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Article ; Online: Older Adults' Social Profiles and Links to Functional and Biological Aging in the United States and Mexico.

Wilson, Stephanie J / Marini, Christina M

2023

Abstract: Objective: Social stress-loneliness, isolation, and low relationship quality-increase risks for aging-related diseases. However, the ways in which they intersect to undermine healthy aging remain poorly understood. We utilized latent class analysis to ... ...

Abstract	Objective: Social stress-loneliness, isolation, and low relationship quality-increase risks for aging-related diseases. However, the ways in which they intersect to undermine healthy aging remain poorly understood. We utilized latent class analysis to identify groups of older adults based on their social stress in both the United States and Mexico. Thereafter, we examined their cross-sectional associations with markers of functional and biological aging. Method: Participants in the Health and Retirement Study (HRS, N = 8,316) and Mexican Health and Aging Study (MHAS, N = 15,001) reported their loneliness, isolation (i.e., living alone), and relationship quality with spouse, children, and friends. Outcomes included C-reactive protein (CRP), functional limitations, self-rated health, comorbidities, gait speed, and grip strength. Models controlled for demographics, health behaviors, and body mass index (BMI). Results: In both countries, five classes emerged, a Supported group and four with elevated social stress: (1) Strained, (2) Isolated, (3) Spousal Ambivalence, and (4) Unhappily Married. Compared to the others, Strained participants in both samples had greater functional limitations, poorer self-rated health, and more comorbidities, as well as slower gait in HRS and weaker grip in MHAS. Generally, Supported participants fared better than the other groups. In HRS, CRP levels differed between the Strained group and others, but these associations were explained by health behaviors and BMI. Conclusions: Older adults in both countries with strained relationships fared worst in their aging-related outcomes, revealing new insights about the links between toxic social stress and unhealthy aging.
Language	English
Publishing date	2023-09-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	3469-1
ISSN	1534-7796 ; 0033-3174
ISSN (online)	1534-7796
ISSN	0033-3174
DOI	10.1097/PSY.0000000000001248
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Article ; Online: Loneliness and Marital Quality as Predictors of Older Adults' Insomnia Symptoms.

Lawrence, Carly / Marini, Christina M

International journal of aging & human development

2023 Volume 98, Issue 2, Page(s) 243–262

Abstract: The current study examined associations between marital quality, loneliness, and sleep within a nationally representative sample of older adults who participated in Wave 2 of the National Social Life, Health, and Aging Project (NSHAP). Participants ( ...

Abstract	The current study examined associations between marital quality, loneliness, and sleep within a nationally representative sample of older adults who participated in Wave 2 of the National Social Life, Health, and Aging Project (NSHAP). Participants (
MeSH term(s)	Humans ; Aged ; Sleep Initiation and Maintenance Disorders/epidemiology ; Loneliness/psychology ; Sleep ; Aging/psychology ; Marriage/psychology
Language	English
Publishing date	2023-10-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	187072-5
ISSN	1541-3535 ; 0091-4150
ISSN (online)	1541-3535
ISSN	0091-4150
DOI	10.1177/00914150231208013
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Article: The Days Add Up: Daily Marital Discord and Depressive Reactivity Linked to Past-Month Depressed Mood and Marital Risk across 10 Years.

Wilson, Stephanie J / Marini, Christina M

Journal of social and personal relationships

2022 Volume 40, Issue 4, Page(s) 1172–1193

Abstract: Marital discord fuels depression, according to decades of research. Most prior studies in this area have focused on macro-longitudinal change in depression over the course of years, and on global ratings of marital satisfaction. Less work has examined ... ...

Abstract	Marital discord fuels depression, according to decades of research. Most prior studies in this area have focused on macro-longitudinal change in depression over the course of years, and on global ratings of marital satisfaction. Less work has examined fluctuations in depressed mood and marital discord in daily life, and none has investigated associations of short-term patterns with longer-term depressed mood and marital outcomes. Using data from participants in the Midlife in the U.S. (MIDUS) project, the current study examined daily associations between marital discord and depressed mood, as well as their links to concurrent and prospective patterns of past-month depressed mood and marital risk. Results showed that, on average, depressed mood rose on days when individuals had an argument or tension with their spouse (i.e., marital discord). More frequent daily marital discord was also associated with greater past-month depressed mood and marital risk, above and beyond prior levels. Those with larger depressive mood responses to discord in daily life (i.e., greater reactivity) exhibited higher concurrent past-month depressed mood and greater 10-year increases in depressed mood. As the first study to link daily marital patterns to concurrent and prospective changes in depressed mood and marital outcomes, this investigation uncovered two novel processes-daily marital discord and depressive reactivity-as important for understanding long-term patterns of marital risk and depression.
Language	English
Publishing date	2022-07-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2023968-3
ISSN	1460-3608 ; 0265-4075
ISSN (online)	1460-3608
ISSN	0265-4075
DOI	10.1177/02654075221116277
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Article ; Online: Patient Perceptions of Integrating Meditation-based Interventions in Office-based Opioid Treatment with Buprenorphine: A Mixed-methods Survey.

Tofighi, Babak / Marini, Christina / Lee, Joshua D / Garland, Eric L

Journal of addiction medicine

2023 Volume 17, Issue 5, Page(s) 517–520

Abstract: Introduction: Recent findings support the provision of meditation-based interventions (MBIs) in primary care. However, the acceptability of MBI among patients prescribed medications for opioid use disorder (eg, buprenorphine) in primary care remains ... ...

Abstract	Introduction: Recent findings support the provision of meditation-based interventions (MBIs) in primary care. However, the acceptability of MBI among patients prescribed medications for opioid use disorder (eg, buprenorphine) in primary care remains unclear. This study assessed experiences and preferences for adopting MBI among patients prescribed buprenorphine in office-based opioid treatment (OBOT). Methods: This 23-item, semistructured cross-sectional survey was administered by study staff to patients enrolled in OBOT (N = 72) and consisted of demographic and clinical characteristics, perceptions, experiences with MBI, and preferred strategies to access MBI to support their treatment on buprenorphine. Results: Most participants reported practicing at least 1 category of MBI (90.3%) on at least a daily (39.6%) or weekly (41.7%) basis including (1) spiritual meditation (eg, centering prayer; 67.7%); (2) nonmantra meditation (eg, comfortable posture; 61.3%); (3) mindfulness meditation (eg, mindfulness-based stress reduction; 54.8%); and (4) mantra meditation (eg, transcendental meditation; 29.0%). Interest in MBI was motivated by improving one's general health and well-being (73.4%), treatment outcomes with medications for OUD (eg, buprenorphine; 60.9%), and relationships with others (60.9%). Perceived clinical benefits of MBI included reduced anxiety or depression symptoms (70.3%), pain (62.5%), illicit substance or alcohol use (60.9%), cravings for illicit substances (57.8%), and opioid-related withdrawal symptoms (51.6%). Conclusions: Findings from this study indicate high acceptability for adopting MBI among patients prescribed buprenorphine in OBOT. Further research is needed to assess the efficacy of MBI to improve clinical outcomes among patients initiating buprenorphine in OBOT.
MeSH term(s)	Humans ; Buprenorphine/therapeutic use ; Analgesics, Opioid/therapeutic use ; Meditation ; Cross-Sectional Studies ; Opioid-Related Disorders/drug therapy ; Narcotics/therapeutic use ; Opiate Substitution Treatment/methods
Chemical Substances	Buprenorphine (40D3SCR4GZ) ; Analgesics, Opioid ; Narcotics
Language	English
Publishing date	2023-03-28
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	1935-3227
ISSN (online)	1935-3227
DOI	10.1097/ADM.0000000000001160
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The Social Context of Partnered Older Adults' Insomnia Symptoms.

Marini, Christina M / Zhaoyang, Ruixue / Martire, Lynn M / Buxton, Orfeu M

International journal of aging & human development

2022 Volume 97, Issue 1, Page(s) 18–34

Abstract: The current study included an examination of social factors that mitigate or exacerbate insomnia symptoms among older adults who are married or living with a partner. We first examined the unique effects of spousal support and strain on insomnia symptoms ...

Abstract	The current study included an examination of social factors that mitigate or exacerbate insomnia symptoms among older adults who are married or living with a partner. We first examined the unique effects of spousal support and strain on insomnia symptoms and then evaluated the degree to which extramarital social factors (e.g., friend support) moderated spousal influences. Data came from Waves 2 and 3 of the National Social Life, Health, and Aging Project. Our sample consisted of 495 participants who were either married or cohabitating with a partner (
MeSH term(s)	Humans ; Aged ; Sleep Initiation and Maintenance Disorders/epidemiology ; Marriage ; Marital Status ; Aging ; Social Environment
Language	English
Publishing date	2022-09-28
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	187072-5
ISSN	1541-3535 ; 0091-4150
ISSN (online)	1541-3535
ISSN	0091-4150
DOI	10.1177/00914150221128973
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Article: Dyadic Links Between Health Changes and Well-Being: The Role of Non-Spousal Confidants.

Martire, Lynn M / Zhaoyang, Ruixue / Marini, Christina M / Nah, Suyoung

Journal of social and personal relationships

2022 Volume 39, Issue 8, Page(s) 2617–2638

Abstract: Although the marital relationship is often the primary source of emotional support in adulthood, sole reliance on the spouse to discuss health-related issues may be harmful to the well-being of both partners. The first aim of this study was to examine ... ...

Abstract	Although the marital relationship is often the primary source of emotional support in adulthood, sole reliance on the spouse to discuss health-related issues may be harmful to the well-being of both partners. The first aim of this study was to examine whether declines in health during later life would be associated with poorer psychological well-being in self and partner. We further investigated whether declining health would have a stronger impact on own and partner psychological well-being in the absence of non-spousal health confidants. Longitudinal actor-partner interdependence models (APIMs) were used to test both hypotheses with dyadic data from Wave 2 (2010-2011) and Wave 3 (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP). Contrary to prediction, increased anxiety following spousal declines in gait speed and cognitive function occurred for those whose spouse
Language	English
Publishing date	2022-04-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2023968-3
ISSN	1460-3608 ; 0265-4075
ISSN (online)	1460-3608
ISSN	0265-4075
DOI	10.1177/02654075221086509
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Article ; Online: Marital Quality and Loneliness Among Aging Vietnam-Era Combat Veterans: The Moderating Role of PTSD Symptom Severity.

Marini, Christina M / Yorgason, Jeremy B / Pless Kaiser, Anica / Erickson, Lance D

Clinical gerontologist

2023 , Page(s) 1–15

Abstract: Objectives: We examined links between marital quality and loneliness among aging veterans and explored whether veterans' PTSD symptom severity moderated these associations.: Methods: Data came from 269 Vietnam-Era combat veterans who had a spouse/ ... ...

Abstract	Objectives: We examined links between marital quality and loneliness among aging veterans and explored whether veterans' PTSD symptom severity moderated these associations. Methods: Data came from 269 Vietnam-Era combat veterans who had a spouse/partner (M age = 60.50). Utilizing two waves of data spanning six years, we estimated multiple regression models that included positive and negative marital quality, PTSD symptom severity, and loneliness in 2010 as predictors of loneliness in 2016. Results: Facets of positive (but not negative) marital quality were associated with veterans' loneliness. Companionship - spousal affection and understanding - was associated with lower subsequent loneliness among veterans with low/moderate - but not high - PTSD symptom severity. Conversely, sociability - the degree to which one's marriage promotes socializing with others - was associated with lower subsequent loneliness regardless of PTSD symptom severity. Conclusions: Companionship and sociability were each associated with veterans' subsequent loneliness. Whereas benefits of companionship were attenuated at higher levels of PTSD symptom severity, benefits of sociability were not. Clinical implications: For veterans with higher PTSD symptoms, recommending mental health treatment to decrease symptom severity may help them to reap the benefits of close/intimate relationships. However, bolstering veterans' social participation more broadly may provide an additional means of reducing their loneliness.
Language	English
Publishing date	2023-10-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	226146-7
ISSN	1545-2301 ; 0731-7115
ISSN (online)	1545-2301
ISSN	0731-7115
DOI	10.1080/07317115.2023.2274052
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Article: A Mixed-Methods Evaluation of the Feasibility of a Medical Management-Based Text Messaging Intervention Combined With Buprenorphine in Primary Care.

Tofighi, Babak / Durr, Meghan / Marini, Christina / Lewis, Crystal F / Lee, Joshua D

Substance abuse : research and treatment

2022 Volume 16, Page(s) 11782218221078253

Abstract: Background: Mobile health (mHealth) tools offer an effective and personalized approach to enhance chronic disease management and may partially offset provider-level barriers to increasing buprenorphine prescribing in primary care. This study assessed ... ...

Abstract	Background: Mobile health (mHealth) tools offer an effective and personalized approach to enhance chronic disease management and may partially offset provider-level barriers to increasing buprenorphine prescribing in primary care. This study assessed the feasibility of integrating a text messaging-based medical management tool (TeMeS) in primary care among patients initiating buprenorphine. Methods: TeMeS messages are categorized per the medical management model, programed in a HIPAA-compliant texting software (Apptoto©), and delivered in a tiered fashion over 8-weeks to patients. This mixed-methods evaluation of TeMeS utilized key stakeholder feedback (patients, physicians, administrators, nursing), text messaging software process measures, thematic analysis of patient participant text message content, and electronic administrative data (eg, appointment adherence, treatment retention) at 2-months. Results: The study team approached 65 patients and n = 14 (21%) were ineligible or declined to participate in the study. Most eligible participants owned a smartphone (90%), responded to at least one text query (88%) over an average of 24 days, and few requested to stop receiving texts (6%). Participant text replies included responses to cognitive behavioral therapy-based queries (13.8%), confirming or rescheduling appointments (6.1%), and insurance, pharmacy, or clinical issues pertaining to buprenorphine dispensation or dosing (2%). Suggestions for design modifications included personalizing message content and adjusting message frequency per patient risk of illicit opioid reuse, use of video-based informational content, and real-time provider and staff support for emergent issues. Conclusion: Our findings highlight the acceptability, feasibility, and high rates of engagement of utilizing text messaging to enhance self-management among patients initiating buprenorphine treatment.
Language	English
Publishing date	2022-03-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	1458030-5
ISSN	1547-0164 ; 1178-2218 ; 0889-7077
ISSN (online)	1547-0164
ISSN	1178-2218 ; 0889-7077
DOI	10.1177/11782218221078253
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Article ; Online: Opening the Black Box of an mHealth Patient-Reported Outcome Tool for Diabetes Self-Management: Interview Study Among Patients With Type 2 Diabetes.

Marini, Christina / Cruz, Jocelyn / Payano, Leydi / Flores, Ronaldo Patino / Arena, Gina-Maria / Mandal, Soumik / Leven, Eric / Mann, Devin / Schoenthaler, Antoinette

JMIR formative research

2023 Volume 7, Page(s) e47811

Abstract: Background: Mobile health (mHealth) tools are used to collect data on patient-reported outcomes (PROs) and facilitate the assessment of patients' self-management behaviors outside the clinic environment. Despite the high availability of mHealth diabetes ...

Abstract	Background: Mobile health (mHealth) tools are used to collect data on patient-reported outcomes (PROs) and facilitate the assessment of patients' self-management behaviors outside the clinic environment. Despite the high availability of mHealth diabetes tools, there is a lack of understanding regarding the underlying reasons why these mHealth PRO tools succeed or fail in terms of changing patients' self-management behaviors. Objective: This study aims to identify the factors that drive engagement with an mHealth PRO tool and facilitate patients' adoption of self-management behaviors, as well as elicit suggestions for improvement. Methods: This qualitative study was conducted within the context of a randomized controlled trial designed to evaluate the efficacy of an mHealth PRO tool (known as i-Matter) versus usual care regarding reduction in glycated hemoglobin (HbA Results: The sample comprised 71 patients, of whom 67 (94%) completed at least one interview (n=48, 72% female patients; n=25, 37% identified as African American or Black; mean age 56.65 [SD 9.79] years). We identified 4 overarching themes and 6 subthemes. Theme 1 showed that the patients' reasons for engagement with i-Matter were multifactorial. Patients were driven by internal motivating factors that bolstered their engagement and helped them feel accountable for their diabetes (subtheme 1) and external motivating factors that helped to serve as reminders to be consistent with their self-management behaviors (subtheme 2). Theme 2 revealed that the use of i-Matter changed patients' attitudes toward their disease and their health behaviors in 2 ways: patients developed more positive attitudes about their condition and their ability to effectively self-manage it (subtheme 3), and they also developed a better awareness of their current behaviors, which motivated them to adopt healthier lifestyle behaviors (subtheme 4). Theme 3 showed that patients felt more committed to their health as a result of using i-Matter. Theme 4 highlighted the limitations of i-Matter, which included its technical design (subtheme 5) and the need for more resources to support the PRO data collected and shared through the tool (subtheme 6). Conclusions: This study isolated internal and external factors that prompted patients to change their views about their diabetes, become more engaged with the intervention and their health, and adopt healthy behaviors. These behavioral mechanisms provide important insights to drive future development of mHealth interventions that could lead to sustained behavior change.
Language	English
Publishing date	2023-09-19
Publishing country	Canada
Document type	Journal Article
ISSN	2561-326X
ISSN (online)	2561-326X
DOI	10.2196/47811
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Article: Precision Concussion Management: Approaches to Quantifying Head Injury Severity and Recovery.

de Souza, Daniel N / Jarmol, Mitchell / Bell, Carter A / Marini, Christina / Balcer, Laura J / Galetta, Steven L / Grossman, Scott N

Brain sciences

2023 Volume 13, Issue 9

Abstract: Mitigating the substantial public health impact of concussion is a particularly difficult challenge. This is partly because concussion is a highly prevalent condition, and diagnosis is predominantly symptom-based. Much of contemporary concussion ... ...

Abstract	Mitigating the substantial public health impact of concussion is a particularly difficult challenge. This is partly because concussion is a highly prevalent condition, and diagnosis is predominantly symptom-based. Much of contemporary concussion management relies on symptom interpretation and accurate reporting by patients. These types of reports may be influenced by a variety of factors for each individual, such as preexisting mental health conditions, headache disorders, and sleep conditions, among other factors. This can all be contributory to non-specific and potentially misleading clinical manifestations in the aftermath of a concussion. This review aimed to conduct an examination of the existing literature on emerging approaches for objectively evaluating potential concussion, as well as to highlight current gaps in understanding where further research is necessary. Objective assessments of visual and ocular motor concussion symptoms, specialized imaging techniques, and tissue-based concentrations of specific biomarkers have all shown promise for specifically characterizing diffuse brain injuries, and will be important to the future of concussion diagnosis and management. The consolidation of these approaches into a comprehensive examination progression will be the next horizon for increased precision in concussion diagnosis and treatment.
Language	English
Publishing date	2023-09-21
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2651993-8
ISSN	2076-3425
ISSN	2076-3425
DOI	10.3390/brainsci13091352
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