Family Science Theses and Dissertations
Permanent URI for this collectionhttp://hdl.handle.net/1903/2770
Browse
207 results
Search Results
Item FINANCIAL HARDSHIP, PSYCHOLOGICAL DISTRESS, AND RELATIONSHIP FUNCTIONING(2024) Chawla, Isha; Falconier, Mariana; Kim, Jinhee; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This dissertation aimed to expand understanding of the impact of financial hardship on individual and relationship well-being within Black and Latinx populations during a time when these groups were facing disproportionately high economic challenges due to the COVID-19 pandemic. This goal was achieved through a comprehensive literature review and two empirical studies. The literature review highlighted the need for further research on the impact of financial hardship on psychological distress and relationship functioning in Black and Latinx during the COVID-19 pandemic. The literature review suggested that, although the link between financial hardship and psychological distress had been studied during the COVID-19 pandemic, research on potential moderating and mediating mechanisms, such as race-based trauma and social exclusion, remains unexplored.The first empirical study aimed to expand understanding of the association between pandemic related financial hardship and psychological distress, as proposed by the Family Stress Model (FSM; Conger et al., 1994), in Latinx and Black adults by examining potential mediating and moderating factors. Using the FSM framework, this study analyzed secondary data from non-Latinx Black (n = 355) and non-Black/non-White Latinx (n = 46) adults who completed the Maryland Pandemic Survey (UME, 2021) during the COVID-19 pandemic. The path analysis results showed a positive and significant relationship between pandemic related financial hardship and psychological distress. The study found a significant mediating role of pandemic related difficulty in accessing mental health care in the relationship between pandemic related financial hardship and psychological distress. Specifically, pandemic related financial hardship was positively associated with pandemic related difficulty accessing mental health care, which in turn, was positively linked to psychological distress. The second empirical study aimed to test FSM comprehensively by including all mediating mechanisms through which financial hardship may be associated with relationship dissatisfaction in both partners and to evaluate potential racial-ethnic differences by comparing Latinx and non-Latinx Black couples with non-Latinx White couples. Using baseline data from a federally funded relationship education program (collected between 2020 and 2023 during the COVID-19 period), the study conducted a path analysis to test the hypothesized relationships among heterosexual couples in which both partners identified as non-Latinx Black (n =167 couples), non-Black/non-White Latinx (n =78 couples), and non-White Latinx (n = 47 couples). Consistent with the FSM, results indicated a significant indirect positive relationship between each partner’s financial hardship and their hostility towards their partner, mediated by increases in their own psychological distress. Also consistent with FSM (Conger et al., 1994), there was an indirect positive relationship between each partner's psychological distress and their partner’s relationship dissatisfaction, mediated through increases in their own hostility towards their partner. In line with FSM’s hypothesized full pathways of influence, each partner’s financial hardship was positively and indirectly related to their partner’s relationship dissatisfaction (partner effect) through increases in their own psychological distress and hostility towards the other partner. Additionally, each partner’s financial hardship was indirectly related to their own relationship dissatisfaction (actor effect) through the same pathways of influence. The results highlight that financial hardship exacerbates psychological distress and relationship functioning, particularly among Black and Latinx populations. Barriers to mental health access and increased hostility within relationships were pivotal in linking financial hardship to adverse outcomes. These findings particularly emphasize the need for inclusive, culturally attuned support systems, as well as policy and programming efforts to mitigate the dual impacts of financial hardship on vulnerable communities during crises like the COVID-19 pandemic.Item Navigating a Relational Bind: Black and Latino Emergent Adult Men’s Negotiation of their Relational Needs in a Masculine Context(2024) Hedelund, Adam Jens; Roy, Kevin; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Emergent adulthood is a period of discovery and transition for humans aged 18 to 29 that often requires many practical as well as relational resources. Black and Latino emergent adult men from low socioeconomic backgrounds often navigated through this time period through alternate pathways because of a lack of resources. They may have also experienced substantial stress in childhood that prompted the reliance on hegemonic masculinity as a guide for how to cope with these stressors. This study sought to examine how Black and Latino emergent adult men negotiated their relational needs and abilities within the context of their masculine identities. Using semi-structured life history interviews, Black and Latino young men were interviewed from two youth development centers in the Washington DC/Baltimore area. Findings suggested that the impact of the provider role as adultified children, as well as exposure to violence, increased the participant’s likelihood of hegemonic masculine disconnection from family and friends in emergent adulthood. However, this disconnection was often complicated given their human desire for closeness and support as well as obligations to family members. This complexity was conceptualized as a type of relational bind. Participants used a variety of strategies to resolve this bind that often left them more isolated.Item LGBTQ+ Youth Therapeutic Engagement and Experiences: Associations with LGBTQ+ Family Environment(2024) Zheng, Azure; Fish, Jessica N,; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)LGBTQ+ youth experience unique stressors that increase the risk for poor mental health. LGBTQ+ youth’s family environment, often measured as parental acceptance and rejection of youth’s LGBTQ+ status, is associated with youth mental health; less often studied is how the family environment may be linked to LGBTQ+ youth’s access to therapy and, more importantly, experiences with LGBTQ+ affirmative and competent providers. Using a contemporary non-probability national sample of LGBTQ+ youth ages 13-17, our study examined the association among LGBTQ+ youth’s reports of caregiver supportive and rejection behaviors related to their LGBTQ+ identity and youth’s engagement and experiences in therapy. Using a step-wise logistic regression method, results tell a clear story. There is a consistent positive association between parent’s LGBTQ+ support behaviors and (1) youth access to therapy and (2) their therapists' LGBTQ+ competency. In the absence of controls, we found that parents’ rejecting behaviors were also positively associated with the youth’s access to therapy, but this relationship was mediated by the youth’s depression and anxiety symptoms. For youth who did not access therapy in the last year, those who reported more parental support were inversely related, and parental rejection positively related to wanting therapy but not receiving it. Youth who reported more rejecting behaviors from parents were less likely to perceive their therapists as LGBTQ+ competent. Findings point to varied pathways and experiences in therapy engagement for LGBTQ+ youth based on parents' support of their LGBTQ+ identity.Item THE INTERGENERATIONAL TRANSMISSION AND IMPACTS OF ADVERSE CHILDHOOD EXPERIENCES(2024) McConnell, Krystle; Shenassa, Edmond; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Evidence that adverse childhood experiences (ACEs) are associated with a wide range of adverse health and behavioral outcomes, including poor behavioral outcomes, and increased substance use, has been expanded to demonstrate that ACEs may be a determinant in adverse health and behavioral outcomes across generations as well. To disentangle the intergenerational impacts of ACEs on select health and behavioral outcomes and inform future intergenerational research and practice, three separate studies were conducted as part of this investigation. The first is a systematic review assessing whether ACEs predict earlier age of initiation differently depending on substance, conducted to inform timing of ACE screening and substance use intervention within generations. Given evidence to suggest that maternal ACEs predict related behavioral outcomes, the association between ACEs and earlier age of substance use may extend across generations as well. Informed by the first study, the second study in this investigation assesses the association between maternal ACEs and offspring age of alcohol initiation. Because offspring concordant for higher intergenerational ACE exposure may be most susceptible to the intergenerational impacts of adversity, this study also assesses whether the association between maternal ACEs and offspring age of alcohol initiation is different depending on offspring ACE exposure. The third study of this investigation assesses the association between maternal ACEs and internalizing and externalizing behavior. Importantly, the well-established intergenerational continuity of adversity was considered conceptually and methodologically for the latter two studies. If there is a direct association of maternal ACEs on offspring outcomes independent of offspring ACEs, then ACE screening and intervention efforts should be expanded to include and consider maternal ACEs in addition to offspring ACEs. Therefore, the controlled direct effect of maternal ACEs, not through offspring ACEs, was estimated. Findings from the first study suggest that while ACEs are associated with earlier age of alcohol, nicotine, marijuana, and opioid initiation, often in a dose-dependent manner, ACEs may predict earlier initiation of alcohol and nicotine relative to other substances assessed. Three or more ACEs were associated with initiation of alcohol across multiple studies, with effect sizes (OR) ranging from 1.9 (95% CI: 1.7, 2.1) to 6.2 (95% CI: 4.6, 8.3). Among the youngest samples included in this review (aged 9-10), ACEs were positively associated with use of alcohol at the time of interview OR=1.3 (95% CI: 1.1, 1.5). Studies that assessed the association between ACEs and nicotine used thresholds between 15-17 to define early initiation and reported a range of effect sizes (OR) from 1.6 (95% CI: 1.2, 2.2) after exposure to more than one ACE to 5.2 (95% CI: 2.9, 9.3) after exposure to more than two ACEs. Exposure to two or more ACEs was associated with initiating vaping before age 11 (OR=3.4 (95% CI: 2.2, 5.4). While not rising to statistical significance (p<0.05), findings from the second study suggest there is a small inverse relationship between maternal ACEs and offspring age of alcohol initiation among the full sample. However, among offspring exposed to >2 ACEs themselves, 2 maternal ACEs are associated with =-1.4 (95% CI: -2.7, -0.1) and >2 maternal ACEs are associated with =-2.1 (95% CI: -3.8, -0.5) earlier age of alcohol initiation. These findings suggest that offspring exposed to high levels of intergenerational ACE exposure are at greatest risk for early alcohol initiation. Findings from the third study suggest that maternal ACEs are associated with offspring internalizing and externalizing behavior in a dose-dependent manner, independent of offspring ACE exposure. Specifically, 1, 2, and >2 maternal ACEs were independently associated with a 1.8 (95% CI: 0.9, 2.8), 2.1 (95% CI: 0.7, 3.4), and 2.7 (95% CI: 1.0, 4.4) increase in internalizing score and a 1.8 (95% CI: 0.8, 2.7), 3.1 (95% CI: 1.7, 4.4), and 3.3 (95% CI: 1.4, 5.1) increase in externalizing score, respectively. Taken together, findings from this investigation suggest that universal ACE screening in pediatric settings, particularly prior to onset of puberty, may identify youth for service provision prior to substance initiation and that maternal ACEs should be screened for and considered in addition to offspring ACE exposure to inform interventions related to adolescent substance use and internalizing and externalizing behavior. To that end, the prenatal period may be an opportune time for maternal ACE screening. Conclusions from these investigations may apply to the impact of maternal ACEs on other relevant offspring outcomes across the life course. Future directions for research, including assessment of relevant biological and psychosocial mechanisms, and potential moderators of identified associations are discussed.Item WOMEN’S AUTONOMY AND REPRODUCTIVE AND PERINATAL HEALTH OUTCOMES IN AFGHANISTAN(2024) Ibrahimi, Sahra; Thoma, Marie; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Studies show that women’s autonomy (WA)--as measured by household decision making, healthcare decision making, and permission to go out--facilitates access to resources, including education, employment, and healthcare resources. In return, these resources determine maternal and child health. Prior studies, conducted in countries other than Afghanistan, have resulted in inconsistent findings because the degree and direction of the association between WA and health outcomes differ among countries based on their laws and cultural context. There is no research examining the impact of WA on reproductive and perinatal health outcomes in Afghanistan. Conducting this research in Afghanistan is critical given the country’s unique political and socio-cultural environment that shape its population health. For instance, less than one in two of Afghan women make decisions about their healthcare, while 53% of them have experienced physical domestic violence. The 2021 ruling of the country by the Taliban has exacerbated the violation of women’s rights in Afghanistan, making the examination of the impact of WA on reproductive health outcomes even more pertinent. My dissertation addresses these gaps in the literature by examining the association between women’s autonomy and 1. experience of domestic violence types (physical, sextual, and emotional), 2. unintended pregnancy, and 3. pregnancy loss. I also assess the moderating effect of education on the association of WA and domestic violence, and the mediating effect of domestic violence on the association of WA and unintended pregnancy and pregnancy loss. I used data from 19,098 married women aged 15-49, who completed the 2015 Afghanistan Demographic and Health Survey- the first and only national survey administered in the country. WA was measured across 5 domains (healthcare, visiting family, household purchases, spending, and contraceptive use). Adjusted odds ratios and 95% confidence intervals for the association between WA and the outcomes of interest were estimated using multiple logistic regression and adjusted for relevant confounders including age, ethnicity, education, wealth, residency, and parity. Additionally, to assess moderation and mediation, interaction terms and casual mediation models were used for each respective analysis. I found that about one in two Afghan women did not have autonomy in making decisions and experienced domestic violence, and approximately one in ten women experienced unintended pregnancy and pregnancy loss. In Aim 1, in the adjusted Model 2 (adjusting for confounders), women’s autonomy in healthcare decisions (Adjusted odds ratio [AOR]=0.70, CI: 0.60-0.81), spending (AOR=0.58, CI: 0.51-0.66), visiting families (AOR=0.69, CI: 0.60-0.80), household purchases (AOR=0.59, CI: 0.52-0.68), and not using contraception (AOR=0.66, CI: 0.46-0.93) were significantly associated with decreased experience of physical violence. In addition, women’s autonomy in healthcare decisions (AOR = 0.51, 95% CI: 0.39-0.65), spending (AOR=0.62, CI: 0.48-0.80), and household purchases (AOR=0.56, CI: 0.43-0.72) were significantly associated with decreased experience of sexual violence. Lastly, women’s autonomy in healthcare (AOR=0.82, CI: 0.72-0.94), spending (AOR=0.61, CI: 0.53-0.71), visiting families (AOR=0.79, CI: 0.70-0.88), and not using contraception (AOR=0.58, CI: 0.42-0.80) were significantly associated with decreased experience of emotional violence. We also found a greater protective effect of WA in visiting family among women with some education (vs. no education) across each domestic violence outcome. In Aim 2, Model 2, women’s autonomy in healthcare decisions (AOR=0.87, CI: 0.77 - 0.97) and spending (AOR=0.86, CI: 0.76 - 0.97) were significantly associated with decreased experience of unintended pregnancy. However, women’s autonomy in visiting families (AOR=1.15, CI: 1.02 - 1.29) was associated with slightly increased experience of unintended pregnancy. This association was partially mediated by physical and sexual domestic violence (21% of total effect mediated by domestic violence) in that the reduction of violence with WA attenuated the effect of WA on unintended pregnancy. Lastly, in Aim 3, Model 2, women’s autonomy in healthcare decisions (AOR=0.86, CI: 0.78 - 0.95), household purchases (AOR=0.87, CI: 0.79 - 0.97), and visiting families (AOR=0.90, CI: 0.82 - 1.00), were significantly associated with decreased experience of pregnancy loss. Some of the protective effects of autonomy in healthcare (18%) and household purchase (15%) on pregnancy loss were mediated through reduced experience of domestic violence during pregnancy. Beyond filling the gap in the literature, this study provides evidence and brings awareness (about the impact of the lack of women’s autonomy on adverse health outcomes) that is needed to urge policymakers and program implementers in targeting and improving women’s autonomy and health outcomes in Afghanistan. The findings of this study can also be translated into Dari and Pashto and be shared with the general public in Afghanistan. Interventions that may improve women’s autonomy and health outcomes in Afghanistan, such as establishing laws about women’s rights, granting access to education, awareness campaigns, microfinancing, and community-based distribution programs, could foster gender equity and improve maternal and child health – moving to more sustainable development, consistent with Sustainable Development Goal (SDG) 3 and 5.Item “PERSONAL RELATIONSHIP WITH GOD”: A MIXED-METHODS EXPLORATION OF RELIGION AND SPIRITUALITY WITHIN FORMERLY INCARCERATED PEOPLES’ DESISTANCE PROCESS(2024) Dougall, Mansi; Morgan, Dr. Amy A.; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Research on the relationship between religion and spirituality in promoting desistance among the formerly incarcerated remains mixed. Certain studies indicate a negative correlation between religiosity and criminal behavior (Johnson, 2011; Levitt & Loper, 2009), whereas others report no significant link between religion and post-release conduct (Giordano et al., 2008; Stansfield et al., 2017). To advance this body of literature, the present mixed-methods cross-sectional study examined the association between religion and spirituality on self-reported instances of almost re- offending among formerly incarcerated individuals utilizing secondary data analysis. Additionally, perceptions on how religion and/or spirituality contributed to formerly incarcerated individual’s desistance process was explored, sensitized by Family Systems Theory. The sample consisted of n = 191 formerly incarcerated individuals who were released from a carceral setting two or more years ago, and reported successfully desisting from further criminal behavior. Data analysis involved descriptive statistics and logistic regression to examine the relationships between religion, spirituality, and self-reported reoffending. Thematic analysis was used to analyze participants’ qualitative responses of how religion and spirituality contributed to the desistance process. The present study contributed to the advancement of knowledge in desistance processes, with implications for criminal justice rehabilitation to guide efforts in supporting the successful reintegration of formerly incarcerated individuals into societyItem Mental health among black lesbian, gay, and bisexual people: Examining patterns of risk, treatment utilization, and mental health management strategies(2023) Williams, Natasha Diamond; Fish, Jessica N; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Empirically, a Black-White “double paradox” exists whereby 1) despite living in a society plagued by anti-Black racism, Black individuals in the United States are no more likely to experience depression than their White counterparts and 2) Black individuals are more likely to report severe psychological distress, a construct that is correlated with depression. Further, intersectional theory suggests that Black lesbian, gay, and bisexual, transgender, and queer (LGBTQ+) young adults may experience elevated risk for mental health issues due to overlapping systems of oppression (i.e., racism, heterosexism). Lastly, Black LGBTQ+ persons’ utilization of professional mental health services (PMHS; e.g. therapy, medication) may be impacted by these same forces, but quantitative research has yet to explore utilization disparities at this intersection. Therefore, Studies 1 & 2 of this investigation documented disparities in major depressive episodes (MDE) and severe psychological distress (SPD), as well as differences in the utilization of outpatient PMHS. Study 3 involved semi-structured interviews with Black LGBTQ+ young adults that explored participants’ (i) experiences of intersectional minority stress; (ii) perceptions of the relationship between these experiences and their mental health; and (iii) strategies for managing their mental health. In Study 1 covariate-adjusted models, compared to White heterosexual individuals, Black LGB males and females evidenced similar or reduced odds of an MDE; there were no statistical differences between these groups for SPD. Compared to their White LGB peers, Black LGB males and females were less likely to report an MDE or SPD. However, compared to their Black heterosexual counterparts, Black LGB males and females had higher odds of an MDE and SPD. Bisexual identity (as opposed to lesbian/gay identity), age, and education were associated with MDE or SPD among the subsample of Black LGB adults. In Study 2 unadjusted models, compared to White heterosexual females, Black LGB females were less likely to use PMHS. This relationship was not significant in models adjusted for covariates. In models that accounted for mental health need, Black LGB females were less likely to use PMHS than White heterosexual females in unadjusted and adjusted models. The association for Black LGB males, relative to White heterosexual males, was not significant in unadjusted or adjusted models, regardless of mental health need. Still, predicted probabilities illustrated disparities among Black LGB adults, with and without accounting for mental health need, in PMHS utilization relative to White LGB adults and Black heterosexual adults. Age, income, and education were also associated with PMHS utilization among Black LGB individuals. Participants in Study 3 generally did not describe their identities or attribute their bias experiences in intersectional terms. Rather, most described themselves as “Black first” and discussed instances of anti-Black or, separately, anti-queer discrimination. Almost all shared periods of poor mental health and discussed myriad strategies for managing their mental health, including seeking PMHS, as well as social supports and self-care strategies. Together, these studies illustrate differences in risk for depression and psychological distress, disparities in utilization of PMHS, and mental health experiences of Black [LGB]TQ+ young people. Based on all three studies, it appears that the experience of being a sexual minority in Black contexts may have different, and potentially more deleterious, mental health consequences than being Black in queer contexts. In aggregate, this investigation’s findings have implications for health policy and mental health practice related to bias/discrimination, barriers to care, and PMHS quality. Directions for future research are also discussed.Item Exploring Couple and Family Therapist Involvement in Social Justice Praxis(2023) Golojuch, Laura; Mittal, Mona; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)As the nation becomes more diverse, multicultural competence and social justice are being increasingly recognized as essential components to effective therapy practice (Hays, 2020; Ratts et al., 2016; Vera & Speight, 2003). While some scholars in the field of Couple and Family Therapy (CFT) have urged the importance of infusing social justice into training and clinical practice for years (see Hardy, 2001; Knudson-Martin et al., 2019; McDowell et al., 2019; McGoldrick, 2007), this topic is understudied and underprioritized by the field at large. Recent CFT scholars also acknowledge the importance of advocacy as an accompaniment to therapy (J. M. Goodman et al., 2018, Jordan & Seponski, 2018a, 2018b). Counseling and social work fields have prioritized social justice advocacy and codified it into mission statements and ethical codes (Ratts et al., 2016; Ratts & Greenleaf, 2018; Toporek & Daniels, 2018). Although CFTs are trained systemically, and may be enacting micro-level advocacy intervention in the therapy room, they do not always view themselves as advocates or enact macro-level advocacy interventions (J. M. Goodman et al., 2018; Holyoak et al., 2020; Jordan & Seponski, 2018b). This study utilized a sequential transformative mixed methods design to assess multicultural competence, social justice commitment and self-efficacy, and advocacy competence in a nationally representative sample of CFTs (n = 101) using survey methods. A subsample of 22 participants were interviewed to further explore their practices as multiculturally competent and socially just clinicians. Three complementary frameworks were utilized to ground the study: The Multicultural and Social Justice Counseling Competencies (MSJCC), critical consciousness, and Public Health Critical Race praxis. Overall, multicultural competence, social justice commitment, and social justice self-efficacy scores were high in this sample, while advocacy competence scores were lower. Results showed that identifying as Black or African American and completing additional training in multicultural competence and social justice were associated with multicultural competence. Results also showed that working in an agency setting vs. other settings was associated with lower levels of multicultural competence. Results showed that identifying as female compared to male, having a higher level of oppression, a higher level of civic engagement, and more additional training in multicultural competence were all associated with social justice commitment. Results showed that being older, completing more additional training, and having a higher level of oppression were all associated with higher levels of social justice self-efficacy. Finally, results showed that identifying as non-binary compared to male, completing more hours of additional training, and experiencing higher levels of oppression were all associated with advocacy competence. Additionally, receiving more post-graduate hours of training in multicultural competence, social justice, and advocacy competence was associated with higher multicultural competence, social justice, and advocacy competence. Qualitative findings revealed ways in which CFTs developed and embodied socially just clinical practice and explored recommendations for training.Item EXAMINING THE ASSOCIATION BETWEEN INTERPREGNANCY INTERVAL AND MATERNAL HEALTH IN THE POSTPARTUM PERIOD(2023) Barber, Gabriela A; Thoma, Marie E; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Interpregnancy interval (IPI) is defined as the period of time between a previous birth and a subsequent conception, usually measured in months. While recommendations issued by the World Health Organization and the American College of Obstetricians and Gynecologists provide guidance for ideal birth spacing, many births occur after non-optimal IPIs – either too short (<18 months) or too long (60+ months). These recommendations were motivated by the body of research on a host of adverse infant and maternal health outcomes associated with non-optimal IPIs. To date, the literature has focused heavily on the association between IPI and adverse infant health outcomes, with limited attention in comparison being given to IPI and maternal health. Within the research on IPI and maternal health, there is a narrow focus on physical health outcomes related to pregnancy/delivery complications, with few studies looking at health outcomes in the postpartum and beyond. In order to fill this gap, this research investigated the association between IPI and several postpartum maternal health outcomes/indicators, including 1) postpartum depression (PPD), 2) attendance at a postpartum checkup, and 3) postpartum contraceptive use (any and type). One of the perennial difficulties in studying IPI is parsing out whether IPI has an independent association with a health outcome or behavior or is exerting its effects through pregnancy intention, therefore, for each aim, pregnancy intention was tested as a moderator. For each aim, unique cut-offs for IPI were determined after examination of the association between more detailed IPI categories and the outcome of interest. Categories were collapsed into broader IPI classifications when the associations were similar in order to maximize precision of the estimates and in order to allow us to characterize the most clinically relevant exposure for specific health outcomes. In fully adjusted models, individuals who had IPIs less than 18 months were significantly more likely to experience elevated PPD symptoms (aOR: 1.19, 95% CI: 1.02 – 1.39, p=0.024) when compared to individuals with long IPIs, and individuals who had IPIs less than 12 months were significantly less likely to attend their postpartum checkup (aOR: 0.78, 95% CI: 0.66 – 0.93, p=0.006) when compared to those with long IPIs. Pregnancy intention was not found to significantly moderate either of these associations. For the third aim, pregnancy intention was found to moderate the association between IPI and any use of postpartum contraception. Stratified analyses show that it is among unintended pregnancies that there is an association between short IPI and increased use of any contraception in the postpartum. Among unintended pregnancies, those with IPIs less than 6 months (aOR: 2.31, 95% CI: 1.37 – 3.90, p=0.002) and those with IPIs of 6-11 months (aOR: 2.15, 95% CI: 1.48 – 3.10, p=0.001) were more likely to be using any contraception in the postpartum than those with long IPIs, and the magnitude of this association exceeded that of other IPI intervals and pregnancy intention categories. Among those who were using contraception in the postpartum, individuals with IPIs less than 6 months were more likely to be using highly-effective methods (aOR: 1.59, 95% CI: 1.22 – 2.10, p=0.001) than least-effective methods of contraception. Pregnancy intention did not significantly moderate the association between IPI and type of contraception. Future research should continue to explore the association between IPI and a broader range of maternal health outcomes and work to identify the mechanisms through which IPI may be impacting these outcomes. Recent changes in reproductive policies in the U.S. may also soon change the proportion of individuals who experience short IPIs, therefore making it even more important to understand how this shift may impact a broad range of maternal health behaviors and outcomes. This research highlights how an increase in births occurring after a short IPI would likely increase rates of PPD and increase demand for certain family planning services.Item ¡Hay que hablar sobre esto! [We need to talk about this]: Exploring the Relationship Between Contraceptive and Consent Knowledge, Sexual Self-efficacy and Psychological Distress Among Latino Adolescents(2023) Kerlow, Marina Angelica; Lewin, Amy; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Latino adolescents are a growing population in the US (U.S. Census Bureau, 2020), and they experience disproportionately high rates of unintended teen pregnancy, STIs and HIV (Guilamo-Ramos et al., 2012; Martin et al., 2021). Also, adolescents struggle with high rates of mental health issues (Bitsko et al., 2022; Merikangas et al., 2010). Some studies support that psychological distress plays a role in teens’ sexual behavior and sexual self-efficacy (Lehrer et al., 2006; Seth et al., 2009; Seth et al., 2011). Yet, few studies have looked at the association between aspects of sexual health and psychological distress within Latino teens. This study conducted secondary data analysis using baseline data from a randomized controlled trial to test the effectiveness of El Camino, a comprehensive sexual health education curriculum developed by Child Trends. Participants consisted of 474 Latino adolescents (44.8% male and 53.1% female) and they completed electronic self-report surveys (mean age 16.55 years). 84.2% of the sample was foreign born and 15.8% was US born. Results indicated that there was a significant correlation between sexual self-efficacy and knowledge about contraception and sexual consent (r = .31, p < 0.001). There was a small significant correlation between sexual self-efficacy and psychological distress (r = .12, p < 0.001). Psychological distress did not moderate the relationship between knowledge and sexual self-efficacy. Interestingly, the interaction term between knowledge and gender was statistically significant (β = -0.44, SE = 0.09, p= <.001), indicating that the relationship between knowledge and sexual self-efficacy is stronger for males than for females. The findings support that Latino youth may benefit from interventions that strengthen their knowledge and sexual self-efficacy, despite differences in nativity status and levels of psychological distress. Future studies should consider potentially important cultural, societal, and relational factors that may further explain these results.