Silvia M. Bigatti
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Improving the mental health of Latino youth
Professor Silvia Bigatti is concerned about the high rate of depression among Latino adolescents in Indianapolis who endure the stress of straddling two cultures. In 2012, she started a partnership with the Latino Health Organization and received funding from the Indiana Minority Health Coalition to pursue a pilot research project that investigated the stress and depressive outcomes in this population. The study revealed that nearly 60 percent of participants had some form of depressive symptoms—and that they were seven times more likely to have depression if they suffered from moderate levels of acculturative stress. Based on the ¬findings, the research team developed a program, “Your Life. Your Story.” The YLYS program begins with a one-week summer day camp that builds resilience and develops self-identities and future goals. In the second phase of the YLYS program, a monthly meeting cements components from the camp. Data suggest that one week of the YLYS camp has a statistically significant impact on participants, who showed an increase in resilience and a decrease in depressive symptoms. These differences were maintained at a six-month follow-up. YLYS has the potential to create a large and lasting impact on the Indianapolis community. While the program has been focused on Latino youth, it can be applied and tailored to any group of youth. Professor Bigatti’s work to improve the mental health of Latino youth in Indianapolis is another example of how IUPUI faculty are TRANSLATING RESEARCH INTO PRACTICE.
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Item The influences of course effort and outside activities on grades in a college course(2006-09) Svanum, Soren; Bigatti, Silvia M.The influences of course effort and outside (family, job, social) activities on grades earned in a college course were examined for 230 urban college students. Multiple measurements of hours of work, social and family activities, and course effort were collected over a semester. Path modeling revealed that cumulative GPA and course effort had significant and independent predictive paths with grades. Outside activities did not directly influence course grade. Job activities, however, negatively influenced course grade indirectly through reduced course effort and mediated the influence GPA exerted on course grade. Thus, work demands lessened course effort and lessened GPA-indexed potential for course success. Cumulative GPA positively influenced effort, and effort mediated part of the relation between cumulative GPA and grades.Item Role Strains and Mood in Husbands of Women with Fibromyalgia Syndrome: A Test of the Stress Process Model(2008) Bigatti, Silvia M.; Lydon, Jennifer R.; Brothers, Brittany M.Spouses of patients experience role strains as a result of informal caregiving, which has been associated with mood in numerous research studies. However, most research is on female caregivers, and little is known about the experience of male spouses, or of the caregiving provided to fibromyalgia patients. The Stress Process Model was used to examine mediators and moderators of the relation between role strain and mood among 135 husbands of women with fibromyalgia. Results indicated that the more activities of daily living and instrumental activities of daily living performed by the husband, the greater the role strain. Role strain was associated with worse mood. A test of the Stress Process Model supported a partial mediation model, where social support and emotion-focused coping partially mediated the relation between role strain and mood. No evidence was found for a moderation model or for problem-focused coping as a mediator. Our research suggests significant impairment and caregiving needs among this patient population, which in turn relates to the mood of the husband who is also an informal caregiver. Our findings also support the Stress Process Model in explaining the complexity of caregiving effects. The results of the study suggest avenues for intervention for individuals strained by their partners’ illness.Item Sleep Disturbances in Fibromyalgia Syndrome: Relationship to Pain and Depression(2008-07) Bigatti, Silvia M.; Hernandez, Ann Marie; Cronan, Terry A.; Rand, Kevin L.Objective This study is an examination of sleep, pain, depression, and physical functioning at baseline and 1-year followup among patients with fibromyalgia syndrome (FMS). Although it is clear that these symptoms are prevalent among FMS patients and that they are related, the direction of the relationship is unclear. We sought to identify and report sleep problems in this population and to examine their relationship to pain, depression, and physical functioning. Methods Patients diagnosed with fibromyalgia were recruited from a Southern California health maintenance organization and evaluated according to American College of Rheumatology criteria in the research laboratory. Six hundred patients completed the baseline assessment and 492 completed the 1-year assessment. Measures included the Center for Epidemiologic Studies Depression Scale, the McGill Pain Questionnaire, the Pittsburgh Sleep Quality Index, and the Fibromyalgia Impact Questionnaire. Results The majority of the sample (96% at baseline and 94.7% at 1 year) scored within the range of problem sleepers. Path analyses examined the impact of baseline values on 1-year values for each of the 4 variables. No variable of interest predicted sleep, sleep predicted pain (β = 0.13), pain predicted physical functioning (β = −0.13), and physical functioning predicted depression (β = −0.10). Conclusion These findings highlight the high prevalence of sleep problems in this population and suggest that they play a critical role in exacerbating FMS symptoms. Furthermore, they support limited existing findings that sleep predicts subsequent pain in this population, but also extend the literature, suggesting that sleep may be related to depression through pain and physical functioning.Item Academic course engagement during one semester forecasts college success: Engaged students are more likely to earn a degree, do it faster, and do it better(2009-01) Svanum, Soren; Bigatti, Silvia M.Item The Binational/Crosscultural Health Enhancement Center(Office of the Vice Chancellor for Research, 2010-04-09) Bergman, Alicia April; Bigatti, Silvia M.; Clark Jr., Charles M.; Everetts, David R.; Kahn, Hilary E.; Lorant, Diane Estella; Maupome, Gerardo; Mays, Rose M.; Riner, Mary E.; Snodgrass, Michael David; Soto, Armando; Stelzner, Sarah M.; Whitehead, Dawn Michele; Wilson, Gregory A.; Yoder, Karen M.The Binational/Cross-Cultural Health Enhancement Center (BiCCHEC) fosters multidisciplinary research collaborations that address the biological, cultural, historical, legal, behavioral and demographic issues that impact the health status of communities where Latinos are born and where they live in Indiana. Since its inception, BiCCHEC projects have been multidisciplinary, 80% of the projects involve two or more IUPUI schools. BiCCHEC projects are also collaborative, 70% of the projects have one or more community partners. BiCCHEC researchers have also established a strong commitment to teaching and service, actively involving students in research (25% of current projects are student led) and servicelearning activities, developing exchange programs through our partnerships and providing direct health services in community organized events. Signature center funds have been utilized to fund internal pilot projects. The current poster will highlight four of those projects that have received pilot funding from signature center funds and have resulted in external grant applications or have already received funding, or have resulted in peer reviewed-publications. These projects are considered representative of BiCCHEC’s activities, because of their collaborative, multidisciplinary and community-based nature and include: • Study on oral health disparities using community-based participatory research • Study on the attitudes regarding children with disabilities, beliefs regarding death, coping skills and supports used during bereavement in communities in Indiana and rural Mexico • Building of a bi-national research partnership for healthful eating and diabetes prevention among Mexican and Mexican-American children • Study on emigration and return migration in 20th Century Mexico: Across the border and back again • Study on the effects of migrants' acculturation on oral health and diet in Indianapolis and Tala, Jaliscco using social network theoryItem Characterizing Burden, Role Strains and Psychological Distress of Husbands of Breast Cancer Patients During Treatment and Beyond(Wolters Kluwer, 2011) Wagner, Christina D.; Das, Lala Tanmoy; Bigatti, Silvia M.; Storniolo, Anna MariaBackground: Husbands, as the primary providers of support for women with breast cancer, can experience significant burden and role strain, but also perceive positive aspects to the caregiving. Little is known about the specific caregiving tasks husbands perform, for how long, or how burden and positive aspects relate to later psychological distress. Objective: Our primary aim was to better characterize the caregiving responsibilities and role strains of husbands during active cancer treatment and 1 year later. We also evaluated positive aspects during active treatment. Our second aim was to determine which of these predicted psychological distress 1 year later. Methods: Husbands of women undergoing chemotherapy for breast cancer completed a battery of surveys during the time of wives' treatment and again 1 year later. Results: Husbands performed a variety of caregiving tasks for wives during and after breast cancer treatment and also reported benefits associated with caregiving. Breast cancer-related worries were high at both time points. At 1 year after treatment, role strains improved in the social domain but worsened in the domestic domain. Domestic strains during active treatment were the strongest predictor of 1-year distress. Conclusions: Husbands who report persistent domestic role strain are at high risk for continued psychological distress following their wives' breast cancer treatment. Implications for practice: Health care providers should monitor husbands' caregiver burden regularly. Providing couples with resources to reduce domestic role strain (such as social support and communication training) may prevent or alleviate psychological distress in these husbands.Item Matched and Mismatched Cognitive Appraisals in Patients with Breast Cancer and their Partners: Implications for Psychological Distress(Wiley, 2011) Bigatti, Silvia M.; Steiner, Jennifer L.; Makinabakan, Nermin; Hernandez, Ann Marie; Johnston, Erica; Storniolo, Anna MariaThe present study sought to identify couples’ cognitive appraisals of breast cancer and the extent to which matched or mismatched appraisals within a couple contribute to distress. Women with breast cancer (n = 57) and their partners completed the Cognitive Appraisals of Health Scale along with two self-report measures of distress, the Profile of Mood States and the Impact of Events Scale. Four groups were created based on their cognitive appraisals. Couples where both patient and partner scored highest on challenge or benign appraisals formed the positive outlook group (P+S+); when both scored highest on threat or harm/loss they formed the negative outlook group (P-S-). In the mismatched groups the patient had a positive outlook and their partner had a negative outlook (P+S-), or vice versa (P-S+). In general, lower distress was related to participants’ own positive outlook. Higher distress for patients was found in the matched group P-S-; for partners it was found in the mismatched group P+S-. These findings suggest partner effects for both patients and partners. When the patient had a negative outlook, a partner negative outlook was associated with the highest psychological distress. When the partner had a negative outlook, a patient positive outlook was associated with the highest psychological distress. There are several possible explanations for these findings, each with different implications for clinical practice. Future research with different groups of cancer patients and longitudinal, mixed methods designs may clarify their meaning.Item Depression in Husbands of Breast Cancer Patients: Relationships to Coping and Social Support(Springer, 2011) Bigatti, Silvia M.; Wagner, Christina D.; Lydon, Jennifer R.; Steiner, Jennifer L.; Miller, Kathy D.PURPOSE: The purpose of the present study was to examine depression in husbands of women with breast cancer, as depression is typically as high in husbands as in patients, and impacts functioning in both. METHODS: We compared husbands of patients to husbands of women without chronic illness on depressive symptoms with the Center for Epidemiological Studies Depression Scale, social support with the Interpersonal Support Evaluation List, and coping with the Ways of Coping Questionnaire. Using the stress and coping model, we examined whether coping mediated social support and depression differently by group, as has been found in the literature. RESULTS: Husbands of patients reported higher scores on the measure of depression and lower use of problem-focused coping, while groups reported equivalent social support. Escape-avoidance coping emerged as a full mediator between social support and depression in husbands of patients, but only a partial mediator in comparison husbands. Accepting responsibility coping partially mediated social support and depression in both groups. Low social support appears particularly detrimental in husbands of patients as it is associated with ineffective coping and depression. CONCLUSIONS: Findings suggest that among husbands of patients, social support relates to depression only through its relationship with coping, indicating healthcare providers should direct attention and intervention to the coping strategies employed by husbands with low social support.Item Research to Encourage Exercise for Fibromyalgia (REEF): Use of motivational interviewing design and method(Contemporary Clinical Trials, 2011) Ang, Dennis C.; Kaleth, Anthony S.; Bigatti, Silvia; Mazzuxa, Steve; Saha, Chandan; Hilligoss, Janna; Lengerich, Mimi; Bandy, RobertFibromyalgia (FM), defined as the presence of both chronic widespread pain and the finding of 11/18 tender points on examination, is an illness associated with major personal and societal burden. Supervised aerobic exercise is an important treatment modality to improve patient symptoms. Unfortunately, adherence to an exercise regimen after a structured supervised program is disappointingly low. Since FM is a chronic illness, studies are needed to test strategies that would enhance exercise adherence in these individuals. Individuals who are able to adhere to exercise almost always maintain the symptomatic benefits of exercise. The objective of this paper was to describe the protocol of the Research to Encourage Exercise for Fibromyalgia (REEF). REEF is a randomized attention-controlled trial that seeks to test the efficacy of 6 sessions of telephone delivered motivational interviewing (MI) that targets exercise adherence to improve FM-relevant clinical outcomes (i.e., physical function and pain severity). The trial has recently completed enrolling 216 subjects, and randomization has resulted in well-balanced groups. Details on the study design, MI program, and treatment fidelity are provided in the paper. Outcome assessments at week 12, week 24 and week 36 will test the immediate, intermediate and long-term effects of exercise-based MI on adherence (as measured by the Community Health Activities Model Program for Seniors/CHAMPS and accelerometer) and clinical outcomes. When completed, REEF will determine whether exercise-based MI could be utilized as a management strategy to sustain the clinical benefits of exercise for FM.Item Cancer Screening in the United States and Europe(2012) Cronan, Terry A.; Santoro, Maya; Van Liew, Charles; Bigatti, Silvia M.