission tomography (PET) images, respectively. Individual regression models tested associations of each APOE allele with Aβ or tau PET overall, stratified by racialized group, and with a racialized group interaction. We included 358 older adults (42% African American) with Aβ PET, 134 (29% African American) of whom had tau PET. APOE*4 was associated with higher Aβ in non-Hispanic white (P < 0.0001), but not African American (P = 0.64) participants; racialized group modified the association between APOE*4 and Aβ (P < 0.0001). There were no other racialized group differences. These results suggest that the association of APOE*4 and Aβ differs between African American and non-Hispanic white populations. Other drivers of AD pathology in African American populations should be identified as potential therapeutic targets.
Collapse
Affiliation(s)
- Sarah K Royse
- University of Pittsburgh Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA 15261, USA; University of Pittsburgh Department of Radiology, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
| | - Beth E Snitz
- University of Pittsburgh Department of Neurology, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - Ashley V Hill
- University of Pittsburgh Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA 15261, USA
| | - Alexandria C Reese
- University of Pittsburgh Department of Radiology, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Rebecca E Roush
- University of Pittsburgh Department of Neurology, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - M Ilyas Kamboh
- University of Pittsburgh Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA 15261, USA; University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; University of Pittsburgh Department of Human Genetics, 130 De Soto Street, Pittsburgh, PA 15213, USA
| | - Marnie Bertolet
- University of Pittsburgh Department of Epidemiology, 130 De Soto Street, Pittsburgh, PA 15261, USA; University of Pittsburgh Department of Biostatistics, 130 De Soto Street, Pittsburgh, PA 15213, USA
| | - Anum Saeed
- University of Pittsburgh Heart and Vascular Institute, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Brian J Lopresti
- University of Pittsburgh Department of Radiology, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Victor L Villemagne
- University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Oscar L Lopez
- University of Pittsburgh Department of Neurology, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA; University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Steven E Reis
- University of Pittsburgh Heart and Vascular Institute, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - James T Becker
- University of Pittsburgh Department of Neurology, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA; University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; University of Pittsburgh Department of Psychology, 210 South Bouquet Street, Pittsburgh, PA 15260, USA
| | - Ann D Cohen
- University of Pittsburgh Department of Psychiatry, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| |
Collapse
|
2
|
Moore M, Balascio P, Bonner-Johnson T, Garth J, Brinkman B, Hill AV. Implementing Comprehensive Sex and Sexuality Education in Kindergarten-Grade 12 Schools: Guiding Practices and Examples. J Sch Health 2024; 94:374-379. [PMID: 38351584 DOI: 10.1111/josh.13431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 12/08/2023] [Accepted: 12/20/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND Comprehensive sex and sexuality education (CSE) is an evidence-based intervention associated with improved sexual and reproductive health outcomes. Currently, there are no standardized requirements for sex and sexuality education in the United States, despite expert recommendations. CONTRIBUTIONS TO THEORY In the United States, a Whole School, Whole Community, Whole Child theoretical model proposed by the Centers for Disease Control, and current examples of school sex education policy is used to make recommendations for the standardization of comprehensive sexual health education in K-12 schools. This article describes the necessary components to adopt CSE equitably, and provides an example of the process implemented to improve CSE in 1 school district in Pittsburgh, PA. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Understanding the key components of legislation that align with recommended standards, and the process of advocating for school policy change, allows local advocacy groups and education policymakers to create and pass feasible legislation that will ensure appropriate instruction. There is additional room for improvement in states and local districts that have current CSE legislation, to adopt approaches grounded in frameworks that critically evaluate social determinants of health and amend legislation to further improve health equity. CONCLUSIONS Several states and local districts have passed CSE regulations, and are implementing and evaluating their efficacy, providing support and examples for other regions interested in adopting similar policies and processes. Pittsburgh Public Schools can be used as an example adapting current legislation and adopting more comprehensive language.
Collapse
Affiliation(s)
- Mikaela Moore
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Phoebe Balascio
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Tausha Bonner-Johnson
- Health & Wellness Workgroup, Black Girls Equity Alliance, New Voices for Reproductive Heath, Pittsburgh, PA
| | - José Garth
- Health & Wellness Workgroup, Black Girls Equity Alliance, Gwen's Girls, Pittsburgh, PA
| | - Britney Brinkman
- Black Girls Equity Alliance, Gwen's Girls, Pittsburgh, Pennsylvania; Department of Psychology, Point Park University, Pittsburgh, PA
| | - Ashley V Hill
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
3
|
Brown RE, Noah AI, Hill AV, Taylor BD. Fetal Sexual Dimorphism and Preeclampsia Among Twin Pregnancies. Hypertension 2024; 81:614-619. [PMID: 38152884 PMCID: PMC10922256 DOI: 10.1161/hypertensionaha.123.22380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/13/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND In singleton pregnancies, fetal sexual dimorphism has been observed in hypertensive disorders of pregnancy, particularly preeclampsia, a morbid syndrome that increases the risk of adult-onset cardiovascular disease for mothers and their offspring. However, few studies have explored the effect of fetal sex on hypertensive disorders of pregnancy among twin pregnancies. METHODS We conducted a retrospective cohort study of 1032 twin pregnancies between 2011 and 2022 using data from a perinatal database that recruits participants from 3 hospitals in Houston, TX. We categorized pregnancies based on fetal sex pairings into female/female, male/male, and female/male. Pregnancies with female/female pairs were used as our reference group. Our primary outcomes included gestational hypertension, preeclampsia, superimposed preeclampsia, and preeclampsia subtyped by gestational age of delivery. A modified Poisson regression model with robust error variance was used to calculate the relative risk and 95% CI for the association between fetal sex pairs and hypertensive disorders of pregnancy. RESULTS Adjusted models of female/male pairs were associated with preterm preeclampsia (relative risk, 2.01 [95% CI, 1.15-3.53]) relative to those with female/female pairs. No associations with other hypertensive disorders of pregnancy were observed among pregnancies with male/male pairs compared with those with female/female fetal sex pairs. CONCLUSIONS We found some evidence of sexual dimorphism for preterm preeclampsia among female/male twin pairs. Additional research is needed to understand what biological mechanisms could explain these findings.
Collapse
Affiliation(s)
- Rebekah E. Brown
- Department of Obstetrics and Gynecology, Division of Basic Science and Translational Research, University of Texas Medical Branch, Galveston, TX, USA
| | - Akaninyene I. Noah
- Department of Obstetrics and Gynecology, Division of Basic Science and Translational Research, University of Texas Medical Branch, Galveston, TX, USA
| | - Ashley V. Hill
- Department of Epidemiology, School of Public Health, University of Pittsburgh, USA
| | - Brandie DePaoli Taylor
- Department of Obstetrics and Gynecology, Division of Basic Science and Translational Research, University of Texas Medical Branch, Galveston, TX, USA
- Department of Population Health and Health Disparities, University of Texas Medical Branch, Galveston, TX, USA
| |
Collapse
|
4
|
Hill AV, Balascio P, Moore M, Hossain F, Dwarkananth M, De Genna NM. Young black women's desired pregnancy and birthing support during coronavirus disease 2019 pandemic. SSM Qual Res Health 2023; 4:100333. [PMID: 38106375 PMCID: PMC10722556 DOI: 10.1016/j.ssmqr.2023.100333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Objective To document pregnancy and birthing experiences of young, Black pregnant women in one geographic area to make recommendations for improving young Black women's pregnancy and birthing experiences. Methods Participants were recruited through The YoungMoms Study (R01 DA04640101A1) in Pittsburgh, Pennsylvania, and included Black or biracial participants ages 16-23 (n = 25). Individual interviews were conducted from March 2022-July 2022 to assess pre-, peri-, and post-natal healthcare system encounters; experiences of structural and obstetric racism and discrimination in healthcare settings while obtaining prenatal care; attitudes around healthcare systems and medical professionals; effects of COVID-19 pandemic on participants lives and the impact of enacted healthcare policies in their perinatal experience; substance use changes during pregnancy; and coping mechanisms for stress. NVivo 13 was used to code transcripts, then major themes and subthemes were identified using thematic content analysis and based on grounded theory. Results Twenty-five interviews were conducted, and four themes emerged from participant experiences of racial discrimination in healthcare settings; (1) awareness of historical racism that influences perinatal care; (2) clinical providers assume participant substance use and enact reproductive coercion; (3) clinical providers question validity of Black women's birthing complaint; and (4) Young Black pregnant women know and will express what they desire in their perinatal experience if asked. Conclusions Young Black pregnant women encounter structural racism and intersectional bias from healthcare providers. By centering the perspectives and experiences of this overlooked population, public health researchers and clinical providers can utilize anti-racist frameworks to create more equitable, just practices in reproductive healthcare.
Collapse
Affiliation(s)
- Ashley V. Hill
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Phoebe Balascio
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Mikaela Moore
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Fahmida Hossain
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Megana Dwarkananth
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Natacha M. De Genna
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| |
Collapse
|
5
|
De Genna NM, Hossain F, Dwarakanath M, Balascio PM, Moore MM, Hill AV. Pandemic stressors and vaccine hesitancy among young, pregnant Black people: A qualitative study of health disparities during a global pandemic. Birth Defects Res 2023; 115:1912-1922. [PMID: 37807480 PMCID: PMC11061795 DOI: 10.1002/bdr2.2262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The novel coronavirus 2019 (COVID-19) pandemic exacerbated existing health inequities in the United States, but no studies have focused on the lived experiences of younger Black birthing people. The goal of this qualitative study was to center the experiences of younger pregnant and birthing Black and Biracial people during the pandemic. METHODS We recruited 25 Black and Biracial pregnant and birthing people ages 16-23 for individual semi-structured interviews. Participants were asked about experiences with the healthcare system during the pandemic, and interviews were transcribed verbatim and coded for qualitative analysis using nVivo. We adhered to the Consolidated Criteria for Reporting Qualitative Research guidelines. RESULTS Participants identified pandemic-related stressors such as fears about infection, lack of support, and pressure to get vaccinated. Reasons for vaccine hesitancy included mistrust in the government and racism experienced during reproductive healthcare. Provider appeals highlighting patient autonomy and science were more effective in encouraging vaccine uptake than emotional appeals that made participants feel guilty about potentially infecting loved ones. CONCLUSIONS Restrictions on children and support people created barriers to timely prenatal care and reduced tangible support for young Black and Biracial birthing people during the pandemic. Their vaccine hesitancy was related to mistrust, concerns that the vaccines had not been tested enough prior to roll-out, and possible side effects of the vaccine including infection with the virus and pregnancy loss. Obstetric providers need to understand and recognize the ongoing impact of obstetric and scientific racism on health communication with younger Black and Biracial patients.
Collapse
Affiliation(s)
- Natacha M. De Genna
- Department of Psychiatry and Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Fahmida Hossain
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Megana Dwarakanath
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Phoebe Ms. Balascio
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Mikaela Ms. Moore
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Ashley V. Hill
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
6
|
Brown RE, Noah AI, Hill AV, DePaoli Taylor B. Fetal sexual dimorphism and preeclampsia among twin pregnancies. medRxiv 2023:2023.11.10.23298403. [PMID: 37986979 PMCID: PMC10659481 DOI: 10.1101/2023.11.10.23298403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background In singleton pregnancies, fetal sexual dimorphism has been observed in hypertensive disorders of pregnancy (HDP), particularly preeclampsia, a morbid syndrome that increases risk of adult onset cardiovascular disease for mothers and their offspring. However, few studies have explored the effect of fetal sex on HDP among twin pregnancies. Methods We conducted a retrospective cohort study of 1,032 twin pregnancies between 2011 - 2022 using data from a perinatal database that recruits participants from three hospitals in Houston, TX. We categorized pregnancies based on fetal sex pairings into female/female, male/male, and female/male. Pregnancies with a female/female fetal sex were used as our reference group. Our primary outcomes included gestational hypertension, preeclampsia, superimposed preeclampsia, and preeclampsia subtyped by gestational age of delivery. A modified Poisson regression model with robust error variance was used to calculate the relative risk (RR) and 95% confidence interval (CI) for the association between fetal sex pairs and HDP. Results Adjusted models of female/male fetal sex pairs were associated with preterm preeclampsia (RR 2.01, 95% CI 1.15-3.53) relative to those with female/female fetuses. No associations with other HDP were observed among pregnancies with male/male fetal sex compared to those with female/female fetal sex pairs. Conclusions We found some evidence of sexual dimorphism for preterm preeclampsia among female/male twin pairs. Additional research is needed to understand what biological mechanisms could explain these findings.
Collapse
Affiliation(s)
- Rebekah E. Brown
- Department of Obstetrics and Gynecology, Division of Basic Science and Translational Research, University of Texas Medical Branch, Galveston, TX, USA
| | - Akaninyene I. Noah
- Department of Obstetrics and Gynecology, Division of Basic Science and Translational Research, University of Texas Medical Branch, Galveston, TX, USA
| | - Ashley V. Hill
- Department of Epidemiology, School of Public Health, University of Pittsburgh, USA
| | - Brandie DePaoli Taylor
- Department of Obstetrics and Gynecology, Division of Basic Science and Translational Research, University of Texas Medical Branch, Galveston, TX, USA
- Department of Population Health and Health Disparities, University of Texas Medical Branch, Galveston, TX, USA
| |
Collapse
|
7
|
Dwarakanath M, Hossain F, Balascio P, Moore MC, Hill AV, De Genna NM. Experiences of postpartum mental health sequelae among black and biracial women during the COVID-19 pandemic. BMC Pregnancy Childbirth 2023; 23:636. [PMID: 37667206 PMCID: PMC10478375 DOI: 10.1186/s12884-023-05929-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 08/16/2023] [Indexed: 09/06/2023] Open
Abstract
OBJECTIVE The objective of this study was to qualitatively examine coping mechanisms and desired supports in pregnant and birthing Black and Biracial adolescent and young adult women during the COVID-19 pandemic. METHODS Black and Biracial participants ages 16-23 were recruited for virtual individual semi-structured interviews. Participants (n = 25) were asked about pre- and post-natal experiences with the healthcare system, effects of the pandemic, and participants' experiences of or desires for ideal care within the healthcare system. Interviews were transcribed verbatim and coded for qualitative analysis using nVivo. Discussions around postpartum mental health evolved organically when asked about how participants were coping postpartum. RESULTS Nearly half the interviewees organically reported mental health symptoms consistent with postpartum depression (PPD) during questions regarding their postpartum experience. Of the 11 interviewees who reported mental health symptoms consistent with PPD, 2 were afraid to disclose their symptoms to a healthcare provider due to fear of child protective services involvement and their belief they would be treated unfairly because of their race. CONCLUSION Clinicians who care for Black and Biracial adolescent and young adult mothers must be particularly attuned to structural barriers for appropriate screening and treatment of postpartum depression. Expanding investigations of intersectional influences on young mothers' perinatal health and PPD are needed.
Collapse
Affiliation(s)
- Megana Dwarakanath
- University of Pittsburgh Medical Center, 200 Lothrop Street Pittsburgh, 15213, Pittsburgh, PA, USA.
| | - Fahmida Hossain
- University of Pittsburgh Medical Center, 200 Lothrop Street Pittsburgh, 15213, Pittsburgh, PA, USA
| | - Phoebe Balascio
- University of Pittsburgh Medical Center, 200 Lothrop Street Pittsburgh, 15213, Pittsburgh, PA, USA
| | - Mikaela C Moore
- University of Pittsburgh Medical Center, 200 Lothrop Street Pittsburgh, 15213, Pittsburgh, PA, USA
| | - Ashley V Hill
- University of Pittsburgh Medical Center, 200 Lothrop Street Pittsburgh, 15213, Pittsburgh, PA, USA
| | - Natacha M De Genna
- University of Pittsburgh Medical Center, 200 Lothrop Street Pittsburgh, 15213, Pittsburgh, PA, USA
| |
Collapse
|
8
|
Hill AV, Dyer HP, Gianakas J, Howze R, King A, Gary-Webb TL, Méndez DD. Correlates of COVID-19 Vaccine Uptake in Black Adults Residing in Allegheny County, PA. Health Equity 2023; 7:419-429. [PMID: 37638118 PMCID: PMC10457607 DOI: 10.1089/heq.2022.0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Efforts to address vaccine uptake and access among black adults will be relevant for continued coronavirus disease 2019 (COVID-19) eradication efforts and can be transferable to other prevention efforts in future pandemics. This study investigated factors related to COVID-19 vaccine uptake and access among black residents in Allegheny County, PA. Methods Surveys were administered electronically from October 2021 to January 2022 to black Allegheny County residents aged 18 and older. Questions included thoughts on COVID mitigation strategies (e.g., masking, social distancing), vaccination status, intention to vaccinate children, trust of COVID-19 information sources and vaccines, family needs, access to support services, and social media use to access information. Descriptive statistics and significant correlates of being vaccinated using adjusted logistic regression models are reported. Results Of the overall sample (N=397), the majority were fully vaccinated (n=306, 77%). Fully vaccinated participants were more likely to be female (62.5%, p=0.010), age 60 years or older (34.3%, p=0.0002), have some college education (23.2%, p<0.0001), and be employed full time (50.0%, p=0.0001) compared with nonvaccinated individuals. Among the unvaccinated participants (n=91), the primary reason was fear of illness (8.9%), long-term effects (6.5%), mistrust in the vaccine (6.3%), and needing more information (4.5%). Vaccine-hesitant participants were more likely to be unvaccinated (adjusted odds ratio=2.3, 95% confidence interval 1.25-4.14) after adjusting for age, education, employment, insurance, health status, and income. Conclusion Vaccine hesitancy may be improved by directly addressing fear of illness resulting from vaccines and improving clarity in the vaccine development and approval process to improve uptake among black adults.
Collapse
Affiliation(s)
- Ashley V. Hill
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
- Black Equity Coalition, Pittsburgh, Pennsylvania, USA
| | - Harika P. Dyer
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
- Black Equity Coalition, Pittsburgh, Pennsylvania, USA
| | - John Gianakas
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
- Epidemiology Data Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ruth Howze
- Black Equity Coalition, Pittsburgh, Pennsylvania, USA
| | - Ayanna King
- Black Equity Coalition, Pittsburgh, Pennsylvania, USA
| | - Tiffany L. Gary-Webb
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
- Black Equity Coalition, Pittsburgh, Pennsylvania, USA
| | - Dara D. Méndez
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
- Black Equity Coalition, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
9
|
Opara I, Gabriel C, Duran-Becerra B, Bond K, Hill AV, Hussett-Richardson S, Alves C, Kershaw T. Sexual Health and Drug Use Prevention for Black Girls (The Dreamer Girls Project): Protocol for an Intervention Development. JMIR Res Protoc 2023; 12:e45007. [PMID: 37556188 PMCID: PMC10448282 DOI: 10.2196/45007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/02/2023] [Accepted: 05/05/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Substance use among adolescent girls is associated with numerous risk characteristics, including engaging in sexual risk behaviors, which can lead to HIV and sexually transmitted infection (STI) diagnoses. This is an important phenomenon to target as there is a significant race-gendered paradox that occurs when Black girls use and misuse drugs. When misuse occurs among this group, they are more likely to face harsher consequences and worse health outcomes than boys and other ethnic-minority girls. Therefore, there is a need to understand the risk and protective factors of drug use and sexual risk behaviors among Black girls and develop a robust intervention that can cater for this group. OBJECTIVE We propose the development of a strengths-based prevention education intervention for Black girls between the ages of 13 and 18 years to promote protective factors. METHODS A sequential, mixed methods study will be conducted, and we will use the first 3 steps of the ADAPT-ITT (assessment, decision, adaptation, production, topical experts, integration, training, testing) framework to begin the development of the intervention. Three aims will be described in this protocol. First, aim 1 is to explore sociocultural risk and protective factors among Black girls between the ages 13 and 18 years in drug use and HIV/STI prevention using focus group methodology and surveys. We will conduct at least 10 focus groups to include up to 75 Black girls or until we reach saturation. Our target sample size for the quantitative portion of the study will be 200 participants. Aim 2 will focus on deciding upon an intervention based on findings from aim 1 and forming a youth advisory board to guide intervention development. Aim 3 will be to conduct a pretest of the intervention with the youth advisory board to determine if the intervention is feasible and will be accepted by Black girls. RESULTS The study is part of a 2-year research pilot study award from the National Institutes of Mental Health. Data collection for this study began in October 2021. For aim 1, data collection is 95% complete. We expect to complete all data collection for aim 1 on or before May 30, 2023. Study activities for aim 2 are occurring simultaneously as data are being collected and analyzed and will be completed in the summer of 2023. Study activities for aim 3 will begin in the fall of 2023. CONCLUSIONS This study will be one of the few interventions that address both sexual health and drug use together and cater to Black girls. We anticipate that the intervention will be beneficial for Black girls across the nation to work on building culturally appropriate prevention education and building peer social supports, resulting in reduction or delayed substance use and improved sexual health. TRIAL REGISTRATION ClinicalTrials.gov NCT05014074; https://clinicaltrials.gov/ct2/show/NCT05014074. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/45007.
Collapse
Affiliation(s)
- Ijeoma Opara
- Yale School of Public Health, New Haven, CT, United States
| | - Cora Gabriel
- Yale School of Public Health, New Haven, CT, United States
| | | | - Keosha Bond
- City University of New York School of Medicine, New York, NY, United States
| | - Ashley V Hill
- University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Courtnae Alves
- Columbia University School of Public Health, New York, NY, United States
| | - Trace Kershaw
- Yale School of Public Health, New Haven, CT, United States
| |
Collapse
|
10
|
Opara I, Martin R, Hill AV, Calhoun A. Addressing Gendered Racism Against Black Girls Using a Strengths-Based Empowerment-Intersectional Framework for Sexual Health and Substance Use Prevention Programming. Health Promot Pract 2023; 24:617-622. [PMID: 37166152 DOI: 10.1177/15248399231171145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Although Black girls use substances at lower rates than boys and girls from various other racial groups, they tend to have worse health outcomes associated with substance use that can also impact their sexual health. The association between substance use and sexual risk behaviors is usually attributed to lack of access to quality health care and lack of culturally specific prevention programming and treatment options tailored to this group. Accordingly, the theoretical frameworks for health promotion for Black girls often focus on addressing deficits, ignoring the powerful and intersecting social forces that can impact identity, agency, and behavioral options. Key among these forces is gendered racism. We propose a strengths-based conceptual framework to address and challenge gendered racism as a critical foundation for promoting health and wellbeing for Black girls. Our approach integrates Intersectionality Theory and Empowerment Theory, with psychological and intrapersonal empowerment identified as critical mediators of behavior and health outcomes, supported by protective factors of positive racial identity and gendered racial socialization. This framework has been developed with and for Black girls but can be adapted for health promotion efforts with other minoritized groups.
Collapse
Affiliation(s)
- Ijeoma Opara
- Yale University School of Public Health, New Haven, CT, USA
| | | | - Ashley V Hill
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Amanda Calhoun
- Yale Child Study Center, Yale New Haven Hospital, New Haven, CT, USA
| |
Collapse
|
11
|
Noah AI, Perez-Patron MJ, Gongalla M, Hill AV, Taylor BD. Foreign-born status and risk of gestational diabetes mellitus by years of residence in the United States. Sci Rep 2023; 13:10060. [PMID: 37344555 DOI: 10.1038/s41598-023-36789-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023] Open
Abstract
To explore the association between acculturation among foreign-born (FB) women, gestational diabetes (GDM) and GDM-associated adverse birth outcomes, we conducted a retrospective cohort study of 34,696 singleton pregnancies from Houston, TX, between 2011 and 2022. FB women (n = 18,472) were categorized based on years of residence in US (0-5, 6-10, and > 10 years), while US-born women (n = 16,224) were the reference group. A modified Poisson regression model determined the association between acculturative level and GDM within the entire cohort and stratified by race/ethnicity. Compared to US-born women, FB women with 0-5 years [adjusted relative risk (RRadj.) 1.27, 95% confidence interval [CI] 1.14-1.42)], 6-10 years (RRadj. 1.89, 95%CI 1.68-2.11) and > 10 years in the US (RRadj. 1.85, 95%CI 1.69-2.03) had higher risk of GDM. Results were consistent for all racial/ethnic groups, although associations were not significant at 0-5 years. FB women had lower risk of other adverse pregnancy outcomes, except for preeclampsia with severe features at higher levels of acculturation. Results were similar among those with and without GDM. In conclusion, FB status increases risk of GDM among all racial/ethnic groups but is elevated with higher acculturation levels.
Collapse
Affiliation(s)
- Akaninyene I Noah
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, MRB, 11.158A, 301 University Blvd, Galveston, TX, 77555, USA
| | - Maria J Perez-Patron
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Megha Gongalla
- Department of Sociology, College of Liberal Arts, Temple University, Philadelphia, PA, USA
| | - Ashley V Hill
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
| | - Brandie DePaoli Taylor
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, MRB, 11.158A, 301 University Blvd, Galveston, TX, 77555, USA.
- Department of Population Health and Health Disparities, University of Texas Medical Branch, Galveston, TX, USA.
| |
Collapse
|
12
|
Hooks SK, Abiodun-Ojo O, Noah AI, Hill AV, Perez-Patron MJ, Menon R, Taylor BD. Evaluating the Impact of Fetal Sex on Gestational Diabetes Mellitus Following Interaction with Maternal Characteristics. Reprod Sci 2023; 30:1359-1365. [PMID: 36241953 DOI: 10.1007/s43032-022-01106-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/07/2022] [Indexed: 11/30/2022]
Abstract
Fetal-sex-specific changes to placental immunity and metabolism occur in response to obesity. Few studies have determined if fetal sex interacts with maternal characteristics to alter risk of gestational diabetes mellitus (GDM). Among 43,727 singleton pregnancies, we examined the association between male fetal sex and GDM using log-binomial logistic regression to calculate relative risks (RR) and 95% confidence intervals (CI). Interactions were examined between fetal sex and maternal characteristics on the risk of GDM by calculating relative excess risk due to interaction. After adjusting for body mass index, race/ethnicity, maternal age, education, and gravidity, male fetal sex was not associated with GDM (RRadj. 0.95, 95% CI 0.93, 1.04). We found a positive interaction between male fetal sex and obesity (p = 0.04). Nonobese women with male fetuses were less likely to develop GDM, but in the presence of obesity, an opposite trend was observed. There was a positive interaction between male fetal sex and GDM on the risk of preterm delivery < 37-weeks gestation (p = 0.0006). In response to underlying maternal obesity, fetal sex may modify the risk of GDM. In addition, male fetal sex may increase the occurrence of preterm birth among women with GDM.
Collapse
Affiliation(s)
- Sarah Kaitlyn Hooks
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch-Galveston, Galveston, TX, USA
| | - Olayinka Abiodun-Ojo
- Department of Internal Medicine, Piedmont Athens Regional Medical Center, Athens, GA, USA
| | - Akaninyene I Noah
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
| | - Ashley V Hill
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria J Perez-Patron
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Ramkumar Menon
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
| | - Brandie DePaoli Taylor
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch-Galveston, Galveston, TX, USA.
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA.
| |
Collapse
|
13
|
Dwarakanath M, Hossain F, Balascio P, Moore MC, Hill AV, De Genna NM. Barriers to Diagnosis of Postpartum Depression among Younger Black Mothers. Res Sq 2023:rs.3.rs-2500330. [PMID: 36824914 PMCID: PMC9949245 DOI: 10.21203/rs.3.rs-2500330/v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Objective: The objective of this study was to qualitatively examine coping mechanisms and desired supports in pregnant and birthing Black and biracial adolescent and young adult women during the COVID-19 pandemic. Method: Black and biracial participants ages 16-23 were recruited for virtual individual semi-structured interviews. Participants (n=25) were asked about pre- and post-natal experiences with the healthcare system, effects of the pandemic, and participants' experiences of or desires for ideal care within the healthcare system. Interviews were transcribed verbatim and coded for qualitative analysis using nVivo. Discussions around postpartum mental health evolved organically when asked about how participants were coping postpartum. Results: Nearly half the interviewees reported mental health symptoms consistent with postpartum depression (PPD). Of the 11 interviewees who reported mental health symptoms consistent with PPD, 2 were afraid to disclose their symptoms to a healthcare provider due to fear of child protective services involvement and their belief they would be treated unfairly because of their race. Conclusion: Clinicians who care for Black and biracial adolescent and young adult mothers must be particularly attuned to structural barriers for appropriate screening and treatment of postpartum depression. Expanding investigations of intersectional influences on young mothers' perinatal health and PPD are needed.
Collapse
|
14
|
Balascio P, Moore M, Gongalla M, Regan A, Ha S, Taylor BD, Hill AV. Measures of Racism and Discrimination in Preterm Birth Studies. Obstet Gynecol 2023; 141:69-83. [PMID: 36701611 PMCID: PMC9886318 DOI: 10.1097/aog.0000000000005023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/29/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Preterm birth (any birth at less than 37 weeks of gestation) disproportionally affects Black birthing people and is associated with adverse perinatal and fetal health outcomes. Racism increases the risk of preterm birth, but standardized measurement metrics are elusive. This narrative synthesis examines literature on measures of racial discrimination used in preterm birth research. DATA SOURCES Six databases (CINAHL, Cochrane, EMBASE, PubMed [MEDLINE], Scopus, Web of Science) and ClinicalTrials.gov were searched. Search terms were categorized into three groups (racism terms, measurement terms, preterm birth terms) to identify original research articles that explored associations between racism and preterm birth. English-language, original research articles with U.S. populations were included. METHODS OF STUDY SELECTION Studies were excluded if conducted in only White populations, if only paternal factors were included, or if only racial differences in preterm birth were described. Articles were independently reviewed by two blinded researchers for inclusion at every stage of screening and data extraction; a third reviewer resolved discrepancies. TABULATION, INTEGRATION, AND RESULTS Sixty studies were included in the final analysis. Articles primarily included measures examining interpersonal forms of racism (n=17) through the Experiences of Discrimination and Everyday Discrimination scales, neighborhood composition (n=22) with the Neighborhood Deprivation Index and the Index of Concentration at the Extremes, policy-level racism (n=12) through institutions such as residential racial segregation or policy inequities, or multiple forms (n=9). CONCLUSION Among studies, assessment methods and application of constructs varied. This heterogeneity poses significant challenges to understanding associations between racial discrimination and preterm birth and to describing potential etiologic pathways of preterm birth, which ultimately hinders development of effective intervention. Strategies to capture multilevel exposures to racism require the development and expansion of metrics that are culturally inclusive, empirically valid, and reliable among Black pregnant populations. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42022327484.
Collapse
Affiliation(s)
- Phoebe Balascio
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, and the Department of Sociology, College of Liberal Arts, Temple University, Philadelphia, Pennsylvania; the Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, Texas; and the School of Nursing and Health Professions, University of San Francisco, San Francisco, and the Department of Public Health, Health Science Research Institute, University of California, Merced, Merced, California
| | | | | | | | | | | | | |
Collapse
|
15
|
Hill AV, Hill AL, Jackson Z, Gilreath TD, Fields A, Miller E. Adolescent Relationship Abuse, Gender Equitable Attitudes, Condom and Contraception Use Self-Efficacy Among Adolescent Girls. J Interpers Violence 2022; 37:NP22329-NP22351. [PMID: 35324369 PMCID: PMC9549914 DOI: 10.1177/08862605221080976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Experiencing adolescent relationship abuse (ARA) negatively impacts sexual health and influences risk behaviors of adolescent girls. ARA may be associated with more inequitable gender attitudes among girls, a potentially modifiable factor in violence prevention. This study examines the association among gender equitable attitudes, experiences of ARA, and sexual behaviors among girls participating in Sisterhood 2.0, a community-based violence prevention program implemented in low resource neighborhoods. Methods: Data were from baseline surveys collected for Sisterhood 2.0 implemented in Pittsburgh, PA. Participant demographics, gender equitable attitudes, self-efficacy to use condoms with partners, and self-efficacy to select appropriate contraception were assessed. A latent class analysis (LCA) estimated probability of responses to nine indicators, including sexual behavior self-efficacy and violence. Multigroup LCA by grade (9-12) was also estimated and analyses were performed with SAS V9.4. Results: Female-identified adolescents ages 13-19 (n = 246) were primarily Black (75%) and evenly distributed across grade in school. Sixty-five percent reported emotional relationship abuse and 31% reported physical abuse within the previous nine months. A three-class solution was best fitting for the LCA. Experiences of violence were related to less equitable gender attitudes, being sexually active, and lower condom and contraception self-efficacy. Younger participants who were sexual minorities with less educated heads of household had more experiences with ARA and less equitable gender attitudes. Discussion: Gender equitable attitudes were lower in adolescent girls with greater experiences of ARA and worse condom and contraception self-efficacy. Integrating discussions about healthy sexual relationships and gender equity may be salient factors in violence prevention.
Collapse
Affiliation(s)
- Ashley V. Hill
- Department of Epidemiology, University of Pittsburgh, School of Public Health, Pittsburgh, PA, USA
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Amber L. Hill
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Pediatrics, C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, MI, USA
| | - Zachary Jackson
- Department of Health and Kinesiology, Whitlowe R. Green College of Education, Prairie View A&M University, Prairie View, TX, USA
| | - Tamika D. Gilreath
- Transdisciplinary Center for Health Equity Research, College of Health and Human Development, Texas A&M University, College Station, TX, USA
| | - Alana Fields
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| |
Collapse
|
16
|
Johnson RM, Hill AV, Jones VC, Powell TW, Dean LT, Gilreath TD. Racial/Ethnic Inequities in Adverse Childhood Experiences and Selected Health-Related Behaviors and Problems Among Maryland Adolescents. Health Promot Pract 2022; 23:935-940. [PMID: 33899564 PMCID: PMC8542051 DOI: 10.1177/15248399211008238] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We examined racial/ethnic inequities in the prevalence of adverse childhood experiences (ACEs) and examined the association between ACEs and selected health-related behaviors and problems. Data for this cross-sectional study come from the 2018 Maryland Youth Risk Behavior Survey/Youth Tobacco Survey, a statewide survey of high school students (n = 40,188). ACEs included caregiver verbal abuse and household food insecurity, substance use or gambling, mental illness, and involvement with the criminal justice system. We estimated the prevalence of ACEs overall and by race/ethnicity, and then used multiple logistic regression to determine associations between ACEs and emotional/behavioral problems, adjusting for race/ethnicity. Outcome variables included emotional distress, poor school performance, suicidal ideation, fighting, alcohol use, and marijuana use. More than one fifth of students reported each individual ACE. Differences in the prevalence of ACEs by race/ethnicity were statistically significant (p < .001). More than one fourth (25.8%) reported one of the five ACEs, 15.1% reported two, and 15.4% reported three or more. For each ACE, reporting having experienced it (vs. not) was associated with a >30% higher prevalence for each of the outcome variables. Among students who reported three or more ACEs (relative to none), the odds of emotional distress and suicidal ideation were more than 8 times greater. Among Maryland adolescents, ACEs are common, are inequitably distributed by race/ethnicity, and are strongly linked to behavioral health. Findings suggest the need to monitor ACEs as a routine component of adolescent health surveillance and to refocus assessment and intervention toward "upstream" factors that shape adolescent health.
Collapse
Affiliation(s)
- Renee M. Johnson
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ashley V. Hill
- UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Vanya C. Jones
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Lorraine T. Dean
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | |
Collapse
|
17
|
DePaoli Taylor B, Hill AV, Perez-Patron MJ, Haggerty CL, Schisterman EF, Naimi AI, Noah A, Comeaux CR. Sexually transmitted infections and risk of hypertensive disorders of pregnancy. Sci Rep 2022; 12:13904. [PMID: 35974035 PMCID: PMC9381495 DOI: 10.1038/s41598-022-17989-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/03/2022] [Indexed: 11/09/2022] Open
Abstract
Hypertensive disorders of pregnancy (HDP) result in maternal morbidity and mortality but are rarely examined in perinatal studies of sexually transmitted infections. We examined associations between common sexually transmitted infections and HDP among 38,026 singleton pregnancies. Log-binomial regression calculated relative risk (RRs) and 95% confidence intervals (CIs) for associations with gestational hypertension, preeclampsia with severe features, mild preeclampsia, and superimposed preeclampsia. All models were adjusted for insurance type, maternal age, race/ethnicity, and education. Additional adjustments resulted in similar effect estimates. Chlamydia was associated with preeclampsia with severe features (RRadj. 1.4, 95% CI 1.1, 1.9). Effect estimates differed when we examined first prenatal visit diagnosis only (RRadj. 1.3, 95% CI 0.9, 1.9) and persistent or recurrent infection (RRadj. 2.0, 95% CI 1.1, 3.4). For chlamydia (RRadj. 2.0, 95% CI 1.3, 2.9) and gonorrhea (RRadj. 3.0, 95% CI 1.1, 12.2), women without a documented treatment were more likely to have preeclampsia with severe features. Among a diverse perinatal population, sexually transmitted infections may be associated with preeclampsia with severe features. With the striking increasing rates of sexually transmitted infections, there is a need to revisit the burden in pregnant women and determine if there is a link between infections and hypertensive disorders of pregnancy.
Collapse
Affiliation(s)
- Brandie DePaoli Taylor
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA. .,Department of Preventive Medicine and Population Health, University of Texas Medical Branch-Galveston, Galveston, TX, USA.
| | - Ashley V Hill
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria J Perez-Patron
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Catherine L Haggerty
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Enrique F Schisterman
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ashley I Naimi
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Akaninyene Noah
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
| | - Camillia R Comeaux
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
| |
Collapse
|
18
|
Hill AV, Mistry S, Paglisotti TE, Dwarakanath N, Lavage DR, Hill AL, Iwuanyanwu R, Stokes LR, Jones KA, Miller E. Assessing feasibility of an adolescent relationship abuse prevention program for girls. J Adolesc 2022; 94:333-353. [PMID: 35390205 PMCID: PMC9009219 DOI: 10.1002/jad.12026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/19/2021] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Sexual violence and relationship abuse are prevalent among adolescents and programs promoting gender equity, reproductive justice, and healthy relationships are key strategies for prevention. While such "gender transformative" approaches appear promising for boys, they have not been evaluated among girls. This study assessed the feasibility of this community-based program, called Sisterhood 2.0, among girls in socially disadvantaged urban neighborhoods in Pittsburgh, Pennsylvania. METHODS This quasi-experimental trial examined feasibility of Sisterhood 2.0 (n = 246), delivered through 8 weekly sessions, assessed through attendance, retention and satisfaction. Participants completed surveys at baseline and end of program assessing other relevant measures. Generalized linear mixed models estimated changes from baseline to follow up comparing intervention to control participants. RESULTS Eleven neighborhoods were assigned to Sisterhood 2.0 (n = 5 neighborhoods) or job-readiness training (n = 6 neighborhoods). Girls were between the ages of 13 and 19, 8-10th graders (59%), and self-identified as Black (69%). Participants most often attended because they thought the program would be interesting (74%) and returned because of the women teaching the program (71%). Girls reported experiences with physical adolescent relationship abuse (ARA) (30% in both arms), emotional ARA (66% intervention; 56% control), or sexual ARA (11% intervention; 12% control). Physical ARA perpetration was high in both arms (intervention: 47%; control: 46%). Significant intervention effects were observed in recognition of abuse (β = 0.41, 95% confidence interval 0.03-0.78). No other significant intervention effects were observed. CONCLUSIONS Community-based gender-transformative programming for girls is feasible and may be a promising approach for addressing interpersonal violence and promoting sexual health.
Collapse
Affiliation(s)
- Ashley V Hill
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Sejal Mistry
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - T E Paglisotti
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Namita Dwarakanath
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Daniel R Lavage
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Amber L Hill
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rosemary Iwuanyanwu
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Lynissa R Stokes
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kelley A Jones
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
19
|
Edison B, Coulter RWS, Miller E, Stokes LR, Hill AV. Sexual Communication and Sexual Consent Self-Efficacy Among College Students: Implications for Sexually Transmitted Infection Prevention. J Adolesc Health 2022; 70:282-289. [PMID: 34620545 PMCID: PMC9028224 DOI: 10.1016/j.jadohealth.2021.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE Obtaining affirmative consent, a hallmark of sexual violence prevention education on college campuses, may influence sexual communication and behaviors such as condom use. This study examined the relationship between self-efficacy to obtain sexual consent with sexual health communication and behaviors among a sample of U.S. college students. METHODS Data were from 2,291 students enrolled in a cluster-randomized controlled trial conducted on 28 college campuses from 2015 to 2017. Students reported their self-efficacy to obtain sexual consent, communication about sexual health, and sexual health behaviors. Multivariable logistic regression, adjusted for school clustering, history of violence victimization, and sexually transmitted infection history, estimated odds ratios and 95% confidence intervals (CIs) for sexual consent self-efficacy and sexual health communication. RESULTS Females (n = 1,150) reported higher self-efficacy to obtain consent than males (b1 = .32, 95% CI = .23, .41), but lower odds of communication about condom use (adjusted odds ratio [AOR] = .75, 95% CI = .60, .96) and HIV prevention (AOR = .63, 95% CI = .48, .81). Black and other race students reported higher odds of HIV/sexually transmitted infection prevention communication than white students. Odds of consistent condom use were highest among students reporting condom use communication and high self-efficacy to obtain sexual consent (AOR = 1.99, 95% CI = 1.58, 2.51). CONCLUSIONS Campus sexual assault prevention education that focuses narrowly on obtaining sexual consent may be missing an opportunity to enhance sexual health communication broadly, including condom and contraceptive use discussion to promote overall sexual health.
Collapse
Affiliation(s)
- Briana Edison
- Department of Infectious Diseases & Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Robert W. S. Coulter
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA USA,Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Lynissa R. Stokes
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Ashley V. Hill
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| |
Collapse
|
20
|
Hill AV, Geffel KM, Lavage DR, Davis A, Dwarakanath N, Ettinger AK, Ragavan MI. Parent-Reported Intention to Vaccinate Children Against COVID-19: Influences of COVID-19 and Seasonal Influenza Vaccination. Clin Pediatr (Phila) 2022; 61:107-111. [PMID: 34528490 PMCID: PMC9573798 DOI: 10.1177/00099228211046499] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ashley V. Hill
- University of Pittsburgh, Pittsburgh, PA, USA,UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
| | | | | | | | | | | | | |
Collapse
|
21
|
Omowale SS, Casas A, Lai YH, Sanders SA, Hill AV, Wallace ML, Rathbun SL, Gary-Webb TL, Burke LE, Davis EM, Mendez DD. Trends in Stress Throughout Pregnancy and Postpartum Period During the COVID-19 Pandemic: Longitudinal Study Using Ecological Momentary Assessment and Data From the Postpartum Mothers Mobile Study. JMIR Ment Health 2021; 8:e30422. [PMID: 34328420 PMCID: PMC8457341 DOI: 10.2196/30422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Stress is associated with adverse birth and postpartum health outcomes. Few studies have longitudinally explored racial differences in maternal stress in a birthing population in the United States during the ongoing COVID-19 pandemic. OBJECTIVE This study aimed to do the following: (1) assess changes in reported stress before, during, and after initial emergency declarations (eg, stay-at-home orders) were in place due to the COVID-19 pandemic, and (2) assess Black-White differences in reported stress in a pregnant and postpartum population from Southwestern Pennsylvania. METHODS We leveraged data from the ongoing Postpartum Mothers Mobile Study (PMOMS), which surveys participants in real time throughout the pregnancy and postpartum periods via ecological momentary assessment (EMA) and smartphone technology. We analyzed data from a subset of PMOMS participants (n=85) who were either Black or White, and who submitted EMA responses regarding stress between November 1, 2019, and August 31, 2020, the time frame of this study. We divided data into four phases based on significant events during the COVID-19 pandemic: "pre" phase (baseline), "early" phase (first case of COVID-19 reported in United States), "during" phase (stay-at-home orders), and "post" phase (stay-at-home orders eased). We assessed mean stress levels at each phase using linear mixed-effects models and post hoc contrasts based on the models. RESULTS Overall mean stress (0=not at all to 4=a lot) during the pre phase was 0.8 for Black and White participants (range for Black participants: 0-3.9; range for White participants: 0-2.8). There was an increase of 0.3 points (t5649=5.2, P<.001) in the during phase as compared with the pre phase, and an increase of 0.2 points (t5649=3.1, P=.002) in the post phase compared with the pre phase (n=85). No difference was found between Black and White participants in the change in mean stress from the pre phase to the during phase (overall change predicted for the regression coefficient=-0.02, P=.87). There was a significant difference between Black and White participants in the change in mean stress from the during phase to the post phase (overall change predicted for the regression coefficient=0.4, P<.001). CONCLUSIONS There was an overall increase in mean stress levels in this subset of pregnant and postpartum participants during the same time as the emergency declarations/stay-at-home orders in the United States. Compared to baseline, mean stress levels remained elevated when stay-at-home orders eased. We found no significant difference in the mean stress levels by race. Given that stress is associated with adverse birth outcomes and postpartum health, stress induced by the ongoing COVID-19 pandemic may have adverse implications for birthing populations in the United States. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/13569.
Collapse
Affiliation(s)
- Serwaa S Omowale
- School of Social Work, University of Pittsburgh, Pittsburgh, PA, United States
- Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrea Casas
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yu-Hsuan Lai
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sarah A Sanders
- Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ashley V Hill
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Stephen L Rathbun
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, United States
| | - Tiffany L Gary-Webb
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lora E Burke
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Esa M Davis
- Division of Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Dara D Mendez
- Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Division of Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| |
Collapse
|
22
|
Opara I, Hill AV, Calhoun A, Francois M, Alves C, Garcia-Reid P, Reid RJ. Sociopolitical control as a mediator between ethnic identity and social support on 30-day drug use among black girls. J Ethn Subst Abuse 2021:1-20. [PMID: 34533434 PMCID: PMC8926931 DOI: 10.1080/15332640.2021.1975007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
While Black girls have lower rates of drug use, they face worse health and wellbeing consequences associated with drug use. Understanding which strengths-based factors serve as buffers to limit adverse outcomes related to drug use among Black girls is essential for prevention. This study investigated the mediating role of sociopolitical control on drug use among Black girls (n = 340). Using path analysis, models were tested to include the variables of interest. Sociopolitical control (e.g. leadership competency and policy control) significantly mediated the relationship between ethnic identity and social support on drug use. Implications from this study may consider bolstering empowerment-based strategies in drug use prevention for Black girls.
Collapse
Affiliation(s)
- Ijeoma Opara
- Yale School of Public Health, Yale University, New Haven, Connecticut
| | | | - Amanda Calhoun
- Yale University School of Medicine, New Haven, Connecticut
| | | | | | | | | |
Collapse
|
23
|
Coulter RWS, Paglisotti T, Montano G, Bodnar K, Bersamin M, Russell ST, Hill AV, Mair C, Miller E. Intersectional Differences in Protective School Assets by Sexuality, Gender, Race/Ethnicity, and Socioeconomic Status. J Sch Health 2021; 91:318-330. [PMID: 33740272 PMCID: PMC8432425 DOI: 10.1111/josh.13005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 11/03/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND School assets-such as connectedness, caring relationships with adults, high behavioral expectations from adults, and meaningful participation-are associated with positive outcomes for adolescents. However, little is known about how school assets differ among adolescents with intersecting marginalized identities. METHODS We used the 2013-2014 California Healthy Kids Survey (N = 320,462 students) to examine differences in school assets with respect to sexuality, gender, race/ethnicity, and socioeconomic status using adjusted multilevel linear regression models. RESULTS Sexual minority, gender minority, racial/ethnic minority, and low socioeconomic status adolescents had significantly lower protective school assets. For all outcomes, the differences between sexual minority and heterosexual adolescents were more pronounced among nontransgender girls than nontransgender boys; however, these differences were not consistently present among racial/ethnic minority students. For school connectedness and meaningful participation, differences for racial/ethnic minorities versus white adolescents were more pronounced among nontransgender girls than nontransgender boys. Differences between transgender adolescents and nontransgender boys were more pronounced for white adolescents compared to some other racial/ethnic minority students. Overall, adolescents with certain multiple marginalized identities had lower school assets. CONCLUSIONS Interventions are needed to strengthen school assets among marginalized students, thereby helping mitigate health and education inequities.
Collapse
Affiliation(s)
- Robert W S Coulter
- Assistant Professor, , Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 6129 Public Health Building, 130 De Soto Street, Pittsburgh, PA, 15261., USA
| | - Taylor Paglisotti
- Data Analyst Coordinator, , Department of Pediatrics, School of Medicine, University of Pittsburgh, 120 Lytton Avenue, Pittsburgh, PA, 15213-1444., USA
| | - Gerald Montano
- Assistant Professor of Pediatrics, , Department of Pediatrics, School of Medicine, University of Pittsburgh, University Center, Suite 225, 120 Lytton Avenue, Pittsburgh, PA, 15213-1481., USA
| | - Kaitlin Bodnar
- Research Assistant, , University of Pittsburgh, Graduate School of Public Health, P.O. Box 7319, Pittsburgh, PA, 15213., USA
| | - Melina Bersamin
- Senior Research Scientist, , Prevention Research Center, 1516 East Franklin Street, Chapel Hill, NC, 27514., USA
| | - Stephen T Russell
- Professor, , Department of Human Development and Family Sciences, Population Research Center, University of Texas at Austin, 108 E Dean Keeton Street, Austin, TX, 78712., USA
| | - Ashley V Hill
- Postdoctoral Researcher, , Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University Center, Suite 302.4, 120 Lytton Avenue, Pittsburgh, PA, 15213-1481., USA
| | - Christina Mair
- Associate Professor, , Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 6136 Public Health Building, 130 De Soto Street, Pittsburgh, PA, 15261., USA
| | - Elizabeth Miller
- Professor, , Department of Pediatrics, School of Medicine, University of Pittsburgh, University Center, Suite 302.2, 120 Lytton Avenue, Pittsburgh, PA, 15213-1481., USA
| |
Collapse
|
24
|
Gilreath TD, Dangerfield DT, Montiel Ishino FA, Hill AV, Johnson RM. Polytobacco use among a nationally-representative sample of black high school students. BMC Public Health 2021; 21:206. [PMID: 33485321 PMCID: PMC7824955 DOI: 10.1186/s12889-021-10228-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 01/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background Studies of the patterns of polytobacco use have increased. However, understanding the patterns of using multiple tobacco products among Black adolescents is minimal. This study identified the patterns of polytobacco use among U.S. Black adolescents. Methods Latent class analysis (LCA) was used to identify patterns of adolescent polytobacco use among a representative sample of Black youth from the 2017 Youth Risk Behavior Survey (n = 2782). Ever and recent (past 30 day) use of cigarettes, electronic cigarettes, cigars, and dip or chewing tobacco were used as latent class indicators. Multinomial regression was conducted to identify the association if smoking adjusting for sex, age, grade, and marijuana use. Results Most students were in the 9th grade (29%), e-cigarette users (21%) and were current marijuana users (25%). Three profiles of tobacco use were identified: Class 1: Non-smokers (81%), Class 2: E-cigarette Users (14%), and Class 3: Polytobacco Users (5%). Black adolescent Polytobacco users were the smallest class, but had the highest conditional probabilities of recent cigarette use, e-cigarette use, ever smoking cigars or chewing tobacco. Ever and current use of marijuana were associated with increased odds of being in the e-cigarette user versus non-smoker group, and current marijuana use was associated with increased odds of polytobacco use (aOR = 24.61, CI = 6.95–87.11). Conclusions Findings suggests the need for targeted interventions for reducing tobacco use and examining the unique effects of polytobacco use on Black adolescents. Findings confirm a significant association of marijuana use with tobacco use.
Collapse
Affiliation(s)
- Tamika D Gilreath
- Department of Health & Kinesiology, College Station, Texas A & M University, 267 Gilchrist, 4243 TAMU, College station, TX, 77843-4243, USA.
| | | | - Francisco A Montiel Ishino
- Division of Intramural Research, National Institute for Minority Health Disparities, Bethesda, MD, 20892, USA
| | - Ashley V Hill
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Renee M Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
25
|
Hill AV, Perez-Patron M, Tekwe CD, Menon R, Hairrell D, Taylor BD. Chlamydia trachomatis Is Associated With Medically Indicated Preterm Birth and Preeclampsia in Young Pregnant Women. Sex Transm Dis 2020; 47:246-252. [PMID: 32004256 PMCID: PMC8096198 DOI: 10.1097/olq.0000000000001134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Studies on Chlamydia trachomatis-associated pregnancy outcomes are largely conflicting, ignoring the heterogeneous natures of pregnancy complications and potential effect modification by maternal age. This study determined if prenatal C. trachomatis infection is associated with preterm birth (PTB) and preeclampsia subtypes. METHODS A retrospective cohort study was conducted using 22,772 singleton pregnancies with a prenatal C. trachomatis diagnostic test. Spontaneous and medically indicated PTBs, and term and preterm preeclampsia were outcomes. Modified Poisson regression calculated relative risk (RR) and 95% confidence intervals (CI) with propensity score adjustments stratified by maternal ages <25 and ≥25 years. RESULTS Overall, C. trachomatis was significantly associated with term preeclampsia (adjusted RR [RRadj], 1.88; 95% CI, 1.38-2.57). Among young women (age <25 years), C. trachomatis was significantly associated with medically indicated PTB (RRadj, 2.29; 95% CI, 1.38-3.78) and term preeclampsia (RRadj, 1.57; 95% CI, 1.05-2.36) in propensity-adjusted models. No significant associations in older women were detected. CONCLUSION C. trachomatis was associated with medically indicated PTB and term preeclampsia in young women. Associations between chlamydia and perinatal outcomes may depend on the subtype of PTB and preeclampsia, which should be investigated through mechanistic studies.
Collapse
Affiliation(s)
- Ashley V. Hill
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX USA
| | - Maria Perez-Patron
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX USA
| | - Carmen D. Tekwe
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN USA
| | - Ramkumar Menon
- Division of Maternal-Fetal Medicine & Perinatal Research, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX USA
| | - Deanna Hairrell
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX USA
| | - Brandie D. Taylor
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX USA
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA USA
| |
Collapse
|
26
|
Hill AV, Menon R, Perez-Patron M, Carrillo G, Xu X, Taylor BD. High-mobility group box 1 at the time of parturition in women with gestational diabetes mellitus. Am J Reprod Immunol 2019; 82:e13175. [PMID: 31353785 DOI: 10.1111/aji.13175] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/28/2019] [Accepted: 07/19/2019] [Indexed: 12/14/2022] Open
Abstract
PROBLEM High-mobility group box 1 (HMGB1), a danger-associated molecular pattern marker, may indicate sterile inflammation through innate immune pathways. HMGB1 is implicated in hyperglycemia and excess glucose in trophoblast. Metabolic dysfunction and dyslipidemia are associated with gestational diabetes mellitus (GDM), but few studies examined associations between HMGB1 and GDM. We determined HMGB1 levels, and the ratio of HMGB1 to innate immune markers, in women with GDM at parturition. METHOD OF STUDY This case-control study of 50 GDM pregnancies and 100 healthy controls utilized data and plasma samples from PeriBank. HMGB1, pentraxin-3, and interleukin (IL)-6 were measured by ELISA. Logistic regression calculated odds ratios (OR) and 95% confidence intervals (CI) adjusting for age, pre-pregnancy body mass index, and type of labor. RESULTS There were no significant associations between HMGB1 and GDM. The ratio of HMGB1 to pentraxin-3 and IL-6 did not alter the odds of GDM. There was a significant statistical interaction between HMGB1 and maternal age (P = .02). When associations were examined by age groups, HMGB1 was associated with reduced odds of HMGB1 among women ≤25 (AOR = 0.007 CI 95% <0.001-0.3). Odds ratios increased as age increased (AOR range 1.2-3.8) but results were not statistically significant. CONCLUSION High-mobility group box 1 was not associated with GDM. However, we found evidence that maternal age was a potential effect modifier of the relationship between HMGB1 and GDM. As there is growing evidence that HMGB1 may play important roles in reproduction, future studies should explore maternal factors that may alter HMGB1 levels.
Collapse
Affiliation(s)
- Ashley V Hill
- Department of Epidemiology and Biostatistics, Texas A&M University, College Station, TX, USA.,Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ramkumar Menon
- Division of Maternal-Fetal Medicine and Perinatal Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Maria Perez-Patron
- Department of Epidemiology and Biostatistics, Texas A&M University, College Station, TX, USA
| | - Genny Carrillo
- Department of Environmental and Occupational Health, Texas A&M University, College Station, TX, USA
| | - Xiaohui Xu
- Department of Epidemiology and Biostatistics, Texas A&M University, College Station, TX, USA
| | - Brandie D Taylor
- Department of Epidemiology and Biostatistics, Texas A&M University, College Station, TX, USA.,Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA, USA
| |
Collapse
|
27
|
Hill AV, De Genna NM, Perez-Patron MJ, Gilreath TD, Tekwe C, Taylor BD. Identifying Syndemics for Sexually Transmitted Infections Among Young Adults in the United States: A Latent Class Analysis. J Adolesc Health 2019; 64:319-326. [PMID: 30447953 DOI: 10.1016/j.jadohealth.2018.09.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/14/2018] [Accepted: 09/15/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Syndemic theory suggests that the convergence of social, environmental, and ecological factors can interact to exacerbate behavioral health problems and are often intensified by social conditions and disparities. This study used latent class analysis (LCA) to determine gender and racial/ethnic specific classes for sexually transmitted infection (STI) risk. METHODS LCA included 18 measured socioeconomic, depression, substance use, and sexual behavioral variables from 1,664 young adults ages 18-25 in the NHANES. Models were stratified by gender and then by race/ethnicity. Logistic regression determined associations between latent class membership and testing positive for one or more STIs (Chlamydia trachomatis, HIV or herpes simplex virus-II). For each stratified analysis, classes with the lowest probability of reported risk factors in the LCA were the reference groups. RESULTS Class 3 in females (highest probability of reporting both socioeconomic and behavioral factors) and class 3 in males (majority behavioral factors) had increased odds of STI (females: OR = 2.7, 95% CI 1.6-4.5; males: OR 2.5, 95% CI 1.3-4.6). By race for females, depression (highest in Hispanics), poverty, and less educated households (highest in blacks and Hispanics) were evident in classes associated with STI. Class 1 black males (majority behavioral factors) had a higher odds of STI compared with low risk white males (OR = 16.4 95% CI 3.7-72.0) However, no other associations were observed among males. CONCLUSIONS Risk patterns for STI differed by gender and race/ethnicity. Consistent with syndemic theory, effective STI interventions need to address socioeconomic factors and mental health rather than individual behaviors, particularly for minority women.
Collapse
Affiliation(s)
- Ashley V Hill
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, Texas.
| | - Natacha M De Genna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maria J Perez-Patron
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, Texas
| | - Tamika D Gilreath
- Transdisciplinary Center for Health Equity Research, College of Education and Human Development, Texas A&M University, College Station, Texas
| | - Carmen Tekwe
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, Texas
| | - Brandie DePaoli Taylor
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, Pennsylvania.
| |
Collapse
|
28
|
|
29
|
|
30
|
Affiliation(s)
- A V Hill
- Physiological Laboratory, University of Manchester, Manchester, England
| |
Collapse
|
31
|
Moorthy VS, Diggs C, Ferro S, Good MF, Herrera S, Hill AV, Imoukhuede EB, Kumar S, Loucq C, Marsh K, Ockenhouse CF, Richie TL, Sauerwein RW. Report of a consultation on the optimization of clinical challenge trials for evaluation of candidate blood stage malaria vaccines, 18-19 March 2009, Bethesda, MD, USA. Vaccine 2009; 27:5719-25. [PMID: 19654061 DOI: 10.1016/j.vaccine.2009.07.049] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Accepted: 07/17/2009] [Indexed: 10/20/2022]
Abstract
Development and optimization of first generation malaria vaccine candidates has been facilitated by the existence of a well-established Plasmodium falciparum clinical challenge model in which infectious sporozoites are administered to human subjects via mosquito bite. While ideal for testing pre-erythrocytic stage vaccines, some researchers believe that the sporozoite challenge model is less appropriate for testing blood stage vaccines. Here we report a consultation, co-sponsored by PATH MVI, USAID, EMVI and WHO, where scientists from all institutions globally that have conducted such clinical challenges in recent years and representatives from regulatory agencies and funding agencies met to discuss clinical malaria challenge models. Participants discussed strengthening and harmonizing the sporozoite challenge model and considered the pros and cons of further developing a blood stage challenge possibly better suited for evaluating the efficacy of blood stage vaccines. This report summarizes major findings and recommendations, including an update on the Plasmodium vivax clinical challenge model, the prospects for performing experimental challenge trials in malaria endemic countries and an update on clinical safety data. While the focus of the meeting was on the optimization of clinical challenge models for evaluation of blood stage candidate malaria vaccines, many of the considerations are relevant for the application of challenge trials to other purposes.
Collapse
Affiliation(s)
- V S Moorthy
- Initiative for Vaccine Research, Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Hennig BJ, Fry AE, Hirai K, Tahara H, Tamori A, Moller M, Hopkin J, Hill AV, Bodmer W, Beverley P, Tchilian E. PTPRC (CD45) variation and disease association studied using single nucleotide polymorphism tagging. ACTA ACUST UNITED AC 2008; 71:458-63. [PMID: 18312479 DOI: 10.1111/j.1399-0039.2008.01014.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
CD45 is a haemopoietic tyrosine phosphatase, crucial for lymphocyte signalling. Two polymorphisms (C77G and A138G), which alter CD45 isoform expression, are associated with autoimmune and infectious diseases. Using HapMap data, we show that there is substantial linkage disequilibrium across the CD45 gene (PTPRC), with similar patterns in different populations. Employing a set of single nucleotide polymorphisms, correlated with a substantial proportion of variation across this gene, we tested for association with type 1 diabetes, Graves' disease in a Japanese population, hepatitis C in UK population and tuberculin response in a Chinese population. A limited number of common haplotypes was found. Most 138G alleles are present on only one haplotype, which is associated with Graves' disease, supporting previous data that A138G is a functionally important CD45 polymorphism.
Collapse
Affiliation(s)
- B J Hennig
- Wellcome Trust Centre for Human Genetics, University of Oxford, and John Radcliffe Hospital, Oxford, UK
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
|
34
|
|
35
|
|
36
|
|
37
|
Barcroft J, Bock AV, Hill AV, Parsons TR, Parsons W, Shoji R. On the hydrogen-ion concentration and some related properties of normal human blood. J Physiol 2007; 56:157-78. [PMID: 16993559 PMCID: PMC1405393 DOI: 10.1113/jphysiol.1922.sp001999] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
38
|
|
39
|
|
40
|
|
41
|
|
42
|
|
43
|
|
44
|
|
45
|
|
46
|
|
47
|
|
48
|
|
49
|
|
50
|
|