Acculturation and Syndemic Risk: Longitudinal Evaluation of Risk Factors Among Pregnant Latina Adolescents in New York City
Acculturation and Syndemic Risk: Longitudinal Evaluation of Risk Factors Among Pregnant Latina Adolescents in New York City
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DOI：
10.1007/s12160-017-9924-y
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发表时间：
2018-01-01
影响因子：
3.8
通讯作者：
Ickovics, Jeannette R.
中科院分区：
文献类型：
--
作者：
Martinez, Isabel;Kershaw, Trace S.;Ickovics, Jeannette R.
背景 综合症流行病是同时发生的流行病，它们协同地导致特定的风险或健康结果。尽管有大量证据证明它们的存在，但人们对它们在青少年中随时间的变化知之甚少。目的本文的目的是确定药物使用、亲密伴侣暴力和抑郁症的纵向变化，并确定移民/文化因素是否会随着时间的推移缓解这种症状。方法在纽约市 772 名怀孕的拉丁裔青少年（14-21 岁）中，我们将药物使用、亲密伴侣暴力和抑郁症作为一种综合症进行了研究。我们使用纵向混合效应模型来评估从怀孕到产后 1 年，较高的综合征评分是否预示较高的综合征严重程度。使用交互项来确定移民一代和分离取向是否是随时间变化的显着调节因素。结果我们发现随着时间的推移，流行病严重程度的线性效应显着增加（β = 0.0413，P = 0.005）。流行病评分显着预测了流行病的严重程度（β = -0.1390，P = 0.0001），移民一代也是如此（β（移民）= -0.1348，P = 0.0001；β（第一代）= -0.1932，P = 0.0005）。移民一代（beta（移民）= -0.1125，P = 0.0035；beta（第一代）= -0.0135，P = 0.7279）和分居取向（beta = 0.0946，P = 0.0299）与从怀孕到产后1年的严重程度变化显着相关。 结论 怀孕为降低拉丁裔青少年的综合症风险提供了机会。未来的研究应探索流行病随时间的变化，特别是在高危青少年中。预防应以降低产后流行病风险为目标，以确保危险因素在怀孕后不会增加。
Background Syndemics are co-occurring epidemics that synergistically contribute to specific risks or health outcomes. Although there is substantial evidence demonstrating their existence, little is known about their change over time in adolescents.Purpose The objectives of this paper were to identify longitudinal changes in a syndemic of substance use, intimate partner violence, and depression and determine whether immigration/cultural factors moderate this syndemic over time.Methods In a cohort of 772 pregnant Latina adolescents (ages 14-21) in New York City, we examined substance use, intimate partner violence, and depression as a syndemic. We used longitudinal mixed-effect modeling to evaluate whether higher syndemic score predicted higher syndemic severity, from pregnancy through 1 year postpartum. Interaction terms were used to determine whether immigrant generation and separated orientation were significant moderators of change over time.Results We found a significant increasing linear effect for syndemic severity over time (beta = 0.0413, P = 0.005). Syndemic score significantly predicted syndemic severity (beta = -0.1390, P = 0.0001), as did immigrant generation (beta(Immigrant) = -0.1348, P = 0.0001; beta(1st Gen) = -0.1932, P = 0.0005). Both immigrant generation (beta(Immigrant) = -0.1125, P = 0.0035; beta(1st Gen) = -0.0135, P = 0.7279) and separated orientation (beta = 0.0946, P = 0.0299) were significantly associated with change in severity from pregnancy to 1 year postpartum.Conclusion Pregnancy provides an opportunity for reducing syndemic risk among Latina adolescents. Future research should explore syndemic changes over time, particularly among high-risk adolescents. Prevention should target syndemic risk reduction in the postpartum period to ensure that risk factors do not increase after pregnancy.