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ABSTRACT: This chapter provides a broad overview of the role of setting in family based prevention. This chapter has several related
goals: First, we provide a brief overview of the ecodevelopmental model. Second, we explore the existing empirical literature
providing evidence to support how specific settings may present risk or protection for HIV/STDs for individuals within a family,
using the framework of the ecodevelopmental model. The settings to be explored in this chapter include the home, school, neighborhood,
church, and substance abuse treatment settings. Finally, for each setting we provide examples illustrating which aspects of
settings may be most important for conducting HIV/STD family based preventive interventions.
12/2011: pages 69-93;
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ABSTRACT: This study examines possible bidirectional relationships between neighborhood climate (i.e., perceived neighborhood social environment) and walking behavior across a 12-month period in older Hispanics.
A population-based sample of 217 community-dwelling older Hispanics in Miami, Florida, completed measures of perceived neighborhood climate and neighborhood walking, at two assessment time points (12 months apart).
Structural equation modeling analyses revealed that neighborhood climate predicted subsequent walking 12 months later, such that more positive perceptions of neighborhood climate predicted more walking. Follow-up analyses revealed that older adults who resided in the top half of neighborhoods based on perceived neighborhood climate scores at initial assessment were 2.57 times as likely to have walked at least one block in the last week at follow-up, relative to older adults residing in neighborhoods whose climate was in the lower half.
Perceptions of a more positive neighborhood social environment may promote walking in urban, older Hispanics.
Journal of Aging and Health 09/2011; 23(8):1325-51. · 1.56 Impact Factor
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ABSTRACT: Depressive symptoms and physical inactivity are health risks among minority older adults. This study examined whether social support moderated the relationship of depressive symptoms to walking behavior among 217 community-dwelling, Hispanic older adults.
Cross-sectional analyses were used to test whether different forms of social support interacted with depressive symptoms to affect both likelihood and amount of walking.
Analyses showed a significant interaction between depressive symptoms and instrumental support related to the likelihood of walking and a marginally significant interaction between depressive symptoms and instrumental social support related to the amount of walking. Depressive symptoms were associated with a lower likelihood and lower amount of walking among participants receiving high levels of instrumental social support (e.g., help with chores) but not low instrumental support. Emotional and informational support did not moderate the depression to walking relationship.
Receiving too much instrumental support was related to sedentary behavior among depressed older adults.
Journal of Aging and Health 04/2011; 23(6):974-93. · 1.56 Impact Factor
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ABSTRACT: This study examines the relationship between depressive symptoms and walking behavior across 30 months in a prospective study of 217 community-dwelling, Hispanic older adults in Miami, Florida (ages 70-100 years).
Analyses examine the direction of the relationship between depressive symptoms and physical activity (i.e., walking) over time, as well as test for a potential bi-directional or reciprocal relationship between these two variables.
Structural equation modeling (SEM) with a cross-lagged panel design revealed that walking was unrelated to subsequent depressive symptoms. However, depressive symptoms were related to subsequent walking behavior at every time-point, such that higher levels of depressive symptoms were predictive of less walking in the future. Older adults who had clinically-relevant depressive symptoms at the initial assessment had 1.34 times the risk of not walking 30 months later, compared to older adults without clinically-relevant depressive symptoms.
Results support the need for primary care providers to evaluate and address depressive symptoms among older adults, as a means of reducing sedentary behavior and potentially improving health. Further research on the prevention and management of depressive symptoms and sedentary behavior is needed, given the morbidity related to both of these health risks, particularly for minority and low-socio-economic status (SES) older adults.
Aging and Mental Health 03/2010; 14(2):211-9. · 1.37 Impact Factor
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ABSTRACT: This study examines the relationship of neighborhood climate (i.e., neighborhood social environment) to perceived social support and mental health outcomes in older Hispanic immigrants.
A population-based sample of 273 community-dwelling older Hispanic immigrants (aged 70 to 100) in Miami, Florida, completed self-report measures of neighborhood climate, social support, and psychological distress and performance-based measures of cognitive functioning. Structural equation modeling was used to model the relationship of neighborhood climate to elders' perceived social support and mental health outcomes (i.e., cognitive functioning, psychological distress).
Neighborhood climate had a significant direct relationship to cognitive functioning, after controlling for demographics. By contrast, neighborhood climate had a significant indirect relationship to psychological distress, through its relationship to perceived social support. Moreover, social support mediated the relationship between neighborhood climate and psychological distress.
Findings suggest that a more positive neighborhood social environment may be associated with better mental health outcomes in urban, older Hispanic immigrants.
Journal of Aging and Health 07/2009; 21(3):431-59. · 1.56 Impact Factor
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ABSTRACT: This study examines the relationship between neighboring behavior and depressive symptoms across 3 years in a prospective study of 273 community-dwelling, Hispanic older adults in Miami, Florida. The analyses extend the literature by testing for a bidirectional or reciprocal relationship between neighboring behavior and depressive symptoms over time and examining the relationship between these variables in Hispanic older adults, a group at risk of developing depressive symptoms. Structural Equation Modeling with a cross-lagged panel design showed that depressive symptoms were unrelated to subsequent neighboring behavior. However, neighboring behavior was related to subsequent depressive symptoms at every time point, such that higher levels of neighboring behavior were related to lower levels of depressive symptoms. Findings suggest that neighboring behavior may be a protective factor against depressive symptoms in community-dwelling Hispanic older adults. © 2009 Wiley Periodicals, Inc.
Journal of Community Psychology 06/2009; 37(5):618 - 634. · 0.99 Impact Factor
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ABSTRACT: Research on contextual and neighborhood effects increasingly includes the built (physical) environment's influences on health and social well-being. A population-based study examined whether architectural features of the built environment theorized to promote observations and social interactions (e.g., porches, windows) predict Hispanic elders' psychological distress.
Coding of built environment features of all 3,857 lots across 403 blocks in East Little Havana, Florida, and enumeration of elders in 16,000 households was followed by assessments of perceived social support and psychological distress in a representative sample of 273 low socioeconomic status (SES) Hispanic elders. Structural-equation modeling was used to assess relationships between block-level built environment features, elders' perceived social support, and psychological distress.
Architectural features of the front entrance such as porches that promote visibility from a building's exterior were positively associated with perceived social support. In contrast, architectural features such as window areas that promote visibility from a building's interior were negatively associated with perceived social support. Perceived social support in turn was associated with reduced psychological distress after controlling for demographics. Additionally, perceived social support mediated the relationship of built environment variables to psychological distress.
Architectural features that facilitate direct, in-person interactions may be beneficial for Hispanic elders' mental health.
The Journals of Gerontology Series B Psychological Sciences and Social Sciences 03/2009; 64(2):234-46. · 2.62 Impact Factor
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ABSTRACT: This study documents a 35% prevalence of clinically relevant depressive symptoms in a population-based sample of mostly Cuban older adults residing in a low-income, urban Miami neighborhood. This rate is comparable to, or higher than, prevalence rates reported by most other population-based samples of U.S. older adults. Logistic regression analyses indicate that perceived financial strain was the only sociodemographic factor associated with greater odds of clinically relevant symptoms when other sociodemographic factors were statistically controlled. Gender, age, and marital status were not related to elevated depressive symptoms. A case study illustrates the impact of financial strain on older adults' mental health. Findings highlight the need for mental health screening and case management services among these older adults, particularly those who experience financial strain.
Clinical Gerontologist 01/2009; 32(1):26-43. · 0.73 Impact Factor
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ABSTRACT: Research on neighborhood effects increasingly includes the influences of the built environment on health and social well-being.
In this population-based study in a low-socioeconomic-status (SES), Hispanic neighborhood, we examined whether architectural features of the built environment theorized to promote direct observations and interactions (e.g., porches, stoops) predicted Hispanic elders' social support and psychological and physical functioning.
We coded built-environment features for all 3,857 lots in the 403-block area of an urban Miami, Florida, community. We then conducted three annual assessments of social support, psychological distress, and physical functioning in a population-based sample of 273 low-SES Hispanic elders (70-100 years of age). We used structural equation modeling analytic techniques to examine hypothesized relationships between the built environment and elders' social support, psychological distress, and physical functioning over a 3-year period.
After controlling for age, sex, and income, architectural features of the built environment theorized to facilitate visual and social contact had a significant direct relationship with elders' physical functioning as measured 3 years later, and an indirect relationship through social support and psychological distress. Further binomial regression analyses suggested that elders living on blocks marked by low levels of positive front entrance features were 2.7 times as likely to have subsequent poor levels of physical functioning, compared with elders living on blocks with a greater number of positive front entrance features [b = 0.99; chi(2) (1 df) = 3.71; p = 0.05; 95% confidence interval, 1.0-7.3].
Architectural features that facilitate visual and social contacts may be a protective factor for elders' physical functioning.
Environmental Health Perspectives 11/2008; 116(10):1300-7. · 7.04 Impact Factor
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ABSTRACT: This study compared 5 psychological models of the relationship between social support (SS) and behavioral health. These theoretical models, which have garnered some level of prior empirical support, were as follows: (a) main effects, (b) buffering effects, (c) social exchange, (d) equity, and (e) protective health outcomes of providing SS. A population-based sample of 273 community-dwelling Hispanic elders drawn from East Little Havana, Florida (ages 70-100 years old; 86% Cuban) completed self-report measures of SS, financial strain, and psychological distress (PD). Hierarchical multiple regression analyses were used to test the competing SS models. Results indicated that satisfaction with received SS was, as specified in the main-effects model, associated with lower PD, whereas received SS was unexpectedly associated with heightened PD. Reciprocal exchanges of SS (equity model) or exchanges where Hispanic elders provided more SS than they received (protective health outcomes of providing SS model) were also associated with lower PD. The feasibility of a 6th model in which the effects of SS are contingent upon the elder's preexisting PD level is proposed. Limitations, implications, and directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
Journal of Counseling Psychology 10/2008; 55(4):427-41. · 3.23 Impact Factor
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ABSTRACT: This study examines the relationship between cognitive functioning and depressive symptoms across 3 years in a prospective study of 273 community-dwelling, Hispanic older adults in Miami. The analyses extend the literature by testing for a bidirectional or reciprocal relationship between depressive symptoms and cognitive functioning over time and by examining the relationship between these variables among Hispanics, an understudied population at risk of developing depressive symptoms and cognitive impairments. Structural equation modeling with a cross-lagged panel design showed that depressive symptoms were unrelated to subsequent cognitive functioning. However, cognitive functioning was related to subsequent depressive symptoms at every time point, such that poorer cognitive functioning was related to higher depressive symptoms. Findings suggest that cognitive declines may predict depressive symptoms in community-dwelling Hispanic older adults.
The Journals of Gerontology Series B Psychological Sciences and Social Sciences 10/2008; 63(5):P309-17. · 2.62 Impact Factor
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ABSTRACT: To determine effective relationships between the built environment and health and well-being, a transdisciplinary team of architectural, behavioral and health scientists developed a built environment coding system (UMBECS). They examined the relationship of resulting streetscape features to health and well-being at the block level. The research team conducted studies of the validity of UMBECS focusing on children through school conduct and grades, and on elders through a longitudinal cognitive functioning study. For children, contrary to popularly held views, commercial-residential mix was as effective as a high proportion of residential use in predicting children's school outcomes (i.e., better conduct, achievement, effort, and grades). For elders, modest but statistically significant relationships existed between block-level features, elders' neighboring behaviors, and social support, which in turn were significantly associated with cognitive and affective functioning. These findings suggest the utility of this built environment coding system for examining the relationship of built environment features to residents' health and well-being. UMBECS offers a useful tool for developing a viable transdisciplinary model of the role of the built environment in behavioral and health outcomes.
Architectural Science Review 09/2007; 50(3):234-245.
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ABSTRACT: A population-based study examined the relationship between diversity of use of the built environment and teacher reports of children's grades. Diversity of use of the built environment (i.e., proportion of a block that is residential, institutional, commercial and vacant) was assessed for all 403 city blocks in East Little Havana, Miami-a Hispanic neighborhood. Cluster analysis identified three block-types, based on diversity of use: Residential, Mixed-Use, and Commercial. Cross-classified hierarchical linear modeling was used to examine the impact of diversity of use, school, gender, and year-in-school on academic and conduct grades for 2857 public school children who lived in these blocks. Contrary to popular belief, mixed-use blocks were associated with optimal outcomes. Specifically, follow-up analyses found that a youth living on a residential block had a 74% greater odds of being in the lowest 10% of conduct grades (conduct GPA <2.17) than a youth living on a mixed-use block. In fact, an analysis of the population attributable fraction suggests that if the risk associated with residential blocks could be reduced to the level of risk associated with mixed-use blocks, a 38% reduction in Conduct GPAs <2.17 could be achieved in the total population. These findings suggest that public policy targeting the built environment may be a mechanism for community-based interventions to enhance children's classroom conduct, and potentially related sequelae.
American Journal of Community Psychology 12/2006; 38(3-4):299-310. · 1.74 Impact Factor
