Objective

Despite growing evidence that discrimination may contribute to poor mental health, few studies have assessed this association among US Latinos. Furthermore, the interaction between discrimination and educational attainment in shaping Latino mental health is virtually unexplored. This study aims to examine the association between perceived discrimination and depressive symptoms and the modifying role of education among a population of Mexican-origin adults.

Design

We utilized population-based data from 629 Mexican-origin adults (mean age = 52.8 years) participating the Niños Lifestyle and Diabetes Study (2013-2014). Perceived discrimination was defined as responding 'sometimes' or 'often' to at least one item on the 9-item Everyday Discrimination Scale. High depressive symptoms were defined as scoring ≥10 on the CESD-10. We used log-binomial and linear-binomial models to estimate prevalence ratios (PR) and prevalence differences (PD), respectively, of high depressive symptoms for levels of perceived discrimination. Final models were adjusted for age, sex, education, cultural orientation, and nativity. General estimating equations were employed to account for within-family clustering.

Results

Prevalence of perceived discrimination and high depressive symptoms were 49.5% and 29.2%, respectively. Participants experiencing discrimination had higher depressive symptom prevalence than those never or rarely experiencing discrimination [PR = 1.94, 95% confidence interval (CI): 1.46-2.58; PD = 0.19, 95% CI: 0.12-0.27]. The strength of this association varied by education level. The association between discrimination and depressive symptoms was stronger among those with >12 years of education (PR = 2.69; PD = 0.24) compared to those with ≤12 years of education (PR = 1.36; PD = 0.09).

Conclusion

US Latinos suffer a high burden of depressive symptoms, and discrimination may be an important driver of this burden. Our results suggest that effortful coping strategies, such as achieving high education despite high perceived discrimination, may magnify discrimination's adverse effect on Latino mental health.

Acculturation markers, such as language use, have been associated with Latino depression. Language use may change between generations; however, few studies have collected intergenerational data to assess how language differences between generations impact depression. Using the Niños Lifestyle and Diabetes Study (2013-2014), we assessed how changes in Spanish language use across two generations of Mexican-origin participants in Sacramento, California, influenced offspring depressive symptoms (N = 603). High depressive symptoms were defined as CESD-10 scores ≥ 10. We used log-binomial and linear-binomial models to calculate prevalence ratios and differences, respectively, for depressive symptoms by language use, adjusting for identified confounders and within-family clustering. Decreased Spanish use and stable-equal English/Spanish use across generations protected against depressive symptoms, compared to stable-high Spanish use. Stable-low Spanish use was not associated with fewer depressive symptoms compared to stable-high Spanish use. Exposure to multiple languages cross-generationally may improve resource access and social networks that protect against depression.

Background

We describe reach, partnerships, products, benefits, and lessons learned of the 25 Community Network Programs (CNPs) that applied community-based participatory research (CBPR) to reduce cancer health disparities.

Methods

Quantitative and qualitative data were abstracted from CNP final reports. Qualitative data were grouped by theme.

Results

Together, the 25 CNPs worked with more than 2,000 academic, clinical, community, government, faith-based, and other partners. They completed 211 needs assessments, leveraged funds for 328 research and service projects, trained 719 new investigators, educated almost 55,000 community members, and published 991 articles. Qualitative data illustrated how use of CBPR improved research methods and participation; improved knowledge, interventions, and outcomes; and built community capacity. Lessons learned related to the need for time to nurture partnerships and the need to attend to community demand for sustained improvements in cancer services.

Implications

Findings demonstrate the value of government-supported, community-academic, CBPR partnerships in cancer prevention and control research.

Objective: To compare 12-month post-treatment health-related quality of life (HR-QoL) and symptom severity (SS) changes among patients with symptomatic uterine fibroids (SUF) not seeking fertility and undergo a hysterectomy, abdominal myomectomy (AM), or uterine artery embolization (UAE). Materials and Methods: The Comparing Options for Management: Patient-Centered Results for Uterine Fibroids (COMPARE-UF) Registry is a multi-institutional prospective observational cohort study of patients treated for SUF. A subset of 1465 women 31-45 years of age, who underwent either hysterectomy (n = 741), AM (n = 446), or UAE (n = 155) were included in this analysis. Demographics, fibroid history, and symptoms were obtained by baseline questionnaires and at 1 year post-treatment. Results were stratified by all treatments and propensity score weighting to adjust for differences in baseline characteristics. Results: Women undergoing UAE reported the lowest baseline HR-QoL and highest SS scores (mean = 40.6 [standard deviation (SD) = 23.8]; 62.3 [SD = 24.2]) followed by hysterectomy (44.3 [24.3]; 59.8 [SD = 24.1]). At 12 months, women who underwent a hysterectomy experienced the largest change in both HR-QoL (48.7 [26.2]) and SS (51.9 [25.6]) followed by other uterine-sparing treatments. Propensity score weighting revealed all treatments produced substantial improvement, with hysterectomy patients reporting the highest HR-QoL score (92.0 [17.8]) compared with myomectomy (86.7 [17.2]) and UAE (82.6 [21.5]) (p < 0.0001). Similarly, hysterectomy patients reported the lowest SS scores (8.2 [15.1]) compared with myomectomy (16.5 [15.1]) and UAE (19.6 [17.5]) (p < 0.0001). Conclusion: All procedures showed improvement in HR-QoL and reduction in SS score at 12 months, hysterectomy showing maximum improvement. Of importance, at 12 months, patients who underwent either a myomectomy or UAE reported comparable symptom relief and HR-QoL. Clinicaltrials.Gov Identifier: NCT02260752.