The impact of poverty-reduction intervention on child mental health mediated by family relations: Findings from a cluster-randomized trial in Uganda.

Reviews that synthesize global evidence on the impact of poverty reduction interventions on child and adolescent mental health (CAMH) report inconclusive results and highlight the need to unpack the mechanisms that connect poverty-reduction to CAMH. To address this gap, we examine the proposition that family relations is an important relational factor transmitting effect of poverty on CAMH, and test whether family relations mediate the effect of poverty-reduction intervention on depression, hopelessness, and self-concept among AIDS orphans in Uganda. We use longitudinal data collected over the course of 48 months in a cluster-randomized controlled trial conducted among N = 1410 AIDS orphans from n = 48 schools in Uganda. To examine the relationship between intervention, latent mediator (family relations and support) and CAMH outcomes (Beck Hopelessness Scale (BHS), Tennessee Self-Concept Scale (TSCS), and Depression), we ran structural equation models adjusting for clustering of individuals within schools. Relative to the control group, participants in both treatment arms reported lower levels of hopelessness and depression, and significantly higher levels of self-concept. They also report significantly higher levels of latent family relationship in all three models. In both treatment arms, the direct effect of the intervention on all three outcomes is still significant when the latent family relations mediator is included in the analyses. This suggests partial mediation. In other words, in both treatment arms, the significant positive effect of the intervention on children's depression, hopelessness, and self-concept is partially mediated by their family relationship quality. Our findings support the argument put forward by the Family Stress Model showing that the poverty-reduction program improves children's mental health functioning by improving family relationships. The implications of our study extend beyond the narrow focus of poverty reduction, suggesting that asset-building interventions have broader impacts on family dynamics and child mental health.

Pathway of effects of adverse childhood experiences on the poly-drug use pattern among adults using drugs: A structural equation modeling.

Introduction: Adverse childhood experiences (ACEs) are associated with an increased risk of poly-substance use among drug-using adults. However, there is a paucity of literature on a direct or indirect relationship between ACEs and drug use patterns. We thus aimed to identify the pathway of effects of ACEs on drug use patterns in adults by the structural equation model (SEM). Methods: A cross-sectional study was conducted by respondent-driving sampling and consecutive sampling among adult drug users in Southwest China in 2021. Descriptive, univariate, and SEM analyses were performed by R software 4.2.1. Results: Of 406 participants recruited from a drug abuse clinic, the average age was 34 years. The majority of the participants were male patients (98.3%) from ethnic minorities (79.6%), who were unmarried (71.6%) and employed (81.2%). Nearly 95.5% experienced ACEs with 46.6% of them reporting four or more ACEs. The median value of self-perception of drug abuse score, friend drug use score, and drug use score was 8.0 (3.0, 11.0), 1.0 (0.0, 1.0), and 1.0 (1.0, 2.0) respectively. In the confirmatory analysis part of SEM, the construct of latent variables fitted well with the data. Poly-drug use was significantly and directly affected by three predictors including monthly incomes (ß = 0.09), friend drug use (ß = 0.50), and ACEs (ß = 0.11). The indirect effect of ACEs passing through self-perception of drugs (ß = 0.09) was not significant. Discussion: ACEs have an independent and direct effect on the drug user for poly-drug use apart from the effect of drug-using friends and family income.

The influence of service quality and anticipated emotions on donor loyalty: an empirical analysis in blood centres in Spain.

Blood donation centres need to recruit and retain donors to ensure the effectiveness and efficiency of healthcare systems, as COVID-19 has recently evidenced. In such risky settings, blood donation services must increase donations. Service quality can increase donations but its evaluation only amounts to a cognitive evaluation, and not to an emotional appraisal. Consequently, both service quality and emotions should be considered when predicting donor behaviour. In fact, donating blood is an emotionally charged service, thus representing an ideal setting to investigate how emotions influence consumer behaviour. This research proposes a new method to predict blood donors' intentions by integrating a cognitive approach measuring perceived quality, and an emotional approach including anticipated emotions (both positive and negative) of 'donation' and 'non-donation'. Based on a sample of 30,621 active Spanish donors, it is concluded that service quality is an antecedent for anticipated emotions and that both service quality and anticipated emotions influence donor loyalty. Designing the donation process based on quality criteria would provoke encouraging emotions and diminish discouraging emotions, therefore improving donor loyalty.

Assessing Health-Related Outcomes of Medical Cannabis Use among Older Persons: Findings from Colorado and Illinois.

OBJECTIVES: To assess health-related outcomes associated with medical cannabis use among older patients in Colorado and Illinois enrolled in their home state's medical cannabis program. METHODS: Cross-sectional data from anonymous surveys were collected from 139 persons over the age of 60 using medical cannabis in the past year. We used structural equation modeling (SEM) to confirm the hypothesized four-factor structure that includes health-related quality of life (HRQL), health-care utilization (HCU), symptom effects, and adverse events. We then examined associations between cannabis use and self-reported outcome changes using linear regression. RESULTS: The four-factor model was the best fitting structure (X2(df) = 81.63 (67), p> X2 = 0.108) relative to reduced structures. We also found that using cannabis 1-4 times per week is associated with 3.30 additional points on the HRQL scale (p < .001), 2.72 additional points on the HCU scale (p < .01), and 1.13 points on pain (p < .001). The frequency of use reported at 5-7 times per week is associated with 4.71 additional HRQL score points (p < .001). No significant associations were observed between the frequency of use and adverse events. CONCLUSIONS: We observed how cannabis use outcomes fall into four independent factors, and those using more frequently reported higher values on HRQL, HCU, and pain measures. However, we are cautious about the generalizability of our findings. CLINICAL IMPLICATIONS: Clinicians should consider how older patients using medical cannabis can experience positive and negative outcomes simultaneously or separately and assess these outcomes directly along with considering patient self-reports.

Propiedades psicométricas de la escala de intensificación de demandas del trabajo a partir de una muestra colombiana / Propiedades psicométricas de la escala de intensificación de demandas del trabajo a partir de una muestra colombiana

Abstract The acceleration of the pace of organizational management poses new challenges that can be expressed as an intensification of job demands, and people express it as an increase in the intensity levels of their task development, and a feeling of a greater time pressure in their work context. The objective of this study was to examine, in a sample of Colombian workers, the evidence of construct validity and reliability of the Spanish version of the Intensification of Job Demands Scale (IDS) developed by Kubicek, Paškvan and Korunka in 2015, which evaluates five job demands subject to intensification. The sample consisted of 420 healthcare professionals located in Bogotá, Colombia. Descriptive statistics, item discrimination indexes, internal structure through exploratory and confirmatory factor analysis, and evidence of construct validity were established. The original five-factor structure of the test was maintained explaining 47.12% of the total variance. By using Structural Equation Models (SEM), an adequate adjustment and parsimony of the model in congruence with the theoretical proposal of the scale is evidenced. This Spanish version of the IDS has adequate psychometric properties and it can contribute to research in the country, on the intensification of work as a demand that is associated with the impairment of workers' health and well-being.

Resumen La aceleración del ritmo de gestión organizacional plantea nuevos desafíos para las empresas, que pueden reflejarse en la intensificación de las demandas del trabajo y en que las personas expresen un aumento tanto en los niveles de intensidad en el desarrollo de sus tareas como en la sensación de una mayor presión del tiempo en su contexto laboral. Teniendo esto en cuenta, el objetivo del presente estudio fue examinar en una muestra de trabajadores colombianos las evidencias de validez de constructo y confiabilidad de la versión en español de la escala Intensification of Job Demands Scale (IDS), desarrollada por Kubicek et al. en 2015 para evaluar cinco demandas del trabajo sujetas a la intensificación -la muestra estuvo compuesta por 420 profesionales del sector de servicios de la salud en Bogotá, Colombia-. Para esto, se establecieron los estadísticos descriptivos, así como los índices de discriminación de los ítems, la estructura interna del instrumento mediante análisis factorial exploratorio y confirmatorio, y las evidencias de validez de constructo. Como resultado, se mantiene la estructura original de cinco factores de la prueba, que explican el 47.12 % de la varianza total; y, por medio de la utilización de modelos de ecuaciones estructurales, se evidencia un adecuado ajuste y parsimonia del modelo en congruencia con la propuesta teórica de la escala. Se concluye que esta versión en español de la IDS posee propiedades psicométricas adecuadas y que puede contribuir a la investigación en la región sobre la intensificación del trabajo como una demanda asociada al deterioro en la salud y al bienestar en los trabajadores.

Analysis of health habits, vices and interpersonal relationships of Spanish adolescents, using SEM statistical model.

The objective of this article is to know the state of health of a sample of adolescents and how it relates to toxic habits and personal relationships. Likewise, it is presented how can influence eating habits, sports practice and interpersonal relationships in their general health status. The research has carried out through a survey of 56 questions to 470 adolescents, between 13 and 18 years old, of both sexes, of different schools in the province of Cordoba, Spain. These results have been subjected to a statistical model widely used in health and social sciences in general, called Structural Equations Model (SEM), through the SPSS program, v. 23 and AMOS. SEM is widely used in the social sciences to estimate regression models (usually multi-equational). The estimated model shows a significant global acceptability based on the usual statistical tests and goodness-of-fit measures. In this regard, these results are: CMIN = 17.554 with 33 degrees of freedom (DF) and a probability level, p = 0.987, which is higher than any reasonable level of significance (α = 0.05, 0.10, even 0.20). Likewise, FMIN = 0.038, CFI = 1.000 and RMSEA = 0.000. The main recommendation of this research aimed at improving good eating and healthy habits, and to avoid toxic habits of adolescents, is to begin the education in the family, in coordination with their school and high school.

Risk factors associated with subsequent initiation of cigarettes and e-cigarettes in adolescence: A structural equation modeling approach.

BACKGROUND: Previous youth tobacco research has identified multiple correlated risk factors for initiation of cigarette and e-cigarette use; whether these factors are independently associated with initiation is not known, due to challenges with disentangling the independent effects of these correlated risk factors. METHODS: Students in 11th/12th grade enrolled in the Southern California Children's Health Study were surveyed in 2014 (baseline) and again in 2015 (N = 1553). Structural equation models (SEM) were developed to investigate associations of susceptibility, marketing, and the social environment (as latent factors), and other tobacco use at baseline with cigarette or e-cigarette initiation between baseline and follow-up. Analyses were restricted to baseline never cigarette users (N = 1293) for models evaluating cigarette initiation, and to never e-cigarette users (N = 1197) for models evaluating e-cigarette initiation. RESULTS: In fully-adjusted prospective SEM models, latent factors for cigarette susceptibility, marketing, and the social environment, along with ever e-cigarette use and ever hookah use at baseline were independently associated with cigarette initiation between baseline and follow-up (P < 0.05). Similarly, latent factors for e-cigarette susceptibility, marketing, and the social environment, along with ever hookah use at baseline were associated with e-cigarette initiation between baseline and follow-up (P < 0.05); however, cigarette use at baseline was not associated with e-cigarette initiation in SEM models (P = 0.16). CONCLUSIONS: We identified independent effects of multiple risk factors in SEM models on initiation of cigarettes and e-cigarettes. E-cigarette use was associated with cigarette initiation, but cigarette use was not associated with e-cigarette initiation in fully adjusted models. Research to identify underlying causal mechanisms is warranted.

Adverse Birth Outcomes as Indicators of Poor Fetal Growth Conditions in a French Newborn Population-A Stratified Analysis by Neighborhood Deprivation Level.

Background: Adverse birth outcomes are related to unfavorable fetal growth conditions. A latent variable, named Favorable Fetal Growth Condition (FFGC), has been defined by Bollen et al., in 2013; he showed that this FFGC latent variable mediates the effects of maternal characteristics on several birth outcomes. Objectives: The objectives of the present study were to replicate Bollen's approach in a population of newborns in Paris and to investigate the potential differential effect of the FFGC latent variable according to the neighborhood socioeconomic level. Methods: Newborn health data were available from the first birth certificate registered by the Maternal and Child Care department of the City of Paris. All newborns (2008-2011) were geocoded at the mother residential census block. Each census block was assigned a socioeconomic deprivation level. Several mothers' characteristics were collected from the birth certificates: age, parity, education and occupational status and the occupational status of the father. Three birth outcomes were considered: birth weight (BW), birth length (BL) and gestational age (GA). Results: Using a series of structural equation models, we confirm that the undirected model (that includes the FFGC latent variable) provided a better fit for the data compared with the model where parental characteristics directly affected BW, BL, and/or GA. However, the strength, the direction and statistical significance of the associations between the exogenous variables and the FFGC were different according to the neighborhood deprivation level. Conclusion: Future research should be designed to assess the how robust the FFGC latent variable is across populations and should take into account neighborhood characteristics to identify the most vulnerable group and create better design prevention policies.