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On September 20, 2017, Hurricane Maria made landfall in Puerto Rico, devastating the archipelago and forcing thousands of Puerto Ricans to migrate to the U.S. mainland. Guided by a cultural stress theory framework, the present mixed method study examined how various cultural stressors impact participants' daily interactions and mental health outcomes. A total of 319 adult Hurricane Maria survivors residing on the U.S. mainland participated in the study. A mixed method sequential explanatory design was used. First, we used latent profile analysis (LPA) and multinomial logistic regression to identify the varied cultural stress experiences that participants had. Then we used data from semistructured interviews to better understand the experiences of participants classified into the different LPA profiles. Four profiles were identified: "moderate cultural stress" (35%), "overall low" (29%), "high cultural stress" (26%), and "low language stress" (10%). Multinomial regression indicated that members of the moderate cultural stress, high cultural stress, and low language stress profiles all reported significantly higher depressive and anxiety symptoms compared to members of the overall low profile. Qualitative data exemplified the daily experiences of participants placed into each profile, demonstrating that participants have rich and varied experiences that can contribute to their mental health symptoms. The present study documents the contributions of hurricane trauma and cultural stress vis-à-vis current mental health symptoms. Clinicians working with Hurricane Maria survivors should be cognizant of and inquire about migration-related cultural stressors including discrimination, feelings of being unwelcomed, and difficulty communicating in the destination community's dominant language. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Hurricane María caused significant devastation on the island of Puerto Rico, impacting thousands of lives. Puerto Rican crisis migrant families faced stress related to displacement and relocation (cultural stress), often exhibited mental health symptoms, and experienced distress at the family level. Although cultural stress has been examined as an individual experience, little work has focused on the experience as a family. To address this gap, we conducted a mixed-methods study designed to examine the predictive effects of cultural stress on family conflict and its mental health implications among Puerto Rican Hurricane María parent and child dyads living on the U.S. mainland. In the quantitative phase of the study, 110 parent-child dyads completed an online survey assessing cultural stress, family dynamics, and mental health. As part of our primary analysis, we estimated a structural equation path model. Findings from the quantitative phase showed a significant positive relationship between family cultural stress and family conflict, as well as individual parent and child mental health symptoms. In the qualitative phase of the study, 35 parent-child dyads participated in individual interviews. Findings from the interviews revealed variations in difficulties related to language, discrimination, and financial burdens, with some participants adapting more quickly and experiencing fewer stressors. Findings also highlight the impact on mental health for both parents and youth, emphasizing the family-level nature of cultural stress, while noting a potential discrepancy between qualitative and quantitative findings in the discussion of family conflict., (© 2024 Family Process Institute.)

Background: Adverse childhood experiences (ACEs) are common, often co-occur, and are associated with poor health outcomes across the life course. Emerging research has emphasized the lasting consequences of ACEs across generations, suggesting parental ACEs are associated with poor physical and mental health outcomes in children. However, the individual effects of fathers' ACEs and pathways of transmission remain unclear. A scoping review was conducted to summarize the current knowledgebase of the intergenerational consequences of parental ACEs on offspring health, clarify pathways of transmission, understand how ACEs are operationalized in the intergenerational literature, and identify gaps in knowledge., Methods: Six electronic databases were searched for articles published in English from 1995 to 2022 relating to the long-term consequences of parental ACEs on offspring physical and mental health. Articles underwent title, abstract, and full-text review by two investigators. Content analysis was performed to integrate findings across the included studies., Results: The search yielded 14,542 unique articles; 49 met the inclusion criteria. Thirty-six articles focused exclusively on mothers, one solely on fathers, and 12 included both mothers and fathers in their analyses. Six studies used an expanded definition of ACEs. Both direct and indirect associations between parental ACEs and poor offspring outcomes were identified, primarily through biological and psychosocial pathways., Conclusions: Findings underscore the importance and oversight of fathers and the need to solidify a unified definition and measure of ACEs. This review identified modifiable protective factors (social support, father involvement) and pathways of transmission (parental mental health, parenting); both having important implications for intervention development., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Latina immigrant women are among the least physically active when compared with women in other racial/ethnic groups in the US. Similarly, Mexican mothers in Mexico have low rates of physical activity. Motherhood and immigration experiences are recognized barriers to engage in physical activity among Latina immigrant mothers. Less is known about the factors that promote and limit physical activity engagement among Mexican mothers in Mexico, and how their experiences compare with their immigrant counterparts. This transnational qualitative study aimed to investigate the barriers and facilitators of physical activity of 25 Latina mothers in Mexico and the US. Low-income Mexican mothers of kindergarten aged children and Latino mothers of similar aged children were recruited in San Luis Potosí, Mexico and central Illinois, US. Semi-structured interviews were administered by two bilingual and bicultural researchers in participants language of preference. Interviews were transcribed verbatim and analyzed using a thematic network approach and multi-stage coding analysis guided by the Socio-Ecological Model framework. We found that at the macro-level: 1) familial obligations, and 2) cold weather after migrating; at the mezzo-level: 1) changes in walking patterns, and 2) social cohesion (e.g., lack of an invitation to engage in activities); and at the micro-level: 1) individual perceptions, particularly unattainable perceptions of physical activity and 2) shift exhaustion were perceived as barriers and occasionally facilitators of physical activity by mothers in both countries. Context-specific interventions are needed to increase women's physical activity levels in the US and Mexico., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Pérez-Flores et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aims: This study aimed to understand the perceptions driving type 2 diabetes mellitus prevention and management behaviours of Mexican and Latina mothers in Mexico and the United States., Methods: Low-income Mexican mothers in San Luis Potosí, Mexico and Latina mothers in Illinois, United States, were recruited by the Holistic Obesity Prevention Study (HOPS). Verbatim transcripts of the semistructured interviews conducted in Spanish (n = 24) and English (n = 1) were analysed using the Health Belief Model (HBM) framework., Results: Of the 25 participants, 22 (88%) indicated 'knowing someone with diabetes'-specifically a father (n = 8), mother (n = 6) or grandparent (n = 7). Using the HBM, themes showed that mothers perceived: that Type 2 diabetes can happen to anyone, are attributable to genetic predisposition and may be driven by strong emotions (perceived susceptibility). Type 2 diabetes introduces severe comorbidities and emotional difficulties for people and their families (perceived severity). Adopting a healthier diet, exercising and staying in good spirits were recognized as benefits of Type 2 diabetes prevention (perceived benefits). The costs of food, challenges of exercising, dieting, modifying habits and time limitations were recognized as perceived costs. Cues to action included doctors' recommendations (external) and fear (internal). Mothers acknowledged they could live a healthy life by controlling their weight, exercising, adhering to treatments/medications and having the determination to carry-on (self-efficacy)., Conclusions: Mothers sought to prevent Type 2 diabetes and live healthy lives, particularly, after receiving a diagnosis of gestational diabetes or when learning about their children's risks for Type 2 diabetes but perceived significant barriers to Type 2 diabetes prevention., (© 2023 Diabetes UK.)

Introduction: High quality investments during early childhood allow children to achieve their full potential by setting developmental foundations. However, challenges in the scale-up of evidence-based interventions make across-the-board implementation a non-trivial matter. Moreover, extreme contextual conditions -such as community violence, forced displacement, and poverty- impose a double threat. First, by directly affecting early childhood development (ECD), forced displacement and exposure to violence during early childhood, coupled with deficits in nurturing relationships, can trigger toxic stress, affecting children's mental health and social and emotional learning. Second, contexts of extreme adversity exacerbate common implementation pitfalls in the scale-up of interventions. Recognizing and documenting "what it takes" to successfully implement "what works" can contribute to the expansion and effectiveness of evidence-based programs that promote ECD in these settings. Semillas de Apego (SA, onward), a community-based psychosocial support model for caregivers, materialized as a strategy to promote ECD in communities affected by violence and forced displacement., Methods: This article presents the results of the process evaluation of SA during the 2018-2019 implementation in Tumaco, a violence ridden municipality in the south-west border of Colombia, South America. In this phase, the program reached 714 families, 82% direct victims of violence and 57% were internally displaced. The process evaluation combined qualitative and quantitative methodological approaches to produce evidence of factors that promoted implementation quality., Results: Findings identified salient components of the program that promoted the program's acceptability, adoption, appropriateness, fidelity and sustainability: a rigorous cultural adaptation; well-structured team selection and training methodologies; and a team support and supervision protocol to provide continuous capacity building and prevent burn-out and other occupational hazards common among professionals in mental health and psychosocial support interventions. The statistical analysis using monitoring data identified key predictors of the dosage delivered (a measure of fidelity). Evidence suggests that initial attendance to the program and observable characteristics -such as educational attainment, violence victimization and employment status-predict a successful compliance (in terms of dosage to benefit from the program)., Discussion: This study provides evidence for the development of structural, organizational, and procedural processes for the adoption, appropriate adaptation, and high-fidelity delivery of psychosocial support models delivered in territories affected by extreme adversity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Harker Roa, Córdoba Flechas, Moya and Pineros-Leano.)

Objective: To examine the experiences of labor and delivery (L&D) nurses and certified nurse-midwives who cared for women during labor and birth in the United States during the first wave of the COVID-19 pandemic., Design: Subgroup analysis of a larger study with a qualitative descriptive design., Setting: Telephone interviews., Participants: The parent study included 100 nurses across various specialty areas who provided patient care during the first wave of COVID-19 in the United States. Our subgroup analysis included 19 participants: L&D nurses (n = 11) and certified nurse-midwives (n = 8)., Methods: Semistructured interview guide., Results: Participants described their experiences providing patient care in L&D settings during the first wave of the COVID-19 pandemic. We identified five major themes: Separation of COVID-19-Positive Mothers and Newborns, Isolation of Women in Active Labor, Disparities in Access to Care, Barriers to Communication, and Effect on the Mental Health of Members of the Care Team., Conclusion: Our findings captured the experiences of maternity care team members who worked during the COVID-19 pandemic when standards of quality maternity care were compromised. The challenges of caring for COVID-19-positive mothers, including isolation during active labor and infant removal from mothers at birth, affected their psychological well-being and their mental health and must now be addressed to prevent burnout and turnover., Competing Interests: Conflict of Interest The authors report no conflicts of interest or relevant financial relationships., (Copyright © 2022 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.)

Although immigrants' health is better compared to their native-born counterparts, their wellbeing starts to deteriorate as they spend more time in the United States. To date, few qualitative studies investigate how migration can influence the perinatal period. This study qualitatively assesses Latina immigrant mothers' perinatal experiences. Thirty Latina women were recruited in 2015 to participate in interviews, all of which were conducted in Spanish. The data were analyzed using thematic analysis. Latina mothers' experiences during the perinatal period were impacted by the cultural expectations that may or may not depend on the context where they are located. Context-independent themes included: (1) Cravings and (2) Body dissatisfaction. Context-dependent themes included: (1) Breastfeeding and (2) Loss of extended social ties. In order to reduce health disparities in the perinatal period among Latina immigrant mothers and their children, it is necessary to provide interventions that promote healthy behaviors and increase social capital and peer support., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: The Latinx population is the largest and fastest-growing segment of the U.S. While the vast majority of Latinx children are U.S.-born, over half are growing up in a family where they live with at least one foreign-born parent. Despite research showing that Latinx immigrants are less likely to experience mental, emotional, and behavioral (MEB) health issues (e.g., depression, conduct disorder, substance misuse), their children have one of the country's highest rates of MEB disorders. To address the MEB health of Latinx children and their caregivers, culturally grounded interventions have been developed, implemented, and tested to promote MEB health. The purpose of this systematic review is to identify these interventions and summarize their findings., Methods: We searched PubMed, PsycINFO, ERIC, Cochrane Library, Scopus, HAPI, ProQuest, and ScienceDirect databases from 1980 through January 2020 as part of a registered protocol (PROSPERO) following PRISMA guidelines. Our inclusion criteria were randomized controlled trials of family interventions among a predominantly Latinx sample. We assessed the risk of bias in the included studies using the Cochrane Risk of Bias Tool., Findings: Initially, we identified 8,461 articles. After going through the inclusion criteria, 23 studies were included in the review. We found a total of 10 interventions, with Familias Unidas and Bridges/Puentes having the most information available. Overall, 96% of studies demonstrated their effectiveness in addressing MEB health, namely substance use, alcohol and tobacco use, risky sexual behaviors, conduct disorder, and internalizing symptoms among Latinx youths. Most interventions focused on improving parent-child relationships as the main mechanism to improve MEB health among Latinx youths., Discussion: Our findings show that family interventions can be effective for Latinx youths and their families. It is likely that including cultural values such as familismo and issues related to the Latinx experience such as immigration and acculturation can help the long-term goal of improving MEB health in Latinx communities. Future studies investigating the different cultural components that may influence the acceptability and effectiveness of the interventions are warranted., Competing Interests: Declarations of interest: none

Objectives: Studies have demonstrated that Latinx populations face significant health disparities in access to mental health care. The objective of this study was to describe the impact of the COVID-19 pandemic on the mental health needs of Latinx families, from the perspectives of direct service providers working with Latinx communities., Methods: Twenty-one semi-structured interviews were conducted virtually with direct service providers to the Latinx community from August to October 2020. Interviews were transcribed verbatim and analyzed using thematic analysis., Results: Two-thirds of providers were female, with a median age of 33 years, and provided direct services to Latinx clients and had extensive experience working with immigrant families, particularly in Massachusetts. Key themes identified describing the impact of COVID-19 on the mental health needs of Latinx families included: (1) exacerbation of mental health symptoms, (2) financial stressors, (3) preoccupation regarding transnational lives, (4) secondary needs becoming more salient, and (5) immigration status as a main driver of inequality., Conclusions: Our findings highlight the importance of focusing on the mental health needs of Latinx immigrants and ensuring their access to mental health services. Telehealth seems to be a potential tool that promotes mental health access among Latinx clients. Future research needs to continue investigating the role of telehealth in decreasing mental health access disparities., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Pineros-Leano, Pérez-Flores, Damian, Rodrigues, Ortiz and Simonovich.)

Childhood overweight and obesity are a primary social and public health concern. Over the past 30 years, rates of childhood overweight and obesity in the United States of America (USA) have drastically increased, particularly among Black and Latino/a populations. However, they tend to be underrepresented in the childhood obesity literature. This study expands previous literature by identifying different BMI growth trajectories for Black, Latino/a, and White children from birth to age nine. This study found a high prevalence rate of overweight and obesity in a predominantly low-income minority group. Using growth-based trajectory modeling, this study also found different growth trajectories by racial/ethnic groups, with Latino/a children having the most concerning growth trajectories from birth to 9 years. These findings demonstrate that ethnic/racial disparities in childhood overweight and obesity start as early as birth, indicating the need to devote more attention from researchers and health policy-makers to address these disparities as early as possible., (© 2021. W. Montague Cobb-NMA Health Institute.)

Objective: Childhood obesity is a public health concern that often worsens with age. Although several risk factors at the child and maternal levels have been identified in cross-sectional studies, less is known about their long-term contribution to racial/ethnic disparities in childhood obesity. This study examines child- and maternal-level factors associated with the growth trajectories of White, Black, and Latino children., Methods: Group-based trajectory models were used to identify BMI z score trajectories from birth to 9 years of age among White, Black, and Latino children. The associations of child- and maternal-level factors with the trajectory group identified as at risk for obesity were examined using adjusted logistic regression analysis, stratified by race/ethnicity., Results: Among White children, fast-food consumption (odds ratio [OR] = 1.66; 95% CI: 1.09-2.52) was associated with higher odds of following an at-risk trajectory. Among Black and Latino children, prepregnancy BMI was associated with following an at-risk trajectory (OR = 1.05; 95% CI: 1.03-1.08 for Black children, and OR = 1.12; 95% CI: 1.07-1.17 for Latino children)., Conclusions: These findings showed racial/ethnic differences in the risk factors that influence the likelihood of obesity during childhood. Further research is needed to identify modifiable racial/ethnic specific risk factors to guide obesity-prevention interventions., (© 2022 The Obesity Society.)

Background: The American College of Obstetricians and Gynecologists recommends prenatal genetic testing (PGT) be offered to all pregnant persons regardless of known risk factors. However, significant racial/ethnic differences exist regarding acceptance of PGT contributing to disparities. Latinas (Latinx), one of the fastest growing ethnic groups in the United States, have low PGT acceptance rates. This systematic scoping review aimed to provide a landscape of existing literature on Latinx individuals' knowledge of, preferences for, and experiences with prenatal and preconception genetic testing. Synthesizing the current state of the science may inform development of culturally tailored interventions to support high-quality PGT decisions (e.g., informed, aligned with a pregnant persons' values)., Methods: We conducted a structured, systematic literature search of published articles and gray literature in electronic databases (PubMed, PsycINFO, CINAHL, Medline, Embase, Eric, Social Services Abstracts, and PsycArticles). Articles in English published prior to March 2021 were retrieved relating to genetics, pregnancy, and Latina women. Articles underwent title, abstract and full-text review by independent investigators to assess inclusion and exclusion criteria. Risk of bias was evaluated by two investigators. Iterative thematic analysis was employed to group study findings into themes to identify possible targets for interventions., Results: The search generated 5511 unique articles. After title screening, 335 underwent abstract review and subsequently 61 full-text review. Twenty-eight studies met inclusion criteria and 7 additional studies were included after reviewing reference lists. Three overarching themes emerged: genetic knowledge/literacy (26/35, 74%), provider (mis)communication/patient satisfaction (21/35, 60%), and cross-cultural beliefs (12/35, 34%). Studies indicate discordant patient-provider language (n = 5), miscommunication (n = 4), and lack of concordant decision-making (n = 4) pose barriers to high-quality PGT decisions. Immigration status (n = 1) and religious beliefs (n = 5) are additional factors influencing PGT decisions., Conclusions: Identified studies suggest that cultural and linguistic factors affect Latinx PGT decision-making. Latinx individual's comprehension and recall of PGT information is enhanced by culturally and linguistically concordant providers-suggesting that culturally-informed interventions may enhance PGT acceptability and support high-quality decisions. Future directions to surmount PGT disparities may include community health workers and cultural brokers to empower Latinx people to make informed decisions aligned with their values and preferences., (© 2022. The Author(s).)

Objective: Maternal mental health disorders are a leading complication of childbirth. While few systems are adequately able to identify and treat depression, people experiencing perinatal depression may benefit from the intervention of home visiting. The intent of home visiting interventions is to alleviate stressors of parenthood for people facing additional risk factors. The aim of this scoping review is to investigate the effect of home visiting on perinatal depression grounded in published studies., Methods: We conducted a scoping review of the existing literature of studies relevant to perinatal depression and home visiting. We entered keywords in five search databases: MEDLINE, PsycInfo, CINAHL, Social Work Abstracts, and Google Scholar. All relevant literature published between January 1999-December 2019 was reviewed. Duplicates, books, and errata were excluded from the study. As a scoping review, we included all studies published in English describing the inclusion of maternal depression in home visits. We hypothesize birthing people with perinatal depression will benefit from home visiting interventions., Results: The results from the scoping review and describe the use of home visiting to improve perinatal mental health. An initial 12,652 records were identified in the search. After duplicates were removed, the titles of 2,140 articles were assessed for applicability, however 29 identified for full-text eligibility and were included in this analysis. The majority of the studies included in this review were quantitative ( n = 23), followed by qualitative ( n = 3), and mixed methods ( n = 3). Nearly all studies ( n = 28) using validated instruments such as the Edinburgh Postnatal Depression Scale to determine depressive symptoms., Discussion: This review offers preliminary qualitative insights on the efficacy of home visiting for administrating perinatal depression care. Studies show that home visiting programs can provide treatment for perinatal depression and reduce the effects of depression for birthing people. Our review suggests that the efficacy of home visiting programs beginning in the postpartum period are less predictable than prenatal home visiting intervention among various populations, including people experiencing both high-risk and low-risk situations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Tabb, Bentley, Pineros Leano, Simonovich, Nidey, Ross, Huang and Huang.)

Bullying and childhood obesity are public health concerns in the United States. While obesity has been found to be associated with bullying victimization, it is less clear how it is differentially associated with biological sex and grade level across varying patterns of bullying victimization. Based on the subset of U.S. students in the Health Behavior in School-Aged Children study, patterns of co-occurring bullying victimization and sex and grade level differences in the association between the patterns of bullying victimization and weight status were examined among 9,124 students in Grades 5 to 10. The latent class analysis revealed three patterns of bullying victimization: verbal-relational victimization (Class 1), all-type victimization (Class 2), and noninvolved pattern (Class 3). The results found that females had a higher likelihood of being in Class 1 than males. Moreover, fifth to sixth and seventh to eighth-graders were more likely than ninth to tenth graders to be in both Class 1 and Class 2. Obese males and overweight females were more likely to be in Class 1 and Class 2 than in Class 3. In addition, obesity and overweight status were positively associated with bullying victimization among fifth to sixth and seven to eighth-graders. However, no significant association was found between obesity and overweight status and bullying victimization among ninth to tenth graders. Findings from the study suggest that school-based strategies, especially sex- and age-specific programs, need to take into consideration the bullying involvement of students who are overweight or obese.

Background: Depression affects approximately 7.5 million parents in the United States each year. Parental depression has detrimental consequences for both the parent and the parent-child relationship. The purpose of this study was to: (1) understand the prevalence of parental depressive episodes longitudinally, (2) identify the risk and protective factors for parental depressive episodes, and (3) compare the risk and protective factors for depressive episodes among mothers and fathers., Methods: We used six waves of the Fragile Families and Child Wellbeing Study to descriptively examine parental depression over a period of 15 years. We used logistic and fixed effects regressions to assess the association between a number of demographic, health and parenting variables and maternal and paternal depression., Results: Our sample was primarily Black (48%) and Hispanic/Latino (27%). Fathers had a slightly lower prevalence of depression compared to mothers at all waves (approximately 13% averaged across waves for fathers, compared to 18% for mothers). Factors negatively correlated with depression among mothers and fathers included: social support, employment, and better-perceived health. Factors positively associated with depression for mothers and fathers were substance misuse and having a parent with a history of depression, anxiety, or drug misuse., Limitations: Our study was unable to identify causal relationships and the directionality of the relationship between depression and other variables of interest., Conclusions: We found that parental depression is prevalent in a sample of predominantly racially minoritized parents. Addressing comorbidities and increasing social support access may help manage parental depression and ensure a healthy child development., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Healthy eating and active lifestyles are associated with children's healthy weight and cognitive development. This study examines whether family behaviors relevant for nutrition and activity levels are associated with children's working memory, independent of their weight status. A convenience sample of child-caregiver dyads ( n = 85 dyads) were recruited from a public preschool serving a low-income community in central Mexico. Caregivers reported the frequency of ten family behaviors using the Family Nutrition and Physical Activity screening tool. Children completed a test of their ability to recall four words after a 60-s distraction task, an assessment of working memory. Multiple linear regression models were used to test the association of children's working memory with each family behavior, adjusting for children's sex, age, mother's age and education, and subjective social status and then also adjusting for children's age- and sex-specific body mass index percentile (BMI-P) and covariates. Higher frequency of breakfast intake was significantly associated with working memory (β = 0.57, p = 0.013). This association was independent of children's BMI-P. Other family behaviors (frequent family mealtimes, limiting screen time, and others) were not significantly associated with children's working memory. Frequent breakfast intake could benefit young children's working memory, regardless of their weight status. This association merits further investigation.

Maternal depression affects 10 percent to 17 percent of mothers in the United States. Women of color, particularly Latina women, may be at an elevated risk for adverse consequences of maternal depression. However, scant research addresses cultural experiences and perceptions of maternal depressive feelings. This study included interviews with 30 Latina immigrant mothers who were living in rural or small towns in the Midwest. Data were analyzed in Spanish using a thematic network approach. Authors identified three themes in relation to the experiences that Latina immigrant mothers described around sadness and depressive feelings: (1) normalization of feelings of sadness, (2) lack of social support that exacerbates feelings of isolation and sadness, and (3) traditional gender roles that compromise disclosure of feelings. The results from this study indicate that it is critical to increase support, provide culturally grounded discussions around mental health among Latina immigrant women, and continue these conversations beyond the perinatal period., (© 2021 National Association of Social Workers.)

Children of mothers with depressive symptoms are at a higher risk for psychosocial, behavioral, and developmental problems. However, the effects of maternal depression on children's physical growth are not well understood. To address the gaps in the literature, this study examined the association between maternal depressive symptoms, breastfeeding behaviors, and child weight outcomes. Data from 204 mother-child dyads who participated in the STRONG Kids 1 Study were used. Mothers and children were assessed twice when the children were 3 and 4 years old. Height and weight measurements of children and mothers were collected by trained researchers during both assessments. Multiple linear regression and analysis of covariance tests were used to examine the associations between maternal depressive symptoms, breastfeeding, and age and sex-adjusted child body mass index percentile. Recurrent maternal depressive symptoms when the child was 3 and 4 years old were not associated with child body mass index percentiles (BMI-P) at age 4. Mothers who breastfed for at least 6 months had significantly lower depressive symptoms when their children were 3 years of age, but the differences did not persist at age 4. In this community sample, maternal depressive symptoms were not associated with child BMI-P, regardless of breastfeeding duration.

Background: Female led migration is a recent trend that has been gaining momentum, particularly in Latin America. However, little attention has been given to the psychological consequences of mothers who leave their children in their country of origin and migrate to a host country to work. Therefore, it is important to investigate the mental health status of transnational mothers and to further identify issues for intervention and supportive services. Methods: PubMed, PsycINFO, ERIC, CENTRAL, Scopus, and ScienceDirect databases were searched systematically for peer-reviewed articles published from inception through July 2019. The search included the following terms: migrant, immigrant, transnational, transnational mother, AND mood disorders, depressive symptoms, and depression. Initially, 8,375 studies were identified. After exclusionary criteria were applied, 17 studies were identified and included in the review. Results: We found six quantitative studies that investigated depressive symptoms among transnational mothers. Of these studies, three found a positive association between transnational motherhood and depressive symptoms; three of these articles found a null correlation. A total of eight qualitative studies and three mixed-methods studies were found that addressed depressive symptoms and emotional distress among transnational mothers. The eight qualitative studies identified highlighted the significant emotional distress transnational mothers experience. Lastly, the three mixed-methods studies similarly discussed the emotional hardships faced by transnational mothers. Implications: The studies identified suggest that depressive symptoms and emotional distress are prevalent among transnational mothers. Therefore, public health social workers and other mental health providers need to focus on developing strategies to identify and screen transnational mothers for depressive symptoms., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Pineros-Leano, Yao, Yousuf and Oliveira.)

Studies suggest that telomere lengths, a biomarker of aging, could also capture the physiological weathering attributable to poor health behaviors and adverse experiences, particularly those experienced in early life. For these reasons, we propose that telomere lengths may be a pivotal biomarker for measuring the heightened susceptibility to illness resulting from the cumulative exposure to acculturation to the US culture. This binational study used an Actor-Partner Interdependence Model to test if maternal acculturation to the US moderates the cross-sectional associations of telomere lengths with percentage of body fat (PBF) among Mexican women, among their children, and the intergenerational associations of mother and children telomere lengths with each other's PBF. Low income Mexican child-mother dyads (n ​= ​108 dyads) were recruited to participate in this cross-sectional study in Mexico and the US. The pooled dataset included measurements of maternal acculturation to the US, mother and children's salivary telomere lengths, PBF measured through bioelectrical impedance, and demographic characteristics. Results showed that the influences of maternal acculturation in the associations of telomere lengths with PBF were different for mothers and their children: Among mothers with higher maternal acculturation to the US, longer salivary telomere lengths were associated with lower PBF. In contrast, among mothers with lower maternal acculturation to the US, salivary telomere lengths were not associated with PBF. There were no significant associations between children's salivary telomere lengths and PBF, and the null associations did not vary across different levels of maternal acculturation to the US. Future longitudinal studies are needed to determine whether acculturation to the US (experienced through immigration or remotely) influences the association of telomere length attrition with obesity risks among immigrant and non-immigrant Mexican children and adults., (© 2021 The Author(s).)

Food insecurity, or limited access to nutritious foods, is a significant public health concern especially among vulnerable populations including infants and young children in low-income households. While literature to date has thoroughly examined the psychological and behavioral impacts of food insecurity on children, no known study to date has specifically synthesized the literature exploring the relationship between food insecurity and physiological health outcomes during early childhood. The purpose of this study was to review the literature on physiological health outcomes associated with food insecurity during early childhood among children aged 0-5 years in developed countries. Our literature search sources included PubMed, PsycInfo, CINAHL, and Embase databases. A total of 657 articles published up to September 2019 were reviewed for eligibility by two coders, with a third reviewer in cases of disagreement. Eighty-three articles remained after screening by abstract, with a final 27 studies ultimately included in the final synthesis. This review is registered with PROSPERO and adhered to PRISMA guidelines. In total, 20 articles (74%) noted significant relationships between food insecurity and physiological health outcomes in young children. Findings included an association with overweight or obesity (n = 9), anemia (n = 3), poor child health (n = 3), low birth weight (n = 3), chronic illness (n = 1), special health care needs (n = 1), and increased cortisol (n = 1), in young children who experience food insecurity. Identifying relationships between food insecurity and health outcomes during early childhood has the potential to inform future prevention interventions to reduce health disparities in these vulnerable populations., (© Society of Behavioral Medicine 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Childhood overweight and obesity have become a primary social and public health concern. Over the past 30 years, rates of childhood overweight and obesity in the United States have increased dramatically from 6% to 35%. A potential risk factor of interest is maternal depression. To date, there are mixed findings available on the association between maternal depression and childhood obesity development, and there is a dearth of longitudinal research available. To address these gaps in the literature, this study investigated the association between maternal depression at age 1 and/or age 3 years and childhood obesity longitudinally. Methods: This study used data from the Fragile Families Child Wellbeing Study (FFCWS) to investigate the research questions. FFCWS is a national dataset that has information on 4898 women, and their children, from predominantly nonmarital, low-income minority groups in the United States. This study used information collected at the birth of the child (wave 1) through age 9 years (wave 5). The analytic sample consisted of 3500 mother-children dyads. Group-based trajectory modeling and multivariable logistic regression were used. Results: The results indicated that there was no association between maternal depression and childhood obesity development in this sample of low-income and mostly minority participants. Maternal prepregnancy BMI, number of biological children in the house, and Latino ethnicity were significant predictors of risky growth trajectories in the full sample. Suggestions for designing childhood obesity prevention interventions based on research are discussed.

Background: Worldwide, overweight and obesity rates have more than tripled over the past three decades. Overweight and obesity rates are particularly high among Latinos. In order to determine some of the potential reasons, it is imperative to investigate how first-generation Latina mothers living in non-metropolitan and small metro areas decide how and what to feed their children. Using the Socio-Ecological Model, this study aimed to understand how Latina immigrant mothers make feeding decisions for their children., Methods: A total of 29 semi-structured interviews were conducted with a purposive sample of immigrant mothers from Latin American countries whose preschoolers were enrolled in a Women, Infant, and Children supplemental nutrition program located in non-metropolitan and small metro areas. All interviews were recorded and transcribed verbatim in Spanish, and analyzed by a bilingual team., Results: Multi-stage qualitative analysis was employed to analyze the data. Nineteen participants originated from Mexico, four from Central America, and six from South America. Five themes emerged that helped illuminate mother's decision-making around feeding choices: 1) culture as all-encompassing, 2) location and access to fresh and traditional foods, 3) disjunction between health provider advice and cultural knowledge 4) responsiveness to family needs and wants as determinants of food choices, 5) intrapersonal conflict stemming from childhood poverty and food insufficiency., Conclusion: Findings suggest that Latina immigrant mothers engage in a difficult and even conflicting process when deciding how to feed their children. Future interventions should focus on implementing hands-on activities that can help consolidate, promote, and encourage healthy feeding choices., Competing Interests: The authors have declared that no competing interests exist.

Purpose: Although variations in breastfeeding initiation are well documented, the contributing role of maternal race remains poorly understood, especially among the multiracial-two or more races-population. The purpose of this study is to examine differences in breastfeeding initiation among a racially and ethnically diverse population of low-income women. Methods: Participants for this study ( n =1010) were enrolled in the supplemental nutrition program for women, infant, and children and concurrently enrolled in a perinatal depression registry at a public health clinic in the Midwest. Race was obtained from medical records. Breastfeeding initiation was gathered through a clinical interview during the first postpartum visit. Logistic regression was conducted using STATA 14.2. Results: Sixty-eight percent of study participants reported breastfeeding initiation. The bivariate analysis demonstrated that there were significant differences in rates of breastfeeding initiation by race/ethnicity. The logistic regression models showed that after adjusting for maternal education, age, income, nativity, parity, body mass index, and antenatal smoking, Black (odds ratio [OR] 0.47; confidence interval [95% CI] 0.34-0.66), multiracial (OR 0.21; 95% CI 0.07-0.65), and Latina women (OR 0.48; 95% CI 0.26-0.86) were significantly less likely to initiate breastfeeding compared with White women. Conclusion: These findings highlight the need for further understanding of the underlying barriers to the initiation of breastfeeding among low-income Black, multiracial, and Latina women. Moreover, breastfeeding should remain a priority for intervention and policy development, particularly among racially and ethnically diverse low-income women., Competing Interests: No competing financial interests exist.

Background : Disparities in birth outcomes remain a problem in the United States. This study examined whether pre-pregnancy weight and gestational weight gain moderate the association between nativity and birth outcomes in the United States. Methods : We conducted a systematic review using Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. We searched PubMED, CINAHL, PsychInfo, and Cochrane Database of Systematic Reviews for relevant articles published before May 27, 2016. Results : Four articles met the eligibility criteria by adjusting for pre-pregnancy or gestational weight gain when examining birth outcomes by nativity. Results : Results from these studies show statistically significant differences in the risk of delivering low birth weight babies between foreign-born and U.S.-born women. These differences remained after adjusting for pre-pregnancy weight or gestational weight gain. However, results stratified by nativity still vary significantly by race/ethnicity. Conclusion : Few investigations include pre-pregnancy weight and gestational weight gain when examining differences in birth outcomes by nativity. Additional studies are needed to examine possible effect modification of these weight variables on the association between nativity and birth outcomes., Competing Interests: The authors declare no conflict of interest.

Background: In order to address the needs of the growing Latino immigrant population, this study aimed to systematically review peer-reviewed articles of intervention studies that used cognitive behavioral therapy to treat depressive symptoms among Latino immigrants in the U.S., Methods: We searched PsycINFO, PubMed, and Medline databases from January 1995 through July 2016 as part of a registered review protocol (PROSPERO) following PRISMA guidelines. Inclusion criteria were intervention studies that used cognitive behavioral techniques to treat depressive symptoms among a predominantly U.S. Latino immigrant sample -- or subsample with disaggregated results, and the use of standardized measures of depression. We used the National Heart, Lung, and Blood Institute quality assessment tools for systematic reviews to assess risk of bias., Results: We identified 11 studies that met inclusion criteria. Nine of the included studies reported a reduction of depressive symptoms. Each study used a least one cultural adaptation to deliver the intervention. Using an existing content model, cultural adaptations were categorized as (a) cognitive-informational adaptations, (b) affective-motivational adaptations, and (c) environmental adaptations., Limitations: Heterogeneity of articles in terms of sample size, cultural adaptations, methodological rigor, and setting limited comparability of effectiveness across studies., Conclusions: Culturally adapted CBT to address depressive symptoms among Latino immigrants appears promising but further research is needed. The most commonly used cultural adaptations included language, inclusion of migration experience, and adjusting for literacy level. Study design elements and adaptations were often responsive to geographic characteristics and available resources., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: Although it is known that maternal disordered eating is related to restrictive feeding practices, there is little research exploring mechanisms for this association or its effects on other feeding practices. The purpose of this study was to assess whether maternal emotion responses mediate the association between maternal binge eating (BE) and child feeding practices, in order to identify potential risk factors for feeding practices that influence child weight., Methods: This longitudinal observational study included (n = 260) mothers and children from the STRONG Kids Panel Survey. At Wave 1, children were an average of 37 months old (SD = 6.9), and at Wave 2 children were an average of 57 months old (SD = 8.3). Mothers self-reported their frequency of binge eating behavior (Wave 1), responses to children's negative emotions (Wave 1), feeding practices (Wave 1 and Wave 2), and child height and weight were measured at both time points. Using bias-corrected bootstrapping procedures, we tested the hypothesis that longitudinal associations between maternal BE and nonresponsive parent feeding practices would be mediated by parents' unsupportive responses to children's negative emotion. We also tested a serial mediation model positing that maternal BE predicts child body mass index (BMI) percentile change 18-24 months later, indirectly through unsupportive responses to negative emotion and nonresponsive feeding practices., Results: Maternal BE predicted use of more nonresponsive feeding practices (e.g. Emotion Regulation, Restriction for Health, Pressure to Eat, and Food as Reward), indirectly through more Distress responses to children's negative emotions. In the serial mediation model, maternal BE was associated with greater use of Distress responses, which indirectly predicted higher child BMI percentile through Food as Reward feeding practices., Conclusions: These results suggest that maternal eating and emotion responsiveness are important for understanding the interpersonal context of feeding behaviors, and child weight outcomes. Distress responses may serve as a risk factor for use of unhealthful feeding practices among mothers with BE and these responses may increase children's risk for weight gain., Trial Registration: This study used an observational prospective design. Therefore, it has not been registered as a clinical intervention trial.

Objective: Best practices for addressing women's mental health and screening for depression in public health clinics are not available. Clinic staff are often responsible for screening for depression; however, few studies examine staff perceptions on feasibility and acceptability of using perinatal screening for mood disorders in ethnically diverse public health clinics., Methods: During December 2012, we conducted four focus groups using a semistructured interview guide with public health clinic staff of varying disciplines (n=25) in a Special Supplemental Nutrition Program for Women, Infants, and Children. All interviews were audio recorded and analyzed using thematic analysis., Results: We found five descriptive themes related to acceptability and feasibility of screening for perinatal depression in a public health clinic. The main themes include (1) literacy barriers, (2) need for referrals and follow-up with outside services, (3) training and capacity needs, (4) stigma of depression, and (5) location and privacy of screening. Although multiple barriers to universal depression screening in a public health clinic were identified, participants found value in practice of screening low-income women for depression., Conclusion: Factors for facilitating implementation of systematic depression screening in a public health clinic have been identified. Implications discuss how policy makers and public health clinic administrators can improve the universal depression screening process., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: The use of mHealth technology is an innovative approach for screening low-income mothers for depression. Past studies show that the use of technology removes barriers such as literacy issues, language challenges, concerns about privacy and lack of transportation and can also increase reliability. However, little is known about staff attitudes and perceptions towards using mHealth technology for screening low-income women for depression in clinics., Methods: Four focus groups were conducted with staff members in a supplemental nutrition program for women, infants and children located in a public health clinic. A semi-structured focus group interview guide was used to examine staff perceptions related to depression screening with tablet technology. All interviews were audio recorded and transcribed verbatim. Thematic analysis was used to analyse all focus group data., Results: Three major benefits and two major barriers were found. The benefits of using technology for perinatal depression screenings were reduction of literacy and language barriers, reduction of redundancy and errors and increased privacy for clients. The barriers were increased network issues and responsibility for technology, which included fear of the devices being lost, stolen or broken., Implications: Before implementing mHealth tablet technology for depression screening in a public health clinic, it is important to address the concerns of staff members to make the transition more effective. This study provides timely information on staff-perceived benefits and barriers when implementing mHealth technology in a public health setting., (© The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)