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Mental health, neuroscience and neuroethics researchers must engage local African communities to enable discourses on cultural understandings of mental illness. To ensure that these engagements are both ethical and innovative, they must be facilitated with cultural competence and humility, because serious consideration of different contextual and local factors is critical.

As genomic and personalized medicine becomes mainstream, assessing and understanding the public’s genetic literacy is paramount. Because genetic research drives innovation in this area and involves much of the public, it is equally important to assess its impact on genetic literacy. We designed a survey to assess genetic literacy in three ways (familiarity, knowledge, and skills) and distributed it to two distinct samples: 2050 members of the general population, and 2023 individuals currently enrolled in a large-scale genetic research study. We compared these data to a similar survey implemented in 2013. The results indicate that familiarity with basic genetic terms in 2021 (M = 5.36, p

Caregiving networks of individuals with Alzheimer’s disease and related dementias (ADRD) are comprised of family and friends directly involved in caregiving activities and those supporting these activities. The purpose of this study was to investigate whether caregiving-related behaviors and interactions (i.e., uplift, malfeasance, and nonfeasance), kinship tie (i.e., friend, family), and family history of ADRD were associated with caregivers’ emotional support networks. Seventy-one caregivers across 30 families provided information about 776 network members. Perceived emotional support and interactions representing uplift, malfeasance, and nonfeasance were assessed. Results indicated that uplift and friendship were associated with increased, whereas nonfeasance was associated with decreased, likelihood of perceived emotional support. Caregivers with a family history of ADRD were particularly more likely to report emotional support from friends and uplifting network members. Findings suggest the need for differential strategies based on families’ prior caregiving experience to facilitate positive and minimize negative interactions within caregiving networks.

Caring for a child, particularly one with a rare disease, presents a challenging set of stressors that can impact entire family networks. Given this shared impact, caregivers can engage in communal coping to address the caregiving process, defined as the perception of caregiving as shared and collaborative behaviors to address it. In this study, we examined one common measure of communal coping-first person plural pronouns or "we-talk"-in caregivers of either (a) children with rare or undiagnosed diseases or (b) typically developing children. We sought to examine how we-talk is linked to (a) caregiver health and well-being and (b) social network involvement in caregiving. Caregivers (

Background Recommendations for promoting mental health during the COVID-19 pandemic include maintaining social contact, through virtual rather than physical contact, moderating substance/alcohol use, and limiting news and media exposure. We seek to understand if these pandemic-related behaviors impact subsequent mental health. Methods Daily online survey data were collected on adults during May/June 2020. Measures were of daily physical and virtual (online) contact with others; substance and media use; and indices of psychological striving, struggling and COVID-related worry. Using random-intercept cross-lagged panel analysis, dynamic within-person cross-lagged effects were separated from more static individual differences. Results In total, 1148 participants completed daily surveys [657 (57.2%) females, 484 (42.1%) males; mean age 40.6 (s.d. 12.4) years]. Daily increases in news consumed increased COVID-related worrying the next day [cross-lagged estimate = 0.034 (95% CI 0.018–0.049), FDR-adjusted p = 0.00005] and vice versa [0.03 (0.012–0.048), FDR-adjusted p = 0.0017]. Increased media consumption also exacerbated subsequent psychological struggling [0.064 (0.03–0.098), FDR-adjusted p = 0.0005]. There were no significant cross-lagged effects of daily changes in social distancing or virtual contact on later mental health. Conclusions We delineate a cycle wherein a daily increase in media consumption results in a subsequent increase in COVID-related worries, which in turn increases daily media consumption. Moreover, the adverse impact of news extended to broader measures of psychological struggling. A similar dynamic did not unfold between the daily amount of physical or virtual contact and subsequent mental health. Findings are consistent with current recommendations to moderate news and media consumption in order to promote mental health.

Introduction: Family Health Histories (FHH) have been endorsed by the surgeon general as a powerful yet underutilized tool for identifying individuals at risk for complex chronic diseases such as diabetes, heart disease, and cancer. FHH tools provide a mechanism for increasing communication about disease history and motivating behavior change to reduce disease risk. A critical gap in translation efforts includes a lack of research that adapts and evaluates tools for low-income, minority populations who experience disparities in chronic disease. Methods: This study is a formative mixed-methods evaluation of an evidence-based FHH intervention called “Families SHARE” among African Americans residing in low-income neighborhoods. Participants (N = 51) completed assessments before and 6 weeks after receiving the intervention, including surveys and focus groups. We evaluated (a) their use, understanding, and perceived value of the tool; (b) if the intervention led to increased intentions to adopt disease risk-reducing behaviors among those with heightened disease risk, given their FHH; and (c) acceptability of and recommendations for the tool. Results: The quantitative and qualitative data indicated that this population valued and used the tool, and it prompted communication about FHH with family, friends, and others. Receipt of the intervention resulted in mixed accuracy of their perceived disease risk, and it did not shift intentions to change health behaviors. Qualitative data provide insights for future iterations of the Families SHARE tool. Conclusion: Families SHARE is an engaging FHH tool that can be further tailored to optimize its value and benefits for low-income African Americans.

Cascade genetic testing provides a method to appropriately focus colonoscopy use in families with Lynch syndrome (LS). However, research suggests that up to two-thirds at risk to inherit LS don’t participate. Within the United States, no studies have assessed colonoscopy use within this elusive and high-risk subset. We set forth to (1) document colonoscopy use within those not undergoing genetic testing (NGT) and (2) identify factors associated with completing colonoscopy. Data came from a cross sectional survey of families with molecularly confirmed LS. One hundred seventy-six (176) adults participated; 47 of unknown variant status and 129 with variant status known (59 carriers/70 non-carriers). Despite a high level of awareness of LS (85%) and identical recommendations for colonoscopy, NGT reported significantly lower use of colonoscopy than carriers (47% vs. 73%; p = 0.003). Our results show that perceived risk to develop colon cancer (AOR = 1.99, p p Trial Registration Clinical Trials.gov Identifier: NCT00004210.

Family history of metabolic conditions is a primary factor for clinicians to consider when administering preventive care. Sharing this information with healthcare providers proactively is therefore important to individual health outcomes. This brief report seeks to identify factors associated with sharing family history with healthcare providers in individuals of Mexican heritage. Data were obtained from a health education intervention study conducted during 2008–2010, which recruited 497 adult participants from 162 multigenerational households in Houston, Texas to receive family history-based risk feedback generated by Family Healthware™. Households were randomized to receive a pedigree of metabolic conditions or a pedigree coupled with supplementary information about one’s personalized risk assessment and behavioral recommendations. Participants completed two follow-up surveys at three and ten months post intervention, respectively. Analysis based on 296 participants from 147 households who read but did not share their feedback at three-month follow-up suggests benefits of providing personalized risk assessment and tailored behavioral recommendations in addition to a simple pedigree. Participants receiving supplementary risk feedback are more likely to share it with family members at three-month follow-up, which is associated with increased sharing and willingness to share risk feedback with healthcare providers at ten-month follow-up. The findings highlight the importance of family relationships in medical information disclosure in Mexican American adults. Future interventions should capitalize on family relationships in health education and promotion programs for optimal prevention of metabolic conditions in at-risk populations.

Sickle cell disease (SCD) can cause both physical and psychological complications, such as severe pain and depression. These effects often necessitate social and caregiving support. Few studies have assessed support networks within the adult SCD population. Here, we describe the support networks of adults with SCD and identify who in these networks (1) provides emotional support, (2) is dependable during crisis situations, including social and financial adversities, and (3) provides assistance in health crises. Forty-nine adults with SCD completed surveys and social network assessments through interview. Generalized mixed-effects linear regression models were fitted to investigate the composition of support provision within these personal networks. Our findings indicate that parents and 'other important people' (e.g., friends, spouses) play key roles in the support provided to those with SCD. Siblings with SCD appeared to be more emotionally supportive than unaffected siblings. With much research centered around the pediatric and adolescent SCD populations, focus needs to extend to adults and the individuals involved in their care and disease management. Understanding the flow of support within these networks can help genetic counselors and healthcare providers to better identify both social ties that serve as support resources and less supportive relationships for individuals living with SCD and other chronic genetic conditions that might be targeted for intervention.

Multi-layer networks arise when more than one type of relation is observed on a common set of actors. Modeling such networks within the exponential-family random graph (ERG) framework has been previously limited to special cases and, in particular, to dependence arising from just two layers. Extensions to ERGMs are introduced to address these limitations: Conway--Maxwell-Binomial distribution to model the marginal dependence among multiple layers; a "layer logic" language to translate familiar ERGM effects to substantively meaningful interactions of observed layers; and non-degenerate triadic and degree effects. The developments are demonstrated on two previously published data sets.

Background: Healthcare-associated infections impose a signi cant burden on the health care system. Current methods for detecting these infections are constrained by combinations of high cost, long processing times, and imperfect accuracy, reducing their effectiveness. Methods: We examine whether the quantity of time a patient spends in a ward with other patients clinically-suspected of infection, which we call co-presence, can be used as a tool to predict subsequent healthcare-associated infection. Compared to contact tracing, this leverages passively-collected electronic data rather than manually-collected data, allowing for improved monitoring. We abstracted all 133,304 inpatient records between 2011 and 2015 from a healthcare system in the UK. We calculate the AUROC for each of ve pathogens based on co-presence time, the sensitivity and speci city for the test, and how much earlier co-presence would have predicted infection for the true positives. Findings: Across the ve pathogens, AUROC ranged from 0.92 to 0.99, and was 0.52 for the negative control. Optimal cut-points of co-presence ranged from 25 to 59 hours, and would have led to detection of true positives up to an average of one day earlier. Interpretation: These findings show that co-presence time would help predict healthcare-acquired infection, and would do so earlier than the current standard of care. Using this measure prospectively in hospitals based on real-time data could limit the consequences of infection, both by being able to treat individual infected patients earlier, and by preventing potential secondary infections stemming from the original infected patient. Funding: This research was funded via NHGRI, NIH (ZIA HG200335) and the Oxford Martin School, University of Oxford (LC1213-006).

BACKGROUND: Propionic acidemia (PA), an autosomal recessive metabolic disorder, has an estimated incidence of 1:105,000–130,000 in the United States(1,2). Nutritional management is a main intervention for PA. Research in inborn errors of metabolism (IEM) such as phenylketonuria (PKU) has identified association of parental perceptions and practices with dietary outcomes. Parental perceptions and practices in the nutritional management of PA have not been investigated. OBJECTIVE: To assess the dietary perceptions and practices of parental caregivers having children affected by PA. METHODS: PA parents were surveyed about perceptions and practices associated with feeding their affected child(ren). The single page survey was anonymous and responses to survey items were not identifiable. Parents provided information on how often they followed the prescribed diet and rationale for any adjustments. RESULTS: Parents “always” or “most of the time” followed the prescribed diet for children 4–20 years of age; yet, open-ended responses indicated 71.4% made situational adjustments to their child’s diet for a variety of reasons including illness, iatrogenic effects, and, social events. CONCLUSIONS: PA parents make situational adjustments to their child’s highly specialized diet. Uncertainty exists as to the situational adjustments being within the guidelines used by the metabolic health care team. We rely on parents to inform providers about dietary situational adjustments.

Entity resolution in settings with rich relational structure often introduces complex dependencies between co-references. Exploiting these dependencies is challenging—it requires seamlessly combining statistical, relational, and logical dependencies. One task of particular interest is entity resolution in familial networks. In this setting, multiple partial representations of a family tree are provided, from the perspective of different family members, and the challenge is to reconstruct a family tree from these multiple, noisy, partial views. This reconstruction is crucial for applications such as understanding genetic inheritance, tracking disease contagion, and performing census surveys. Here, we design a model that incorporates statistical signals (such as name similarity), relational information (such as sibling overlap), logical constraints (such as transitivity and bijective matching), and predictions from other algorithms (such as logistic regression and support vector machines), in a collective model. We show how to integrate these features using probabilistic soft logic, a scalable probabilistic programming framework. In experiments on real-world data, our model significantly outperforms state-of-the-art classifiers that use relational features but are incapable of collective reasoning.

In health care settings, patients who are physically proximate to other patients (co-presence) for a meaningful amount of time may have differential health outcomes depending on who they are in contact with. How to best measure this co-presence, however is an open question and previous approaches have limitations that may make them inappropriate for complex health care settings. Here, we introduce a novel method which we term “consistent co-presence”, that implicitly models the many complexities of patient scheduling and movement through a hospital by randomly perturbing the timing of patients’ entry time into the health care system. This algorithm generates networks that can be employed in models of patient outcomes, such as 1-year mortality, and are preferred over previously established alternative algorithms from a model comparison perspective. These results indicate that consistent co-presence retains meaningful information about patient-patient interaction, which may affect outcomes relevant to health care practice. Furthermore, the generalizabiity of this approach allows it to be applied to a wide variety of complex systems.

Collecting complete and accurate family health history is critical to preventing type 2 diabetes. Whether there are any racial difference in family health history knowledge of type 2 diabetes and whether such differences are related to interpersonal mechanisms remain unclear. We seek to identify the interpersonal mechanisms that give rise to discrepancies in family health history knowledge of type 2 diabetes in families of different racial backgrounds. We analyze informant-dyad consensus with respect to shared family history of type 2 diabetes in 127 informants of 45 families in the greater Cincinnati area (white: 28 families, 78 informants; black/African-American: 17 families, 49 informants). We first document a difference in informant-dyad consensus by race and then test whether this difference can be explained by interpersonal ties, particularly health communication. Compared with their white counterparts, dyads in families of black/African-American background are more likely to have an uneven distribution of knowledge, with one informant knowing and the other not knowing his/her family health history. The racial difference is explained by dyads in families of black/African-American background having fewer reciprocal health communication ties. While associated with informant-dyad consensus, education, kinship ties, and closeness ties do not account for the observed racial difference. Activating health communication is a key to improving family health history knowledge, especially in families of black/African-American background. Researchers and clinicians should leverage communication ties in the family network for better collection and utilization of family health history in preventive services.

Objectives Caregiving to individuals affected by Alzheimer’s disease and related dementia (ADRD) is a family-systems process where tasks are distributed between multiple caregivers in a network. We evaluate the extent to which multiple network members nominate one another as filling primary caregiver (PCG) roles and factors associated with nomination. Method Data come from the Caregiving Roles and Expectations Networks project, which aimed to characterize the caregiving networks of families affected by ADRD. All persons affected by ADRD were either full-time residents in residential care facilities or community-dwelling adult day-care participants. Generalized Poisson regression was used to model the count of incoming PCG nominations of each network member. Results On average, there were multiple network members identified as PCGs across different network contexts. Network members who were perceived to perform essential caregiving tasks, such as making decisions on behalf of and spending time with the care recipient, received more primary caregiving nominations from their network peers, adjusting for personal attributes, and the context of care. Discussion Having multiple PCGs in a network may result in lack of consensus in who fills those roles, potentially putting families at risk for interpersonal conflicts. Future work aimed at intervention development should fully assess the social contexts surrounding caregiving processes in order to better understand how network composition might impact outcomes.

Background: Siblings of children with chronic diseases may ultimately become their sibling’s primary caregivers, yet research on their caregiving contributions during childhood is limited. Studies on sibling caregiving have largely focused on the roles and needs of adults caring for their siblings. Moreover, research on siblings of children with chronic illnesses or disabilities primarily examines their experiences and psychosocial outcomes. No known research explores the caregiving contributions of siblings of pediatric patients, or how these …

Background In human fetuses with Down syndrome, placental pathology, structural anomalies and growth restriction are present. There is currently a significant lack of information regarding the early life span in mouse models of Down syndrome. Objective The objective of this study was to examine embryonic day 18.5 and placental phenotype in the 3 most common mouse models of Down syndrome (Ts65Dn, Dp(16)1/Yey, Ts1Cje). Based on prenatal and placental phenotyping in 3 mouse models of Down syndrome, we hypothesized that one or more of them would have a similar phenotype to human fetuses with trisomy 21, which would make it the most suitable for in utero treatment studies. Study Design Here, C57BL6J/6 female mice were mated to Dp(16)1/Yey and Ts1Cje male mice and Ts65Dn female mice to C57BL/B6Eic3Sn.BLiAF1/J male mice. At embryonic day 18.5, dams were euthanized. Embryos and placentas were examined blindly for weight and size. Embryos were characterized as euploid or trisomic, male or female by polymerase chain reaction. A subset of embryos (34 euploid and 34 trisomic) were examined for malformations. Results The Ts65Dn mouse model showed the largest differences in fetal growth, brain development, and placental development when comparing euploid and trisomic embryos. For the Dp(16)1/Yey mouse model, genotype did not impact fetal growth, but there were differences in brain and placental development. For the Ts1Cje mouse model, no significant association was found between genotype and fetal growth, brain development, or placental development. Euploid mouse embryos had no congenital anomalies; however, 1 mouse embryo died. Hepatic necrosis was seen in 6 of 12 Dp(16)1/Yey (50%) and 1 of 12 Ts1Cje (8%) mouse embryos; hepatic congestion or inflammation was observed in 3 of 10 Ts65Dn mouse embryos (30%). Renal pelvis dilation was seen in 5 of 12 Dp(16)1/Yey (42%), 5 of 10 Ts65Dn (50%), and 3 of 12 Ts1Cje (25%) mouse embryos. In addition, 1 Ts65Dn mouse embryo and 1 Dp(16)1/Yey mouse embryo had an aortic outflow abnormality. Furthermore, 2 Ts1Cje mouse embryos had ventricular septal defects. Ts65Dn mouse placentas had increased spongiotrophoblast necrosis. Conclusion Fetal and placental growth showed varying trends across strains. Congenital anomalies were primarily seen in trisomic embryos. The presence of liver abnormalities in all 3 mouse models of Down syndrome (10 of 34 cases) is a novel finding. Renal pelvis dilation was also common (13 of 34 cases). Future research will examine human autopsy material to determine if these findings are relevant to infants with Down syndrome. Differences in placental histology were also observed among strains.

Grandparenting can be a rewarding and health-promoting experience for older adults. However, grandparent-caregivers often experience greater stress and poorer health relative to non-caregiving grandparents. Further, little is known about grandparents caring for a child with a rare, chronic illness. This study aimed to extend knowledge of the expectations, roles, and experiences of grandparents providing care to a child affected with an inherited metabolic condition. The sample included 23 grandparent-mother dyads from the Inherited Diseases, Caregiving, and Social Networks Study. The grandparent sub-sample ranged from 49 to 79 years of age (Mage = 64), the majority were female (83%) and married (74%), and almost half (48%) were retired. Social network assessments were analyzed to determine concordance between mother- and grandparent-reports of grandparents’ role in the child’s caregiving network. Fifteen mother-grandparent dyads (65%) agreed on grandparents’ role in the child’s network, with the majority of those (93%) considering the grandparent to be very close and important (versus less close or excluded from the caregiving network). Grandparents whose self-reports of their role in their child’s caregiving networks were consistent with mother-reports appeared more likely to report that they spend enough time caregiving than those whose reports were inconsistent. Content analysis of grandparents’ interviews provided supporting information about the joys and regrets of their grandparenting experience and perspectives on caregiving expectations. This research leverages multi-informant social network and qualitative data to illuminate grandparents’ role in the caregiving networks of chronically ill children and adaptation to non-normative grandparenting experiences.

Background and ObjectivesPrevious research has found a negative association between network size and age, suggesting that people experience greater isolation from their personal networks with advancing age. In this paper, we evaluate age differences in how individuals perceive their social worlds to be structured, rather than focusing solely on network size.Research Design & MethodsA nationally represented sample of respondents (n=1,824) reported on their own ties to their close personal network members (i.e., ego-alter ties) as well as their perceptions of the acquaintanceship between those members (i.e., alter-alter ties). We used social network analysis to assess how the structure of these relationships vary by respondent age.ResultsThere is a strong pattern of age-homophily with some inter-generational contact for both ego-to-alter and alter-to-alter ties. Egos perceive less age-heterophily among their alters than they perceive in their own ties. Net of the results for age-mixing, we find a positive association between ego age and personal network size and a negative association between average alter age and personal network size. Finally, we find that as alters’ ages increase, their expected degrees as perceived by ego decreases regardless of ego’s own age. Discussion & ImplicationOur results suggest that our social worlds shift in terms of size and structure across the life course. While contemporary close personal networks may grow slightly with age, our perceptions of older people having fewer network ties remains. We discuss these results in the context of recent findings that suggest aging uniformly insulates individuals from social contact from both structural and symbolic perspectives. Specifically, the findings here challenge the notion that network size declines with age suggesting that this result may be the product of perceptions and not reality.

We investigate how interpersonal ties influence communication about type 2 diabetes risk and encouragement to maintain or adopt a healthy lifestyle between family members of Mexican heritage, after a family history-based risk assessment intervention. Results suggest that individuals are more likely to initiate risk communication with another family member if they are close to, already seek advice from, or discuss health with him or her. Risk communication precedes encouragement, which is initiated by the older generation of the family. Understanding the role of interpersonal relationships in Mexican-heritage families can help identify who best to target in future health behavior interventions.

Since its nascency, the field of social network analysis has been intrinsically linked to human health and well-being. In fact, the very first empirical article ever published in Sociometry evaluated a psychiatric treatment to inter-personal distress that employed the spontaneous interactions unfolding in a triad of physician, patient, and proxy actors (Moreno, 1937). This was a first attempt in a research context to show that there may be direct effects that tie patterns of social relations to individual well-being in small groups. Moreno & Jennings (1938) also made the early and astute argument that the social structure observed through measurement of social relations is inseparable from biological and psychological frames of reference: they are all inherently interdependent. More than 80 years of research in this area has since been developed and yet the field is still flush with opportunities to learn about the interplay between social networks and health. In this special issue of the Journal of Social Structure, we highlight the work of leading scientists in this field.

Background For people with intellectual disabilities (ID), social networks play a key role in facilitating social inclusion, health, and quality of life. This study shows that a multi-informant approach to collecting social network data improves our understanding of the social worlds of people with Down Syndrome (DS). Method A mixed methods egocentric network approach was employed to investigate 27 dyads comprised of people with DS and their family members as proxy reporters to examine variability in network characteristics across self- and proxy reports. Results The self-reported total network size of people with DS was significantly smaller than the network size based on proxy reports. Significant differences were found between self- and proxy-reported networks with respect to most relationship groups. Proxy informants reported more "paid staff". Conclusion Our study showed that multiple perspectives on the social networks of people with DS are advantageous for researchers, policy makers, and practitioners.

Background Despite prevalent binge drinking and alcohol-dependent symptoms among Hispanics, few studies have examined how multidimensional factors influence Hispanic adolescents' binge drinking. Purpose This study examines the effects of genetic, psychological, and social network factors on binge drinking over time among Mexican heritage adolescents in the USA and whether there are correlations among genetic variants that are associated with binge drinking and psychological and network characteristics. Methods Mexican heritage adolescents (n = 731) participated in a longitudinal study, which included genetic testing at baseline, alcohol use assessments at first and second follow-ups, and questionnaires on sensation seeking, impulsivity, and peer and family network characteristics at second follow-up. Logistic regression and Spearman correlation analyses were performed. Results After adjusting for demographic characteristics, underlying genetic clustering, and binge drinking at first follow-up, two genetic variants on tryptophan hydroxylase 2 (TPH2; rs17110451, rs7963717), sensation seeking and impulsivity, and having a greater fraction of peers who drink or encourage drinking alcohol were associated with greater risk whereas another genetic variant on TPH2 (rs11178999) and having a greater fraction of close family relationships were associated with reduced risk for binge drinking at second follow-up. Genetic variants in TPH1 (rs591556) were associated with sensation seeking and impulsivity, while genetic variants in TPH2 (rs17110451) were associated with the fraction of drinkers in family. Conclusions Results reveal that genetic variants in the serotonin pathway, behavioral disinhibition traits, and social networks exert joint influences on binge drinking in Mexican heritage adolescents in the USA.

Mexican American adolescents report high rates of alcohol consumption as well as media use. Viewing alcohol images in the media is associated with increased alcohol consumption; however, to date, this association has not been examined across different ethnic groups in the United States. To bridge this gap, we examined the association between viewing alcohol use images in PG-13-rated movies and alcohol initiation in Mexican-heritage adolescents. A cohort of 1,154 Mexican-heritage youth, average age 14 years, was followed for 2 years; in 2008-2009, participants reported alcohol use in the past 30 days and again in 2010-2011. Exposure to alcohol use images in PG-13-rated movies was estimated from 50 movies randomly selected from a pool of 250 of the top box office hits in the United States using previously validated methods. A series of generalized linear models, adjusting for age, gender, peer and family alcohol use, family functioning, anxiety, sensation-seeking tendency, and acculturation were completed. Multiple imputation was utilized to address missing data. Overall, N = 652 participants reported no alcohol use in 2008-2009; by 2010-2011, 33.6% (n = 219) had initiated alcohol use. Adjusted models indicated an independent association between exposure to alcohol use images in PG-13-rated movies and alcohol initiation (comparing quartiles 3 to 1: RR =1.53; 95% CI [1.11, 2.10]). The findings emphasize that the relationship between viewing alcohol use scenes in American films and alcohol initiation holds among Mexican-heritage adolescents and underscore the need to limit adolescents' exposure to such powerful images in PG-13-rated movies.

Introduction Improving diet is a prime target for the prevention and management of chronic disease. The communal coping model suggests that families can mitigate shared risk of chronic disease through encouragement of healthful eating, eliciting preventive behaviors. Method Using network data from 69 Australian families across three ancestry groups (Anglo, Italian, and Asian) with varied family health histories, the present study applied social network analysis to identify patterns of intergenerational encouragement of healthful eating behavior within families, and assess whether patterns varied by family ancestry or disease density. Results Findings indicated variation in patterns of health encouragement by ancestry such that Asian-Australian families were most distinct from the other ancestry groups. While there was no main effect of familial disease history, it moderated the effect of Italian ancestry on intergenerational encouragement patterns. Discussion These results provide important context for future family based interventions that leverage normative patterns of intergenerational exchange of encouragement or aim to modify such patterns in an effort to improve family health. (PsycINFO Database Record (c) 2019 APA, all rights reserved).