Behavioral & Community Health Research Works

Permanent URI for this collection


Recent Submissions

Now showing 1 - 5 of 48
  • Item
    Familial sources of encouragement and breast-feeding practices among women participating in the US Special Supplemental Nutrition Programme for Women, Infants and Children
    (Cambridge University Press, 2023-04-05) Channell Doig, Amara; Aparicio, Elizabeth M; Gallo, Sina
    Objective: To explore how sources of familial encouragement are associated with breast-feeding initiation and duration among a national sample participating in the US Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Design: This study uses the 2013–2015 WIC Infant and Toddler Feeding Practices Study 2 (WIC ITFPS-2) data. Breast-feeding initiation was measured at the first month, while duration was derived from a composite of the first 13 months. The analysis used logistic and linear regression to explore the association between encouragement sources and breast-feeding outcomes. Setting: A nationally representative sample of WIC participants in the USA. Participants: WIC participants who completed the 13-month interview of the WIC ITFPS-2 (n 2807). Results: Encouragement was significantly associated with both initiation and duration. Each source of encouragement was associated with a 3·2 (95 % CI 2·8, 3·8) increase in odds of initiating breast-feeding in the unadjusted model and 3·0 (95 % CI 2·5, 3·6) increased odds, controlling for age, education, nativity, poverty status, race and ethnicity (<0·0001). When predicting log duration, each percent increase in source of encouragement was associated with an increasing duration on average by 0·003 d (95 % CI 0·2, 0·3, <0·0001). When controls were added, it was associated with an increase of an average of 0·002 d (95 % CI 0·2, 0·3) per percent increase in encouragement source (<0·0001). Conclusions: Women who receive encouragement appear to be more likely to breastfeed. Additional work is needed to explore sources of encouragement and how to include them in intervention work.
  • Item
    Impact of early, weekly drinking on latent classes of alcohol involvement progression and recovery: Evidence from the NESARC Waves 1 and 2.
    (Elsevier, 2022-01-26) Green, Kerry M.; Reboussin, Beth A.; Storr, Carla L.; Mojtabai, Ramin; Susukida, Ryoko; Young, Andrea S.; Cullen, Bernadette A.; Luken, Amanda; Amin-Esmaeili, Masoumeh
    Introduction: Early drinkers have been found to have higher risk of developing alcohol use disorder; however, the association of early drinking with progression to problematic alcohol involvement that does not meet disorder criteria (i.e., subclinical problems) or to severe stages of alcohol involvement, sex-specific associations, and relationship of early drinking with alcohol recovery have rarely been investigated. Methods: Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we applied latent transition analyses to investigate the impact of weekly drinking before age 18 on alcohol progression and recovery operationalized as three classes of alcohol involvement using abuse and dependence indicators. We analyzed data separately for male (n = 12,276) and female (n = 14,750) drinkers and applied propensity score methods to address confounding. Results: We observed significant associations between early, weekly drinking and alcohol involvement class membership at Wave 1 for both males and females. For males, early, weekly drinking was also associated with greater odds of transitioning from moderate to severe alcohol problems (aOR = 3.19, 95% CI = 1.72, 5.35). For females, early, weekly drinking predicted the transition from no to severe problems (aOR = 2.98, 95% CI = 1.11–8.00). Contrary to our hypothesis, early, weekly drinking was associated with greater likelihood of transition from severe to no problems for males (aOR = 3.23, 95% CI = 1.26, 8.26). Discussion: Frequent, early drinking seems to be an important indicator of drinking progression with differential associations by sex. This information is useful to identify those at greater risk of progressing to severe drinking problems to intervene appropriately.
  • Item
    Leveraging 13 million responses to the U.S. COVID-19 Trends and Impact Survey to examine vaccine hesitancy, vaccination, and mask wearing, January 2021-February 2022
    (Springer Nature, 2022-10-13) Nguyen, Quynh C.; Yardi, Isha; Gutierrez, Francia Ximena Marin; Mane, Heran; Yue, Xiaohe
    The urgency of the COVID-19 pandemic called upon the joint efforts from the scientific and private sectors to work together to track vaccine acceptance and prevention behaviors. Our study utilized individual responses to the Delphi Group at Carnegie Mellon University U.S. COVID-19 Trends and Impact Survey, in partnership with Facebook. We retrieved survey data from January 2021 to February 2022 (n = 13,426,245) to examine contextual and individual-level predictors of COVID-19 vaccine hesitancy, vaccination, and mask wearing in the United States. Adjusted logistic regression models were developed to examine individual and ZIP code predictors of COVID-19 vaccine hesitancy and vaccination status. Given the COVID-19 vaccine was rolled out in phases in the U.S. we conducted analyses stratified by time, January 2021-May 2021 (Time 1) and June 2021-February 2022 (Time 2). In January 2021 only 9% of U.S. Facebook respondents reported receiving the COVID-19 vaccine, and 45% were vaccine hesitant. By February 2022, 80% of U.S. Facebook respondents were vaccinated and only 18% were vaccine hesitant. Individuals who were older, held higher educational degrees, worked in white collar jobs, wore a mask most or all the time, and identified as white and Asian had higher COVID-19 vaccination rates and lower vaccine hesitancy across Time 1 and Time 2. Essential workers and blue-collar occupations had lower COVID vaccinations and higher vaccine hesitancy. By Time 2, all adults were eligible for the COVID-19 vaccine, but blacks and multiracial individuals had lower vaccination and higher vaccine hesitancy compared to whites. Those 55 years and older and females had higher odds of wearing masks most or all the time. Protective service, construction, and installation and repair occupations had lower odds of wearing masks. ZIP Code level percentage of the population with a bachelors’ which was associated with mask wearing, higher vaccination, and lower vaccine hesitancy. Associations found in earlier phases of the pandemic were generally found to also be present later in the pandemic, indicating stability in inequities. Additionally, inequities in these important outcomes suggests more work is needed to bridge gaps to ensure that the burden of COVID-19 risk does not disproportionately fall upon subgroups of the population.
  • Item
    Men missing from the HIV care continuum in sub-Saharan Africa: a meta-analysis and meta-synthesis
    (Journal of the International AIDS Society, 2022-03-24) Nardell, Maria; Adeoti, Oluwatomi; Peters, Carson; Kakuhikire, Bernard; Govathson-Mandimika, Caroline; Long, Lawrence; Pascoe, Sophie; Tsai, Alexander; Katz, Ingrid
    Introduction: Men are missing along the HIV care continuum. However, the estimated proportions of men in sub-Saharan Africa meeting the UNAIDS 95-95-95 goals vary substantially between studies. We sought to estimate proportions of men meeting each of the 95-95-95 goals across studies in sub-Saharan Africa, describe heterogeneity, and summarize qualitative evidence on factors influencing care engagement. Methods: We systematically searched PubMed and Embase for peer-reviewed articles published between 1 January 2014 and 16 October 2020. We included studies involving men ≥15 years old, with data from 2009 onward, reporting on at least one 95-95-95 goal in sub-Saharan Africa. We estimated pooled proportions of men meeting these goals using DerSimonion-Laird random effects models, stratifying by study population (e.g. studies focusing exclusively on men who have sex with men vs. studies that did not), facility setting (healthcare vs. community site), region (eastern/southern Africa vs. western/central Africa), outcome measurement (e.g. threshold for viral load suppression), median year of data collection (before vs. during or after 2017) and quality criteria. Data from qualitative studies exploring barriers to men’s HIV care engagement were summarized using meta-synthesis. Results and discussion: We screened 14,896 studies and included 129 studies in the meta-analysis, compiling data over the data collection period. Forty-seven studies reported data on knowledge of serostatus, 43 studies reported on antiretroviral therapy use and 74 studies reported on viral suppression. Approximately half of men with HIV reported not knowing their status (0.49 [95% CI, 0.41–0.58; range, 0.09–0.97]) or not being on treatment (0.58 [95% CI, 0.51–0.65; range, 0.07–0.97]), while over three-quarters of men achieved viral suppression on treatment (0.79 [95% CI, 0.77–0.81; range, 0.39–0.97]. Heterogeneity was high, with variation in estimates across study populations, settings and outcomes. The meta-synthesis of 40 studies identified three primary domains in which men described risks associated with engagement in HIV care: perceived social norms, health system challenges and poverty. Conclusions: Psychosocial and systems-level interventions that change men’s perceptions of social norms, improve trust in and accessibility of the health system, and address costs of accessing care are needed to better engage men, especially in HIV testing and treatment.
  • Item
    Experiences of young parents with foster care backgrounds during the COVID-19 pandemic: Brief report
    (2021-12) Shpiegel, Svetlana; Aparicio, Elizabeth
    The COVID-19 pandemic has brought unique challenges to parents of young children due to the closure of schools and childcare centers and increased caregiver burden. These challenges may be especially pronounced for youth with foster care backgrounds, as they often lack family supports and other critical safety nets. This multi-method qualitative study aimed to explore the unique experiences of parenting foster care alumni during the COVID-19 pandemic. Our study included 26 young parents ages 18-26, who participated in in-depth interviews or Photovoice sessions between January and March 2021. A structured thematic analysis approach was used to examine youths` accounts. Findings indicated that young parents with foster care backgrounds faced significant challenges due to COVID-19, and often struggled to access critical resources and supports. Implications for policy and practice are discussed below.