142nd APHA Annual Meeting and Exposition

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I ka wā mamua, ka wā ma hope: Adverse childhood experiences and current depressive symptoms among Native Hawaiians and Other Pacific Islanders

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Tasha Tydingco, MPH , Department of Public Health Sciences, University of Hawaii, Honolulu, HI
Tetine Sentell, PhD , Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI
Maile Taualii, PhD, MPH , Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI

Background: Adverse childhood experiences (ACE) are a risk factor for poorer adult health. There is little to no published research on ACE among Native Hawaiians and Other Pacific Islanders (NHOPI). This study examined the prevalence of ACE and the association of ACE with current depressive symptoms (CDS) in NHOPI.

Methods: Behavior Risk Factor Surveillance System (BRFSS) 2010 data was analyzed for the five states that included the optional ACE module (n=16,478). Eleven ACE indicators were considered individually and by category (household dysfunction, physical, verbal, and sexual abuse).  CDS were evaluated using the Patient Health Questionnaire (PHQ-8).  Multivariable logistic models predicted CDS for NHOPI (vs. whites) considering ACE, age, sex, education, income, and chronic diseases.  Final models included an interaction term to compare the relationship of ACE to CDS for NHOPI (vs. whites). 

Results: Overall, 70.54 % NHOPI experienced one or more ACE, compared to 62.75% whites (p=0.02). NHOPI had a significantly higher prevalence of household dysfunction (59.32% vs. 47.6%;p=<0.001), physical abuse (23.11% vs. 17.54%;p=0.017), and forced sex (7.45% vs. 3.85%;p=0.005) compared to whites. There was a strong positive association between one or more ACE and CDS (OR=3.86;95%CI=2.81-5.30). The relationship did not differ significantly between NHOPI and whites (OR=0.78;95%CI =0.24-2.52;p=0.769).

Conclusions: Adverse childhood experiences are more prevalent in NHOPI compared to whites, especially household dysfunction, physical abuse, and forced sex. ACE are significantly associated with CDS in adulthood.  Further research is needed on the role of ACE in NHOPI health and policies to support NHOPI families with culturally-rooted, strengths-based efforts.

Learning Areas:

Administer health education strategies, interventions and programs
Chronic disease management and prevention
Diversity and culture
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the prevalence of Adverse Childhood Experiences (ACEs) among Native Hawaiians and Other Pacific Islanders (NHOPI). Compare the relationship of ACEs to Current Depressive Symptoms (CDS) in NHOPI and whites. Recommend policies that will address ACE and CDS in NHOPI.

Keyword(s): Asian and Pacific Islanders, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the primary person responsible for (1) the study conception and design, analysis, and interpretation as well as (2) the drafting and final approval of the submitted abstract. I was the primary investigator as the project. I also performed the review of existing literature, made decisions about study methods and analysis, and completed the discussion of findings, including policy recommendations. I drafted the abstract which was then reviewed by my co-authors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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