Poor Psychosocial Health Research Articles

Infant BMI trajectories as early risk markers of poor psychosocial health in preadolescence

BackgroundCommon mental disorders often emerge during childhood and adolescence, and their prevalence is disproportionately elevated among those affected by obesity. Early life growth patterns may provide a useful target for primordial prevention; however, research is lacking. Therefore, this study aimed to identify distinct body mass index (BMI) trajectories during the first year of life and to assess their associations with psychosocial outcomes in preadolescence (9–13 years).MethodsData were obtained from n = 1778 Greek children (9–13 years). Infant anthropometric data were obtained from paediatric health records and BMI trajectories during the first year of life were estimated using group-based trajectory modelling. Preadolescent emotional functioning, self-esteem, body image dissatisfaction and dieting behaviours were self-reported via validated questionnaires. Associations were estimated using binary and ordinal logistic regression, adjusted for key confounders.ResultsFour BMI trajectories were identified: low (26.7%), average (41.8%), high (25.2%), and very high (6.4%). Children belonging to the very high trajectory had greater odds of body image dissatisfaction (OR: 1.62, 95%CI: 1.11, 2.38), dieting behaviour (OR: 1.49, 95%CI: 1.01, 2.20) and restrained eating (OR: 1.69 95%CI: 1.14, 2.52) than children belonging to the average trajectory. Body image dissatisfaction was also greater in children belonging to the high trajectory (OR: 1.40, 95%CI: 1.11, 1.76). However, infant BMI trajectories did not significantly predict childhood emotional functioning or self-esteem status.ConclusionInfants with BMI growth in the high reference ranges had poorer psychosocial outcomes in preadolescence. Whilst further research is needed to replicate these findings, monitoring early infant growth trajectories may allow for early stratification of infants at risk of poor psychosocial outcomes.

Resilience and distress among adolescents and young adults receiving hematopoietic cell transplantation: The Promoting Resilience in Stress Management randomized trial.

Adolescents and young adults (AYAs) receiving hematopoietic cell transplantation (HCT) are at high risk of poor psychosocial health. This study aimed to determine whether the Promoting Resilience in Stress Management (PRISM) intervention mitigated these risks during the first 6 months posttransplant. This multisite, parallel, randomized trial was conducted from April 2019 to March 2023. Eligible AYAs were aged 12-24 years, English speaking, and within 1 month of HCT for cancer or cancer predisposition syndrome. They were assigned 1:1 to PRISM (a brief, skills-based intervention targeting "resilience resources" [stress management, goal setting, cognitive reframing, and meaning making]) or usual care (UC). Outcomes included total symptoms of depression and anxiety (Hospital Anxiety and Depression Scale; primary outcome), hope (Snyder Hope Scale), resilience (10-item Connor-Davidson Resilience Scale), and health-related quality of life (HRQOL; Pediatric Quality of Life Inventory Cancer Module). Analyses leveraged multivariable linear regressions; exploratory analyses assessed the influence of baseline depression or anxiety. Of 94 enrolled and randomized AYAs, the mean age was 16.7 years (SD,4.2); 43 (46%) were female, 56 (60%) were non-Hispanic White, 22 (23%) were Hispanic, and nine (10%) were Black. Most (77%) had leukemia. Of n=50 randomized to PRISM and n=44 to UC, 37 (74%) and 33 (73%) completed all study procedures, respectively. In intention-to-treat analyses, PRISM did not affect 6-month depression and anxiety (β=-1.1; 95% CI, -3.7 to 1.5), hope (β=0.83; 95% CI, -3.3 to 4.9), resilience (β=-0.01; 95% CI, -3.0 to 3.0), or HRQOL (β=1.5; 95% CI, -4.7 to 7.9). Among AYAs with preexisting anxiety or depression, PRISM recipients reported greater 6-month improvements in hope (score change, +3.71; SD,6.9) versus UC recipients (score change, -2.76; SD,6.5) (p=.04). Resilience coaching did not influence outcomes in this sample. Exploratory findings suggest it may be more effective when directed toward those with concurrent distress.

Cross-sectional association of food insecurity with loneliness in older adults: The role of sex, age, and psychosomatic factors

ObjectiveFood insecurity (FI) is a critical social determinant of poor psychosocial health. While data on the specific roles of sex and age in the FI-loneliness link among older adults are limited, the underlying mechanisms are largely unknown. This study examines the age-sex-specific associations of FI with loneliness among older adults in Ghana and quantifies the extent to which psychosomatic factors mediate the association. MethodsWe analyzed cross-sectional data from the Aging, Health, Psychological, and Health-seeking Behavior Study in Ghana. The past 30-day FI was assessed using items on hunger and breakfast skipping frequency due to a lack of resources. We assessed loneliness severity with the University of California, Los Angeles 3-item Loneliness Scale. Multivariable OLS regressions and bootstrapping mediation analysis using the Hayes PROCESS macro plug-in were used to evaluate the associations. ResultsWe included 1,201 individuals aged ≥50 years (mean = 62.9 [SD = 11.9]; women = 63.3%). The prevalence of loneliness was 17.7%. The prevalence of moderate and severe FI was 44.0% and 8.5%, respectively. In the adjusted model, greater FI was significantly associated with loneliness severity (B = .22, SE = .029, p < .001). We found significant interactive effects of FI × age (B = −.17, SE = .023, p < .01) and FI × sex (B = −.28, SE = .036, p < .001) on loneliness. Thus, the FI-loneliness link was respectively more marked among women (B = .25, SE = .035, p < .001) and ≥65 age groups (B = .34, SE = .041, p < .001) than men (B = .16, SE = .051, p < .01) and those aged 50−64 (B = .22; SE = .040, p < .001). Finally, comorbid depression/anxiety (41.07%), hopelessness (48.6%), worthlessness (42.1%), functional limitations (8.2%), and pain severity (6.4%) mediated the FI-loneliness association. ConclusionsAge- and sex-specific associations between FI and loneliness exist among older Ghanaians. Addressing FI in concert with psychosomatic problems in older adults may contribute meaningfully to reducing loneliness in later life.

Survivorship after adolescent and young adult cancer: models of care, disparities, and opportunities.

Survivors of adolescent and young adult (AYA; age 15-39 years at diagnosis) cancer are a growing population with the potential to live for many decades after treatment completion. Survivors of AYA cancer are at risk for adverse long-term outcomes including chronic conditions, secondary cancers, impaired fertility, poor psychosocial health and health behaviors, and financial toxicity. Furthermore, survivors of AYA cancer from racially minoritized and low socioeconomic status populations experience disparities in these outcomes, including lower long-term survival. Despite these known risks, most survivors of AYA cancer do not receive routine survivorship follow-up care, and research on delivering high-quality, evidence-based survivorship care to these patients is lacking. The need for survivorship care was initially advanced in 2006 by the Institute of Medicine. In 2019, the Quality of Cancer Survivorship Care Framework (QCSCF) was developed to provide an evidence-based framework to define key components of optimal survivorship care. In this commentary focused on survivors of AYA cancer, we apply the QCSCF framework to describe models of care that can be adapted for their unique needs, multilevel factors limiting equitable access to care, and opportunities to address these factors to improve short- and long-term outcomes in this vulnerable population.

The psychosocial health of sexual and gender minority people with anal and colorectal cancer: a mixed methods study.

Sexual and gender minority (SGM) cancer survivors have poorer psychosocial health than their heterosexual cisgender counterparts. Nevertheless, most research has focused on breast and prostate survivors. It is unknown how different gastrointestinal (GI) cancers affect the psychosocial well-being of SGM individuals. We (1) described the psychosocial health of SGM people with GI cancers and (2) identified differences in psychosocial health outcomes by cancer type. We conducted a concurrent mixed-methods secondary analysis with identical samples (n = 295) using data from "OUT: The National Cancer Survey." Likert-type and open-ended questions about demographics, satisfaction with care, social support, and access to mental health resources were included in the analysis. Poor mental health was the primary outcome. Quantitative (linear regression) and qualitative (thematic analysis) data were independently analyzed, then integrated through the narrative, weaving approach. Three concepts emerged after data integration, (1) positive and negative influences on the psychological well-being of the participants; (2) social adaptations with the participants' friends, partners, and family members; and (3) additional factors affecting the psychosocial well-being during and after cancer, particularly interactions with providers, comorbidities, and treatment side effects. Clinical characteristics, demographic factors, and culturally responsive care influenced the psychosocial health of SGM survivors of GI cancers. Participants developed their own coping strategies and advocated for the SGM community. Interventions promoting peer support and self-esteem are a priority for this population. Healthcare professional training should incorporate historical trauma awareness and assess the delivery of culturally responsive care.

Targeting belongingness among older people through engagement in senior centres: intervention development study in Denmark.

Adults often experience a loss of social relations and sense of belonging in later life, leading to the risk of social isolation. Municipal senior centres offer a potential site for intervention, as they provide social communities targeting older people. However, not all older people find it easy to access these social communities due to experiencing physical and/or psychosocial frailties and could therefore continue to experience a decline in social relations and sense of belonging, which potentiates poor physical and psychosocial health and well-being. To date, there are limited evidence-based interventions in Denmark. The present article describes the development of an intervention to increase belongingness and decrease social isolation among older people with frailties who attend Danish municipal senior centres. The development process was conducted with reference to the INDEX (IdentifyiNg and assessing different approaches to DEveloping compleX intervention) guidance. The development process resulted in a 6-month supportive intervention, consisting of four elements: skills development workshops for all staff members; a start conversation including frailty screening; allocation of a 'buddy' among existing service users; and monthly follow-up conversations with staff members. This theory-informed approach can progress to feasibility testing and outcome evaluation in order to generate an evidence base. Concurrently, the article reflects on current guidance for intervention development and how it may be used and optimized to strengthen developmental processes in the future.

Abstract WMP13: The Modifying Effects of Psychosocial Health on the Association Between Cerebrovascular Health and Dementia Risk: The Atherosclerosis Risk in Communities (ARIC) Neurocognitive Study

Introduction: Associations between magnetic resonance imaging (MRI) markers of vascular pathology and dementia risk in older adults have been established, but it remains less clear how lifestyle factors may modify this association. We hypothesized that a weaker association between MRI markers of vascular pathology and incident dementia will be present among older adults with strong as compared to poor psychosocial health in mid-life. Methods: Social support and social isolation were assessed among ARIC participants, aged 46 - 68, via self-reported questionnaires (1990 - 1992). Following categorization of both factors, participants were classified as having strong or poor mid-life psychosocial health. From 2011 - 2013, 1977 participants, aged 67 - 90, underwent 3T brain MRI quantifying white matter hyperintensity (WMH) volume, subcortical cerebral microbleeds (sCMB), infarcts, and white matter integrity through diffusion tensor imaging. Incident dementia cases were identified from time of imaging through December 31, 2019 (median follow-up: 6.4 years) with ongoing surveillance. Relative contributions of psychosocial health and MRI markers to incident dementia were evaluated with demographic and vascular risk factor-adjusted Cox-proportional hazard regression models. Results: Among 1612 dementia-free participants with measures of psychosocial health, MRI markers were associated with dementia risk in the hypothesized direction. Mid-life psychosocial health significantly modified the associations between sCMB and WMH, each, with incident dementia risk (Table 1; greater risk of dementia shown in individuals with poor psychosocial health). Conclusions: The elevated risk of dementia associated with sCMB and WMH is reduced in participants with strong psychosocial health in mid-life. Future studies evaluating social factors through the life course and the mechanisms by which they modify the relationship between pathology and dementia are needed.

Associations Between Demographic Variables, Psychosocial Health, Quality of Life, and Happiness in the Context of COVID-19

PurposeThe purpose was to examine the association between demographic variables, psychosocial health, quality of life, and happiness in the context of COVID. The hypothesis was that psychosocial health variables have mediating roles between demographic variables and experienced quality of life (QoL) and happiness.MethodsCross-sectional surveys were conducted across four countries: Norway, USA, UK, and Australia among 1649 individuals. Multiple regression analysis identified those variables that made independent statistically contributions onto the QoL and happiness outcome variables, and the analysis of psychological distress, fatigue and loneliness as mediational variables was performed.ResultsNot having a spouse/ partner was associated with poorer QoL, and older age was associated with lower happiness. The psychosocial health variables made the highest variance in QoL (R2 change = 0.51) and happiness (R2 change = 0.46) and poorer psychosocial health had a mediating role between civil status and QoL (p < 0.001) and between age and happiness outcomes (p < 0.001).ConclusionPsychosocial health is of considerable importance in individuals in the time of COVID-19.

Exposure to the Indian Ocean Tsunami shapes the HPA-axis resulting in HPA “burnout” 14 years later

Despite significant research on the effects of stress on the hypothalamic-pituitary-adrenal (HPA) axis, questions remain regarding long-term impacts of large-scale stressors. Leveraging data on exposure to an unanticipated major natural disaster, the 2004 Indian Ocean tsunami, we provide causal evidence of its imprint on hair cortisol levels fourteen years later. Data are drawn from the Study of the Tsunami Aftermath and Recovery, a population-representative longitudinal study of tsunami survivors who were living along the coast of Aceh, Indonesia, when the tsunami hit. Annual rounds of data, collected before, the year after and 2 y after the disaster provide detailed information about tsunami exposures and self-reported symptoms of post-traumatic stress. Hair samples collected 14 y after the tsunami from a sample of adult participants provide measures of cortisol levels, integrated over several months. Hair cortisol concentrations are substantially and significantly lower among females who were living, at the time of the tsunami, in communities directly damaged by the tsunami, in comparison with similar females living in other, nearby communities. Differences among males are small and not significant. Cortisol concentrations are lowest among those females living in damaged communities who reported elevated post-traumatic stress symptoms persistently for two years after the tsunami, indicating that the negative effects of exposure were largest for them. Low cortisol is also associated with contemporaneous reports of poor self-rated general and psychosocial health. Taken together, the evidence points to dysregulation in the HPA axis and "burnout" among these females fourteen years after exposure to the disaster.

AYA-UNITE: Lessons Learned on Intervention Development Promoting Social and Physical Health of Adolescent/Young Adult Cancer Survivors.

Adolescent/young adult cancer survivors (AYACS) struggle with poor psychosocial health related to social disruptions due to cancer diagnosis, impacting long-term goal achievement and overall health. In particular, social health promotion is overlooked in AYACS' care. AYA-UNITE, a sociobehavioral exercise intervention pilot for AYACS 15-21 years of age at cancer diagnosis, was designed to foster AYACS' social and physical health. AYA-UNITE was a 12-week group-based virtual exercise program incorporating strength training and aerobic activity. In this brief report, we account AYA-UNITE's conceptual design, lessons learned through AYA-UNITE intervention development, and opportunities for improvement in implementing effective AYACS psychosocial interventions (NCT03778658).

656-P: COVID-19 Exposure and Perceived Impact Associated with Poor Psychosocial, Behavioral, and Physical Health

Aim: To describe the exposure and impact of COVID-19 in teens with T1D and associations with health outcomes. Methods: In the first month of an intervention trial to reduce distress in teens with T1D, COVID-19 emerged. Thus, in addition to planned surveys (Table), participants reported on COVID-19 exposure and perceived impact of the pandemic. Subscales assessed: 1) COVID-19 exposure - a tally of whether teen/important contact was diagnosed, hospitalized, or died, 2) Pandemic-impact - overall worry/feelings about the pandemic (range: 2-10), and 3) T1D-impact - pandemic effect on diabetes care (range: 13-65). Higher scores indicated more exposure or perceived impact. Pearson correlations described all associations. Results: Of the 172 teens (A1C M=8.7%±2.0%, 56% female, 73% White, 19% Hispanic), 50% reported no exposures, 23% reported 1, 24% 2-3, and 2% 4-7 exposures. Mean pandemic-impact score was 5.6±1.6 (range=2-10), while mean T1D-impact was 36.8±6.9 (range=18-54). Table summarizes associations of subscales with A1C and behavioral markers. Conclusions: COVID-19 exposure and perceived impact were consistently linked with worse psychosocial and behavioral metrics and A1C for teens with T1D. In particular, associations with T1D-impact were strong. These findings suggest the impact of stressful life events should be monitored within the context of T1D management. Disclosure J.Yi-frazier: None. M.Bradford: None. C.Zhou: None. A.Rosenberg: None. M.E.Hilliard: None. M.B.O'donnell: None. B.M.Ellisor: None. S.Garcia perez: None. F.Malik: None. Y.Rojas: None. D.Desalvo: Consultant; Dexcom, Inc., Research Support; Insulet Corporation. C.Pihoker: None. S.R.Scott: None. Funding National Institutes of Health (R01DK121224)

Midlife Life's Simple 7, Psychosocial Health, and Physical Frailty, Hospital Frailty, and Comprehensive Frailty 10 Years Later.

This study aims to examine the associations between midlife Life's Simple 7 (LS7) status, psychosocial health (social isolation and loneliness), and late-life multidimensional frailty indicators, and to investigate their synergistic effect on frailty. We used cohort data from the UK Biobank. Frailty was assessed using physical frailty phenotype, hospital frailty risk score, and frailty index. Cox proportional-hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) on the association between the LS7 score, psychosocial health, and frailty. For the association of LS7 with physical and comprehensive frailty, 39,047 individuals were included. After a median follow-up of 9.0 years, 1329 (3.4%) people were identified with physical frailty, and 5699 (14.6%) with comprehensive frailty. For the association of LS7 with hospital frailty, 366,570 people were included. After a median follow-up of 12.0 years, 18,737 (5.1%) people were identified with hospital frailty. Compared to people with a poor LS7 score, those with an intermediate (physical frailty: 0.64, 0.54-0.77; hospital frailty: 0.60, 0.58-0.62; and comprehensive frailty: 0.77, 0.69-0.86) and optimal LS7 score (physical frailty: 0.31, 0.25-0.39; hospital frailty: 0.39, 0.37-0.41; and comprehensive frailty: 0.62, 0.55-0.69) were associated with a lower risk of frailty. Poor psychosocial health was associated with an increased risk of frailty. People who had a poor psychosocial status and poor LS7 score had the highest risk of frailty. A better LS7 score in midlife was associated with a reduced risk of physical, hospital, and comprehensive frailty. There was a synergistic effect of psychosocial status and LS7 on frailty.

EffEx-HN trial: study protocol for a randomized controlled trial on the EFFectiveness and feasibility of a comprehensive supervised EXercise program during radiotherapy in Head and Neck cancer patients on health-related quality of life

BackgroundWith over 500,000 annually reported cases worldwide, head and neck cancer (HNC) is the seventh most common type of cancer worldwide. Treatment of HNC with chemoradiotherapy frequently results in serious impairments in physical and psychosocial functioning. Besides, HNC patients typically start their cancer treatment already with poor physical and psychosocial health. It has been shown that a sufficient level of physical activity (PA) before, during, and after cancer treatment is associated with fewer negative treatment-related side effects and a better quality of life (QOL). In order to prevent worsening of functioning and limit the physical impact of the HNC treatment, a comprehensive supervised exercise program (CSEP) may be beneficial during early cancer treatment. However, up to now, the feasibility and effectiveness of such a program are not yet investigated thoroughly in HNC. Therefore, the primary objective of this study is to examine the effectiveness of a CSEP during HNC treatment, in addition to usual supportive care, compared to usual supportive care alone, on health-related QOL up to 1 year post-diagnosis. Secondary objectives entail gathering information on (1) the effectiveness of a CSEP on secondary outcomes such as physical and mental function, activities of daily life, and participation in society and (2) the feasibility, possible barriers, and facilitators for participation in a CSEP during HNC treatment.MethodsTo investigate the effectiveness of the CSEP, a parallel, open-label randomized controlled trial will be performed. To study the feasibility of the CSEP, a mixed-method study will be performed in a subgroup of participants. HNC patients are eligible if they receive radiotherapy at the Radiation-Oncology department of the University Hospital of Leuven. A 4-size permuted block randomization will be used. The control group receives the current standard of supportive care. The intervention group receives a CSEP, additional to the same usual supportive care. The CSEP consists of a 12-week intensive phase with 3 exercise sessions of 1 h per week, where supervision is gradually reduced after 6 weeks. During the maintenance phase (from week 13), patients exercise at home with monthly tele-consultations with a physiotherapist. The CSEP contains supervised aerobic and resistance training. In both groups, outcomes of interest are evaluated through self-reported questionnaires and clinical assessments, at baseline, 6 weeks, 12 weeks, 6 months, and 12 months post-diagnosis. The primary endpoint is health-related QOL, measured with the EORTC QLQ-C30 at 6 months post-diagnosis.DiscussionThe study will be conducted in accordance with the Declaration of Helsinki. This protocol has been approved by the ethical committee of the University Hospitals Leuven (s65549). Recruitment started in January 2022. Results will be disseminated via peer-reviewed scientific journals and presentations at congresses.Trial registrationTrial Registration: ClinicalTrials.govIdentifier: NCT05256238Date of registration: February 25, 2022

Abstract P122: Life’s Simple 7 and Psychosocial Health Predict Physical Frailty, Hospital Frailty, and Comprehensive Frailty Index 10 Years Later

Introduction: Life’s Simple 7 (LS7) is a metric for cardiovascular health (CVH). Evidence has shown that LS7 in late life was linked to late-life physical frailty, while the association of LS7 in midlife with multidimensional frailty indicators in late life remains unclear. In addition, there might be synergistic interactions between cardiovascular health and psychosocial health factors on risk of frailty. Hypothesis: Based on the bio-psycho-social medical model, we hypothesized that midlife LS7 status might be related to late life multidimensional frailty indicators (physical frailty, hospital frailty, and comprehensive frailty index), and psychosocial health (social isolation and loneliness) might interact the association between LS7 and frailty. Methods: We used cohort data from UK Biobank. CVH was measured by LS7. A higher score indicated better CVH. Psychosocial health status was measured by social isolation and loneliness and divided into good or poor. Frailty was assessed using physical Frailty Phenotype (FP), a validated Hospital Frailty Risk Score (HFRS) and a comprehensive Frailty Index (FI). Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) on the association between the LS7 score, psychosocial health, and frailty. The synergistic effects of LS7 and psychosocial health on frailty were also analyzed. All HRs were adjusted for sex, age at last follow-up, race, education level, alcohol drinking, and income. Results: For the association of LS7 with FP and FI, 39,047 individuals who attended baseline and visit 2 were included. After a median follow-up of 9.0 years, FP identified 1,329 (3.4%) people with frailty, and FI identified 5,699 (14.6%) with frailty. For association of LS7 with HFRS, 366,570 people were included. After a median follow-up of 12.0 years, 18,737 (5.1%) people were identified as with hospital frailty. Compared to people with poor LS7 score, those with intermediate (FP:HR=0.64, 0.54-0.77; FI: HR=0.77, 0.69-0.86; HFRS: HR=0.60, 0.58-0.62) and optimal LS7 score (FP: HR=0.31, 0.25-0.39; FI: HR=0.62, 0.55-0.69; HFRS: HR=0.39, 0.37-0.41) were associated with lower risk of frailty. Poor psychosocial health was associated with an increased risk of frailty (FP: 1.87, 1.44-2.43; FI: 1.46, 1.24-1.71; HFRS: 1.53, 1.44-1.62). We observed synergistic effects of LS7 and psychosocial health on frailty. People who had good psychosocial status and optimal LS7 score had the lowest risk of frailty (FP: 0.30, 0.24-0.38; FI: 0.63, 0.56-0.70; HFRS: 0.38, 0.36-0.41). Conclusions: Higher LS7 score or good psychosocial health in midlife was associated with reduced risk of physical frailty, hospital frailty, and overall frailty. Psychosocial status interacted with LS7 on frailty. Individuals who had good psychosocial health and optimal LS7 score were associated with the lowest risk of frailty.

Intimate Partner Violence and Health Outcomes Among Women Living With HIV/AIDS in Ghana: A Cross-Sectional Study.

Intimate partner violence (IPV) is known to have negative health consequences for victims. For women living with HIV/AIDS, whose health may be compromised, exposure to IPV can be devastating. Yet few (if any) studies have explored the health implications of exposure to IPV among HIV-positive women. We begin to fill this gap by examining the effects of various dimensions of IPV (physical, sexual, psychological/emotional, and economic) on the cardiovascular, psychosocial, and sexual reproductive health outcomes of HIV-positive women in Ghana. Data were collected from a cross-section of 538 HIV-positive women aged 18 years and older in the Lower Manya Krobo District in the Eastern Region. We used logit models to explore relationships between IPV and health. The findings indicate high prevalence of IPV in our sample: physical violence (61%), sexual violence (50.9%), emotional/psychological violence (79.6%), and economic violence (66.8%). Generally, participants with experiences of IPV reported cardiovascular health problems, unwanted pregnancies and pregnancy loss, and poor psychosocial health. Our findings suggest the importance of screening for IPV as part of HIV care in Ghana.

Understanding women’s views of and preferences for accessing postpartum contraception: a qualitative evidence synthesis

BackgroundNearly half of women experience unintended pregnancies. These are associated with increased risk of poor maternal physical and psychosocial health outcomes. Many pregnancies in the first year postpartum are unintended,...

Intersectionality of Self-Reported Food Insecurity and Perceived Stress of College Students at a Land-Grant Southeastern Higher Education Institution during the COVID-19 Pandemic

College food insecurity (FI) and poor psychosocial health are prevalent public health issues in the U.S., yet often overlooked. Since the COVID-19 pandemic, repercussions on these critical inequity issues remain unclear. During the summer months of 2020, this cross-sectional survey examined associations between students’ self-reported FI and perceived stress (PSS-10), one aspect of poor psychosocial health. An anonymous online survey was distributed to a convenience sample of college students at a land grant institution of higher education in the southeastern U.S., and $10 e-gift card was provided to survey respondents. The survey response rate was 26.2% (n=235) and participants were predominantly female, White, and from upper-division including junior and senior students. Among respondents, 31.3% were food insecure and 37.8% were laid off or temporarily furloughed. Students who worked before the pandemic were 3.49 times more likely to continue working despite the pandemic; however, employment status was not significantly associated with since-PSS-10 scores or FI. In multiple linear regression models, pre-PSS-10 scores, age, and lower division were significant predictors of since-PSS-10 scores. Additionally, students experiencing FI and having higher pre-PSS-10 scores were predicted of having higher since-PSS-10 scores. This study adds important findings about college FI and perceived stress to the limited literature regarding college student health during the pandemic. A more rigorous study design with a larger, nationally or regionally representative sample is recommended for future studies. To address both complex issues of college FI and poor psychosocial health, a multi-faceted interdisciplinary approach, well-supported by college administrators, would be warranted.

Calling on All Child and Family Practitioners to Help Mitigate the Impacts of the Poor Behavioural Health of Children with Psychiatric Illness

Adolescents and children (aged 6 to 17+ years) admitted to inpatient psychiatry or intensive out-of-home mental health programs (formerly called residential mental health treatment centres) are among those with the most severe psychiatric illnesses. Moreover, these children also have very poor behavioural and biopsychosocial health including sleep deprivation, difficult relationships, problematic use of electronic devices, academic difficulty, poor school engagement, insufficient exercise and poor diets; all of these were noted before the pandemic. The pandemic has only increased the social isolation, poor health behaviours and mental health challenges for many children and adolescents. The poor behavioural and psychosocial health of those in their youth with psychiatric illnesses can exacerbate symptoms and can interfere with academic performance, development and good decision making; these biopsychosocial health behaviours are modifiable. All child and family practitioners including pediatricians, family physicians, nurses, social workers, psychologists and psychotherapists have an important role in fostering the behavioural and biopsychosocial health (i.e., sleep, positive relationships, electronic device use, exercise and diet) of all family members and especially children with psychiatric illness. Enacting biopsychosocial lifestyle interventions before or during childhood and adolescence may reduce the burden of mental illness.

PCR95 Functional Quality of Life Among People Living With Obesity: A Longitudinal Cohort of Patient Reported Outcomes

Obesity is a chronic disease associated with decreased physical functioning and poor psychosocial health. We evaluated self-reported limitations in daily activities and quality of life (QOL) across BMI categories among people with obesity participating in a longitudinal observational survey.

Exploring the associations between discrimination, coping, skin tone, and the psychosocial health of young adults of color

Although valuable strides have been made in linking racial and ethnic discrimination to health outcomes, scholars have primarily used between-person methodological approaches, which assess the implications of reporting high or low mean levels of discrimination. Alternatively, within-person approaches assess the implications of intraindividual variation, or acute changes, in an individual's exposure to discrimination. These approaches pose two fundamentally different questions about the association between discrimination and health, and empirical work that disaggregates these effects remains scarce. Scholars have also called for research exploring whether sociocultural factors-such as race-related coping and skin tone-contour these associations. To address gaps in extant literature, the current study examined 1) how an individual's average level of exposure to discrimination (between-person) and weekly fluctuations in these encounters (within-person) relate to psychosocial health and 2) whether race-related coping (confrontational and passive coping) and skin tone moderate these associations. Analyses were conducted using weekly diary data from African American and Latinx young adults (n = 140). Findings indicated that reporting higher mean levels of exposure to discrimination and encountering more discrimination than usual on a given week were both associated with poorer psychosocial health. Results also suggest that the efficacy of young adults' coping mechanisms may depend on their skin tone and the nature of the discriminatory events encountered.