Krista M. Perreira’s research while affiliated with Microbiome Core Facility USA and other places

What is this page?


This page lists works of an author who doesn't have a ResearchGate profile or hasn't added the works to their profile yet. It is automatically generated from public (personal) data to further our legitimate goal of comprehensive and accurate scientific recordkeeping. If you are this author and want this page removed, please let us know.

Publications (44)


Linear regression coefficients and 95% confidence intervals for first‐generation (vs multigenerational) high school graduates and cognitive performance, overall and by Hispanic/Latino heritage. Hispanic/Latino heritage‐stratified models adjusted for age, sex, nativity, country of education, language, and field center.
Linear regression coefficients and 95% confidence intervals for first‐generation (vs multigeneration) high school graduates and cognitive performance, by nativity. *Nativity‐stratified models adjusted for age, sex, Hispanic/Latino heritage, country of education, language, and field center.
Linear regression coefficients and 95% confidence intervals for first‐generation (vs multigenerational) high school graduates and average cognitive change from Visit 1 to Visit 2. *Models adjusted for age, sex, Hispanic/Latino heritage, nativity, country of education, language, and field center.
Intergenerational upward educational mobility and cognitive performance: results from the Study of Latinos‐Investigation of Neurocognitive Aging (SOL‐INCA)
  • Article
  • Full-text available

May 2025

·

14 Reads

·

Wassim Tarraf

·

·

[...]

·

Hector M. González

INTRODUCTION Upward educational attainment is associated with better cognitive function; differences by Hispanic/Latino heritage are unclear. METHODS We analyzed data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and its ancillary study SOL‐Investigation of Neurocognitive Aging (SOL‐INCA; n = 3300) to compare cognitive function and 7‐year cognitive change between first‐generation and multigenerational high school (HS) graduates (i.e., neither parent vs 1+ parent graduated HS) using survey‐linear regression models, and assessing for heterogeneity by heritage and nativity. RESULTS First‐generation Cuban, Mexican, and Puerto Rican HS graduates had significantly lower baseline cognitive scores than multigenerational graduates, while Dominican, Central, and South American graduates had similar cognitive scores. We found some evidence of heterogeneity by nativity. Cognitive change was similar across groups. DISCUSSION More studies of Latinos across the life course are needed to disentangle the role of educational mobility and cognitive health, particularly among US‐born Hispanic/Latino adults. Highlights Intergenerational upward educational mobility has been linked with better late‐life health. Despite significant educational gains, little is known about the association between educational mobility and cognitive function among Hispanic/Latino adults. First‐generation HS graduates had significantly lower cognitive scores at baseline compared to their multigenerational counterparts, particularly among individuals of Cuban, Mexican, and Puerto Rican heritage. Disparities in cognitive scores between first‐generation and multigenerational HS graduates were more pronounced in individuals born outside the United States. Cognitive change appeared similar across groups and did not vary by Hispanic/Latino heritage or nativity.

Download

Disparities in stage of diagnosis of colon cancer: Differences by Hispanic background, race, and ethnicity.

February 2025

·

1 Read

Journal of Clinical Oncology

24 Background: Given noted heterogeneity in Hispanic adults, cancer outcomes reported in aggregate may not detect disparities within specific Hispanic subgroups. The objective was to assess whether any potential differences in colon cancer (CC) stage at diagnosis among patients with Hispanic background (HBackground) could be explained by differences in socio-economic determinants of health (SDOH) including income, education and insurance status. Methods: The National Cancer Database was queried for patients diagnosed with CC from 2004 to 2021. Two logistic regression models generated adjusted odds ratios of late-stage (III-IV) vs early-stage (I-II) CC at diagnosis, disaggregated either by HBackground or R&E, compared to non-Hispanic White (NHW) patients. Model 1 controlled for patient/facility characteristics; Model 2 controlled for additional SDOH. Results: Of the 442,742 CC patients identified, 6% were Hispanics. Compared to NH adults, Hispanic patients were more likely (6% higher odds, p<0.0001) to present with late-stage CC. When Hispanic patients were disaggregated by HBackground, some were more likely (Mexicans 16%; Cubans 20% and South/Central Americans 12%) than NHW adults to present with late-stage CC while others (Puerto Ricans and Dominicans) were not. Disaggregation by R&E indicated that only Hispanic-White patients were more likely (12%) to present with late-stage disease than NHW patients. Controlling for SDOH, R&E differences in stage at diagnosis persisted but HBackground differences became insignificant (Table). Conclusions: Disaggregation of Hispanic adults by HBackground identifies specific subgroups at increased risk for late-stage CC at diagnosis. Understanding modifiable SDOH may identify opportunities for improving early detection of CC and outcomes in specific Hispanic subgroups. Odds of presenting with late-stage colon cancer of “Hispanic” patients disaggregated by race and ethnicity or Hispanic background compared to non-Hispanic Whites. Disaggregation based on: Model 1: Adjusted for age, facility type, year of diagnosis, and Charlson-Deyo comorbidity Model 2: Adjusted for age, facility type, year of diagnosis, Charlson-Deyo comorbidity, neighborhood income, neighborhood education, and insurance status aOR (95% CI) p-value aOR (95% CI) p-value Non-Hispanic White (n=418,046) (ref) (ref) Hispanic White (n=24,058) 1.12 (1.09, 1.15) <.0001 1.04 (1.01, 1.07) 0.01 Hispanic Background Mexican (n=3,612) 1.16 (1.08, 1.24) <.0001 1.05 (0.97, 1.13) 0.25 South/Central American (n= 1,734) 1.12 (1.02, 1.24) 0.02 1.01 (0.91, 1.12) 0.83 Cuban (n=937) 1.20 (1.05, 1.36) 0.001 1.11 (0.97, 1.27) 0.13 Puerto Rican (n=1,280) 1.07 (0.95, 1.19) 0.28 1.01 (0.90, 1.14) 0.88 Dominican (n=465) 1.14 (0.94, 1.39) 0.18 1.02 (0.83, 1.25) 0.85 aOR, Adjusted odds ratio; CI, confidence Interval.


A new measure of professional caregiver coping in long‐term care: The LTC COPE

December 2024

·

14 Reads

INTRODUCTION The professional caregiver workforce (nursing assistants and personal care aides) is critical to quality of care and quality of life in nursing home (NH) and assisted living (AL) settings. The work is highly stressful, so improving responses to stress in this workforce could contribute to satisfaction and retention. This research developed a coping measure appropriate for the diverse professional caregiver workforce. METHODS A multistage process identified and refined existing and new items. Ten racially and ethnically diverse professional caregivers advised on item selection and refinement. Subsequently, using an online QR code‐accessed questionnaire, data were collected from 391 professional caregivers from 10 NHs and 3 AL communities in three states, yielding a sample that was 87% female, widely distributed in age and experience, and racially/ethnically diverse (42% Black, non‐Hispanic/Latinx; 25% White, non‐Hispanic/Latinx; 20% Hispanic/Latinx; 7% Asian, non‐Hispanic/Latinx; and 21% born outside the United States). Analyses examined psychometric properties and principal components analysis identified factors within which items and scales aggregated. RESULTS The final instrument, named the Long‐Term Care Cope (LTC Cope), includes 26 items aggregated into six factors, which explained 60% of the variance: avoidance (five items, loadings 0.58–0.76); adaptive psychological strategies (six items, loadings 0.33–0.89); active engagement (five items, 0.47–0.89); maladaptive psychological strategies (three items, loadings 0.90–0.93); actions to minimize emotional impact (four items, loadings 0.28–0.74); and substance use (three items, loadings 0.61–0.88). Respondents often reported using multiple items within multiple factors when responding to stressful situations at work. DISCUSSION The coping strategies of professional caregivers are highly individual, with caregivers tending to utilize multiple strategies. The LTC Cope instrument and its component subscales are promising for future research to improve understanding of stress‐related coping in this diverse workforce and inform and evaluate interventions. Highlights A new measure was developed to help us better understand how professional caregivers (nursing assistants and personal care aides) deal with work‐related stress. Professional caregivers in nursing homes and assisted living tend to use multiple approaches to deal with job stress. Ways professional caregivers cope with stress vary widely—some address problems directly, some try to deal with the emotional toll of the work, and others involve avoiding the problems or their emotional consequences.


Stress‐related coping and its relationship to well‐being in nursing assistants and personal care aides in nursing homes and assisted living

December 2024

·

38 Reads

INTRODUCTION Professional caregivers (nursing assistants and personal care aides) in nursing homes (NH) and assisted living (AL) provide the majority of long‐term residential care for persons with Alzheimer's disease and related dementias. Their work is stressful, but until recently, no measures were available to assess stress in this workforce. Using the new Long‐Term Care Cope (LTC COPE) scale, this study evaluates the relationship of coping with staff demographic characteristics and outcomes; the findings can be used to develop and evaluate interventions to improve staff well‐being. METHODS We used a cross‐sectional online questionnaire completed by professional caregivers working in a purposive selection of 10 NHs and three AL communities in California, New York, and North Carolina. The sample included 391 professional caregivers and had a representative distribution by age; it was 87% female; 42% non‐Hispanic/Latinx (NHL) Black, 25% NHL White, 20% Hispanic/Latinx, and 7% NHL Asian. Worker job satisfaction, mental health, and health‐related quality of life were examined in relation to caregiver demographics and the following approaches to coping as measured by the LTC COPE: avoidance, adaptive psychological strategies, active engagement, maladaptive psychological strategies, minimizing emotional impact, and substance use. Statistical comparisons used non‐parametric Spearman correlation coefficients. RESULTS Little difference in coping strategies was noted by sex and education; older caregivers used adaptive psychological strategies more than younger caregivers; and traditionally minoritized adults (NHL Black, NHL Asian, and Hispanic/Latinx), compared to NHL White adults, more often used adaptive and less often used maladaptive psychological coping strategies. The use of maladaptive and avoidance strategies was strongly associated with depressive symptoms, anxiety, and burnout. DISCUSSION Professional caregivers report using a wide variety of coping strategies, with multiple strategies being the norm, and both adaptive/engaged and maladaptive/disengaged approaches are common. Certain coping approaches are strongly linked to depression, anxiety, and burnout; attention to training and support of adaptive and positive coping may augment other efforts to improve job satisfaction and performance. The LTC COPE scale has the potential to guide and evaluate practices to improve workers’ well‐being. Highlights Professional caregivers in nursing homes and assisted living generally use multiple strategies to cope with work‐related stress. Certain coping approaches are strongly linked to depression, anxiety, and burnout. The Long‐Term Care Cope scale has potential to guide and evaluate practices to improve worker well‐being.



The effect of social media use on mental health of college students during the pandemic

June 2024

·

556 Reads

·

18 Citations

Health Economics

Social media is viewed to be a key contributor to worsening mental health in adolescents, as most recently reflected in a public health advisory by the US Surgeon General. We provide new evidence on the causal effects of social media on mental health of college students during the Covid‐19 pandemic, exploiting unique, longitudinal data collected before the Covid‐19 pandemic began and at two points during the pandemic. We find small insignificant effects of social media 4 months into the pandemic during a period of social distancing, but large statistically significant negative effects 18 months into the pandemic when colleges were mostly back to normal operations. Using rich data on substance use, exercise, sleep, stress, and social support, we find some evidence of substitution away from activities that better support mental health at later stages of the pandemic but not at early stages. We find that the negative effects of social media are mostly concentrated among socially‐isolated students. Both social support and resilience protect students from the negative effects of social media use. Policy implications include regulating social media while also bolstering social support and resilience as important protective factors.



Figure 3: Distribution of the gendered indices in female and male participants.
Estimated association of demographic, acculturation, and psychological measures with sex and with insomnia.
Gendered indices variables and coefficients.
Association of reported sex and standardized gendered indices with insomnia
A sociodemographic index identifies non-biological sex-related effects on insomnia in the Hispanic Community Health Study/Study of Latinos

April 2024

·

34 Reads

Background Sex differences are related to both biological factors and the gendered environment. To untangle sex-related effects on health and disease it is important to model sex-related differences better. Methods Data came from the baseline visit of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a longitudinal cohort study following 16,415 individuals recruited at baseline from four study sites: Bronx NY, Miami FL, San Diego CA, and Chicago IL. We applied LASSO penalized logistic regression of male versus female sex over sociodemographic, acculturation, and psychological factors jointly. Two "gendered indices", GISE and GIPSE, summarizing the sociodemographic environment (GISE, primary) and psychosocial and sociodemographic environment (GIPSE, secondary) associated with sex, were calculated by summing these variables, weighted by their regression coefficients. We examined the association of these indices with insomnia derived from self-reported symptoms assessed via the Women Health Initiative Insomnia Rating Scale (WHIIRS), a phenotype with strong sex differences, in sex-adjusted and sex-stratified analyses. All analyses were adjusted for age, Hispanic/Latino background, and study center. Results The distribution of GISE and GIPSE differed by sex with higher values in male individuals, even when constructing and validating them on separate, independent, subsets of HCHS/SOL individuals. In an association model with insomnia, male sex was associated with lower likelihood of insomnia (odds ratio (OR)=0.60, 95% CI (0.53, 0.67)). Including GISE in the model, the association was slightly weaker (OR=0.63, 95% CI (0.56, 0.70)), and weaker when including instead GIPSE in the association model (OR=0.78, 95% CI (0.69, 0.88)). Higher values of GISE and of GIPSE, more common in male sex, were associated with lower likelihood of insomnia, in analyses adjusted for sex (per 1 standard deviation of the index, GISE OR= 0.92, 95% CI (0.87, 0.99), GIPSE OR=0.65, 95% CI (0.61, 0.70)). Conclusions New measures such as GISE and GIPSE capture sex-related differences beyond binary sex and have the potential to better model and inform research studies of health. However, such indices do not account for gender identity and may not well capture the environment experienced by intersex and non-binary persons.



STRESS AND COPING AMONG NURSING ASSISTANTS AND PERSONAL CARE AIDES IN LONG-TERM CARE

December 2023

·

20 Reads

Innovation in Aging

Care in nursing homes and assisted living communities is largely provided by direct caregivers (nursing assistants [NAs] and personal care aides [PCAs]), who are >50% minoritized, 20% immigrant, 90% female, 87% without a college degree, and often in poverty. The well-being of direct caregivers is critical to quality of care, but research aimed at improving well-being is hampered because existing measures of stress and coping translate poorly to their backgrounds and work-related experience. To address this gap, we designed and conducted research aimed at describing the range of coping approaches used to address work-related stress, gathering data on a diverse sample of 391 direct caregivers from 9 nursing homes and 4 assisted living communities in 3 states, of which 75% were racially or ethnically minoritized and 21% were immigrant – mirroring the national workforce. Results indicated that 78% of respondents often felt stressed at work, with 30% screening positive for depression and 28% for anxiety, with some caregivers experiencing both (21%). However, working with residents and their families, while stressful (76%), was considered less stressful than workload (90%) and lack of support (83%); in fact, 89% of caregivers said that caring for residents makes them feel appreciated. Coping strategies were diverse, but the most common includedresilient coping (93%), mindfulness (89%), recognizing common humanity (84%), self-kindness (83%), and planning (69%). This presentation will address differences in coping based on demographic characteristics, as well as the relationship between types of coping strategies and reasons for staying in a direct caregiver position.


Citations (30)


... Emerging adults faced great challenges during the pandemic, including reduced emotional support, restricted social interaction, and heightened exposure to COVID-19 related news (Hotez et al., 2021), all of which were linked to psychological distress and anxiety (Dotson et al., 2022;Shanahan et al., 2022). Moreover, anxiety itself manifested differently across pandemic stages (Fruehwirth et al., 2025). Given the particular challenges of the early pandemic stage, our study focuses on this period to better understand its immediate impact on emerging adults' anxiety. ...

Reference:

Dynamic interplay among emotional support, social interaction, COVID-19 news exposure and anxiety symptoms in emerging adults during the early COVID-19 pandemic
Mental Health Symptoms Among US College Students Before, Early, and Late Into the COVID-19 Pandemic: A Longitudinal Analysis
  • Citing Article
  • November 2024

Journal of Adolescent Health

... Young adults encounter distinct psychosocial stressors that may compromise psychological health and potentially engender long-term health impacts [6]. These stressors include academic performance expectations, career establishment challenges, financial precarity, and social media-related pressures [7,8]. ...

The effect of social media use on mental health of college students during the pandemic

Health Economics

... Although census region, which overlaps with heritage to a certain degree, was controlled for in Garcia and colleagues (2020) analysis, it cannot fully account for heritage. Furthermore, certain cultural factors that have been implicated in cognitive function (e.g., familism) may be more salient in specific heritage groups due to sociopolitical events and policies (Barbosa et al., 2023;Estrella et al., 2024). Additionally, certain heritage groups may be more inclined to acculturate given access to certain resources (e.g., citizenship for those of Puerto Rican heritage; Baldoz & Ayala, 2013). ...

Psychosocial factors associated with 7‐year change in cognition among middle‐aged and older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos‐Investigation of Neurocognitive Aging (SOL‐INCA) and Sociocultural ancillary studies

... Culture-centric narratives are argued to be appropriate for developing health messages for homogenous audiences because they reflect the values, beliefs, and norms of the culture (Larkey & Hecht, 2010). However, Latinos living in the US are not a homogenous cultural group, with differences in connection to Latino culture impacting vaccine uptake (D'Agostino et al., 2023) and mental wellness practices (Koneru et al., 2007). Acculturation occurs "when groups of individuals having different cultures come into continuous first-hand contact, with subsequent changes in the original culture patterns of either or both groups" (Redfield et al., 1936, p. 149). ...

Examining COVID-19 testing and vaccination behaviors by heritage and linguistic preferences among Hispanic, Latino, or Spanish RADx-UP participants

Preventive Medicine Reports

... Worldwide, PA has been proven to be beneficial in several ways, for example, physical health, psychological well-being, body image, and enhanced quality of life [22,23]. Current research indicates that students are not meeting the recommended PA guidelines [24]. Numerous reasons are reported for the decline in PA among the undergraduate student population, including a lack of mental health, motivation [25], and social support [26]. ...

Perceived stress, mental health symptoms, and deleterious behaviors during the transition to college

... It is important to acknowledge that academics choosing to engage with industry need to manage expectations associated with delivering high-quality research while also ensuring efficiency. In turn, practitioners can show value by co-authoring articles, assisting academics by supplying completed real world case studies to include in course materials for students and more (Chen et al., 2013;Buerck et al., 2023;D'Agostino et al., 2022). ...

Listening to Community Partners: Successes and Challenges in Fostering Authentic, Effective, and Trusting Partnerships in the RADx-UP Program
  • Citing Article
  • November 2022

American Journal of Public Health

... Furthermore, the RADx-UP COVID-19 Equity Evidence Academy (EA) team, within the CDCC, led the development and implementation of a virtual conference series during which project teams shared and disseminated COVID-19 related information. The EA series provided a forum for convening community and academic partners during a public health emergency to engage in collaborative idea generation and consensus building [7,8]. The attendees shared their experiences, ideas, and recommendations for overcoming disparities in COVID-19 testing; these recommendations were disseminated to inform future research and action related to COVID-19. ...

RADx-UP Coordination and Data Collection: An Infrastructure for COVID-19 Testing Disparities Research
  • Citing Article
  • September 2022

American Journal of Public Health

... Immigration socialization has been identified as a distinct aspect of ERS that is salient for many Latino families (Ayón, Nieri, and Ruano 2020;Cross et al. 2020;Stein et al. 2016). Study findings aligned with prior research, particularly, as participants reported witnessing adverse experiences faced by their Latino clients, including family separation and immigration-related discrimination (Ayón and Becerra 2013;Eyal, Perreira, and Schilling 2022). In these instances, participants reflected on their efforts to provide a safe environment for their Latino clients to process these experiences. ...

“We Can’t Say This Won’t Happen to Me”: Parent-Child Communication About Anti-Latino Discrimination
  • Citing Article
  • February 2022

Journal of Family Issues

... Further, the results held after adjusting for infant difficult temperament, a well-established risk factor for later child behavior problems and maternal stress/mental health (Kiff et al., 2011), strengthening our interpretation that RSA synchrony accounts for variation in later maternal and child outcomes. Our focus on lowincome, Mexican-origin families addressed a critical gap in the literature, which has typically focused on White populations with relatively low levels of environmental risk (e.g., Graziano & Derefinko, 2013;van IJzendoorn & Bakermans-Kranenburg, 2015), despite the higher likelihood of postpartum mental health problems and child behavior problems among low-income, Latina families in the United States (e.g., Chaudron et al., 2005), for whom dyadic factors may be especially salient source of resilience (Cabrera et al., 2022;Perreira & Allen, 2021). ...

The Health of Hispanic Children from Birth to Emerging Adulthood
  • Citing Article
  • July 2021

The Annals of the American Academy of Political and Social Science

... Similar to the barriers faced in depression treatment use, the reasons for this are multifactorial. Many Latino/a/x families face language barriers, transportation issues, and negative experiences with the U.S. health care system which deter them from receiving needed health care (Perreira et al., 2021). Additionally, Latino/a/x youth who are U.S. citizens are less likely to have health insurance, even when eligible, if living in a family with a mix of citizenship statuses (Jewers & Ku, 2021). ...

Access to Health Insurance and Health Care for Hispanic Children in the United States
  • Citing Article
  • July 2021

The Annals of the American Academy of Political and Social Science