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Bishop MD, Ioverno S, Russell ST. Sexual minority youth's mental health and substance use: The roles of victimization, cybervictimization, and non-parental adult support. CURRENT PSYCHOLOGY 2023; 42:5075-5087. [PMID: 38344657 PMCID: PMC10857851 DOI: 10.1007/s12144-021-01812-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 01/03/2023]
Abstract
Victimization is a well-established driver of sexual minority youth's (SMY) mental health and substance use risk. The current study examined and extended this research by exploring how victimization, cybervictimization, and non-parental supportive adults contribute to SMY's vulnerability to poor mental health and substance use. Using data from the first representative sample of Texas youth that measures sexual identity, we analyzed sex-stratified models of the association between sexual identity, mental health, and substance use, and the confounding effects of victimization, cybervictimization, and non-parental adult support. Victimization was more common among SMY and accounted for a greater proportion of sexual identity disparities on mental health and substance use, especially for males. Sexual minority females were more likely to report cybervictimization than heterosexual youth, and cybervictimization was associated with mental health risk. SMY reported fewer available non-parental supportive adults, which was associated with more sadness, suicidality, and polysubstance use. Our study adds to extant evidence that victimization drives SMY's increased susceptibility to mental health and substance use risk. Schools should implement inclusive policies that prohibit bullying based on sexual minority identity and offer professional development opportunities for supporting SMY.
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Affiliation(s)
- Meg D. Bishop
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, TX 78712, USA
| | - Salvatore Ioverno
- Department of Sociology, Ghent University, St. Pietersnieuwstraat 33, 9000 Ghent, Belgium
| | - Stephen T. Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, TX 78712, USA
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Stepanchak M, Katzman K, Soukup M, Elkin E, Choate K, Kristman-Valente A, McCarty CA. Youth-Reported School Connection and Experiences of a Middle School-Based Screening, Brief Intervention, and Referral to Treatment Initiative: Preliminary Results From a Program Evaluation. J Adolesc Health 2022; 71:S49-S56. [PMID: 36122969 DOI: 10.1016/j.jadohealth.2022.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 04/26/2022] [Accepted: 05/19/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed (1) to evaluate the feasibility of a school-based Screening, Brief Intervention, and Referral to Treatment (SBIRT) program that expands on traditional SBIRT to support the mental health and well-being of middle school students and (2) to assess its effects on students' connection with adults at school. METHODS Focus group discussions were conducted with 26 students in grades 6-8 to understand student perspectives about an innovative school-based SBIRT program. A subset of middle school students from the SBIRT program who received a brief intervention (BI) after screening (n = 116) were asked to rate their experience meeting with the interventionist in terms of feeling comfortable, feeling listened to, and talking about their goals. Additionally, these students' ratings of connection to adults at school was compared from the time of screening (baseline) to following BI using two-sided paired t-tests. RESULTS Students who participated in focus groups expressed favorable opinions about universal screening and this school-based SBIRT model and noted that relationship building with adults at school was an important factor for open communication and motivating behavior change for students. Nearly all students who completed the post-BI survey rated their experiences with interventionists during BI as "Excellent," "Very Good," or "Good" in all categories (98%). Students' reported mean school connection scores significantly higher after participation in school-based SBIRT than at baseline (5.9/8 vs. 7.0/8, p < .001). DISCUSSION Middle school students were satisfied with the school-based SBIRT model and participation in the program resulted in increased student connection with adults at school. These findings improve our understanding of the experience of SBIRT intervention with middle school students and on school connection in particular.
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Affiliation(s)
- Maria Stepanchak
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington.
| | - Kate Katzman
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Margaret Soukup
- King County Department of Community and Human Services, Seattle, Washington
| | - Evan Elkin
- Reclaiming Futures, Portland State University, Portland, Oregon
| | - Kathryn Choate
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Allison Kristman-Valente
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Carolyn A McCarty
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
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Burt CJ, Kondo MC, Hohl BC, Gong CH, Bushman G, Wixom C, South EC, Cunningham RM, Carter PM, Branas CC, Zimmerman MA. Community Greening, Fear of Crime, and Mental Health Outcomes. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 69:46-58. [PMID: 34333789 PMCID: PMC8803989 DOI: 10.1002/ajcp.12544] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Unmaintained vacant land in urban areas is associated with a number of negative outcomes for residents of urban areas, including mental and physical health, safety, and quality of life. Community programs which promote land parcel maintenance in urban neighborhoods have been found to reverse some of the effects that unmaintained land has on nearby residents. We explored how land parcel maintenance is associated with mental health outcomes using data collected in Flint, MI in 2017-2018. Trained observers assessed the maintenance of approximately 7200 land parcels and surveyed 691 residents (57% Female, 53% Black, M age = 51). We aggregated resident and parcel rating data to 463 street segments and compared three structural equation models (SEM) to estimate the mediating effects of fear of crime on the association of parcel qualities on mental distress for residents. We found that fear of crime mediated the association between parcel maintenance values and mental distress indicating that poor maintenance predicted more fear of crime which was associated with mental distress. Our findings add to our understanding about the mechanism by which vacant lot improvements may operate to enhance psychological well-being of residents who live on streets with vacant and unkept lots.
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Affiliation(s)
- Cassidy J. Burt
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Michelle C. Kondo
- USDA Forest Service, Northern Research Station, Philadelphia Field Station, Philadelphia, PA, USA
| | - Bernadette C. Hohl
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | | | - Gregory Bushman
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Caroline Wixom
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Eugenia C. South
- Urban Health Lab, Department of Emergency Medicine, Perelman School of Medicine, Philadelphia, PA, USA
| | - Rebecca M. Cunningham
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Patrick M. Carter
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Charles C. Branas
- Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY, USA
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Mala J, Corral MD, McGarry JE, Macauley CDT, Arinze NA, Ebron K. Positive Impacts of a Sport Intervention on Male Students of Color and School Climate. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:36-52. [PMID: 32854601 DOI: 10.1080/02701367.2020.1789039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 06/25/2020] [Indexed: 06/11/2023]
Abstract
A positive school climate is strongly associated with enhanced student outcomes. With the disengagement of Black and Latinx youth living in poverty being at an all-time high, participation in sport-based youth development (SBYD) programs may enhance school climate, while capitalizing on existing interests. Purpose: The purpose of this study was to examine the impact of a SBYD intervention on male students of color and school climate. Method: Using a mixed-methods quasi-experimental design, 32 male students of color (11 Black, 13 Latinx, 8 two or more races) participated in an SBYD intervention, twice a week for a total of 20 weeks (Ages 10-14, M = 11.46). School climate data were gathered at the beginning and the end of the school year. Student, teacher, and administrator focus groups and interviews were also conducted at the end of the year. Results: A statistically significant interaction was found between students who participated in the intervention and those who did not participate in the intervention, on school climate measures F(1,74) = 15.00, p < .01, partial η2 = .17. Overall school climate scores were statistically significantly greater in the intervention group (F(1,74) = 19.22, p < .01, partial η2 = .20) at the end of the year. Focus group data also revealed themes of improved school connectedness, peer support, the acquisition of social/civic skills, and school engagement. Conclusions: A SBYD intervention may be a viable strategy to engage disconnected students and increase school climate perceptions, particularly among male students of color living in poverty.
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The Art and Science of Urban Gun Violence Reduction: Evidence from the Advance Peace Program in Sacramento, California. URBAN SCIENCE 2022. [DOI: 10.3390/urbansci6010006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Urban gun violence is a critical human health and social justice issue. Strategies to reduce urban gun violence are increasingly being taken out of the domain of police and into community-based programs. One such community-driven gun violence reduction program analyzed here is called Advance Peace. Advance Peace (AP) uses street outreach workers as violence interrupters and adult mentors to support the decision making and life chances of those at the center of urban gun violence. We reported on the impact Advance Peace had on gun violence and program participants in the City of Sacramento, California, from 2018–2019. Using an interrupted time series model, we attributed a gun violence reduction of 18% city wide and up to 29% in one of the AP target neighborhoods from the intervention. We also found that of the 50 participants in the Advance Peace Sacramento program 98% were alive, 90% did not have a new gun charge or arrest, 84% reported an improved outlook on life, all received cognitive behavioral therapy, and 98% reported that their AP outreach worker was one of the most important adults in their life. Advance Peace is a viable community-driven, urban gun violence, and healing-focused program.
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Culyba AJ, Branas CC, Guo W, Miller E, Ginsburg KR, Wiebe DJ. Route Choices and Adolescent-Adult Connections in Mitigating Exposure to Environmental Risk Factors During Daily Activities. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP8852-NP8878. [PMID: 31057045 PMCID: PMC8024113 DOI: 10.1177/0886260519846859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
While adolescent-adult connections have been shown to be protective against violence perpetration and victimization, mechanisms through which these connections confer protection from violence are poorly understood. We assessed whether adolescent-adult connections protected youth in lower resource urban neighborhoods from exposure to environmental risk factors for violence during daily activities. We overlaid on the city landscape minute-by-minute activity paths from 274 randomly sampled predominantly African American male youth, ages 10 to 24, enrolled in a population-based study of daily activities in Philadelphia, PA, to calculate environmental exposures and to compare exposures along actual versus shortest potential travel routes. Adolescent-adult connections were defined using brief survey questions and detailed family genograms. Analyses demonstrated that youth's selected travel routes resulted in significantly lower exposure to several types of crime, including vandalism, narcotics arrests, and disorderly conduct, than would have occurred on shortest potential routes. On average, youth with adolescent-adult connections spent less time outdoors than youth without connections, although these differences did not reach statistical significance (p = .06). There were no significant differences in environmental risk factors encountered by youth with versus without adolescent-adult connections. Future mixed-methods research combining qualitative and geographic information systems (GIS) approaches should investigate which factors shape travel decisions during daily activities to guide multimodal violence prevention interventions.
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Affiliation(s)
- Alison J Culyba
- The Children's Hospital of Philadelphia, PA, USA
- University of Pennsylvania, Philadelphia, USA
| | | | | | - Elizabeth Miller
- UPMC Children's Hospital of Pittsburgh, PA, USA
- University of Pittsburgh, PA, USA
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Christie M, Froh EB. Parental Perceptions of Adolescent Connectedness and the Role of the Primary Care Provider. J Pediatr Health Care 2021; 35:23-31. [PMID: 32948373 DOI: 10.1016/j.pedhc.2020.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/01/2020] [Accepted: 07/10/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Adolescent connectedness to adults, schools, and peers is a protective factor for development. This study aimed to describe parental perceptions of opportunities for youth connectedness and the potential role of the primary care provider in supporting these opportunities. METHOD Eleven parents or caregivers of youth aged 11-18 years participated in semistructured interviews for a prospective qualitative descriptive study. Interview transcripts were analyzed using constant comparison and deductive and inductive coding. RESULTS Findings suggest that parents and caregivers view adolescent participation in activities as positive, and nonparental adults play a large role in influencing adolescent involvement in activities. Parents and caregivers did not recall discussing connectedness with their adolescent's primary care provider but would find this helpful. DISCUSSION Conversations about connectedness are missing from the well adolescent visit, and more research is needed to explore the most effective ways to have these discussions with adolescents and their parents or caregivers.
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Affiliation(s)
- Melissa Christie
- Melissa Christie, Pediatric Nurse Practitioner, Primary Care, Drexel Hill, Children's Hospital of Philadelphia, PA; Elizabeth B. Froh, Nurse Scientist, Center for Pediatric Nursing Research and Evidence-Based Practice, Children's Hospital of Philadelphia; and Adjunct Assistant Professor, School of Nursing, University of Pennsylvania, Philadelphia, PA.
| | - Elizabeth B Froh
- Melissa Christie, Pediatric Nurse Practitioner, Primary Care, Drexel Hill, Children's Hospital of Philadelphia, PA; Elizabeth B. Froh, Nurse Scientist, Center for Pediatric Nursing Research and Evidence-Based Practice, Children's Hospital of Philadelphia; and Adjunct Assistant Professor, School of Nursing, University of Pennsylvania, Philadelphia, PA
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Kaufman MR, Casella A, Wiginton JM, Xu W, DuBois DL, Arrington-Sanders R, Simon J, Levine D. Mentoring Young African American Men and Transgender Women Who Have Sex With Men on Sexual Health: Formative Research for an HIV Mobile Health Intervention for Mentors. JMIR Form Res 2020; 4:e17317. [PMID: 33331822 PMCID: PMC7775199 DOI: 10.2196/17317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 06/30/2020] [Accepted: 10/02/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND African American men who have sex with men (MSM) and transgender women bear a disproportionate burden of HIV. Young MSM account for 75% of this burden for youth. When youths lack socially protective resources such as strong networks of adults, including parents, teachers, or community members, mentors may play a critical role in promoting health behaviors. This is especially true for youth at risk for HIV, such as African American youth with sexual and gender minority (SGM) identities. In the past decade, natural mentoring and mentoring programs have proliferated as a key prevention and intervention strategy to improve outcomes for young people at risk for poor academic, social, and health issues. Mentors appear to be able to facilitate health promotion among young SGM by modeling healthy behaviors; however, mentors' knowledge and resource needs regarding sexual health topics including HIV are understudied, as is the potential role of mobile technology in enhancing mentoring relationships and the ability of mentors to learn about sensitive issues faced by youth. OBJECTIVE The aim of this study is to explore how mentoring plays a role in the sexual health of African American SGM youth and understand how mentoring relationships can be strengthened through mobile technology to promote youth HIV prevention behaviors. METHODS In-depth interviews were conducted with African American SGM youth mentees (n=17) and mentors (n=20) to such youths in 3 Mid-Atlantic cities. Mentee interviews focused on discussions regarding sexual health and HIV and how a mentor could broach such topics. Mentor interviews explored whether sexual health and HIV are currently mentoring topics, mentors' knowledge and confidence in mentoring on these issues, and barriers to discussions. All participants were asked if a mobile app could help facilitate mentoring on sensitive health issues, particularly HIV and sexual health. Data were transcribed, coded, and analyzed for relevant themes. RESULTS Sexual health was a common topic in mentoring relationships, occurring more in natural mentorships than in mentoring program pairs. Mentors and mentees felt positive about such discussions. Mentors expressed having limited knowledge beyond condom use and HIV testing, and expressed a need for more complete resources. Both mentors and mentees had mixed comfort levels when discussing sexual health. Sufficient trust and shared lived experiences made discussions easier. Mentees have multifaceted needs; however, mentors stated that an app resource that provided self-training, resources, support from other mentors, and tips for better mentoring could prove beneficial. CONCLUSIONS For the African American SGM community, access to natural mentors is crucial for young people to learn healthy behaviors. A mobile resource to assist mentors in confidently having discussions with mentees may be a promising way to promote healthy practices.
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Affiliation(s)
- Michelle R Kaufman
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Albert Casella
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - John Mark Wiginton
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Wenjian Xu
- Department of Sociology & Psychology, School of Public Administration, Sichuan University, Chengdu, China
| | - David L DuBois
- Division of Community Health Sciences and Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | | | | | - Deb Levine
- DKF Consulting, Oakland, CA, United States
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Culyba AJ, Miller E, Albert SM, Abebe KZ. Co-occurrence of Violence-Related Risk and Protective Behaviors and Adult Support Among Male Youth in Urban Neighborhoods. JAMA Netw Open 2019; 2:e1911375. [PMID: 31517967 PMCID: PMC6745057 DOI: 10.1001/jamanetworkopen.2019.11375] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
IMPORTANCE Male youth in lower-resource neighborhoods bear a disproportionate burden of violence involvement, but little is known about clusters of specific violence-related behaviors to inform cross-cutting interventions that address multiple forms of violence. OBJECTIVE To examine associations between adult support and patterns of violence and risk or protective behavior co-occurrence among male youths in urban neighborhoods. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional analysis of baseline and end-of-program data from a recently completed cluster-randomized sexual violence prevention trial across 20 lower-resource neighborhoods. Participants were male youths, aged 13 to 19 years, enrolled at youth-serving community agencies in Pittsburgh, Pennsylvania, from July 27, 2015, to June 5, 2017. Data were analyzed from July 1, 2018, to February 28, 2019. EXPOSURES Social support and natural mentoring, as defined by validated survey measures. MAIN OUTCOMES AND MEASURES Validated survey measures (youth violence, bullying, sexual and dating violence, history of exposure to violence and related adversities, substance use, school engagement, and future orientation) were assessed for detailed co-occurrence patterns using hierarchical clustering, dendrograms, and heatmaps across prespecified domains. Wilcoxon rank sum tests and logistic regression models examined associations between adult support and violence involvement. RESULTS Among 866 participants, the mean (SD) age was 15.5 (1.6) years and 632 participants (77.5%) identified as African American. All 866 participants completed baseline surveys and 577 completed end-of-program surveys. Seven clusters of risk and protective behaviors emerged: (1) school engagement; (2) career and future aspirations; (3) substance use and bullying exposure; (4) exposure to violence and related adversities, sexual violence exposure, peer delinquency, and gang involvement; (5) sexual violence, youth violence, and bullying perpetration; (6) dating abuse perpetration; and (7) physical or sexual partner violence perpetration. The strongest association cluster occurred among sexual violence perpetration behaviors. Youth with high social support engaged in significantly fewer of the 40 prespecified risk behaviors (high social support median [interquartile range], 8 [5-12] behaviors vs low social support median [interquartile range], 10 [6-14] behaviors; mean difference, 1.64 behaviors; 95% CI, 0.63-2.64 behaviors; P = .004). High social support and natural mentoring were both inversely associated with gang involvement (social support: odds ratio [OR], 0.39; 95% CI, 0.22-0.71; and natural mentoring: OR, 0.44; 95% CI, 0.25-0.76) and sexual violence exposure (social support: OR, 0.39; 95% CI, 0.24-0.64; and natural mentoring: OR, 0.61; 95% CI, 0.39-0.98). CONCLUSIONS AND RELEVANCE These findings suggest that co-occurrence of risk and protective behaviors differ significantly among youth with vs without adult support. Violence prevention interventions designed to leverage adult support should address broader co-occurrence patterns.
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Affiliation(s)
- Alison J. Culyba
- Division of Adolescent and Young Adult Medicine, UMPC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UMPC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Steven M. Albert
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kaleab Z. Abebe
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Richmond TS, Foman M. Firearm Violence: A Global Priority for Nursing Science. J Nurs Scholarsh 2018; 51:229-240. [PMID: 30215887 DOI: 10.1111/jnu.12421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE This purpose of this article is to frame firearm violence as a health and public health problem, to illustrate the magnitude of the problem, to examine factors that increase the risk to be injured by a firearm, or conversely, that confer protection, and to identify relevant priority areas for nursing science. ORGANIZING CONSTRUCT Firearm violence results in physical and psychological injuries and is a global health priority. Firearm violence is categorized as intentional (interpersonal and self-inflicted) and unintentional (interpersonal and self-inflicted) and accounts for an estimated 196,000 to 220,000 nonconflict deaths annually. METHODS We reviewed the theoretical and scientific literature to analyze the magnitude and geographic distribution of firearm violence, the factors associated with firearm injury, the consequences of firearm violence, and areas where nursing science can make an impact on prevention, outcomes, and recovery. FINDINGS Firearm violence is a significant public health problem that affects the health of individuals, families, and communities. The burdens and contributors to firearm violence vary worldwide, making it important to understand the local context of this global phenomenon. Relevant areas of inquiry span primary prevention focusing on individual and environmental risk factors; and focus on managing the physical and psychological consequences postinjury; and mitigating long-term consequences of firearm violence. CONCLUSIONS Reducing the global burden of firearm violence and improving the health and safety of individuals, families, and communities provide compelling reasons to integrate this area into nursing science. CLINICAL RELEVANCE The goals of nursing are to keep people healthy and safe and to help return those injured to their optimal levels of health and well-being. Understanding the factors that come together to injure people with a firearm in various physical, social, economic, and cultural environments positions nurses to both extend the dialogue beyond pro-gun versus anti-gun and to design and carry out rigorous studies to reduce firearm violence.
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Affiliation(s)
- Therese S Richmond
- Andrea B. Laporte Professor of Nursing, Associate Dean for Research & Innovation, Biobehavioral Health Sciences Department, School of Nursing, University of Pennsylvania, Penn Injury Science Center, Philadelphia, PA, USA
| | - Matthew Foman
- Research Assistant, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.,Student, History and Sociology of Science Department, School of Arts & Sciences, University of Pennsylvania, Philadelphia, PA, USA
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Culyba AJ, Miller E, Ginsburg KR, Branas CC, Guo W, Fein JA, Richmond TS, Halpern-Felsher BL, Wiebe DJ. Adult Connection in Assault Injury Prevention among Male Youth in Low-Resource Urban Environments. J Urban Health 2018; 95:361-371. [PMID: 29700679 PMCID: PMC5993693 DOI: 10.1007/s11524-018-0260-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Strengths-based strategies to reduce youth violence in low-resource urban communities are urgently needed. Supportive adolescent-adult relationships may confer protection, but studies have been limited by self-reported composite outcomes. We conducted a population-based case-control study among 10- to 24-year-old males in low-resource neighborhoods to examine associations between supportive adult connection and severe assault injury. Cases were victims of gunshot assault injury (n = 143) and non-gun assault injury (n = 206) from two level I trauma centers. Age- and race-matched controls (n = 283) were recruited using random digit dial from the same catchment. Adolescent-adult connections were defined by: (1) brief survey questions and (2) detailed family genograms. Analysis used conditional logistic regression. There were no significant associations between positive adult connection, as defined by brief survey questions, and either gunshot or non-gun assault injury among adolescents with high prior violence involvement (GSW OR = 2.46, 95% CI 0.81-7.49; non-gun OR = 1.59, 95% CI 0.54-4.67) or low prior violence involvement (GSW OR = 0.92, 95% CI 0.34-2.44; non-gun OR = 1.96, 95% CI 0.73-5.28). In contrast, among adolescents with high levels of prior violence involvement, reporting at least one supportive adult family member in the family genogram was associated with higher odds of gunshot assault injury (OR = 4.01, 95% CI 1.36-11.80) and non-gun assault injury (OR = 4.22, 95% CI 1.48-12.04). We were thus unable to demonstrate that positive adult connections protected adolescent males from severe assault injury in this highly under-resourced environment. However, at the time of injury, assault-injured adolescents, particularly those with high prior violence involvement, reported high levels of family support. The post-injury period may provide opportunities to intervene to enhance and leverage family connections to explore how to better safeguard adolescents.
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Affiliation(s)
- Alison J Culyba
- Craig-Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. .,Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kenneth R Ginsburg
- Craig-Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Charles C Branas
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Wensheng Guo
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Joel A Fein
- Division of Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Therese S Richmond
- Biobehavioral and Health Systems Department, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Douglas J Wiebe
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Hohl BC, Wiley S, Wiebe DJ, Culyba AJ, Drake R, Branas CC. Association of Drug and Alcohol Use With Adolescent Firearm Homicide at Individual, Family, and Neighborhood Levels. JAMA Intern Med 2017; 177:317-324. [PMID: 28055064 PMCID: PMC5567686 DOI: 10.1001/jamainternmed.2016.8180] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Homicide is the third leading cause of death for adolescents in the United States and the leading cause of death for adolescents who are African American. Large cities have disproportionate homicide rates. Objective To determine the relationships between exposures to drugs and alcohol at the individual, family, and neighborhood levels and adolescent firearm homicide and to inform new approaches to preventing firearm violence. Design, Setting, and Participants Population-based case-control study from January 2010 to December 2012 of all 13- to 20-year-olds who were homicide victims in Philadelphia during the study period matched to randomly selected 13- to 20-year-old controls from the general population. Exposures Individual drug and alcohol use at the time of injury, history of drug and alcohol use, caregiver drug and alcohol use, and neighborhood availability of alcohol and illegal drugs. We also controlled for age, race, school suspensions, arrests, and neighborhood ethnicity. Main Outcomes and Measures Adolescent firearm homicide identified from police and medical examiner's reports. Results We enrolled 161 adolescent homicide cases, including 157 (97.5%) firearm homicide cases and 172 matched controls, including 166 (96.5%) firearm homicide controls. Adolescents with a history of alcohol use (adjusted odds ratio [AOR], 4.1; 95% CI, 1.2-14.0) or drug use (AOR, 4.4; 95% CI, 1.7-11.6) had increased odds of firearm homicide. Adolescents whose caregiver had a history of drug use had increased odds of firearm homicide (AOR, 11.7; 95% CI, 2.8-48.0). Adolescents in neighborhoods with high densities of alcohol outlets (AOR, 3.2; 95% CI, 1.1-9.1) and moderate or high drug availability had increased odds of firearm homicide (AOR, 3.4; 95% CI, 1.1-10.3 vs AOR, 7.5; 95% CI, 2.2-25.8). Conclusions and Relevance Almost all adolescent homicides in Philadelphia between 2010 and 2012 were committed with a firearm. Substance use at the individual, family, and neighborhood levels was associated with increased odds of adolescent firearm homicide; drug use was associated at all 3 levels and alcohol at the individual and neighborhood levels. Expanding violence prevention efforts to target drug and alcohol use at multiple levels may help to reduce the firearm violence that disproportionately affects adolescents in minority populations in large US cities.
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Affiliation(s)
- Bernadette C Hohl
- Department of Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway2School of Criminal Justice, Rutgers University, Newark, New Jersey3Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Shari Wiley
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia4Department of Mathematics, School of Science, Hampton University, Hampton, Virginia
| | - Douglas J Wiebe
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Alison J Culyba
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia5The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Rebecca Drake
- Medical Examiner's Office, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
| | - Charles C Branas
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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