Browsing by Author "Hill, Sherika"

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    ItemOpen Access
    Estimating the effect of anticipated depression treatment-related stigma on depression remission among people with noncommunicable diseases and depressive symptoms in Malawi.
    (PloS one, 2023-01) Dussault, Josée M; Zimba, Chifundo; Akello, Harriet; Stockton, Melissa; Hill, Sherika; Aiello, Allison E; Keil, Alexander; Gaynes, Bradley N; Udedi, Michael; Pence, Brian W

    Purpose

    While mental health stigma research is sparse in Malawi, research in other settings suggests that stigma represents a barrier to mental health treatment and recovery. Accordingly, we conducted an analysis to understand the role of treatment-related stigma in depression care in Malawi by estimating the effect of patients' baseline anticipated treatment-related stigma on their 3-month probability of depression remission when newly identified with depression.

    Methods

    We conducted depression screening and treatment at 10 noncommunicable disease (NCD) clinics across Malawi from April 2019 through December 2021. Eligible cohort participants were 18-65 years with depressive symptoms indicated by a PHQ-9 score ≥5. Questionnaires at the baseline and 3-month interviews included a vignette-based quantitative stigma instrument that measured treatment-related stigma, i.e., concerns about external stigma because of receiving depression treatment. Using inverse probability weighting to adjust for confounding and multiple imputation to account for missing data, this analysis relates participants' baseline levels of anticipated treatment stigma to the 3-month probability of achieving depression remission (i.e., PHQ-9 score < 5).

    Results

    Of 743 included participants, 273 (37%) achieved depression remission by their 3-month interview. The probability of achieving depression remission at the 3-month interview among participants with high anticipated treatment stigma (0.31; 95% Confidence Interval [CI]: 0.23, 0.39)) was 10 percentage points lower than among the low/neutral stigma group (risk: 0.41; 95% CI: 0.36, 0.45; RD: -0.10; 95% CI: -0.19, -0.003).

    Conclusion

    In Malawi, a reduction in anticipated depression treatment-related stigma among NCD patients initiating depression treatment could improve depression outcomes. Further investigation is necessary to understand the modes by which stigma can be successfully reduced to improve mental health outcomes and quality of life among people living with depression.
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    ItemOpen Access
    Impact of a universal perinatal home-visiting program on reduction in race disparities in maternal and child health: Two randomised controlled trials and a field quasi-experiment.
    (Lancet regional health. Americas, 2022-11) Dodge, Kenneth A; Goodman, W Benjamin; Bai, Yu; Best, Debra L; Rehder, Peter; Hill, Sherika

    Background

    Public health interventions must become accountable for reduction of race disparities, particularly among Black, Hispanic, and Non-Hispanic White families in the United States. Family Connects (FC) is a universal perinatal home-visiting program that assesses family-specific needs, offers support, and provides connections to community resources to address identified needs. Two previously-published randomised controlled trials and a field quasi-experiment have shown positive impact on maternal mental health, infant emergency medical care utilization, and government investigations for child maltreatment; however, these reports have not tested impact on reducing race disparities in these outcomes. The current report examined three questions in these trials: 1) the extent of race disparities in maternal and infant health and well-being, absent intervention; 2) whether intervention can be implemented with high reach and fidelity among all race groups; and 3) whether assignment to intervention reduces race disparities in important outcomes.

    Methods

    Data were re-examined from: 1) a randomised controlled trial of 4777 birthing families in Durham, NC, USA; 2) a replication randomised controlled trial of 923 birthing families in Durham, NC, USA; and 3) a quasi-experiment of 988 birthing families in rural NC, USA. Families were classified as Black, Hispanic, Non-Hispanic White, or Other. Disparity reduction was tested by the interaction effect between treatment assignment and race.

    Findings

    1) In the absence of intervention, large and statistically significant differences between Black familes and Non-Hispanic White families were found in maternal anxiety, maternal depression, father non-support, child emergency medical care, and child maltreatment investigations. Few differences were found between Non-Hispanic White familes and Hispanic families.2) High rates of participation in treatment were found for each race group.3) Across studies, assignment to FC was associated with statistically significant reductions in 7 of 12 disparities, in maternal anxiety and depression, father non-support, infant emergency medical care, and child maltreatment investigations.

    Interpretation

    This study provides a method, metric, and mandate to prioritise testing of whether public health interventions reduce race disparities in family outcomes.

    Funding

    This research was supported by grant R01HD069981 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and a grant from The Duke Endowment.
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    ItemOpen Access
    Polyvictimization and Psychosocial Outcomes Among Trauma-Exposed, Clinic-Referred Youth Involved in the Juvenile Justice System.
    (Child maltreatment, 2022-11) Pane Seifert, Heather T; Tunno, Angela M; Briggs, Ernestine C; Hill, Sherika; Grasso, Damion J; Adams, Zachary W; Ford, Julian D
    Polyvictimization is a robust predictor of emotional and behavioral problems and is linked to involvement in juvenile justice and other public sector systems. This study extends prior research by employing person-centered methods for identifying polyvictimization patterns among trauma-exposed, clinic-referred, justice-involved youth (n = 689; ages 12-18 years) and how identified classes differ on psychosocial outcomes and demographic characteristics. Most participants had experienced multiple traumatic event (TE) types. Latent class analyses identified three classes: mixed trauma/bereavement exposure group (55.1%; Mean = 3.0 TE types); maltreatment polyvictimized group (29.3%; Mean = 5.7 TE types); and maltreatment plus extreme violence polyvictimized group (15.7%; Mean = 9.3 TE types). Polyvictimized youth were more likely to be female, in out-of-home placements, and experiencing negative psychosocial outcomes (e.g., Posttraumatic Stress Disorder). Hispanic/Latino youth were overrepresented in the extreme polyvictimized subgroup. Results underscore the need for cross-system coordination of trauma-informed, comprehensive services for clinic-referred, justice-involved youth.