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Kimberly A Updegraff - One of the best experts on this subject based on the ideXlab platform.
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mexican origin Adolescent Mothers economic contexts educational re engagement and their children s school readiness
Child Development, 2021Co-Authors: Elana R Mcdermott, Laudan B Jahromi, Adriana J Umanataylor, Stefanie Martinezfuentes, Shandra M Jones, Kimberly A UpdegraffAbstract:Drawing on data from a longitudinal study of 204 Mexican-origin Adolescent Mothers, their mother figures, and their children, the current investigation examined (a) Adolescent Mothers' educational re-engagement and attainment beginning during their pregnancy and ending when their child was 5 years old; and (b) the influence of the family economic context on Adolescent Mothers' educational re-engagement and attainment and their children's academic and social-emotional outcomes. Findings detailed Adolescent Mothers' re-engagement in school after the birth of their child and revealed that family income during Adolescents' pregnancies was directly associated with re-engagement and attainment, and also initiated cascade effects that shaped Adolescents' economic contexts, their subsequent re-engagement and attainment, and ultimately their children's academic and social-emotional outcomes at age 5.
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maternal self efficacy is protective for child but not mother body mass index among mexican origin children with negative temperament
Journal of Developmental and Behavioral Pediatrics, 2019Co-Authors: Sonali Rajan, Laudan B Jahromi, Adriana J Umanataylor, Diamond Y Bravo, Kimberly A UpdegraffAbstract:Objective Childhood obesity persists as a serious public health concern, particularly among Mexican-origin youth. Teen Mothers are also at heightened obesity risk. Multiple factors may exacerbate this risk, including stressors associated with parenting. Indeed, difficult child temperaments pose unique parenting challenges, which may also be linked to physical health outcomes in Mothers. The purpose of this study was to examine whether the interaction between negative child temperament and parenting self-efficacy is related to the body mass index (BMI) of young children and their Adolescent Mothers while controlling for important contextual factors. We also examined which pathways differed for girls versus boys. Methods Data were from a longitudinal study spanning 5 years that included 204 Mexican-origin young Mothers and their children (with data collected at birth, age 4 years, and age 5 years). A multigroup structural equation modeling framework was used. Results The rate of early childhood obesity was low in comparison with national averages, whereas the rate of Adolescent mother obesity was notably higher than the national average. Negative child temperament was associated with higher child BMI among those Adolescent Mothers with low parenting self-efficacy. Among the children with a negative temperament, their Mothers' high parenting self-efficacy may have served as a protective factor against unhealthy child BMI. This significant interaction held for both boys and girls. Conclusion Research evaluating the potential effectiveness of interventions that promote parenting self-efficacy during early childhood as a means to reduce the rate of obesity among children of Adolescent Mothers should be conducted.
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discrimination and ethnic racial identity understanding direction of effects using within and between person analyses
Child Development, 2019Co-Authors: Katharine H Zeiders, Kimberly A Updegraff, Adriana J Umanataylor, Sara Douglass Bayless, Chelsea L Derlan, Laudan B JahromiAbstract:Ethnic-racial identity (ERI) development and ethnic-racial discrimination are two salient experiences among Adolescents in the United States. Despite growing awareness of the costs and benefits of these experiences individually, we know little about how they may influence one another. The current study examined competing hypotheses relating discrimination and components of ERI (i.e., exploration, resolution, affirmation) among a sample of Mexican-origin Adolescent Mothers (N = 181; Mage at Wave 1 = 16.83, SD = 1.01) across six waves of data. Findings revealed that within-person changes in discrimination predicted subsequent ERI resolution and affirmation; however, ERI did not predict subsequent discrimination. Between-person effects of discrimination on affirmation were significant. Our findings underscore the importance of discrimination experiences in shaping Mexican-origin Adolescent Mothers' normative developmental competencies. [ABSTRACT FROM AUTHOR]
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coparenting conflict and academic readiness in children of teen Mothers effortful control as a mediator
Family Process, 2018Co-Authors: Laudan B Jahromi, Katharine H Zeiders, Kimberly A Updegraff, Adriana J Umanataylor, Sara Douglass BaylessAbstract:Children's exposure to coparenting conflict has important implications for their developmental functioning, yet limited work has focused on such processes in families with diverse structures or ethnically and culturally diverse backgrounds. This longitudinal study examined the processes by which Mexican-origin Adolescent Mothers' coparenting conflict with their 3-year-old children's grandMothers and biological fathers (N = 133 families) were linked to children's academic and social skills at 5 years of age, and whether children's effortful control at 4 years of age mediated the link between coparenting conflict and indices of children's academic readiness. Findings revealed that Adolescent Mothers' coparenting conflict with their child's biological father was linked to indices of children's academic and social school readiness through children's effortful control among girls, but not boys, whereas conflict with grandMothers was directly linked to boys' and girls' social functioning 2 years later. Findings offer information about different mechanisms by which multiple coparenting units in families of Adolescent Mothers are related to their children's outcomes, and this work has important implications for practitioners working with families of Adolescent Mothers.
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an idiographic and nomothetic approach to the study of mexican origin Adolescent Mothers socio cultural stressors and adjustment
Prevention Science, 2015Co-Authors: Katharine H Zeiders, Kimberly A Updegraff, Adriana J Umanataylor, Laudan B JahromiAbstract:The current study examined the longitudinal relations of socio-cultural stressors (i.e., acculturative stressors, enculturative stressors, ethnic discrimination) and Mexican-origin Adolescent Mothers’ depressive symptoms and risk-taking behaviors. Utilizing an idiographic and nomothetic approach, we conducted lagged analyses to examine how individuals’ fluctuations in stressors predicted subsequent adjustment. Further, we investigated potential threshold effects by examining if the impact of fluctuations in stressors differed at varying levels of stressors. Mexican-origin Adolescent females (N = 184) participated in yearly in-home assessments across 5 years and reported on their experiences of acculturative and enculturative stressors, ethnic discrimination, depressive symptoms, and risk-taking behaviors. Findings revealed that within-person fluctuations in acculturative stressors and, to a lesser extent, perceived discrimination related to youths’ depressive symptoms. For risk-taking behaviors, however, only within-person fluctuations in enculturative stressors emerged as significant. Further, a threshold effect emerged in the link between enculturative stressors and risk-taking behaviors, suggesting that fluctuations in enculturative stressors predicted changes in risk-taking behaviors at high levels of enculturative stressors but not low levels. Our findings highlight the differential relations between socio-cultural stressors and Adolescent females’ adjustment and suggest that prevention programs aimed at reducing depressive symptoms should attend to any degree of change in socio-cultural stressors, whereas programs focused on risk-taking behaviors should be especially attuned to levels of enculturative stress.
Laudan B Jahromi - One of the best experts on this subject based on the ideXlab platform.
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mexican origin Adolescent Mothers economic contexts educational re engagement and their children s school readiness
Child Development, 2021Co-Authors: Elana R Mcdermott, Laudan B Jahromi, Adriana J Umanataylor, Stefanie Martinezfuentes, Shandra M Jones, Kimberly A UpdegraffAbstract:Drawing on data from a longitudinal study of 204 Mexican-origin Adolescent Mothers, their mother figures, and their children, the current investigation examined (a) Adolescent Mothers' educational re-engagement and attainment beginning during their pregnancy and ending when their child was 5 years old; and (b) the influence of the family economic context on Adolescent Mothers' educational re-engagement and attainment and their children's academic and social-emotional outcomes. Findings detailed Adolescent Mothers' re-engagement in school after the birth of their child and revealed that family income during Adolescents' pregnancies was directly associated with re-engagement and attainment, and also initiated cascade effects that shaped Adolescents' economic contexts, their subsequent re-engagement and attainment, and ultimately their children's academic and social-emotional outcomes at age 5.
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maternal self efficacy is protective for child but not mother body mass index among mexican origin children with negative temperament
Journal of Developmental and Behavioral Pediatrics, 2019Co-Authors: Sonali Rajan, Laudan B Jahromi, Adriana J Umanataylor, Diamond Y Bravo, Kimberly A UpdegraffAbstract:Objective Childhood obesity persists as a serious public health concern, particularly among Mexican-origin youth. Teen Mothers are also at heightened obesity risk. Multiple factors may exacerbate this risk, including stressors associated with parenting. Indeed, difficult child temperaments pose unique parenting challenges, which may also be linked to physical health outcomes in Mothers. The purpose of this study was to examine whether the interaction between negative child temperament and parenting self-efficacy is related to the body mass index (BMI) of young children and their Adolescent Mothers while controlling for important contextual factors. We also examined which pathways differed for girls versus boys. Methods Data were from a longitudinal study spanning 5 years that included 204 Mexican-origin young Mothers and their children (with data collected at birth, age 4 years, and age 5 years). A multigroup structural equation modeling framework was used. Results The rate of early childhood obesity was low in comparison with national averages, whereas the rate of Adolescent mother obesity was notably higher than the national average. Negative child temperament was associated with higher child BMI among those Adolescent Mothers with low parenting self-efficacy. Among the children with a negative temperament, their Mothers' high parenting self-efficacy may have served as a protective factor against unhealthy child BMI. This significant interaction held for both boys and girls. Conclusion Research evaluating the potential effectiveness of interventions that promote parenting self-efficacy during early childhood as a means to reduce the rate of obesity among children of Adolescent Mothers should be conducted.
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discrimination and ethnic racial identity understanding direction of effects using within and between person analyses
Child Development, 2019Co-Authors: Katharine H Zeiders, Kimberly A Updegraff, Adriana J Umanataylor, Sara Douglass Bayless, Chelsea L Derlan, Laudan B JahromiAbstract:Ethnic-racial identity (ERI) development and ethnic-racial discrimination are two salient experiences among Adolescents in the United States. Despite growing awareness of the costs and benefits of these experiences individually, we know little about how they may influence one another. The current study examined competing hypotheses relating discrimination and components of ERI (i.e., exploration, resolution, affirmation) among a sample of Mexican-origin Adolescent Mothers (N = 181; Mage at Wave 1 = 16.83, SD = 1.01) across six waves of data. Findings revealed that within-person changes in discrimination predicted subsequent ERI resolution and affirmation; however, ERI did not predict subsequent discrimination. Between-person effects of discrimination on affirmation were significant. Our findings underscore the importance of discrimination experiences in shaping Mexican-origin Adolescent Mothers' normative developmental competencies. [ABSTRACT FROM AUTHOR]
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coparenting conflict and academic readiness in children of teen Mothers effortful control as a mediator
Family Process, 2018Co-Authors: Laudan B Jahromi, Katharine H Zeiders, Kimberly A Updegraff, Adriana J Umanataylor, Sara Douglass BaylessAbstract:Children's exposure to coparenting conflict has important implications for their developmental functioning, yet limited work has focused on such processes in families with diverse structures or ethnically and culturally diverse backgrounds. This longitudinal study examined the processes by which Mexican-origin Adolescent Mothers' coparenting conflict with their 3-year-old children's grandMothers and biological fathers (N = 133 families) were linked to children's academic and social skills at 5 years of age, and whether children's effortful control at 4 years of age mediated the link between coparenting conflict and indices of children's academic readiness. Findings revealed that Adolescent Mothers' coparenting conflict with their child's biological father was linked to indices of children's academic and social school readiness through children's effortful control among girls, but not boys, whereas conflict with grandMothers was directly linked to boys' and girls' social functioning 2 years later. Findings offer information about different mechanisms by which multiple coparenting units in families of Adolescent Mothers are related to their children's outcomes, and this work has important implications for practitioners working with families of Adolescent Mothers.
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an idiographic and nomothetic approach to the study of mexican origin Adolescent Mothers socio cultural stressors and adjustment
Prevention Science, 2015Co-Authors: Katharine H Zeiders, Kimberly A Updegraff, Adriana J Umanataylor, Laudan B JahromiAbstract:The current study examined the longitudinal relations of socio-cultural stressors (i.e., acculturative stressors, enculturative stressors, ethnic discrimination) and Mexican-origin Adolescent Mothers’ depressive symptoms and risk-taking behaviors. Utilizing an idiographic and nomothetic approach, we conducted lagged analyses to examine how individuals’ fluctuations in stressors predicted subsequent adjustment. Further, we investigated potential threshold effects by examining if the impact of fluctuations in stressors differed at varying levels of stressors. Mexican-origin Adolescent females (N = 184) participated in yearly in-home assessments across 5 years and reported on their experiences of acculturative and enculturative stressors, ethnic discrimination, depressive symptoms, and risk-taking behaviors. Findings revealed that within-person fluctuations in acculturative stressors and, to a lesser extent, perceived discrimination related to youths’ depressive symptoms. For risk-taking behaviors, however, only within-person fluctuations in enculturative stressors emerged as significant. Further, a threshold effect emerged in the link between enculturative stressors and risk-taking behaviors, suggesting that fluctuations in enculturative stressors predicted changes in risk-taking behaviors at high levels of enculturative stressors but not low levels. Our findings highlight the differential relations between socio-cultural stressors and Adolescent females’ adjustment and suggest that prevention programs aimed at reducing depressive symptoms should attend to any degree of change in socio-cultural stressors, whereas programs focused on risk-taking behaviors should be especially attuned to levels of enculturative stress.
Adriana J Umanataylor - One of the best experts on this subject based on the ideXlab platform.
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mexican origin Adolescent Mothers economic contexts educational re engagement and their children s school readiness
Child Development, 2021Co-Authors: Elana R Mcdermott, Laudan B Jahromi, Adriana J Umanataylor, Stefanie Martinezfuentes, Shandra M Jones, Kimberly A UpdegraffAbstract:Drawing on data from a longitudinal study of 204 Mexican-origin Adolescent Mothers, their mother figures, and their children, the current investigation examined (a) Adolescent Mothers' educational re-engagement and attainment beginning during their pregnancy and ending when their child was 5 years old; and (b) the influence of the family economic context on Adolescent Mothers' educational re-engagement and attainment and their children's academic and social-emotional outcomes. Findings detailed Adolescent Mothers' re-engagement in school after the birth of their child and revealed that family income during Adolescents' pregnancies was directly associated with re-engagement and attainment, and also initiated cascade effects that shaped Adolescents' economic contexts, their subsequent re-engagement and attainment, and ultimately their children's academic and social-emotional outcomes at age 5.
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maternal self efficacy is protective for child but not mother body mass index among mexican origin children with negative temperament
Journal of Developmental and Behavioral Pediatrics, 2019Co-Authors: Sonali Rajan, Laudan B Jahromi, Adriana J Umanataylor, Diamond Y Bravo, Kimberly A UpdegraffAbstract:Objective Childhood obesity persists as a serious public health concern, particularly among Mexican-origin youth. Teen Mothers are also at heightened obesity risk. Multiple factors may exacerbate this risk, including stressors associated with parenting. Indeed, difficult child temperaments pose unique parenting challenges, which may also be linked to physical health outcomes in Mothers. The purpose of this study was to examine whether the interaction between negative child temperament and parenting self-efficacy is related to the body mass index (BMI) of young children and their Adolescent Mothers while controlling for important contextual factors. We also examined which pathways differed for girls versus boys. Methods Data were from a longitudinal study spanning 5 years that included 204 Mexican-origin young Mothers and their children (with data collected at birth, age 4 years, and age 5 years). A multigroup structural equation modeling framework was used. Results The rate of early childhood obesity was low in comparison with national averages, whereas the rate of Adolescent mother obesity was notably higher than the national average. Negative child temperament was associated with higher child BMI among those Adolescent Mothers with low parenting self-efficacy. Among the children with a negative temperament, their Mothers' high parenting self-efficacy may have served as a protective factor against unhealthy child BMI. This significant interaction held for both boys and girls. Conclusion Research evaluating the potential effectiveness of interventions that promote parenting self-efficacy during early childhood as a means to reduce the rate of obesity among children of Adolescent Mothers should be conducted.
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discrimination and ethnic racial identity understanding direction of effects using within and between person analyses
Child Development, 2019Co-Authors: Katharine H Zeiders, Kimberly A Updegraff, Adriana J Umanataylor, Sara Douglass Bayless, Chelsea L Derlan, Laudan B JahromiAbstract:Ethnic-racial identity (ERI) development and ethnic-racial discrimination are two salient experiences among Adolescents in the United States. Despite growing awareness of the costs and benefits of these experiences individually, we know little about how they may influence one another. The current study examined competing hypotheses relating discrimination and components of ERI (i.e., exploration, resolution, affirmation) among a sample of Mexican-origin Adolescent Mothers (N = 181; Mage at Wave 1 = 16.83, SD = 1.01) across six waves of data. Findings revealed that within-person changes in discrimination predicted subsequent ERI resolution and affirmation; however, ERI did not predict subsequent discrimination. Between-person effects of discrimination on affirmation were significant. Our findings underscore the importance of discrimination experiences in shaping Mexican-origin Adolescent Mothers' normative developmental competencies. [ABSTRACT FROM AUTHOR]
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coparenting conflict and academic readiness in children of teen Mothers effortful control as a mediator
Family Process, 2018Co-Authors: Laudan B Jahromi, Katharine H Zeiders, Kimberly A Updegraff, Adriana J Umanataylor, Sara Douglass BaylessAbstract:Children's exposure to coparenting conflict has important implications for their developmental functioning, yet limited work has focused on such processes in families with diverse structures or ethnically and culturally diverse backgrounds. This longitudinal study examined the processes by which Mexican-origin Adolescent Mothers' coparenting conflict with their 3-year-old children's grandMothers and biological fathers (N = 133 families) were linked to children's academic and social skills at 5 years of age, and whether children's effortful control at 4 years of age mediated the link between coparenting conflict and indices of children's academic readiness. Findings revealed that Adolescent Mothers' coparenting conflict with their child's biological father was linked to indices of children's academic and social school readiness through children's effortful control among girls, but not boys, whereas conflict with grandMothers was directly linked to boys' and girls' social functioning 2 years later. Findings offer information about different mechanisms by which multiple coparenting units in families of Adolescent Mothers are related to their children's outcomes, and this work has important implications for practitioners working with families of Adolescent Mothers.
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an idiographic and nomothetic approach to the study of mexican origin Adolescent Mothers socio cultural stressors and adjustment
Prevention Science, 2015Co-Authors: Katharine H Zeiders, Kimberly A Updegraff, Adriana J Umanataylor, Laudan B JahromiAbstract:The current study examined the longitudinal relations of socio-cultural stressors (i.e., acculturative stressors, enculturative stressors, ethnic discrimination) and Mexican-origin Adolescent Mothers’ depressive symptoms and risk-taking behaviors. Utilizing an idiographic and nomothetic approach, we conducted lagged analyses to examine how individuals’ fluctuations in stressors predicted subsequent adjustment. Further, we investigated potential threshold effects by examining if the impact of fluctuations in stressors differed at varying levels of stressors. Mexican-origin Adolescent females (N = 184) participated in yearly in-home assessments across 5 years and reported on their experiences of acculturative and enculturative stressors, ethnic discrimination, depressive symptoms, and risk-taking behaviors. Findings revealed that within-person fluctuations in acculturative stressors and, to a lesser extent, perceived discrimination related to youths’ depressive symptoms. For risk-taking behaviors, however, only within-person fluctuations in enculturative stressors emerged as significant. Further, a threshold effect emerged in the link between enculturative stressors and risk-taking behaviors, suggesting that fluctuations in enculturative stressors predicted changes in risk-taking behaviors at high levels of enculturative stressors but not low levels. Our findings highlight the differential relations between socio-cultural stressors and Adolescent females’ adjustment and suggest that prevention programs aimed at reducing depressive symptoms should attend to any degree of change in socio-cultural stressors, whereas programs focused on risk-taking behaviors should be especially attuned to levels of enculturative stress.
Margo Devoe - One of the best experts on this subject based on the ideXlab platform.
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Motivational intervention to reduce rapid subsequent births to Adolescent Mothers: A community-based randomized trial
Annals of Family Medicine, 2009Co-Authors: Beth Barnet, Jiexin Liu, Margo Devoe, Anne K Duggan, Melanie A Gold, Edward PecukonisAbstract:PURPOSE: One-quarter of Adolescent Mothers bear another child within 2 years, compounding their risk of poorer medical, educational, economic, and parenting outcomes. Most efforts to prevent rapid subsequent birth to teenagers have been unsuccessful but have seldom addressed motivational processes.\n\nMETHODS: We conducted a randomized trial to determine the effectiveness of a computer-assisted motivational intervention (CAMI) in preventing rapid subsequent birth to Adolescent Mothers. Pregnant teenagers (N = 235), aged 18 years and older who were at more than 24 weeks' gestation, were recruited from urban prenatal clinics serving low-income, predominantly African American communities. After completing baseline assessments, they were randomly assigned to 3 groups: (1) those in CAMI plus enhanced home visit (n = 80) received a multi-component home-based intervention (CAMI+); (2) those in CAMI-only (n = 87) received a single component home-based intervention; (3) and those in usual-care control (n = 68) received standard usual care. Teens in both intervention groups received CAMI sessions at quarterly intervals until 2 years' postpartum. Those in the CAMI+ group also received monthly home visits with parenting education and support. CAMI algorithms, based on the transtheoretical model, assessed sexual relationships and contraception-use intentions and behaviors, and readiness to engage in pregnancy prevention. Trained interventionists used CAMI risk summaries to guide motivational interviewing. Repeat birth by 24 months' postpartum was measured with birth certificates.\n\nRESULTS: Intent-to-treat analysis indicated that the CAMI+ group compared with the usual-care control group exhibited a trend toward lower birth rates (13.8% vs 25.0%; P = .08), whereas the CAMI-only group did not (17.2% vs 25.0%; P = .32). Controlling for baseline group differences, the hazard ratio (HR) for repeat birth was significantly lower for the CAMI+ group than it was with the usual-care group (HR = 0.45; 95% CI, 0.21-0.98). We developed complier average causal effects models to produce unbiased estimates of intervention effects accounting for variable participation. Completing 2 or more CAMI sessions significantly reduced the risk of repeat birth in both groups: CAMI+ (HR = 0.40; 95% CI, 0.16-0.98) and CAMI-only (HR = 0.19; 95% CI, 0.05-0.69).\n\nCONCLUSIONS: Receipt of 2 or more CAMI sessions, either alone or within a multicomponent home-based intervention, reduced the risk of rapid subsequent birth to Adolescent Mothers.
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double jeopardy depressive symptoms and rapid subsequent pregnancy in Adolescent Mothers
Obstetrical & Gynecological Survey, 2008Co-Authors: Beth Barnet, Jiexin Liu, Margo DevoeAbstract:Adolescent Mothers in the United States are twice as likely as adults to become depressed, and African Americans seem to be especially at risk. A recent meta-analysis showed that nearly 1 in 5 teen Mothers had another pregnancy within 12 months, and nearly 40% within 2 years. Both rapid subsequent pregnancy and maternal depression are associated with an increased risk of child abuse and neglect, as well as impaired intellectual development and psychosocial functioning. This study evaluated depressive symptoms using the Center for Epidemiological Studies Depression Scale in 269 pregnant teenagers age 12-18 years who were seen at 5 community-based prenatal sites. The subjects-predominantly low-income African Americans-were interviewed 1 and 2 years after delivery. Nearly half of the 245 teens followed until 2 years postpartum had at least one subsequent pregnancy, and 10% had more than one. One-third of 24 participants had another pregnancy within 12 months. The mean interval between the index birth and first subsequent pregnancy was 11.4 months. The teens who had a subsequent pregnancy were more likely to have dropped out of school, to not use condoms consistently, and to claim a relationship with their infant's father. Subsequent pregnancies were significantly more frequent in teens having depressive symptoms at baseline, even after adjusting for numerous possible confounding factors. In addition, teens with depressive symptoms tended to have a subsequent pregnancy significantly sooner after the index birth compared to those without such symptoms. These findings suggest that, in teenage Mothers, depression may be an important and independent risk factor for a subsequent pregnancy within 1 to 2 years of an index pregnancy. Because depression is treatable, it will be of interest to learn whether better recognition will lessen the risk of a rapid subsequent pregnancy.
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double jeopardy depressive symptoms and rapid subsequent pregnancy in Adolescent Mothers
JAMA Pediatrics, 2008Co-Authors: Beth Barnet, Jiexin Liu, Margo DevoeAbstract:Objective To examine whether depressive symptoms are a risk factor for a subsequent pregnancy in Adolescent Mothers. Design Secondary analysis from a longitudinal risk-reduction intervention. Setting Five community-based prenatal sites in Baltimore, Maryland. Participants Two hundred sixty-nine consenting teens, predominantly African American and with low income, who received prenatal care at any of the 5 community-based prenatal sites and completed follow-up questionnaires at 1 or 2 years post partum. Intervention Baseline depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale. Outcome Measure Occurrence of and time to subsequent pregnancy by 2 years post partum. Results Among teens completing at least 1 follow-up questionnaire, baseline depressive symptoms were present in 46%. A subsequent pregnancy by 2 years post partum was experienced by 49%, with a mean (SD) time to first subsequent pregnancy of 11.4 (5.8) months. Depressive symptoms were associated with increased risk of subsequent pregnancy in both unadjusted models (hazard ratio, 1.44; 95% confidence interval, 1.01-2.03) and adjusted models (hazard ratio, 1.44; 95% confidence interval, 1.00-2.01). Conclusions Depressive symptoms may be an independent risk factor for subsequent pregnancy in African American Adolescent Mothers. Because depression is treatable, future studies should evaluate whether improved recognition and treatment of Adolescent depression reduces the risk of rapid subsequent pregnancy.
Beth Barnet - One of the best experts on this subject based on the ideXlab platform.
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Motivational intervention to reduce rapid subsequent births to Adolescent Mothers: A community-based randomized trial
Annals of Family Medicine, 2009Co-Authors: Beth Barnet, Jiexin Liu, Margo Devoe, Anne K Duggan, Melanie A Gold, Edward PecukonisAbstract:PURPOSE: One-quarter of Adolescent Mothers bear another child within 2 years, compounding their risk of poorer medical, educational, economic, and parenting outcomes. Most efforts to prevent rapid subsequent birth to teenagers have been unsuccessful but have seldom addressed motivational processes.\n\nMETHODS: We conducted a randomized trial to determine the effectiveness of a computer-assisted motivational intervention (CAMI) in preventing rapid subsequent birth to Adolescent Mothers. Pregnant teenagers (N = 235), aged 18 years and older who were at more than 24 weeks' gestation, were recruited from urban prenatal clinics serving low-income, predominantly African American communities. After completing baseline assessments, they were randomly assigned to 3 groups: (1) those in CAMI plus enhanced home visit (n = 80) received a multi-component home-based intervention (CAMI+); (2) those in CAMI-only (n = 87) received a single component home-based intervention; (3) and those in usual-care control (n = 68) received standard usual care. Teens in both intervention groups received CAMI sessions at quarterly intervals until 2 years' postpartum. Those in the CAMI+ group also received monthly home visits with parenting education and support. CAMI algorithms, based on the transtheoretical model, assessed sexual relationships and contraception-use intentions and behaviors, and readiness to engage in pregnancy prevention. Trained interventionists used CAMI risk summaries to guide motivational interviewing. Repeat birth by 24 months' postpartum was measured with birth certificates.\n\nRESULTS: Intent-to-treat analysis indicated that the CAMI+ group compared with the usual-care control group exhibited a trend toward lower birth rates (13.8% vs 25.0%; P = .08), whereas the CAMI-only group did not (17.2% vs 25.0%; P = .32). Controlling for baseline group differences, the hazard ratio (HR) for repeat birth was significantly lower for the CAMI+ group than it was with the usual-care group (HR = 0.45; 95% CI, 0.21-0.98). We developed complier average causal effects models to produce unbiased estimates of intervention effects accounting for variable participation. Completing 2 or more CAMI sessions significantly reduced the risk of repeat birth in both groups: CAMI+ (HR = 0.40; 95% CI, 0.16-0.98) and CAMI-only (HR = 0.19; 95% CI, 0.05-0.69).\n\nCONCLUSIONS: Receipt of 2 or more CAMI sessions, either alone or within a multicomponent home-based intervention, reduced the risk of rapid subsequent birth to Adolescent Mothers.
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double jeopardy depressive symptoms and rapid subsequent pregnancy in Adolescent Mothers
Obstetrical & Gynecological Survey, 2008Co-Authors: Beth Barnet, Jiexin Liu, Margo DevoeAbstract:Adolescent Mothers in the United States are twice as likely as adults to become depressed, and African Americans seem to be especially at risk. A recent meta-analysis showed that nearly 1 in 5 teen Mothers had another pregnancy within 12 months, and nearly 40% within 2 years. Both rapid subsequent pregnancy and maternal depression are associated with an increased risk of child abuse and neglect, as well as impaired intellectual development and psychosocial functioning. This study evaluated depressive symptoms using the Center for Epidemiological Studies Depression Scale in 269 pregnant teenagers age 12-18 years who were seen at 5 community-based prenatal sites. The subjects-predominantly low-income African Americans-were interviewed 1 and 2 years after delivery. Nearly half of the 245 teens followed until 2 years postpartum had at least one subsequent pregnancy, and 10% had more than one. One-third of 24 participants had another pregnancy within 12 months. The mean interval between the index birth and first subsequent pregnancy was 11.4 months. The teens who had a subsequent pregnancy were more likely to have dropped out of school, to not use condoms consistently, and to claim a relationship with their infant's father. Subsequent pregnancies were significantly more frequent in teens having depressive symptoms at baseline, even after adjusting for numerous possible confounding factors. In addition, teens with depressive symptoms tended to have a subsequent pregnancy significantly sooner after the index birth compared to those without such symptoms. These findings suggest that, in teenage Mothers, depression may be an important and independent risk factor for a subsequent pregnancy within 1 to 2 years of an index pregnancy. Because depression is treatable, it will be of interest to learn whether better recognition will lessen the risk of a rapid subsequent pregnancy.
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double jeopardy depressive symptoms and rapid subsequent pregnancy in Adolescent Mothers
JAMA Pediatrics, 2008Co-Authors: Beth Barnet, Jiexin Liu, Margo DevoeAbstract:Objective To examine whether depressive symptoms are a risk factor for a subsequent pregnancy in Adolescent Mothers. Design Secondary analysis from a longitudinal risk-reduction intervention. Setting Five community-based prenatal sites in Baltimore, Maryland. Participants Two hundred sixty-nine consenting teens, predominantly African American and with low income, who received prenatal care at any of the 5 community-based prenatal sites and completed follow-up questionnaires at 1 or 2 years post partum. Intervention Baseline depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale. Outcome Measure Occurrence of and time to subsequent pregnancy by 2 years post partum. Results Among teens completing at least 1 follow-up questionnaire, baseline depressive symptoms were present in 46%. A subsequent pregnancy by 2 years post partum was experienced by 49%, with a mean (SD) time to first subsequent pregnancy of 11.4 (5.8) months. Depressive symptoms were associated with increased risk of subsequent pregnancy in both unadjusted models (hazard ratio, 1.44; 95% confidence interval, 1.01-2.03) and adjusted models (hazard ratio, 1.44; 95% confidence interval, 1.00-2.01). Conclusions Depressive symptoms may be an independent risk factor for subsequent pregnancy in African American Adolescent Mothers. Because depression is treatable, future studies should evaluate whether improved recognition and treatment of Adolescent depression reduces the risk of rapid subsequent pregnancy.