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Perceived social support has been linked to lower rates of morbidity and mortality. However, more information is needed on the biological mechanisms potentially responsible for such links. The main aim of this paper was to conduct a meta-analytic review of the association between perceived social support and awake ambulatory blood pressure (ABP) which is linked to cardiovascular morbidity and mortality. The review identified 12 studies with a total of 3254 participants. The omnibus meta-analysis showed that higher perceived social support was not significantly related to lower ABP (Zr = -0.052, [ -0.11, 0.01]). In addition, there was evidence of significant bias across several indicators. Future research will be needed to explore the boundary conditions linking social support to ABP and its implications for theoretical models and intervention development.

BackgroundThe biological consequences of stress from the social environment pattern health outcomes. This study investigated whether social stress is prospectively associated with fracture incidence among racially and ethnically diverse, postmenopausal women.MethodsData from 160 709 postmenopausal women in the Women’s Health Initiative was analysed using Cox proportional hazards regression models to examine prospective associations of social stress with time to total and hip fracture incidence. Self-reported questionnaires measuring social strain, social functioning and social support were used to assess social stress.ResultsAge and race/ethnicity modified associations between social stress and total and hip fractures. HRs for the associations between higher social support (indicating lower social stress) and total fractures among those age 50–59 years were 0.92 (95% CI: 0.90 to 0.94); HR=0.94 (95% CI: 0.93 to 0.95) for those age 60–69 years and HR=0.96 (95% CI: 0.95 to 0.98) for those age 70–79 years. Higher social strain was associated with greater hip fracture incidence among Native American women (HR=1.84, 95% CI: 1.10 to 3.10), Asian women (HR=1.37, 95% CI: 1.01 to 1.86) and white women (HR=1.04, 95% CI: 1.01 to 1.08).ConclusionIdentifying population patterns of fracture incidence as biological expressions of social environments reveals how race/ethnic specific social environmental factors influence disparities in fractures.

Background: Study participants, patients, and care partners are key stakeholders in research and have asked for greater inclusion in the dissemination of scientific learning. However, the participation of general audiences in scientific conferences dedicated to Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD) is not widely supported or studied. Objective: Our objectives were to evaluate the interest, level of engagement, and impact of including general audiences in a virtual dementia conference. Methods: A diverse group of lay participants, identified via community-based health advocacy groups and research centers, were invited to attend the 2021 Alzheimer’s Association International Conference (AAIC), with optional small-group discussions. Participants received complimentary access to all scientific sessions and were supported via navigation tips, recommended sessions, and a glossary of frequently used terms and acronyms. Results: Lay participants demonstrated a high level of engagement, even among those that were research-naïve, attending virtual sessions for an average of 11.7 hours across the five days and recommending a variety of sessions to each other on topics extending from prevention of dementia to new therapies and care. Most participants said they would attend the conference again and rated the quality of interaction as high, while requesting more opportunities to engage directly with researchers. Conclusion: General audiences, in particular research participants, are advocating for greater participation in scientific conferences. This program can serve as a model to accomplish inclusion; thereby acknowledging their invaluable contribution to science.

OBJECTIVES Racial-ethnic differences in physical/mental health are well documented as being associated with disparities; however, emerging conceptual models increasingly suggest that group differences in social functioning and organization contribute to these relationships. There is little work examining whether racial-ethnic groups respond similarly to classic measures of social networks and perceived support and whether there are significant between-groups differences on these measures. METHOD A multisite, cross-sectional study of 2,793 non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic participants was conducted using common measures of social networks and perceived support. A confirmatory factor analytic model was used to test for the invariance of factor covariance and mean structures in a three latent constructs model including social network, social provisions, and interpersonal support. Between-group differences in structural and functional support were assessed. RESULTS We established measurement invariance of the latent representations of these measures suggesting that racial-ethnic groups responded comparably. In direct comparisons, Hispanics and NHWs demonstrated similar levels of network structure and support. In contrast, NHWs reported support advantages on a majority of measures compared with NHBs. CONCLUSIONS Findings support the use of these measures across groups and provide initial support for potential differences in this hypothesized mediator of racial-ethnic health disparities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background Despite a substantially worse risk factor profile, Hispanics in the United States experience lower incidence of many diseases and longer survival than non-Hispanic Whites (NHWs), an epidemiological phenomenon known as the Hispanic Health Paradox (HHP). This systematic review evaluated the published longitudinal literature to address whether this pattern extends to lung cancer survival. Methods Searches of Medline, PubMed, Embase, Web of Science, and the Cochrane Library were conducted for publications dated from January 1, 2000, to July 18, 2018. Records were restricted to articles written in English, employing a longitudinal design, and reporting a direct survival comparison (overall survival [OS], cancer-specific survival [CSS]) between NHW and Hispanic lung cancer patients. Results A final sample of 29 full-text articles were included, with 28 fully adjusted models of OS and 21 of CSS included. Overall, 26 (92.9%) OS models and 20 (95.2%) CSS models documented either no difference (OS = 16, CSS = 11) or a Hispanic survival advantage (OS = 10, CSS = 9). Both larger studies and those including foreign-born Hispanics were more likely to show a Hispanic survival advantage, and 2 studies of exclusively no-smokers showed a survival disadvantage. A number of reporting gaps were identified including Hispanic background and sociodemographic characteristics. Conclusions Hispanics exhibit similar or better survival in the context of lung cancer relative to NHWs despite a considerably worse risk factor profile. These findings support the HHP in the context of lung cancer. Further research is needed to understand the potential mechanisms of the HHP as it relates to lung cancer.

Background and Purpose Hispanic ethnic density (HED) is associated with salubrious health outcomes for Hispanics, yet recent research suggests it may also be protective for other groups. The purpose of this study was to test whether HED was protective for other racial-ethnic groups. We tested whether social support or neighborhood social integration mediated the association between high HED and depressive symptoms (CES-D) and physical morbidity 5 years later. Lastly, we tested whether race-ethnicity moderated both main and indirect effects. Methods We used Waves 1 (2005–2006), and 2 (2010–2011) from The National Social Life, Health, and Aging Project, a national study of older U.S. adults. Our sample was restricted to Wave 1 adults who returned at Wave 2, did not move from their residence between waves, and self-identified as Hispanic, non-Hispanic White (NHW), or non-Hispanic Black (NHB; n = 1,635). We geo-coded respondents’ addresses to a census-tract and overlaid racial–ethnic population data. Moderated-mediation models using multiple imputation (to handle missingness) and bootstrapping were used to estimate indirect effects for all racial–ethnic categories. Results Depressive symptoms were lower amongst racial-ethnic minorities in ethnically (Hispanic) dense neighborhoods; this effect was not stronger in Hispanics. HED was not associated with physical morbidity. Sensitivity analyses revealed that HED was protective for cardiovascular events in all racial–ethnic groups, but not arthritis, or respiratory disease. Social support and neighborhood social integration were not mediators for the association between HED and outcomes, nor were indirect effects moderated by race–ethnicity. Conclusions This study offers some evidence that HED may be protective for some conditions in older adults; however, the phenomena underlying these effects remains a question for future work.

Emerging work suggests that experiences of racial discrimination may impact overall sleep health; however, there is limited work on the link between racial microaggressions and sleep. Using weekly diary data, the current study examined young adults' weekly reports of racial microaggressions across 4 weeks, and their relation to weekly reports of sleep-onset latency, reduced total sleep time and poorer sleep quality. This design allowed us to examine how within-person fluctuations in racial microaggressions corresponded with young adults' sleep. Data were collected among 140 African American (62.1%) and Latinx (37.9%) college students attending a Midwestern University. Students were randomly selected to participate; they were, on average, 20.70 years old (SD = 1.22) and the majority were female (69.3%). Participants self-reported their racial microaggressions and sleep behaviours (i.e. sleep-onset latency, total sleep time and sleep quality) each week (across 4 weeks). Multilevel modelling showed significant within-person effects of racial microaggressions for sleep onset and sleep quality, but not for total sleep duration. Specifically, on weeks that individuals reported increases in racial microaggressions, they reported greater sleep-onset duration and poorer sleep quality. The current findings provide preliminary evidence that racial microaggressions are associated with sleep-onset durations and sleep quality among African American and Latinx young adults. Although racial microaggressions are often considered subtle, they may impact the sleep health of young adults in marginalized groups.

Sexual orientation disparities in suicide behavior are well-documented. Yet, few studies have examined how developmental assets – key values, self-perceptions, skills, relationships, and opportunities that have been identified as the building blocks of positive youth development – are associated with suicide behaviors, particularly among sexual minority youth. This study examined concurrent associations between young people’s developmental assets and suicidal behavior by sexual orientation using a large sample of 116,925 in-school U.S. adolescents (ages 11 to 19, M = 14.74, SD = 1.78). Most of the sample identified as only heterosexual (90.2%); 5% identified as mostly heterosexual, 3.5% as bisexual, 0.6% as mostly lesbian/gay, and 0.7% as only lesbian/gay. Most participants identified as White, non-Latina/o (62.6%) and as cisgender female (50.3%) or cisgender male (47.8%). Compared to only heterosexual adolescents, youth with all other sexual orientations reported lower levels of internal and external developmental assets except for non-sports extracurricular activity participation and social justice values. Identifying as a racial/ethnic minority, particularly for only heterosexual adolescents, and specifically as Latina/o for sexual minority adolescents was associated with greater risk for suicidal behavior. Further, identifying as a gender minority exacerbated risk for suicidal behavior. Relatedly, when youth reported feeling unsafe with their family, or in their school or neighborhood, they were at greater risk for suicidal behavior, regardless of sexual orientation. Feeling hopeful was associated with lower risk for suicidal behavior for all youth. Regardless of sexual orientation, planning and decision-making skills were associated with lower risk and social-emotional skills were associated with heightened risk for suicidal behavior. School boundaries and social justice values were associated with lower risk for suicidal behavior among bisexual adolescents; there were no additional protective assets for mostly/only lesbian/gay adolescents. In conclusion, sexual orientation disparities exist in the lives of adolescents for several internal and external developmental assets. Disparities in suicidal behavior by sexual orientation, however, were largely unexplained by differential associations between developmental assets and suicidal behavior.

ObjectiveEpidemiologic data increasingly support sleep as a determinant of cardiovascular disease risk. Fewer studies have investigated the mechanisms underlying this relationship using objective sleep assessment approaches. Therefore, the aim of this study was to examine associations between daily blood pressure (BP) and both objectively assessed sleep duration and efficiency.MethodsA diverse community sample of 300 men and women aged 21 to 70 years, enrolled in the North Texas Heart Study, participated in the study. Actigraphy-assessed sleep was monitored for two consecutive nights with ambulatory BP sampled randomly within 45-minute blocks on the first and second day as well as the second night.ResultsOverall, sleep duration results paralleled those of sleep efficiency. Individuals with lower sleep efficiency had higher daytime systolic (B = -0.35, SE = 0.11, p = .0018, R = 0.26) but not diastolic BP (B = -0.043, SE = 0.068, p = .52, R = 0.17) and higher nighttime BP (systolic: B = -0.37, SE = 0.10, p < .001, R = .15; diastolic: B = -0.20, SE = 0.059, p < .001, R = .14). Moreover, lower sleep efficiency on one night was associated with higher systolic (B = -0.51, SE = 0.11, p < .001, R = 0.23) and diastolic BP (B = -0.17, SE = 0.065, p = .012, R = .16) the following day. When 'asleep' BP was taken into account instead of nighttime BP, the associations between sleep and BP disappeared. When both sleep duration and efficiency were assessed together, sleep efficiency was associated with daytime systolic BP, whereas sleep duration was associated with nighttime BP.ConclusionsLower sleep duration and efficiency are associated with higher daytime systolic BP and higher nighttime BP when assessed separately. When assessed together, sleep duration and efficiency diverge in their associations with BP at different times of day. These results warrant further investigation of these possible pathways to disease.

Purpose We examined the relations between African-American and Latino young adults’ microaggressions and subsequent changes in weekly diurnal cortisol parameters (i.e., cortisol awakening responses, overall cortisol output (AUC), and diurnal slopes). Methods Young adults (N = 53, Mage = 20years, SD = .90; 72% female) participated in a 4-week diary study in which they reported their weekly experiences of microaggressions and completed 2 days ofsaliva samples each week. Saliva samples were obtained at waking, 30-minutes after waking, and bedtime on each sampling day (six samples each week; 24 samples total). In line with an idiographic approach to stress, young adults’ increases and decreases in microaggressions (relative to their own average) were linked to changes in cortisol parameters the following week. Results Increases in microaggressions predicted greater AUC the subsequent week, controlling for gender, race, parental education, prior week's AUC, and weekly behavioral controls. Follow-up analyses of specific types of microaggressions indicated that experiences centered around criminality and second-class citizenship also related to increases in young adults’ cortisol awakening responses the subsequent week. Microaggressions were unrelated to changes in diurnal slopes. Conclusions Microaggressions were linked to subsequent changes in diurnal cortisol among African-American and Latino young adults. Given the rigorous within-person design, findings point to the importance and impact of subtle forms of discrimination on young adults’ hypothalamic-pituitary-adrenal axis activity, which is theorized to underlie health and well-being.

Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change.

Obesity and its comorbidities have emerged as a leading public health concern. The aim of this study was to explore the relationship between body mass index (BMI) and sleep patterns, including duration and disturbances.A convenience sample of 515 college students completed an online survey consisting of the Pittsburgh Sleep Quality Index (PSQI), and self-reported height and weight to calculate BMI. Univariate and multivariate logistic regression analyses were performed using components of the PSQI as predictors of overweight (BMI ≥ 25).One-third of the participants had BMI ≥ 25, and 51% were poor-quality sleepers (PSQI5). Controlling for age and sex, only sleep disturbances were associated with overweight (odds ratio = 1.66, 95% confidence interval [1.08, 2.57]).Sleep disturbances, rather than sleep duration, predicted overweight among young adults; this is consistent with the most recent evidence in the literature. These findings support expanding the scope of wellness programs to promote healthy sleep among students.

Extending new verbs is important in becoming a productive speaker of a language. Prior results show children have difficulty extending verbs when they have seen events with varied agents. This study further examines the impact of variability on verb learning and asks whether variability interacts with event complexity or differs by language. Children (aged 2½ to 3 years) in the United States, China, Korea, and Singapore learned verbs linked to simple and complex events. Sets of events included one or three agents, and children were asked to extend the verb at test. Children learning verbs linked to simple movements performed similarly across conditions. However, children learning verbs linked to events with multiple objects were less successful if those events were enacted by multiple agents. A follow-up study rules out an influence of event order. Overall, similar patterns of results emerged across languages, suggesting common cognitive processes support children's verb learning.

Patent ductus arteriosus (PDA) is a common problem for premature babies. Indomethacin, traditionally the treatment of choice for PDA closure, varies in effectiveness and can have serious side effects, such as intraventricular cerebral hemorrhage and decreased mesenteric and renal blood flow. Researchers abroad are examining the efficacy and safety of ibuprofen as an alternative PDA therapy. Their findings have been promising and indicate the need for clinical trials in the U.S.