School of Public Health
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The collections in this community comprise faculty research works, as well as graduate theses and dissertations.
Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.
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Item Influence of Latinx Fathers' Behaviors, Cognitions, Affect, and Family Congruence on Youth Energy Balance-Related Health Outcomes(2022) Rodriguez, Matthew Rene; Roy, Kevin; Hurtado Choque, Ghaffar Ali; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)For decades, researchers have studied and theorized about the ways fathers interact with children and other members of the family. While this research provides important evidence, few father involvement studies have included Latinx fathers. Numerous father involvement conceptual frameworks have helped us understand the ways fathers interact with their families. Much of this research has focused on fathers' behaviors, but research suggests other domains need more investigation, such as fathers' cognitions and affect. Understanding these additional domains of father involvement can provide important evidence for understanding the ways fathers influence the health of children. Fathers influence the health of their children within different cultural and socio-political contexts. When considering Latinx father involvement within a social determinants of health approach, research has encouraged focusing on upstream factors that can contribute to the health of Latinx families. Addressing these upstream factors can shape the health and wellbeing of children. Currently, Latinx youth suffer disproportionately from obesity compared to all other racial and ethnic groups in the U.S. Through investigating Latinx father involvement, I fill an important gap by researching the extent to which Latinx fathers' affect, behaviors, and cognitions shape youth health outcomes. I also investigate theorized moderators that may influence the relationship between fathers' involvement and youth health outcomes. Using a cross sectional study design with a community-based sample of Latinx fathers and youth (ages 10-14) (n=193), I use latent moderation structural analyses to test the theorized causal mechanisms.Item AN INTERSECTIONALITY, MINORITY STRESS, AND LIFE-COURSE THEORY INFORMED LATENT PROFILE ANALYSIS OF STRESS(OR) AND PSYCHOSOCIAL BUFFERING FACTORS AMONG FIRST-GENERATION LATINX IMMIGRANT YOUTH FROM THE NORTHERN TRIANGLE: EFFECTS ON MENTAL HEALTH AND SUICIDALITY(2022) Salerno, John P.; Boekeloo, Bradley O; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)In alignment with the intersectionality theoretical framework, first-generation Latinx immigrant youth from the Northern Triangle (i.e., El Salvador, Guatemala, and Honduras) may suffer from complex forms of vulnerability as a result of their multiple marginalized social identities and statuses. Indeed, consistent with the life-course perspective, immigrant youth from the Northern Triangle face unique risks for experiencing cumulative external stressors across the life-course in the context of the phases of migration, including pre- to post-migration victimization, and immigration-related family separation (e.g., forced family separation). The minority stress theory adds the potential for experiencing immigrant minority identity/status-related stress, such as discrimination or negative feelings attributed to being an immigrant, specifically during the post-migration context in the U.S., which could exacerbate mental health by adding to cumulative stress. Yet, the post-migration time period may be an important turning point for Latinx immigrant youth from the Northern Triangle, during which psychosocial buffering resources, like school, peer, and family support, and ethnic identity importance may have a strong and distinct impact that could significantly mitigate the cumulative mental health effects of life-course and minority stress(ors). Considering the increasing surge of immigrant youth from the Northern Triangle, which account for the majority of youth being apprehended at the U.S.-Mexico border, as well as grave concerns about their experiences of vulnerability and mental health, it is of utmost importance to utilize intersectionality, minority stress, and life-course theories to identify and understand the psychosocial risk and protective factors that can mitigate or exacerbate their mental health during post-migration in the U.S. To this end, in collaboration with a community-partner and a high school in Hyattsville, Maryland, primary surveys assessing external life-course stressors across the phases of migration (i.e., pre- to post-migration victimization, and family separation), post-migration immigrant-related minority stress (i.e., immigrant-related discrimination and negative immigrant stress-related feelings), and post-migration psychosocial buffering factors (i.e., family, peer, and school support, and ethnic identity importance) among first-generation Latinx immigrant youth from the Northern Triangle were administered (N = 172). In Paper 1, the aim was to identify potential intersections of minority stress (post-migration immigrant minority stress) and psychosocial buffering resources (family, peer, and school support, and ethnic identity importance), and their associations with external stressors (pre- to post-migration victimization and immigration-related family separation). Latent profile analysis was conducted to identify and describe latent profiles that varied at the intersections of post-migration immigrant minority stress and psychosocial buffering factors, and their associations with pre- to post- migration victimization, and family separation stressors. In Paper 2, the aim was to understand whether latent profiles characterized by the intersections of immigrant minority stress and psychosocial buffering factors, and external stressors (pre- to post-migration victimization and immigration-related family separation) jointly predicted mental health outcomes. ANOVA models were conducted to examine the associations of latent profile membership, pre- to post-migration victimization, and family separation with mental health outcomes (i.e., PTSD, depression, anxiety, and emotional problem symptoms) when all were included in the model as independent predictors. In Paper 3, the aim was to understand whether latent profile membership and external stressors jointly predicted suicidality. Logistic regression models were conducted to examine the associations of latent profile membership, pre- to post-migration victimization, and family separation with suicidality (i.e., suicidal ideation) when all were included in the model as independent predictors. Paper 1 findings revealed a three latent-profile model characterized by post-migration 1) moderate immigrant minority stress and low psychosocial buffering factors (moderate stress/low buffer), 2) moderate immigrant minority stress and moderate psychosocial buffering factors (moderate stress/moderate buffer), and 3) low immigrant minority stress and high psychosocial buffering factors (low stress/high buffer). Post-migration victimization was significantly associated with latent profile membership, such that those in the low stress/high buffer profile group (11%) were least likely to experience post-migration victimization compared to the moderate stress/moderate buffer (most likely; 49%) and moderate stress/low buffer (33%) profile groups (p < .001). Overall prevalence of in-transit victimization (7.70%) was too low for valid statistical assessment. Pre-migration victimization and family separation were not significantly associated with latent profile membership. Paper 2 factorial ANOVA analyses demonstrated that latent profile membership post-migration victimization, and family separation were statistically significant predictors of mental health outcomes (PTSD, depression, anxiety, and emotional problem symptoms) when all were included in the models. Bonferroni-corrected factorial ANOVA test findings revealed that youth in the low stress/high buffer profile group were significantly less likely to experience PTSD (p < .001, p = .003), depression (p < .001, p < .001), anxiety (p < .001, p < .001), and emotional problem symptoms (p = .002, p = .041) compared to youth in both the moderate stress/moderate buffer and moderate stress/low buffer profile groups (respectively). The moderate stress/low buffer profile group did not differ significantly from the moderate stress/moderate buffer profile group in-terms of any mental health outcome. Post-migration victimization was independently and positively associated with PTSD (p = .010), anxiety (p < .001), and emotional problem (p = .042) symptoms (but not depression symptoms), and forced family separation was independently and positively associated with PTSD (p = .026), anxiety (p = .017), and depression symptoms (p = .009; but not emotional problem symptoms) in factorial ANOVA. Pre-migration victimization was not a significant predictor of any mental health outcomes, and in-transit victimization prevalence was too low for valid statistical assessment of its association with mental health outcomes. Paper 3 multivariable logistic regression analyses demonstrated that latent profile membership was the only statistically significant predictor of suicidality. The low stress/high buffer profile group was significantly less likely to experience suicidality compared to both the moderate stress/moderate buffer (87.8% decrease in the odds; OR = 0.122; p < .001) and moderate stress/low buffer (95.6% decrease in the odds; OR = 0.044; p < .001) profile groups in multivariable logistic regression. The moderate stress/low buffer profile group did not differ significantly from the moderate stress/moderate buffer profile group in-terms of suicidality. Post-migration victimization was no longer a statistically significant predictor of suicidality in the multivariable logistic regression model. Pre-migration victimization and family separation were not significant predictors of suicidality, and in-transit victimization prevalence was too low for valid statistical assessment of its association with suicidality. Considering the results of all three studies in Papers 1-3, latent profiles, characterized by the intersections of immigrant minority stress and psychosocial buffering resources, were a significant independent predictor of all mental health outcomes and suicidality. Yet, external stressors, particularly post-migration victimization (PTSD, anxiety, and emotional problem symptoms) and immigration-related family separation (PTSD, anxiety, and depression symptoms) were also significant independent predictors of mental health outcomes, suggesting that these factors also explain post-migration mental health outcomes to some degree above and beyond latent profile membership. In totality, findings strongly suggest that further exploration of post-migration immigrant minority stress and psychosocial buffering resources is urgently warranted to identify ways of overcoming the effects of externalized immigrant-related stressors and reducing mental health burden among first-generation Latinx immigrant youth from the Northern Triangle, a highly vulnerable population. Consistent with minority stress and intersectionality theories, protective associations with mental health were present when post-migration immigrant minority stress was low and psychosocial buffering was high, but these protective associations were lost when immigrant minority stress increased to moderate level and when psychosocial buffering decreased to moderate or low level. From another viewpoint, there were risk associations with mental health when post-migration immigrant minority stress was moderate and psychosocial buffering was low or moderate, but these risk associations were reversed toward being protective when immigrant minority stress lowered to low level and when psychosocial buffering increased to high level. That post-migration victimization and forced family separation remained positive predictors of mental health outcomes in multivariable analyses highlights that these external life-course stressors exacerbated mental health above and beyond the associations of post-migration immigrant minority stress and psychosocial buffering latent profile membership alone. Findings provide valuable information for policy and intervention development and reform in the U.S. that focuses on factors that can be intervened on during the post-migration phase in the U.S. (as opposed to less intervenable factors that occurred during pre and in-transit migration) to positively impact mental health and wellbeing among first-generation Latinx immigrant youth from the Northern Triangle. When immigrant youth experience low immigrant minority stress, strong peer and family support networks, as well as supportive schools and feeling that their foreign, cultural, and ethnic identities are celebrated and welcomed, this could have a significant protective effect toward their mental health and suicidality. However, if youth are facing low levels of these psychosocial buffering experiences and moderate (or potentially high) levels of immigrant minority stress, they may experience negative effects that hinder their mental health and suicidality. Additionally, post-migration victimization and forced family separation are particularly impactful predictors of mental health above and beyond the effects of latent profile group membership alone, which indicate the urgent need for mental health services and support resources that address these stressful and traumatic life-course experiences among first-generation Latinx immigrant youth from the Northern Triangle. Findings elucidate post-migration immigrant minority stress and psychosocial buffering pathways for future development and evaluation to improve Northern Triangle immigrant youths’ mental health and suicidality.Item Evaluating immigrant-specific adverse childhood experiences as a social determinant of health among Latino immigrant families(2022) Conway, C. Andrew; Lew, Amy; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Research consistently demonstrates the critical role of Adverse Childhood Experiences (ACEs), traditionally defined as exposure to abuse, neglect, and household risk factors, in shaping overall health and well-being throughout life and even across generations. However, our current conceptualization and measurement of ACEs are based on items initially examined in a primarily white, middle-class, highly educated sample. This strategy may provide a limited understanding of childhood adversity within marginalized groups. This study aimed to examine the relationship between ACEs (both traditionally studied ACEs and immigrant-specific ACEs) and the psychological well-being of Latino immigrant adolescents. The relationship between parental experiences of ACEs, child ACEs, and child psychological well-being was also explored. Data comes from a community sample of 338 Latino immigrant adolescents. These youth completed an 11-item measure of traditional ACEs (ACE-T), a novel 13-item measure of immigrant-specific ACEs (ACE-I), the Strengths and Difficulties Questionnaire, and health risk behavior items as part of the intake process for a positive youth development program. Data on parent ACEs was available for a subsample (n¬ = 112). Structural equation modeling was used to examine the relationship between the ACEs measures and the psychological and health risk outcomes. Immigrant youth, on average, reported more adversities on the ACE-I measure than the ACE-T measure (3.6 vs. 1.6). Both ACE-T and ACE-I scores were positively related to increased emotional issues (standardized coefficients were .24 and .25, respectively). Only ACE-T scores were related to increased conduct problems and peer relationship problems. There was no relationship between adolescents' ACE-T or ACE-I scores with prosocial or health risk behaviors. The parent's ACE-T scores were positively related to the child's ACE-T scores (b = .18). These findings suggest that essential early adverse experiences for immigrants, which have not been considered, impact adolescents' psychological well-being. Broadening our conceptualization and measurement of ACEs among immigrant populations could provide valuable insight into social determinants of health and avenues for intervention for immigrant adolescents and families.Item Examining the Food-Insecurity Obesity Paradox among Latino Immigrants(2019) Amador, Maria Aileen; Garza, Mary A; King-Marshall, Evelyn C; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Obesity is linked to chronic illnesses such as type 2 diabetes, cardiovascular disease, and some cancers (breast, kidney, and liver). Food insecurity refers to lack of access to nutritious and safe food. Latinos are a rapidly growing population in the US with higher levels of food insecurity than the national average, and higher obesity rates than non-Latino white adults. The “food insecurity-obesity” is a paradoxical relationship seen in rising obesity and correspondingly high food insecurity rates. We examined demographic factors, acculturation, stress, dietary habits, and food access among Latina immigrants to understand this paradox. This sub-analysis (n=128) found that education level (p=0.03) and marital status (p=0.08) were significantly and marginally significantly associated with food security level. Additionally, this analysis helped to better describe a population that lacks research. A better understanding of the “food insecurity-obesity” paradox and related factors will inform future culturally-tailored interventions to address obesity among Latina immigrants.Item "Sin Querer Queriendo": Exploring The Factors Associated With Pregnancy Prevention And Pregnancy Intention Among Latino Youth In Montgomery County(2010) Martinez-Garcia, Genevieve; Atkinson, Nancy; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This study seeks to determine the factors that influence pregnancy desire and pregnancy prevention behavioral intentions among Latino youth. One out of two Latino girls in the U.S. will become pregnant before they turn 20. A pregnancy significantly hinders a teen's ability to pursue an education and develop professionally, and places an undue economic burden on the family. In order to appropriately address the factors that fuel teen birth rates, it is imperative to study behavioral, social, and cultural dynamics associated with pregnancy prevention and sexual behavior in the local Latino community. This study utilized the Theory of Planned Behavior (TPB) to explore factors associated with pregnancy prevention behaviors, namely abstinence, condom use, and birth control pill use. The study specifically addresses attitudes, subjective norms, and perceived behavioral controls of Latino adolescents/teens regarding three pregnancy prevention behaviors. The Pregnancy Wantedness Scale was designed to specifically measure pregnancy attitudes among youth. The study answered three main questions: 1) What are the characteristics of Latino youth who desire a pregnancy during their adolescent years?; 2) Are pregnancy prevention behavioral intentions associated with pregnancy wantedness?; and 3) Are attitudes, subjective norms and perceived behavioral control associated with pregnancy prevention behavioral intentions? A questionnaire was designed in English and Spanish using input from local community stakeholders. A total of 949 Latino youth were recruited using a central location intercept approach. Univariate and multiple linear regression analyses were used to answer the three research questions. Analyses were conducted separately for males and females with some and no sexual experience. Psychometric studies and factor analysis were conducted to assess the reliability and underlying structure of the scale. This study found that multiple demographic, familial and acculturation factors influenced youth's pregnancy intentions. For most groups, pregnancy wantedness was mostly influenced by youth's religion salience, acculturation level and living with a parent. Only condom use intention was associated with lower pregnancy wantedness for males. Perceived behavioral control and parental norms was positively associated with increased behavioral intentions across all three behaviors for most groups. This study suggests that practitioners should be aware of the gender, sexual experience and acculturation level of Latino youth when designing education interventions. Moreover, the findings of this study suggest that strengthening parental role and communication will protect youth from desiring a pregnancy and motivate them to use contraception effectively.Item The Prevalence and Role of Avoidance Coping Methods for Latinos in the United States(2009) Stevenson, Tiffani Debra; Leslie, Leigh A; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Current research concerning Latinos in the United States has indicated that they are at a higher risk for mental illness (e.g., PTSD) than other racial/ethnic groups. The purpose of this study was to understand the possible function a culturally normative coping style plays in the occurrence of depression for Latinos when compared to other racial/ethnic groups. The prevalence of avoidance coping methods and the relationship of depression and avoidance coping was examined for a sample (N=429) of Latino (n=129) White (n=150) and Black (n=150) clients. Results indicated that the frequency with which Latinos engaged in avoidance coping was no different than other groups. However, Black participants were significantly more likely to use avoidance coping that White participants. Furthermore, the use of defensive avoidance coping was linked to high depression; however there was no race/ethnicity by avoidance coping interaction. The empirical and clinical implications of these findings are discussed.