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Clinician Perspectives on Implementing HPV Vaccination Guidelines into Practice.
IF 2 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2024-12-20 DOI: 10.1080/08964289.2024.2438022
Erika L Thompson, Idara N Akpan, Tanjila Taskin, Sarah Alkhatib, Jessica Grace, Ellen M Daley, Gregory D Zimet, Christopher W Wheldon

In the United States, HPV vaccination is available for unvaccinated 27 to 45 year olds based on a shared clinical decision with a health care provider. Since the implementation of the guideline, little has been known about provider perceptions of this recommendation. The purpose of this study was to elucidate health care provider perspectives on HPV vaccination for 27 to 45 year olds in the United States. Semi-structured interviews were conducted virtually with 18 health care providers regarding current HPV vaccination practices for 27 to 45 year olds, perceptions of the guideline, and shared clinical decision-making needs. Thematic analysis was conducted using interview transcripts, and interrater reliability was achieved for >10% of the transcripts. Overall, most participants reported that they have recommended HPV vaccination to patients aged 27 to 45 year olds; however, they applied various criteria to guide these discussions. Some participants considered the patients' relationship statuses, sexual partnerships, past HPV infection history, and age. Potential needs to facilitate shared clinical decision-making processes included medical record prompts and brief educational materials. While most health care providers in this sample discussed HPV vaccination with their patients ages 27 to 45 years old, there were inconsistencies in the interpretation of the guideline. The lack of specificity in the recommendation will likely result in significant and potentially inequitable implementation difficulties.

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引用次数: 0
Adverse Childhood Experiences and Body Mass Index Status among Children and Youth with Special Health Care Needs. 有特殊健康护理需求的儿童和青少年的童年不良经历和体重指数状况。
IF 2 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2024-11-21 DOI: 10.1080/08964289.2024.2424172
Iulia Mihaila, Cheng-Shi Shiu, Leah Bernard, Deana Herrman, Janine Salameh, Kristin Berg, Kruti Acharya

The present study examined the association between adverse childhood experiences (ACEs) and body mass index (BMI) status among children and youth with special health care needs (CYSHCN), and the role of health characteristics and lifestyle factors in predicting BMI. Data from the 2016-2020 National Survey of Children's Health were utilized. Key variables included: ACEs, BMI status, level of functional impairment, depression, weekly level of physical activity, and daily screen time. Multivariable ordinal logistic regression analyses were used to examine associations between selected variables and BMI status. The sample consisted of 19,743 CYSHCN. Respectively, CYSHCN with exposure to 1-2 ACEs (vs. none) and 3+ ACEs (vs. none), had a 22% and 32% increase in odds of a one-level increase in BMI status, controlling for sociodemographic characteristics, level of functional impairment, and depression. When lifestyle factors (i.e., physical activity and screen time) were included in analyses, CYSHCN with exposure to 3+ ACEs (vs. none) had a 27% increase in odds of a one-level increase in BMI status. Thus, we found that ACEs were significantly associated with BMI status. However, the strength of this relation changed when considering CYSHCN health characteristics and CYSHCN lifestyle factors. A higher weekly level of physical activity, in particular, seemed to play a significant role in reducing risk of higher BMI status among CYSHCN with exposure to 3+ ACEs (vs. none). Findings support the development of physical activity promotion programs and education regarding strategic utilization of screen time (e.g., educational apps and games) for CYSHCN and their families.

本研究考察了有特殊医疗保健需求的儿童和青少年(CYSHCN)的童年不良经历(ACE)与体重指数(BMI)之间的关联,以及健康特征和生活方式因素在预测体重指数中的作用。研究利用了 2016-2020 年全国儿童健康调查的数据。主要变量包括ACE、BMI 状态、功能障碍程度、抑郁、每周体育活动量和每天屏幕时间。多变量序数逻辑回归分析用于研究选定变量与 BMI 状态之间的关联。样本包括 19743 名儿童健康中心的儿童。在控制社会人口特征、功能障碍程度和抑郁的情况下,接触过 1-2 次 ACE(与未接触过 ACE 相比)和 3 次以上 ACE(与未接触过 ACE 相比)的 CYSHCN 的 BMI 状态上升一级的几率分别增加了 22% 和 32%。当将生活方式因素(即体育活动和屏幕时间)纳入分析时,接触过3次以上ACE(与未接触过ACE相比)的幼儿健康中心儿童的BMI值增加一级的几率增加27%。因此,我们发现 ACE 与 BMI 状态有显著的关联。然而,当考虑到幼儿健康中心的健康特征和幼儿健康中心的生活方式因素时,这种关系的强度发生了变化。尤其是每周较高水平的体育活动,似乎在降低接触过 3+ ACEs(与未接触过 ACEs 相比)的 CYSHCN 的较高 BMI 状态风险方面发挥了重要作用。研究结果支持为幼儿健康网及其家庭制定体育活动促进计划,并开展有关战略性利用屏幕时间(如教育应用程序和游戏)的教育。
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引用次数: 0
Prospective Attitudes Towards Respiratory Syncytial Virus (RSV) Vaccine in Pregnant Women in Greece. 希腊孕妇对呼吸道合胞病毒 (RSV) 疫苗的前瞻性态度。
IF 2 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2024-11-15 DOI: 10.1080/08964289.2024.2424171
Anna Damatopoulou, Michail Matalliotakis, Ypatia Diamanta, Ioannis Pikrides, Emmanouil Ierapetritis, Persefoni Kakouri, Matthaios Fraidakis, Fani Ladomenou

Respiratory Syncytial Virus (RSV) is a common respiratory pathogen with high morbidity and mortality, especially in children under two years of age. Severe RSV infection poses a significant threat to healthcare systems, making vaccination an utmost need. In August 2023, the U.S. FDA approved an RSV maternal vaccine to prevent lower respiratory tract disease (LRTD) in infants throughout their first six months of life. This cross-sectional survey was designed to evaluate pregnant women's willingness to receive the vaccine during pregnancy. An anonymous survey was administered from April 2023 to December 2023 to pregnant women aged above 16 years old attending gynecology wards of randomly selected public and private hospitals in Crete. The primary outcome was the intention to receive the vaccine. Univariable and multivariable analyses were carried out to identify factors associated with the intention to get vaccinated. Questionnaires were distributed to a sample of 335 pregnant females who agreed to participate in this study. The intention to get vaccinated against RSV was positively associated with educational level, the presence of school-age children, RSV infection awareness, intention to get routine pregnancy vaccines according to the National Immunization Program (NIP), and previous vaccination against COVID-19. The majority of pregnant females were not familiar with the term RSV and the upcoming vaccine. An educational campaign regarding RSV infection and its vaccine is required to improve women's perceptions and to support healthcare workers in promoting it upon its availability in Greece.

呼吸道合胞病毒 (RSV) 是一种常见的呼吸道病原体,发病率和死亡率都很高,尤其是在两岁以下的儿童中。严重的 RSV 感染对医疗保健系统构成重大威胁,因此接种疫苗是当务之急。2023 年 8 月,美国 FDA 批准了一种 RSV 母体疫苗,用于预防婴儿出生后六个月内的下呼吸道疾病 (LRTD)。这项横断面调查旨在评估孕妇在怀孕期间接种该疫苗的意愿。从 2023 年 4 月到 2023 年 12 月,我们对在克里特岛随机选择的公立和私立医院妇科病房就诊的 16 岁以上孕妇进行了匿名调查。主要结果是接种疫苗的意向。研究人员进行了单变量和多变量分析,以确定与接种意向相关的因素。研究人员向同意参与本研究的 335 名孕妇发放了调查问卷。接种 RSV 疫苗的意愿与受教育程度、是否有学龄儿童、对 RSV 感染的认识、是否有意按照国家免疫计划(NIP)接种常规孕期疫苗以及之前是否接种过 COVID-19 疫苗呈正相关。大多数孕妇不了解 RSV 和即将接种的疫苗。有必要开展有关RSV感染及其疫苗的教育活动,以提高妇女的认识,并在疫苗在希腊上市后支持医护人员推广疫苗。
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引用次数: 0
The Role of Intersectional Stigma in Coronary Artery Disease Among Cisgender Women Aging with HIV. 交叉性污名在感染艾滋病毒的顺性别老年妇女冠状动脉疾病中的作用》(The Role of Intersectional Stigma in Coronary Artery Disease Among Cisgender Women Aging with HIV.
IF 2 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2024-11-15 DOI: 10.1080/08964289.2024.2429073
Tiffany R Glynn, Michaela E Larson, Maria Bernal, Sanjana Satish, Carolina Cruzval O'Reilly, Nicholas Fonseca Nogueira, Ana Salazar Zetina, Vanessa Hurtado, Karla Inestroza, Sapna Kedia, Lilliana Vilchez, Barbara Lang, Priscilla Valls, Yoel Siegel, Chris Schettino, Eduard Ghersin, Suresh Pallikkuth, Margaret Roach, Savita Pahwa, Armando Mendez, Isabella Rosa-Cunha, Barry E Hurwitz, JoNell Potter, Mariano Kanamori, Lunthita M Duthely, Claudia Martinez

Cisgender women living with HIV experience elevated cardiovascular disease (CVD) risk that increases with age, a concern given extended life expectancies for people living with HIV. The CVD risk disparity among cisgender women aging with HIV is understudied and remains unclear. Taking a psychoneuroimmunology approach, given this group's intersecting marginalized identities, one potential driver of the disparity is intersectional stigma. Yet not all women living with HIV have coronary artery disease (CAD). Resilience to stigma may serve as a protective factor to CAD, as observed in other health issues. This study aimed to explore the relationship between intersectional stigma, resilience, "traditional" CVD risk factors, and objective indicators of CAD among women aging with HIV. A diverse sample of cisgender women aging with HIV (aged ≥ 35, N = 48) completed a cross-sectional survey, clinical health interview, blood sample, blood pressure, anthropometric measurements, and computed tomography angiography (CTA). CART-based machine learning models assessed the statistical importance of traditional CVD risk factors, intersectional stigma, and resilience for classifying individuals with coronary artery stenosis, calcification, and inflammatory markers associated with CAD. Of the n = 31 who completed CTA, 74% had detectable calcification and 39% stenosis. Intersectional stigma was identified as an important variable for explaining calcification, but not stenosis, and for explaining sCD163, an inflammatory biomarker associated with CAD. Results show a potential psychoneuroimmunology pathway to the CAD disparity among this group. Future longitudinal research should investigate the mechanisms of this pathway and consider stigma as target for intervention to improve cardiovascular health among women aging with HIV.

随着年龄的增长,感染艾滋病毒的顺性别女性患心血管疾病(CVD)的风险也随之升高。对感染艾滋病毒的顺性别女性的心血管疾病风险差异研究不足,目前仍不清楚。从心理神经免疫学的角度来看,考虑到这一群体的交叉边缘化身份,造成这种差异的一个潜在驱动因素是交叉污名化。然而,并非所有女性艾滋病感染者都患有冠状动脉疾病(CAD)。正如在其他健康问题中观察到的那样,抵御污名化的能力可能是冠心病的一个保护因素。本研究旨在探讨交叉性污名、复原力、"传统的 "心血管疾病风险因素以及感染艾滋病毒的老年女性中冠心病的客观指标之间的关系。不同性别的感染艾滋病毒的老年妇女样本(年龄≥ 35 岁,N = 48)完成了横断面调查、临床健康访谈、血液样本、血压、人体测量和计算机断层扫描血管造影术(CTA)。基于 CART 的机器学习模型评估了传统心血管疾病风险因素、交叉污名和复原力对冠状动脉狭窄、钙化和与 CAD 相关的炎症标志物个体分类的统计重要性。在完成 CTA 的 31 人中,74% 发现了钙化,39% 发现了狭窄。交叉污名被认为是解释钙化而非狭窄的重要变量,也是解释与 CAD 相关的炎症生物标志物 sCD163 的重要变量。研究结果表明,心理神经免疫学可能是导致该群体患上冠状动脉粥样硬化症的原因之一。未来的纵向研究应调查这一途径的机制,并考虑将污名化作为干预目标,以改善女性艾滋病患者的心血管健康。
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引用次数: 0
Men's Preferences for Language and Communication in Mental Health Promotion: A Qualitative Study. 男性在心理健康宣传中对语言和沟通的偏好:定性研究。
IF 2 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2024-11-11 DOI: 10.1080/08964289.2024.2424168
Paul Sharp, John L Oliffe, Joan L Bottorff, Simon M Rice, Nico Schulenkorf, Cristina M Caperchione

Tailored language and communication strategies underpin men's engagement with public health initiatives. The aim of this study was to explore men's preferences for language and communication in mental health promotion and provide recommendations for current and future programs. A sequential mixed-methods design was used including five focus groups and 21 individual interviews with 64 men. Interpretive description was used to inductively derive three themes: (1) Using coded language to confer mental health, which highlighted the tacit meaning and implications of language as well as men's covert strategies to communicate their challenges and emotions; (2) Summoning masculine capital with association and metaphors, wherein men's strategies for conveying mental health in acceptable and relatable ways are chronicled; and (3) Dynamism language to signal action and growth, illustrating participants' preference for strength-based approaches and gain-framed messaging that positions men as drivers of self-management and personal development. Important implications for men's mental health promotion are discussed.

量身定制的语言和沟通策略是男性参与公共卫生活动的基础。本研究旨在探讨男性在心理健康宣传中对语言和沟通的偏好,并为当前和未来的项目提供建议。研究采用了一种连续的混合方法设计,包括对 64 名男性进行了 5 次焦点小组讨论和 21 次个别访谈。通过解释性描述归纳出三个主题:(1) 使用编码语言来表达心理健康,这突出了语言的隐含意义和含义,以及男性传达其挑战和情绪的隐蔽策略;(2) 通过联想和隐喻来唤起男性资本,其中记录了男性以可接受和可亲近的方式传达心理健康的策略;(3) 以充满活力的语言来传达行动和成长的信号,说明参与者偏好以力量为基础的方法和以收益为框架的信息,将男性定位为自我管理和个人发展的推动者。讨论了对促进男性心理健康的重要意义。
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引用次数: 0
Diet Quality Changes in a 12-Week Web-Based Physical Activity Intervention without Explicit Dietary Guidance. 在没有明确膳食指导的情况下,基于网络的 12 周体育锻炼干预的膳食质量变化。
IF 2 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2024-10-23 DOI: 10.1080/08964289.2024.2417077
Bruna C Mazzolani, Gabriel P Esteves, Jessica Cheng, Jennifer K Frediani, Britney Beatrice, Jacob K Kariuki

Lifestyle habits seem interconnected and extant studies suggest that a lifestyle-related modification can impact other related behaviors. For instance, interventions targeting physical activity (PA) could potentially impact dietary patterns and quality. Therefore, we hypothesized that a web-based intervention to increase PA would lead to changes in diet quality without explicit dietary guidance. Our aim was to evaluate changes in diet quality, measured by the Healthy Eating Index 2020 (HEI-2020), following a 12-week web-based PA intervention in adults with obesity. The study consisted of secondary analysis of a 12-week pilot randomized controlled trial, wherein participants (N = 82) were randomized to the Physical Activity for The Heart (PATH) intervention group, which included workout videos and virtual coaching, or a wait-list control group. Diet quality was assessed at baseline and post-intervention using the HEI-2020 based on recalls collected through the Automated Self-Administered 24-h recall (ASA-24) system. Baseline characteristics were similar across groups. Both groups showed small improvements in HEI-2020 total scores after 12 wk (PATH: 65.11 vs. Control: 62.24). Stratification by moderate to vigorous physical activities increase (<60 min. vs. ≥60 min.) revealed greater improvements in specific HEI-2020 components in the ≥60 min group, though overall changes remained modest. The PA intervention led to small improvements in certain diet quality components, suggesting potential interconnectedness between PA and dietary habits. However, overall changes in HEI-2020 scores were modest. Future research with larger samples should explore the effects of PA intervention alone vs. combined with dietary guidance on diet quality in adults with obesity.

生活习惯似乎是相互关联的,现有研究表明,与生活方式相关的改变会影响其他相关行为。例如,针对体育锻炼(PA)的干预可能会影响饮食模式和质量。因此,我们假设,在没有明确饮食指导的情况下,以增加体育锻炼为目的的网络干预会导致饮食质量的改变。我们的目的是评估肥胖症成人在接受为期 12 周的网络体育锻炼干预后饮食质量的变化,饮食质量由《2020 健康饮食指数》(Healthy Eating Index 2020,HEI-2020)来衡量。该研究包括对一项为期 12 周的试点随机对照试验的二次分析,参与者(N = 82)被随机分配到心脏体育锻炼(PATH)干预组(包括锻炼视频和虚拟指导)或候补对照组。在基线和干预后,使用 HEI-2020 根据自动自控 24 小时回忆系统 (ASA-24) 收集的回忆数据对饮食质量进行评估。各组的基线特征相似。12 周后,两组的 HEI-2020 总分均有小幅提高(PATH 组:65.11 分;对照组:62.24 分)。根据中度到剧烈运动的增加情况进行分层 (
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引用次数: 0
The Right Advice, from the Right Person, in the Right Way: Non-Engaged Consumer Families' Preferences for Lifestyle Intervention Design Relating to Severe Obesity in Childhood. 正确的建议,来自正确的人,以正确的方式:未参与的消费者家庭对儿童严重肥胖的生活方式干预设计的偏好。
IF 2 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2024-10-01 Epub Date: 2023-10-16 DOI: 10.1080/08964289.2023.2269288
Liz A Saunders, James A Dimmock, Ben Jackson, Lisa Y Gibson, Justine Doust, Elizabeth A Davis, Lyndsey Price, Timothy Budden

Family-based lifestyle interventions for children/adolescents with severe levels of obesity are numerous, but evidence indicates programs fail to elicit short- or longer-term weight loss outcomes. Families with lived experience can provide valuable insight as we strive to improve outcomes from programs. Our aim was to explore elements that families desired in a program designed to treat severe levels of obesity in young people. We recruited a cross-sectional sample of 13 families (parents and young people) who had been referred but had not engaged with the state-wide Perth Children's Hospital, Healthy Weight Service (Perth, Australia), between 2016 and 2018. Utilizing semi-structured interviews and reflexive qualitative thematic analysis, we identified two broad themes, (1) bridging the gap between what to do and how to do it, and (2) peers doing it with you. The first theme reflected parents' and young people's feelings that programs ought to teach specialist-designed practical strategies utilizing non-generic information tailored to address the needs of the family, in a collaboratively supportive way, and encourage young people to learn for themselves. The second theme reflected the importance of social connection facilitated by peer support, and intervention programs should be offered in a group format to foster inclusion. Families indicated a willingness to engage in tertiary intervention programs but desired support from specialized health professionals/programs to be tailored to their needs, sensitive to their experiences and challenges and provide useful practical strategies that support the knowledge-to-action process.

针对严重肥胖儿童/青少年的家庭生活方式干预措施很多,但有证据表明,这些计划未能带来短期或长期的减肥效果。在我们努力改善项目成果的过程中,有生活经验的家庭可以提供宝贵的见解。我们的目的是在一个旨在治疗年轻人严重肥胖的项目中探索家庭想要的元素。我们招募了13个家庭(父母和年轻人)的横断面样本,这些家庭在2016年至2018年间曾被转诊,但没有参与全州珀斯儿童医院健康体重服务(澳大利亚珀斯)。利用半结构化访谈和反射性定性主题分析,我们确定了两个广泛的主题,(1)弥合该做什么和如何做之间的差距,以及(2)同行与你一起做。第一个主题反映了父母和年轻人的感受,即项目应该以协作支持的方式,利用非通用信息,教授专业设计的实用策略,以满足家庭需求,并鼓励年轻人自学。第二个主题反映了同伴支持促进社会联系的重要性,干预计划应以小组形式提供,以促进包容性。家庭表示愿意参与三级干预计划,但希望得到专业卫生专业人员/计划的支持,以适应他们的需求,对他们的经历和挑战敏感,并提供有用的实际策略,支持知识到行动的过程。
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引用次数: 0
Keeping the 'C' in CBPR: Exploring Community Researchers' Experiences with Human Subjects Protection Training Requirements. 保持 CBPR 中的 "C":探索社区研究人员在人类研究对象保护培训要求方面的经验。
IF 2 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2024-10-01 Epub Date: 2023-08-24 DOI: 10.1080/08964289.2023.2249574
Naomi Cruz, Christiana Adams, Constance Akhimien, Fauziyya Allibay Abdulkadir, Cherriece Battle, Maria Oluwayemi, Olanike Salimon, Teri Lassiter, Leslie Kantor

Community-engaged research is increasingly recognized for its potential to advance health equity. The ability to conduct such research in the United States is predicated on the completion of human subjects protection courses; however, prior studies suggest that many of these required courses may not adequately accommodate the varied skillsets and backgrounds of community members involved with carrying out research. The present study explores community researchers' (CRs') experiences with a human subjects protection course frequently required by U.S. academic institutions. Six CRs involved in conducting a community-based participatory research (CBPR) project on Black women's pregnancy-related experiences were interviewed about their completion of the required course. Across multiple interviews, CRs noted challenges with the training length, competing external demands, module readability, content relevancy, end-of-module quizzes, and technology requirements. Despite such obstacles, CRs still valued the opportunity to learn and felt more knowledgeable and capable post-course completion. Recommendations for course improvement were explored. University requirements for human subjects protection trainings may place an undue burden on community members preparing to conduct research, impede academic-community partnerships, and discourage the initiation and continuation of community-engaged studies. Course alternatives that are tailored to CRs as well as community-academic partnerships could enhance the feasibility, relevance, and effectiveness of such trainings.

社区参与式研究在促进健康公平方面的潜力日益得到认可。在美国,开展此类研究的能力取决于是否完成了人类受试者保护课程;然而,先前的研究表明,许多此类必修课程可能无法充分满足参与开展研究的社区成员的不同技能和背景要求。本研究探讨了社区研究人员(CRs)对美国学术机构经常要求开设的人类受试者保护课程的体验。六名社区研究人员参与了一个关于黑人妇女怀孕相关经历的社区参与式研究(CBPR)项目,并就他们完成必修课程的情况接受了访谈。在多次访谈中,注册研究员指出了培训长度、外部需求竞争、模块可读性、内容相关性、模块结束测验和技术要求等方面的挑战。尽管存在这些障碍,公约与建议委员会仍然重视学习的机会,并在完成课程后感到自己的知识和能力得到了提高。探讨了改进课程的建议。大学对人类受试者保护培训的要求可能会给准备开展研究的社区成员带来不必要的负担,妨碍学术界与社区的合作,并阻碍社区参与研究的启动和继续。针对社区参与研究以及社区-学术合作而量身定制的替代课程可以提高此类培训的可行性、相关性和有效性。
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引用次数: 0
Psychosocial and structural stressors and engagement in medical care among young sexual minority men across racial identities. 不同种族身份的性少数群体年轻男性的社会心理和结构性压力与就医情况。
IF 2 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2024-10-01 Epub Date: 2023-12-21 DOI: 10.1080/08964289.2023.2277931
Daniel Teixeira da Silva, Pablo K Valente, Willey Lin, Lisa Hightow-Weidman, Kenneth Mayer, Katie Biello, José Bauermeister

Psychosocial and structural stressors and low engagement in medical care likely contribute to the disproportionate burden of chronic disease among sexual minority men (SMM) across the life course. However, how these stressors impact engagement in medical care among young SMM (YSMM) across racial identities remains understudied. The association of psychosocial and structural stressors with forgoing care among YSMM across racial identities was examined using race-stratified adjusted logistic regression of cross-sectional data. Among 737 HIV-negative SMM aged 16-24 years, nearly all (93%) experienced discrimination in their daily lives. Non-Hispanic/Latinx Black participants reported significantly higher levels of discrimination, exposure to community violence, and food insecurity. Medical mistrust and mental health were not significantly different across racial groups. In the full sample model, education, food insecurity, and discrimination were associated with forgoing care. Among the non-Hispanic/Latinx White sample, medical mistrust and discrimination were associated with forgoing care. Among the non-Hispanic/Latinx Black sample, discrimination was associated with forgoing care. Among the Hispanic/Latinx sample, food insecurity was associated with forgoing care. Psychosocial and structural stressors were common in this YSMM cohort, and significantly different across racial/ethnic identities. Race-stratified analysis revealed differences in the association of stressors with forgoing care among YSMM across racial identities, not appreciated in the analysis limited to the total study population. Our findings may support efforts to address health inequity and improve engagement in medical care among SMM.

社会心理和结构性压力以及较低的医疗参与度可能是造成性少数群体男性(SMM)在整个生命过程中慢性疾病负担过重的原因。然而,这些压力因素如何影响不同种族身份的年轻性少数群体男性(YSMM)参与医疗护理的情况仍未得到充分研究。我们使用种族分层调整后的逻辑回归方法对横截面数据进行了研究,探讨了社会心理和结构性压力因素与不同种族身份的少数族裔青年放弃就医的关系。在 737 名 16-24 岁的 HIV 阴性 SMM 中,几乎所有人(93%)在日常生活中都遭受过歧视。非西班牙裔/拉丁裔黑人参与者报告的歧视、遭受社区暴力和食物无保障的程度明显更高。不同种族群体在医疗不信任和心理健康方面没有显著差异。在全样本模型中,教育、粮食不安全和歧视与放弃治疗有关。在非西班牙裔/拉丁裔白人样本中,医疗不信任和歧视与放弃治疗有关。在非西班牙裔/拉丁裔黑人样本中,歧视与放弃治疗有关。在西班牙裔/拉丁裔样本中,食物不安全与放弃治疗有关。社会心理和结构性压力因素在这组 YSMM 群体中很常见,并且在不同种族/民族身份中存在显著差异。种族分层分析表明,不同种族身份的 YSMM 中,压力因素与放弃治疗的关系存在差异,而仅限于整个研究人群的分析则没有发现这种差异。我们的研究结果可能有助于解决健康不平等问题,并提高SMM的医疗参与度。
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引用次数: 0
Religious Coping Is Differentially Associated with Physiological and Subjective Distress Indicators: Comparing Cortisol and Self-Report Patterns. 宗教应对与生理和主观痛苦指标的差异:比较皮质醇和自我报告模式。
IF 2 4区 医学 Q3 BEHAVIORAL SCIENCES Pub Date : 2024-10-01 Epub Date: 2023-11-15 DOI: 10.1080/08964289.2023.2277926
Alison M Haney, Sean P Lane

Use of religious coping in response to life stress is associated with improved mental and physical health outcomes. The aim of this study was to examine the influence of religious coping on conscious self-reported and non-conscious physiological stress responses to an acute, real-world stressor to better understand how this benefit may be conferred. This study examined the trajectory of subjective distress and cortisol patterns leading up to and following a stressful college exam using daily diary and ambulatory saliva samples, respectively (N students = 246). Religious coping was not significantly associated with subjective reports of distress. However, prior to the exam, greater use of religious coping was associated with an ostensibly more adaptive accelerated return to a cortisol baseline. This protective effect was no longer significant when the exam was over, suggesting that religious coping acts as a protective buffer against physiological stress responses rather than aiding in subjective recovery from stress.

使用宗教方式应对生活压力与改善心理和身体健康结果有关。本研究的目的是研究宗教应对对有意识的自我报告和无意识的生理应激反应的影响,以更好地理解这种益处是如何被赋予的。本研究分别使用每日日记和流动唾液样本(N名学生= 246)检查了导致压力大的大学考试前后的主观痛苦和皮质醇模式的轨迹。宗教应对与主观痛苦报告没有显著关联。然而,在考试之前,更多地使用宗教应对与表面上更具适应性的皮质醇基线加速恢复有关。当考试结束时,这种保护作用不再显著,这表明宗教应对作为生理应激反应的保护性缓冲,而不是帮助从压力中主观恢复。
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引用次数: 0
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Behavioral Medicine
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