We examined the relationship between parental efficacy and depressive symptoms in a diverse sample of low income mothers. The sample consisted of 607 European American, African American, and Hispanic mothers who participated in The Early Steps Project, a multi-site, longitudinal, preventative intervention study. Parental efficacy was found to be significantly associated with depressive symptoms in the entire sample of low income mothers. Ethnicity moderated results, however, such that parental efficacy was significantly associated with depressive symptoms for European American mothers but was not for the African American and Hispanic mothers. Ethnic differences in the various categories of depressive symptoms (i.e., total, somatic, and psychological) were also explored, with the results showing that African American mothers reported higher levels of depressive symptoms than both European American and Hispanic mothers in each of the categories. The theoretical and clinical implications of these results are discussed.
BACKGROUND AND OBJECTIVES:It is unclear which specific well-child visits (WCVs) are most frequently missed and whether age-specific patterns of attendance differ by race or insurance type.
METHODS:We conducted a retrospective cohort study of children 0 to 6 years old between 2011 and 2016 within 2 health networks spanning 20 states. WCVs were identified by using International Classification of Diseases, Ninth and 10th Revisions and Current Procedural Terminology codes. We calculated adherence to the 13 American Academy of Pediatricsrecommended WCVs from birth to age 6 years. To address data completeness, we made 2 adherence calculations after a child's last recorded WCV: 1 in which we assumed all subsequent WCVs were attended outside the network and 1 in which we assumed none were.
RESULTS:We included 152 418 children in our analysis. Most children were either publicly insured (77%) or uninsured (14%). The 2-, 4-, and 6-month visits were the most frequently attended (63% [assuming no outside care after the last recorded WCV] to 90% [assuming outside care]), whereas the 15-and 18-months visits (41%-75%) and 4-year visit (19%-49%) were the least frequently attended. Patients who were publicly insured and uninsured (versus privately insured) had higher odds of missing WCVs. Hispanic and Asian American (versus non-Hispanic white) patients had higher odds of attending WCVs.
DISCUSSIONThe 15-and 18-month WCVs as well as the 4-year WCV are the least frequently attended WCVs. The former represent opportunities to identify developmental delays, and the latter represents an opportunity to assess school readiness.
The content analysis of exercise interventions in knee osteoarthritis demonstrated low scores for moderate- to high-quality trials. Improved standardized reporting is recommended to ensure knowledge transfer and replication of effective exercise programs for individuals with knee osteoarthritis.
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