Socioeconomic Background Research Articles

Psychometric properties of the toddler feeding style questionnaire in fathers and its gender invariance

Parental feeding practices and behaviours are closely related to a number of child outcomes, including eating behaviour and health. The Toddler Feeding Style Questionnaire (TFSQ) was developed to provide an accurate instrument for evaluating parental feeding practices for toddlers by assessing two dimensions: responsiveness and demandingness. As the initial validation study was conducted in a sample of mothers only, the aims of this study are: a) to validate the TFSQ in fathers, b) to analyse its measurement invariance as a function of gender and parenting experience and c) to explore associations between socio-demographic variables and both dimensions. The TFSQ was completed by 377 fathers and 583 mothers. CFA confirmed the two-factor structure within the same items as the initial validation study, with good model fit indices (X2 = 230.089; TLI = 0.883; CFI = 0.91; RMSEA = 0.08 (90% CI 0.068–0.092), SRMR = 0.070). Strict invariance measurement in terms of gender and parenting experience was achieved. Overall, fathers scored higher than mothers on demandingness, regardless of their parenting experience. Primiparous mothers scored higher than multiparous mothers and primiparous fathers on the responsiveness dimension. However, there were no gender-based differences on this dimension for parents with more than one child. These results confirm that the TFSQ is an adequate and validated instrument for assessing parenting dimensions, as it performs equally well for mothers and fathers, regardless of their parenting experience. There is also support for the notion that parental attitudes to feeding may be related to their socio-economic background.

The rhythm of risk: Exploring spatio-temporal patterns of urban vulnerability with ambulance calls data

Urban vulnerability is affected by changing patterns of hazards due to climate change, increasing inequalities, rapid urban growth and inadequate infrastructure. While we have a relatively good understanding of how urban vulnerability changes in space, we know relatively little about the temporal dynamics of urban vulnerability. This paper presents a framework to assess urban vulnerability over time and space to address this gap. We apply the framework to Amsterdam, Rotterdam, and The Hague, the Netherlands. Using high-resolution, anonymised ambulance calls and socio-economic, built environment, and proximity data, we identify three temporal patterns: ’Midday Peaks’, ’Early Birds’, and ’All-Day All-Night’. Each pattern represents a unique rhythm of risk arising from the interaction of people with diverse demographic and socio-economic backgrounds and the temporal flow of their daily activities within various urban environments. Our findings also highlight the polycentric nature of modern Dutch cities, where similar rhythms emerge in areas with varying population densities. Through these case studies, we demonstrate that our framework uncovers the spatio-temporal dynamics of urban vulnerability. These insights suggest that a more nuanced approach is necessary for assessing urban vulnerability and enhancing preparedness efforts.

Ameliorating Racial Disparities in HIV Prevention via a Nurse-Led, AI-Enhanced Program for Pre-Exposure Prophylaxis Utilization Among Black Cisgender Women: Protocol for a Mixed Methods Study.

HIV pre-exposure prophylaxis (PrEP) is a critical biomedical strategy to prevent HIV transmission among cisgender women. Despite its proven effectiveness, Black cisgender women remain significantly underrepresented throughout the PrEP care continuum, facing barriers such as limited access to care, medical mistrust, and intersectional racial or HIV stigma. Addressing these disparities is vital to improving HIV prevention outcomes within this community. On the other hand, nurse practitioners (NPs) play a pivotal role in PrEP utilization but are underrepresented due to a lack of awareness, a lack of human resources, and insufficient support. Equipped with the rapid evolution of artificial intelligence (AI) and advanced large language models, chatbots effectively facilitate health care communication and linkage to care in various domains, including HIV prevention and PrEP care. Our study harnesses NPs' holistic care capabilities and the power of AI through natural language processing algorithms, providing targeted, patient-centered facilitation for PrEP care. Our overarching goal is to create a nurse-led, stakeholder-inclusive, and AI-powered program to facilitate PrEP utilization among Black cisgender women, ultimately enhancing HIV prevention efforts in this vulnerable group in 3 phases. This project aims to mitigate health disparities and advance innovative, technology-based solutions. The study uses a mixed methods design involving semistructured interviews with key stakeholders, including 50 PrEP-eligible Black women, 10 NPs, and a community advisory board representing various socioeconomic backgrounds. The AI-powered chatbot is developed using HumanX technology and SmartBot360's Health Insurance Portability and Accountability Act-compliant framework to ensure data privacy and security. The study spans 18 months and consists of 3 phases: exploration, development, and evaluation. As of May 2024, the institutional review board protocol for phase 1 has been approved. We plan to start recruitment for Black cisgender women and NPs in September 2024, with the aim to collect information to understand their preferences regarding chatbot development. While institutional review board approval for phases 2 and 3 is still in progress, we have made significant strides in networking for participant recruitment. We plan to conduct data collection soon, and further updates on the recruitment and data collection progress will be provided as the study advances. The AI-powered chatbot offers a novel approach to improving PrEP care utilization among Black cisgender women, with opportunities to reduce barriers to care and facilitate a stigma-free environment. However, challenges remain regarding health equity and the digital divide, emphasizing the need for culturally competent design and robust data privacy protocols. The implications of this study extend beyond PrEP care, presenting a scalable model that can address broader health disparities. PRR1-10.2196/59975.

Maternal heart rate variability at 3-months postpartum is associated with maternal mental health and infant neurophysiology

Previous research has demonstrated a critical link between maternal mental health and infant development. However, there is limited understanding of the role of autonomic regulation in postpartum maternal mental health and infant outcomes. In the current study, we tested 76 mother-infant dyads from diverse socioeconomic backgrounds when infants were 3-months of age. We recorded simultaneous ECG from dyads while baseline EEG was collected from the infant; ECG heart rate variability (HRV) and EEG theta-beta ratio and alpha asymmetry were calculated. Dyadic physiological synchrony was also analyzed to better understand the role of autonomic co-regulation. Results demonstrated that lower maternal HRV was associated with higher self-reported maternal depression and anxiety. Additionally, mothers with lower HRV had infants with lower HRV. Maternal HRV was also associated with higher infant theta-beta ratios, but not alpha asymmetry. Exploratory analyses suggested that for mother-infant dyads with greater physiological synchrony, higher maternal HRV predicted increased infant theta-beta ratio via infant HRV. These findings support a model in which maternal mental health may influence infant neurophysiology via alterations in autonomic stress regulation and dyadic physiological co-regulation.

Impact of Park Redesign and Renovation on Children's Quality of Life.

Despite increasing interest in the role of parks on children's health, there has been little empirical research on the impact of park interventions. We used a quasi-experimental pre-post study design with matched controls to evaluate the effects of park redesign and renovation on children's quality of life (QoL) in underserved neighborhoods in New York City, with predominantly Hispanic and Black populations. Utilizing longitudinal data from the Physical Activity and Redesigned Community Spaces (PARCS) Study, we examined the parent-reported QoL of 201 children aged 3-11 years living within a 0.3-mile radius of 13 renovated parks compared to 197 children living near 11 control parks before and after the park intervention. QoL was measured using a modified version of the KINDL questionnaire, a health-related QoL scale that assessed children's physical and emotional well-being, self-esteem, and well-being in home, peer, and school functioning. Linear mixed regression model was used to examine the difference in difference (DID) between the intervention vs. control group for QoL. We found a significant differential improvement in the physical well-being subscale of KINDL in the intervention vs. control group (DID = 6.35, 95% Confidence Interval [CI] = 0.85-11,85, p = 0.024). The effect was particularly strong among girls (DID = 7.88, p = 0.023) and children of the lowest socio-economic background (p < 0.05). No significant DID was found in other KINDL domains. Our study indicated a beneficial impact of improving park quality on the physical well-being of children residing in underserved neighborhoods. These findings lend support for investments in neighborhood parks to advance health equity.

Double-duty actions addressing the double burden of malnutrition among adolescents aged 10-19: protocol for a scoping review.

The global adolescent population faces the challenge of the double burden of malnutrition (DBM), characterized by the coexistence of undernutrition and overweight/obesity, including diet-related non-communicable diseases (NCDs). This dual challenge, prevalent across various socio-economic backgrounds, necessitates double-duty actions, i.e., integrated interventions designed to concurrently address both sets of conditions. These actions are critical for fostering the overall health and well-being of adolescents. The objective of this review is to describe the content, setting, and delivery mechanisms of double-duty actions, synthesize their impacts on adolescents' nutritional status, and offer policy and program implications for future interventions. As part of this scoping review, we will conduct a comprehensive search across multiple databases, including MEDLINE, Embase, CENTRAL, CINAHL, and Google Scholar, to identify relevant interventions, programs, policies, guidelines, evaluation studies, and strategies targeting DBM among adolescents aged 10-19 years. Inclusion criteria encompass a range of evidence sources with methodologically sound and well-described study designs. All full-text articles and abstracts will be independently screened by two reviewers to ensure a comprehensive inclusion of papers that align with the established criteria. The final protocol is available on Open Science Forum (https://osf.io/kxapb). Addressing DBM through integrated double-duty actions is crucial for achieving global nutrition and public health goals. However, challenges persist in the form of uncoordinated efforts, lack of comprehensive evidence for what interventions work among adolescents, and the need for context-specific strategies to effectively address the heterogeneity of DBM. The results of this scoping review may provide evidence for future policies and interventions, emphasizing integrated, multi-sectoral strategies tailored to the unique needs of the adolescent population.

“Don't Touch!”: The Role of Cultural Knowledge in Low‐SES Parents' Perceptions of Museums

Museums can provide valuable benefits for children, but children from low socioeconomic (SES) backgrounds are less likely to have exposure to such institutions. We draw on interviews with 52 low‐SES parents to explore how perceptions of museums influence whether parents would consider bringing their children there. Respondents express a clear preference for enriching activities for their children. However, our findings reveal a tension between this general desire and parents' impressions of what museums are and how their children will experience them. We illustrate how limited familiarity with museums produces a circumscribed view of the range of experiences available at different kinds of museums and influences parents' perceptions of their child‐appropriateness, thus demonstrating the role of class‐based cultural knowledge in shaping the choices parents make about out‐of‐school activities. Our findings complicate the binary narrative that attributes parental investments to either preferences or resources and highlights how cultural knowledge about such activities may contribute to social inequality. The study also offers insights for cultural institutions that wish to attract a more socioeconomically diverse base of visitors.

Course Correction: Navigating Equity in Ninth-Grade Advanced Placement

This robust mixed-methods study examines ninth-grade advanced course placement in Arkansas, revealing disparities rooted in race and socioeconomic status. Utilizing a logit analysis for a five-year pooled sample ( n = 163,616), we find persistent enrollment gaps for Black ninth-grade students after controlling for prior academic achievement, highlighting systemic barriers to access to advanced courses. Socioeconomic divides are also evident in our analysis. Qualitative findings from counselor interviews highlight the importance of parental involvement in course placement decisions, particularly for students from lower socioeconomic backgrounds. Overall, we find through these interviews that districts consider a myriad of factors when considering course placement for ninth-grade courses. We recommend systemic changes for districts, including local norm-based placement systems and automatic enrollment policies to enhance fairness in advanced course placement.

What Does It Mean to Successfully Age?: Multinational Study of Older Adults' Perceptions.

Successful aging is a mainstay of the gerontological literature, but it is not without criticism, including the often-limited way that it is studied and measured as well as the exclusion of older adults' voices in its formulation and understanding. This study sought to address these issues through a qualitative investigation across multiple countries. This was a mixed-methods, cross-sectional, exploratory study using an online survey. Nations that received the survey included Australia, New Zealand, the United Kingdom, Ireland, Canada, and the Unites States. Participants aged 65 and older were asked to describe what successful aging means to them in an open-ended survey item. Summative content analysis was utilized to examine the responses. Successful aging was defined by 1,994 participants, and 6 themes along with 20 subthemes were found. In contrast to conception that successful aging is solely or predominantly related to the absence of disease and decline, the most prominent theme in this study was "active, independent, and engaged" as the hallmark of success. Although health and health maintenance were present in other themes, these findings support a multidimensional definition of successful aging that promotes the perspectives of older people. Future research should seek to further investigate the ways in which person-in-environment factors influence definitions of successful aging, including culture, gender and gender identity, race and ethnicity, and socioeconomic background.

Mapping local suitability for STEM work-related experiential opportunities in Georgia

Internships, job shadows, cooperative education programs, and other forms of experiential education can play a crucial role in students successfully transitioning from their undergraduate program to a career pathway. We collectively term these opportunities as work-related experiential activities (WREAs). While valuable, students’ access to these experiences can vary based on multiple factors, including their own socioeconomic background, access to social networks, university programs, and geographic context. Little research has been done on the last of these factors, and this paper helps fill this gap by developing a geospatial WREA opportunity index for STEM related opportunities, using census and point-of-interest data to identify census tracts with the greatest rate of WREA opportunity and attractive amenities for students. To do so, we draw on surveys and interviews across multiple college campuses in Georgia, both to identify desirable characteristics for students and to catalog the WREAs they have participated in. This index highlights disparities across college campuses, particularly between those located in metropolitan Atlanta compared to those in smaller cities in the state. This tool provides a way to quantify and visualize those differences in ways that can support investment in programs that help bridge opportunity gaps for students.

Evaluation of the quality of life among transgender men before and after gender reassignment surgery: a survey from Iran

BackgroundGender dysphoria, characterized by a misalignment between one’s gender identity and assigned sex, propels individuals towards medical interventions like gender reassignment surgery (GRS) to harmonize their bodies with their gender. This process aims to enhance overall quality of life (QoL), functioning, and body image. Recognizing the importance of cultivating a positive body image for transgender individuals navigating societal norms, this narrative highlights the ongoing debate surrounding QoL post-GRS. In response, our study is outlined, aiming to scrutinize QoL and self-image among transgender men post-GRS, offering valuable insights into societal perceptions and psychological well-being in this context.MethodThis cross-sectional survey focused on transgender men aged 15 to 35 who underwent gender reassignment surgery (GRS) in 2018–2022 in Shiraz, Iran. Participants, after passing psychiatric evaluations, completed World Health Organization Quality of Life (WHOQOL-100) questionnaires pre- and at least one-year post-surgery. The scores of the Brief-WHOQOL questionnaire were evaluated in four domains of physical health, psychological health, social relationships, and environmental health.ResultsA total of 60 individual who underwent GRS completed our questionnaire. The average age of the patients was 24.1 ± 3.8 years. Following GRS, the most increase was observed in the psychological factor (by 25.6%). The increase in score was statistically significant in all subgroups (P < 0.001) after operation. Urban living location had a significant association with higher increase in physical health (P < 0.010), psychological health (P = 0.005), and environmental health (P = 0.012) after GRS. In regards to physical health, the low socioeconomic group had a significantly less physical score improvement in QoL compared to the moderate group (P = 0.024) following GRS. In regards to environmental health, the high socioeconomic groups had significantly higher improvement in QoL compared to the low (P = 0.006) and moderate (P < 0.001) group after operation.ConclusionThe results demonstrate that GRS brings about improvements across all aspects of QoL. However, this enhancement is less pronounced among patients hailing from low socioeconomic backgrounds and rural areas.

What We Know about Student Families: A Sociological Analysis

This study analyzes the phenomenon of student parents in Russia. The authors examine the demographic context, the characteristics of student parents, and their experience of combining study and parenthood. The study is based on data from the longitudinal project “Trajectories in Education and Profession” and in-depth interviews with student mothers. The results show that student families are relatively rare, which is in line with the general trend of increasing age of marriage and childbearing. Nevertheless, most students plan to start a family in the future. Students from families with lower socioeconomic background are more likely to start families during their studies. Analysis of the interviews revealed the main strategies for combining study and motherhood, including reorganization of daily routines, sabbaticals, and distance learning. The importance of support from partners and relatives was also noted. Student mothers expressed a demand for more flexible study formats, material support, and infrastructure development (e.g. kindergartens at universities). The authors conclude that an individualized approach to supporting student families is needed, given their rarity and diversity of needs. Directions for further research are suggested, including the study of social conditions influencing the age of family formation, analysis of family plans of older undergraduate and graduate students, and a more detailed study of the typology and daily life of student families.

Social and Emotional Learning Interventions for Preadolescents and Adolescents: Assessing the Evidence Base.

The social and emotional learning (SEL) framework is widely recognized as being effective for developing social and emotional competencies among students of all ages. However, the evidence for specific intervention models with older student populations is less established. The objective of this systematic review was to rate the evidence supporting the effectiveness of SEL interventions aimed at improving mental health outcomes among preadolescents and adolescents. A search of major databases, gray literature, and evidence base registries was conducted to identify studies published from 2008 to 2022 that assessed the effects of SEL interventions on mental health outcomes among students ages 10-19 years. The authors rated the evidence for SEL interventions as high, moderate, or low based on established rating criteria. In total, 25 articles reporting on 17 original research studies were reviewed. Sixteen intervention models were assessed, with 11 resulting in improved mental health symptoms; however, no intervention was evaluated in a large enough number of studies to surpass a low evidence rating. Some studies reported cost benefits and high effectiveness of an intervention with students from diverse racial-ethnic or low socioeconomic backgrounds. SEL interventions can improve mental health outcomes among preadolescents and adolescents. Additional research is needed to strengthen the evidence base for specific intervention models.

High School Curriculum and Cognitive Function in the Eighth Decade of Life.

Formal educational attainment, or years of schooling, has a well-established positive effect on cognitive health across the life course. We hypothesized that the content and difficulty of the curriculum influence this relationship, such that more challenging curricula in high school lead to higher levels of socioeconomic attainment in adulthood and, in turn, to better cognitive outcomes in older adulthood. We estimated multilevel structural equation models (MSEMs) in data from 2,405 individuals who attended one of 1,312 US high schools in 1960 and participated in the Project Talent Aging Study in 2018. A college preparatory curriculum and a greater number of semesters of math and science in high school were positively related to word recall and verbal fluency at an average age of 75. Effects were robust to controlling for adolescent cognitive ability, academic performance, socioeconomic background, and school characteristics. We discuss the implications of these findings for educational policy.

The Influence of Socioeconomic Factors on Access to Mental Health

Mental health is a pivotal aspect of overall well-being, yet access to mental health services is unevenly distributed across different socioeconomic groups. This study explores the influence of socioeconomic factors—such as income, education, employment status, and housing—on access to mental health care. Employing a mixed-methods approach, the research integrates quantitative analysis of survey data with qualitative interviews to reveal significant disparities in service utilization. Findings indicate that individuals from lower socioeconomic backgrounds face substantial barriers, including financial constraints, stigma, and geographic limitations. The study underscores the persistent nature of these inequalities and highlights the need for targeted policy interventions and systemic reforms. Expanding insurance coverage, reducing stigma, and increasing mental health infrastructure in underserved areas are critical for improving access. Future research should focus on evaluating policy impacts and exploring innovative service delivery models.

Teletherapy to address language disparities in deaf and hard-of-hearing children: study protocol for an inclusive multicentre clinical trial

IntroductionChildren who are deaf or hard-of-hearing (DHH) are at risk for speech and language delay. Language outcomes are worse in DHH children from lower socioeconomic backgrounds, due in part to...

Health and income inequality: a comparative analysis of USA and Italy.

Socio-economic background is often an important determinant for health with low income households having higher exposure to risk factors and diminished access to healthcare and prevention, in a way that is specific to each country. Here, we perform a comparative analysis of the relations between health and income inequality in two developed countries, USA and Italy, using longitudinal and cross-sectional data from surveys. We show that the income class determines the incidence of chronic pathologies, associated risk-factors and psychiatric conditions, but find striking differences in health inequality between the two countries. We then focus our attention on a fraction of very disadvantaged households in the USA whose income in persistently at the bottom of the distribution over a span of 20 years and which is shown to display particularly dire health conditions. Low income people in the USA also display comorbidity patterns that are not found in higher income people, while in Italy income appears to be less relevant for comorbidity. Taken together our findings illustrate how differences in lifestyle and the healthcare systems affect health inequality.

The challenges of confronting racism as a social disease by second-generation Indians in social and professional space in Australia: A qualitative study

ABSTRACT This qualitative study investigated the experiences of racism encountered by second-generation Indian Australians in social and professional domains through semi-structured interviews with 30 participants aged 15–25 years living in Melbourne and Sydney. Purposive and snowball sampling were used to recruit participants. Data was analysed thematically using critical race theory. Key findings included experiences of racism in educational settings, which had psychological impacts. Moreover, racism also influenced family life and career opportunities, reflecting tangible consequences. The study underlines distinct challenges that emerged based on gender, religion, geographic location and socio-economic background, highlighting intersectionality. Racism was found to permeate multiple life spheres through institutional and individual biases. The findings highlight that anti-racism strategies addressing educational, workplace and community inclusion in an intersectional framework, thereby advancing multicultural societies of equity and belonging for all.

Planning to Take More Mathematics Courses in High School: Who Does and Who Doesn't?

What are the most common motives invoked by 9th graders when asked about their plans to take (or not) more mathematics courses during high school? How do beliefs about math course-taking affect students’ actual planning? To what extent is planning of math course-taking associated with high school students’ socio-demographic backgrounds? The study employs data from the High School Longitudinal Survey of 2009 to examine the issue of persistence in math course-taking during high school. The study shows that almost two-thirds of 9th graders plan to do math during all their high school years, although intentions to persist in math vary across racial and especially socioeconomic backgrounds. The study also demonstrates the importance of belief constructs such as math identity, internal motivation toward math learning and math utility on math course-taking planning. A better understanding of students’ motives to engage in high school math may help develop classroom practices that emphasize the long-term benefits of math learning.

“I just want to annoy him now and say, look, I can do STEM too!”: a qualitative investigation into the attitudes and engagement of female students in STEM education in Ireland

ABSTRACT Women are underrepresented in STEM (Science, Technology, Engineering and Maths); with further stratification existing for those from low socio-economic backgrounds. Understanding the reasons for this is essential to progress towards equality in STEM fields. This paper takes the perspective of such marginalized groups and explores their beliefs about STEM within a school-based system, for the purposes of this study a focus has been placed on gender and socio-economic status. Focus groups were conducted with 18 female participants attending Irish secondary schools. The results provide insight into the challenges faced when pursuing STEM; additionally, the motivating and inhibiting factors are reported. Results reveal how social and academic barriers prevent young women from progressing in STEM, highlighting how intersectional layers of disadvantage limit equal access in STEM education. Such findings can inform the development of policies to help students access STEM-education, especially those attending schools characterized by higher concentrations of students from low-socio-economic backgrounds.