The Role of Empowerment-Based Protective Factors on Substance Use Among Youth of Color

Future Directions for Community-Engaged Research in Clinical Psychological Science with Youth

Despite advances in clinical science, the burden of mental health problems among youth is not improving. To tackle this burden, clinical science with youth needs methods that include youth and family perspectives on context and public health. In this paper, we illustrate how community-engaged research (CEnR) methods center these perspectives. Although CEnR methods are well-established in other disciplines (e.g. social work, community psychology), they are underutilized in clinical science with youth. This is due in part to misperceptions of CEnR as resource-intensive, overly contextualized, incompatible with experimentally controlled modes of inquiry, or irrelevant to understanding youth mental health. By contrast, CEnR methods can provide real-world impact, contextualized clinical solutions, and sustainable outcomes. A key advantage of CEnR strategies is their flexibility-they fall across a continuum that centers community engagement as a core principle, and thus can be infused in a variety of research efforts, even those that center experimental control (e.g. randomized controlled trials). This paper provides a brief overview of this continuum of strategies and its application to youth-focused clinical science. We then discuss future directions of CEnR in clinical science with youth, as well as structural changes needed to advance this work. The goals of this paper are to help demystify CEnR and encourage clinical scientists to consider adopting methods that better consider context and intentionally engage the communities that our work seeks to serve.

Breathing life into social emotional learning programs: A Bio-Psycho-Social approach to risk reduction and positive youth development

INTRODUCTION

Over one-third of US adolescents engage in health risk and problem behaviors. Additionally, significant percentages of problem-free youth aren't flourishing. Left unaddressed, the lifetime mental/physical health and financial burdens may be substantial. Social-Emotional Learning (SEL) and Positive Youth Development (PYD) programs have proliferated to address the drivers of adaptive versus risk behaviors. Research suggests SEL/PYD program outcomes can be improved by adding techniques that physiologically induce calmness, yet few studies exist.

METHODS

This randomized controlled trial of 79 urban eighth-graders examined a standardized bio-psycho-social program, SKY Schools, which incorporates a physiologically calming component: controlled yogic breathing.

RESULTS

Repeated-measures ANOVAs demonstrated that compared to controls, SKY graduates exhibited significant improvements in emotion regulation, planning and concentration, and distractibility. After 3 months, significant improvements were evidenced in emotion regulation, planning and concentration, identity formation, and aggressive normative beliefs.

CONCLUSION

SEL/PYD programs may benefit by incorporating biologically-calming techniques to enhance well-being and prevent risk/problem behaviors.

Association between longitudinal patterns of child maltreatment experiences and adolescent substance use

BACKGROUND

Although there is a well-established link between child maltreatment and adolescent substance use, it remains unclear if and how longitudinal patterns of maltreatment experiences are associated with substance use in adolescence.

OBJECTIVE

The purpose of the study was to examine how distinct patterns of longitudinal maltreatment experiences are associated with adolescent substance use.

PARTICIPANTS AND SETTING

The participants were 899 adolescents from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN).

METHODS

We conducted repeated measures latent class analysis (RMLCA) to identify patterns of physical abuse, sexual abuse, and neglect from birth to age 17 and their relations to tobacco, alcohol, and marijuana use at age 18.

RESULTS

RMLCA identified three physical abuse classes (Stable low physical abuse; School age peak physical abuse; Physical abuse primarily in infancy/toddlerhood), two sexual abuse classes (Stable no/low sexual abuse; School age peak sexual abuse), and three neglect classes (High neglect in childhood; Neglect primarily in infancy/toddlerhood; Neglect primarily at school age). Adolescents in the school age peak physical abuse class showed greater alcohol, cigarette, and marijuana use, compared to other physical abuse classes. Similarly, adolescents in the school age peak sexual abuse class showed greater substance use than those in the stable no/low sexual abuse class. Lastly, adolescents in the neglect primarily in infancy/toddlerhood class showed significantly less substance use than those in the other two neglect classes.

CONCLUSIONS

Findings highlight the importance of early intervention and ongoing maltreatment prevention.

The Role of Socialization Contexts on Adolescent Substance Use across Racial and Ethnic Groups

Purpose of Review

This review summarizes theories and empirical work regarding socialization contexts contributing to substance use across marginalized adolescents. Future directions and recommendations to minimize the perpetuation of racial stereotypes are provided.

Recent Findings

Neighborhoods high in social cohesion may offset substance use risk. Promoting school connectedness via increased support from teachers and peers could reduce school-based discrimination and enhance feelings of belongingness. The influence of peers on substance use engagement largely differs across racial groups and level of acculturation. Family cultural values emphasizing respect, obedience, and collectivism offer protection from substance use.

Summary

Despite lower prevalence rates of adolescent substance use within racial/ethnic groups, rates of negative consequences due to substances are far greater compared to White adolescents. Transcultural factors (e.g., strong family ties), as well as culture-specific factors, should be leveraged to delay the onset of substance use and prevent negative sequelae resulting from substance use initiation.

Perspectives on reasons for suicidal behaviour and recommendations for suicide prevention in Kenya: qualitative study

BACKGROUND

Little is known about the reasons for suicidal behaviour in Africa, and communities' perception of suicide prevention. A contextualised understanding of these reasons is important in guiding the implementation of potential suicide prevention interventions in specific settings.

AIMS

To understand ideas, experiences and opinions on reasons contributing to suicidal behaviour in the Coast region of Kenya, and provide recommendations for suicide prevention.

METHOD

We conducted a qualitative study with various groups of key informants residing in the Coast region of Kenya, using in-depth interviews. Audio-recorded interviews were transcribed and translated from the local language before thematic inductive content analysis.

RESULTS

From the 25 in-depth interviews, we identified four key themes as reasons given for suicidal behaviour: interpersonal and relationship problems, financial and economic difficulties, mental health conditions and religious and cultural influences. These reasons were observed to be interrelated with each other and well-aligned to the suggested recommendations for suicide prevention. We found six key recommendations from our thematic content analysis: (a) increasing access to counselling and social support, (b) improving mental health awareness and skills training, (c) restriction of suicide means, (d) decriminalisation of suicide, (e) economic and education empowerment and (f) encouraging religion and spirituality.

CONCLUSIONS

The reasons for suicidal behaviour are comparable with high-income countries, but suggested prevention strategies are more contextualised to our setting. A multifaceted approach in preventing suicide in (coastal) Kenya is warranted based on the varied reasons suggested. Community-based interventions will likely improve and increase access to suicide prevention in this study area.

Critical Consciousness and Wellbeing in Adolescents and Young Adults: A Systematic Review

Youth experiencing systemic oppression(s) face heightened challenges to wellbeing. Critical consciousness, comprised of reflection, motivation, and action against oppression, may protect wellbeing. Wellbeing here refers to mental, socioemotional, and physical health. The aim of this systematic review was to synthesize research on the relationship between critical consciousness and wellbeing among adolescents and young adults (ages 12-29). Five databases (PsycInfo, PsychArticles, ERIC, Sociological Abstracts, and PubMed) were searched systematically using keyword searches and inclusion/exclusion criteria; 29 eligible studies were included. Results demonstrated that the critical consciousness and wellbeing relationship varied by critical consciousness dimension and age. The studies of adolescents most often focused on racial/ethnic marginalization and found critical motivation most strongly associated with better wellbeing. The studies of young adults focused on young adult college students and identified mixed results specifically between activism and mental health. Study methods across age spans were primarily quantitative and cross-sectional. Research on critical consciousness and wellbeing can benefit from studies that consider multiple critical consciousness dimensions, use longitudinal approaches, and include youth experiencing multiple and intersecting systems of privilege and marginalization.

Protective Factors for Decreasing Nicotine, Alcohol, and Cannabis Use Among Adolescents with a History of Adverse Childhood Experiences (ACEs)

Adolescents who have experienced adversity have an increased likelihood of using substances. This study examined if individual-, family-, school-, and community-level protective factors were associated with a decreased likelihood of substance use. Data from the Well-Being and Experiences Study (the WE Study) collected from 2017 to 2018 were used. The sample was adolescents aged 14 to 17 years (N = 1002) from Manitoba, Canada. Statistical methods included descriptive statistics and logistic regression models. The prevalence of past 30-day substance use was 20.5% among boys and 29.2% among girls. Substance use was greater among adolescent girls compared to boys. Protective factors associated with an increased likelihood of not using substances included knowing culture or language, being excited for the future, picturing the future, sleeping 8 to 10 h per night (unadjusted models only), participating in non-sport activity organized by the school, having a trusted adult in the family, frequent hugs from parent, parent saying “I love you” (unadjusted models only), eating dinner together every day, mother and father understanding adolescent’s worries and problems, being able to confide in mother and father, feeling close to other students at school, having a trusted adult at school, feeling a part of school, having a trusted adult in the community (unadjusted models only), volunteering once a week or more, and feeling motivated to help and improve one’s community. Knowledge of protective factors related to decreased odds of substance use may help inform strategies for preventing substance use and ways to foster resilience among adolescents.

Ethnic Identity as a Moderator Between HIV Knowledge, Viral Hepatitis Knowledge, and Psychological Antecedents Among Racial-Ethnic Minority Youth Living in an Urban Community

Racial-ethnic minority youth between the ages of 13 and 24 in the USA are disproportionately impacted by HIV. Low HIV knowledge and psychological antecedents such as low perception of risk and low sexual negotiation skills have all been associated with HIV risk behaviors; however, the role of ethnic identity on these factors is unclear in the literature. Ethnic identity, which is a critical part of identity development among racial-ethnic minority youth, has been found to be a protective factor in risk-taking behaviors. However, limited research is available on the role of ethnic identity in HIV prevention research among youth. For this study, data were collected as part of a larger HIV prevention education program using a sample of 564 students of color (Mean_age = 16.30, standard deviation [SD] = 1.26; 67.4% Hispanic, 29.5% Black) from an underserved northeastern US urban community. We examined whether ethnic identity moderated the relationship between psychological antecedents (e.g., perception of risk and sexual negotiation skills), gender, and viral hepatitis knowledge on HIV knowledge. Findings revealed that ethnic identity significantly moderated the relationship between psychological antecedent variables and HIV knowledge by strengthening these associations as ethnic identity increased. Female adolescents were also more likely to have higher levels of HIV knowledge than males. Findings provide support for cultural and gender-specific prevention programs for racial-ethnic minority youth that seek to reduce HIV risk behaviors by increasing ethnic identity, particularly in under-resourced communities.