共查询到20条相似文献，搜索用时 31 毫秒
1.
Eliza Hartley Briony Hill Cate Bailey Matthew Fuller-Tyszkiewicz Helen Skouteris 《Women's health issues》2018,28(6):530-538
Background
Postpartum depression and anxiety are prevalent in the first year after giving birth and can have problematic health outcomes for the mother and infant, although further research is required about the factors that contribute to their development. This study explored the trajectory of depressive and anxiety symptoms across the first postpartum year and their associations with body attitudes, body mass index, and weight retention.Methods
Participants were 467 women recruited during pregnancy via online forums, in parenting magazines, and at baby and children's markets, or from a large tertiary Australian hospital. Participants reported retrospectively on the prepregnancy period and provided data in early pregnancy (Baseline; M = 17.1 weeks pregnant), at 3 months postpartum (T1; M = 13.1 weeks after birth), 6 months postpartum (T2; M = 26.6 weeks after birth), and 12 months postpartum (T3; M = 52.8 weeks after birth).Results
Latent growth curve modelling revealed that, from T1 to T3, depressive symptoms significantly decreased, whereas anxiety symptoms did not change significantly. Demographic factors, weight retention, body mass index, and body attitudes at T1 did not significantly predict the course of depression and anxiety over time; however, greater postpartum weight retention and negative body attitudes at T1 predicted a more severe experience of both depression and anxiety at T3.Conclusions
These findings emphasize the need to assess and monitor the risk factors that can have an adverse impact on postpartum women's psychological health. This finding is particularly important for women deemed to be at risk of problematic body image or weight issues so that health professionals can intervene, and better ensure the health of new mothers in the longer term. 相似文献2.
Leah N. Torres David K. Turok Erin A.S. Clark Jessica N. Sanders Emily M. Godfrey 《Women's health issues》2018,28(5):393-400
Objective
To assess the impact of contraceptive counseling on the uptake of long-acting reversible contraception (LARC), namely, intrauterine devices and the contraceptive implant, by 3 months postpartum among women with a recent preterm birth.Design
We enrolled patients in a single-blinded, one-to-one, randomized, controlled trial to assess the impact of enhanced family planning counseling immediately after a viable preterm birth in the inpatient setting. Participants received either structured counseling with an emphasis on LARC by a family planning specialist (intervention) or routine postpartum care (control). We followed participants to the primary outcome of LARC use 3 months postpartum.Results
We followed 121 participants for 3 months. Primary outcome data were available for 119 participants (61 intervention, 58 control). We found no demographic differences between the groups. Participants in the intervention group were significantly more likely to use LARC at 3 months postpartum compared with controls (51% vs. 31%; p < .05). For every six women who received the counseling intervention, one additional woman was using a LARC method at 3 months.Conclusions
After a preterm birth, brief LARC-focused, structured counseling before hospital discharge significantly increased LARC method use at 3 months postpartum. 相似文献3.
Purpose
To examine the concordance of labor induction measures derived from birth certificate and hospital discharge data with each other and with maternal report.Methods
Birth certificate data were linked with hospital discharge data and structured interviews of 2,851 mothers conducted 1 month after first childbirth. Those who reported that a doctor or nurse tried to cause their labor to begin, and were not in labor before that event, were classified as undergoing labor induction. The mothers were aged 18 to 35 years at study entry and delivered at 78 hospitals (76 in Pennsylvania and 2 out of state) from 2009 to 2011.Results
The labor induction rate was 34.3% measured by maternal report, 29.4% by birth certificate data, and 26.2% by hospital discharge data. More than one-third of the women who reported labor induction were not reported as having been induced in the birth certificate data (33.6%), with similar results for the hospital discharge data (36.5%). The rate of underreporting of labor induction in the birth certificate data was higher for inductions occurring before 39 weeks of gestation (43.9%) than for inductions at 39 weeks or later (29.9%; p < .0001). Agreement between birth certificate and hospital discharge data was relatively low (kappa = 0.56), as was agreement between maternal report and birth certificate data (kappa = 0.58), and maternal report and hospital discharge data (kappa = 0.60).Conclusions
Both the birth certificate and hospital discharge data exhibit relatively poor agreement with maternal report of labor induction and seem to miss a substantial portion of labor inductions. 相似文献4.
Caitlin Cross-Barnet Brigette Courtot Ian Hill Sarah Benatar Morgan Cheeks Jenny Markell 《Women's health issues》2018,28(2):152-157
Background
Closely spaced, unintended pregnancies are common among Medicaid beneficiaries and create avoidable risks for women and infants, including preterm birth. The Strong Start for Mothers and Newborns Initiative, a program of the Center for Medicare and Medicaid Innovation, intended to prevent preterm birth through psychosocially based enhanced prenatal care in maternity care homes, group prenatal care, and birth centers. Comprehensive care offers the opportunity for education and family planning to promote healthy pregnancy spacing.Methods
As of March 30, 2016, there were 42,138 women enrolled in Strong Start and 23,377 women had given birth. Individual-level data were collected through three participant survey instruments and a medical chart review, and approximately one-half of women who had delivered (n = 10,374) had nonmissing responses on a postpartum survey that asked about postpartum family planning. Qualitative case studies were conducted annually for the first 3 years of the program and included 629 interviews with staff and 122 focus groups with 887 Strong Start participants.Results
Most programs tried to promote healthy pregnancy spacing through family planning education and provision with some success. Group care sites in particular established protocols for patient-centered family planning education and decision making. Despite program efforts, however, barriers to uptake remained. These included state and institutional policies, provider knowledge and bias, lack of protocols for timing and content of education, and participant issues such as transportation or cultural preferences.Conclusions
The Strong Start initiative introduced a number of successful strategies for increasing women's knowledge regarding healthy pregnancy spacing and access to family planning. Multiple barriers can impact postpartum Medicaid participants' capacity to plan and space pregnancies, and addressing such issues holistically is an important strategy for facilitating healthy interpregnancy intervals. 相似文献5.
Catherine Chanfreau-Coffinier Howard S. Gordon C. Amanda Schweizer Bevanne A. Bean-Mayberry Jill E. Darling Ismelda Canelo Elizabeth M. Yano 《Women's health issues》2018,28(5):430-438
Background
Identifying factors influencing patient experience and communication with their providers is crucial for tailoring comprehensive primary care for women veterans within the Veterans Health Administration. In particular, the impact of mental health (MH) conditions that are highly prevalent among women veterans is unknown.Methods
From January to March 2015, we conducted a cross-sectional survey of women veterans with three or more primary care and/or women's health visits in the prior year at 12 Veterans Health Administration sites. Patient measures included ratings of provider communication, trust in provider, and care quality; demographics, health status, health care use; and brief screeners for symptoms of depression, anxiety, and posttraumatic stress disorder. We used multivariate models to analyze associations of patient ratings and characteristics.Results
Among the 1,395 participants, overall communication ratings were high, but significant variations were observed among women screening positive for MH conditions. In multivariate models, high communication ratings were less likely among women screening positive for multiple MH conditions compared with patients screening negative (odds ratio, 0.43; p < .001). High trust in their provider and high care ratings were significantly less likely among women with positive MH screens. Controlling for communication, the effect of MH on trust and care ratings became less significant, whereas the effect of communication remained highly significant.Conclusions
Women veterans screening positive for MH conditions were less likely to give high ratings for provider communication, trust, and care quality. Given the high prevalence of MH comorbidity among women veterans, it is important to raise provider awareness about these differences, and to enhance communication with patients with MH symptoms in primary care. 相似文献6.
Kota Tsutsumimoto Takehiko Doi Hyuma Makizako Ryo Hotta Sho Nakakubo Minji Kim Satoshi Kurita Takao Suzuki Hiroyuki Shimada 《Journal of the American Medical Directors Association》2018,19(6):504-510
Objectives
To examine the association between each type of frailty status and the incidence rate of depressive symptoms among community-dwelling older adults.Design
Prospective cohort study.Setting
General communities in Japan.Participants
Participants comprised 3538 older Japanese adults.Measurements
We assessed our participants in terms of frailty status (physical frailty, cognitive impairment, and social frailty), depressive symptoms (geriatric depression scale ≥6), and other covariates, and excluded those who showed evidence of depression. Then, after a 4-year interval, we again assessed the participants for depressive symptoms. Physical frailty was defined by the Fried criteria, showing 1 or more of these were physical frailty. To screen for cognitive impairment, receiving a score below an age-education adjusted reference threshold in 1 or more tests was cognitive impairment. Finally, social frailty was defined using 5 questions, and those who answered positively to 1 or more of these were considered to have social frailty.Results
After multiple imputations, the incidence rate of depressive symptoms after 4 years of follow-up was 7.2%. The incidence rates of depressive symptoms for each frailty status were as follows: 9.6% for physical frailty vs 4.6% without, 9.3% for cognitive impairment vs 6.5% without, and 12.0% for social frailty vs 5.1% without. Finally, through the application of multivariable logistic regression analysis, the incidence of depressive symptoms was found to have a significant association with social frailty (odds ratio 1.55; 95% confidence interval 1.10–2.20) but not with physical frailty or cognitive impairment.Conclusions
This study revealed that social frailty, in comparison with physical frailty and cognitive impairment, is more strongly associated with incidences of depressive symptoms among elderly. 相似文献7.
8.
Sheryl L. Coley Jasmine Y. Zapata Rebecca J. Schwei Glen Ellen Mihalovic Maya N. Matabele Elizabeth A. Jacobs Cynthie K. Anderson 《Women's health issues》2018,28(2):158-164
Introduction
African American mothers and other mothers of historically underserved populations consistently have higher rates of adverse birth outcomes than White mothers. Increasing prenatal care use among these mothers may reduce these disparities. Most prenatal care research focuses on prenatal care adequacy rather than concepts of quality. Even less research examines the dual perspectives of African American mothers and prenatal care providers. In this qualitative study, we compared perceptions of prenatal care quality between African American and mixed race mothers and prenatal care providers.Methods
Prenatal care providers (n = 20) and mothers who recently gave birth (n = 19) completed semistructured interviews. Using a thematic analysis approach and Donabedian's conceptual model of health care quality, interviews were analyzed to identify key themes and summarize differences in perspectives between providers and mothers.Findings
Mothers and providers valued the tailoring of care based on individual needs and functional patient–provider relationships as key elements of prenatal care quality. Providers acknowledged the need for knowing the social context of patients, but mothers and providers differed in perspectives of “culturally sensitive” prenatal care. Although most mothers had positive prenatal care experiences, mothers also recalled multiple complications with providers' negative assumptions and disregard for mothers’ options in care.Conclusions
Exploring strategies to strengthen patient–provider interactions and communication during prenatal care visits remains critical to address for facilitating continuity of care for mothers of color. These findings warrant further investigation of dual patient and provider perspectives of culturally sensitive prenatal care to address the service needs of African American and mixed race mothers. 相似文献9.
Kelly M. Bower Ruth J. Geller Nancy A. Perrin Jeanne Alhusen 《Women's health issues》2018,28(6):495-501
Background
Racial disparities in birth outcomes represent a significant public health concern in the United States. Factors associated with racism have been posited as a mechanism underlying these disparities. Yet, findings from previous studies are mixed and based on small, geographically limited samples. This study aims to examine the relationship between experiences of racism and preterm birth in a population-based sample and to explore the role of adequacy of prenatal care within that relationship.Methods
Data from the 2004 through 2012 Pregnancy Risk Assessment Monitoring System were analyzed. The sample included non-Hispanic Black mothers from 11 states and New York City who delivered neonates from 2004 to 2012 (n = 11,582). Survey-weighted regression analyses were used to examine the association between women feeling upset by experiences of racism in the 12 months before delivery and subsequent preterm birth. Adequacy of prenatal care was tested as an effect modifier.Results
Feeling upset by experiences of racism was significantly associated with greater odds of preterm birth (adjusted odds ratio, 1.29; 95% CI, 1.04–1.59). Results from interaction models revealed that the associations of experiences of racism with preterm birth differed by level of prenatal care, although the interaction term was not significant.Conclusions
Findings suggest that, for non-Hispanic Black women, the emotional effect of experiences of racism may contribute to the risk of preterm birth. Future studies should consider the role of adequate prenatal care in this relationship. Racism is an important public health problem with a measurable impact on preterm birth and should be addressed to eliminate racial inequities in birth outcomes. 相似文献10.
Jennifer K. Straughen Shawnita Sealy-Jefferson Michael Bazydlo Laura Helmkamp Dawn P. Misra 《Women's health issues》2018,28(6):488-494
Background
Few studies have identified modifiable risk factors that are associated with the prevention of preterm delivery (PTD). This study examined the relationship between PTD and physical activity during pregnancy.Methods
Data were obtained by medical record review and postpartum questionnaires from a cohort of African American women (N = 1,410) delivering singleton infants. Physical activity was self-reported and analyses compared any and none. Additional analyses classified leisure time physical activity (LTPA) and walking for a purpose as 0, 1 to 19, 20 to 39, and 40 minutes per day or more and stair climbing as 0, 1 to 5, 6 to 9, and 10 or more times per day. Log-Poisson models adjusted for previous PTD, pregnancy complications, and income were used to examine the association between PTD and physical activity during pregnancy across body mass index categories.Results
Overall, 16.4% of deliveries were preterm. LTPA was associated with a decreased prevalence of PTD (prevalence ratio [PR], 0.73; 95% confidence interval [CI], 0.55–0.96), but stratification by maternal prepregnancy body mass index suggested that LTPA was only protective against PTD among women with normal weight (PR, 0.43; 95% CI, 0.23–0.79). Stair climbing 10 or more times per day was associated with a decreased prevalence of PTD among women with normal weight (PR, 0.32; 95% CI, 0.11–0.94) and women with overweight (PR, 0.24; 95% CI, 0.07–0.80) only. Walking for a purpose (e.g., to the store, the bus stop, or to work) was not associated with PTD.Conclusions
African American women who participate in either LTPA or stair climbing during pregnancy have a decreased prevalence of PTD, but the protective effect varied by maternal body mass index. 相似文献11.
12.
Bradley M. Appelhans Molly A. Martin Marieli Guzman Tamara Olinger Andrew Pleasant Jennifer Cabe Lynda H. Powell 《Journal of nutrition education and behavior》2018,50(1):51-55.e1
Objective
This report describes the development and validation of a technology-based system that integrates data on food choice, nutrition, and plate waste to generate feedback reports summarizing students' dietary intake at school meals.Methods
Cafeteria staff used the system to document the school lunch choices of seventh-graders (n = 37) in an urban charter school for 5 months. Plate waste was assessed by research staff using a visual estimation method that was validated against directly weighed plate waste.Results
Most food choices (97.1%) were correctly recorded through the system. Visual estimates of plate waste had excellent interrater reliability (r's ≥ .94) and agreement with direct measurements (ρ's ≥ .75). Plate waste assessment required approximately 10 s/tray. Fifty-four percent of parents received feedback reports consistently.Conclusions and Implications
The technology-based system enabled staff to monitor dietary intake accurately at school meals. The system could potentially inform lunch menu modifications aimed at reducing plate waste. 相似文献13.
Jana Hummel Cecilia Weisbrod Leila Boesch Katharina Himpler Klaus Hauer Martin Hautzinger Andrea Gaebel Tania Zieschang Andrea Fickelscherer Slawomira Diener Ilona Dutzi Bertram Krumm Peter Oster Daniel Kopf 《Journal of the American Medical Directors Association》2017,18(4):341-349
Background
Comorbid depression is highly prevalent in geriatric patients and associated with functional loss, frequent hospital re-admissions, and a higher mortality rate. Cognitive behavioral psychotherapy (CBT) has shown to be effective in older depressive patients living in the community. To date, CBT has not been applied to older patients with acute physical illness and comorbid depression.Objectives
To evaluate the effectiveness of CBT in depressed geriatric patients, hospitalized for acute somatic illness.Design
Randomized controlled trial with waiting list control group.Setting
Postdischarge intervention in a geriatric day clinic; follow-up evaluations at the patients’ homes.Participants
A total of 155 randomized patients, hospitalized for acute somatic illness, aged 82 ± 6 years and suffering from depression [Hospital Anxiety and Depression Scale (HADS) scores >7]. Exclusion criteria were dementia, delirium, and terminal state of medical illness.Intervention
Fifteen, weekly group sessions based on a CBT manual. Commencement of psychotherapy immediately after discharge in the intervention group and a 4-month waiting list interval with usual care in the control group.Measurements
HADS depression total score after 4 months. Secondary endpoints were functional, cognitive, psychosocial and physical status, resource utilization, caregiver burden, and amount of contact with physician.Results
The intervention group improved significantly in depression scores (HADS baseline 18.8; after 4 months 11.4), whereas the control group deteriorated (HADS baseline 18.1; after 4 months 21.6). Significant improvement in the intervention group, but not in the control group, was observed for most secondary outcome parameters such as the Barthel and Karnofsky indexes. Intervention effects were less pronounced in patients with cognitive impairment or acute fractures.Conclusions
CBT is feasible and highly effective in geriatric patients. The benefits extend beyond effective recovery and include improvement in physical and functional parameters. Early diagnosis, good access to psychotherapy, and early intervention could improve care for depressive older patients.14.
Objectives
Childrearing responsibilities create additional demands on women's time and effort, especially in low-income families. We explore whether childrearing demands and differences in time use increase the risk of overweight and obesity for women in different income brackets.Methods
We use data for women ages 18–55 years from the 2006–2008 and 2014–2015 American Time Use Surveys (N = 17,914). We predict whether women engage in particular activities using logistic regression and, among those who do particular activities, we predict the minutes spent in various activities using ordinary least squares models. We also predict women's risk of overweight or obesity using logistic regression. All models examine conditional relationships between income level and motherhood status.Results
Replicating prior research, we find a greater risk of overweight and obesity for mothers with low (odds ratio, 1.66; p < .001) and subpoverty (odds ratio, 1.93; p < .001) incomes compared with mothers with moderate/upper incomes and all child-free women. Motherhood and income status jointly predict women's time use, but including these time use behaviors in models of overweight and obesity does not attenuate the significantly higher risks for mothers with low and subpoverty incomes.Conclusions
Mothers experiencing economic hardship are at greater risk of overweight and obesity relative to other women. Additional research is warranted, however, because differences in time use do not explain this important health disparity. 相似文献15.
Katy B. Kozhimannil Ifeoma Muoto Blair G. Darney Aaron B. Caughey Jonathan M. Snowden 《Women's health issues》2018,28(3):224-231
Background
In 2011, Oregon implemented a policy that reduced the state's rate of early (before 39 weeks' gestation) elective (without medical need) births.Objective
This analysis measured differential policy effects by race, examining whether Oregon's policy was associated with changes in non-Hispanic Black–White disparities in early elective cesarean and labor induction.Methods
We used Oregon birth certificate data, defining prepolicy (2008–2010) and postpolicy (2012–2014) periods, including non-Hispanic Black and White women who gave birth during these periods (n = 121,272). We used longitudinal spline models to assess policy impacts by race and probability models to measure policy-associated changes in Black–White disparities.Results
We found that the prepolicy Black–White differences in early elective cesarean (6.1% vs. 4.3%) were eliminated after policy implementation (2.8% vs. 2.5%); adjusted models show decreases in the odds of elective early cesarean among Black women after the policy change (adjusted odds ratio, 0.47; 95% confidence interval, 0.22–1.00; p = .050) and among White women (adjusted odds ratio, 0.79; 95% confidence interval, 0.67–0.93; p = .006). Adjusted probability models indicated that policy implementation resulted in a 1.75-percentage point narrowing (p = .011) in the Black–White disparity in early elective cesarean. Early elective induction also decreased, from 4.9% and 4.7% for non-Hispanic Black and non-Hispanic White women to 3.8% and 2.5%, respectively; the policy was not associated with a statistically significant change in disparities.Conclusions
A statewide policy reduced racial disparities in early elective cesarean, but not early elective induction. Attention to differential policy effects by race may reveal changes in disparities, even when that is not the intended focus of the policy. 相似文献16.
Jennifer B. Saunders Marian P. Jarlenski Robert Levy Katy B. Kozhimannil 《Women's health issues》2018,28(2):130-136
Background
Opioid misuse during pregnancy is increasingly common and is associated with preterm birth and neonatal abstinence syndrome. As such, there is increased policy attention on reducing opioid misuse and increasing detection and treatment of opioid use disorder around the time of childbirth.Methods
We conducted a review of peer-reviewed and grey literature to identify policy strategies to address opioid misuse among pregnant women; to describe current federal and state laws that impact women before pregnancy, during pregnancy, at birth, and postpartum; and to identify gaps and challenges related to these efforts.Results
We identify two gaps in current efforts: 1) limited attention to prevention of opioid misuse among reproductive-age women, and 2) lack of policies addressing opioid misuse among postpartum women. We also discuss barriers to accessing care for women who misuse opioids, including provider shortages (e.g., too few addiction medicine specialists accept pregnant women or Medicaid beneficiaries as patients), logistical barriers (e.g., lack of transportation, child care), stigma, and fear of legal consequences.Conclusions
As policymakers pursue strategies to address the opioid epidemic, the unique needs of pregnant and postpartum women and barriers to treatment should be addressed. 相似文献17.
Cong Huang Haruki Momma Yufei Cui Masahiko Chujo Atsushi Otomo Shota Sugiyama Zhongyu Ren Kaijun Niu Ryoichi Nagatomi 《Journal of epidemiology / Japan Epidemiological Association》2017,27(1):42-47
Background
Unhealthy eating has been found to be associated with the prevalence of depressive symptoms. However, prospective evidence of the combined effects of unhealthy eating and depressive symptoms has not been reported. This study aimed to elucidate the prospective relationship between habitual unhealthy eating habits and depressive symptoms.Methods
A 2-year prospective cohort study of 376 Japanese adults aged 24–83 years without depressive symptoms at baseline was conducted. Information about participants' eating behaviors was obtained via a self-administered questionnaire, in which skipping breakfast, eating dinner shortly before bedtime, and snacking after dinner were recorded. Depressive symptoms were assessed using the Japanese version of the Zung Self-rating Depression Scale.Results
The 2-year incidence of depressive symptoms was found to be 23.7% (89/376). Covariate-adjusted multivariate Poisson regression analyses showed that habitual snacking after dinner was significantly associated with the incidence of depressive symptoms (relative risk [RR] 1.77; 95% confidence interval [CI], 1.00–3.14, p = 0.049), whereas no relationship was found between skipping breakfast or eating dinner shortly before bedtime and depressive symptoms. On the other hand, there was an interaction effect of snacking after dinner and dinner before bedtime on depressive symptoms (p for the interaction = 0.044). Participants with more than two unhealthy eating behaviors had a higher incidence of depressive symptoms compared to those with fewer than two unhealthy eating behaviors (RR 1.71; 95% CI, 1.06–2.77, p = 0.028).Conclusions
This prospective study is the first to reveal the combined relationship between unhealthy eating and the incidence of depressive symptoms. 相似文献18.
Background
Postpartum depression is underdiagnosed and undertreated. The purpose of this study was to describe the prevalence and timing of depression diagnoses and treatment use in the year after childbirth among women with private and Medicaid health insurance coverage.Methods
Using two large claims databases (private employer-sponsored and multistate Medicaid), we identified women with a live birth in 2014. We calculated the percentage of women with a depression diagnosis in the year after giving birth and identified their mental health treatment use (antidepressant medication filled and/or psychotherapy). We calculated days to diagnosis, days to treatment initiation, and number of therapy sessions. Percentages were compared using Cohen's h measure of effect size between two independent proportions (h ≥ 0.20 are meaningful).Results
After childbirth, 7% of privately insured women and 13% with Medicaid were newly diagnosed with depression (h = 0.22). Those with Medicaid were diagnosed earlier (median 43 days vs. 78 days for private), but treatment initiation occurred later (h = 0.38) and at a lower rate (54% with Medicaid received some treatment vs. 71% with private insurance, h = 0.35). Many women received medication without therapy (44% with Medicaid vs. 51% with private insurance). Therapy was used more commonly by private enrollees (20% vs. 10% of Medicaid; h = 0.28). Among those who received therapy, the median was three sessions.Conclusions
Postpartum depression diagnosis was more prevalent among women with Medicaid coverage, yet the treatment gap was greater and initiation was later. These findings suggest that there is room for improvement when it comes to early intervention and treatment engagement. 相似文献19.
Purpose
Depression poses a significant public health burden, with varying prevalence by race/ethnicity, gender, and socioeconomic status (SES). It is unclear whether race/ethnicity and gender modify relationships between SES and depression. The purpose of this study was to investigate such effect modification.Methods
A cross-sectional analysis was performed on Multi-Ethnic Study of Atherosclerosis participants at the baseline (n = 5559). Multivariable logistic regression models stratified by race/ethnicity and gender were performed to evaluate associations between income, education, occupation, and neighborhood SES with depressive symptoms, defined by Center for Epidemiologic Studies Depression Scale values of 16 or greater.Results
Depressive symptom odds were lower with increasing income, and this was pronounced in white women, black men, and Hispanic women. Lower odds of depressive symptoms were seen in management/professional occupations for Hispanic men, and in blacks as neighborhood SES increased. Education was not associated with odds of depressive symptoms. Multiplicative interaction terms were significant for gender-income (P = .028) and race/ethnicity-neighborhood (P = .010). Race/ethnicity-neighborhood interaction was also observed on the additive scale.Conclusions
Associations varied across races/ethnicities and gender, and evidence for effect modification was seen by gender with income, and by race/ethnicity with neighborhood SES. These findings provide a nuanced understanding of race/ethnicity and gender differences in SES related to depressive symptoms. 相似文献20.
Anu Manchikanti Gomez Stephanie Arteaga Natalie Ingraham Jennet Arcara Elodia Villaseñor 《Women's health issues》2018,28(5):408-414