Leslie Adams

All Publications

• Structural racism and intimate partner violence perpetration among racially diverse men transitioning into fatherhood: an anti-racist approach to IPV prevention. Injury epidemiology Willie, T. C., Linton, S., Adams, L. B., Overstreet, N. M., Whittaker, S., Faller, T., Knight, D., Kershaw, T. S. 2025; 12 (1): 10

  Abstract

  Young couples transitioning into parenthood are at elevated risk of experiencing intimate partner violence (IPV), in part, due to the social and economic stressors associated with this critical time. Interpersonal racial discrimination is a known risk factor for male-to-female IPV perpetration, however few studies have examined this relationship among men transitioning to fatherhood. Similarly, structural racism acknowledges how inequitable systems reinforce racial discrimination; yet, few studies have investigated whether structural racism relates to the discrimination-IPV perpetration association. This study examined relationships among structural racism, racial discrimination, stress, and IPV perpetration among racially diverse men transitioning into fatherhood.Using data from the 2007-2011 American Community Survey, a structural racism was assessed using a latent variable with four indicators: racial residential segregation, education inequity, income inequity, and employment inequity. Individual-level prospective data were collected during 2007-2011 from 296 men in expectant couples recruited from obstetrics, and ultrasound clinics in Connecticut. Structural equation models were conducted to investigate longitudinal associations among structural racism, discrimination, stress, optimism and emotional IPV perpetration.Compared to white men, Black men were more likely to experience structural racism (B = 0.95, p <.001). Structural racism was associated with more racial discrimination (B = 0.45, p <.05), more stress (B = 0.40, p <.05), and less optimism (B=-0.50, p <.001). Racial discrimination was associated with more stress (B = 0.23, p <.05) and marginally associated with a greater likelihood to perpetrate emotional violence against a female partner (B = 0.23, p =.06). Stress was associated with a greater likelihood to perpetrate emotional violence against a female partner (B = 0.31, p =.05). The indirect path from structural racism to IPV perpetration via racial discrimination and stress was marginally significant (B = 0.05, p =.07).This study provides evidence of the ways in which structural racism in housing, education, income, and employment can contribute to men's use of aggression and violence against a female partner. Future intervention efforts to reduce emotional IPV perpetration could benefit from addressing structural racism.

  View details for DOI 10.1186/s40621-025-00562-4

  View details for PubMedID 40012062

  View details for PubMedCentralID PMC11866592

• NAVIGATING DIVERSITY THROUGH CODING AND THEMATIC ANALYSIS IN QUALITATIVE RESEARCH Velez, G. E., Spencer, A. E., Adams, L. B., Florez, M., Martin, A. ELSEVIER SCIENCE INC. 2024: S383

  View details for DOI 10.1016/j.jaac.2024.07.894

  View details for Web of Science ID 001330511903204

• Masculinity and Afrocentric Worldview: Assessing Risk and Protective Factors of Self-Reliance and Ubuntu on Young Black Men's Suicide Ideation. Journal of racial and ethnic health disparities Lateef, H., Adams, L., Leach, B., Boahen-Boaten, B., Jallesma, F., Bernard, D., Williams, E. D. 2024

  Abstract

  Over the past three decades, there has been a disproportionate increase in premature deaths among young Black Males (YMBs) in the US. This devastating trend has been largely driven by suicide in YBMs. Ecological and interpersonal psychological theories can be leveraged to understand the etiology of premature death in YBMs through both risk and protective factors. This cross-sectional study assessed the influence of depression, self-reliance, Ubuntu (a commonly noted feature of the Afrocentric worldview), and attitudes toward mental health help-seeking behaviors on suicidal ideation among YBMs.Participants (n = 422) who were identified as male, Black American, or African American and aged 18-29 years old completed an online survey between June and July 2022. Ordinal logistic regression correctly classified 76.5% of cases and found a statistically significant difference between observed and expected values.The odds of reporting suicidal ideation were higher among those with more symptoms of depression and self-reliance and lower among participants who reported more compassion compared to the reference group.These findings suggest that compassion, an important aspect of Ubuntu, may have a protective effect against suicidal ideation, whereas high levels of depression and self-reliance may be linked to a greater vulnerability to suicidal ideation. As such, the current study recommends that interventions should reduce suicidal ideation and increase mental well-being among YBMs.

  View details for DOI 10.1007/s40615-024-02098-7

  View details for PubMedID 39039262

  View details for PubMedCentralID PMC11751127

• Acceptability and Feasibility of a Smartphone-Based Real-Time Assessment of Suicide Among Black Men: Mixed Methods Pilot Study. JMIR formative research Adams, L. B., Watts, T., DeVinney, A., Haroz, E. E., Thrul, J., Stephens, J. B., Campbell, M. N., Antoine, D., Lê Cook, B., Joe, S., Thorpe, R. J. 2024; 8: e48992

  Abstract

  Suicide rates in the United States have increased recently among Black men. To address this public health crisis, smartphone-based ecological momentary assessment (EMA) platforms are a promising way to collect dynamic, real-time data that can help improve suicide prevention efforts. Despite the promise of this methodology, little is known about its suitability in detecting experiences related to suicidal thoughts and behavior (STB) among Black men.This study aims to clarify the acceptability and feasibility of using smartphone-based EMA through a pilot study that assesses the user experience among Black men.We recruited Black men aged 18 years and older using the MyChart patient portal messaging (the patient-facing side of the Epic electronic medical record system) or outpatient provider referrals. Eligible participants self-identified as Black men with a previous history of STB and ownership of an Android or iOS smartphone. Eligible participants completed a 7-day smartphone-based EMA study. They received a prompt 4 times per day to complete a brief survey detailing their STB, as well as proximal risk factors, such as depression, social isolation, and feeling like a burden to others. At the conclusion of each day, participants also received a daily diary survey detailing their sleep quality and their daily experiences of everyday discrimination. Participants completed a semistructured exit interview of 60-90 minutes at the study's conclusion.In total, 10 participants completed 166 EMA surveys and 39 daily diary entries. A total of 4 of the 10 participants completed 75% (21/28) or more of the EMA surveys, while 9 (90%) out of 10 completed 25% (7/28) or more. The average completion rate of all surveys was 58% (20.3/35), with a minimum of 17% (6/35) and maximum of 100% (35/35). A total of 4 (40%) out of 10 participants completed daily diary entries for the full pilot study. No safety-related incidents were reported. On average, participants took 2.08 minutes to complete EMA prompts and 2.72 minutes for daily diary surveys. Our qualitative results generally affirm the acceptability and feasibility of the study procedures, but the participants noted difficulties with the technology and the redundancy of the survey questions. Emerging themes also addressed issues such as reduced EMA survey compliance and diminished mood related to deficit-framed questions related to suicide.Findings from this study will be used to clarify the suitability of EMA for Black men. Overall, our EMA pilot study demonstrated mixed feasibility and acceptability when delivered through smartphone-based apps to Black men. Specific recommendations are provided for managing safety within these study designs and for refinements in future intervention and implementation science research.RR2-10.2196/31241.

  View details for DOI 10.2196/48992

  View details for PubMedID 38252475

  View details for PubMedCentralID PMC10845025

• Factors Associated With Suicide in Four West African Countries Among Adolescent Students: An Analysis Using the Global School-Based Student Health Survey. The Journal of adolescent health : official publication of the Society for Adolescent Medicine Diallo, I., Aldridge, L. R., Bass, J., Adams, L. B., Spira, A. P. 2023; 73 (3): 494-502

  Abstract

  Globally, suicide is a leading cause of death among adolescents, with the highest burden of suicide occurring in Africa. Despite this, little is known about the epidemiology of suicide among adolescents in West Africa. In this study, we explore suicidality among West African adolescents.Using pooled data from the Global School-Based Student Health Survey in four West African countries (Ghana, Benin, Liberia, and Sierra Leone), we investigated the prevalence of suicidal ideation and suicide attempt and examined associations with 15 covariates using univariate and multivariable logistic regression.Overall, 18.6% of adolescents in the pooled sample (N = 9,726) had considered suicide, while 24.7% reported attempting suicide. Significant correlates of suicide attempt included older age (16+ years; odds ratio [OR]: 1.70, confidence interval [CI]: 1.09-2.63), difficulty sleeping due to worry (OR: 1.27, CI: 1.04-1.56), loneliness (OR: 1.65, CI: 1.39-1.96), truancy (OR: 1.38. CI: 1.05-1.82), being a target of bullying (OR: 1.53, CI: 1.26-1.85), getting physically attacked (OR: 1.73, CI: 1.42-2.11), physical fighting (OR: 1.47, CI: 1.21-1.79), current cigarette use (OR: 2.71, CI: 1.88-3.89), and initiation of drug use (OR: 2.19, CI: 1.71-2.81). Conversely, having close friends was associated with lower odds of suicide attempt (OR: 0.67, CI: 0.48-0.93). Several covariates were also significantly associated with suicidal ideation.Suicidal ideation and attempts are highly prevalent among school-going adolescents in these West African countries. Multiple modifiable risk and protective factors were identified. Programs, interventions, and policies aimed at addressing these factors may play a significant role in preventing suicides in these countries.

  View details for DOI 10.1016/j.jadohealth.2023.04.017

  View details for PubMedID 37330706

• Investigating the Role of Suicidality and Ethnic Identity among Black Adolescents: A Latent Profile Analysis. Archives of suicide research : official journal of the International Academy for Suicide Research Bernard, D. L., Adams, L. B., Lateef, H. A., Azasu, E., Joe, S. 2023; 27 (4): 1261-1277

  Abstract

  Suicide among Black adolescent youth has steadily increased in recent years, yet few studies describe how facets of social identity shape suicidal thoughts and behaviors (STBs) during this critical stage of development. Ethnic identity represents an underexplored, yet important element of social identity among Black youth that may contribute to differential associations with STBs. This study examined the association between ethnic identity and self-reported suicidal ideation, planning, and attempts.Data were drawn from 1,170 African American (n = 810) and Caribbean Black (n = 368) adolescents aged 13-17 (Mean age = 15) that participated in the National Survey of American Life Adolescent supplement study.Using latent profile analyses, three patterns of ethnic identity were identified: Undifferentiated, Low Ethnic Identification, and Alienated. Caribbean Black adolescents were more likely to be in the Low Ethnic Identification class relative to the Undifferentiated class. Adolescents in the Undifferentiated group reported higher proportions of suicidal ideation, planning, and attempts compared to the remaining latent profile groups.Findings demonstrate that ethnic identity is an important aspect of social identity that can influence STBs among Black adolescents. Considering increased suicide attempts and death rates among Black youth, findings underscore the importance of examining culturally relevant developmental processes that may shape suicidal beliefs and behaviors.

  View details for DOI 10.1080/13811118.2022.2114868

  View details for PubMedID 36004769

  View details for PubMedCentralID PMC9958283

• A Cascade of Care Model for Suicide Prevention. American journal of preventive medicine Haroz, E. E., Sarapik, L. M., Adams, L. B., Nestadt, P. S., Athey, A., Alvarez, K., Slade, E. P., Cwik, M., Berman, A. L., Wilcox, H. C. 2023; 64 (4): 599-603

  View details for DOI 10.1016/j.amepre.2022.09.022

  View details for PubMedID 36402646

  View details for PubMedCentralID PMC10166000

• Achieving mental health equity in Black male suicide prevention. Frontiers in public health Adams, L. B., Thorpe, R. J. 2023; 11: 1113222

  Abstract

  Despite a steady decrease in suicide rates in the United States, the rate among Black males has increased in recent decades. Moreover, suicide is now positioned as the third leading cause of death in this population, signaling a public health crisis. Enhancing the ability for future suicide prevention scholars to fully characterize and intervene on suicide risk factors is an emerging health equity priority, yet there is little empirical evidence to robustly investigate the alarming trends in Black male suicide. We present fundamental areas of expansion in suicide prevention research focused on establishing culturally responsive strategies to achieve mental health equity. Notably, we identify gaps in existing research and offer future recommendation to reduce suicide death among Black males. Our perspective aims to present important and innovative solutions for ensuring the inclusion of Black males in need of suicide prevention and intervention efforts.

  View details for DOI 10.3389/fpubh.2023.1113222

  View details for PubMedID 37064715

  View details for PubMedCentralID PMC10098101

• Understanding the Role of Past Health Care Discrimination in Help-Seeking and Shared Decision-Making for Depression Treatment Preferences. Qualitative health research Progovac, A. M., Cortes, D. E., Chambers, V., Delman, J., Delman, D., McCormick, D., Lee, E., De Castro, S., Sanchez Roman, M. J., Kaushal, N. A., Creedon, T. B., Sonik, R. A., Quinerly, C. R., Rodgers, C. R., Adams, L. B., Nakash, O., Moradi, A., Abolaban, H., Flomenhoft, T., Nabisere, R., Mann, Z., Hou, S. S., Shaikh, F. N., Flores, M., Jordan, D., Carson, N. J., Carle, A. C., Lu, F., Tran, N. M., Moyer, M., Cook, B. L. 2020: 1049732320937663

  Abstract

  As a part of a larger, mixed-methods research study, we conducted semi-structured interviews with 21 adults with depressive symptoms to understand the role that past health care discrimination plays in shaping help-seeking for depression treatment and receiving preferred treatment modalities. We recruited to achieve heterogeneity of racial/ethnic backgrounds and history of health care discrimination in our participant sample. Participants were Hispanic/Latino (n = 4), non-Hispanic/Latino Black (n = 8), or non-Hispanic/Latino White (n = 9). Twelve reported health care discrimination due to race/ethnicity, language, perceived social class, and/or mental health diagnosis. Health care discrimination exacerbated barriers to initiating and continuing depression treatment among patients from diverse backgrounds or with stigmatized mental health conditions. Treatment preferences emerged as fluid and shaped by shared decisions made within a trustworthy patient-provider relationship. However, patients who had experienced health care discrimination faced greater challenges to forming trusting relationships with providers and thus engaging in shared decision-making processes.

  View details for DOI 10.1177/1049732320937663

  View details for PubMedID 32713258

• DEPRESSIVE SYMPTOMS, SLEEP, AND QUALITY OF LIFE IN ADULTS WITH CHRONIC CONDITIONS Diallo, I., Bass, J., Musci, R., Adams, L., Gallo, J., Spira, A. OXFORD UNIV PRESS. 2024: 1020

  View details for DOI 10.1093/geroni/igae098.3284

  View details for Web of Science ID 001394198701310

• Structural racism, interpersonal discrimination, and IPV perpetration among heterosexual men transitioning to parenthood Willie, T. C., Adams, L., Linton, S., Whittaker, S., Phillips, K., Knight, D., Overstreet, N., Kershaw, T. WILEY. 2024: 48-49

  View details for Web of Science ID 001376753800092

• Eliciting patient past experiences of healthcare discrimination as a potential pathway to reduce health disparities: A qualitative study of primary care staff HEALTH SERVICES RESEARCH Cortes, D. E., Progovac, A. M., Lu, F., Lee, E., Tran, N. M., Moyer, M. A., Odayar, V., Rodgers, C. R., Adams, L., Chambers, V., Delman, J., Delman, D., de Castro, S., Sanchez Roman, M., Kaushal, N. A., Creedon, T. B., Sonik, R. A., Rodriguez Quinerly, C., Nakash, O., Moradi, A., Abolaban, H., Flomenhoft, T., Nabisere, R., Mann, Z., Shu-Yeu Hou, S., Shaikh, F. N., Flores, M. W., Jordan, D., Carson, N., Carle, A. C., Le Cook, B., McCormick, D. 2024: e14373

  Abstract

  To understand whether and how primary care providers and staff elicit patients' past experiences of healthcare discrimination when providing care.Twenty qualitative semi-structured interviews were conducted with healthcare staff in primary care roles to inform future interventions to integrate data about past experiences of healthcare discrimination into clinical care.Qualitative study.Data were collected via semi-structured qualitative interviews between December 2018 and January 2019, with health care staff in primary care roles at a hospital-based clinic within an urban safety-net health system that serves a patient population with significant racial, ethnic, and linguistic diversity.Providers did not routinely, or in a structured way, elicit information about past experiences of healthcare discrimination. Some providers believed that information about healthcare discrimination experiences could allow them to be more aware of and responsive to their patients' needs and to establish more trusting relationships. Others did not deem it appropriate or useful to elicit such information and were concerned about challenges in collecting and effectively using such data.While providers see value in eliciting past experiences of discrimination, directly and systematically discussing such experiences with patients during a primary care encounter is challenging for them. Collecting this information in primary care settings will likely require implementation of multilevel systematic data collection strategies. Findings presented here can help identify clinic-level opportunities to do so.

  View details for DOI 10.1111/1475-6773.14373

  View details for Web of Science ID 001298609800001

  View details for PubMedID 39192536

• The Association Between HIV-Related Stigma and the Uptake of HIV Testing and ART Among Older Adults in Rural South Africa: Findings from the HAALSI Cohort Study AIDS AND BEHAVIOR Mahlalela, N. B., Manne-Goehler, J., Ohene-Kwofie, D., Adams, L. B., Montana, L., Kahn, K., Rohr, J. K., Baernighausen, T., Gomez-Olive, F. X. 2024; 28 (3): 1104-1121

  Abstract

  HIV testing and antiretroviral therapy (ART) remain critical for curbing the spread of HIV/AIDS, but stigma can impede access to these services. Using data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we used a multivariable logistic regression to examine the correlation between HIV-related stigma, HIV testing and ART uptake in older adults. We used four questions to measure stigma, with three assessing social stigma (reflecting social distancing preferences) and one assessing anticipated stigma (disclosure concern). We combined the three social stigma questions to generate a social stigma score ranging from 0 to 3, with higher scores indicating higher stigma. Anticipated stigma was prevalent 85% (95% CI 0.84-0.86), and social stigma was also frequent 25% (95% CI 0.24-0.27). Higher social stigma scores correlated with decreased HIV testing for all participants with social stigma. Compared to those with a score of 0, odds of testing decreased with higher stigma scores (OR = 0.66, 95% CI 0.53-0.81, p = 0.000) for a score of 1 and (OR = 0.56, 95% CI 0.38-0.83, p = 0.004) for a score of 3. ART uptake also decreased with higher social stigma scores among people living with HIV (PLWH), although it was significant for those with a score of 2 (OR = 0.41, 95% CI 0.19-0.87, p = 0.020). These findings emphasize that HIV-related stigma hampers testing and ART uptake among older adults in rural South Africa. Addressing stigma is crucial for improving testing rates, early diagnosis, and treatment initiation among the older population and achieving UNAIDS 95-95-95 targets.

  View details for DOI 10.1007/s10461-023-04222-w

  View details for Web of Science ID 001150465200003

  View details for PubMedID 38286975

  View details for PubMedCentralID PMC10896802

• UNDERSTANDING DIVERSITY THROUGH QUALITATIVE RESEARCH Velez, G. E., Spencer, A. E., Adams, L. B., Florez, M. ELSEVIER SCIENCE INC. 2023: S425-S426

  View details for DOI 10.1016/j.jaac.2023.07.983

  View details for Web of Science ID 001098830402079

• Mental Health Treatment-Seeking Appraisal, Afrocentric Cultural Norms, and Mental Health Functioning: Buffering Factors of Young Black Men's Externalizing Behavior JOURNAL OF RACIAL AND ETHNIC HEALTH DISPARITIES Lateef, H., Adams, L., Bernard, D., Jellesma, F., Frempong, M., Boahen-Boaten, B., Leach, B. B., Borgstrom, E., Nartey, P. B. 2023: 3150-3161

  Abstract

  Depression rates are disproportionately high among Black American Men. This disparity--compounded by low mental healthcare seeking rates and high incorrect diagnosis rates in men--could be related to masculine norms, including self-reliance, restrictive emotionality, and stoicism. Furthermore, men are more likely to engage in externalized behavior, such as aggression, to cope with mental health challenges; this pattern is influenced by cultural and environmental factors. Contrary to these detrimental factors, social relationships, belief in social networks, and collectivism have been associated with positive mental health in these populations. Similarly, an Afrocentric worldview (including concepts like Ubuntu and African self-consciousness) has been hypothesized to promote positive mental health outcomes among Black American men. However, little research exists on harnessing these factors as a means of increasing health-seeking behaviors in young Black males.To elucidate the effect of region, depression, African humanism, collectivism, and help-seeking values and needs concerning aggression in young Black males.This study included Black or African American participants (n = 428) identifying as male, aged 18-25 years, who responded to a Qualtrics survey with questions on region, aggression, depression, African humanism, collectivism, and help-seeking value and need.Hierarchical linear regression revealed that collectivism, humanness, value, and the need for seeking treatment were inversely associated with aggression (p < 0.001).Highlighting the effect of cultural norms and help-seeking behaviors and the aggravating effect of depression on aggression in young Black males can help to develop aggression-mitigating interventions rooted in Afrocentric Norms.

  View details for DOI 10.1007/s40615-023-01771-7

  View details for Web of Science ID 001063558900005

  View details for PubMedID 37624539

  View details for PubMedCentralID PMC10894312

• Demographic predictors of emergency service utilization patterns in youth at risk of suicide SUICIDE AND LIFE-THREATENING BEHAVIOR Bajaj, M. A., Wilcox, H. C., Adams, L. B., Berman, A. L., Cwik, M., Kitchen, C., Miller, L., Nestadt, P. S., Slade, E. P., Haroz, E. E. 2023; 53 (4): 702-712

  Abstract

  To explore demographic predictors of Emergency Department (ED) utilization among youth with a history of suicidality (i.e., ideation or behaviors).Electronic health records were extracted from 2017 to 2021 for 3094 8-22 year-old patients with a history of suicidality at an urban academic medical center ED in the Mid-Atlantic. Logistic regression analyses were used to assess for demographic predictors of ED utilization frequency, timing of subsequent visits, and reasons for subsequent visits over a 24-month follow-up period.Black race (OR = 1.45, 95% CI = 1.11-1.92), Female sex (OR = 1.59, 95% CI = 1.26-2.03), and having Medicaid insurance (OR = 1.71, 95% CI = 1.37-2.14) were associated with increased utilization, while being under 18 was associated with lower utilization (<12: OR = 0.38, 95% CI = 0.26-0.56; 12-18: OR = 0.47, 95% CI = 0.35-0.63). These demographics were also associated with ED readmission within 90 days, while being under 18 was associated with a lower odds of readmission.Among patients with a history of suicidality, those who identify as Black, young adults, patients with Medicaid, and female patients were more likely to be frequent utilizers of the ED within the 2 years following their initial visit. This pattern may suggest inadequate health care access for these groups, and a need to develop better care coordination with an intersectional focus to facilitate utilization of other health services.

  View details for DOI 10.1111/sltb.12975

  View details for Web of Science ID 001025936500001

  View details for PubMedID 37431982

  View details for PubMedCentralID PMC10916713

• The relationship between neighborhood typologies and self-rated health in Maryland: A latent class analysis HEALTH & PLACE Roth, K. B., Goplerud, D. K., Adams, L. B., Maury, M. E., Musci, R. J. 2023; 83: 103079

  Abstract

  Despite widespread evidence that neighborhood conditions impact health, few studies apply theory to clarify the physical and social factors in communities that drive health outcomes. Latent class analysis (LCA) addresses such gaps by identifying distinct neighborhood typologies and the joint influence that neighborhood-level factors play in health promotion. In the current study, we conducted a theory-driven investigation to describe Maryland neighborhood typologies and examined differences in area-level self-rated poor mental and physical health across typologies. We conducted an LCA of Maryland census tracts (n = 1384) using 21 indicators of physical and social characteristics. We estimated differences in tract-level self-rated physical and mental health across neighborhood typologies using global Wald tests and pairwise comparisons. Five neighborhood classes emerged: Suburban Resourced (n = 410, 29.6%), Rural Resourced (n = 313, 22.6%), Urban Underserved (n = 283, 20.4%), Urban Transient (n = 226, 16.3%), Rural Health Shortage (n = 152, 11.0%). Prevalence of self-rated poor physical and mental health varied significantly (p < 0.0001) by neighborhood typology, with the Suburban Resourced neighborhood class demonstrating the lowest prevalence of poor health and the Urban Underserved neighborhoods demonstrating the poorest health. Our results highlight the complexity of defining "healthy" neighborhoods and areas of focus to mitigate community-level health disparities to achieve health equity.

  View details for DOI 10.1016/j.healthplace.2023.103079

  View details for Web of Science ID 001039808700001

  View details for PubMedID 37423092

  View details for PubMedCentralID PMC11311254

• Depressive symptoms and their association with age, chronic conditions and health status among middle-aged and elderly people in peri-urban Tanzania CAMBRIDGE PRISMS-GLOBAL MENTAL HEALTH Stieglitz, L., Adams, L., Baernighausen, T., Berghoefer, A., Kazonda, P. H., Killewo, J., Leyna, G. K., Lohmann, J., Rohr, J., Kohler, S. 2023; 10: e27

  Abstract

  Depression is a global mental health challenge. We assessed the prevalence of depressive symptoms and their association with age, chronic conditions, and health status among middle-aged and elderly people in peri-urban Dar es Salaam, Tanzania.Depressive symptoms were measured in 2,220 adults aged over 40 years from two wards of Dar es Salaam using the ten-item version of the Center of Epidemiologic Studies Depression Scale (CES-D-10) and a cut-off score of 10 or higher. The associations of depressive symptoms with age, 13 common chronic conditions, multimorbidity, self-rated health and any limitation in six activities of daily living were examined in univariable and multivariable logistic regressions.The estimated prevalence of depressive symptoms was 30.7% (95% CI 28.5-32.9). In univariable regressions, belonging to age groups 45-49 years (OR 1.35 [95% CI 1.04-1.75]) and over 70 years (OR 2.35 [95% CI 1.66-3.33]), chronic conditions, including ischemic heart disease (OR 3.43 [95% CI 2.64-4.46]), tuberculosis (OR 2.42 [95% CI 1.64-3.57]), signs of cognitive problems (OR 1.90 [95% CI 1.35-2.67]), stroke (OR 1.56 [95% CI 1.05-2.32]) and anemia (OR 1.32 [95% CI 1.01-1.71]) and limitations in activities of daily living (OR 1.35 [95% CI 1.07-1.70]) increased the odds of depressive symptoms. Reporting good or very good health was associated with lower odds of depressive symptoms (OR 0.48 [95% CI 0.35-0.66]). Ischemic heart disease and tuberculosis remained independent predictors of depressive symptoms in multivariable regressions.Depressive symptoms affected almost one in three people aged over 40 years. Their prevalence differed across age groups and was moderated by chronic conditions, health status and socioeconomic factors.

  View details for DOI 10.1017/gmh.2023.17

  View details for Web of Science ID 001000368300001

  View details for PubMedID 37854410

  View details for PubMedCentralID PMC10579685

• <i>When Death Hits You in Your Face, You Have to Listen":</i> A Qualitative Investigation of Peer Bereavement Support Volunteers in Black American Communities OMEGA-JOURNAL OF DEATH AND DYING Adams, L., Athey, A., Brooks, K., Lazarus, K., DeVinney, A., Leaf, P. J. 2023: 302228231161816

  Abstract

  Efforts to support grief in Black American communities are often under-recognized despite their potential to address negative mental health outcomes in this population. The aim of the current study was to qualitatively assess the community-level influence of bereavement support programs on predominantly Black communities in Baltimore, Maryland. Five focus groups (n = 23) were conducted with volunteers from a non-profit bereavement organization. Participants were queried about how their training may be sustainably applied as a community resource in Baltimore City. Thematic analysis from focus groups revealed three main themes: (1) enhancing feelings of belongingness fosters a sense of community cohesion, (2) use of bereavement support tools as a source of personal healing, and (3) applications of bereavement support in the community. Implications of our study support the widespread influence of peer-led bereavement support training to reduce the reverberating impact of personal and collective grief in Black American communities.

  View details for DOI 10.1177/00302228231161816

  View details for Web of Science ID 000941796200001

  View details for PubMedID 36857204

  View details for PubMedCentralID PMC10471771

• Rapid and Deferred Help Seeking Among African American Parents of Children With Emotional and Behavioral Difficulties. Psychiatric services (Washington, D.C.) Richmond, J., Adams, L. B., Annis, I. E., Ellis, A. R., Perryman, T., Sikich, L., Thomas, K. C. 2022; 73 (12): 1359-1366

  Abstract

  Little is known about the factors African American parents consider when seeking care for their child after emotional and behavioral difficulties emerge. This study aimed to examine factors associated with seeking professional care within 30 days after identifying a child's need (i.e., rapid care seeking) and with deferring care for ≥1 year.This cross-sectional study surveyed African American parents raising a child with emotional or developmental challenges (N=289). Logistic regression was used to examine associations of parent activation, medical mistrust, and care-seeking barriers with two outcomes: rapidly seeking care and deferring care seeking.About 22% of parents rapidly sought care, and 49% deferred care for 1 year or longer. Parents were more likely to rapidly seek care if they had higher parent activation scores; lived with other adults with mental health challenges; or, contrary to the authors' hypothesis, mistrusted doctors. Parents were less likely to rapidly seek care if the challenge did not initially bother them much or if their health insurance would not cover the service. Parents were more likely to defer care if they feared involuntary hospitalization for their child or if their health insurance would not cover the service. Parents were less likely to defer care if they had at least some college education or lived with other adults with mental health challenges.Community-based pediatric and child welfare professionals should be informed about facilitators and barriers to mental health care seeking as part of efforts to develop interventions that support African American families.

  View details for DOI 10.1176/appi.ps.202100553

  View details for PubMedID 35678082

  View details for PubMedCentralID PMC9722499

• Marital experiences and depressive symptoms among older adults in rural South Africa. SSM. Mental health Jennings, E. A., Chinogurei, C., Adams, L. 2022; 2

  Abstract

  This paper advances the understanding of how marital transitions may influence mental health by investigating these associations among a population of rural, Black South Africans aged 40+ that was directly impacted by apartheid. Using two waves of data from 4,176 men and women in Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we investigated associations between marital experiences and depressive symptoms, by gender, and explored whether economic resources is a moderator of these associations. We found that experiencing a marital dissolution was associated with more depressive symptoms than remaining married for both men and women. We also found that men, but not women, report greater depressive symptoms if they remained separated/divorced, remained widowed, or remained never married between waves. We found no evidence that a decline in wealth moderated the impact of marital dissolution on depressive symptoms for women or men. These findings suggest that the documented benefits of marriage for mental health, and differences by gender in those benefits, may extend to older, rural South Africans, despite the unique experiences of this population.

  View details for DOI 10.1016/j.ssmmh.2022.100083

  View details for PubMedID 36277994

• Typologies of mental healthcare discrimination experiences and associations with current provider care ratings: A latent class analysis. SSM. Mental health Adams, L. B., Zimmer, C., Progovac, A. M., Creedon, T., Rodgers, C. R., Sonik, R. A., Cook, B. L. 2022; 2

  Abstract

  Discrimination is experienced across demographic attributes (e.g., race and gender) and vantage points (e.g., personal and vicarious), yet few studies have classified these different experiences of discrimination within healthcare systems. Moreover, which discriminatory experiences have greater influence on patient-reported quality outcomes remains poorly understood. To address these gaps, we used latent class analysis (LCA) to identify typologies of past experiences with healthcare discrimination among adults with depression-who experience more frequent and stigmatizing healthcare interactions than the general population-and assess the relationship between class membership and current ratings of patient-reported quality outcomes.We surveyed a nationally representative sample of adults with depression (n = 803) to assess past experiences of discrimination by medical providers in terms of both the characteristics targeted for discrimination and whether healthcare discrimination was experienced personally or by friends and family members. We conducted an LCA to identify discrimination-exposure classes and a modified Poisson regression to identify associations between class membership and patient-reported quality outcomes (e.g., overall medical provider quality, respect, clear communication, and careful listening), while adjusting for covariates.We identified four latent classes of healthcare discrimination: low discrimination (LD; referent class: 72.2% of total sample), vicarious linguistic discrimination (VL; 13.9%), elevated personal and vicarious racial discrimination (EPVR; 10.5%), and high racial/ethnic discrimination (HRE; 3.4%). Compared to those in the LD class, individuals in the EPVR class had higher rates of reporting their current medical provider's respect and careful listening skills as sometimes or never, (Respect aIRR: 1.90, 95% CI: 1.05-3.42; Listening aIRR: 2.18, 95% CI: 1.29-3.66). Those in the HRE class reported higher rates of reporting their medical provider's quality and communication as poor or fair and lower ratings of careful listening (Quality aIRR: 2.06, 95% CI: 1.08-3.93; Communication aIRR: 1.97, 95% CI: 1.00-3.63; Listening aIRR: 2.41, 95% CI: 1.27-4.59), compared to those in the LD class. Those in the VL class had higher rates of reporting that their medical provider never or sometimes respected or carefully listened to them (Respect aIRR: 2.12, 95% CI: 1.20-3.72; Listening aIRR:1.67, 95% CI:1.03-2.71) than those in, the LD class.Healthcare organizations committed to providing equitable patient care should establish more robust quality improvement approaches to prevent discrimination at the medical provider level as well as structures of accountability to reconcile previously embedded social inequities within the healthcare system.

  View details for DOI 10.1016/j.ssmmh.2022.100105

  View details for PubMedID 36819115

  View details for PubMedCentralID PMC9937509

• Factor analysis of the Center for Epidemiological Studies Depression Scale in American Indian women RESEARCH IN NURSING & HEALTH Brooks, J. L., Adams, L. B., Woods-Giscombe, C. L., Currin, E. G., Corbie-Smith, G. M. 2022; 45 (6): 733-741

  Abstract

  The Center for Epidemiological Studies Depression Scale (CES-D) is widely used to assess depressive symptoms in the general population. It lacks validation for widespread use within the American Indian population, however. To address this gap, we explored and confirmed the factor structure of the CES-D among a community sample of southeastern American Indian women. We analyzed data from a sample of 150 American Indian women ages 18-50 from a southeastern tribe who had complete responses on the CES-D as part of a larger cross-sectional, community-engaged study. We performed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to assess the measure's validity. We examined EFA models ranging from one to five factors, with the four-factor structure yielding the best overall model fit (CFI = 1.00, TLI = 0.99, RMSEA = 0.03). Differences between the four-factor EFA-retained structure from our sample and Radloff's four-factor structure emerged. Only the interpersonal factor was common to both factor structures. Our study findings confirm the validity of the original four-factor structure of the CES-D for younger adult American Indian women in the southeast. Contrasting findings with the EFA-retained structure, however, provide a more nuanced interpretation of our results.

  View details for DOI 10.1002/nur.22267

  View details for Web of Science ID 000859071300001

  View details for PubMedID 36161722

  View details for PubMedCentralID PMC9922528

• Perceived healthcare discrimination and well-being among older adults in the United States and Brazil. SSM - population health Dixon, A. R., Adams, L. B., Ma, T. 2022; 18: 101113

  Abstract

  Despite well-documented evidence illustrating the relationship between discrimination and health, less is known about the influence of unfair treatment when receiving medical care. Moreover, our current knowledge of cross-national and racial variations in healthcare discrimination is limited in aging populations. This article addresses these gaps using two harmonized data sets of aging populations to clarify the relationship between healthcare discrimination and health in the United States and Brazil. We use nationally representative, harmonized data from the Health and Retirement Study in the United States and the Brazilian Longitudinal Study of Aging to examine and compare perceived discrimination in the healthcare setting and its relationship to self-rated health, depression diagnosis, and depressive symptoms across national contexts. Using Poisson regression models and population attributable risk percent estimates, we found that aging adults reporting healthcare discrimination were at higher risk of poor self-rated health, diagnosed depression, and depressive symptoms. Our results also suggest that reducing perceived healthcare discrimination may contribute to improved self-rated health and mental well-being in later life across racialized societies. In two comparative settings, we highlight the differential impact of healthcare discrimination on self-rated health and depression. We describe the implications of our study's findings for national public health strategies focused on eliminating discrimination in the healthcare setting, particularly among aging countries.

  View details for DOI 10.1016/j.ssmph.2022.101113

  View details for PubMedID 35664925

  View details for PubMedCentralID PMC9160820

• Suicide attempt endophenotypes: Latent profiles of child and adolescent aggression and impulsivity differentially predict suicide attempt in females PREVENTIVE MEDICINE REPORTS Musci, R. J., Ballard, E. D., Stapp, E. K., Adams, L., Wilcox, H. C., Ialongo, N. 2022; 28: 101829

  Abstract

  Suicide is a leading cause of death in young adulthood. Identifying early prevention targets to reduce later suicide is a public health priority. Impulsivity and aggression in early childhood may represent actionable early prevention candidate endophenotypes for later suicidal behavior. Our objective is to to understand the association of aggression and impulsivity trajectories with mental health outcomes to inform future prevention efforts. Participants were part of a longitudinal cohort of a preventative intervention trial (n = 597) and predominantly Black. They were assessed for aggressive and impulsive behaviors yearly in 1st-3rd and 6th-12th grades, and provided mental health data via self-report beginning in 6th grade. Longitudinal latent profiles of aggressive and impulsive behaviors were derived for males and females and used to determine whether profiles was associated with lifetime suicide attempt and meeting diagnostic criteria for major depressive disorder. Two impulsivity and aggression classes were found for males, characterized by low behaviors or moderate to high behaviors across development. Three classes were found for females, one of which was characterized by an undulating pattern of behaviors. For females, the class of severe behaviors was associated with significant risk of suicide attempt (Wald = 6.01, p = 0.05). No relationship was found for males or for MDD diagnosis. An endophenotype model of impulsivity and aggression in predicting later suicide attempt was supported in females, but not males. Results underscore the importance of evaluating sex differences in suicide research and the potential identification of females at risk for later suicidal behavior in school settings.

  View details for DOI 10.1016/j.pmedr.2022.101829

  View details for Web of Science ID 000804931900001

  View details for PubMedID 35620051

  View details for PubMedCentralID PMC9126944

• Methodological Considerations in Scale Refinement with Diverse Populations: A Case Example Using the CES-D with a Community Sample of American Indian Women ISSUES IN MENTAL HEALTH NURSING Brooks, J. L., Knafl, G. J., Adams, L. B., Woods-Giscombe, C. L., Berry, D. C., Currin, E. G., Corbie-Smith, G. M. 2022; 43 (8): 776-783

  Abstract

  Although many psychometric assessments are used extensively in population-based research to determine psychopathology, these tools have not been thoroughly validated or appropriately adapted for use in diverse populations. Indeed, depression measurement studies among American Indian and female populations are scarce, omitting key opportunities to tailor psychological measurement for this population. To build psychometric evidence of measures in this population, we used a procedural method to examine a standard psychological instrument-the Center for Epidemiological Studies Depression Scale (CES-D)-with a community sample of southeast American Indian women. Our results showed strong psychometric reliability of the 20-item CES-D. The "effort" item presented diminished validity, as demonstrated by a negative counter-intuitive item-to-total correlation (ITC) value. Dropping the "effort" item resulted in a 19-item scale with a better fit in the within-group examination of community-based American Indian women. Compared to the 20-item CES-D scale, the revised 19-item measure ("effort" item removed) resulted in minimal changes to women's depression categories. However, we did detect patterns in shifts such that the 19-item scale generally underestimated (i.e., placed women in a lower category) depressive symptoms compared to the 20-item scale. Depending on their study goals, researchers engaging in population-based research should carefully weigh the use of original scales that allow for consistency in reporting with refined scales that fit psychometrically. We present the outlined method as a tool that expands on current approaches in scale refinement, and aids researchers in making more informed decisions regarding refined scales with diverse populations.

  View details for DOI 10.1080/01612840.2022.2053012

  View details for Web of Science ID 000773787200001

  View details for PubMedID 35344449

  View details for PubMedCentralID PMC9375584

• Adolescents' Concerns About School Violence or Shootings and Association With Depressive, Anxiety, and Panic Symptoms JAMA NETWORK OPEN Riehm, K. E., Mojtabai, R., Adams, L. B., Krueger, E. A., Mattingly, D. T., Nestadt, P. S., Leventhal, A. M. 2021; 4 (11): e2132131

  Abstract

  The prevalence of internalizing problems among US adolescents has risen in the past decade. The extent to which concerns about school violence or shootings are associated with risk of internalizing problems is unknown.To examine the prospective association of concern, worry, and stress related to school violence or shootings with internalizing problems and to examine sex and racial and ethnic differences in the magnitude of the associations.This longitudinal cohort study involved 3 surveys administered 6 months apart (fall of grade 11 [prebaseline]; spring of grade 11 [baseline]; and fall of grade 12 [follow-up]) from 2015 to 2016. Participants included 2263 students from 10 high schools in Los Angeles, California. Analyses were performed from April 29, 2020, to April 8, 2021.Baseline self-reported level of concern, worry, and stress about shootings or violence at the student's school or other schools, each rated on 5-point scales (ranging from not at all [0] to extremely [4]) with a mean score calculated as a 3-item composite index rescaled into z-score standard deviation units.Surpassing clinically significant or borderline significant thresholds for major depressive disorder, generalized anxiety disorder, or panic disorder based on symptom ratings on the Revised Children's Anxiety and Depression Scale at 6-month follow-up.Of the 2263 students included in the analyses (1250 [55.2%] girls; mean [SD] age, 16.5 [0.4] years), appreciable proportions reported being very or extremely concerned (850 0f 2226 [38.2%]), worried (703 of 2209 [31.8%]), or stressed (332 of 2183 [15.2%]) about shootings or violence at their school or other schools. After adjusting for prebaseline covariates, concerns about school violence or shootings were associated with clinically significant generalized anxiety symptoms (odds ratio [OR], 1.31; 95% CI, 1.15-1.50) and panic symptoms (OR, 1.18; 95% CI, 1.05-1.32), but not depressive symptoms (OR, 1.13; 95% CI, 0.99-1.30) at the 6-month follow-up. There was a significant association between concern with school violence or shootings and depressive symptoms for Black youth (OR, 3.15; 95% CI, 1.38-7.19) and non-Hispanic/Latinx White youth (OR, 1.62 [95% CI, 1.25-2.09]) but not for youth of other races and ethnicities (OR for Asian, 1.26 [95% CI, 0.86-1.85]; OR for Hispanic/Latinx, 0.94 [95% CI, 0.76-1.16]; OR for other, 0.93 [95% CI, 0.54-1.61]). Sex did not moderate these associations.The findings of this study suggest that concern, worry, and stress related to school violence or shootings may be risk factors for internalizing problems among adolescents, with variation in the strength of the association by race/ethnicity.

  View details for DOI 10.1001/jamanetworkopen.2021.32131

  View details for Web of Science ID 000714704600006

  View details for PubMedID 34724552

  View details for PubMedCentralID PMC8561324

• Assessing the Real-time Influence of Racism-Related Stress and Suicidality Among Black Men: Protocol for an Ecological Momentary Assessment Study JMIR RESEARCH PROTOCOLS Adams, L., Igbinedion, G., DeVinney, A., Azasu, E., Nestadt, P., Thrul, J., Joe, S. 2021; 10 (10): e31241

  Abstract

  Suicide is the third leading cause of death among Black adults aged 18-35 years. Although men represent a majority of suicide deaths among Black adults, less is known regarding the extent to which unique cultural stressors, such as racism-related stress (eg, racial discrimination), are salient in exacerbating suicide risk among Black men. Moreover, few studies examine the daily influence of racism-related stressors on suicide outcomes using real-time smartphone-based approaches. Smartphone-based mobile health approaches using ecological momentary assessments (EMA) provide an opportunity to assess and characterize racism-related stressors as a culturally sensitive suicide risk factor among Black young adult men.The goal of this study is to describe a protocol development process that aims to capture real-time racism-related stressors and suicide outcomes using a smartphone-based EMA platform (MetricWire).Guided by the Interpersonal Theory of Suicide (ITS), we developed a brief EMA protocol using a multiphased approach. First, we conducted a literature review to identify brief measures previously used in EMA studies, with special emphasis on studies including Black participants. The identified measures were then shortened to items with the highest construct validity (eg, factor loadings) and revised to reflect momentary or daily frequency. Feasibility and acceptability of the study protocol will be assessed using self-report survey and qualitative responses. To protect participants from harm, a three-tier safety protocol was developed to identify participants with moderate, elevated, and acute risk based on EMA survey response to trigger outreach by the study coordinator.The final EMA protocol, which will be completed over a 7-day period, is comprised of 15 questions administered 4 times per day and a daily questionnaire of 22 items related to sleep-related impairment and disruption, as well as racism-related stress. Study recruitment is currently underway. We anticipate the study will be completed in February 2023. Dissemination will be conducted through peer-reviewed publications and conference presentations.This protocol will address gaps in our understanding of Black men's suicide outcomes in the social contexts that they regularly navigate and will clarify the temporal role of racism-related stressors that influence suicidal outcomes.PRR1-10.2196/31241.

  View details for DOI 10.2196/31241

  View details for Web of Science ID 000713855600030

  View details for PubMedID 34668869

  View details for PubMedCentralID PMC8567147

• Barriers to and Facilitators of Vocational Development for Black Young Adults With Serious Mental Illnesses PSYCHIATRIC REHABILITATION JOURNAL Delman, J., Adams, L. B. 2022; 45 (1): 1-10

  Abstract

  Black young adults with serious mental illnesses (SMI) have low rates of employment and school completion. Racial disparities exist in the delivery of vocational services, with Black people less likely to be screened in, and if screened in less likely to receive job training. This qualitative exploratory study examined how Black young adults with SMI perceive the barriers and facilitators to achieving their vocational goals.Our conceptual model for this study is the Social-Ecological Model (SEM), which contains four domains of analysis (intrapersonal, interpersonal, community, and societal), informed by Critical Race Theory (CRT). We completed semistructured, qualitative interviews with 28 Black young adults with SMI. We analyzed data using qualitative content and inductive analyses.Numerous respondents were experiencing racial discrimination in their vocational pursuits and their lives overall, and expressed doubts about achieving vocational success in racially imbalanced environments. Facilitating their vocational growth was trusting relationships with nonjudgmental and understanding vocational counselors (VC) who provided supports reflecting client preferences. As college students, respondents benefited from the presence and accessibility of Black faculty and students. As employees, they valued workplace supervisors who provided direct support and feedback.Black young adults with SMI face high and racialized barriers to pursuing work and education at multiple socioecological levels. The field of psychiatric rehabilitation should prepare VCs to understand and address the needs and expressed preferences of Black young adults with SMI. Also called for is research, centered on and directed by Black communities, on the effectiveness of race-conscious vocational practices. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

  View details for DOI 10.1037/prj0000505

  View details for Web of Science ID 000733051300001

  View details for PubMedID 34582230

• Refining Black men's depression measurement using participatory approaches: a concept mapping study BMC PUBLIC HEALTH Adams, L. B., Baxter, S. K., Lightfoot, A. F., Gottfredson, N., Golin, C., Jackson, L. C., Tabron, J., Corbie-Smith, G., Powell, W. 2021; 21 (1): 1194

  Abstract

  Despite cumulative socioeconomic disadvantage and risk factors, Black Americans have a lower prevalence of depression than whites. Given the emerging focus of depression as a public mental health crisis, culturally informed depression measures and scale development techniques are needed to better alleviate the mental health burden of socially marginalized populations. Yet, for Black men, race- and gender-related factors that position emotional vulnerability as a sign of weakness, may potentially mask the timely identification of mental health needs in this population. Thus, we address these gaps by employing a stakeholder-driven, community-engaged process for understanding Black men's depression experience.We use concept mapping, a structured mixed methods approach, to determine how stakeholders of Black men's health conceptualize their depressive symptoms. Thirty-six stakeholders participated in a three-phase concept mapping study conducted in 2018. Three separate stakeholder groups were engaged for this study, including Black men, Black women, and primary care providers.Participants generated 68 characteristics of Black men's depression which were reflected within five conceptual clusters: (1) physical states; (2) emotional states; (3) diminished drive; (4) internal conflicts; (5) communication with others; and (6) social pressures. Using a content analysis approach, we found that items comprising the "social pressures" cluster were not reflected in any common depression scales.Findings from this study illustrate the similar and divergent pathways in which Black men express depressed mood. Furthermore, concept mapping results also yield a novel opportunity for culturally informed scale development in future research.

  View details for DOI 10.1186/s12889-021-11137-5

  View details for Web of Science ID 000665779400011

  View details for PubMedID 34158011

  View details for PubMedCentralID PMC8220674

• Association between psychological resilience and changes in mental distress during the COVID-19 pandemic JOURNAL OF AFFECTIVE DISORDERS Riehm, K. E., Brenneke, S. G., Adams, L. B., Gilan, D., Lieb, K., Kunzler, A. M., Smail, E. J., Holingue, C., Stuart, E. A., Kalb, L. G., Thrul, J. 2021; 282: 381-385

  Abstract

  Psychological responses to potentially traumatic events tend to be heterogeneous, with some individuals displaying resilience. Longitudinal associations between resilience and mental distress during the COVID-19 pandemic, however, are poorly understood. The objective of this study was to examine the association between resilience and trajectories of mental distress during the COVID-19 pandemic.Participants were 6,008 adults from the Understanding America Study, a probability-based Internet-panel representative of the US adult population. Baseline data were collected between March 10 and March 31, 2020, with nine follow-up waves conducted between April 1 and August 4. Mixed-effects logistic regression was used to examine the association between date and mental distress, stratified by resilience level (low, normal, or high).In contrast to the high resilience group, participants in the low and normal resilience groups experienced increases in mental distress in the early months of the pandemic (low: OR=2.94, 95% CI=1.93-4.46; normal: OR=1.91, 95% CI=1.55-2.35). Men, middle-aged and older adults, Black adults, and adults with a graduate degree were more likely to report high resilience, whereas adults living below the poverty line were less likely to report high resilience.These associations should not be interpreted as causal, and resilience was measured at only one time-point.Trajectories of mental distress varied markedly by resilience level during the early months of the COVID-19 pandemic, with low-resilience adults reporting the largest increases in mental distress during this crisis. Activities that foster resilience should be included in broader strategies to support mental health throughout the pandemic.

  View details for DOI 10.1016/j.jad.2020.12.071

  View details for Web of Science ID 000619295400053

  View details for PubMedID 33421866

  View details for PubMedCentralID PMC7889692

• Parent Activation and Child Mental Health Service use in African American Families in a Large Cross-Sectional Study. The Permanente journal Thomas, K. C., Annis, I., Ellis, A. R., Adams, L. B., Davis, S. A., Lightfoot, T., Perryman, T., Wheeley, M., Sikich, L., Morrissey, J. P. 2020; 25: 1

  Abstract

  OBJECTIVES: 1) To describe activation skills of African American parents on behalf of their children with mental health needs. 2) To assess the association between parent activation skills and child mental health service use.METHODS: Data obtained in 2010 and 2011 from African American parents in North Carolina raising a child with mental health needs (n = 325) were used to identify child mental health service use from a medical provider, counselor, therapist, or any of the above or if the child had ever been hospitalized. Logistic regression was used to model the association between parent activation and child mental health service use controlling for predisposing, enabling, and need characteristics of the family and child.RESULTS: Mean parent activation was 65.5%. Over two-thirds (68%) of children had seen a medical provider, 45% had seen a therapist, and 36% had seen a counselor in the past year. A quarter (25%) had been hospitalized. A 10-unit increase in parent activation was associated with a 31% higher odds that a child had seen any outpatient provider for their mental health needs (odds ratio = 1.31, confidence interval = 1.03-1.67, p = 0.03). The association varied by type of provider. Parent activation was not associated with seeing a counselor or a therapist or with being hospitalized.CONCLUSION: African American families with activation skills are engaged and initiate child mental health service use. Findings provide a rationale for investing in the development and implementation of interventions that teach parent activation skills and facilitate their use by practices in order to help reduce disparities in child mental health service use.

  View details for DOI 10.7812/TPP/20.003

  View details for PubMedID 33635757

• Dimensionality and differential item endorsement of depressive symptoms among aging Black populations in South Africa: Findings from the HAALSI study JOURNAL OF AFFECTIVE DISORDERS Adams, L. B., Farrell, M., Mall, S., Mahlalela, N., Berkman, L. 2020; 277: 850-856

  Abstract

  The Center for Epidemiologic Studies-Depression (CES-D) scale is a widely used measure of depressive symptoms, but its construct validity has not been adequately assessed in sub-Saharan Africa. This study validates the CES-D among an aging Shangaan-speaking and predominantly Black African sample in rural South Africa, with a special emphasis on gender differences.An 8-item CES-D scale was administered in Shangaan to 5059 respondents, aged 40+ years, residing in Agincourt, South Africa. We used Cronbach's alpha and exploratory and confirmatory factor analysis to examine and confirm dimensionality of the CES-D scale. Differential endorsement of CES-D items by gender were assessed using the Mantel-Haenszel (MH) odds ratio test.Reliability of the CES-D scale differed by gender with women reporting higher internal consistency on items than men. A two-factor solution was retained and confirmed representing two latent factors: (1) Negative Affect (six items) and (2) Diminished Positive Affect (two items). MH results showed that men exhibited significantly higher odds of putting an effort in everything that they did (OR: 1.33, 95% CI: 1.15-1.54) and lower odds of feeling depressed (OR: 0.71, 95% CI: 0.56-0.89) and having restless sleep (OR: 0.67, 95% CI:0.58-0.77) than women.Analyses were limited to a dichotomous, short form of the CES-D, a self-reported population-based measure.Aging Black Africans differ in endorsing affective and somatic items on the CES-D scale by gender, which may lead to skewed population-level estimates of depression in key subpopulations. These findings highlight the importance of continued research disentangling cross-cultural and gendered nuances of depression measurements.

  View details for DOI 10.1016/j.jad.2020.08.073

  View details for Web of Science ID 000577467600036

  View details for PubMedID 33065826

  View details for PubMedCentralID PMC7575820

• Community Health Worker Training Curricula and Intervention Outcomes in African American and Latinx Communities: A Systematic Review HEALTH EDUCATION & BEHAVIOR Adams, L. B., Richmond, J., Watson, S. N., Cene, C. W., Urrutia, R., Ataga, O., Dunlap, P., Corbie-Smith, G. 2021; 48 (4): 516-531

  Abstract

  In recent years, community health workers (CHWs) have emerged as key stakeholders in implementing community-based public health interventions in racially diverse contexts. Yet little is known about the extent to which CHW training curriculums influence intervention effectiveness in marginalized racial and ethnic minority communities. This review summarizes evidence on the relationship between CHW training curricula and intervention outcomes conducted among African American and Latinx populations. We conducted a literature search of intervention studies that focused on CHW public health interventions in African American and Latinx populations using PubMed, PsycINFO, ERIC, CINAHL, EMBASE, and Web of Science databases. Included studies were quantitative, qualitative, and mixed methods studies employed to conduct outcome (e.g., blood pressure and HbA1c) and process evaluations (e.g., knowledge and self-efficacy) of CHW-led interventions. Out of 3,295 articles from the database search, 36 articles met our inclusion criteria. Overall, the strength of evidence linking specific CHW training curricula components to primary intervention health outcomes was weak, and no studies directly linked outcomes to specific characteristics of CHW training. Studies that described training related to didactic sessions or classified as high intensity reported higher percentages of positive outcomes compared to other CHW training features. These findings suggest that CHW training may positively influence intervention effectiveness but additional research using more robust methodological approaches is needed to clarify these relationships.

  View details for DOI 10.1177/1090198120959326

  View details for Web of Science ID 000578571200001

  View details for PubMedID 34254544

  View details for PubMedCentralID PMC8532175

• Addressing Major Health Disparities Related to Coronavirus for People With Behavioral Health Conditions Requires Strength-Based Capacity Building and Intentional Community Partnership WORLD MEDICAL & HEALTH POLICY Progovac, A. M., Cortes, D. E., Chambers, V., Adams, L. B., Jean-Claude, S., Willison, C. E., Flores, M., Creedon, T. B., Cook, B. L. 2020; 12 (3): 242-255

  Abstract

  Far from being an equalizer, as some have claimed, the COVID-19 pandemic has exposed just how vulnerable many of our social, health, and political systems are in the face of major public health shocks. Rapid responses by health systems to meet increased demand for hospital beds while continuing to provide health services, largely via a shift to telehealth services, are critical adaptations. However, these actions are not sufficient to mitigate the impact of coronavirus for people from marginalized communities, particularly those with behavioral health conditions, who are experiencing disproportional health, economic, and social impacts from the evolving pandemic. Helping these communities weather this storm requires partnering with existing community-based organizations and local governments to rapidly and flexibly meet the needs of vulnerable populations.

  View details for DOI 10.1002/wmh3.364

  View details for Web of Science ID 000562789600001

  View details for PubMedID 32904922

  View details for PubMedCentralID PMC7461022

• Factor Analysis of the CES-D 12 among a Community Sample of Black Men AMERICAN JOURNAL OF MENS HEALTH Adams, L. B., Gottfredson, N., Lightfoot, A. F., Corbie-Smith, G., Golin, C., Powell, W. 2019; 13 (2): 1557988319834105

  Abstract

  The Center for Epidemiologic Studies Depression (CES-D) scale is one of the most widely used measures for assessing depression in population-based research. Little is known about the varying range of symptomatology expressed by Black men, who report higher chronicity and disability of their depressive symptoms compared to men of other racial and ethnic backgrounds. This study assessed the dimensional structure of the CES-D 12-item scale using exploratory and confirmatory factor analysis in a community-based sample of Black men ( n = 683). Two latent factors emerged from the scale that best fit the data: interpersonal negative affect (INA) and diminished positive affect (DPA). The item "I felt like everything I did was an effort" was removed from the final measure, resulting in an 11-item scale. The total score for the revised CES-D-11 displayed acceptable internal consistency on both latent factors (Cronbach's α = 0.83 [INA] and 0.73 [DPA]) and model fit (χ2 = 165.58, TLI = 0.967, CFI = 0.974, RMSEA = 0.065). Results differ from CES-D factor analyses in other demographic groups, including studies with other male subpopulations, such that depressed mood and interpersonal problems factors are merged as a unidimensional construct. Findings suggest that the "effort" item from the CES-D 12 should be interpreted with caution among Black men. Future studies should continue to disentangle the divergent pathways in which Black men express depressed mood.

  View details for DOI 10.1177/1557988319834105

  View details for Web of Science ID 000462038300001

  View details for PubMedID 30894043

  View details for PubMedCentralID PMC6440056

• Patient-Centered Values and Experiences with Emergency Department and Mental Health Crisis Care ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH Thomas, K. C., Owino, H., Ansari, S., Adams, L., Cyr, J. M., Gaynes, B. N., Glickman, S. W. 2018; 45 (4): 611-622

  Abstract

  Little is known about what patients value in psychiatric crisis services or how they compare community-based services with those received in the emergency department. Three focus groups (n = 27) were held of participants who had received psychiatric crisis services in emergency departments or a community mental health center. Participants described care experiences and preferences. Focus groups were audio recorded, transcribed, and coded using a value-based lens. Themes included appreciation for feeling respected, basic comforts, and shared decision-making as foundations of quality care. Participants preferred the community mental health center. Research should address long-term outcomes to motivate change in psychiatric crisis care.

  View details for DOI 10.1007/s10488-018-0849-y

  View details for Web of Science ID 000435348200008

  View details for PubMedID 29383464

  View details for PubMedCentralID PMC6002899

• Implicit Bias and Mental Health Professionals: Priorities and Directions for Research. Psychiatric services (Washington, D.C.) Merino, Y., Adams, L., Hall, W. J. 2018; 69 (6): 723-725

  Abstract

  This Open Forum explores the role of implicit bias along the mental health care continuum, which may contribute to mental health disparities among vulnerable populations. Emerging research shows that implicit bias is prevalent among service providers. These negative or stigmatizing attitudes toward population groups are held at a subconscious level and are automatically activated during practitioner-client encounters. The authors provide examples of how implicit bias may impede access to care, clinical screening and diagnosis, treatment processes, and crisis response. They also discuss how implicit attitudes may manifest at the intersection between mental health and criminal justice institutions. Finally, they discuss the need for more research on the impact of implicit bias on health practices throughout the mental health system, including the development of interventions to address implicit bias among mental health professionals.

  View details for DOI 10.1176/appi.ps.201700294

  View details for PubMedID 29493411

• Medical Mistrust and Colorectal Cancer Screening Among African Americans JOURNAL OF COMMUNITY HEALTH Adams, L. B., Richmond, J., Corbie-Smith, G., Powell, W. 2017; 42 (5): 1044-1061

  Abstract

  Despite well-documented benefits of colorectal cancer (CRC) screening, African Americans are less likely to be screened and have higher CRC incidence and mortality than Whites. Emerging evidence suggests medical mistrust may influence CRC screening disparities among African Americans. The goal of this systematic review was to summarize evidence investigating associations between medical mistrust and CRC screening among African Americans, and variations in these associations by gender, CRC screening type, and level of mistrust. MEDLINE, CINAHL, Web of Science, PsycINFO, Google Scholar, Cochrane Database, and EMBASE were searched for English-language articles published from January 2000 to November 2016. 27 articles were included for this review (15 quantitative, 11 qualitative and 1 mixed methods study). The majority of quantitative studies linked higher mistrust scores with lower rates of CRC screening among African Americans. Most studies examined mistrust at the physician level, but few quantitative studies analyzed mistrust at an organizational level (i.e. healthcare systems, insurance, etc.). Quantitative differences in mistrust and CRC screening by gender were mixed, but qualitative studies highlighted fear of experimentation and intrusiveness of screening methods as unique themes among African American men. Limitations include heterogeneity in mistrust and CRC measures, and possible publication bias. Future studies should address methodological challenges found in this review, such as limited use of validated and reliable mistrust measures, examination of CRC screening outcomes beyond beliefs and intent, and a more thorough analysis of gender roles in the cancer screening process.

  View details for DOI 10.1007/s10900-017-0339-2

  View details for Web of Science ID 000410472900028

  View details for PubMedID 28439739

  View details for PubMedCentralID PMC5654700

• School-Based Mental Health Services for Newly Arriving Immigrant Adolescents JOURNAL OF IMMIGRANT AND MINORITY HEALTH Adams, L. B. 2016; 18 (4): 715-717

  View details for DOI 10.1007/s10903-015-0319-5

  View details for Web of Science ID 000378074100001

  View details for PubMedID 26660482

• Intervention Efficacy in Engaging Black and White Veterans with Post-traumatic Stress Disorder into Treatment SOCIAL WORK IN PUBLIC HEALTH Stecker, T., Adams, L., Carpenter-Song, E., Nicholson, J., Streltzov, N., Xie, H. 2016; 31 (6): 481-489

  Abstract

  This study examined racial differences among Black and White Veterans who screened positive for post-traumatic stress disorder (PTSD) but were not in PTSD treatment and were participating in an intervention trial. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans with PTSD but not yet engaged in treatment were recruited and randomly assigned to control or intervention conditions. Intervention participants received a cognitive-behavioral engagement intervention by phone. All participants received follow-up calls to assess symptoms and utilization of treatment. Black and White participants were compared to assess differences in treatment utilization. Intervention session notes were analyzed qualitatively for explanatory themes. Participants of both races who received the intervention had higher PTSD treatment initiation than their respective control groups (Blacks: 85% vs. 58% and Whites: 53% vs. 45%, respectively). However, Blacks completed fewer PTSD treatment sessions compared to Whites overall (M = 2.06 [SD = 2.3] vs. M = 3.77 [SD = 9.9]; p < .05). Within the intervention condition, Blacks were significantly more likely to initiate treatment (odds ratio = 2.3, p < .04), and had a greater reduction in PTSD symptom compared to Whites (PTSD Checklist - Military Version [PCL] scores: 12.75 vs. 9.68). Based on qualitative analysis of intervention session notes, themes emerged that may suggest cultural differences involving social connection, attitudes towards treatment, and the desire to appear "okay." Blacks had a higher initiation rate and greater reduction in PTSD severity but completed fewer treatment sessions than Whites. These are promising results with respect to other studies which demonstrate that Black Veterans are less likely to seek treatment for PTSD.

  View details for DOI 10.1080/19371918.2016.1160340

  View details for Web of Science ID 000382304900003

  View details for PubMedID 27210830

  View details for PubMedCentralID PMC5012529

• Masculinity and Race-Related Factors as Barriers to Health Help-Seeking Among African American Men BEHAVIORAL MEDICINE Powell, W., Adams, L. B., Cole-Lewis, Y., Agyemang, A., Upton, R. D. 2016; 42 (3): 150-163

  Abstract

  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.

  View details for DOI 10.1080/08964289.2016.1165174

  View details for Web of Science ID 000379671200004

  View details for PubMedID 27337619

  View details for PubMedCentralID PMC4979354

• Gender Differences in Service Utilization among OEF/OIF Veterans with Posttraumatic Stress Disorder after a Brief Cognitive-Behavioral Intervention to Increase Treatment Engagement: A Mixed Methods Study WOMENS HEALTH ISSUES Gallegos, A. M., Wolff, K. B., Streltzov, N. A., Adams, L. B., Carpenter-Song, E., Nicholson, J., Stecker, T. 2015; 25 (5): 542-547

  Abstract

  Women veterans who served in Iraq and Afghanistan (Operation Enduring Freedom and Operation Iraqi Freedom [OEF/OIF]) have a moderately higher risk of developing posttraumatic stress disorder (PTSD) than male veterans. However, gender disparities in treatment engagement may prevent women veterans from initiating the care they need. Understanding gender differences in predictors of and barriers to treatment is essential to improving engagement and mental health outcomes. The purpose of this study was to examine gender differences in treatment utilization after a brief, cognitive-behavioral therapy (CBT) intervention among male and female OEF/OIF veterans.Participants were assigned randomly to either the intervention or control conditions. Intervention participants received the telephone-based CBT intervention. Participants were 35 female and 238 male OEF/OIF veterans who screened positive for PTSD and had never initiated PTSD treatment. Participants were asked about treatment utilization, beliefs about PTSD treatment, and symptoms at months 1, 3, and 6 months subsequent to the baseline telephone assessment. The PTSD Checklist-Military Version was used to assess PTSD and the Patient's Health Questionnaire was used to assess symptoms of depression.Female veterans who received an intervention were significantly more likely to have attended treatment over the 6-month follow-up period than male veterans who received an intervention (χ(2) = 7.91; df = 3; odds ratio, 3.93; p = .04).The CBT intervention may be a critical mechanism to engage female veterans in treatment. Further research is needed to understand how to engage male veterans with PTSD in treatment.

  View details for DOI 10.1016/j.whi.2015.04.008

  View details for Web of Science ID 000361060400017

  View details for PubMedID 26051022

  View details for PubMedCentralID PMC4569511

• An encyclopedia of mouse DNA elements (Mouse ENCODE). Genome biology Stamatoyannopoulos, J. A., Snyder, M., Hardison, R., Ren, B., Gingeras, T., Gilbert, D. M., Groudine, M., Bender, M., Kaul, R., Canfield, T., Giste, E., Johnson, A., Zhang, M., Balasundaram, G., Byron, R., Roach, V., Sabo, P. J., Sandstrom, R., Stehling, A. S., Thurman, R. E., Weissman, S. M., Cayting, P., Hariharan, M., Lian, J., Cheng, Y., Landt, S. G., Ma, Z., Wold, B. J., Dekker, J., Crawford, G. E., Keller, C. A., Wu, W., Morrissey, C., Kumar, S. A., Mishra, T., Jain, D., Byrska-Bishop, M., Blankenberg, D., Lajoie1, B. R., Jain, G., Sanyal, A., Chen, K. B., Denas, O., Taylor, J., Blobel, G. A., Weiss, M. J., Pimkin, M., Deng, W., Marinov, G. K., Williams, B. A., Fisher-Aylor, K. I., Desalvo, G., Kiralusha, A., Trout, D., Amrhein, H., Mortazavi, A., Edsall, L., McCleary, D., Kuan, S., Shen, Y., Yue, F., Ye, Z., Davis, C. A., Zaleski, C., Jha, S., Xue, C., Dobin, A., Lin, W., Fastuca, M., Wang, H., Guigo, R., Djebali, S., Lagarde, J., Ryba, T., Sasaki, T., Malladi, V. S., Cline, M. S., Kirkup, V. M., Learned, K., Rosenbloom, K. R., Kent, W. J., Feingold, E. A., Good, P. J., Pazin, M., Lowdon, R. F., Adams, L. B. 2012; 13 (8): 418

  Abstract

  ABSTRACT: To complement the human Encyclopedia of DNA Elements (ENCODE) project and to enable a broad range of mouse genomics efforts, the Mouse ENCODE Consortium is applying the same experimental pipelines developed for human ENCODE to annotate the mouse genome.

  View details for DOI 10.1186/gb-2012-13-8-418

  View details for PubMedID 22889292

  View details for PubMedCentralID PMC3491367

• Scaled Cortical Impact in Immature Swine: Effect of Age and Gender on Lesion Volume JOURNAL OF NEUROTRAUMA Missios, S., Harris, B. T., Dodge, C. P., Simoni, M. K., Costine, B. A., Lee, Y., Quebada, P. B., Hillier, S. C., Adams, L. B., Duhaime, A. 2009; 26 (11): 1943-1951

  Abstract

  The piglet scaled cortical impact model creates a focal contusion using a skull-mounted, spring-loaded blunt indentation device scaled to achieve identical tissue strains in subjects with different brain sizes. Preliminary data showed that contusion size increased proportional to subject age. This study details the results from a new, larger series of subjects of three ages, and compares the effect of age and additional host and physiologic variables on injury response. Sixty-seven subjects, including infant (5- to 7-day-old), "toddler" (1-month-old), and early adolescent (4-month-old) swine underwent scaled cortical impact under strict anesthetic protocols. Serum glucose, testosterone, and 17beta-estradiol levels were measured. Lesion size was measured at 1 week post injury, as the ratio of the lesion area over the area of the contralateral hemisphere. Adolescent subjects had lesions over eight times larger than infants (p < 0.0001). Lesion volumes were larger in toddlers than in infants, most significantly for males (p < 0.05). Adolescent subjects were warmer on average, but there was no correlation between temperature and lesion volume within any age group. Serum glucose did not differ among ages. Infant males had the highest levels of circulating sex steroids. In this model, age was the most robust predictor of lesion size. Temperature had an effect, but did not explain all the variability seen among age groups. There was an interaction among gender, hormone levels, and lesion size in younger subjects. Characterization of these variables allows use of this model for treatment trials for subjects at different stages of maturation.

  View details for DOI 10.1089/neu.2009.0956

  View details for Web of Science ID 000272049600010

  View details for PubMedID 19469691

  View details for PubMedCentralID PMC2822800