Religious involvement and its association to risk behaviors among older youth in foster care

Social epidemiology of early adolescent alcohol expectancies

PURPOSE

To determine the sociodemographic correlates of alcohol expectancies (i.e., beliefs regarding positive or negative effects of alcohol) in a national (U.S.) cohort of early adolescents 10-14 years old. A second aim was to determine associations between alcohol sipping and alcohol expectancies.

METHODS

We analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,868; Year 2). Linear regression analyses were conducted to estimate associations between sociodemographic factors (sex, race/ethnicity, sexual orientation, household income, parental education, parent marital status, religiosity) and positive (e.g., stress reduction) and negative (e.g., loss of motor coordination) alcohol expectancies. Additional linear regression analyses determined associations between alcohol sipping and alcohol expectancies, adjusting for sociodemographic factors.

RESULTS

Overall, 48.8% of the participants were female and 47.6% racial/ethnic minorities, with a mean age of 12.02 (SD 0.67) years. Older age among the early adolescent sample, male sex, and sexual minority identification were associated with more positive and negative alcohol expectancies. Black and Latino/Hispanic adolescents reported less positive and negative alcohol expectancies compared to White non-Latino/Hispanic adolescents. Having parents with a college education or greater and a household income of $200,000 and greater were associated with higher positive and negative alcohol expectancies. Alcohol sipping was associated with higher positive alcohol expectancies.

CONCLUSIONS

Older age, White non-Latino/Hispanic race, male sex, sexual minority status, higher parental education, and higher household income were associated with higher positive and negative alcohol expectancies. Future research should examine the mechanisms linking these specific sociodemographic factors to alcohol expectancies to inform future prevention and intervention efforts.

Religiosity and Sexual Initiation Among Hispanic Adolescents: The Role of Sexual Attitudes

Introduction: Religiosity and sexuality present numerous interconnections. Little is known regarding the specific causal pathways between each religiosity dimension and sexual behavior. The objectives of this study were (1) to explore the relationship between religiosity (measured through attendance at religious services, salience, and prayer) and sexual initiation in adolescents and (2) to establish the role of sexual permissiveness as mediator of the impact produced by religiosity in sexual initiation. Methods: This study analyzes data from an ongoing school-based international study examining what young people feel and think about relationships, love, and sexuality. An anonymous, self-administered online questionnaire was developed in Spanish. A total of 4,366 students, aged 14-18, completed the questionnaire. A final sample of 2,919 questionnaires was analyzed. Two unconditional logistic regression models were fit with religiosity variables and possible confounders as independent variables (with and without permissiveness, respectively). The dependent variable was sexual initiation. A final path analysis was performed to further understand the results. Results: Our study highlights that, in predominantly Catholic and Spanish-speaking countries, the fact of attending church and praying may greatly contribute to postponing sexual relations during adolescence, even independently of their attitudes on sexual permissiveness. Conversely, the effect of salience on sexual initiation seems to be fostered only through the mediation of sexual permissiveness. Our findings point to an indirect effect of the three religiosity dimensions (and in particular, religious salience) through permissive attitudes. Conclusion: Religiosity could be a relevant factor to explain sexual initiation during adolescence.

Risk and protective factors among at-risk ultraorthodox Jewish youth in Israel: A contextual model of positive adjustment

This study examined the role of personal (mastery), familial (relationship with parents), and communal (sense of community and sense of belonging to a youth centre) aspects for at-risk youths' adjustment. Specifically, we investigated their role as protective and risk factors for behavioural adjustment (risk behaviour) and psychological adjustment (hope). The study, conducted among Ultraorthodox Jewish males, included 80 participants, ages 14-24 (M = 16.8, SD = 2.33), who attended youth centres designed especially for Ultraorthodox at-risk youth, in five cities with a high percentage of Ultraorthodox population. Findings indicated a significant contribution of mastery to lower levels of risk behaviour and to higher levels of hope. The youth/parent relationship made a significant contribution only to lower levels of risk behaviours, while sense of community made a significant positive contribution only to hope. Surprisingly, the sense of belonging to a youth centre was found to be a risk factor for higher levels of risk behaviours. In contrast, a mediation model revealed an indirect positive contribution of sense of belonging to a youth centre to hope via mastery. The discussion highlights the unique phenomena of at-risk youth in the Ultraorthodox community and suggest carefully and thoroughly checking whether youth centres in this context should actually be discouraged. It also addresses the importance of recognising the unique protective and risk factors for positive adjustment among at-risk Ultraorthodox youth.

Risk and Protective Factors for Alcohol, Marijuana, and Cocaine Use Among Child Welfare-Involved Youth

Youth involved in child welfare services (CWS) are at elevated risk for substance use. CWS involvement may provide an opportunity for intervention to prevent subsequent use; however, little is known about mitigating substance use risk in this population. Using data from the second National Survey of Child and Adolescent Well-Being (NSCAW II), the present study examined individual, psychological, and contextual risk factors (e.g., prior substance use, depression, posttraumatic stress, maltreatment experiences) and protective factors (e.g., caregiver monitoring, peer relationships) following CWS involvement (Wave 1) in relation to alcohol, marijuana, and cocaine use 36 months later (Wave 3). The nationally-representative sample of CWS-involved youth was restricted to individuals who were aged 11 years or older at Wave 1 and had at least a partial interview at Wave 3 (N = 763). Three logistic regression models showed that Wave 1 substance use increased the likelihood of marijuana and cocaine use at Wave 3 [marijuana OR = 1.41 (1.19-1.68); cocaine OR = 1.26 (1.07-1.50)] but not binge alcohol use [OR = 1.44 (0.95-2.19)]. Other risk and protective factors had limited predictive value for Wave 3 substance use. The present findings suggest that initiating substance use prior to or at the time of CWS involvement is a critical risk factor for later substance use. Substance use screening and referral to treatment is imperative for CWS-involved youth.

Smoking Behaviors Among Adolescents in Foster Care: A Gender-Based Analysis

BACKGROUND AND OBJECTIVES

Adolescents in foster care are at high risk for cigarette smoking. However, it is not clear how their smoking behaviors vary by gender. The present study examined lifetime and current smoking among males and females, and explored gender-specific risk factors for engagement in smoking behaviors.

METHOD

Data from the Multi Site Evaluation of Foster Youth Programs was used to evaluate patterns of smoking among adolescents aged 12-18 years (N = 1121; 489 males, 632 females).

RESULTS

Males and females did not differ significantly in rates of lifetime and current smoking, or in the age of smoking initiation and number of cigarettes smoked on a typical day. Gender-based analyses revealed that older age and placement in group homes or residential treatment facilities were associated with heightened risk of smoking among males. In contrast, sexual minority status (i.e., nonheterosexual orientation) and increased childhood victimization were associated with heightened risk of smoking among females. A history of running away was linked to smoking in both genders.

CONCLUSION

Gender should be considered when designing intervention programs to address cigarette smoking among foster youth, as the stressors associated with smoking may differ for males and females.

Tobacco Use among Foster Youth: Evidence of Health Disparities

Youth aging out of foster care face a challenging road to independence. Following exposure to myriad risk factors such as abuse, neglect, parental substance use, and severe housing mobility, supportive services decrease upon exit from care, often increasing risk for substance use, homelessness, and unemployment. Although tobacco use is also highly prevalent, little attention has been paid to screening, assessment, and treatment of tobacco use in this vulnerable group. The current study (N = 116) reports on tobacco use prevalence, consequences, and co-occurrence with other substances in a sample of youth (ages 18 to 19) exiting the foster care system. In the face of an overall decrease in tobacco use among general population adolescents and young adults, results suggest disproportionate levels of lifetime, recent, and daily use among foster youth. Prevalence of recent tobacco use (46%) is nearly triple national rates, while daily smoking (32%) is almost four times that of general population young adults. Tobacco users were more likely than non-users to drink (70% vs. 40%) and to smoke marijuana (72% vs. 25%). We strongly encourage researchers and practitioners to increase attention to this tobacco-related health disparity.

Religious socialization of youth involved in child welfare

Increased religiosity is associated with a variety of improved outcomes, especially for youth in disadvantaged contexts. Although youth involved in child welfare may experience protective effects of religious participation or values, little is known about the impact of maltreatment on religious development. Using the National Survey of Child and Adolescent Well-Being, a nationally representative study of child welfare involved families, correlates of religious attendance and importance of religion for youth were investigated using weighted logistic regression at two waves 18 months apart. Youth self-reports of religious attendance and their ratings of its importance were associated with religious attendance of their caregivers, whether birth-parents or foster parents. Foster parents were more likely to attend religious services than birth parents. Increases in youth attendance from Wave 1 to Wave 2 were associated with high youth religious importance at Wave 1, whereas decreases in attendance were associated with moving between home and foster placements. Increases in religious importance from Wave 1 to Wave 2 were associated with religious attendance at Wave 1 and with the youth being Black.

Religiosity and adolescent substance use in central Mexico: exploring the influence of internal and external religiosity on cigarette and alcohol use

This study explores the multidimensional nature of religiosity on substance use among adolescents living in central Mexico. From a social capital perspective, this article investigates how external church attendance and internal religious importance interact to create differential pathways for adolescents, and how these pathways exert both risk and protective influences on Mexican youth. The data come from 506 self-identified Roman Catholic youth (ages 14-17) living in a semi-rural area in the central state of Guanajuato, Mexico, and attending alternative secondary schools. Findings indicate that adolescents who have higher church attendance coupled with higher religious importance have lower odds of using alcohol, while cigarette use is lower among adolescents who have lower church attendance and lower religious importance. Adolescents are most at risk using alcohol and cigarettes when church attendance is higher but religious importance is lower. In conclusion, incongruence between internal religious beliefs and external church attendance places Mexican youth at greater risk of alcohol and cigarette use. This study not only contributes to understandings of the impact of religiosity on substance use in Mexico, but highlights the importance of understanding religiosity as a multidimensional phenomenon which can lead to differential substance use patterns.

Religiosity as a protective factor against HIV risk among young transgender women

PURPOSE

Young transgender women (YTW) face many challenges to their well-being, including homelessness, joblessness, victimization, and alarming rates of HIV infection. Little has been written about factors that might help in preventing HIV in this population. Our objective was to examine the role of religion in the lives of YTW and its relationship to HIV risk.

METHODS

This study is derived from baseline data collected for an HIV prevention intervention. A convenience sample of YTW aged 16-25 years from Chicago were recruited consecutively and completed an audio computer-assisted self-interview. Logistic regression models were used to evaluate the relationship between sexual risk taking (sex work, multiple anal sex partners, unprotected receptive anal sex), alcohol use, formal religious practices (service attendance, reading/studying scripture), and God consciousness (prayer, thoughts about God).

RESULTS

A total of 92 YTW participated in the study, their mean age being 20.4 years; 58% were African American, 21% white, and 22% other. On multivariate logistic regression, alcohol use was significantly associated with sexual risk in both models, with adjusted odds ratio (OR) of 5.28 (95% confidence intervals [CI]: 1.96-14.26) in the Formal Practices model and 3.70 (95% CI: 1.53-8.95) in the God Consciousness model. Controlling for alcohol use, it was found that Formal Practices was significantly associated with sexual risk (OR = .29, 95% CI: .11-.77), but God Consciousness was not (OR = .60, 95% CI: .25-1.47).

CONCLUSION

Among YTW, formal religious practices may attenuate sexual risk-taking behaviors and therefore HIV risk. Further research is needed to explore the role of the religion in the lives of YTW as a protective asset.

Associations between religiosity and sexual and contraceptive behaviors

STUDY OBJECTIVE

To determine associations between religiosity and female adolescents' sexual and contraceptive behaviors.

DESIGN

We conducted a secondary analysis on data from a randomized controlled trial comparing interventions designed to prevent pregnancy and sexually transmitted diseases (STDs). Multivariable modeling assessed the association between a religiosity index consisting of items related to religious behaviors and impact of religious beliefs on decisions and sexual outcomes.

PARTICIPANTS

572 female adolescents aged 13 to 21, recruited via a hospital-based adolescent clinic and community-wide advertisements.

MAIN OUTCOME MEASURES

Sexual experience, pregnancy, STDs, number of lifetime partners, frequency of sexual activity, previous contraceptive use, and planned contraceptive use.

RESULTS

Mean participant age was 17.4 +/- 2.2 years and 68% had been sexually active. Most (74.1%) had a religious affiliation and over half (52.8%) reported that their religious beliefs impact their decision to have sex at least "somewhat." Multivariate analyses showed that, compared with those with low religiosity, those with high religiosity were less likely to have had sexual intercourse (OR = 0.23, 95% CI = 0.14, 0.39). Among sexually active participants, those with high religiosity were less likely to have been pregnant (OR = 0.46, 95% CI = 0.22, 0.97), to have had an STD (OR = 0.42, 95% CI = 0.22, 0.81), or to have had multiple (>or=4) lifetime partners (OR = 0.38, 95% CI = 0.21, 0.68) compared to those with low religiosity. Levels of religiosity were not significantly associated with frequency of intercourse, contraception use at last intercourse, or planned contraceptive use.

CONCLUSION

In this cohort, religiosity appeared to be a protective factor rather than a risk factor with regard to sexual behavior and was not associated with contraception use.

Exploring spirituality among youth in foster care: findings from the Casey Field Office Mental Health Study

This study examined spiritual coping mechanisms, beliefs about spirituality and participation in spiritual activities and in other positive activities among adolescents in foster care. A multidimensional measure of spirituality was developed for face-to-face interviews with 188 youth (ages 14-17) from diverse racial/ethnic backgrounds in the United States. Findings revealed 95% of youth believe in God, over 70% believe God is 'creator' and God is 'love', and 79% considered prayer a spiritual practice. Most youth said love and forgiveness help them heal. Two-thirds (67%) reported responding to 'bad or tragic things happening' by spending time alone, and over half responded by praying (59%) or sharing the problem with someone else (56%). Youth's top three spiritual goals were to follow God's plan for them, become a better person, and know their purpose in life. Based on the value youth ascribed to spiritual coping mechanisms, recommendations for policy and practice focus on the integration of spirituality into practice and caregiving for youth in foster care.

Sexual Risk Behaviors Among Youth in the Child Welfare System

This study uses data from the National Survey of Child and Adolescent Well-Being (NSCAW) to provide estimates of sexual risk behaviors for 877 youth, age 11-14 at baseline, in the child welfare system. It examines the association between baseline psychosocial risk and protective factors on engagement in sexual risk behaviors after 36 months. It further compares rates of sexual risk behaviors between youth placed in out-of-home care and those who remained with their biological family. Key findings include a high rate of pregnancy, a high percentage of youth who initiated sexual activity at or before age 13 as well as a limited role of protective factors in moderating sexual risk behaviors. A history of placement into out-of-home care is not significantly associated with greater engagement in sexual risk behaviors. Implications for intervention development and child welfare policy for this population are discussed.

The roles of parenting, church attendance, and depression in adolescent smoking

The aim of the present study was to identify contextual factors related to smoking among urban African-American and White adolescents. We administered a survey assessing demographic and psychosocial variables to 299 adolescents in an urban pediatric clinic in the Midwest. Results indicated that being female, older age, lower academic performance, depressive symptoms, less frequent church attendance, parental smoking, and parental attitudes toward smoking were related to adolescent smoking. After controlling for demographics, the multivariate model predicting adolescent smoking included depressive symptoms, less frequent church attendance, and parental disapproval of smoking. Given these findings, efforts to decrease adolescent smoking may be enhanced by attending to depressive symptoms demonstrated by adolescents as well as contextual factors including parental attitudes and church attendance.