A Pilot Study to Address Intergenerational Health Impacts of Childhood Trauma

Posted on February 5, 2024 by nknox

We Are Recruiting 3-4 Month Postpartum Women Who Received Care at Emory: Click here to participate by completing our form!

Prevalence of cardiometabolic risk and health factors among Puerto Rican young adults

Posted on December 20, 2023 by nknox

As part of the Boricua Youth Study – Health Assessment study, which examines the cardiovascular health of Puerto Rican young adults in the San Juan metro area in Puerto Rico and the South Bronx, NY, we recently published on the prevalence of cardiometabolic risk factors and ideal cardiovascular health (CVH) among this population.

The BYS-HA study conducted home visits to collect objective anthropometric, blood pressure and blood samples when participants were on average 23 years of age. Information on diet, physical activity and sleep were collected via surveys. In addition to calculating measures of obesity, diabetes and hypertension we also calculated a measure of ideal cardiovascular Health (CVH). We utilized the American Heart Association, Life’s Essential 8 metric which includes 8 markers of cardiovascular health: adequate sleep, healthy diet, physical activity, no tobacco exposure, blood pressure, weight status, diabetes and lipids. We characterized CVH scores as continuous with higher scores indicating more optimal CVH and categorically (80-100 scores for ideal CVH). We examined different prevalence of cardiometabolic risk factors and CVH by site (NY vs PR) and by sex.

In this sample of 759 participants, 413 of the participants lived in Puerto Rico with 346 in the South Bronx NY. The mean age of participants was 22.6 years and 50% were female. Twenty-seven percent of the sample received public assistance in young adulthood. Overall, there was a high prevalence of obesity and high HBA1C (≥5.7, a measure of diabetes risk) with noted differences across study site. Participants in NY had a higher prevalence of obesity (35% in NY and 19% in PR) and hypertension (8% in NY and 2% in PR). Across both sites, men had a higher prevalence of hypertension, but women had a higher prevalence of obesity and low total cholesterol compared to men. In both NY and PR, women had better blood pressure and lipids but lower physical activity compared to men. In PR, women also had better diet and nicotine exposure scores compared to men.

Mean CVH score among NY participants was lower (61.9) than in PR (68.9). No participant had all ideal health metrics, 36% of participants in PR had 5 or more ideal CVH; while only 16% in NY met this criterion.

Our findings suggest sociocultural factors can influence cardiometabolic health measures. Overall, 4 of the 7 metrics examined were worse in the NY population compared to PR. In PR, measures of diet and PA were worse compared to the NY site. While study participants are ethnically homogenous, Puerto Ricans living in NY are considered and ethnic minority while those living in Puerto Rico are the ethnic majority, experiences of discrimination and racism may differ across groups. Furthermore, BYS participants live in distinct social, political, cultural and built environments. Differences between sites based on access to food, recreational facilities and walkability of neighborhoods could explain noted cardiometabolic differences. Similarly social, political, and cultural factors, including economic and political instability, structural racism, adequate health care access and educational and occupational opportunities differ across sites. Interventions to maintain and improve CVH across the life course, tailored to sociocultural environments, are necessary for the prevention of cardiovascular disease.

https://www.sciencedirect.com/science/article/abs/pii/S1047279723002144

Tips (and a plug) for PhD accountability groups

Posted on June 16, 2021 by nknox

Accountability groups and writing groups are fairly common, particularly in academic settings, where students and faculty may have a variety of roles and shifting demands. A quick Google search yields posts from people seeking groups to join, and institution-specific groups for students or faculty to join. A Pub-Med search even identified a study examining differences in “scholarly production” from participants of a faculty research/writing group compared to a matched group of faculty not participating in the group. The results indicated that participation in the group provided junior faculty with the support system needed to feel confident, and that over time, faculty in the group increased their productivity. (https://www-sciencedirect-com.proxy.library.emory.edu/science/article/pii/S1877129716301459)

I joined the SDOH-LIFE research group in the spring of 2019 to begin a project examining cumulative social stress and childhood obesity using data from the Early Childhood Longitudinal Study – Kindergarten Class 2010-11 (ECLS-K:2011). In the fall of 2019, four fellow PhD students and I started an accountability group to motivate ourselves and try to remain productive in the amorphous post-coursework days of our PhD program. We are all completing our PhDs in Epidemiology, though in a variety of different topic areas, and the group has since become integral to our productivity and progress. Our accountability not only serves as a place for goal-setting and planning, but a sounding board for advice, and navigating imposter syndrome and mentor relationships.

Through that first semester we learned what worked and what did not work for our group, and tried to make progress on various projects and dissertations. Probably most importantly, we learned more about each other and how to support each other in the PhD program. Ultimately, the accountability group has seen its members through successful grant submissions, PhD milestones, and of course the pandemic and transition to working from home. During the pandemic we continue to meet via zoom, though those first months were mostly spent figuring out how to make our new reality work for us.

Since its inception, our AG has settled on some best practices and lessons learned for our group that could be adapted for others:

Block off the time on your calendar, and treat it like you would any other meeting
Have some kind of tracking document for short and long term goal setting
Keep track of accomplishments!
Check in at regular intervals for wrap-up and next set of long term goals (semesters, quarterly, etc.)
Be ready to talk about both what you did and how you did it – we have had a lot of success with helping each other identify processes that work!

Since joining the SDOH-Life Research group, I have also worked on other projects examining bullying and school connectedness in relation to adolescent adiposity in the Fragile Families Child and Wellbeing Study, completed my dissertation proposal and moved into candidacy, submitted pre-doctoral grants, and worked on other projects outside of the research group – and I did most of this while working from home! While it is possible I could have done all these things without an accountability group, the group provided structure and community to help me navigate the challenges of academic life while keeping my sanity intact.