The first aim examined associations between Type 2 diabetes (diabetes) and psychological distress in Native Hawaiian and Pacific Islander (NHPI) adults in the United States. The second aim examined the mediating role of sleep quality and quantity in the association between diabetes and psychological distress. Multinomial logistic regression models explored direct associations of diabetes as a risk of psychological distress. Second, the extent to which sleep quality and sleep quantity mediated the association between diabetes and psychological distress was examined. The sample comprised 1,490 NHPI adults. Diabetes was significantly associated with 2.23 times greater odds, 95% confidence intervals (CI) [1.19, 4.17], of low psychological distress, 4.64 times greater odds, 95% CI [1.83, 11.75], of high psychological distress, and 4.48 times greater odds, 95% CI [1.46, 15.70], of very high psychological distress compared with no psychological distress. Mediation analysis demonstrated that the proportion of the total effect of diabetes on high psychological distress mediated by trouble falling asleep was 4.6% (95% CI [2.2, 19.2]), and the proportion of the total effect of diabetes on very high psychological distress mediated by trouble falling asleep was 6.7% (2.4, 21.9). The proportion of the total effect of diabetes on high psychological distress mediated by trouble staying asleep was 6.2% (95% CI [3.0, 25.6]), and the proportion of the total effect of diabetes on very high psychological distress mediated by trouble staying asleep was 9.5% (2.8, 29.8). Sleep quantity did not have a mediating effects. Among NHPIs, diabetes was independently and positively associated with psychological distress. Sleep quality partially mediated the association between diabetes and high psychological distress.
What is the public significance of this article?This study suggests that among Native Hawaiians and Pacific Islanders, there is a strong association between diabetes and psychological distress, and this association may be partially explained by sleep quality. The patterns of associations among diabetes, psychological distress, and sleep quality suggest the need for health professionals to inquire about sleep to better inform diabetes treatment and alleviate psychological distress experienced by Native Hawaiians and Pacific Islanders.
ObjectiveThe present study aimed to examine the key influences on infant and child feeding practices among a Marshallese community at each social ecological level. It is the first study to examine the key influences on infant and child feeding practices with Marshallese immigrant women in the USA and helps fill a gap in the previous literature that has included other immigrant women.DesignCommunity-based participatory research design with twenty-seven participants taking part in four qualitative focus groups.SettingThe study took place within the Marshallese community in Arkansas, USA.ParticipantsParticipants included Marshallese women with children aged 1–3 years and/or caregivers. Caregivers were defined as someone other than the parent who cares for children. Caregivers were often older women in the Marshallese community.ResultsThere were five primary themes within multiple levels of the Social Ecological Model. At the intrapersonal level, mothers’ and caregivers’ autonomy emerged. At the interpersonal level, child-led and familial influences emerged. At the organizational level, health-care provider influences emerged; and at the policy level, the Special Supplemental Nutrition Program for Women, Infants, and Children emerged as the most salient influence.ConclusionsMarshallese immigrant women’s infant and child feeding practices are influenced at intrapersonal, interpersonal, organizational and policy levels. Understanding these multidimensional influences is necessary to inform the creation of culturally tailored interventions to reduce health disparities within the Marshallese community.
Results indicate social distancing is prominent among pharmacy students. Results may be used in the future to help identify solutions for improving social distancing and increasing pharmacy student interaction to patients with mental illness. Further training related to mental illness may assist with decreasing social distancing among pharmacy students.
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