Physical and Mental Health Outcomes of Community-Based Hispanic Parent-Adolescent Dyadic Interventions: A Scoping Review

Race, Ethnicity and Experienced Racism Are Associated with Adverse Physical and Mental Health Outcomes Among Cancer Survivors

Obesity and mental health disorders are 2 major public health problems in American adolescents, with prevalence even higher in Hispanic teens. Despite the rapidly increasing incidence and adverse health outcomes associated with overweight and mental health problems, very few intervention studies have been conducted with adolescents to improve both their healthy lifestyles and mental health outcomes. Even fewer studies have been conducted with Hispanic youth. The purpose of this study was to evaluate the preliminary efficacy of the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, and Nutrition) program, a manualized educational and cognitive behavioral skills-building program, on Hispanic adolescents' healthy lifestyle choices as well as mental and physical health outcomes. A cluster randomized controlled pilot study was conducted with 19 Hispanic adolescents enrolled in 2 health classes in a southwestern high school. One class received COPE and the other received an attention control program. Adolescents in the COPE program increased their healthy lifestyle choices and reported a decrease in depressive and anxiety symptoms from baseline to postintervention follow-up. A subset of 7 overweight adolescents in the COPE program had a decrease in triglycerides and an increase in high-density lipoproteins. In addition, these overweight adolescents reported increases in healthy lifestyle beliefs and nutrition knowledge along with a decrease in depressive symptoms. The COPE TEEN program is a promising school-based strategy for improving both physical and mental health outcomes in adolescents.

BackgroundDivorce has been linked with poor physical and mental health outcomes among civilians. Given the unique stressors experienced by U.S. service members, including lengthy and/or multiple deployments, this study aimed to examine the associations of recent divorce on health and military outcomes among a cohort of U.S. service members.MethodsMillennium Cohort participants from the first enrollment panel, married at baseline (2001–2003), and married or divorced at follow-up (2004–2006), (N = 29,314). Those divorced were compared to those who remained married for mental, behavioral, physical health, and military outcomes using logistic regression models.ResultsCompared to those who remained married, recently divorced participants were significantly more likely to screen positive for new-onset posttraumatic stress disorder, depression, smoking initiation, binge drinking, alcohol-related problems, and experience moderate weight gain. However, they were also more likely be in the highest 15th percentile of physical functioning, and be able to deploy within the subsequent 3-year period after divorce.ConclusionsRecent divorce among military members was associated with adverse mental health outcomes and risky behaviors, but was also associated with higher odds of subsequent deployment. Attention should be given to those recently divorced regarding mental health and substance abuse treatment and prevention strategies.

The environment an adult resides within is associated with their health behaviours, and their mental and physical health outcomes: a nationwide geospatial study

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) people report worse physical and mental health than their heterosexual peers. We review the literature on physical and mental health outcomes among parents and children in LGBTQ-parent families through a family resilience framework. In doing so, we describe research on mechanisms of vulnerability and resilience in families. We found few studies specifically focused on LGBTQ parents and physical health outcomes. Experiences of stigma and peer victimization among LGBTQ parents and children are stressful and associated with psychological distress. However, stressful experiences do not appear to result in significant mental health disparities between children of same-sex and children of different-sex parents. Instability and the ability to mitigate instability appear to be more strongly related to mental health outcomes than family status, parent gender, and family formation method. Clinicians can help mitigate potential negative mental and physical health outcomes by identifying and providing support to families for coping with stress related to stigma, discrimination, and family transitions. School policies and personnel can do more to intervene in bullying based on family status. Additional research on health outcomes, particularly physical health, is needed, including among LGBTQ-parent families of color, bisexual and transgender parent families, and second-generation LGBTQ youth. Overall, there is more to learn about how best to support the health and well-being of these often marginalized families.

Sexual minority women (SMW; e.g., lesbian, bisexual) report higher rates of almost every negative physical health (e.g., asthma, arthritis, cardiovascular disease), mental health (e.g., depression, anxiety), and substance use outcome compared to heterosexual women. Adverse Childhood Experiences (ACEs) have been identified as risk factors for negative health outcomes. Despite this, no study to date has synthesized existing literature examining ACEs and health outcomes among SMW. This gap is important because SMW are significantly more likely than heterosexual women to report every type of ACE and a higher total number of ACEs. Therefore, using a scoping review methodology, we sought to expand understanding of the relationship between ACEs and health outcomes among SMW. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for. Scoping Reviews protocol, we searched five databases: Web of Science, PsycInfo, CINAHL, PubMed, and Embase for studies published between January 2000 and June 2021 that examined mental health, physical health, and/or substance use risk factors and outcomes among adult cisgender SMW who report ACEs. Our search yielded 840 unique results. Studies were screened independently by two authors to determine eligibility, and 42 met full inclusion criteria. Our findings provide strong evidence that ACEs are an important risk factor for multiple negative mental health and substance use outcomes among SMW. However, findings were mixed with respect to some health risk behaviors and physical health outcomes among SMW, highlighting the need for future research to clarify these relationships.

To compare physical and mental health outcomes of chronically ill adults, including elderly and poor subgroups, treated in health maintenance organization (HMO) and fee-for-service (FFS) systems. A 4-year observational study of 2235 patients (18 to 97 years of age) with hypertension, non-insulin-dependent diabetes mellitus (NIDDM), recent acute myocardial infarction, congestive heart failure, and depressive disorder sampled from HMO and FFS systems in 1986 and followed up through 1990. Those aged 65 years and older covered under Medicare and low-income patients (200% of poverty) were analyzed separately. Offices of physicians practicing family medicine, internal medicine, endocrinology, cardiology, and psychiatry, in HMO and FFS systems of care. Types of practices included both prepaid group (72% of patients) and independent practice association (28%) types of HMOs, large multispecialty groups, and solo or small, single-specialty practices in Boston, Mass, Chicago, Ill, and Los Angeles, Calif. Differences between initial and 4-year follow-up scores of summary physical and mental health scales from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) for all patients and practice settings. On average, physical health declined and mental health remained stable during the 4-year follow-up period, with physical declines larger for the elderly than for the nonelderly (P<.001). In comparisons between HMO and FFS systems, physical and mental health outcomes did not differ for the average patient; however, they did differ for subgroups of the population differing in age and poverty status. For elderly patients (those aged 65 years and older) treated under Medicare, declines in physical health were more common in HMOs than in FFS plans (54% vs 28%; P<.001). In 1 site, mental health outcomes were better (P<.05) for elderly patients in HMOs relative to FFS but not in 2 other sites. For patients differing in poverty status, opposite patterns of physical health (P<.05) and for mental health (P<.001) outcomes were observed across systems; outcomes favored FFS over HMOs for the poverty group and favored HMOs over FFS for the nonpoverty group. During the study period, elderly and poor chronically ill patients had worse physical health outcomes in HMOs than in FFS systems; mental health outcomes varied by study site and patient characteristics. Current health care plans should carefully monitor the health outcomes of these vulnerable subgroups.

Survivors of cancer are at risk for adverse mental and physical health outcomes. It is not well understood, however, how these outcomes are differentially experienced according to an individual's exposure to racism. This study sought to evaluate associations of race/ethnicity, and experiences of racism, with adverse health outcomes in survivors of cancer. Using the Behavioral Risk Factor Surveillance System database, data from 48,200 survivors between 2014 and 2020 were evaluated. Survey items included negative physical and emotional symptoms as a result of race-based treatment. Outcomes of interest included days of poor mental and physical health, activity limitations, depression, and inadequate sleep. Associations using prevalence ratios were evaluated. All historically marginalized racial/ethnic groups were more likely to experience at least one adverse health outcome compared with non-Hispanic White survivors. Those who physically experienced racism were 2.1 (95% CI, 1.64-2.69) times as likely to report poor physical health, 3.51 (95% CI, 2.61-4.71) times as likely to report poor mental health, 2.14 (95% CI, 1.77-2.58) times as likely to report inadequate sleep, 2.33 (95% CI: 1.91-2.83) times as likely to report depression, and 1.42 (95% CI, 1.04-1.93) times as likely to report activity limitations compared with those who have not experienced racism. Similar associations were observed for emotionally experienced racism. Racial inequities in health outcomes for survivors of cancer from marginalized racial/ethnic groups are well-established. Experienced racism contributes to adverse health outcomes and widens these disparities. Improving outcomes for survivors of cancer may require screening for experienced racism. Survivors of cancer from marginalized racial/ethnic populations are more likely to have poor mental and physical health than their non-Hispanic White counterparts. Whether survivors from certain racial/ethnic populations of smaller size also have poorer health is less well understood. Generally, individuals who report experienced racism also report poor health, this association has not been studied in survivors of cancer. This study, from a national survey of survivors of cancer, describes disparities in health outcomes experienced by a variety of racial and ethnic populations. Our findings suggest racism is associated with poor mental and physical health in survivors of cancer.

The number of physically and mentally unhealthy days as a measure of health-related quality of life (HRQOL) is used to examine the different effects of the adverse childhood experiences (ACEs) on physical and mental health outcomes. The data, a cross-sectional state-level survey, is obtained from the Behavioral Risk Factor Surveillance System (BRFSS) collected by the Centers for Disease Control and Prevention (CDC) in 2012. Multiple regression analyses are conducted for the study. The results indicate that all individual ACE categories are inversely associated with both physical and mental health, as respondents who exposed to any adverse childhood experience are likely to have physically- and mentally-related poor HRQOL in adulthood. The estimated coefficients for individual ACEs in magnitude on the mental health outcome are, in overall, greater than the estimated coefficients on the physical health outcome. The regression results with accumulative ACE scores indicate that higher levels of the ACE score would affect higher negative health outcomes, such as the dosage effects that appear again in this study. The estimated coefficients of accumulative ACE scores on the mental health outcome exceed the coefficients of ACE scores on physical health outcome for an ACE score of 2 and above. The gap in the estimated coefficients of ACE scores between physically and mentally unhealthy days increases as the ACE score rises. The estimated coefficient at the score ACE8 for the mentally unhealthy days becomes almost twice as large as the coefficient for the physically unhealthy days. Importantly, the negative effects of ACEs on mental health outcomes are significantly greater than the negative effects on physical health outcomes.

A growing body of evidence suggests that parental offending may be linked to poor physical health, mental health, and drug use problems in offspring. However, previous systematic reviews have limited their scope to the association between parental incarceration and child substance use and mental health problems. We extend this research by conducting a systematic literature review on the impact of any parental offending, more broadly, on child physical and mental health outcomes, including drug use problems. We searched relevant electronic databases and the reference lists of previous reviews for research examining the relationship between parental offending, excluding studies focused on incarceration alone, and health outcomes in offspring less than 18 years of age. Our search identified 1279 unique studies, 19 of which met the criteria for inclusion. Across this literature, associations were found between parental offending and poor physical health outcomes in young children and, more robustly, drug use in adolescence. The associations between parental offending and child health outcomes, particularly for child mental health, were found to be at least partially explained by other factors, such as child maltreatment and abuse. However, owing to methodological limitations, conclusions regarding the causal impact of parental offending on child health could not be confidently made. Parental offending may be useful marker for identifying children at risk of poor health outcomes who may benefit from intervention.

Despite concerns regarding the potential deleterious physical and mental health outcomes among family members of a child with a life-threatening condition (LTC), few studies have examined empirical measures of health outcomes among these family members. To examine whether mothers, fathers, sisters, and brothers of children with 1 of 4 types of pediatric LTCs have higher rates of health care encounters, diagnoses, and prescriptions compared with families of children without these conditions. This retrospective cohort study included US families with commercial insurance coverage from a single carrier. Children who had 1 of 4 LTCs (substantial prematurity, critical congenital heart disease, cancer, or a condition resulting in severe neurologic impairment) were identified by a diagnosis in their insurance claim data between July 1, 2015, and June 30, 2016. Each case child and their family was matched with up to 4 control children and their families based on the age of the case and control children. Data were analyzed between August 2020 and March 2021. Having a child or sibling with substantial prematurity, critical congenital heart disease, cancer, or a condition resulting in severe and progressive neurologic impairment. Rates of occurrence of health care encounters, physical and mental health diagnoses, and physical and mental health medication prescriptions, identified from insurance claims data, were compared between case and control families using a multivariable negative binomial regression model. The statistical analysis adjusted for observed differences between case and control families and accounted for clustering at the family level. The study included 25 528 children (6909 case children [27.1%] and 18 619 control children [72.9%]; median age, 6.0 years [IQR, 1-13 years]; 13 294 [52.1%] male), 43 357 parents (11 586 case parents [26.7%] and 31 771 control parents [73.3%]; mean [SD] age, 40.4 [8.1] years; 22 318 [51.5%] female), and 25 706 siblings (7664 case siblings [29.8%] and 18 042 control siblings [70.2%]; mean [SD] age, 12.1 [6.5] years; 13 114 [51.0%] male). Overall, case mothers had higher rates of the composite outcome of health care encounters, diagnoses, and prescriptions compared with control mothers (incident rate ratio [IRR], 1.61; 95% CI, 1.54-1.68), as did case fathers compared with control fathers (IRR, 1.55; 95% CI, 1.46-1.64). Sisters of children with LTCs had higher rates of the composite outcome compared with sisters of children without LTCs (IRR, 1.68; 95% CI, 1.55-1.82), as did brothers of children with LTCs compared with brothers of children without LTCs (IRR, 1.70; 95% CI, 1.56-1.85). In this cohort study, mothers, fathers, sisters, and brothers who had a child or sibling with 1 of 4 types of LTCs had higher rates of health care encounters, diagnoses, and medication prescriptions compared with families who did not have a child with that condition. The findings suggest that family members of children with LTCs may experience poorer mental and physical health outcomes. Interventions for parents and siblings of children with LTCs that aim to safeguard their mental and physical well-being appear to be warranted.

Racism, sexism, homophobia, and low socioeconomic status (SES) have the potential to affect physical and mental health outcomes and treatment differentially. This chapter examines each of these sociocultural factors, guided by the assumption that an intersectionality analysis is valuable to conceptualizing the consequences of these categories of identity and diversity. The minority stress framework is used to consider the negative effect of carrying a marginalized identity. A review of the literature is presented, highlighting studies that incorporate the multiple and overlapping effects of racism, sexism, homophobia, and low SES to shape mental and physical health outcomes and treatment of individuals. Implications for mental and physical health research and practice are discussed.

The elderly have a higher risk of experiencing less social support because of role losses and changes associated with aging and chronic disease processes, and there is pressure from third-party payors to reduce the length of home healthcare services. Few studies have examined patients' instrumental social support after discharge from home healthcare. Therefore, this descriptive study examined instrumental social support of discharged home healthcare clients (N = 57) who were older than 65 years old, using a telephone interview and retrospective record review. The purposes were to investigate (1) source and number of sources of received support based on age, gender, marital status, race, and functional ability; (2) whether source of support was associated with physical and mental health outcomes; (3) whether clients' perception of need for more support was associated with physical and mental health outcomes. The results indicated that the number of sources of social support was associated with clients' gender, marital status; and functional status; trends toward improvements in mental and physical health outcomes were associated with support provided by friends and neighbors.

Economic, social, and traumatic stressors have been shown to impact mental and physical health. Few studies have considered whether different domains of stressors have a differential effect on health outcomes or have considered stressors across the lifecourse. We characterize stress cumulatively (life stress) and across different domains and examine their relation to adult mental and physical health using prospectively collected data from the DISPAR study. At 4 timepoints (birth, age 9, 15, and 50), economic, relational, and traumatic stressors were assessed, and interviews were conducted between 1959 and 2012. Experiences of major discrimination were assessed at age 50. Life stress scores and domain-specific stress scores, (occurring in either childhood or adulthood), were created. The Kessler distress scale, self-reported health, and objective measured allostatic load (AL) were assessed at age 50. Adjusting for race and sex, life stress was associated with all 3 outcomes. Domain-specific analysis showed that only SES stressors impacted all outcomes (poorer self-rated health, higher distress, and higher AL). Relational stress was associated with distress only; experiences of discrimination were associated with poor self-rated health and distress. Stressors across the lifecourse have been proposed to affect wear and tear on multiple bodily systems and to affect multiple health outcomes. Our empirical test supported this hypothesis in a 50-year old cohort and in particular the impact of economic stress across physical and mental health outcomes.

Changing language, changes lives: Learning the lexicon of LGBTQ+ health equity.