Jooyoung Kong

Patterns and predictors of enactment of state childhood obesity legislation in the United States: 2006-2009.

OBJECTIVES We developed a content review for state policies related to childhood obesity, and we have quantitatively described the predictors of enactment. METHODS We collected an inventory of 2006 through 2009 state legislation on 27 childhood obesity topics from legislative databases. We coded each bill for general information, topic content, and other appropriate components. We conducted a general descriptive analysis and 3 multilevel analyses using bill- and state-level characteristics to predict bill enactment. RESULTS Common topics in the 27% of the bills that were enacted were community physical activity access, physical education, and school food policy. Committee and bipartisan sponsorship and having term limits significantly predicted enactment in at least 1 model. Bills with safe routes to school or health and nutrition content were twice as likely to be enacted. Bills containing product and menu labeling or soda and snack taxes were significantly less likely to be enacted. CONCLUSIONS Bipartisan and committee support and term limits are important in bill enactment. Advocacy efforts can be tailored to increase awareness and sense of priority among policymakers.

It's all in the lens: differences in views on obesity prevention between advocates and policy makers.

BACKGROUND Intervention strategies to reduce obesity include policy and environmental changes that are designed to provide opportunities, support, and cues to help people develop healthier behaviors. Policy changes at the state level are one way to influence access, social norms, and opportunities for better nutrition and increased physical activity among the population. METHODS Ten states were selected for a broad variance in obesity rates and number of enacted obesity prevention policies during the years of 2006-2009. Within the selected states, a purely qualitative study of attitudes of childhood obesity policy using semistructured telephone interviews was conducted. Interviews were conducted with state policy makers who serve on public health committees. A set of six states that had more than eight childhood obesity policies enacted were selected for subsequent qualitative interviews with a convenience sample of well-established advocates. RESULTS Policy makers in states where there was more childhood obesity policy action believed in the evidence behind obesity policy proposals. Policy makers also varied in the perception of obesity as a constituent priority. The major differences between advocates and policy makers included a disconnect in information dissemination, opposition, and effectiveness of these policies. CONCLUSIONS The findings from this study show differences in perceptions among policy makers in states with a greater number of obesity prevention bills enacted. There are differences among policy makers and advocates regarding the role and effectiveness of state policy on obesity prevention. This presents an opportunity for researchers and practitioners to improve communication and translation of evidence to policy makers, particularly in states with low legislation.

Caring for My Abuser: Childhood Maltreatment and Caregiver Depression

PURPOSE OF THE STUDY This study examined depressive symptoms among adult survivors of childhood maltreatment who provided care to their former abusive/neglectful parents. We also investigated the extent to which four coping styles--problem-focused coping, emotion-focused coping, positive social support, and negative social support--moderated the association between childhood maltreatment and depressive symptoms of the caregivers. DESIGN AND METHODS Among 1,001 filial caregivers from the 2003-2005 wave of the Wisconsin Longitudinal Study, 18.6% of respondents reported verbal, physical, or sexual abuse in childhood; 9.4% reported neglect in childhood. Ordinary least squares regression models were estimated. RESULTS Persons who had a history of parental abuse showed significantly more frequent depressive symptoms when providing care to their abusive parent(s) compared with caregivers who had not experienced parental abuse. Those who had been neglected had significantly more frequent depressive symptoms than caregivers who did not report neglect. Additionally, the use of emotion-focused coping was more strongly associated with more frequent depressive symptoms among abused caregivers than among caregivers with no history of abuse. IMPLICATIONS This vulnerable group of caregivers should be recognized in the development and implementation of support services for family caregivers at the state and national levels. In direct practice settings, when assessing caregiver stress and burden, the history of childhood maltreatment needs to be taken into account.

Sources of psychological pain and suicidal thoughts among homeless adults

Homeless adults experience problems in multiple areas of their lives. It was hypothesized that adults who were troubled by problems in more areas of their lives would be more likely to report suicidal thoughts. The sample included 457 homeless men and women who resided in three emergency shelters. The number of sources of psychological pain, past suicide attempts, and being a man predicted current suicidal thoughts, but being diagnosed with a depressive disorder did not. Shelter workers should ask adults whether they have attempted suicide in the past and how troubled they are by each area of their lives.

A History of Childhood Maltreatment and Intimate Partner Violence Victimization Among Native American Adults

This study examined the association between childhood maltreatment and intimate partner violence (IPV) victimization among Native American adults. Based on Riggs’s theoretical model of the long-term effects of childhood abuse, we also examined the mediating roles of insecure attachment patterns and depressive symptoms. The current study was a secondary data analysis using the 2013 General Well-Being Among Native Americans dataset (N = 479). Structural equation modeling was used to examine the hypothesized relationships among key constructs. Consistent with existing literature of revictimization, our findings showed that the experience of childhood maltreatment was positively associated with IPV victimization. Mediation analyses indicated that depression was a significant mediator in the association between childhood maltreatment and IPV victimization. In addition, all the paths linking childhood maltreatment, fearful attachment, depressive symptoms, and IPV victimization were statistically significant, although the overall mediation effect was not significant. The results of this study suggest that Riggs’s model can serve as a useful theoretical framework for understanding the long-term effects of childhood maltreatment among Native American adults. Practitioners in the area of IPV should include maltreatment history and current attachment patterns in client assessments, which could help address conflict and violence within intimate relationships.

The Long-Term Effects of Participant Direction of Supports and Services for People With Disabilities.

Numerous studies have demonstrated the short-term effectiveness of the Cash and Counseling model option of participant-directed home and community-based personal care service programs for Medicaideligible recipients with disabilities requiring long-term care. However, long-term experiences with participant-directed services have yet to be examined for these individuals. We addressed this gap in the literature through participatory action research and qualitative content analysis. Working together as coresearchers with members of the National Participant Network, a peer organization for people interested in or enrolled in participant-directed services, we interviewed 17 adults enrolled in one state’s Cash and Counseling-based program. Participants’ ages ranged from 40 to 83 years, had been enrolled for at least 5 years, and acted as their own representative within the program. Our major findings show (a) the program’s flexibility allowed for adaptation to meet participants’ changing needs over time and (b) that program attendants helped connect participants with community in multiple ways. In this article, we provide important policy and practice implications for participant-directed programs for people with disabilities.