TY - JOUR
T1 - SHS-Related Pediatric Sick Visits are Linked to Maternal Depressive Symptoms Among Low-Income African American Smokers
T2 - Opportunity for Intervention in Pediatrics
AU - Collins, Bradley N.
AU - Nair, Uma S.
AU - Shwarz, Michelle
AU - Jaffe, Karen
AU - Winickoff, Jonathan
PY - 2013/10
Y1 - 2013/10
N2 - Maternal smoking and depressive symptoms are independently linked to poor child health outcomes. However, little is known about factors that may predict maternal depressive symptoms among low-income, African American maternal smokers-an understudied population with children known to have increased morbidity and mortality risks. The objective of this study was to test the hypothesis that secondhand smoke exposure (SHSe)-related pediatric sick visits are associated with significant maternal depressive symptoms among low-income, African American maternal smokers in the context of other depression-related factors. Prior to randomization in a behavioral counseling trial to reduce child SHSe, 307 maternal smokers in Philadelphia completed the Center for Epidemiologic Studies Depression (CES-D) and questionnaires measuring stressful events, nicotine dependence, social support, child health and demographics. CES-D was dichotomized at the clinical cutoff to differentiate mothers with significant versus low depressive symptoms. Results from direct entry logistic regression demonstrated that maternal smokers reporting more than one SHSe-related sick visit (OR 1.38, p <.001), greater perceived life stress (OR 1.05, p <.001) and less social support (OR 0.82, p <.001) within the last 3 months were more likely to report significant depressive symptoms than mothers with fewer clinic visits, less stress, and greater social support. These results suggest opportunities for future hypothesis-driven evaluation, and exploration of intervention strategies in pediatric primary care. Maternal depression, smoking and child illness may present as a reciprocally-determined phenomenon that points to the potential utility of treating one chronic maternal condition to facilitate change in the other chronic condition, regardless of which primary presenting problem is addressed. Future longitudinal research could attempt to confirm this hypothesis.
AB - Maternal smoking and depressive symptoms are independently linked to poor child health outcomes. However, little is known about factors that may predict maternal depressive symptoms among low-income, African American maternal smokers-an understudied population with children known to have increased morbidity and mortality risks. The objective of this study was to test the hypothesis that secondhand smoke exposure (SHSe)-related pediatric sick visits are associated with significant maternal depressive symptoms among low-income, African American maternal smokers in the context of other depression-related factors. Prior to randomization in a behavioral counseling trial to reduce child SHSe, 307 maternal smokers in Philadelphia completed the Center for Epidemiologic Studies Depression (CES-D) and questionnaires measuring stressful events, nicotine dependence, social support, child health and demographics. CES-D was dichotomized at the clinical cutoff to differentiate mothers with significant versus low depressive symptoms. Results from direct entry logistic regression demonstrated that maternal smokers reporting more than one SHSe-related sick visit (OR 1.38, p <.001), greater perceived life stress (OR 1.05, p <.001) and less social support (OR 0.82, p <.001) within the last 3 months were more likely to report significant depressive symptoms than mothers with fewer clinic visits, less stress, and greater social support. These results suggest opportunities for future hypothesis-driven evaluation, and exploration of intervention strategies in pediatric primary care. Maternal depression, smoking and child illness may present as a reciprocally-determined phenomenon that points to the potential utility of treating one chronic maternal condition to facilitate change in the other chronic condition, regardless of which primary presenting problem is addressed. Future longitudinal research could attempt to confirm this hypothesis.
KW - African American minority population
KW - Child health
KW - Depressive symptoms
KW - Low-income
KW - Maternal depression
KW - Smoking
UR - http://www.scopus.com/inward/record.url?scp=84884126034&partnerID=8YFLogxK
U2 - 10.1007/s10826-012-9663-4
DO - 10.1007/s10826-012-9663-4
M3 - Article
C2 - 24339721
SN - 1062-1024
VL - 22
SP - 1013
EP - 1021
JO - Journal of Child and Family Studies
JF - Journal of Child and Family Studies
IS - 7
ER -