Life Course Research Articles

Implementing Montessori approaches after training: A mixed methods study to examine staff understanding and movement toward action.

Background: This paper uses Normalization Process Theory (NPT) to examine staff impressions of Montessori-based program training and implementation at Veterans Affairs Community Living Centers (VA CLCs; nursing homes). Methods: We conducted a mixed-methods evaluation of Montessori Approaches to Person-Centered Care (MAP-VA) at eight VA CLCs. Trainings were conducted as either a live virtual course or a pre-recorded asynchronous class. Two NPT constructs, coherence building and cognitive participation, informed qualitative interview questions, surveys, and analyses focused on staff movement from knowledge to action during initial implementation. Data collection included staff-completed standardized post-training exams (N = 906), post-training evaluations (N = 761), and optional validated surveys on perceptions of Montessori training (N = 307). Champions (peer-leaders) from each CLC completed semi-structured qualitative interviews post-training (N = 22). Findings: The majority of staff (83%-90%) passed all courses. Staff evaluated the training highly (80%+ agreement) on learning relevant new knowledge and confidence applying new skills. On average, staff felt MAP-VA would become a normal part of their work (7.68/10 scale), and reported increased familiarity with Montessori approaches after training (p = .002). Qualitative interview data from staff trained in Montessori supported three themes concordant with the NPT dimensions of coherence building and cognitive participation. (1) Coherence regarding Montessori: staff demonstrated an understanding of the program and mentioned the benefits of Montessori compared to their previous usual routines. Cognitive participation or engagement with Montessori: (2) staff had positive feelings about Montessori principles/applications and demonstrated a willingness to try the Montessori approach, and (3) staff made sense of the new intervention through early rehearsal of Montessori principles/practices and recognized opportunities for using Montessori in future interactions. Conclusions: Montessori virtual training resulted in high levels of coherence and cognitive participation among multidisciplinary staff, evidenced by high knowledge, self-efficacy, and readiness to act. The asynchronous and synchronous trainings were accessible, relevant, and supported diverse learners.

Reform of Photography Education in Chinese Applied Universities in the Self-Media Era: Evidence from Responsible Persons in the Photography Major

Live streaming and short videos have become the most favored means of communication, and the prevalence of self-media has had a profound impact on traditional media industries, indirectly promoting reforms in Chinese photography education. This study delves into the current state of photography education in Chinese applied universities and the transformations undertaken in response to the challenges posed by self-media. The research covers the development status of university photography programs, the impact of live streaming and short videos on photography education, changes in teaching models, and the issues encountered during these reforms. Through in-depth interviews with heads and instructors of photography programs at five applied universities in China, and using NVIVO software for thematic analysis, the study examines the professional divisions, curriculum design, teaching methods, student employment rates, reform policies, and the challenges faced. The research finds that the prevalence of live streaming and short videos has had a positive impact on the dynamic imaging specialties within photography education, but has been detrimental to the static imaging specialties. Universities have actively reformed their teaching methods in response to market demands, yet still face challenges in integrating live streaming-related courses. This study provides the latest insights for practitioners in the Chinese self-media industry and offers valuable references for university policymakers and researchers.

Impact of Live Tissue Training on Provider Confidence for Operative Trauma Management.

Readiness of military health care providers is essential to maintain a prepared fighting force and remains a central issue for today's military. Maintaining skills regarding operative management of trauma is becoming more difficult if not located at an urban trauma center. Live tissue training may be used to practice skills in a facility that does not have exposure to high acuity trauma. The goal of our live tissue skills course is to train health care providers and ancillary staff in the management of various injury complexes and improve confidence and familiarity with management using a porcine model. A live tissue skills course using a porcine model was offered to surgical residents, attendings, and operating room technicians. Before completing the course, each participant completed a survey assessing comfort level, previous training experiences, and deployments. Operative management was simulated with a standardized sequence of abdominal and thoracic injuries. After the course, each participant then completed a survey assessing comfort level, benefit of the course, and comparison to inanimate simulation training. Survey information was obtained via participant completion of a multiple-choice confidential questionnaire. Responses were collected from 34 participants at our institution. Average abdominal trauma comfort increased from 2.79 to 3.73, with no participants reporting feeling not comfortable at all post-lab. Average thoracic trauma comfort increased from 2.47 to 3.48, with one participant reporting feeling not comfortable at all post-lab. Overall, 85% of participants reported the course to be very beneficial in improving their knowledge, 83% reported the course to be very beneficial compared to inanimate simulators, and 92% reported high fidelity of the live tissue training course. Perceived as highly beneficial, live tissue training increased comfort with operative trauma management by surgical residents, attendings, and technicians supporting continued utilization. Further evaluation of live tissue courses would be advantageous in assessing surgical skill improvement, including comparison with simulation training.

Effects of real-time danmaku interaction on student engagement in live video-streaming teaching: analyzing the mediating roles of social, teaching, and cognitive presences

ABSTRACT This study aimed to gain insights into how real-time danmaku interaction (i.e. organized danmaku interaction (ODI) and unorganized danmaku interaction (UDI)) directly and indirectly relates to student engagement (SE) through community of inquiry (COI) presences in live video-streaming teaching. Survey data gathered from 386 Chinese high school students (10th to 12th grades) who participated in a live video-streaming course were analyzed. Partial least square structural equation modeling results indicated that real-time danmaku interaction has a positive predictive effect on SE, and COI presences have a positive effect on SE. Furthermore, the PROCESS plugin in SPSS was used to conduct mediation analysis. Results demonstrated that after controlling for gender and grade, the relationship between real-time danmaku interaction and SE was partially mediated by COI presences. In particular, COI presences have a significant positive mediating effect between ODI and SE. Social presence also has a significant positive mediating effect between UDI and SE. Meanwhile, cognitive presence has a significant negative mediating effect between UDI and SE. Findings highlight the value of real-time danmaku interaction for SE and the significant mediating role of COI presences. Finally, this research provides effective suggestions on how to enhance students’ SE in live video-streaming teaching.

"I haven't really gone through things like this": Young long-term care workers' experiences of working during the COVID-19 pandemic.

Long-term care (LTC) facilities were hard hit by the COVID-19 pandemic in Canada. Using life course theory concepts, we looked for conditions that led to worker moral distress -i.e. pain or anguish over not being able to take right action - and how life stage may influence experiences. To illuminate the experiences of adults under the age of 30 who stepped into, and/or persevered in, working in LTC during the pandemic, recognizing that this emerging workforce represents the future of LTC in Canada. This secondary analysis uses interview data from a sub-sample of 16 young workers between 18 and 29 years of age who had been working in Canadian LTC facilities for between 8 months and 7 years. Young workers expressed feeling guilt about mourning the loss of socially significant milestones as these milestones paled by comparison to the loss of life and consequences of resident isolation they witnessed at work. To manage feelings of moral distress, young workers attempted to maintain high standards of care for LTC residents and engaged in self-care activities. For some workers, this was insufficient and leaving the field of LTC was their strategy to respond to their mental health needs. The life stage of young LTC workers influenced their experiences of working during the COVID-19 pandemic. Interventions are needed to support young workers' wellbeing and job retention.

The future of presence in distance learning, a speculative design approach

Face-to-face teaching remains for many teachers the golden standard in education. However, learning is always emergent, dependent on the socio-material context. Sharing a physical space is one option, but with new digital technologies, alternative assemblages can create new and exciting learning environments and experiences. Based on the community of inquiry model, I consider cognitive, social, and teaching presence as central to a valuable educational experience in higher education. The aim of this research is to look at what presence could look like in the distance university of the future. Traditional research methods, whether quantitative or qualitative, focus on what is and on linear causal effects. However, education is open, recursive, nonlinear, and new environments introduce new actors, human and material, that affect the learning and teaching. In this research, I experiment with a speculative design method to see if it can lead to opening up new possibilities and to their critical evaluation. In six speculative design workshops, teachers developed prototypes of what presence and affective closeness could look like when students and teachers were spatially and temporally distant. I present the three main categories of prototypes that answer the needs of distance teaching creating social interactions, offering feedback, or re-creating a virtual classroom. These all show how presence can be enacted at a distance, including asynchronously. From a science-based and data-driven approach to the Virtual Reality University, via a live course map and the connected coffee cup, each prototype offers a different view of education with its opportunities, but also challenges. The prototypes also highlight how difficult it is to change our perception of what presence could look like in higher education. I use Bourdieu’s concept of habitus to help explain the difficulty of moving away from the face-to-face experience, and how a revolutionary view rather than a marginal approach to change requires a return to the fundamental questions of how students learn, the purpose of education and the role of the teacher.

Functional connectome through the human life span.

The lifespan growth of the functional connectome remains unknown. Here, we assemble task-free functional and structural magnetic resonance imaging data from 33,250 individuals aged 32 postmenstrual weeks to 80 years from 132 global sites. We report critical inflection points in the nonlinear growth curves of the global mean and variance of the connectome, peaking in the late fourth and late third decades of life, respectively. After constructing a fine-grained, lifespan-wide suite of system-level brain atlases, we show distinct maturation timelines for functional segregation within different systems. Lifespan growth of regional connectivity is organized along a primary-to-association cortical axis. These connectome-based normative models reveal substantial individual heterogeneities in functional brain networks in patients with autism spectrum disorder, major depressive disorder, and Alzheimer's disease. These findings elucidate the lifespan evolution of the functional connectome and can serve as a normative reference for quantifying individual variation in development, aging, and neuropsychiatric disorders.

Longitudinal patterns of adversity from childhood to adolescence: Examining associations with mental health through emerging adulthood using a random-intercept latent transition analysis.

Childhood adversity can have detrimental impacts on life course mental and physical health. Timing, nature, severity, and chronicity of adversity are thought to explain much of the variability in health and developmental outcomes among exposed individuals. The current study seeks to characterize heterogeneity in adverse experiences over time at the individual, family, and neighborhood domains in a cohort of predominantly Black children (85% Black and 15% White, 46.2% girls, 67.2% free/reduced lunch in first grade), and to examine associations with mental health from sixth grade to age 26. Participants were part of a randomized universal preventive interventions trial in first grade with prospective follow-up through early adulthood. Separate models characterized heterogeneity in adversity in elementary, middle, and high schools. Changes in adversity over time and relationships with mental health (anxiety, depression, suicidal behaviors) were investigated using a random-intercept latent transition analysis (RI-LTA). We identified three-class solutions in early childhood, middle school, and high school. Generally, both a higher and a lower poly-adversity class were observed at each time point, with varying nature of adversity characterized by the third class. RI-LTA indicated prevalent within-individual changes in adverse exposure over time and differential associations with mental health and suicidal behaviors. Results suggest that treating adverse exposures as a static construct may limit the ability to characterize salient variation over time. Identifying complexity in adverse experiences and their relation to health and well-being is key for developing and implementing effective prevention and early intervention efforts to mitigate negative effects through the life course. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Current Perspectives on Attention-deficit Hyperactivity Disorder.

Attention-deficit hyperactivity disorder (ADHD) is a neurobiological and neurodevelopmental disorder with an idiosyncratic genetic base. ADHD presents various characteristics, such as inattention, hyperactivity, and impulsivity. Over the period, ADHD leads to noticeable functional disability. A five- to ten-fold progressed risk of disorder development is observed in the populations with familial history of ADHD. The abnormal structure of the brain in ADHD results in altered neural mechanisms, such as cognition, attention, and memorial function. The mesolimbic, nigrostriatal, and mesocortical pathways in the brain get affected by the deterioration of the levels of dopamine. The hypothesis of dopamine in ADHD and its etiopathology suggests that detained attention and impaired arousal functions are due to reduced levels of dopamine. The quickest way to improve strategical treatment is by clarifying the etiological aspects of ADHD and identifying the underlying mechanisms of pathophysiology, which will assist in exploring the biomarkers for better diagnosis. The implementation of life course theory is a very important research principle announced by Grand Challenges in Global Health Initiative (GCMHI). Long-term research is needed to define the progression of ADHD. Interdisciplinary collaborations promise a great future for research innovations in ADHD.

Navigating educational trajectories and transitions: A qualitative systematic literature review on international STEM doctoral students

AbstractTo date, much of the research on international science, technology, engineering, and mathematics (STEM) doctoral students has focused either on international academic mobility or on students' acculturation and adjustment challenges and coping mechanisms in foreign academic contexts. In comparison, very little attention has been paid to Asian doctoral students and their personal experiences from a life course perspective.Based on a qualitative literature review, this article sheds light on the experiences of Asian doctoral students in STEM (science, technology, engineering, and mathematics) disciplines within a life-course theoretical approach, paying particular attention to their agency, socialisation, and educational trajectories and transitions. The process of migration/mobility and transition between academic institutions requires a reassessment of cognitive patterns, behaviours, learning mechanisms, and the exercise of agency and response. The findings highlight how the complex dynamics between agency, socialisation, cultural norms and values, economic factors, academic performance, and institutional parameters influence the educational trajectories and transitions of Asian STEM doctoral students abroad. The result contributes to a synthesis of research findings that could inform doctoral education policy.

Breaking Barriers and Balancing Bytes: Exploring Work-Life Balance among Female ICT Professionals in a South Telecommunications Company - A PhD Thesis Review

Research Aim: This review examines work-life balance experiences offemale Information and Communications Technology (ICT) professionalsin the South African telecommunications sector from the organization,Telkom, drawing from Wiza Munyeka’s 2021 PhD thesis.Design/methodology/approach: The study, encompassing four researcharticles, employs a mixed-methods approach and is theoreticallygrounded in the Life Course perspective and Border Theory. ResearchResearch Findings:The research unveils Telkom’s proactive measures andemployee awareness regarding work-life balance policies. Telkom utilizeswork life balance policies and programmes namely the Telkom Touch(2018) and Telkom Policy on Hours of Work (Other WorkingOpportunities and Overtime) hours (2015). It emphasizes the universalchallenges faced by female ICT professionals, urging targetedinterventions.Theoretical Contribution/Originality: The study contributes significantlyby introducing the Work-Life Balance Framework, synthesizing keytheories and providing a practical guide for understanding andaddressing challenges in diverse contexts. This research review fills acritical gap in the literature, amplifies the voices of an understudieddemographic, and offers practical implications for organizational policies,interventions, and strategies to foster an inclusive and supportive workenvironment.Keywords: Work life balance; females; Information and CommunicationsTechnology; Life Course Perspective; Border Theory

Clients' experiences and satisfaction with produce prescription programs in California: a qualitative evaluation to inform person-centered and respectful program models.

Produce prescription programs have strong potential to improve food security, fruit and vegetable consumption, and health across the life course. Understanding clients' experiences and satisfaction with produce prescription programs is critical for evaluating the person-centeredness and quality of these programs. The objectives of this study were to (1) describe client experiences and satisfaction with produce prescription programs, with an emphasis on the extent to which they felt they were treated with respect and dignity, and (2) identify recommendations for improving client experiences. We conducted four focus group discussions with clients of produce prescription programs in two Federally Qualified Health Centers in California. We used a modified framework analysis approach and organized participants' experiences with programs into themes. Three themes captured participants' program experiences. First, respectful produce prescription programming encompassed interactions with individuals delivering the programs that felt respectful (e.g., program staff showing they cared about participants' health and offering timely assistance with financial incentives) and disrespectful (e.g., not receiving prompt responses to questions about incentives), as well as aspects of program design perceived to be respectful (e.g., provision of gift cards as financial incentives, which offered privacy when purchasing produce). Second, having autonomy to use gift cards to choose their preferred fresh fruits and vegetables was viewed as a positive experience, though participants desired greater autonomy to shop at stores other than the program designated stores. Third, participants frequently discussed program usability, with some reporting that joining the programs and using the cards was easy, and others describing difficulties activating cards and using them at stores due to cashiers' lack of awareness of the programs. Overall, participants were highly satisfied with the programs. To improve client experiences, they recommended increasing privacy (e.g., by educating cashiers on the programs so that clients do not need to explain in public what the card is for) and autonomy (e.g., allowing cards to be used at other chain or local stores). Our findings inform efforts to make produce prescription programs more person-centered and respectful, which in turn may increase program demand, engagement, and impact.

Aging Parents and the Ties That Bind: Intergenerational Relationship Quality Among Culturally Diverse Canadian Families.

Drawing from a life course perspective, this paper examines mid/later-life parent-child relationship quality among ethnically diverse families. Focus is on the role of culture, child, and parental characteristics. Data are drawn from a study of 588 parents aged 50+ of a least one child aged 19-35 who reside in Metro Vancouver, B.C. from four Canadian cultural groups: British, Chinese, Persian/Iranian, and South Asian. Using OLS regression methods, we use two dependent variable scales: positive and negative support/interaction appraisals of the relationship. The positive relationship quality scale is associated with South Asian versus British-Canadian parents, mothers, those with greater income satisfaction, and daughters. The negative scale is inversely associated among South Asian versus British-Canadian parents, income satisfaction, parental health, and being unpartnered (vs. partnered). Interaction effects are found between gender and ethnicity. Implications for theorizing and applied recommendations for those who work with culturally diverse aging families are discussed.

Patient Learning Pathway: Identifying Patient Competencies in Teledermatology for Effective Management of Dermatological Conditions.

Dermatology consultations in Québec, Canada, face accessibility challenges, with most dermatologists concentrated in urban areas. Teledermatology, offering remote diagnosis and treatment, holds promise in overcoming these limitations. However, concerns regarding patient-doctor relationships and logistical issues exist. This article aims to introduce a dermatology patient learning pathway (PLP) developed by the Centre of Excellence on Partnership with Patients and the Public (CEPPP), focusing on knowledge, abilities, and skills mobilized by patients and their loved ones at key moments of the life course with an illness, as well as emerging educational needs. The PLP development was co-developed with dermatology patient and caregiver partners, stakeholders, and the CEPPP team. The process encompassed stakeholder engagement, exploration, recruitment of patient and caregiver partners, co-development of the PLP draft, and validation through consensus building. The PLP methodology led to the creation of 44 learning objectives, comprising a total of 107 subobjectives. These objectives were organized into 8 phases of the patient life course with a dermatological condition: (1) prevention and predisposition; (2) discovery, self-examination, or observation of a change; (3) first consultation; (4) wandering; (5) consultation with a dermatologist; (6) diagnosis; (7) treatments; and (8) living with it. The dermatology PLP serves as a resource outlining patient competency across different stages of managing a dermatological condition throughout their life course. In the context of teledermatology, the PLP might facilitate patient and caregiver engagement by helping select appropriate information and tools to support active participation in care.

Life course socioeconomic status, chronic pain, and the mediating role of allostatic load: findings from the midlife in the United States.

Low socioeconomic status (SES) has been linked to chronic pain (CP); however, the mechanisms by which SES over the life course influences downstream CP outcomes remain unclear. This study utilizes data from the Midlife in the United States (MIDUS) survey, a prospective sample of community-dwelling individuals (N=781), to investigate the chain of risk additive model of SES in relation to CP. Additionally, the study examines the mediating role of allostatic load (AL) in the relationship between life course SES and CP. Confirmatory factor analysis was employed to capture the multidimensionality of life course SES and path analysis was used to examine the direct and indirect effects on CP. AL was computed by quartile-based summation and by latent class analysis. Results indicated lower SES in MIDUS 2 was associated with greater high-interference CP odds in MIDUS 3 (OR=1.069, 95% CI=1.006-1.136, P < 0.05) and no association was found between distal SES and levels of CP interference. Similarly, no significant relationship was observed between SES and the number of CP locations. Additionally, no additive effects of SES were found, and AL did not present mediation effects on the association between life course SES and CP. The present study emphasizes the importance of directly proximal effects of SES on CP, underscoring the need for equitable distribution of health resources and the implementation of policies focused on diminishing socioeconomic inequalities. Further research is needed to examine alternative pathways by which proximal SES impact CP.

Deriving life-course residential histories in brain bank cohorts: A feasibility study.

The exposome is theorized to interact with biological mechanisms to influence risk for Alzheimer's disease but is not well-integrated into existing Alzheimer's Disease Research Center (ADRC) brain bank data collection. We apply public data tracing, an iterative, dual abstraction and validation process rooted in rigorous historic archival methods, to develop life-course residential histories for 1254 ADRC decedents. The median percentage of the life course with an address is 78.1% (IQR 24.9); 56.5% of the sample has an address for at least 75% of their life course. Archivists had 89.7% agreement at the address level. This method matched current residential survey methodology 97.4% on average. This novel method demonstrates feasibility, reproducibility, and rigor for historic data collection. To our knowledge, this is the first study to show that public data tracing methods for brain bank decedent residential history development can be used to better integrate the social exposome with biobank specimens. Public data tracing compares favorably to survey-based residential history. Public data tracing is feasible and reproducible between archivists. Archivists achieved 89.7% agreement at the address level. This method identifies residences for nearly 80% of life-years, on average. This novel method enables brain banks to add social characterizations.

Contextualizing Lives and Historical Time: Examining Changes in the Transition to Adulthood and Age-Arrest Trajectories from the 1960s to 2018

Objectives: The changing nature and timing of adult role acquisition during the transition to adulthood over the past several decades may hold implications for criminal offending as adult roles are fundamental to theories of desistance. This research explores whether changes in adult role attainment during young adulthood are associated with the changes in the level and slope of the age-arrest trajectory over the past half-century. Methods: Combining US Census and Uniform Crime Report data, we map the average rate of adult role attainment (e.g., marriage, parenthood, labor force, independent living) and aggregate age-arrest trajectories among young adults (ages 18-24) biennially from 1960 to 2018. We fit a multilevel growth curve model where ages are nested within years to examine whether variation in the aggregate age-arrest trajectory is associated with variation in the attainment of adulthood. Results: At the macro level, periods with higher levels of adult role attainment are associated with a swifter decline in the young adult arrest rate but not the level. Conclusions: This research positions sociohistorical context at the center of life course criminological inquiry and highlights how historical shifts in the attainment and timing of adult social roles can alter behavioral patterns during the transition to adulthood.

Developmental assets in emerging adulthood—Systematic review

Characterizing emerging adulthood as a period of the life course has proven to be relevant in understanding development and intervention with a focus on a positive orientation in the life course trajectory. Characterized by individualization, this period implies that people are increasingly compelled to depend on their own resources to build their life course trajectory. Identifying which resources place the person on a positive developmental trajectory becomes more relevant. Within the field of the Positive Youth Development, the Developmental Assets® model specifically focuses on which resources, that is, which personal and contextual characteristics of emerging adults can favor a positive orientation in the trajectory of the life course. The objective of this investigation is to analyze the utilization of the Developmental Assets model in the emerging adult population. In the review process, the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) protocol was applied. Research was conducted in July 2023 in electronic databases, namely: Web of Science, Scopus, Science Direct, ERIC, PsycArticles, SciELO and B-on. In this review, 13 articles published between 1999 and 2023 were included. Results indicate diversity in adopted methods, both on conceptualization of the concept and its operationalization. Results of the analysis of studies included indicate the relevance of applying the Developmental Assets model in emerging adults and the importance of its exploration in future investigations. The utilization of the model in the population of emerging adults is suggested as a strategy focusing on a positive developmental trajectory.

Older mothers and their difficult adult children: a life course exploration

ABSTRACT Adult child to parent violence is a growing international social problem that needs to be better understood to develop clinical interventions. An exploratory study on the antecedents of early life adversity on adult child to parent violence/elder mistreatment was carried out using secondary analysis. Directed content analysis was used based on life course theory with a data set of older mothers all > 57 years old (J. R. Smith 2021, 2022). Measurement of instances of child abuse, domestic violence, and birth trauma among abused older mothers was conducted. All the older women had reported being negatively affected by their adult children’s problems and 56% reported being physically attacked. A case example is presented to illustrate how repeated incidents of abuse or neglect in early life might explain an older woman’s inability to take actions for her own safety.

Infertility and risk of postmenopausal breast cancer in the women's health initiative.

Although infertility (i.e., failure to conceive after ≥ 12months of trying) is strongly correlated with established breast cancer risk factors (e.g., nulliparity, number of pregnancies, and age at first pregnancy), its association with breast cancer incidence is not fully understood. Previous studies were primarily small clinic-based or registry studies with short follow-up and predominantly focused on premenopausal breast cancer. The objective of this study was to assess the relationship between infertility and postmenopausal breast cancer risk among participants in the Women's Health Initiative (analytic sample = 131,784; > 25years of follow-up). At study entry, participants were asked about their pregnancy history, infertility history, and diagnosed reasons for infertility. Incident breast cancers were self-reported with adjudication by trained physicians reviewing medical records. Cox proportional hazards models were used to estimate risk of incident postmenopausal breast cancer for women with infertility (overall and specific infertility diagnoses) compared to parous women with no history of infertility. We examined mediation of these associations by parity, age at first term pregnancy, postmenopausal hormone therapy use at baseline, age at menopause, breastfeeding, and oophorectomy. We observed a modest association between infertility (n = 23,406) and risk of postmenopausal breast cancer (HR = 1.07; 95% CI 1.02-1.13). The association was largely mediated by age at first term pregnancy (natural indirect effect: 46.4% mediated, CI 12.2-84.3%). These findings suggest that infertility may be modestly associated with future risk of postmenopausal breast cancer due to age at first pregnancy and highlight the importance of incorporating reproductive history across the life course into breast cancer analyses.