Interactive Effects of Ethnic Identity and a Cognitive Behavioral Stress Management Intervention on Subjective and Objective Stress in Low-Income Minority Women Living with HIV.

Interactive Effects of Ethnic Identity and a Cognitive Behavioral Stress Management Intervention on Subjective and Objective Stress in Low-Income Minority Women Living with HIV.
Author: Corina Reyes Lopez
Publisher:
Total Pages:
Release: 2013
Genre:
ISBN:

The HIV/AIDS epidemic is more prevalent among minority ethnic groups, with mortality rates highest among African-American women. Additionally, low-income minority women with a positive HIV diagnosis experience a variety of stressors that influence their psychological and physical well-being. Research has found that ethnic identity, an intrapersonal resiliency factor, is associated with lower perceived stress in low-income minority women living with HIV, in part through greater levels of coping self-efficacy and social support. Given the benefits of group-based interventions in reducing stress in HIV positive populations, it is important to understand whether ethnic identity influences the efficacy of these interventions in reducing stress in minority women with HIV. The present study examined the interactive effects of ethnic identity and a group-based targeted Cognitive Behavioral Stress Management (CBSM) intervention on objective and subjective stress indicators at post-intervention and at 6-month follow-up. It was hypothesized that women with greater ethnic identity randomized to CBSM would experience more reductions in self-reported and physiological stress (urinary-free norepinephrine) than those in the control group and women with a lower ethnic identity. I also hypothesized that women with greater ethnic identity affirmation and ethnic identity search, assigned to CBSM would report more reduction in self-reported and physiological stress than those in the control group and women with lower ethnic identity subscale scores. Finally, it was hypothesized that the ethnic identity X intervention interaction effect on stress outcomes would work through CBSM-associated changes in social support and coping self-efficacy. Women (n=123) were approximately 38 years old, predominantly African-American (87%), on disability (51%), diagnosed with HIV an average of 7.6 years, and earning an average yearly income of $5,000-10,000. Participants underwent a 24-hour urine collection procedure, completed the Multigroup Ethnic Identity Measure (MEIM), Impact of Events Scale (IES), and Perceived Stress Scale (PSS), and were randomized to a 10-week targeted CBSM (i.e. relaxation, CBT, and interpersonal skills training) or psychoeducational control group, and completed the IES, PSS and provided 24-hour urine samples at post-intervention and at 6-month follow-up. Targeted components in CBSM addressed issues relevant for minority women with HIV and introduced coping strategies that HIV positive women of color draw upon, including flexibility, spirituality, endurance, and positive thinking. Latent growth modeling revealed a significant ethnic identity X intervention interaction in explaining decreases in subjective stress. Post-hoc analyses indicated that for women with moderate to higher reports in ethnic identity, CBSM was associated with lower perceived stress and IES intrusive thoughts after the intervention compared to women in the control group. For women lower in ethnic identity CBSM and control groups did not differ on self-reported stress. No significant moderation effects were found for norepinephrine output. Subscale analyses revealed that the ethnic identity X intervention interaction effects on PSS and IES outcomes were also apparent using ethnic identity affirmation to delineate hi/low ethnic identity groups, but not when women were classified on the basis of ethnic identity search. Findings suggest that women with high ethnic identity may benefit more psychologically (self-reported stress) but not physiologically (using 24-hour urinary norepinephrine) than low ethnic identity women from group-based interventions that teach them additional skills to deal with stress. Future research should continue to investigate cultural resiliency factors influencing stress and explore candidate mediating psychosocial resources that may account for the buffering effects of ethnic identity on perceptions of stress in low-income minority women with HIV.

Parenting Matters

Parenting Matters
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 525
Release: 2016-11-21
Genre: Social Science
ISBN: 0309388570

Decades of research have demonstrated that the parent-child dyad and the environment of the familyâ€"which includes all primary caregiversâ€"are at the foundation of children's well- being and healthy development. From birth, children are learning and rely on parents and the other caregivers in their lives to protect and care for them. The impact of parents may never be greater than during the earliest years of life, when a child's brain is rapidly developing and when nearly all of her or his experiences are created and shaped by parents and the family environment. Parents help children build and refine their knowledge and skills, charting a trajectory for their health and well-being during childhood and beyond. The experience of parenting also impacts parents themselves. For instance, parenting can enrich and give focus to parents' lives; generate stress or calm; and create any number of emotions, including feelings of happiness, sadness, fulfillment, and anger. Parenting of young children today takes place in the context of significant ongoing developments. These include: a rapidly growing body of science on early childhood, increases in funding for programs and services for families, changing demographics of the U.S. population, and greater diversity of family structure. Additionally, parenting is increasingly being shaped by technology and increased access to information about parenting. Parenting Matters identifies parenting knowledge, attitudes, and practices associated with positive developmental outcomes in children ages 0-8; universal/preventive and targeted strategies used in a variety of settings that have been effective with parents of young children and that support the identified knowledge, attitudes, and practices; and barriers to and facilitators for parents' use of practices that lead to healthy child outcomes as well as their participation in effective programs and services. This report makes recommendations directed at an array of stakeholders, for promoting the wide-scale adoption of effective programs and services for parents and on areas that warrant further research to inform policy and practice. It is meant to serve as a roadmap for the future of parenting policy, research, and practice in the United States.

Social Isolation and Loneliness in Older Adults

Social Isolation and Loneliness in Older Adults
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 317
Release: 2020-05-14
Genre: Social Science
ISBN: 0309671035

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

The End of Trauma

The End of Trauma
Author: George A. Bonanno
Publisher: Basic Books
Total Pages: 282
Release: 2021-09-07
Genre: Psychology
ISBN: 1541674375

With “groundbreaking research on the psychology of resilience” (Adam Grant), a top expert on human trauma argues that we vastly overestimate how common PTSD is in and fail to recognize how resilient people really are. After 9/11, mental health professionals flocked to New York to handle what everyone assumed would be a flood of trauma cases. Oddly, the flood never came. In The End of Trauma, pioneering psychologist George A. Bonanno argues that we failed to predict the psychological response to 9/11 because most of what we understand about trauma is wrong. For starters, it’s not nearly as common as we think. In fact, people are overwhelmingly resilient to adversity. What we often interpret as PTSD are signs of a natural process of learning how to deal with a specific situation. We can cope far more effectively if we understand how this process works. Drawing on four decades of research, Bonanno explains what makes us resilient, why we sometimes aren’t, and how we can better handle traumatic stress. Hopeful and humane, The End of Trauma overturns everything we thought we knew about how people respond to hardship.

The Future of the Public's Health in the 21st Century

The Future of the Public's Health in the 21st Century
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 536
Release: 2003-02-01
Genre: Medical
ISBN: 0309133181

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

Investing in the Health and Well-Being of Young Adults

Investing in the Health and Well-Being of Young Adults
Author: National Research Council
Publisher: National Academies Press
Total Pages: 431
Release: 2015-01-27
Genre: Medical
ISBN: 0309309980

Young adulthood - ages approximately 18 to 26 - is a critical period of development with long-lasting implications for a person's economic security, health and well-being. Young adults are key contributors to the nation's workforce and military services and, since many are parents, to the healthy development of the next generation. Although 'millennials' have received attention in the popular media in recent years, young adults are too rarely treated as a distinct population in policy, programs, and research. Instead, they are often grouped with adolescents or, more often, with all adults. Currently, the nation is experiencing economic restructuring, widening inequality, a rapidly rising ratio of older adults, and an increasingly diverse population. The possible transformative effects of these features make focus on young adults especially important. A systematic approach to understanding and responding to the unique circumstances and needs of today's young adults can help to pave the way to a more productive and equitable tomorrow for young adults in particular and our society at large. Investing in The Health and Well-Being of Young Adults describes what is meant by the term young adulthood, who young adults are, what they are doing, and what they need. This study recommends actions that nonprofit programs and federal, state, and local agencies can take to help young adults make a successful transition from adolescence to adulthood. According to this report, young adults should be considered as a separate group from adolescents and older adults. Investing in The Health and Well-Being of Young Adults makes the case that increased efforts to improve high school and college graduate rates and education and workforce development systems that are more closely tied to high-demand economic sectors will help this age group achieve greater opportunity and success. The report also discusses the health status of young adults and makes recommendations to develop evidence-based practices for young adults for medical and behavioral health, including preventions. What happens during the young adult years has profound implications for the rest of the life course, and the stability and progress of society at large depends on how any cohort of young adults fares as a whole. Investing in The Health and Well-Being of Young Adults will provide a roadmap to improving outcomes for this age group as they transition from adolescence to adulthood.

What Is the Evidence on the Role of the Arts in Improving Health and Well-Being

What Is the Evidence on the Role of the Arts in Improving Health and Well-Being
Author: Daisy Fancourt
Publisher:
Total Pages: 142
Release: 2019-06
Genre:
ISBN: 9789289054553

Over the past two decades, there has been a major increase in research into the effects of the arts on health and well-being, alongside developments in practice and policy activities in different countries across the WHO European Region and further afield. This report synthesizes the global evidence on the role of the arts in improving health and well-being, with a specific focus on the WHO European Region. Results from over 3000 studies identified a major role for the arts in the prevention of ill health, promotion of health, and management and treatment of illness across the lifespan. The reviewed evidence included study designs such as uncontrolled pilot studies, case studies, small-scale cross-sectional surveys, nationally representative longitudinal cohort studies, community-wide ethnographies and randomized controlled trials from diverse disciplines. The beneficial impact of the arts could be furthered through acknowledging and acting on the growing evidence base; promoting arts engagement at the individual, local and national levels; and supporting cross-sectoral collaboration.

Cognitive-Behavioral Stress Management

Cognitive-Behavioral Stress Management
Author: Michael H. Antoni
Publisher: Oxford University Press
Total Pages: 144
Release: 2007-09-10
Genre: Psychology
ISBN: 0190450029

Living with HIV can be stressful, which can affect both your emotional and physical well-being. You may feel a loss of control over your life, socially isolated, or anxious and depressed. Studies have shown that prolonged stress can negatively impact the immune system, making it less effective in fighting illness. If you are concerned about the impact stress has on your life and on your health, this book can help you learn to relax and manage stress more effectively. This book presents a group treatment program that has been scientifically proven to reduce stress in individuals living with HIV. Written by the developers of this groundbreaking program, this workbook is based on the principles of Cognitive-Behavioral Stress Management (CBSM). You will learn a variety of relaxation techniques, all designed to help you reduce tension and stress. As you become more aware of stress and its effects, stress management skills will increase your ability to cope. This workbook comes complete with user-friendly monitoring forms and homework exercises designed to help reinforce the skills learned in group. It also includes instructions for relaxation practice that will remain useful long after you've completed the program. Used in conjunction with the group program described in the corresponding facilitator guide, this workbook will help you successfully manage stress and lead a more healthy life. TreatmentsThatWorkTM represents the gold standard of behavioral healthcare interventions! · All programs have been rigorously tested in clinical trials and are backed by years of research · A prestigious scientific advisory board, led by series Editor-In-Chief David H. Barlow, reviews and evaluates each intervention to ensure that it meets the highest standard of evidence so you can be confident that you are using the most effective treatment available to date · Our books are reliable and effective and make it easy for you to provide your clients with the best care available · Our corresponding workbooks contain psychoeducational information, forms and worksheets, and homework assignments to keep clients engaged and motivated · A companion website (www.oup.com/us/ttw) offers downloadable clinical tools and helpful resources · Continuing Education (CE) Credits are now available on select titles in collaboration with PsychoEducational Resources, Inc. (PER)

Families Caring for an Aging America

Families Caring for an Aging America
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 367
Release: 2016-11-08
Genre: Medical
ISBN: 0309448093

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.