College for Health, Community and Policy Faculty Research

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    Physical activity and local blue/green space access during the COVID-19 pandemic
    (SAGE Publications, 2024-04-05) Nicklett, Emily J.; Sharma, Bonita B.; Testa, Alexander
    Purpose: To examine whether local blue and green space access was associated with weekly physical activity frequency during the COVID-19 pandemic. Design: Cross-sectional. Setting: Population-based, nationally representative sample of U.S. adults (May and June 2021). Sample: Adults, ages 18-94 (N = 1,771). Measures: Self-reported data included the presence of blue spaces (e.g., lakes, outdoor swimming pools, riverside trails) and green spaces (e.g., parks, forests, or natural trails) in their neighborhoods, and days of physical activity per week (e.g., running, swimming, bicycling, lifting weights, playing sports, or doing yoga). Analysis: Multiple Poisson regression assessed relationships between blue and green spaces and physical activity, with coefficients transformed into incidence risk ratios (IRR). Results: Among participants, 67.2% reported living near a blue space and 86.1% reported living near a green space. Racial/ethnic and socioeconomic disparities in access to blue and green spaces were observed, with less access among non-Hispanic Black participants and those with lower income and educational attainment. Living near blue (IRR = 1.23, 95% CI = 1.10, 1.39) or green space (IRR = 1.25, 95% CI = 1.02, 1.54) was significantly associated with more frequent weekly physical activity. Conclusion: Proximity to blue or green spaces is associated with more frequent physical activity during the COVID-19 pandemic. Health promotion efforts should include equitable strategies to improve accessibility to blue and green spaces.
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    COVID-19 Pandemic Impact on Nursing Homes Financial Performance
    (SAGE Publications, 2024-03-21) Orewa, Gregory N.; Weech-Maldonado, Robert; Lord, Justin; Davlyatov, Ganisher; Becker, David; Feldman, Sue S.
    Nursing homes expressed concern about potential severe adverse financial outcomes of COVID-19, with worries extending to the possibility of some facilities facing closure. Maintaining a strong financial well-being is crucial, and there were concerns that the pandemic might have significantly impacted both expenses and income. This longitudinal study aimed to analyze the financial performance of nursing homes during COVID-19 pandemic. Specifically, we examined the impact of the pandemic on nursing home operating margins, operating revenue per resident day, and operating cost per resident day. The study utilized secondary data from various sources, including CMS Medicare cost reports, Brown University’s Long Term Care Focus (LTCFocus), CMS Payroll-Based Journal, CMS Care Compare, Area Health Resource File, Provider Relief Fund distribution data, and CDC’s NH COVID-19 public file. The sample consisted of 45 833 nursing home-year observations from 2018 to 2021. Fixed-effects regression analysis was employed to assess the impact of the pandemic on financial performance while controlling for various organizational and market characteristics. The study found that nursing homes’ financial performance deteriorated during the COVID-19 pandemic. Operating margins decreased by approximately 4.3%, while operating costs per resident day increased by $26.51, outweighing the increase in operating revenue per resident day by about $17. Occupancy rates, payer mix, and staffing intensity were found to impact financial performance. The study highlights the significant financial impact of the COVID-19 pandemic on nursing homes. While nursing homes faced substantial financial strains, the findings offered lessons for the future, underscoring the need for nursing homes to improve the accuracy of their cost reports and enhance financial transparency and accountability.
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    COUPLE IDENTITY WORK: Collaborative Couplehood, Gender Inequalities, and Power in Naming
    (SAGE Publications, 2024-01-30) Sue, Christina A.; Vasquez-Tokos, Jessica; Núñez, Adriana C.
    The study of baby naming is valuable for understanding how gender inequality is reproduced in families. Often treated as an event, baby naming also represents an important social and cultural process that can reveal gendered dynamics in couple decision-making. Baby naming, which represents a highly visible and symbolic family milestone, is a strategic site in which to examine how couple identities are constructed—for self, partner, and others—through the naming process and through stories parents tell of how they named the baby. Drawing on 46 interviews with U.S. Mexican-origin heterosexual parents, we expose tensions that result when practices do not align with a desired (egalitarian) couple identity and detail the ensuing cognitive, emotion, and narrative labor that parents—primarily women—perform to reconcile inconsistencies. We introduce the concept of couple identity work, or the work involved in creating and projecting a desired impression of a relationship for multiple audiences, to provide a theoretical framework for these gendered dynamics. We show how couple identity work is enacted—and power expressed—through men’s and women’s strategies of action/inaction and storytelling, and how this work reproduces and obscures gendered power and inequality in the intimate context of baby naming.
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    Diversity and Dynamics in Care Networks of Older Americans
    (SAGE Publications, 2024-01-25) Lin, Zhiyong
    Despite growing interest in exploring caregiving alternatives beyond traditional models, limited research has focused on the diverse care networks that provide assistance to older adults. The aim of this study is to illuminate the complexity of older adults’ care networks by developing a typology that considers care from various sources. Using latent class analysis on longitudinal data from the National Health and Aging Trends Study, the authors identify five distinct care network types: spousal care, care exclusively from children, care from both children and other sources, self-care with assistive technology, and care exclusively from nonfamily sources. Further analysis, including multinomial logistic regression and latent transition analysis, reveals that when a spouse is available, older adults, particularly older men, are more likely to rely on spousal care. However, in cases in which spouses and/or children are unavailable, older adults are inclined to turn to diverse care networks involving nontraditional caregivers or resort to self-care using assistive technologies. Additionally, declining health conditions are associated with a higher likelihood of receiving care from more varied care networks. This underscores the evolving nature of care arrangements in response to changing family structures and health needs.
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    Black Disadvantage or Advantage? Misalignment between State and Popular Understandings of Blackness in Mexico
    (SAGE Publications, 2024-01-25) Sue, Christina A.; Riosmena, Fernando; Telles, Edward
    Growing numbers of countries are including ethnoracial questions on their national censuses, spawning new scholarship on the politics of state classification and ethnoracial stratification. However, these literatures have generally not focused on how alignment or misalignment between state and popular conceptualizations of ethnoracial categories affects official measurements, including population size and ethnoracial inequality. The authors leverage a quasi-natural experiment on state-popular alignment in Mexico by drawing on three recent government surveys, which, for the first time in the nation’s history, sought to measure black identification yet defined blackness in divergent ways. The authors find that questions that define blackness in cultural terms (which misalign with popular conceptions of blackness) produce substantially smaller population estimates and considerably less black disadvantage than a noncultural (racial origins) question. This article bridges the literatures on the politics of ethnoracial classification and stratification and produces new empirical and theoretical insights into the study of ethnoracial measurement and inequality.
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    The Eyes Have It: Visual Feedback Methods to Make Walking in Immersive Virtual Reality More Accessible for People With Mobility Impairments While Utilizing Head-Mounted Displays
    (Association for Computing Machinery, 2023-10-22) Mahmud, M. Rasel; Cordova, Alberto; Quarles, John
    The use of Head-Mounted Displays (HMDs) in Virtual Reality (VR) can cause gait disturbance problems for users because they are unable to see the real world while in VR. This is particularly challenging for individuals with mobility impairments who rely heavily on visual cues to maintain balance. The limited research that has been conducted on this issue has not focused on ways to solve it. IN this study, we investigated how different visual feedback methods affect walking patterns (i.e., gait) in VR. The study involved 50 participants, including 25 individuals with mobility impairments due to multiple sclerosis and 25 without mobility impairments. The participants completed timed walking tasks in both the real world and in VR environments that included various types of visual feedback, such as spatial, static, and rhythmic. The results showed that static and rhythmic visual feedback significantly improved gait performance in VR for people with mobility impairments compared to no visual feedback in VR. The results will help to make more accessible virtual environments for people with mobility impairments.
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    Beyond Being Insured: Insurance Coverage Denial as a Major Barrier to Accessing Care During Pregnancy and Postpartum
    (SAGE Publications, 2023-06-02) Lee, Jusung; Howard, Krista J.; Leong, Caleb; Grigsby, Timothy J.; Howard, Jeffrey T.
    This study investigates the association between insurance coverage denial and delays in care during pregnancy and postpartum. An online survey was administered in March and April 2022 to women who were either pregnant or within 1 year postpartum (n = 1,113). The outcome was delayed care, measured at four time points: during pregnancy and 1 week, 2 to 6 weeks, and after 7 weeks postpartum. The key covariate was insurance coverage denial by providers during pregnancy. Delayed care due to having an unaccepted insurance and being “out-of-network” was more pronounced at 1 week postpartum with 3.37 times and 3.47 times greater odds and in 2 to 6 weeks postpartum with 5.74 times and 2.97 times greater odds, respectively. The association between insurance denial and delays in care encapsulated transportation, rural residency, time issues, and financial constraints. The findings suggest that coverage denial is associated with significant delays in care, providing practical implications for effective perinatal care.
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    Navigating Identity Uncertainty: Identity Distress During the COVID-19 Pandemic
    (SAGE Publications, 2023-09-30) Meca, Alan; Allison, Kelsie K.; Passini, Julia; Veniegas, Taryn; Cruz, Bethany; Castillo, Linda G.; Schwartz, Seth J.; Zamboanga, Byron L.; Michikyan, Minas; Bessaha, Melissa; Regan, Pamela C.; Subrahmanyam, Kaveri; Bartholomew, John; Piña-Watson, Brandy; Cano, Miguel Ángel; Martinez, Charles R. Jr.
    The long-term effects of the COVID-19 pandemic have only recently begun to be explored. Among college students, who were faced with sudden and unprecedented changes and challenges, it is likely that COVID-19 detrimentally impacted the establishment of a sense of self, a key developmental task of the college years. However, no research has examined the relationships among COVID-19 related worries, identity distress, and psychological and academic adjustment. To address these gaps in the current study, we examined the prevalence of identity distress, the relationship between COVID-19 related worries and identity distress, and the direct and indirect associations between COVID-19 related worries and psychological and academic adjustment among a sample of 1627 college students (Mage = 20.51, SD = 2.21). Findings indicated that over a third of the sample reported high levels of identity distress and that COVID-19 related worries were negatively associated, both directly and indirectly through identity distress, with psychological and academic adjustment.
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    A Scoping Review on Gender/Sex Differences in COVID-19 Vaccine Intentions and Uptake in the United States
    (SAGE Publications, 2023-10-17) Sileo, Katelyn M.; Hirani, Inara M.; Luttinen, Rebecca L.; Hayward, Matt; Fleming, Paul J.
    Objective: To explore the empirical literature on gender/sex differences in vaccine acceptance among U.S.-based adults and adolescents in approximately the first 2 years of the pandemic. Data source: Embase, Medline, PsycINFO, EBSCO, CINAHL, Web of Science Study inclusion and exclusion criteria: Peer-reviewed studies conducted in the U.S. with those aged 12 and older, published in English before January 12, 2022, examining the relationship between gender/sex on COVID-19 vaccine intentions and/or uptake. Data extraction: Three authors screened studies and extracted data. Data Synthesis: Univariate and multivariate results are summarized. Results: A total of 53 studies met inclusion criteria (48 intentions, 7 uptake), using mostly cross-sectional designs (92.5%) and non-random sampling (83.0%). The majority of studies supported men’s greater intentions to vaccinate compared to women, and men’s greater vaccine uptake in univariate analyses, but most multivariate analyses supported no gender differences in uptake. Few studies examined gender beyond binary categories (women/men), highlighting a gap in the studies inclusive of transgender or gender-diverse populations in analyses. Conclusion: Women may have been more hesitant to get the vaccine than men early in the pandemic, but these differences may not translate to actual behavior. Future research should include non-binary/transgender populations, explore the gender-specific reasons for hesitancy and differences by sub-populations, utilize more rigorous designs, and test gender-sensitive public health campaigns to mitigate vaccine concerns.
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    Exploring Trust in the Police in South Korea During the COVID-19 Pandemic: Does Fear of the COVID-19 Matter?
    (SAGE Publications, 2023-08-10) Nam, Yongjae; Maskály, Jon; Ivković, Sanja Kutnjak; Neyroud, Peter
    In response to the COVID-19 pandemic, governments restricted community members’ activities and, in turn, patterns of human behavior, both legal and illegal, changed. In many countries, the police have been entrusted to enforce these new COVID-19 related restrictions and were often perceived as the main enforcers of these sometimes unpopular measures. In this paper, we study four types of factors that may affect the public's trust in the police during the COVID-19 pandemic: traditional factors, such as interactions with the police during the pandemic, assessments of the police effectiveness in dealing with the pandemic, COVID-19 related factors, such as instrumental concerns for their personal health, and the adherence to the conspiracy theories. Specifically, using data from a sample of 527 respondents from the Seoul metropolitan area in South Korea, collected in the fall of 2021, we estimate the effects of the factors listed above. The results indicate that trust in the Korean National Police was strengthened when the police were perceived to have effectively dealt with the challenges of the pandemic and addressed the instrumental concerns of the community in the protection of public health. No demographic variables were significantly independently associated with trust in the police during the pandemic. The theoretical and policy implications of the findings are discussed.
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    In Search of Ethics Infrastructure in U.S. Local Governments: Building Blocks or Dead End?
    (SAGE Publications, 2023-08-23) Demir, Tansu; Reddick, Christopher G.; Perlman, Bruce J.
    The literature in public administration has advanced various propositions to promote ethical behavior. Local governments have undertaken various efforts in that direction. Those efforts are considered critical for building ethical leadership and culture in the long run. Based on a literature review and use of Social Learning Theory, we identify four building blocks of an ethics infrastructure for public organizations. Employing a comprehensive survey of local governments, this paper shows that displaying awareness and knowledge of ethics, enforcing rules and norms, demonstrating policy support for ethical behavior, and incentivizing the right behaviors are key building blocks of ethics infrastructure that still need improvement in local governments. The reality of ethics infrastructure revealed by the survey is far from the idealism promoted in the literature. We discuss the results and offer some insights and remedies.
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    Pandemic Job Separation and Psychological Distress: Modeling Chains of Adversity
    (SAGE Publications, 2023-06-09) Hill, Terrence D.; Leppard, Tom R.; Miller, Michael V.; Davis, Andrew P.; Zapata, Veronica R.
    Although recent studies have linked pandemic unemployment with poorer mental health, the mechanisms underlying this association remain understudied. In this paper, we develop a mediation model to explain why pandemic job separation might undermine mental health. Using national data from the 2021 Crime, Health, and Politics Survey (n = 1,258), we test the indirect effects of pandemic job separation on psychological distress through several mechanisms. Mediation analyses reveal compound indirect effects of pandemic job separation on psychological distress through the primary pathway of financial strain and the secondary pathways of social support, self-esteem, mastery, religious struggles, and sleep disturbance. Absent the indirect effect of pandemic job separation through financial strain, we would have failed to observe any simple indirect effects through the other proposed mechanisms. Formal moderated mediation analyses also indicate that our observed indirect effects are invariant to subgroup differences in current employment status, education, and household income. In short, our indirect effects are observed for those respondents who were able to regain employment, those with college degrees, and those with the most financial resources. Our results suggest that the temporary expansion of public assistance has been insufficient to offset widespread unemployment and financial hardship during a global pandemic.
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    The Roles of Perceived Physical Education Competence, Enjoyment, and Persistence on Middle School Students’ Physical Activity Engagement
    (SAGE Publications, 2023-05-24) Guan, Jianmin; Xiang, Ping; Land, William M.; Hamilton, Xiaofen D.
    We examined gender and grade differences in the relationship between students’ perceived competence, their enjoyment of physical education (PE), and their PA persistence on the frequency of their physical activity (PA). We also used structural equation modeling to assess the direct, indirect, and total effects of perceived competence and PE enjoyment on PA frequency through the mediator of PA persistence. Participants were 223 middle school students (115 boys, 108 girls) in grades 7 and 8. We found that, regardless of grade level, girls had lower perceived competence and PE enjoyment than boys. Both perceived competence and PE enjoyment had significant direct and positive connections to persistence, but they had no significant indirect effects on PA frequency through the mediator of persistence. These findings highlight the need for physical educators to be aware of gender differences in perceived competence and PE enjoyment, and the important roles these factors have in enhancing students’ PA participation.
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    Tobacco-control policy support among people from low socioeconomic positions in Massachusetts
    (Elsevier, 2023) Vázquez-Otero, Coralia; Bekalu, Mesfin A.; Dhawan, Dhriti; Viswanath, Kasisomayajula
    People from low socioeconomic positions (SEP) are at a higher risk of smoking, face greater barriers to smoking cessation, and have lower access to health information. To improve tobacco-related health outcomes, policies requiring altering labeling on cigarette packs could be implemented. However, public support is needed to influence the policymaking process. We assessed factors associated with supporting tobacco-control communication policies. We analyzed data from Project CLEAR, a study conducted in Massachusetts. The analytic sample included participants who answered questions on their support for three policies: 1) graphic health warnings (GHWs), 2) Quitline number, and 3) smoking cessation information on cigarette packs (n = 357). Binomial logistic regression modeling was conducted by policy. Independent variables included demographic characteristics and smoking status. We found that younger vs. older individuals (aOR = 0.41, 95 %CI:0.23–0.72), males vs. females (aOR = 0.58, 95 %CI:0.35–0.96), and people who smoke vs. those who don’t smoke (aOR = 0.41, 95 %CI:0.24–0.70) were less likely to support a law requiring GHWs. Participants with a low vs. higher level of education (aOR = 0.55, 95 %CI:0.32–0.95) were less likely to support a law requiring a Quitline number. Younger (18–39) vs. older individuals (aOR = 0.53, 95 %CI:0.29–0.94), males vs. females (aOR = 0.57, 95 %CI:0.34–0.96), and participants with a low vs. higher level of education (aOR = 0.56, 95 %CI:0.32–0.98) were less likely to support a law requiring cessation information on cigarette packs. Findings suggest that targeted theory-based public health and communication strategies should be developed to increase awareness and support towards policies that would help reduce cigarette smoking among people from low SEP to eliminate tobacco-related health inequities in the US.
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    Perceived Family Support Buffers the Impact of PTSD-Depression Symptoms on Suicidal Ideation in College Students
    (SAGE Publications, 2023-05-22) Blessing, Alexis; Russell, Patricia; DeBeer, Bryann B.; Morissette, Sandra B.
    Students reporting symptoms of posttraumatic stress disorder (PTSD) and depression are at increased risk for suicidal ideation, putting them at greater risk for suicidal behavior and attempts. Perceived social support is a robust protective factor against the impact of PTSD and depression on suicidal ideation in college students, however different forms of social support (family, friends, significant others) may have greater influence on this association. In the current study, the influence of the different types of perceived social support on the relationship between PTSD-depression symptoms and suicidal ideation in college students were examined. College students (N = 928; 71% female) were recruited in part of a cross-sectional survey study examining the role of mental health on education functioning. A hierarchical regression indicated that PTSD-depression symptoms (b = .27, p < .001) and perceived family support (b = −.04, p < .01) were significantly associated with current suicidal ideation, while perceived support from friends (b = −.02, p = .417) and significant others (b = −.01, p = .301) were not. Perceived family support interacted with PTSD-depression symptoms (b = −.03, p < .05) to weaken the positive influence of symptoms on current suicidal ideation. Perceived family support appears to be the significant component of social support that moderates the relationship between PTSD-depression symptoms and suicidal ideation. Future research should focus on strengthening family support as a potential mechanism to mitigate suicide risk among college students who may be away from their families for the first time.
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    Male Sexual Dysfunction and the Perpetration of Intimate Partner Violence
    (SAGE Publications, 2023-05-21) Hill, Terrence D.; Garcia-Alexander, Ginny; Sileo, Katelyn; Fahmy, Chantal; Testa, Alexander; Luttinen, Rebecca; Schroeder, Ryan
    We contribute to our understanding of the social epidemiology of intimate partner violence (IPV) by developing a mediation model that frames IPV as an outcome of male sexual dysfunction (performance anxiety and erectile dysfunction) and the mechanisms of masculine discrepancy stress (the perceived failure to conform to internalized normative expectations of masculinity) and anger. Our mediation analyses of recently collected data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of 792 men, confirmed that sexual dysfunction was indirectly associated with the perpetration of any IPV, physical IPV, and sexual IPV through the compound path of masculine discrepancy stress and anger.
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    Acculturative Orientations Among Hispanic/Latinx Caregivers in the ABCD Study: Associations With Caregiver and Youth Mental Health and Youth Brain Function
    (Elsevier, 2023-02-17) Meca, Alan; Peraza, Julio A.; Riedel, Michael C.; Hale, Willie; Pettit, Jeremy W.; Musser, Erica D.; Salo, Taylor; Flannery, Jessica S.; Bottenhorn, Katherine L.; Dick, Anthony S.; Pintos Lobo, Rosario; Ucros, Laura M.; Greaves, Chelsea A.; Hawes, Samuel W.; Sanchez, Mariana; Gonzalez, Marybel R.; Sutherland, Matthew T.; Gonzalez, Raul; Laird, Angela R.
    Background: Population-based neuroscience offers opportunities to examine important but understudied sociocultural factors such as acculturation. Acculturation refers to the extent to which an individual retains their cultural heritage and/or adopts the receiving society’s culture and is particularly salient among Hispanic/Latinx immigrants. Specific acculturative orientations have been linked to vulnerability to substance use, depression, and suicide and are known to influence family dynamics between caregivers and their children. Methods: Using data from first- and second-generation Hispanic/Latinx caregivers in the Adolescent Brain Cognitive Development (ABCD) Study (N = 1057), we examined how caregivers’ acculturative orientation affects their mental health, as well as the mental health and brain function of their children. Neuroimaging analyses focused on regions associated with self- and affiliation-based social processing (ventromedial prefrontal cortex, insula, and temporoparietal junction). Results: We identified 2 profiles of caregiver acculturation: bicultural (retains heritage culture while adopting U.S. culture) and detached (discards heritage culture and rejects U.S. culture). Bicultural caregivers exhibited fewer internalizing and externalizing problems than detached caregivers; furthermore, youth exhibited similar internalizing effects across caregiver profiles. In addition, youth with bicultural caregivers displayed increased resting-state brain activity (i.e., fractional amplitude of low-frequency fluctuations and regional homogeneity) in the left insula, which has been linked to psychopathology; however, differences in long-range functional connectivity were not significant. Conclusions: Caregiver acculturation is an important familial factor that has been linked to significant differences in youth mental health and insula activity. Future work should examine sociocultural and neurodevelopmental changes across adolescence to assess health outcomes and determine whether localized, corticolimbic brain effects are ultimately translated into long-range connectivity differences.
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    Spatiotemporal Variations and Determinants of Under-Five Stunting in Ethiopia
    (SAGE Publications, 2023-02-23) Bitew, Fikrewold H.; Sparks, Corey S.; Nyarko, Samuel H.; Apgar, Lauren
    Background: Stunting has been a major concern in sub-Saharan Africa. However, little evidence exists on the spatiotemporal variations in under-five stunting within a national context. Objective: This paper examines the spatiotemporal variations in under-five stunting and determinants using data from the Ethiopia Demographic and Health Surveys (2000-2016). Methods: Spatial autocorrelation and multilevel logistic regression models were used to conduct the analyses. Results: The stunting prevalence has decreased from 51% to 37%, while the prevalence of severe stunting has decreased by more than half (from 28% to 12%). Wide regional variations in stunting have been consistently observed over the years, which exhibited a higher level of stunting in Tigray (48%), Afar (42%), and Amhara (42%). The results show considerable local and regional variations in under-five stunting levels with diverse patterns of improvements in regional stunting levels over time. Stunting levels were associated with child-level factors such as the sex of a child, birth size, age of a child, birth order, preceding birth interval, and place of birth. Maternal educational attainment, nutritional status, household wealth, toilet facility type, and place of residence were linked to under-five stunting. The regional-level infant mortality rate was associated with under-five stunting. Conclusions: Specially tailored policies and interventions should be devised to address persistent spatial inequalities in stunting by focusing on higher risk populations.
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    Gender Role Discrepancy Stress and COVID-19 Prevention Behaviors Among Men in the United States
    (SAGE Publications, 2023-01-17) Sileo, Katelyn M.; Luttinen, Rebecca; Muñoz, Suyapa; Hill, Terrence D.
    Purpose: To examine the associations between gender role discrepancy (non-conformity to socially prescribed masculine gender role norms) and discrepancy stress (distress arising from this discrepancy) on COVID-19 prevention behaviors among men, and the potential moderating effects of race/ethnicity, sexual orientation, and income on these relationships. Design: A national online survey was conducted between May and June 2021. Setting: The United States. Subjects: 749 adult men residing in the United States. Measures: A scale measured gender role discrepancy and discrepancy stress. COVID-19 prevention outcomes were constructed and included self-reported vaccination status/intentions, social distancing, mask-wearing, and hand-sanitizing. Analysis: Multivariate generalized linear models were performed in SPSS. Results: Gender role discrepancy associated with greater odds of vaccination (AOR = 1.35, 95% CI = 1.02-1.78, P = .04), while discrepancy stress associated with lower odds of vaccination (AOR = .48, 95% CI = .35-.68, P < 0. 001) and mask-wearing (AOR = .54, 95% CI = .37-.79, P = .001) for men overall. Discrepancy stress’s negative effect on specific COVID-19 prevention behaviors was only apparent or was amplified for men in lower income brackets (vaccination, social distancing, mask-wearing), racial/ethnic minority men (vaccination), and sexual minority men (social distancing). Conclusion: This study demonstrates that gender role discrepancy stress negatively affects men’s engagement in COVID-19 prevention, particularly for men in marginalized populations.
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    Mechanisms Linking Masculine Discrepancy Stress and the Perpetration of Intimate Partner Violence Among Men in the United States
    (SAGE Publications, 2022-08-26) Sileo, Katelyn M.; Luttinen, Rebecca; Muñoz, Suyapa; Hill, Terrence D.
    Although studies show that masculine discrepancy stress (i.e., the intrapsychic strain associated with failing to meet internalized masculine ideals) is associated with intimate partner violence (IPV) perpetration, little is known about the processes underlying this association. There may be other social psychological constructs at play that explain this relationship further. The present study uses recently collected data from a national survey of men living in the United States (n = 711) to formally test whether the effects of discrepancy stress on three different forms of IPV perpetration are mediated by anger, self-esteem, and perceived powerlessness. We find that discrepancy stress is directly associated with higher levels of anger, lower levels self-esteem, a sense of powerlessness, and a greater odds of perpetrating any physical IPV and severe physical IPV resulting in injuries, but not sexual IPV perpetration in our sample of men. Our mediation analyses confirms that masculine discrepancy stress is indirectly associated with perpetrating all three forms of IPV through the mechanism of anger. Self-esteem and perceived powerlessness are not supported as mediators. These findings add to our understanding of the link between masculinity and violence perpetration and can inform IPV reduction interventions. Gender transformative interventions that reduce discrepancy stress among men by shifting men’s adherence to traditional masculine norms, and that integrate anger management strategies, should be explored in future research.