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Vina ER, Patel P, Grest CV, Kwoh CK, Jakiela JT, Bye T, White DK. Does Physical Activity Confound Race Differences in Osteoarthritis-Related Functional Limitation? Arthritis Care Res (Hoboken) 2024; 76:200-207. [PMID: 37518677 DOI: 10.1002/acr.25209] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 04/11/2023] [Revised: 06/29/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE This study sought to determine the extent to which physical activity confounds the relation between race and the incidence of osteoarthritis (OA)-related functional limitation. METHODS OA Initiative study participants with or at increased risk of knee OA who wore an accelerometer were included. Race was self-reported. Average time spent in moderate to vigorous physical activity (minutes per day) based on ActiGraph uniaxial accelerometer data was assessed. Functional limitation was based on the following: (1) inability to achieve a community walking speed (1.2 m/s) standard, (2) slow walking speed (<1.0 m/s), and (3) low physical functioning based on a Western Ontario and McMaster Universities OA Index (WOMAC) physical function score greater than 28 of 68. RESULTS African American (AA) participants (n = 226), compared with White participants (n = 1348), had a higher likelihood of developing functional limitation based on various measures. When adjusted for time in moderate to vigorous physical activity, the association between AA race and inability to walk a community walking speed slightly decreased (from relative risk [RR] 2.15, 95% confidence interval [95% CI] 1.64-2.81, to RR 1.99, 95% CI 1.51-2.61). Association between AA race and other measures of functional limitation mildly decreased (slow walking speed: from RR 2.06, 95% CI 1.40-3.01, to RR 1.82, 95% CI 1.25-2.63; low physical functioning: from RR 3.44, 95% CI 1.96-6.03, to RR 3.10, 95% CI 1.79-5.39). When further adjusted for demographic and other clinical variables, only the association between race and low physical functioning (WOMAC) significantly decreased and no longer met statistical significance. CONCLUSION Greater physical activity is unlikely to completely make up for race differences in OA-related functional limitation, and other barriers to health equity need to be addressed.
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Affiliation(s)
- Ernest R Vina
- Temple University, Philadelphia, Pennsylvania, and University of Arizona, Tucson
| | - Puja Patel
- Temple University, Philadelphia, Pennsylvania
| | | | - C Kent Kwoh
- University of Arizona College of Medicine, Tucson
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Kobulsky JM, Cederbaum JA, Wildfeuer R, Grest CV, Clarke L, Kordic T. Comparing the prevalence of sexual behaviors and victimization among adolescents based on child welfare system involvement. Child Abuse Negl 2022; 134:105883. [PMID: 36115325 DOI: 10.1016/j.chiabu.2022.105883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/16/2021] [Revised: 09/01/2022] [Accepted: 09/08/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Sexual behavior presents risks, particularly among vulnerable groups such as adolescents with child welfare system involvement. This study compares the prevalence of sexual behaviors and victimization among adolescents in Los Angeles County with and without child welfare system involvement. It examines associations between online and offline sexual behaviors and victimization. METHODS The sample included middle and high school students (N = 2365) and high school students only (N = 1068) participating in the 2015 Los Angeles Youth Risk Behavior Survey (YRBS). Measures included child welfare system involvement with or without foster care placement, demographics (race, ethnicity, gender, age), in-person sexual behaviors (e.g., unsafe sex), online sexual behaviors (e.g., sent/received sext), and sexual victimization (forced sex, dating physical violence, dating sexual assault). Logistic regressions examined variability in sexual behaviors and victimization based on child welfare involvement, net of demographics. Path analyses associated online sexual behaviors with victimization and offline risk. RESULTS Greater reported sexual behavior and victimization among foster care youths was found, relative to youths without child welfare system involvement (maximum OR = 9.8). Youth with child welfare system involvement but not placed in foster care reported more unsafe sex, sexting because of pressure, finding a sex partner online, having sex with a partner met online, and forced sex (maximum OR = 10.4). Sexting was associated with forced sex and dating sexual assault, finding a sexual partner online, and physical violence. CONCLUSIONS Targeted prevention is needed for online and offline sexual risks and victimization among youth with child welfare system involvement.
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Affiliation(s)
- Julia M Kobulsky
- School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore Ave. #551, Philadelphia, PA 19122, United States of America.
| | - Julie A Cederbaum
- Dworak-Peck School of Social Work, University of Southern California, 669 West 34th Street Montgomery Ross Fisher, 222, Los Angeles, CA 90089-0411, United States of America.
| | - Rachel Wildfeuer
- Department of Sociology, Temple University, 115 Polett Walk, Philadelphia, PA 19122, United States of America.
| | - Carolina Villamil Grest
- School of Social Work, College of Public Health, Temple University, 1301 Cecil B. Moore Ave. #551, Philadelphia, PA 19122, United States of America.
| | - Lauren Clarke
- Dworak-Peck School of Social Work, University of Southern California, 669 West 34th Street Montgomery Ross Fisher, 222, Los Angeles, CA 90089-0411, United States of America.
| | - Timothy Kordic
- Los Angeles Unified School District, United States of America
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Grest CV, Cederbaum JA, Lee DS, Choi YJ, Cho H, Hong S, Yun SH, Lee JO. Cumulative Violence Exposure and Alcohol Use Among College Students: Adverse Childhood Experiences and Dating Violence. J Interpers Violence 2022; 37:557-577. [PMID: 32248736 DOI: 10.1177/0886260520913212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Multiple types of childhood adversities are risk factors for dating violence among college-age youth and in turn, dating violence is associated with alcohol use. This work quantitatively examines associations of childhood adversity and dating violence with alcohol use among college students using a cumulative stress approach. Multi-campus surveys were collected from March to December 2016 in four universities across the United States and Canada (n = 3,710). Latent class analysis identified patterns of childhood adversity and dating violence. Regression analyses investigated the associations of latent class patterns with past year number of drinks, alcohol use frequency, and problematic drinking. Latent class analysis produced seven classes: "low violence exposure" (18.5%), "predominantly peer violence" (28.9%), "peer violence and psychological child abuse" (10.8%), "peer and parental domestic violence" (9.9%), "peer and psychological dating violence" (17%), "peer and dating violence" (6.6%), and "childhood adversity and psychological dating violence" (8.3%). Compared to the "low violence exposure" group, "peer and psychological dating violence" (B = .114, p < .05), "peer and dating violence" (B = .143, p < .05), and "childhood adversity and psychological dating violence" (B = .183, p < .001) groups were significantly associated with problematic drinking. Results highlight how childhood adversity and dating violence contribute to problematic alcohol use, suggesting interventions that address both childhood adversity and dating violence may be most effective at reducing alcohol misuse among college students.
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Affiliation(s)
| | | | - Daniel S Lee
- University of Southern California, Los Angeles, USA
| | | | - Hyunkag Cho
- Michigan State University, East Lansing, USA
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Villamil Grest C, Cederbaum JA, Lee JO, Unger JB. Adverse childhood experiences and the substance use behaviors of Latinx youth. Drug Alcohol Depend 2021; 227:108936. [PMID: 34365223 DOI: 10.1016/j.drugalcdep.2021.108936] [Citation(s) in RCA: 3] [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: 01/05/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Adverse childhood experiences (ACEs) are associated with substance use, how cultural factors influence this association for Latinx youth is unknown. This study uses longitudinal data to examine associations of cultural factors, ACEs and substance use among Latinx young adults. METHODS Latinx youth (N = 1179) completed surveys from a longitudinal study at seven assessment points from 2005 to 2016; ACEs was assessed when participants were on average 21.6 and substance use 23.9 years. ACEs measured psychological, physical, and sexual abuse, parental violence, divorce, substance use, mental illness, and incarceration. A three-stage hierarchical ordinary least squares (alcohol use) and negative binomial regression models (problematic alcohol, marijuana and tobacco use) were estimated to evaluate the role of cultural factors (acculturation, enculturation and ethnic identity) and ACEs in shaping substance use behaviors. RESULTS Controlling for cultural variables, ACEs sum (B = 0.03, p = .01), maltreatment (B = 0.16, p < .01), and household (B = 0.12, p = .03) subdomains predicted alcohol use. One additional increase in maltreatment (IRR=1.23, 95 % CI: 1.00, 1.53) predicted 23 % higher count of problematic alcohol use. Maltreatment (IRR=1.50, 95 % CI: 1.05, 2.13) and household (IRR=1.66, 95 % CI: 1.18, 2.32) subdomains predicted increased counts of marijuana use. Four or more ACEs predicted increased counts of tobacco use (IRR=1.49, 95 % CI: 1.08, 2.06) among Latinx young adults. CONCLUSIONS Results suggest a predictive relationship between ACEs, and alcohol, marijuana and tobacco use, after accounting for cultural factors. Beyond acculturation, enculturation and ethnic identity, findings identify ACEs as a salient predictor of substance use among Latinx young adults.
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Affiliation(s)
- Carolina Villamil Grest
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th Street, Los Angeles, CA, 90989, United States.
| | - Julie A Cederbaum
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th Street, Los Angeles, CA, 90989, United States.
| | - Jungeun Olivia Lee
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th Street, Los Angeles, CA, 90989, United States.
| | - Jennifer B Unger
- Keck School of Medicine, University of Southern California, 2001 N. Soto Street, SSB 302, Los Angeles, CA, 90032, United States.
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Grest CV, Finno-Velasquez M, Cederbaum JA, Unger JB. Adverse Childhood Experiences Among 3 Generations of Latinx Youth. Am J Prev Med 2021; 60:20-28. [PMID: 33341179 DOI: 10.1016/j.amepre.2020.07.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The U.S. immigrant paradox shows worsening health across generations, with U.S.-born Latinx having poorer health outcomes than immigrants. Adverse childhood experiences are associated with increased health risk over the life course, warranting further investigation. This study examines adverse childhood experience distribution across generations in a community sample of first-, second-, and +third-generation Latinx youth. METHODS Survey data were collected at 7 timepoints from 2005 to 2016; 1,303 participants completed follow-ups, including adverse childhood experiences, at Timepoint 5 (mean age=21.6 years). These analyses were performed in 2019. Adverse childhood experiences measured psychological, physical, and sexual abuse, and parental domestic violence, divorce, alcohol/drug use, mental illness, and incarceration. Adverse childhood experiences were operationalized as a continuous variable (number) and by 2 groups: household dysfunction and maltreatment. Associations between immigrant generation and adverse childhood experiences were analyzed in adjusted logistic and multiple regression models. RESULTS Compared with +third-generation youth, first- (OR=0.49, 95% CI=0.27, 0.89) and second- (OR=0.43, 95% CI=0.26, 0.72) generation youth had lower odds of reporting household dysfunction. For first-generation youth, this was specific to living with an alcohol/drug user (OR=0.49, 95% CI=0.29, 0.81). In contrast to other adverse childhood experiences, first-generation youth had twice the odds of reporting sexual abuse (OR=2.01, 95% CI=1.04, 3.88) compared with +third-generation youth. CONCLUSIONS Preventing health disparities among immigrant-origin youth requires understanding the impact of adverse childhood experiences on Latinx youth across generations. Results highlight associations among a Latinx youth community sample, suggesting variations in experiences across generations. Household factors in childhood may be key targets for interventions aimed at improving the outcomes observed in later generations for Latinx families.
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Affiliation(s)
- Carolina Villamil Grest
- School of Social Work, Temple University College of Public Health, Philadelphia, Pennsylvania.
| | | | - Julie A Cederbaum
- Department of Children, Youth, and Families, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Jennifer B Unger
- Institute for Health Promotion and Disease Prevention, University of Southern California, Keck School of Medicine, Los Angeles, California
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Le HN, Perry DF, Villamil Grest C, Genovez M, Lieberman K, Ortiz-Hernandez S, Serafini C. A mixed methods evaluation of an intervention to prevent perinatal depression among Latina immigrants. J Reprod Infant Psychol 2020; 39:382-394. [PMID: 32186924 DOI: 10.1080/02646838.2020.1733504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/24/2022]
Abstract
Objective: The effectiveness of a cognitive behavioural intervention to prevent perinatal depression in low-income Latina immigrant pregnant women and mothers receiving WIC services was evaluated in a mixed methods study using a community based observational design.Background: The Mothers and Babies Course is a preventive intervention for perinatal depression that is based on cognitive behavioural theory (CBT). CBT is an evidence-based treatment and preventive intervention for perinatal depression.Method: Phase 1 includes 86 Latinas, predominantly Central American immigrant women at high risk for depression, who self-selected into the Mothers and Babies Course, a six-week Spanish CBT group intervention aimed at teaching women mood regulation skills to prevent the onset of depression. Participants, who were recruited from the Women, Infants, and Children services, completed measures of depression and psychopathology at pre-, 6 weeks, and 3 months post-intervention. Phase 2 includes qualitative interviews with a randomly selected subsample (n = 26) from Phase 1 to understand the mechanisms and impact of participants' experiences with the intervention and study.Results: Results indicated no significant differences in depressive symptoms among participants with varied attendance levels (0 class; 1-3 classes = non-completers; 4-6 classes = completers). None of the participants met diagnostic criteria for major depressive disorder at the final data collection period. Despite the varied attendance, both quantitative and qualitative results indicated that completers and non-completers reported similar experiences in the intervention and benefiting from study participation.Conclusion: Conducting mixed methods research highlights the complexity of understanding who can benefit from preventive interventions.
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Affiliation(s)
- Huynh-Nhu Le
- George Washington University, Washington, DC, USA
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Grest CV, Amaro H, Unger J. Longitudinal Predictors of Intimate Partner Violence Perpetration and Victimization in Latino Emerging Adults. J Youth Adolesc 2018; 47:560-574. [PMID: 28382461 DOI: 10.1007/s10964-017-0663-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 10/28/2016] [Accepted: 03/17/2017] [Indexed: 12/01/2022]
Abstract
Despite the prevalence of intimate partner violence in emerging adulthood, literature focused on this life stage among Latinos remains limited. This longitudinal study examined acculturation; traditional gender role attitudes; use of alcohol, marijuana, and tobacco; and depressive symptoms in 10th grade as predictors of intimate partner violence perpetration and victimization among Latino emerging adults (N = 823; 58% female). Average age of participants was 15.5 years in 10th grade and 22.7 years in emerging adulthood. The results indicate important gender differences in intimate partner violence outcomes for Latino emerging adults. Higher U.S. acculturation predicted physical intimate partner violence perpetration among young men. More traditional gender role attitudes were significantly associated with psychological and physical intimate partner violence perpetration among male Latino emerging adults. Among Latinas, alcohol use in 10th grade predicted psychological perpetration and victimization in emerging adulthood. The findings have implications for developing gender- and ethnic-relevant prevention interventions focused on intimate partner violence among Latino adolescents and emerging adults.
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Affiliation(s)
- Carolina Villamil Grest
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, 90089, USA.
| | - Hortensia Amaro
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, 90089, USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jennifer Unger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Boden JM, Lee JO, Horwood LJ, Grest CV, McLeod GF. Modelling possible causality in the associations between unemployment, cannabis use, and alcohol misuse. Soc Sci Med 2017; 175:127-134. [DOI: 10.1016/j.socscimed.2017.01.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 11/29/2016] [Accepted: 01/02/2017] [Indexed: 12/01/2022]
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