Parent-child relationship variables are often measured using a two-part approach. For example, when assessing the warmth of the father-child relationship, a child is first asked if they have contact with their father; if so, the level of warmth they feel toward him is ascertained. In this setting, data on the warmth measure is missing for children without contact with their father, and such missing data can pose a significant methodological and substantive challenge when the variable is used as an outcome or antecedent variable in a model. In both cases, it is advantageous to use an analytic method that simultaneously models whether the child has contact with the father, and if they do, the degree to which the father-child relationship is characterized by warmth. This is particularly relevant when the two-part variable is measured over time, as contact status may change. We offer a pragmatic tutorial for using two-part variables in regression models, including a brief overview of growth modeling, an explanation of the techniques to handle two-part variables as predictors and outcomes in the context of growth modeling, examples with real data, and syntax in both R and Mplus for fitting all discussed models.
Objective: We examined married African American breast cancer survivors' perceptions of how cancer affected their marriage, social support from their spouses, and spouses' physical and mental health.
Method: We conducted a thematic analysis of semi-structured interviews with 15 married African American breast cancer survivors who had participated in a larger randomized controlled trial. Interviews were professionally transcribed and then independently coded by two coders.
Results: Themes emerged related to the challenges of maintaining mutually supportive relationships. There was variability in the perceived effects of cancer on relationships, as well as uncertainty about cancer's effects on their husbands' emotional and physical health and the adequacy of emotional and tangible support from their husbands. Participants described husbands' key role in promoting wives' positive body image, as well as the challenges of negotiating sexual activity. Participants were receptive to help from medical professionals in dealing with relationship issues.
Conclusions: Findings show variability in couples' responses to cancer, with some patients and couples adapting well and others needing additional support. During treatment and at follow-up, oncology social workers can assess patients' and family members' social support needs, provide mental health services, and provide patient navigation to help patients and caregivers access health care and community resources.
Objective: A syndemic of violence exposure, substance misuse, and mental health problems (i.e., depression, anxiety, posttraumatic stress disorder) is associated with increased unprotected anal sex and number of sexual partners in young men who have sex with men (YMSM). However, few studies have examined multiple forms of violence-including childhood abuse, intimate partner violence, and community violence-and identified which factors are significant predictors of HIV risk for YMSM when controlling for all other factors. Accordingly, this study examined the additive and independent influence of different forms of violence, substance misuse, and mental health problems associated with sexual risk behaviors in YMSM who used HIV prevention services.
Method: A convenience sample of 168 (97 Black or multiethnic Black, 71 white) YMSM ages 18-34 completed computer-assisted personal interviews assessing syndemic factors and HIV risk behaviors. We conducted Spearman correlations and negative binomial regressions to describe syndemic relationships and identify the significant independent predictors of HIV risk.
Results: A syndemic of violence exposure, substance use, and mental health problems was observed in the sample. Also, participants with depression, drug abuse in the clinical range, and polydrug use reported significantly higher frequencies of sexual risk behaviors. Violence exposure did not uniquely predict sexual risk.
Conclusions: Depression, drug abuse, and polydrug use should be targets for HIV prevention among YMSM using HIV prevention services.
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