Contextual stress and health risk behaviors among African American adolescents

What Do Urban Black Mothers Tell Their Adolescents About Alcohol And Other Drugs?

The current study utilized qualitative content analysis to examine messages conveyed about alcohol and other drugs by urban Black mothers (N=130) with a personal, familial, or personal and familial history of problematic substance use to younger and older adolescents (M = 15.2 years). Data from a two-cohort longitudinal sample revealed considerable similarity in themes across the younger and older cohorts. Results suggest Black mothers offer more messages of information and advice to younger adolescents, while communicating directives related to use to older adolescents.

Gender Differences in Longitudinal Links between Neighborhood Fear, Parental Support, and Depression among African American Emerging Adults

The transition to adulthood is a developmental period marked by increased stress, especially among African Americans. In addition to stress related to emerging adulthood, neighborhood fear may contribute to depressive symptoms for African Americans. We examined gender differences in longitudinal associations between changes in perceived neighborhood fear, parental support, and depressive symptoms among African American youth who were in transition to adulthood. Five hundred and thirteen African American youths (235 males and 278 females) were included in the study. An increase in perceived neighborhood fear was associated with an increase in depressive symptoms and change in perceived maternal support was predictive of depressive symptoms among males, but not females. The findings suggest that policies and programs should help parents provide support to young adult children who live in violent neighborhoods as a strategy to prevent depressive symptoms during emerging adulthood.

Twitter chatter about marijuana

PURPOSE

We sought to examine the sentiment and themes of marijuana-related chatter on Twitter sent by influential Twitter users and to describe the demographics of these Twitter users.

METHODS

We assessed the sentiment and themes of a random sample (n = 7,000) of influential marijuana-related tweets (sent from February 5, 20114, to March 5, 2014). Demographics of the users tweeting about marijuana were inferred using a social media analytics company (Demographics Pro for Twitter).

RESULTS

Most marijuana-related tweets reflected a positive sentiment toward marijuana use, with pro-marijuana tweets outnumbering anti-marijuana tweets by a factor of greater than 15. The most common theme of pro-marijuana tweets included the Tweeter stating that he/she wants/plans to use marijuana, followed by tweeting about frequent/heavy/or regular marijuana use, and that marijuana has health benefits and/or should be legalized. Tweeters of marijuana-related content were younger and a greater proportion was African-American compared with the Twitter average.

CONCLUSIONS

Marijuana Twitter chatter sent by influential Twitter users tends to be pro-marijuana and popular among African-Americans and youth/young adults. Marijuana-related harms may afflict some individuals; therefore, our findings should be used to inform online and offline prevention efforts that work to target individuals who are most at risk for harms associated with marijuana use.

Neighborhood environment and urban African American marijuana use during high school

African American male high school students have the highest rates of marijuana use among all racial, ethnic, and gender groups, yet there is limited research examining contextual factors salient to the African American community. The purpose of this study was to examine how neighborhood environment measured in 8th grade is related to longitudinal transitions in marijuana use during high school (9th to 12th grades) in a sample of urban African Americans. Four hundred and fifty-two African American children were interviewed annually beginning in 1st grade as part of a longitudinal field study in Baltimore city. Latent transition analysis indicated early in high school posed the greatest risk for initiation and progression of marijuana use. Community violence exposure was associated with an increased likelihood of transitioning from no marijuana use to infrequent use (adjusted odds ratios (AOR) = 2.40, p < 0.001). Higher perceived neighborhood disorder (AOR = 3.20, p = 0.004), drug activity and sales in the neighborhood (AOR = 2.28, p = 0.028), and community violence exposure (AOR = 4.54, p < 0.001) were associated with an increased risk of transitioning from no use to frequent/problematic marijuana use. There was evidence for partial mediation of these associations by perceptions of harm and depressed mood. Drug activity and sales was associated with progression from infrequent to frequent and problematic use (AOR = 2.87, p = 0.029). African American youth living in urban environments with exposure to drug activity, violence, and neighborhood disorder are at increased risk for both initiation and progression to more frequent and problematic marijuana use during high school. These findings highlight the need to develop interventions for African American youth that are mindful of the impact of the additional stressors of living in a high-risk urban environment during a critical developmental transition period. Reducing exposure to drug activity and violence in high-risk urban neighborhoods may be the first step to potentially halt increasing rates of marijuana use among African Americans.

“It’ll Never Be the White Kids, It’ll Always Be Us”

We examine how Black high school students, participants in a Youth Participatory Action Research (YPAR) program, understand issues of racial discrimination and inequality in their schools. Through semi-structured individual interviews conducted early in the program, eight students (six boys and two girls) recount experiences of racial stereotyping, discrimination from teachers and staff, lack of institutional support for a positive racial climate, and lack of racial diversity in curricular offerings. Further, through evolving critical analysis supported by the YPAR experience, these students describe rationale for and implications of such negative race-based educational experiences. Findings reveal how Black adolescents interpret the racial discrimination and inequality they experience in school and the implications of parental and community socialization on the development of a critical understanding of race-based social inequalities.

Perceived neighborhood illicit drug selling, peer illicit drug disapproval and illicit drug use among U.S. high school seniors

BACKGROUND

This study examined associations between perceived neighborhood illicit drug selling, peer illicit drug disapproval and illicit drug use among a large nationally representative sample of U.S. high school seniors.

METHODS

Data come from Monitoring the Future (2007-2011), an annual cross-sectional survey of U.S. high school seniors. Students reported neighborhood illicit drug selling, friend drug disapproval towards marijuana and cocaine use, and past 12-month and past 30-day illicit drug use (N = 10,050). Multinomial logistic regression models were fit to explain use of 1) just marijuana, 2) one illicit drug other than marijuana, and 3) more than one illicit drug other than marijuana, compared to "no use".

RESULTS

Report of neighborhood illicit drug selling was associated with lower friend disapproval of marijuana and cocaine; e.g., those who reported seeing neighborhood sales "almost every day" were less likely to report their friends strongly disapproved of marijuana (adjusted odds ratio [AOR] = 0.38, 95% CI: 0.29, 0.49) compared to those who reported never seeing neighborhood drug selling and reported no disapproval. Perception of neighborhood illicit drug selling was also associated with past-year drug use and past-month drug use; e.g., those who reported seeing neighborhood sales "almost every day" were more likely to report 30-day use of more than one illicit drug (AOR = 11.11, 95% CI: 7.47, 16.52) compared to those who reported never seeing neighborhood drug selling and reported no 30-day use of illicit drugs.

CONCLUSIONS

Perceived neighborhood drug selling was associated with lower peer disapproval and more illicit drug use among a population-based nationally representative sample of U.S. high school seniors. Policy interventions to reduce "open" (visible) neighborhood drug selling (e.g., problem-oriented policing and modifications to the physical environment such as installing and monitoring surveillance cameras) may reduce illicit drug use and peer disapproval of illicit drugs.

The association between stress, coping, and sexual risk behaviors over 24 months among African-American female adolescents

Heightened psychosocial stress coupled with maladaptive coping may be associated with greater sexual risk engagement. This study examined the association between stress levels and coping strategy use as predictors of sexual risk behavior engagement over 24 months among African-American adolescent females (N = 701; M = 17.6 years) enrolled in an STI/HIV risk-reduction intervention program. Participants completed audio computer assisted self-interview (ACASI) measures of global stress, interpersonal stress, coping strategy use, and sexual behaviors prior to intervention participation. Follow-up ACASI assessments were conducted at 6, 12, 18, and 24 months post-intervention. Generalized estimated equation models examined associations between baseline stress levels and coping strategy use as predictors of condom use (past 90 days, last sex) and multiple partners during follow-up. Global stress and individual coping strategy usage were not associated with differences in condom use. Higher interpersonal stress was associated with lower proportion condom use (p = .018), inconsistent condom use (p = .011), and not using a condom at last sex (p = .002). There were no significant associations between stress levels, coping strategy use, and multiple partners. Future research should explore mechanisms that may underlie the association between elevated interpersonal stress and decreased condom use among this population.

Witnessing a violent death and smoking, alcohol consumption, and marijuana use among adolescents

Witnessing violence has been linked to maladaptive coping behaviors such as smoking, alcohol consumption, and marijuana use. However, more research is required to identify mechanisms in which witnessing violence leads to these behaviors. The objectives of this investigation were to examine the association between witnessing a violent death and smoking, alcohol consumption, and marijuana use among adolescents, to identify whether exhibiting depressive symptoms was a mediator within this relationship, and to determine if those who had adult support in school were less likely to engage in risky health behaviors. Data were collected from a sample of 1,878 urban students, from 18 public high schools participating in the 2008 Boston Youth Survey. In 2012, we used multilevel log-binomial regression models and propensity score matching to estimate the association between witnessing a violent death and smoking, alcohol consumption, and marijuana use. Analyses indicated that girls who witnessed a violent death were more likely to use marijuana (relative risk (RR) = 1.09, 95% confidence interval (CI) = 1.02, 1.17), and tended towards a higher likelihood to smoke (RR = 1.06, 95% CI = 1.00, 1.13) and consume alcohol (RR = 1.07, 95% CI = 0.97, 1.18). Among boys, those who witnessed a violent death were significantly more likely to smoke (RR = 1.20, 95% CI = 1.11, 1.29), consume alcohol (RR = 1.30, 95% CI = 1.17, 1.45) and use marijuana (RR = 1.33, 95% CI = 1.21, 1.46). When exhibiting depressive symptoms was included, estimates were not attenuated. However, among girls who witnessed a violent death, having an adult at school for support was protective against alcohol consumption. When we used propensity score matching, findings were consistent with the main analyses among boys only. This study adds insight into how witnessing violence can lead to adoption of adverse health behaviors.

Adolescent experiences of violence and relation to violence perpetration beyond young adulthood among an urban sample of Black and African American males

The purpose of this study is to determine if experiences of physical violence during early and late adolescence (12-21 years) places urban Black males at increased risk for interpersonal violence perpetration beyond young adulthood (30 years and older). Participants of this cross-sectional study were Black and African American men (N = 455) between the ages of 30 and 65 years, recruited from four urban clinical sites in the Northeast. Multivariate logistic regression models were used to analyze the relation of adolescent experiences of violence to: (1) past 6 month street violence involvement and (2) past year intimate partner violence perpetration. Ten percent of the sample reported that they experienced adolescent victimization. Men reporting adolescent victimization were significantly more likely to report past 6-month street violence involvement (Adjusted Odds Ratio (AOR) = 3.2, 95 % CI = 1.7-6.3) and past 6 month intimate partner violence perpetration (AOR = 2.8, 95 % CI = 1.8-5.4) compared to men who did not report such victimization. Study findings suggest that in order to prevent adulthood perpetration of violence, more work is needed to address experiences of victimization among young Black males, particularly violence experienced during adolescence.

Neighborhood-level LGBT hate crimes and current illicit drug use among sexual minority youth

OBJECTIVE

To investigate whether past-30 day illicit drug use among sexual minority youth was more common in neighborhoods with a greater prevalence of hate crimes targeting lesbian, gay, bisexual, and transgender (LGBT, or sexual minority) individuals.

METHODS

We used a population-based survey of public school youth in Boston, Massachusetts, consisting of 1292 9th-12th grade students from the 2008 Boston Youth Survey Geospatial Dataset (sexual minority n=108). Data on LGBT hate crimes involving assaults or assaults and battery between 2005 and 2008 were obtained from the Boston Police Department and linked to youths' residential address. Youth reported past-30 day use of marijuana and other illicit drugs. Wilcoxon-Mann-Whitney tests and corresponding p-values were computed to assess differences in substance use by neighborhood-level LGBT assault hate crime rate among sexual minority youth (n=103).

RESULTS

The LGBT assault hate crime rate in the neighborhoods of sexual minority youth who reported current marijuana use was 23.7 per 100,000, compared to 12.9 per 100,000 for sexual minority youth who reported no marijuana use (p=0.04). No associations between LGBT assault hate crimes and marijuana use among heterosexual youth (p>0.05) or between sexual minority marijuana use and overall neighborhood-level violent and property crimes (p>0.05) were detected, providing evidence for result specificity.

CONCLUSIONS

We found a significantly greater prevalence of marijuana use among sexual minority youth in neighborhoods with a higher prevalence of LGBT assault hate crimes. These results suggest that neighborhood context (i.e., LGBT hate crimes) may contribute to sexual orientation disparities in marijuana use.

Self-Reported Experiences of Discrimination and Cardiovascular Disease

Researchers have long speculated that exposure to discrimination may increase cardiovascular disease (CVD) risk but compared to other psychosocial risk factors, large-scale epidemiologic and community based studies examining associations between reports of discrimination and CVD risk have only emerged fairly recently. This review summarizes findings from studies of self-reported experiences of discrimination and CVD risk published between 2011-2013. We document the innovative advances in recent work, the notable heterogeneity in these studies, and the considerable need for additional work with objective clinical endpoints other than blood pressure. Implications for the study of racial disparities in CVD and clinical practice are also discussed.

Health-seeking behaviors among HIV-negative, high-risk black women living in an urban southern city

This study explores the HIV health information-seeking behavior among Black women living in a southern urban city in the United States. Interviews were conducted with 50 Black women to explore their HIV health-seeking behavior, self-efficacy, and locus of control. Results indicate that despite the multiple HIV risk factors faced by the women a majority of them did not seek out HIV health information. Policy implications for HIV prevention education are discussed.

The impact of family and parental education on adolescents' substance use: a study of U.S. high school seniors

This study explores the impact of family structure and parental education on adolescents' substance use using a racially diverse sample of 14,268, 12th-grade high school adolescents. Findings reveal that family structure affects adolescents' substance use. In addition, racial differences are noted. African American adolescents report a relatively lower rate of substance use compared to White and Hispanic adolescents, yet they are gravely affected by substance use outcomes. The study lends further support that family structure and parental education variables may buffer adolescents from substance abuse influences. Implications for practice and policy are discussed.

Does adolescent gambling co-occur with young fatherhood?

BACKGROUND

Young fatherhood is associated with various adverse outcomes. This study aims to describe the relationship of adolescent gambling with young fatherhood (by age 20) while adjusting for several young fatherhood antecedents.

METHODS

Data were from 294 males who have been followed for 16 years since entering first grade in nine inner city public schools (86% African Americans, 81% of the original male cohort). Self-reports of impregnation (including age) and gambling were collected during late adolescence. Nelson-Aalen curves and Cox regression models assessed the hazard of young fatherhood among adolescent nongamblers, social gamblers, and problem gamblers.

RESULTS

More young fathers than nonfathers reported adolescent social (49.2% vs. 42.5%) and problem gambling (28.3% vs. 13.2%, p < .001). Problem gamblers were the most likely to impregnate someone by age 20, followed by social gamblers, then nongamblers. Problem gambling (aHR = 3.16, 95% CI = 1.75, 5.72, p < .001) had the highest increased hazards of young fatherhood, followed by social gambling (aHR = 1.95, 95% CI = 1.30, 2.94, p = .001), high school dropout (aHR = 1.75, 95% CI = 1.14, 2.70, p = .01), and subsidized lunch status (aHR = 1.69, 95% CI = 1.01, 2.38, p = .04).

CONCLUSION

Adolescent male gamblers, particularly problem gamblers, were more likely than their nongambling peers to become fathers by the age of 20. Such a result shows that there is a subpopulation of males who are at high risk for adverse outcomes such as young parenthood and problem behaviors. Only through further studies could the needs of this subpopulation be better assessed so that appropriate assistance could be delivered to better the lives of such individuals.

Pathways to prevention: improving nonresident African American fathers' parenting skills and behaviors to reduce sons' aggression

This study describes a test of the Fathers and Sons Program for increasing intentions to avoid violence and reducing aggressive behaviors in 8- to 12-year-old African American boys by enhancing the parenting skills satisfaction and parenting behaviors of their nonresident fathers. The study included 158 intervention and 129 comparison group families. Structural equation model results indicated that the intervention was effective for improving fathers' parenting skills satisfaction, which was positively associated with sons' satisfaction with paternal engagement. Sons' paternal engagement satisfaction was positively associated with their intentions to avoid violence. Although aggressive behaviors were lower for comparison group sons, the intervention effectively reduced sons' aggressive behaviors indirectly by enhancing fathers' parenting behaviors. Support for family-centered youth violence prevention efforts is discussed.

Racial differences in age at first sexual intercourse: residential racial segregation and the black-white disparity among U.S. adolescents

OBJECTIVES

The age of adolescents at first sexual intercourse is an important risk factor for sexually transmitted diseases (STDs) and adolescent pregnancy. Black adolescents are at higher risk than white adolescents for first sexual intercourse at younger ages as well as STDs and pregnancy. Individual- and family-level factors do not fully explain this disparity. We examined whether five dimensions of black-white residential racial segregation can help explain the racial disparity in age at first sexual intercourse.

METHODS

Using the National Longitudinal Survey of Youth 1997 and U.S. Census 2000 data, we performed multiple hierarchical discrete time-to-event analyses on a nationally representative cohort of adolescents followed since 1997. Although the cohort study is ongoing, we used data from 1997 through 2005.

RESULTS

Concentration and unevenness significantly modified the association of race and age at first sexual intercourse. However, stratified results suggested differences in the effect of race on age at first sexual intercourse at each level of segregation across dimensions of segregation.

CONCLUSIONS

Residential racial segregation may modify the black-white disparity in risk of first sexual intercourse at younger ages, but these associations are complex. Future studies should be conducted to elucidate the causal mechanisms.

Correlates of depressive symptoms among at-risk youth presenting to the emergency department

OBJECTIVE

The study's objective was to identify correlates of depressive symptoms among at-risk youth in an urban emergency department (ED).

METHOD

A systematic sample of adolescents (ages 14-18) in the ED were recruited as part of a larger study. Participants reporting past-year alcohol use and peer aggression self-administered a survey assessing: demographics, depressive symptoms and risk/protective factors. Logistic regression identified factors associated with depressive symptoms.

RESULTS

Among 624 adolescents (88% response rate) meeting eligibility criteria, 22.8% (n=142) screened positive for depressive symptoms. In logistic regression, depressive symptoms were positively associated with female gender [odds ratio (OR): 2.84, 95% confidence interval (CI): 1.78-4.51], poor academic performance (OR: 1.57, 95% CI: 1.01-2.44), binge drinking (OR: 1.88, 95% CI: 1.21-2.91), community violence exposure (OR: 2.25, 95% CI: 1.59-3.18) and dating violence (OR: 2.14, 95% CI: 1.36-3.38) and were negatively associated with same-sex mentorship (OR: 0.52, 95% CI: 0.29-0.91) and older age (OR: 0.55, 95% CI 0.34-0.89). Including gender interaction terms did not significantly change findings.

CONCLUSIONS

Screening and intervention approaches for youth in the urban ED should address the co-occurrence of depressive symptoms with peer and dating violence, alcohol and nonmarijuana illicit drug use.

Stress Among African American Emerging Adults: The Role of Family and Cultural Factors

The aim of this study was to examine the effects of family and cultural variables on stress among African American emerging adults. Data from this study was collected as part of a larger study that examined cultural, family, and contextual factors and smoking among African American youth in 5th, 8th, and 12th grades. Data were collected from high school seniors at the end of their 12th grade year and 6 months post high school. Multiple regression analyses were conducted to determine whether racial identity, family cohesion, and parental monitoring influence students' perceived frequency of stress. Higher levels of racial identity were associated with more perceived stress. There were no significant main effects for either parental monitoring or family cohesion on stress. There were significant interactions between racial identity and parental monitoring and between parental monitoring and family cohesion. Study implications are discussed regarding the importance of stress reduction programs for African American emerging adults and for parents of these adults.

Stressors in multiple life-domains and the risk for externalizing and internalizing behaviors among African Americans during emerging adulthood

Behavioral and mental health outcomes have been associated with experiencing high levels of stress. Yet, little is known about the link between the nature of stressors, their accumulation over time, and the risk for externalizing and internalizing outcomes. Compared to the general population, African Americans are exposed to a disproportionate number of stressors beginning earlier in life. Incorporating Agnew's General Strain Theory into the study of stress, this study examined whether different kinds of stressors are equally salient in the risk for violent behaviors and depressive symptoms among African Americans transitioning into young adulthood. It further examined the effects of the accumulation of stressors in different life domains and their effect on risks. This study utilized data from an African American subsample of an ongoing longitudinal study that followed 604 adolescents (53 % females) from 9th grade into adulthood. Multilevel growth curve models were used to examine how changes in stressors across multiple life domains related to violent behaviors and depressive symptoms. We found that continued exposure to perceived daily stress and racial discrimination stress increased the risk for violent behaviors during young adulthood, and exhibited a nonlinear relationship between the accumulation of stressors and risk for violence. Moreover, we found that exposure to perceived daily stress, financial stress, neighborhood stress, and racial discrimination stress increased the risk of depressive symptoms and led to a linear relationship between the accumulation of stressors and risk for depressive symptoms. Findings suggest identifiable stressors that can persist over time to influence risks at young adulthood.

Racial Respect and Racial Socialization as Protective Factors for African American Male Youth

African American adolescents must negotiate the transition to adulthood in a society that makes the achievement of positive cultural identity and self-respect difficult. Frequently, young men turn to violence in an attempt to achieve respect in their communities. This article explores factors that predict the use of violence among African American male youth. Adolescents from 14 through 18 years of age who completed a written survey in group settings in Oregon included 100 youth who were detained in the juvenile justice system and 100 who were members of a community youth development program. A history of witnessing violence strongly predicted the intensity of violent behavior of study youth; however, endorsing positive attitudes toward racial respect significantly moderated the effects of chronic exposure to violence. Additionally, racial socialization was negatively correlated to violence intensity and was marginally significant in moderating the effects of witnessing violence. Implications for practice with male African American youth are highlighted.

Perceived Racial Discrimination as a Predictor of Health Behaviors: the Moderating Role of Gender

Perceived racial discrimination (PRD) has been implicated in undermining the mental and physical health of racial/ethnic minorities. Researchers have begun to explore the indirect role of health behaviors as one factor in helping to explain this relationship. The goal of the present study was to examine the relationship between PRD and a wide range of health behaviors using a prospective, longitudinal design and to explore the role of gender in moderating these relationships. Using data from the Maryland Adolescent Development in Context Study, we examined the relationship between adolescent PRD (accumulated across ages 14-21) and health behaviors (i.e., diet, substance use, exercise) at age 30 in a sample of middle-class black men and women. Using structural equation modeling, results revealed that more cumulative PRD during adolescence was associated with less healthy eating, more substance use (among men), and more exercise (among women) in young adulthood. Implications of these findings for understanding the role of health behaviors in explaining the link between PRD and health outcomes are considered.