Parents, referral sources, and even therapists wonder whether the gender and racial match between therapists and patients contributes to poorer alliances and treatment dropout. Six hundred adolescent substance abusers and their therapists from a large randomized clinical trial were grouped according to matches and mismatches on both gender and race, and alliance ratings were collected from both patients and therapists. Results revealed that gender-matched dyads reported higher alliances and were more likely to complete treatment. Racial matching predicted greater retention but not patient-rated alliance. However, therapists in mismatched dyads rated significantly lower alliances. Results suggest that, although multicultural training remains critical, training emphasis should also be placed on understanding how gender and racial differences affect therapeutic processes.
Fast-food marketing to children is considered a contributor to childhood obesity. Effects of marketing on parents may also contribute to childhood obesity. The authors explore relevant hypotheses with data from caregivers of 2-to 12-year-old children in medically underserved communities. The results have implications for obesity-related public policies and social marketing strategies.
Breastfeeding is associated with improved developmental and social outcomes for an infant. Despite these health benefits, only 54% of women breastfeed in the early postpartum period. Although an understanding of socio-demographic characteristics, breastfeeding intent, and breastfeeding attitudes can facilitate breastfeeding initiatives, these factors have not been characterized particularly for urban and immigrant mothers. The objectives of this study are to provide a descriptive analysis of the socio-demographic characteristics, breastfeeding intent, and breastfeeding attitudes of primiparas presenting to an inner city prenatal clinic and determine if breastfeeding attitudes are associated with breastfeeding intent and socio-demographic variables. Of 100 primiparas, 79 reported the intent to breastfeed. Breastfeeding intent was associated with 1) positive breastfeeding attitudes, 2) higher household incomes, 3) being born outside the US, 4) being Afro-Caribbean as opposed to African American, 5) having family, peer, and partner support for breastfeeding, 6) attending breastfeeding classes, and 7) greater years of education. These findings suggest that targeting breastfeeding initiatives towards low-income, less educated, US born mothers who lack breastfeeding support from their loved ones may improve breastfeeding rates among urban primiparas.
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT INTERNALIZED WEIGHT STIGMA MODERATES EATING BEHAVIOR 2 ! Abstract 36Weight stigma is a significant socio-structural barrier to reducing health disparities and 37 improving quality of life for higher weight individuals. The aim of this study was to examine the 38 impact of internalized weight stigma on eating behaviors after participating in a randomized 39 controlled trial comparing the health benefits of a weight-neutral program to a conventional 40 weight-management program for 80 community women with high body mass index (BMI > 30, 41 age range: 30-45). Programs involved 6 months of facilitator-guided weekly group meetings 42 using structured manuals. Assessments occurred at baseline, post-intervention (6 months), and 43 24-months post-randomization. Eating behavior outcome measurements included the Eating 44Disorder Examination-Questionnaire and the Intuitive Eating Scale. Intention-to-treat linear 45 mixed models were used to test for higher-order interactions between internalized weight stigma, 46 group, and time. Findings revealed significant 3-way and 2-way interactions between 47 internalized weight stigma, group, and time for disordered and adaptive eating behaviors, 48 respectively. Only weight-neutral program participants with low internalized weight stigma 49 improved global disordered eating scores. Participants from both programs with low internalized 50 weight stigma improved adaptive eating at 6 months, but only weight-neutral program 51 participants maintained changes at follow-up. Participants with high internalized weight stigma 52 demonstrated no changes in disordered and adaptive eating, regardless of program. In order to 53 enhance the overall benefit from weight-neutral approaches, these findings underscore the need 54 to incorporate more innovative and direct methods to reduce internalized weight stigma for 55 women with high BMI. 56Key Words: internalized weight stigma, disordered eating, intuitive eating, obesity, 57 health at every size, conventional weight-management 58 obesity is a pervasive stigmatization of people with a higher weight statusÑa stigmatization that 63 is on the rise among adults and children (Andreyeva, Puhl, & Brownell, 2008; Harriger, 64 Calogero, Witherington, & Smith, 2010;Latner & Stunkard, 2003). Indeed, weight 65 discrimination has been well-documented in educational, workplace, and healthcare settings 66 (e.g., Giel, Thiel, Teufel, Mayer, & Zipfel, 2010;Neumark-Sztainer, Story, & Harr...
Objective: Currently, there is debate in the eating disorders field regarding how to define atypical anorexia (AAN), how prevalent it is in community and clinical settings, and how AAN rates compare with low-weight AN. This systematic review assesses AAN literature from 2007 to 2020, to investigate: (a) the demographic characteristics of AAN studies, (b) the prevalence of AAN compared with AN, (c) the range of operational definitions of AAN and the implications of these definitions, and (d) the proportion of patients with AAN and AN represented in consecutive admission and referral samples. Method: PsychINFO, CINAHL, PubMed, Greylit.org, and ProQuest databases were searched according to methods for Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic reviews, yielding 3,184 potential articles. Seventy-five eligible studies were coded for sixty-one variables.Results: Clinical samples predominantly included younger, female, white samples with limited diversity. In epidemiological designs, AAN was typically as common or more common than AN, and AAN rates varied significantly based on the population studied and operational definitions. In consecutive clinical samples, AAN was frequently less represented.Discussion: Although AAN appears to occur more frequently than AN in communities, fewer patients with AAN are being referred and admitted to eating disorder specific care, particularly in the United States. Given the significant medical and psychosocial consequences of AAN, and the importance of early intervention, this represents a crucial treatment gap. Additionally, results suggest the need for finetuning diagnostic definitions, greater diversity in AAN studies, and increased screening and referral for this vulnerable population. ResumenObjetivo: Actualmente, hay debate en el campo de los trastornos alimenticios sobre c omo definir la anorexia atípica (ANA), cu an prevalente es en entornos comunitarios y clínicos, y c omo las tasas de ANA se comparan con AN de bajo peso. Esta revisi on sistem atica evalúa la literatura de ANA de 2007 a 2020, para investigar: 1) las características demogr aficas de los estudios de ANA, 2) la prevalencia de ANA en comparaci on con AN, 3) el rango de definiciones operativas de ANA y las
R. Baron and D. A. Kenny’s (1986) paper introducing mediation analysis has been cited over 9,000 times, but concerns have been expressed about how this method is used. The authors review past and recent methodological literature and make recommendations for how to address 3 main issues: association, temporal order, and the no omitted variables assumption. The authors briefly visit the topics of reliability and the confirmatory–exploratory distinction. In addition, to provide a sense of the extent to which the earlier literature had been absorbed into practice, the authors examined a sample of 50 articles from 2002 citing R. Baron and D. A. Kenny and containing at least 1 mediation analysis via ordinary least squares regression. A substantial proportion of these articles included problematic reporting; as of 2002, there appeared to be room for improvement in conducting such mediation analyses. Future literature reviews will demonstrate the extent to which the situation has improved.
Link to publication on Research at Birmingham portal General rightsUnless a licence is specified above, all rights (including copyright and moral rights) in this document are retained by the authors and/or the copyright holders. The express permission of the copyright holder must be obtained for any use of this material other than for purposes permitted by law.• Users may freely distribute the URL that is used to identify this publication.• Users may download and/or print one copy of the publication from the University of Birmingham research portal for the purpose of private study or non-commercial research.• User may use extracts from the document in line with the concept of 'fair dealing' under the Copyright, Designs and Patents Act 1988 (?) • Users may not further distribute the material nor use it for the purposes of commercial gain.Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document.When citing, please reference the published version. Take down policyWhile the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.