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  • Social exposures have complex and dynamic relationships and

    2018-11-02

    Social exposures have complex and dynamic relationships and interactions, (Hertzman & Boyce, 2010) but only a few studies examined whether the impact of neighborhood exposures on PTD varies by social factors. Philips et al., found no evidence that the association between neighborhood quality and spontaneous PTD varied by sociodemographic or geographic variables. On the other hand, Ahern et al., using data from a case-control study of AA and Whites, reported that among AAs, the association between neighborhood characteristics and PTD was modified by individual-level socioeconomic status (Ahern, Pickett, Selvin, & Abrams, 2003). Further, our group recently published results from a study where we found evidence of effect modification of the association between subjective reports of the residential environment and PTD, by educational attainment, among AA women (Sealy-Jefferson, Giurgescu, Helmkamp, Misra, & Osypuk, 2015). Religiosity has been conceptualized as a social determinant of health, (Idler, 2014) and includes several domains, including organizational (formal church attendance), non-organizational (private of informal activities), and personal or subjective (experiences, perceptions, and sentiments about religion) (Pargament, 1997; Chatters, Levin & Taylor, 1992; Taylor, Mattis & Chatters, 1999). Specifically, non-organizational religiosity, including prayer, reading religious materials, and soliciting support and prayers from a religious community, is a common response to health issues, chronic poverty, racism, and adverse residential environment among AAs (Dunn and Horgas, 2000; Krause, 1998). Religious coping is also more prevalent among women, (Ellison and Taylor, 1996) and praying for oneself or asking someone to ‘pray on your behalf’ is among the most utilized forms of coping with individual problems and stress, among AAs (Taylor, Chatters, & Levin, 2004). Since neighborhood disadvantage is conceptualized as a stressor, and stress during pregnancy has been established as a risk factor for adverse birth outcomes,(Dunkel Schetter, 2011) examining the associations between neighborhood stressors, religious coping, and PTD among urban AA women could help to identify subgroups of the cholesterol absorption inhibitor which are most susceptible to the influences of adverse neighborhood conditions.
    Methods
    Results Table 1 displays demographic and religious coping characteristics of the study population. The mean age of the sample was 27 years, over 50% were married to or cohabitating with the father of the baby, and more than 70% had a more than 12 years of education. More than half of the women resided in their current neighborhood for ≤2 years. Roughly 50% of study participants reported frequent religious service attendance and a similar number reported satisfaction with the quality of the relationships Isoaccepting tRNAs had with people from their church or place of worship. Approximately 37% asked others to pray for them frequently, while 68% reported praying for themselves frequently. There were weak correlations between the religious coping variables with the highest between religious service attendance and satisfaction with the quality of the relationships with people in church or place of worship (0.41). Similarly, for individual neighborhood quality indicators, weak to moderate correlations were observed, with the highest between median income and median home values (0.68) (data not shown). Table 2 shows the mean and standard deviation of the composite neighborhood disadvantage index and the individual ACS variables, as well as results of log binomial regression analysis of PTD rates among women in the 75th versus the 25th percentiles of individual indicators of neighborhood quality, and our disadvantage index. There was evidence of moderation of the association between neighborhood disadvantage (composite and some individual measures) and PTD by both praying for oneself and asking others for prayer (Table 2). Specifically, asking others for prayer modified associations between PTD rates and the following neighborhood quality measures (p for interaction terms): % African American (p=0.02), % below poverty (p =0.02), % female- headed households (p=0.003), median income (p=0.002), % college graduate (p=0.004), median home value (p<0.001), and the index of neighborhood disadvantage (p=0.005). Evidence of moderation by praying for oneself was present for associations between PTD and % unemployed (p=0.02), % below poverty (p=0.02), median income (p=0.04), and median home value (p=0.02).