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Examining Links between Multidimensional Stress and Health Outcomes in a Pediatric Sample from Low-Income Families
Abstract
Within pediatric health psychology, low socioeconomic status is a risk factor for adverse physical, socio-emotional, and behavioral outcomes (Clarke & Erreygers, 2020). The impact of environmental stressors may be further exacerbated in the context of poverty, which may influence scores and factor-loadings on common pediatric assessments (Hurt & Betancourt, 2017). Therefore, the current study pursued two aims. First, the factor structure and psychometric properties of the 24-item Children’s Somatization Inventory (CSI-24) were examined in a predominantly low-income sample of children and caregivers from a family medicine practice. Second, the impact of multidimensional stressors on somatization, health-related quality of life, mental health, and one-year medical service utilization was examined. Given that modifiable health behaviors may serve as a low-cost way to alleviate negative outcomes associated with chronic environmental stress, moderating variables of physical activity and sleep were considered within the stressor-health association in a predominantly low-income sample (Kleszczewska et al., 2019). A confirmatory factor analysis (CFA) of the CSI-24 was initially proposed; however, the CFA was unfeasible due to the available sample size. Alternate exploratory analyses on the psychometric and structural properties of the CSI-24 were therefore conducted, considering factors identified in prior research. The relationship between multidimensional stress and health outcomes was examined via a series of stepwise multiple regressions, controlling for age and gender. Moderating variables of physical activity and sleep were examined using a separate model for each dependent variable. Results found preliminary support for differences in the psychometric properties of the CSI-24 when used in a low-income sample, supported a relationship between multidimensional stress and health outcomes, and provided a rare examination of sleep and physical activity as moderators in the stress-health relationship in this population. Gaps in the existing literature were addressed related to the stress-health relationship, potential moderators, and properties of the CSI-24 when administered to a low-income sample. Findings have implications for interpretation of the CSI-24, and for targeted interventions related to multidimensional stress and health.
Subject Area
Clinical psychology|Physiological psychology|Public health
Recommended Citation
Kozikowski Yancey, Chelsea Bethany, "Examining Links between Multidimensional Stress and Health Outcomes in a Pediatric Sample from Low-Income Families" (2022). ETD collection for University of Nebraska-Lincoln. AAI29322439.
https://digitalcommons.unl.edu/dissertations/AAI29322439