Faculty Bibliography

BACKGROUND:Community-supported agriculture (CSA) programs are an evidence-based approach to increase fruit and vegetable (F&V) intake while also strengthening the local farming economy and social bonds. However, uptake has been limited due to payment structures and/or CSA offerings not reflecting local community preferences. To address this need, we developed the Harvest Share program, which centers a cost-offset CSA tailored to local communities in New York City. Here, our objective is to conduct a mixed-methods evaluation of year one of Harvest Share to evaluate its preliminary impact on diet and social outcomes. METHODS:Harvest Share participants (n = 542; n = 153 CSA and n = 389 comparison community [CC] participants) completed surveys and Veggie Meter readings-an objective measure of F&V intake-at the start and end of the 20-week growing season (~ June-October 2023). Qualitative interviews were conducted with n = 23 participants to understand program experiences. Mixed effect linear regression models were used to examine the impact of Harvest Share on primary (Veggie Meter score) and secondary outcomes (diet and social variables). Significant associations were based on the group (CSA vs. CC) by time (pre vs. post) interaction term. Descriptive, thematic analysis was used to analyze interviews. RESULTS:Across CSA and CC participants, individuals were, on average, 44 years old; female (80%); Asian (48%) or Hispanic/Latino (37%); and of lower socioeconomic status (55% with annual household income <$50,000). Change in Veggie Meter scores (p = 0.02), F&V consumption (p < 0.0001), and F&V knowledge (p = 0.0004) significantly differed between CSA and CC participants. Veggie Meter scores trended downwards in both groups, but the decline was non-significant among CSA participants (CSA: -7.43 [95%CI: -21.30, 6.44]; CC: -27.29 [95%CI: -36.27, -18.30]). CSA participation was associated with an increased number of different types of F&V consumed (CSA: 3.74 [95%CI: 2.94, 4.53]; CC: 0.05 [95%CI: -0.48, 0.57]) and decreased number of F&V that individuals did not know how to prepare (CSA: -1.60 [95%CI: -2.28, -0.93]; CC: -0.13 [95%CI: -0.57, 0.32]). Qualitative interviews indicated the CSA also promoted family and community connection and improved physical and mental health. CONCLUSIONS:A cost-offset, tailored CSA can improve diet and social outcomes using a model that supports farmers. TRIAL REGISTRATION/BACKGROUND:Registered on ClinicalTrials.gov as NCT05381766 (registration date: May 19, 2022).

The objective of this study was to explore the buffering effect of support on the association between stress and postpartum depression (PPD) among immigrant women. We surveyed 223 Chinese pregnant or postpartum (within one year post-delivery) immigrant women in New York City. Surveys were conducted in English, Simplified Chinese or Mandarin, March-June 2021. PPD was measured with the Edinburgh PPD scale (EPDS); scores of 13 or higher indicate probable depression. Perceived stress was measured with one question, "How often did you feel stressed in the past week?"; responses were collapsed into a binary measure: Never/Rarely and Sometimes/Often/Always. Support was assessed with a general question about perception of receiving needed support and the Patient-Reported Outcomes Measurement Information System (PROMIS) V2.0 Short Form Informational, Instrumental, and Emotional Support measures. Bivariate and multivariable general linear regression models assessed the relationship among stress, support, and PPD. The EPDS mean score was 11.9 (95%CI:11.1-12.7) and 50% (95%CI: 42-57%) had EPDS scores ≥ 13, indicative of serious symptoms; 56% felt stressed in the past week and 37% reported getting needed support. Among women without perceived needed support, mean EPDS scores were higher among women who were stressed compared with women who were not (adjusted mean difference (aMD) 5.4; 95%CI:3.3-7.5); the association between stress and EPDS score was attenuated among women with needed support (aMD 1.1; 95%CI:-1.0, 3.1). Similar patterns held for emotional and instrumental support. Perceived and social support attenuated the association between perceived stress and depression symptoms among Chinese immigrant women. Enhancing support may be effective in countering the impact of stressors on PPD.

Efforts to bolster the school readiness of Latine children from low-income and immigrant homes have focused on fostering parent engagement in children's education. In assessing parent engagement, most measures center school-based activities in alignment with middle class, European American dominant norms, missing the multiple ways that Latine families engage with their children to support their educational experiences and development. Additionally, studies of predictors of Latine parent engagement have mainly focused on parent demographic and linguistic factors, limiting our understanding of how to support parent engagement equitably. Using a measure of parent engagement sensitive to culturally contextualized behaviors of Latine families, this study describes the ways Latine parents living in historically disinvested neighborhoods in New York City engage in their children's learning at home and in school during a nationally charged anti-immigrant, anti-Latine sociopolitical climate. We also examine whether immigration enforcement threat and parent health are associated with Latine family engagement in home and school-based activities. Data come from a larger study conducted with Latine parents (n=103; 42% immigrant) of pre-K children. Descriptive results indicate that despite a charged sociopolitical context, levels of engagement in children's education and development across multiple domains were comparable with mean levels established by the developers. Findings from regression analyses demonstrated that above and beyond demographic, linguistic and financial factors, immigration enforcement threat and parent health were associated with aspects of family engagement in young children's learning among Latine families in low-income communities. Implications for policy and practice are discussed.

Community-based organizations (CBOs) are key players in mitigating the impact of restrictive policy changes on immigrant communities. The ability of these organizations to help diffuse the stress caused by restrictive, rapidly changing immigration policies depends, in part, on the capacity and health of their workforce. This study presents findings from a qualitative study conducted with 10 Bangladeshi community frontline workers working in various CBOs and advocacy organizations to understand their experience navigating a heightened anti-immigrant, anti-Muslim climate. Through thematic analyses, we inferred that the 2016 presidential election increased stress and mobilization among community frontline workers, with a meaningful distinction between participants working for immigration-focused institutions versus those in institutions where immigration issues were not the primary focus (e.g. health services, cultural programming). For those working in immigration-focused institutions, work burden increased due to challenges in managing misinformation, making sense of policy changes, and meeting the needs of families impacted by deportation. A toll on frontline workers' own physical health and mental health was discussed, as well as the need for culturally congruent mental health supports for the South Asian community.

Efforts to bolster the school readiness of Latinx children from low-income homes in the United States have focused on fostering parent engagement in children"™s education. Measurement of parent engagement in early childhood however, has been critiqued for having too narrow a focus on school-based involvement and missing other aspects of Latinx parent engagement. Using a recently developed culturally sensitive assessment of Latinx parent engagement, we test for associations between dimensions of Latinx parent engagement in learning and indicators of school readiness in a diverse sample of Latinx families (n = 114). We find significant associations between multiple dimensions of Latinx parent engagement and indicators of child school readiness. In addition to promoting parent-teacher connections, efforts to support Latinx school readiness equitably are encouraged to attend to various culturally relevant aspects of Latinx parent engagement in early childhood. In particular, investing in programing that supports parents"™ well-being and capacity for home-based engagement in learning may be a promising way to support the school readiness of Latinx children living in historically disinvested neighborhoods.

Public health practitioners working with Latinx families in the United States must consider the historical contexts of colonization and slavery that have created conditions of violence, displacement, and social and economic marginalization throughout Latin America. Although shared experiences of colonization, dispossession, and migration affect all Latinxs, diverse national histories and sociopolitical contexts, migration patterns, and intersecting identities (e.g., gender, social class, race) complicate efforts to develop a uniform approach to this heterogeneous population. We provide a critical analysis of (1) how past experiences contribute to collective trauma and motivate migration, and (2) how these experiences are replicated in the United States through immigration-related adversities that deprive and threaten children and families through marginalization, fear of detention and deportation, and family separation brought on by a parent's deportation. This knowledge is imperative to advance research, practice, and policymaking with US Latinx populations. We provide best practice recommendations for a sociopolitically and trauma- informed public health workforce interfacing with Latinxs in the United States. (Am J Public Health. 2024;114(S6):S485-S494. https://doi.org/10.2105/AJPH.2024.307589) [Formula: see text].

BACKGROUND:While it is recognized that social support can alleviate mental health symptoms, this relationship is not well-understood among Chinese pregnant and parenting immigrants in the United States. This study aims to bridge this gap by exploring the relationships between different types of social support and women's anxiety and depression, and examining how these associations vary with pregnancy status. METHODS:Data were obtained from a cross-sectional survey conducted in Simplified Chinese or Mandarin between March-June 2021 among 526 women who were pregnant and/or parenting a child under five years. The Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Depression, and Social Support scales were used to measure anxiety, depression, and social support levels. Descriptive statistics, t-tests, chi-square tests, and Pearson's correlations were employed for analysis. Hierarchical regression was conducted to investigate the main and interaction effects of social support types and pregnancy status on mental health outcomes. RESULTS:Compared to non-pregnant women, pregnant women reported higher mean scores for anxiety (non-pregnant: 55, pregnant: 59, p < 0.01) and depression (non-pregnant: 54, pregnant: 56, p = 0.02). Instrumental support displayed a significant main effect in relation to anxiety (β=-0.13, p = 0.01) and depression (β=-0.16, p < 0.01); emotional support exhibited a significant main effect solely on depression (β=-0.13, p = 0.01). Notably, the interaction effects between pregnancy status and both instrumental (β=-0.28, p = 0.01) and emotional support (β=-0.42, p < 0.01) were significant for anxiety. In contrast, informational support did not exhibit a significant impact on either anxiety or depression. CONCLUSIONS:The findings indicate that tailoring support to the cultural context is crucial, especially for pregnant women in this Chinese immigrant community, with instrumental and emotional support being particularly beneficial in mitigating maternal anxiety.

Immigrant communities in the United States are diverse and have many assets. Yet, they often experience stressors that can undermine the mental health of residents. To fully promote mental health and well-being among immigrant communities, it is important to emphasize population-level policies and practices that may serve to mitigate stress and prevent mental health disorders. In this paper, we describe the stressors and stress experienced by immigrant families, using Sunset Park, Brooklyn as an example. We discuss ways to build structures and policies in support of equitable environments that promote mental health at the population level and enable families and their children to thrive.