Observed Parenting and Adolescent Brain Structure.

Parent-youth relationships and parenting are critically important to adolescents' development. The present study examined associations between parenting behaviors (which included observed parent emotion expression and negative and positive parenting behaviors during a parent-adolescent interaction) and adolescent brain structure, and sex differences in associations, in 66 12-14 year-olds. The study found that 1) among all adolescents in the sample, greater parent negative emotion expression in parent-youth interactions was associated with greater adolescent gray matter volume (GMV) in the left hippocampus, 2) parent positive emotion expression was not associated with adolescent GMV, 3) several associations differed by sex. These findings suggest that parenting is important for adolescent brain structure and future work should consider this by sex.

Black Representation in the Primary Care Physician Workforce and Its Association With Population Life Expectancy and Mortality Rates in the US.

Importance: Studies have suggested that greater primary care physician (PCP) availability is associated with better population health and that a diverse health workforce can improve care experience measures. However, it is unclear whether greater Black representation within the PCP workforce is associated with improved health outcomes among Black individuals. Objective: To assess county-level Black PCP workforce representation and its association with mortality-related outcomes in the US. Design, Setting, and Participants: This cohort study evaluated the association of Black PCP workforce representation with survival outcomes at 3 time points (from January 1 to December 31 each in 2009, 2014, and 2019) for US counties. County-level representation was defined as the ratio of the proportion of PCPs who identifed as Black divided by the proportion of the population who identified as Black. Analyses focused on between- and within-county influences of Black PCP representation and treated Black PCP representation as a time-varying covariate. Analysis of between-county influences examined whether, on average, counties with increased Black representation exhibited improved survival outcomes. Analysis of within-county influences assessed whether counties with higher-than-usual Black PCP representation exhibited enhanced survival outcomes during a given year of heightened workforce diversity. Data analyses were performed on June 23, 2022. Main Outcomes and Measures: Using mixed-effects growth models, the impact of Black PCP representation on life expectancy and all-cause mortality for Black individuals and on mortality rate disparities between Black and White individuals was assessed. Results: A combined sample of 1618 US counties was identified based on whether at least 1 Black PCP operated within a county during 1 or more time points (2009, 2014, and 2019). Black PCPs operated in 1198 counties in 2009, 1260 counties in 2014, and 1308 counties in 2019-less than half of all 3142 Census-defined US counties as of 2014. Between-county influence results indicated that greater Black workforce representation was associated with higher life expectancy and was inversely associated with all-cause Black mortality and mortality rate disparities between Black and White individuals. In adjusted mixed-effects growth models, a 10% increase in Black PCP representation was associated with a higher life expectancy of 30.61 days (95% CI, 19.13-42.44 days). Conclusions and Relevance: The findings of this cohort study suggest that greater Black PCP workforce representation is associated with better population health measures for Black individuals, although there was a dearth of US counties with at least 1 Black PCP during each study time point. Investments to build a more representative PCP workforce nationally may be important for improving population health.

Racial discrimination, personal growth initiative, and African American men's depressive symptomatology: A moderated mediation model.

OBJECTIVES: Mounting evidence indicates that racial discrimination is a risk factor for depression among African American men. However, the mechanisms underlying the association between racial discrimination and depressive symptomatology remain unclear. The present study investigated the mediating capacity of personal growth initiative (PGI) in the relation between racial discrimination experiences and depressive symptomatology, as well as whether the proposed mediating relation was moderated by age, education, and income. METHOD: Participants included 649 African American men recruited from barbershops in the North, South, West, and Midwest regions of the United States and from academic institutions-events. RESULTS: Results revealed significant associations between racial discrimination and a combined latent factor representing depressed affect, interpersonal problems, and somatic complaints but not the latent factor representing positive affect. PGI mediated the association between racial discrimination and depressive symptomatology; however, the mediational pathway was not moderated by age, education, and income. CONCLUSIONS: Interventions designed to mitigate the mental health consequences of racial discrimination among African American men might focus on enhancing PGI. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Masculinity and Race-Related Factors as Barriers to Health Help-Seeking Among African American Men.

Men's tendency to delay health help-seeking is largely attributed to masculinity, but findings scarcely focus on African American men who face additional race-related, help-seeking barriers. Building principally on reactance theory, we test a hypothesized model situating racial discrimination, masculinity norms salience (MNS), everyday racism (ERD), racial identity, sense of control (SOC), and depressive symptomatology as key barriers to African American men's health help-seeking. A total of 458 African American men were recruited primarily from US barbershops in the Western and Southern regions. The primary outcome was Barriers to Help-Seeking Scale (BHSS) scores. The hypothesized model was investigated with confirmatory factor and path analysis with tests for measurement invariance. Our model fit was excellent [Formula: see text] CFI = 0.99; TLI = 1.00; RMSEA = 0.00, and 90% CI [0.00, 0.07] and operated equivalently across different age, income, and education strata. Frequent ERD and higher MNS contributed to higher BHHS scores. The relationship between ERD exposure and BHHS scores was partially mediated by diminished SOC and greater depressive symptomatology. Interventions aimed at addressing African American men's health help-seeking should not only address masculinity norms but also threats to sense of control, and negative psychological sequelae induced by everyday racism.

A moderated mediation model: racial discrimination, coping strategies, and racial identity among Black adolescents.

This study examined a moderated mediation model among 314 Black adolescents aged 13-18. The model included general coping strategies (e.g., active, distracting, avoidant, and support-seeking strategies) as mediators and racial identity dimensions (racial centrality, private regard, public regard, minority, assimilationist, and humanist ideologies) as moderators of the relation between perceived racial discrimination and depressive symptoms. Moderated mediation examined if the relation between perceived racial discrimination and depressive symptoms varied by the mediators and moderators. Results revealed that avoidant coping strategies mediated the relation between perceptions of racial discrimination and depressive symptoms. The results indicated that avoidant coping strategies mediated the relation between perceived racial discrimination and depressive symptoms among youth with high levels of the minority/oppressive ideology.

The moderating capacity of racial identity between perceived discrimination and psychological well-being over time among African American youth.

This study examined the influence of racial identity in the longitudinal relation between perceptions of racial discrimination and psychological well-being for approximately 560 African American youth. Latent curve modeling (LCM) and parallel process multiple-indicator LCMs with latent moderators were used to assess whether perceptions of racial discrimination predicted the intercept (initial levels) and the slope (rate of change) of psychological well-being over time, and whether racial identity moderates these relations. The results indicated that African American adolescents who reported higher psychological responses to discrimination frequency levels at the first time point had lower initial levels of well-being. Regressing the slope factor for psychological well-being on the frequency of discrimination also revealed a nonsignificant result for subsequent well-being levels.

Beliefs about cancer and diet among those considering genetic testing for colon cancer.

OBJECTIVE: To assess beliefs about the role of diet in cancer prevention among individuals considering genetic testing for Lynch Syndrome. DESIGN: Family-centered, cascade recruitment; baseline assessment of a longitudinal study. SETTING: Clinical research setting. PARTICIPANTS: Participants were 390 persons, ages 18 and older, including persons with a Lynch Syndrome-associated cancer and suspected of carrying a disease causing mutation, and relatives at risk for inheriting a previously identified mutation. MAIN OUTCOME MEASURES: Assess clustering of beliefs about the role of diet in cancer prevention and predictors of class membership. ANALYSIS: Confirmatory factor analysis; 2-class factor mixture model with binary indicators; multilevel regression analyses, individuals nested within families. RESULTS: Women endorsed a relationship between diet and cancer prevention more often than men (P < .01). A 2-class model was used where Class 1 indicated less likely to link cancer to diet, and Class 2 indicated more likely. Factors associated with increased odds of membership in Class 1 expressed belief that nothing can prevent cancer (P < .01) and fate attribution (P < .01); Class 2 mentioned personal cancer history (P < .05) and genetic knowledge (P < .01). CONCLUSIONS AND IMPLICATIONS: Identifying factors associated with a belief in cancer prevention through dietary behaviors can inform targeted interventions.