Family caregiving is a major stressor that can compromise health and activate the HPA axis-one of the body's primary physiological stress systems. A multitude of past research shows that marital status and characteristics of the partnership can help buffer caregiving burden and enhance coping resources to mitigate negative physiological outcomes. However, there are numerous ways to measure the role of the spouse, and the conceptualization of these measures may have different implications for the links between stress and health. Moreover, many studies are limited by designs that specifically recruit both partners into a study, resulting in samples that may be skewed towards couples that already have higher relational quality or provide more support. In this study, parent caregivers of children (n=170) with rare genetic conditions and parent caregivers of typically developing children chose to participate alone or jointly as a couple. Information on caregiving burden, use of individual coping strategies, marital status, and caregiving-specific support by spouse/partner was collected via surveys. Blood samples were collected to assess serum arginine vasopression (AVP) levels-one biomarker of the HPA axis. Caregiving burden was positively associated with AVP, while greater use of individual coping resources was negatively associated with AVP. Marital status was directly linked to lower AVP, while caregiving-specific support and joint participation moderated some of the associations between caregiving burden, individual coping, and AVP. These findings highlight the need to consider multiple aspects of marriage and partnership as potential influences on the biological response to stress in parent caregivers.

Compared to their non-Hispanic White counterparts, individuals of Hispanic/Latinx heritage are more likely to develop disabilities from comorbidity and remain disabled for longer periods over the life course. Among chronic conditions, rheumatoid arthritis (RA) is very common, affecting at least 1% of the U.S. population. Evidence suggests that RA is more active and severe among Hispanic/Latinx individuals, characterized by more flare-ups, greater inflammation, higher tender/swollen joint counts, and more self-reported pain, due in part to their underuse of health services, delay in initiating treatment, and difficulty in adhering to treatment plan. In this study, we sought to identify social network factors relevant to managing RA pain and RA-attributable functional limitations, in a sample of Hispanic/Latinx families residing in the Washington DC region. We analyzed network structure and patterns of interpersonal health communication and assessed how these factors may facilitate or impede proactive healthcare, independent of individual and system-level barriers. The findings are three-fold: First, there is substantial heterogeneity in social network structure in the families examined, likely due to different immigration experiences. Second, severely contracted personal networks (e.g., isolate or singe-edge) were observed among older, foreign-born individuals who spoke Spanish and had less schooling. This was a major barrier to RA management. Finally, more health communication, closeness, and advice-seeking ties in one’s personal network facilitated use of health services which was positively correlated with health outcomes. We discuss the implications of the findings in the context of developing family network-based health education interventions.

Background: Down syndrome is associated with several comorbidities, including intellectual disability, growth restriction, and congenital heart defects. The prevalence of Down syndrome-associated comorbidities is highly variable, and intellectual disability, although fully penetrant, ranges from mild to severe. Understanding the basis of this interindividual variability might identify predictive biomarkers of in utero and postnatal outcomes that could be used as endpoints to test the efficacy of future therapeutic interventions. Objective: The main objective of this study was to examine if antenatal interindividual variability exists in mouse models of Down syndrome and whether applying statistical approaches to clinically relevant measurements (ie, the weights of the embryo, placenta, and brain) could define cutoffs that discriminate between subgroups of trisomic embryos. Study Design: Three commonly used mouse models of Down syndrome (Dp(16)1/Yey, Ts65Dn, and Ts1Cje) and a new model (Ts66Yah) were used in this study. Trisomic and euploid littermate embryos were used from each model with total numbers of 102 for Ts66Yah, 118 for Dp(16)1/Yey, 92 for Ts65Dn, and 126 for Ts1Cje. Placental, embryonic, and brain weights and volumes at embryonic day 18.5 were compared between genotypes in each model. K-mean clustering analysis was applied to embryonic and brain weights to identify severity classes in trisomic embryos, and brain and placental volumetric measurements were compared between genotypes and classes for each strain. In addition, Ts66Yah embryos were examined for malformations because embryonic phenotypes have never been examined in this model. Results: Reduced body and brain weights were present in Ts66Yah, Dp(16)1/Yey, and Ts65Dn embyos. Cluster analysis identified 2 severity classes in trisomic embryos-mild and severe-in all 4 models that were distinguishable using a putative embryonic weight cutoff of <0.5 standard deviation below the mean. Ts66Yah trisomic embryos develop congenital anomalies that are also found in humans with Down syndrome, including congenital heart defects and renal pelvis dilation. Conclusion: Statistical approaches applied to clinically relevant measurements revealed 2 classes of phenotypic severity in trisomic mouse models of Down syndrome. Analysis of severely affected trisomic animals may facilitate the identification of biomarkers and endpoints that can be used to prenatally predict outcomes and the efficacy of treatments.

Abstract In 2008, we launched Project RAMA (Risk Assessments for Mexican Americans) in Houston, Texas, seeking to understand how multigenerational Mexican immigrant families communicate about familial risk for complex disease. Several lessons were learned. First, our community advisory committee endorsed research goals. Second, we listened to the community with regards to immigration concerns and structural racism. Finally, in the summer and fall of 2008, Hurricane Ike struck the region. Because our team provided support and resources to families in need, we had a higher participation rate post-disaster. Pausing recruitment and postponing assessments led us to unexpectedly discover a long-term intervention effect that was not originally hypothesized. These lessons guide a new initiative focused on Hispanic immigrant families affected by rheumatoid arthritis in Washington DC. We discuss how we address challenges in the on-going project during the Covid pandemic, including recruiting through embedded community clinics and integrating community needs into study design.

Background Recent research has shown the mental health consequence of social distancing during the COVID-19 pandemic, but longitudinal data are relatively scarce. It is unclear whether the pattern of isolation and elevated stress seen at the beginning of the pandemic persists over time. This study evaluates change in social interaction over six months and its impact on emotional wellbeing among older adults. Methods We drew data from a panel study with six repeated assessments of social interaction and emotional wellbeing conducted monthly May through October 2020. The sample included a total of 380 White, Black and Hispanic participants aged 50 and over, of whom 33% had low income, who residing in fourteen U.S. states with active stay-at-home orders in May 2020. The analysis examined how change in living arrangement, in-person interaction outside the household, quality of relationship with family and friends, and perceived social support affected trajectories of isolation stress, COVID worry and sadness. Results While their living arrangements (Odds Ratio [OR] = 0.95, 95% Confidence Interval [CI] = 0.87, 1.03) and relationship quality (OR = 0.94, 95% CI = 0.82, 1.01) remained stable, older adults experienced fluctuations in perceived social support (linear Slope b = -1.42, s.e. = 0.16, p < .001, quadratic slope b = 0.50, s.e. = 0.08, p < .001, cubic slope b = -0.04, s.e. = 0.01, p < .001) and increases in in-person conversations outside the household (OR = 1.19, 95% CI = 1.09, 1.29). Living with a spouse/partner stabilized isolation stress (change in linear slope b = 1.16, s.e. = 0.48, p < .05, in quadratic slope b = -0.62, s.e. = 0.26, p < .05, and in cubic slope = 0.09, s.e. = 0.04, p < .05) and COVID worry (change in quadratic slope b = -0.66, s.e. = 0.32, p < .05 and in cubic slope = 0.09, s.e. = 0.04, p < .05) over time. Individuals with better relationship quality with friends had decreased sadness over time (OR = 0.90, 95% CI = 0.82, 0.99). Changes in social support were associated with greater fluctuations in isolation stress and COVID worry. Conclusions During the pandemic, social interactions are protective and lack of stability in feeling supported makes older adults vulnerable to stress. Efforts should focus on (re)building and maintaining companionship and support to mitigate the pandemic’s negative impact.

Abstract Recent research has shown the mental health consequence of social distancing during the COVID-19 pandemic, but longitudinal data are relatively scarce. It is unclear whether the pattern of isolation and elevated stress seen at the beginning of the pandemic persists over time. This study evaluates change in social interaction over six months and its mental health impact among older adults. We drew data from a panel study with six repeated assessments of social interaction and mental health conducted monthly May through October 2020. The sample included a total of 380 White, Black and Hispanic participants aged 50 and over, of whom 33% had low income, who residing in fourteen U.S. states with active stay-at-home orders in May 2020. The analysis examined how change in living arrangement, in-person interaction outside the household, quality of relationship with family and friends, and perceived social support affected trajectories of isolation stress, COVID worry and sadness. While their living arrangements and relationship quality remained stable, older adults experienced fluctuations in perceived social support and increases in in-person conversations outside the household. Living with a spouse/partner stabilized isolation stress and COVID worry over time. Individuals with better relationship quality with friends became happier over time. Changes in social support were associated with greater fluctuations in isolation stress and COVID worry. During the pandemic, social interactions are protective and lack of stability in feeling supported makes older adults vulnerable to stress. Efforts should focus on (re)building and maintaining companionship and support to mitigate the pandemic’s negative impact.

Family history of metabolic conditions is a primary factor for clinicians to consider when administering preventive care. Sharing this information with healthcare providers proactively is therefore important to individual health outcomes. This brief report seeks to identify factors associated with sharing family history with healthcare providers in individuals of Mexican heritage. Data were obtained from a health education intervention study conducted during 2008–2010, which recruited 497 adult participants from 162 multigenerational households in Houston, Texas to receive family history-based risk feedback generated by Family Healthware™. Households were randomized to receive a pedigree of metabolic conditions or a pedigree coupled with supplementary information about one’s personalized risk assessment and behavioral recommendations. Participants completed two follow-up surveys at three and ten months post intervention, respectively. Analysis based on 296 participants from 147 households who read but did not share their feedback at three-month follow-up suggests benefits of providing personalized risk assessment and tailored behavioral recommendations in addition to a simple pedigree. Participants receiving supplementary risk feedback are more likely to share it with family members at three-month follow-up, which is associated with increased sharing and willingness to share risk feedback with healthcare providers at ten-month follow-up. The findings highlight the importance of family relationships in medical information disclosure in Mexican American adults. Future interventions should capitalize on family relationships in health education and promotion programs for optimal prevention of metabolic conditions in at-risk populations.

Background Family health history (FHH) inherently involves collecting proxy reports of health statuses of related family members. Traditionally, such information has been collected from a single informant. More recently, research has suggested that a multiple informant approach to collecting FHH results in improved individual risk assessments. Likewise, recent work has emphasized the importance of incorporating health-related behaviors into FHH-based risk calculations. Integrating both multiple accounts of FHH with behavioral information on family members represents a significant methodological challenge as such FHH data is hierarchical in nature and arises from potentially error-prone processes. Methods In this paper, we introduce a statistical model that addresses these challenges using informative priors for background variation in disease prevalence and the effect of other, potentially correlated, variables while accounting for the nested structure of these data. Our empirical example is drawn from previously published data on families with a history of diabetes. Results The results of the comparative model assessment suggest that simply accounting for the structured nature of multiple informant FHH data improves classification accuracy over the baseline and that incorporating family member health-related behavioral information into the model is preferred over alternative specifications. Conclusions The proposed modelling framework is a flexible solution to integrate multiple informant FHH for risk prediction purposes.

We investigate how interpersonal ties influence communication about type 2 diabetes risk and encouragement to maintain or adopt a healthy lifestyle between family members of Mexican heritage, after a family history-based risk assessment intervention. Results suggest that individuals are more likely to initiate risk communication with another family member if they are close to, already seek advice from, or discuss health with him or her. Risk communication precedes encouragement, which is initiated by the older generation of the family. Understanding the role of interpersonal relationships in Mexican-heritage families can help identify who best to target in future health behavior interventions.

Abstract Previous research has found a negative association between network size and age, suggesting that people experience greater isolation with advancing age. In this paper, we evaluate age differences in how individuals perceive their social worlds to be structured, rather than focusing solely on network size. A nationally represented sample of respondents (n=1,824) reported on their own ties to their close personal network members (i.e., ego-alter ties) as well as their perceptions of acquaintanceship between those members (i.e., alter-alter ties). We used social network analysis to assess how the structure of these relationships vary by respondent age. We find a positive association between respondent age and personal network size and a negative association between network members’ ages and the number of ties respondents’ perceive their members to have to each other. This effect significantly weakens as respondent age increases. Moreover, we find evidence of age-homophily, intergenerational contact spanning three generations in both ego-alter and alter-alter ties, and age differences in ego network composition. Our results suggest that the evolution of our social worlds across the life course shifts in terms of size and structure. While contemporary close personal networks may grow slightly with age, perceived social ties among one’s network members become less cohesive and less diverse with age. We discuss these results in the context of recent findings that suggest aging uniformly insulates individuals from social contact from both structural and symbolic perspectives.

Background Collecting complete and accurate family health history is critical to preventing type 2 diabetes. Purpose We seek to identify the optimal risk feedback approach that facilitates risk communication between parents and their adult children and helps them develop shared appraisals of family history of type 2 diabetes. Methods In a sample of parent-adult child dyads from 125 Mexican-heritage families residing in Houston, Texas, we examine change in parent-child dyadic (dis)agreement with respect to their shared family health history from baseline to 10 months after receipt of risk feedback generated by Family Healthware. A 2 × 2 factorial design is applied to test how the recipient (one parent or all family members) and the content (risk assessment with or without behavioral recommendations) of the feedback affect (dis)agreement through interpersonal ties, particularly dyadic risk communication. Results Providing risk assessment without behavioral recommendations to the parent, but not the adult child, shifts the dyads toward agreement (relative risk ratio [RRR]= 1.78, 95% confidence interval [CI] [1.18-2.67]), by activating reciprocal risk communication between parents and children (RRR =2.70, 95% CI [1.81-4.03]). Dyads with close interpersonal ties are more likely to shift toward agreement (RRR = 3.09, 95% CI [1.89-5.07]). Conclusion Programs aimed at improving family health history knowledge and accuracy of reports should tailor risk feedback strategically for better intervention effect and leverage a network approach in disease prevention among at-risk minority and/or immigrant populations. Trial Registration Number NCT00469339.

OBJECTIVE:Several theories emphasize that systematic interindividual divergence is a key feature of cohort aging and evidence for accumulative social inequality over the life course. While many have documented widening health gaps with age between subgroups, such divergence is only one aspect of the broader social inequality based on race and gender. This article examines patterns of interindividual variability in trajectories of functional limitations within each race/gender.METHODS:Using data from the Health and Retirement Study (HRS)'s HRS cohort (born 1931-1941), I estimate growth curves of functional limitations with Level 2 heteroscedasticity, allowing interindividual variability to differ across 4 groups: white men, black men, white women, and black women. I examine race/gender differences in the age-based pattern of interindividual variability using an interquartile range of estimated individual trajectories.RESULTS:Black men, white women, and black women have greater interindividual variability in functional limitations than do white men. Interindividual variability increases systematically with age at similar rates for all groups but black women.DISCUSSION:Functional limitations become more heterogeneous with age for the entire cohort and for white men, white women, and black men. Future research should identify life-course processes that generate the race and gender patterning of interindividual variability in late-life health.

Collecting complete and accurate family health history is critical to preventing type 2 diabetes. Whether there are any racial difference in family health history knowledge of type 2 diabetes and whether such differences are related to interpersonal mechanisms remain unclear. We seek to identify the interpersonal mechanisms that give rise to discrepancies in family health history knowledge of type 2 diabetes in families of different racial backgrounds. We analyze informant-dyad consensus with respect to shared family history of type 2 diabetes in 127 informants of 45 families in the greater Cincinnati area (white: 28 families, 78 informants; black/African-American: 17 families, 49 informants). We first document a difference in informant-dyad consensus by race and then test whether this difference can be explained by interpersonal ties, particularly health communication. Compared with their white counterparts, dyads in families of black/African-American background are more likely to have an uneven distribution of knowledge, with one informant knowing and the other not knowing his/her family health history. The racial difference is explained by dyads in families of black/African-American background having fewer reciprocal health communication ties. While associated with informant-dyad consensus, education, kinship ties, and closeness ties do not account for the observed racial difference. Activating health communication is a key to improving family health history knowledge, especially in families of black/African-American background. Researchers and clinicians should leverage communication ties in the family network for better collection and utilization of family health history in preventive services.

Consistent with the weathering hypothesis, many studies have captured racial/ethnic disparities in average functional health trajectories. The same mechanisms of social inequality that contribute to worse average health among minority adults may also contribute to greater fluctuations in their physical function at upper ages. Using panel data from the Health and Retirement Study, we examine patterns of intraindividual variability over time in trajectories of functional limitations for White, Black, and Hispanic older adults. Intraindividual variability increases with age for both Whites and Blacks and such increase is greater for Blacks. Hispanics have the greatest intraindividual variability but there is no age-based pattern. Socioeconomic status and comorbidity are associated with intraindividual variability for all race/ethnicity yet do not explain the age-based increase in intraindividual variability for Whites or Blacks. The findings suggest further nuances to the weathering hypothesis-social disadvantage can generate instability in physical function as minority adults age.

Social network analysis is increasingly important in the social and behavioral sciences and has been employed to study a host of inter- and intra-personal social processes. One of the challenges researchers face in this area, however, is balancing the trade-offs between different modes of network measurement and study design. At one end of the spectrum, entirely ego-centered network designs facilitate access to a large, generalizable sample of the population but often lack details on the underlying network structure that embed each respondent. At the other end, whole-network designs offer fine details about the network structure but are costly and suffer from generalizability limitations. In this paper, we employ an ego-centered network sampling design that strikes a balance between these two cases by leveraging how individuals perceive their social worlds vis-a-vis respondent reports of their alter-alter ties. We describe a large sample of close personal networks where respondents informed on their perceptions of the ties between their alters on multiple types of relations. Specifically, we characterize the distribution of network statistics (size, density, and multiplexity) for over a thousand individual ego-centered cognitive networks drawn from a representative sample of the U.S. population. To our knowledge this is the first study to characterize the distribution of mental maps vis-a-vis perceived alter-alter relationships in this large of a sample of respondents involved in close personal networks. In doing so, we more clearly shed light on how Americans perceive the structure of their social worlds and provide an empirical case study in what we characterize as ego-centered cognitive social structures.

Introduction: An accurate family health history is essential for individual risk assessment. This study uses a multiple-informant approach to examine whether family members have consistent perceptions of shared familial risk for four common chronic conditions (heart disease, Type 2 diabetes, high cholesterol, and hypertension) and whether accounting for inconsistency in family health history reports leads to more accurate risk assessment.Methods: In 2012-2013, individual and family health histories were collected from 127 adult informants of 45 families in the Greater Cincinnati Area. Pedigrees were linked within each family to assess inter-informant (in) consistency regarding common biological family member's health history. An adjusted risk assessment based on pooled pedigrees of multiple informants was evaluated to determine whether it could more accurately identify individuals affected by common chronic conditions, using self-reported disease diagnoses as a validation criterion. Analysis was completed in 2015-2016.Results: Inter-informant consistency in family health history reports was 54% for heart disease, 61% for Type 2 diabetes, 43% for high cholesterol, and 41% for hypertension. Compared with the unadjusted risk assessment, the adjusted risk assessment correctly identified an additional 7%-13% of the individuals who had been diagnosed, with a <= 2% increase in cases that were predicted to be at risk but had not been diagnosed.Conclusions: Considerable inconsistency exists in individual knowledge of their family health history. Accounting for such inconsistency can, nevertheless, lead to a more accurate genetic risk assessment tool. A multiple-informant approach is potentially powerful when coupled with technology to support clinical decisions. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine