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Ojukwu E, Bawafaa E, McKay E, Grewal H, Afsah S, Singh S, Saewyc E. Teen pregnancy involvement among African, Caribbean and Black adolescent boys and girls: A scoping review. BMJ Open 2024; 14:e078085. [PMID: 38834331 PMCID: PMC11163604 DOI: 10.1136/bmjopen-2023-078085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 04/29/2024] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVES This study aims to investigate the incidence, associated factors and interventions to address teen pregnancy involvement (TPI) among African, Caribbean and Black (ACB) adolescents in North America. DESIGN We conducted a scoping review of the literature, guided by the social-ecological model. DATA SOURCES Studies were retrieved from databases such as Ovid Medline, Ovid Embase, CINAHL, CAB Direct and Google Scholar and imported into COVIDENCE for screening. ELIGIBILITY CRITERIA The Joanna Briggs Institute scoping reviews protocol guided the establishment of eligibility criteria. Included studies focused on rates, associated factors and interventions related to TPI among ACB boys and girls aged 10-19 in North America. The publication time frame was restricted to 2010-2023, encompassing both peer-reviewed and non-peer-reviewed studies with diverse settings. DATA EXTRACTION AND SYNTHESIS Data were extracted from 32 articles using a form developed by the principal author, focusing on variables aligned with the research question. RESULTS The scoping review revealed a dearth of knowledge in Canadian and other North American literature on TPI in ACB adolescents. Despite an overall decline in teen pregnancy rates, disparities persist, with interventions such as postpartum prescription of long-acting birth control and teen mentorship programmes proving effective. CONCLUSION The findings highlight the need for increased awareness, research and recognition of male involvement in adolescent pregnancies. Addressing gaps in housing, employment, healthcare, sexual health education and health systems policies for marginalised populations is crucial to mitigating TPI among ACB adolescents. IMPACT The review underscores the urgent need for more knowledge from other North American countries, particularly those with growing ACB migrant populations.
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Affiliation(s)
- Emmanuela Ojukwu
- The University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada
| | - Eunice Bawafaa
- The University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada
| | - Emily McKay
- The University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada
| | - Harsimran Grewal
- The University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada
| | - Sara Afsah
- The University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada
| | - Shivangi Singh
- Cognitive Systems Program, Department of Computer Science, Linguistics, Philosophy, and Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Elizabeth Saewyc
- The University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada
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Edwards RC, Hans SL. Young mother risk-taking moderates doula home visiting impacts on parenting and toddler social-emotional development. Dev Psychopathol 2024; 36:236-254. [PMID: 36524235 DOI: 10.1017/s0954579422001158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This longitudinal randomized controlled trial examined the impact of a doula home visiting intervention for young, low-income mothers on parenting and toddler social-emotional development and tested whether intervention effects were moderated by maternal emotional and behavioral health characteristics. 156 mothers were offered home visits from a home visitor starting in mid-pregnancy through several years postpartum, with a community doula also working with the mother during pregnancy and after the birth. 156 received case management. Interviews, video recordings of mother-child interactions, and toddler assessments were conducted at 3 weeks, 3 months, 13 months, and 30 months of age. Intent-to-treat analyses conducted with the full sample showed some intervention effects. Moderation analyses, however, showed that most effects were concentrated among mothers engaged in high levels of risk-taking (delinquent behaviors, school suspensions, smoking, alcohol use, sexual risk-taking). Among higher risk-taking mothers, the intervention was related to less intrusiveness during early infancy, less psychological and physical aggression during toddlerhood, more sensitive parenting attitudes, and greater toddler social relatedness. Maternal depressive symptoms were only a moderator for toddler behavior problems. These findings suggest that doula home visiting may be a particularly effective model for enhancing sensitive, non-aggressive parenting among young mothers with a history of risk-taking behavior.
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Affiliation(s)
- Renee C Edwards
- The University of Chicago, Crown Family School of Social Work, Policy, and Practice, Chicago, IL60637, USA
| | - Sydney L Hans
- The University of Chicago, Crown Family School of Social Work, Policy, and Practice, Chicago, IL60637, USA
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Guo Y, Yang Y, Deveaux L, Dinaj-Koci V, Schieber E, Herbert C, Lee J, Wang B. Exploring effects of multi-level factors on transitions of risk-taking behaviors among middle-to-late adolescents. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2023; 47:210-220. [PMID: 37746313 PMCID: PMC10516360 DOI: 10.1177/01650254221148117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Adolescents experiment with risk behaviors, including delinquency, substance use, and sexual activity. Multi-level social factors, such as having high-risk peers, neighborhood risks, and parental monitoring, influence adolescents' behaviors. We modeled transition patterns in Bahamian adolescents' risk behaviors across three high school years and examined the effects of multi-level factors. We collected data from 2,564 Bahamian adolescents in Grade 10 and follow-ups through Grade 12. We used latent transition model to identify adolescents' risk statuses. Further analyses used multinomial logistic regression to explore the effects of multi-level factors on assignment to those latent statuses and transitions. We identified four distinct statuses: "low risk" (47.9% of the sample at baseline), "alcohol use" (36.8%), "alcohol use and sexual activity" (5.5%), and "high risk" (9.8%). Males were more likely to be in higher-risk statuses at baseline and to transition from a lower-risk status in Grade 10 to a higher-risk status in Grade 11. Social risk factors were significantly associated with higher-risk statuses at baseline. Neighborhood risk and peer risk involvement continued to affect transitions from lower to higher risk; parental monitoring did not have a significant effect in later years. Our findings have important implications for developing targeted and developmentally appropriate interventions to prevent and reduce risk behaviors among middle-to-late adolescents.
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Affiliation(s)
- Yan Guo
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA 01605, USA
| | - Yinmei Yang
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Lynette Deveaux
- Office of HIV/AIDS, Ministry of Health, Shirley Street, Nassau, The Bahamas
| | | | - Elizabeth Schieber
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA 01605, USA
| | - Carly Herbert
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA 01605, USA
| | - JungAe Lee
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA 01605, USA
| | - Bo Wang
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA 01605, USA
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Unsupervised machine learning predicts future sexual behaviour and sexually transmitted infections among HIV-positive men who have sex with men. PLoS Comput Biol 2022; 18:e1010559. [DOI: 10.1371/journal.pcbi.1010559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 11/08/2022] [Accepted: 09/12/2022] [Indexed: 11/09/2022] Open
Abstract
Machine learning is increasingly introduced into medical fields, yet there is limited evidence for its benefit over more commonly used statistical methods in epidemiological studies. We introduce an unsupervised machine learning framework for longitudinal features and evaluate it using sexual behaviour data from the last 20 years from over 3’700 participants in the Swiss HIV Cohort Study (SHCS). We use hierarchical clustering to find subgroups of men who have sex with men in the SHCS with similar sexual behaviour up to May 2017, and apply regression to test whether these clusters enhance predictions of sexual behaviour or sexually transmitted diseases (STIs) after May 2017 beyond what can be predicted with conventional parameters. We find that behavioural clusters enhance model performance according to likelihood ratio test, Akaike information criterion and area under the receiver operator characteristic curve for all outcomes studied, and according to Bayesian information criterion for five out of ten outcomes, with particularly good performance for predicting future sexual behaviour and recurrent STIs. We thus assess a methodology that can be used as an alternative means for creating exposure categories from longitudinal data in epidemiological models, and can contribute to the understanding of time-varying risk factors.
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Gottfredson NC, McNaughton-Reyes HL, Wu J. Predictive Associations Between Adolescent Profiles of Violent and Nonviolent Deviant Behavior With Convictions in Adulthood. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP12207-NP12237. [PMID: 33682492 DOI: 10.1177/0886260521997453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study examines how multivariate trajectory patterns of overt and relational peer and dating violence perpetration, alcohol use, and nonviolent deviant behavior during high school predict convictions in adulthood. Adolescent data are from an accelerated cohort design study that spanned four waves in 2003-2005. In 2019, conviction records were obtained for a random subsample of 1,579 individuals from the original study. We identified latent classes that were jointly characterized by distinct behavioral trajectories and adult conviction status, and described the demographic and psychosocial profiles of each class. The best-fitting model comprised four trajectory classes: Low Deviance (44%), Moderate Stable Deviance (40%), Increasing Deviance (8%), and Dating Violence Perpetrators (8%). Adolescents whose deviance increased during adolescence had substantially higher risk of convictions, including violent convictions, than all other groups. Classes were differentiated by gender, household structure, parental education, school bonding, grades, emotional dysregulation, sensation-seeking, family conflict, and prosocial values. The Increasing Deviance class was predominantly male, had an elevated probability of coming from a single-parent household and of having parents with low education, but values on psychosocial indicators were not extreme. Dating Violence Perpetrators were also more likely to come from a single-parent household, but their parents tended to have more education. This group was the most extreme on several psychosocial indicators that indicate low school and family bonds, and poor emotional regulation. The implications of these patterns in relation to interactional and strain theories, theories of cognitive maturation, and theories of social bonds and social control are discussed.
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Affiliation(s)
| | | | - Juliet Wu
- University of North Carolina at Chapel Hill, NC, USA
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Carter PM, Zimmerman MA, Cunningham RM. Addressing Key Gaps in Existing Longitudinal Research and Establishing a Pathway Forward for Firearm Violence Prevention Research. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2021; 50:367-384. [PMID: 34086512 PMCID: PMC8186821 DOI: 10.1080/15374416.2021.1913741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The main purpose of this article and this special section is to encourage greater attention to the key gaps that exist in our understanding of the epidemiology of adolescent firearm violence and to provide a pathway forward for future longitudinal research that will inform prevention efforts. This increased attention is especially salient given: (a) firearms are the leading cause of death for adolescents and emerging adults in the United States, with the majority of these deaths due to interpersonal violence; (b) significant health and social disparities with regards to the populations that are most affected by interpersonal firearm violence have been documented; and, (c) limitations in federal research funding during the past 30 years have created a deficit of knowledge about key risk and protective factors necessary to inform evidence-based prevention efforts. We discuss the implications of the articles in this special edition for existing and novel prevention programs. We also identify key considerations for future epidemiological research, including the need for a greater focus on collecting longitudinal data among nationally representative samples enriched with subgroups of at-risk youth, the need to examine the role of protective factors and mediating variables within existing and novel theoretical models of firearm risk behaviors, the need to examine key factors across all levels of the socio-ecological model, and the need to incorporate novel and innovative research designs, methods and analyses.
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Affiliation(s)
- Patrick M Carter
- Firearm Safety among Children and Teens Consortium, University of Michigan School of Medicine
- Department of Emergency Medicine, University of Michigan School of Medicine
- Department of Health Behavior/Health Education, University of Michigan School Public Health
- Youth Violence Prevention Center, University of Michigan School of Public Health
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine
| | - Marc A Zimmerman
- Firearm Safety among Children and Teens Consortium, University of Michigan School of Medicine
- Department of Health Behavior/Health Education, University of Michigan School Public Health
- Youth Violence Prevention Center, University of Michigan School of Public Health
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine
| | - Rebecca M Cunningham
- Firearm Safety among Children and Teens Consortium, University of Michigan School of Medicine
- Department of Emergency Medicine, University of Michigan School of Medicine
- Department of Health Behavior/Health Education, University of Michigan School Public Health
- Youth Violence Prevention Center, University of Michigan School of Public Health
- University of Michigan Injury Prevention Center, University of Michigan School of Medicine
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Reyes HLM, Foshee VA, Gottfredson NC, Ennett ST, Chen MS. Codevelopment of Delinquency, Alcohol Use, and Aggression Toward Peers and Dates: Multitrajectory Patterns and Predictors. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2020; 30:1025-1038. [PMID: 32918776 PMCID: PMC7774244 DOI: 10.1111/jora.12577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 06/11/2023]
Abstract
We aimed to characterize developmental patterns of involvement in alcohol use, delinquency, and interpersonal aggression in a normative sample of adolescents by applying multitrajectory group-based modeling. Using seven waves of data from a cohort sequential study spanning the 6th to 12th grades (n = 2,825; 50% girls), we identified four distinct trajectory groups: low risk (33%), declining peer aggressors (44%), peer and dating aggressors (13%), and multidomain high risk (10%). Across all comparisons, girls were more likely than boys to be members of the peer and dating aggressor group and less likely to be members of the multidomain high-risk group. Moreover, individual (self-control, negative emotionality), family (family violence, parental monitoring), and peer (substance use norms) distinguished class membership.
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Affiliation(s)
- H. Luz McNaughton Reyes
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Vangie Ann Foshee
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Nisha C. Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Susan T. Ennett
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - May S. Chen
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
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Houle B, Yu ST, Angotti N, Schatz E, Kabudula CW, Gómez-Olivé FX, Clark SJ, Menken J, Mojola SA. Clusters of HIV Risk and Protective Sexual Behaviors in Agincourt, Rural South Africa: Findings from the Ha Nakekela Population-Based Study of Ages 15 and Older. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2057-2068. [PMID: 32232623 PMCID: PMC7321875 DOI: 10.1007/s10508-020-01663-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 02/12/2020] [Accepted: 02/14/2020] [Indexed: 06/10/2023]
Abstract
Understanding how sexual behaviors cluster in distinct population subgroups along the life course is critical for effective targeting and tailoring of HIV prevention messaging and intervention activities. We examined interrelatedness of sexual behaviors and variation between men and women across a wide age range in a rural South African setting with a high HIV burden. Data come from the Ha Nakekela population-based survey of people aged 15-85-plus drawn from the Agincourt Health and Socio-Demographic Surveillance System. We used latent class analysis of six sexual behavior indicators to identify distinct subgroup sexual behavior clusters. We then examined associations between class membership and sociodemographic and other behavioral risk factors and assessed the accuracy of a reduced set of sexual behavior indicators to classify individuals into latent classes. We identified three sexual behavior classes: (1) single with consistent protective behaviors; (2) risky behaviors; and (3) in union with lack of protective behaviors. Patterns of sexual behaviors varied by gender. Class membership was also associated with age, HIV status, nationality, and alcohol use. With only two sexual behavior indicators (union status and multiple sexual partners), individuals were accurately assigned to their most likely predicted class. There were distinct multidimensional sexual behavior clusters in population subgroups that varied by sex, age, and HIV status. In this population, only two brief questions were needed to classify individuals into risk classes. Replication in other situations is needed to confirm these findings.
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Affiliation(s)
- Brian Houle
- School of Demography, The Australian National University, #9 Fellows Road, Acton, Canberra, ACT, 2601, Australia.
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA.
| | - Shao-Tzu Yu
- School of Demography, The Australian National University, #9 Fellows Road, Acton, Canberra, ACT, 2601, Australia
| | - Nicole Angotti
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
- Department of Sociology and Center on Health, Risk and Society, American University, Washington, DC, USA
| | - Enid Schatz
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
- Department of Public Health, University of Missouri, Columbia, MO, USA
| | - Chodziwadziwa W Kabudula
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - Samuel J Clark
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Sociology, The Ohio State University, Columbus, OH, USA
| | - Jane Menken
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
| | - Sanyu A Mojola
- Department of Sociology and Woodrow Wilson School of Public and International Affairs, and Office of Population Research, Princeton University, Princeton, NJ, USA
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Daspe MÈ, Arbel R, Ramos MC, Shapiro LAS, Margolin G. Deviant Peers and Adolescent Risky Behaviors: The Protective Effect of Nonverbal Display of Parental Warmth. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2019; 29:863-878. [PMID: 29932277 PMCID: PMC6309597 DOI: 10.1111/jora.12418] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study examines whether nonverbal displays of parents' warmth during an in-lab conflict discussion mitigate the links between affiliation with deviant peers and risky behaviors. A sample of 107 youth and their parents participated in a study spanning from mid-adolescence (T1) to late adolescence (T2). At T1, family members discussed a contentious issue, which was coded for parents' nonverbal warmth. At T1 and T2, youth reported on their friends' and their own risky behaviors. Fathers' warmth moderated each prospective association between deviant peers and risky behaviors. Mothers' warmth did not emerge as a significant moderator. Girls, in particular, benefitted from fathers' warmth as a buffer in the trajectory from T1 risky behaviors to T2 risky behaviors and deviant peers.
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Sharma S, Mustanski B, Dick D, Bolland J, Kertes DA. Protective Factors Buffer Life Stress and Behavioral Health Outcomes among High-Risk Youth. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 47:1289-1301. [PMID: 30796646 PMCID: PMC6616218 DOI: 10.1007/s10802-019-00515-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This study investigated internalizing problems, externalizing problems, and polydrug use among African-American youth residing in high-poverty neighborhoods, and tested the potential protective effects of religiosity, parental monitoring, and neighborhood collective efficacy on life stress and behavioral health outcomes (N = 576; 307 females; Mage = 16 years, SD = 1.44 years). A cumulative risk index reflected the combined effects of past year exposure to stressful life events, racial discrimination, and exposure to violence along with poor neighborhood ecology. Structural equation modeling revealed that cumulative risk significantly predicted internalizing problems, externalizing problems, and polydrug use. Interaction tests showed that the association of cumulative risk with internalizing problems was buffered by adolescent religiosity and neighborhood collective efficacy. The association of cumulative risk with externalizing problems was buffered by parental monitoring and collective efficacy. Adolescent sex further moderated these effects. The findings of the present study collectively highlight potential for protective factors to buffer effects of cumulative risk on behavioral health outcomes among youth residing in high-risk neighborhoods.
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Affiliation(s)
- Shubam Sharma
- Department of Psychology, University of Florida, Gainesville, FL, 32611-2250, USA
| | - Brian Mustanski
- Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - Danielle Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - John Bolland
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Darlene A Kertes
- Department of Psychology, University of Florida, Gainesville, FL, 32611-2250, USA.
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Phillips JM, Branch CJ, Brady SS, Simpson T. Parents Speak: A Needs Assessment for Community Programming for Black Male Youth. Am J Prev Med 2018; 55:S82-S87. [PMID: 30670205 DOI: 10.1016/j.amepre.2018.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/04/2018] [Accepted: 05/16/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Although adolescence can be a difficult developmental period for all children, negative environmental forces make this period particularly risky for many inner-city black males. As part of the Center for Healthy African American Men through Partnerships, this project is utilizing community-based participatory concepts to design and implement programs to address risk-taking behaviors among middle school black males. METHODS In 2014, parents of black males between the ages of 11 and 14years were recruited from an urban middle school to participate in focus group discussions. Letters were provided to the school to be mailed to parents inviting them to participate in discussion groups. Four focus groups were conducted. Data analyses were conducted fall 2014. RESULTS Twenty-one parents participated. The major issue affecting the well-being and future success of young black males reported by parents was the lack of social support. Other areas of concern included negative peer pressure, bullying, violence, and lack of opportunities. Across groups, parents identified the lack of male parental presence in households and the subsequent perceived need by the young males to assume leadership roles, anger among the young males, and the lack of licensed counselors to address mental health issues as barriers to success and well-being. Parents emphasized the needs of the individual, family, and community for social support, positive role models, self-esteem, and respect. CONCLUSIONS The present data can inform prevention programs designed to reduce disparities, such as educational underachievement, exposure to violence, and premature mortality experienced by black males. SUPPLEMENT INFORMATION This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.
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Affiliation(s)
- Janice M Phillips
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - C Jason Branch
- Department of Education, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sonya S Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Tina Simpson
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
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Two-Year Trajectories of Sexual Risk Behaviors Among Drug-Using Adolescents and Emerging Adults in an Urban Community. AIDS Behav 2017; 21:2069-2078. [PMID: 27714523 DOI: 10.1007/s10461-016-1570-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Among 14-24 year-olds who used drugs and were recruited from an emergency department, we examined 2-year trajectories of sexual risk behaviors. We hypothesized that those in higher risk trajectories would have more severe substance use, mental health concerns, and dating violence involvement at baseline. Analyses identified three behavioral trajectories. Individuals in the highest risk trajectory had a more severe profile of baseline alcohol use, marijuana use, dating violence involvement, and mental health problems. Future research will examine longitudinal differences in risk factors across trajectories. Understanding risk factors for sexual risk behavior trajectories can inform the delivery and tailoring of prevention interventions.
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Lowry R, Robin L, Kann L. Effect of Forced Sexual Intercourse on Associations Between Early Sexual Debut and Other Health Risk Behaviors Among US High School Students. THE JOURNAL OF SCHOOL HEALTH 2017; 87:435-447. [PMID: 28463448 DOI: 10.1111/josh.12512] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/20/2016] [Accepted: 11/01/2016] [Indexed: 06/07/2023]
Abstract
BACKGROUND Previous research on associations between early sexual debut and other health risk behaviors has not examined the effect of forced sexual intercourse on those associations. METHODS We analyzed data from a nationally representative sample of 19,240 high school students in the United States, age ≥16 years, to describe the effect of forced sexual intercourse on associations between early sexual debut and other health risk behaviors using adjusted prevalence ratios (APR). RESULTS Early sexual debut and forced sexual intercourse were simultaneously and independently associated with sexual risk-taking, violence-related behaviors, and substance use. For example, even after controlling for forced sexual intercourse and race/ethnicity, students who experienced their first sexual intercourse before age 13 years were more likely than students who initiated sexual intercourse at age ≥16 years to have had ≥4 sexual partners during their lifetime (girls, APR = 4.55; boys, APR = 5.82) and to have not used a condom at last sexual intercourse (girls, APR = 1.74; boys, APR = 1.47). CONCLUSIONS Associations between early sexual debut and other health risk behaviors occur independently of forced sexual intercourse. School-based sexual health education programs might appropriately include strategies that encourage delay of initiation of sexual intercourse, and coordinate with violence and substance use prevention programs.
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Affiliation(s)
- Richard Lowry
- Division of Adolescent and School Health, US Centers for Disease Control and Prevention, 1600 Clifton Road, N.E., Mailstop E-75, Atlanta, GA 30329
| | - Leah Robin
- Research Application and Evaluation Branch, Division of Adolescent and School Health, US Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. Mailstop E-75, Atlanta, GA 30329
| | - Laura Kann
- School-Based Surveillance Branch, Division of Adolescent and School Health, US Centers for Disease Control and Prevention, 1600 Clifton Road, N.E. Mailstop E-75, Atlanta, GA 30329
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Chung T, Ye F, Hipwell AE, Stepp SD, Miller E, Borrero S, Hawk M. Alcohol and marijuana use in pathways of risk for sexually transmitted infection in white and black adolescent females. Subst Abus 2016; 38:77-81. [PMID: 27897467 DOI: 10.1080/08897077.2016.1263591] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Some types of sexually transmitted infection (STI) have higher prevalence in females than males, and among black, relative to white, females. Identifying mechanisms of STI risk is critical to effective intervention. The authors tested a model in which alcohol and marijuana use serve as mediating factors in the associations between depression and conduct problems with sexual risk behavior (SRB) and STI in adolescent females. METHODS The Pittsburgh Girls Study is a longitudinal observational study of females who have been followed annually to track the course of mental and physical health conditions. The 3 oldest cohorts (N = 1750; 56.8% black, 43.2% white) provided self-reports of substance use, depression and conduct problems, SRB, and STI at ages 16-18. A path model tested alcohol and marijuana use at age 17 as mechanisms that mediate the associations of depression and conduct problems at age 16 with SRB and STI at age 18. RESULTS Race was involved in 2 risk pathways. In one pathway, white females reported greater alcohol use, which was associated with greater SRB. In another pathway, black females reported earlier sexual onset, which was associated with subsequent SRB. Public assistance use was independently associated with early sexual onset and STI. SRB, but not substance use, mediated the association of depression and conduct problems with STI. CONCLUSIONS Differences by race in pathways of risk for SRB and STI, involving, for example, alcohol use and early sexual onset, were identified for young white and black females, respectively. Depression and conduct problems may signal risk for SRB and STI in young females, and warrant attention to improve health outcomes.
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Affiliation(s)
- Tammy Chung
- a Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania , USA
| | - Feifei Ye
- b School of Education, University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Alison E Hipwell
- a Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania , USA.,c Department of Psychology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Stephanie D Stepp
- a Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania , USA.,c Department of Psychology , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Elizabeth Miller
- d Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA
| | - Sonya Borrero
- e Division of General Internal Medicine, University of Pittsburgh , Pittsburgh , Pennsylvania , USA.,f VA Center for Health Equity and Promotion, VA Pittsburgh Healthcare System , Pittsburgh , Pennsylvania , USA
| | - Mary Hawk
- g Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania , USA
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Taggart T, Taboada A, Stein JA, Milburn NG, Gere D, Lightfoot AF. AMP!: A Cross-site Analysis of the Effects of a Theater-based Intervention on Adolescent Awareness, Attitudes, and Knowledge about HIV. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 17:544-53. [PMID: 27056632 PMCID: PMC4889560 DOI: 10.1007/s11121-016-0645-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AMP! (Arts-based, Multiple component, Peer-education) is an HIV intervention developed for high school adolescents. AMP! uses interactive theater-based scenarios developed by trained college undergraduates to deliver messages addressing HIV/STI prevention strategies, healthy relationships, and stigma reduction towards people living with HIV/AIDS. We used a pre-test/post-test, control group study design to simultaneously assess intervention effect on ninth grade students in an urban county in California (N = 159) and a suburban county in North Carolina (N = 317). In each location, the control group received standard health education curricula delivered by teachers; the intervention group received AMP! in addition to standard health education curricula. Structural equation modeling was used to determine intervention effects. The post-test sample was 46 % male, 90 % self-identified as heterosexual, 32 % reported receiving free or reduced lunch, and 49 % White. Structural models indicated that participation in AMP! predicted higher scores on HIV knowledge (p = 0.05), HIV awareness (p = 0.01), and HIV attitudes (p = 0.05) at the post-test. Latent means comparison analyses revealed post-test scores were significantly higher than pre-test scores on HIV knowledge (p = 0.001), HIV awareness (p = 0.001), and HIV attitudes (p = 0.001). Further analyses indicated that scores rose for both groups, but the post-test scores of intervention participants were significantly higher than controls (HIV knowledge (p = 0.01), HIV awareness (p = 0.01), and HIV attitudes (p = 0.05)). Thus, AMP!'s theater-based approach shows promise for addressing multiple adolescent risk factors and attitudes concerning HIV in school settings.
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Affiliation(s)
- Tamara Taggart
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC), 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599-7440, USA.
| | - Arianna Taboada
- Art & Global Health Center, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Judith A Stein
- Art & Global Health Center, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Norweeta G Milburn
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - David Gere
- Art & Global Health Center, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Alexandra F Lightfoot
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC), 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599-7440, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill (UNC), Chapel Hill, NC, USA
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Parent and youth dopamine D4 receptor genotypes moderate multilevel contextual effects on rural African American youth's risk behavior. Dev Psychopathol 2015; 28:433-45. [PMID: 26189764 DOI: 10.1017/s0954579415000565] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The present investigation extends research on Gene × Environment interactions and youth risk behavior by linking multilevel contextual factors, such as community disadvantage and protective parenting practices, to both parental and youth dopamine D4 receptor (DRD4) genotypes. We expected community disadvantage to influence youth risk behavior via a series of indirect effects involving protective parenting and youth's planful future orientation when both parents' and youth's DRD4 status was considered. Genetic moderation processes also were tested to determine whether they conformed to a diathesis-stress or a differential susceptibility model. Hypotheses were investigated with data from 361 rural African American youth and their parents assessed 3 times when youth were ages 16 to 19. Community disadvantage interacted with parental DRD4 status to predict low levels of protective parenting. Protective parenting, in turn, interacted with youth DRD4 status to forecast increases in youth's planful future orientations, a proximal influence on changes in risk behavior. The Parental DRD4 × Community Disadvantage interaction, but not youth DRD4 × Protective Parenting, conformed to a differential susceptibility model. Indirect effect analyses revealed a significant indirect path linking community disadvantage to youth risk behavior through a series of multilevel Gene × Environment interaction processes.
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Byck GR, Swann G, Schalet B, Bolland J, Mustanski B. Sensation seeking predicting growth in adolescent problem behaviors. Child Psychiatry Hum Dev 2015; 46:466-73. [PMID: 25112599 PMCID: PMC4326633 DOI: 10.1007/s10578-014-0486-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
There is limited literature on the relationship between sensation seeking and adolescent risk behaviors, particularly among African Americans. We tested the association between psychometrically-derived subscales of the Zuckerman Sensation Seeking Scale and the intercepts and slopes of individual growth curves of conduct problems, sexual risk taking, and substance use from ages 13 to 18 years by sex. Boys and girls had different associations between sensation seeking and baseline levels and growth of risk behaviors. The Pleasure Seeking scale was associated with baseline levels of conduct problems in boys and girls, baseline substance use in boys, and growth in sexual risk taking and substance use by girls. Girls had the same pattern of associations with the Danger/Novelty scale as the Pleasure Seeking scale. Knowledge about the relationships between adolescent risk taking and sensation seeking can help in the targeted design of prevention and intervention programs for the understudied population of very low-income, African American adolescents.
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Affiliation(s)
- Gayle R. Byck
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Greg Swann
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Benjamin Schalet
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - John Bolland
- College of Human Environmental Sciences, University of Alabama, Tuscaloosa, Alabama
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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18
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Hebert LE, Lilleston PS, Jennings JM, Sherman SG. Individual, partner, and partnership level correlates of anal sex among youth in Baltimore City. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:619-629. [PMID: 25583375 DOI: 10.1007/s10508-014-0431-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 10/27/2014] [Accepted: 10/28/2014] [Indexed: 06/04/2023]
Abstract
Anal sex is an efficient mode of STI transmission and studies indicate that anal sex is common among heterosexuals, including adolescents. We examined the association between individual, partner, and sexual partnership-level characteristics with anal sex among a household survey of 263 individuals aged 15-24 years in Baltimore City, Maryland. We used weighted multiple logistic regression to examine correlates of anal sex in a heterosexual partnership by gender. Twenty-nine percent of males and 15% of females reported anal sex in a partnership in the past 6 months. For males, anal sex was associated with having two or more partners in the past 3 months (AOR = 13.93, 95% CI 3.87-50.12), having been tested for HIV (AOR = 0.30, 95% CI 0.12-0.72), and oral sex with a partner (AOR = 8.79, 95% CI 1.94-39.78). For females, anal sex was associated with reporting having a main partner (AOR = 6.74, 95% CI 1.74-23.65), partner meeting place (AOR = 3.03, 95% CI 1.04-8.82), partner history of STI (AOR = 0.20, 95% CI 0.05-0.85), and oral sex with a partner (AOR = 8.47, 95% CI 1.08-66.25). Anal sex was associated with inconsistent condom use for both males (OR = 5.77, 95% CI 1.68-19.79) and females (OR = 5.16, 95% CI 1.46-18.30). We conclude that anal sex is a prevalent risk behavior among heterosexual youth and is associated with a range of factors at the individual and partnership levels. These findings provide support for comprehensive sex education that includes information about anal sex; findings from this study can inform public health campaigns targeting youth at risk for STIs.
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Affiliation(s)
- Luciana E Hebert
- Department of Obstetrics and Gynecology, Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, University of Chicago, 1225 E. 60th Street, Rm 122, Chicago, IL, 60637, USA,
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Hawe P, Bond L, Ghali LM, Perry R, Davison CM, Casey DM, Butler H, Webster CM, Scholz B. Replication of a whole school ethos-changing intervention: different context, similar effects, additional insights. BMC Public Health 2015; 15:265. [PMID: 25880841 PMCID: PMC4373008 DOI: 10.1186/s12889-015-1538-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 02/13/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Whole school, ethos-changing interventions reduce risk behaviours in middle adolescence, more than curriculum-based approaches. Effects on older ages are not known. We set out to replicate one of these interventions, Australia's Gatehouse Project, in a rural Canadian high school. METHODS A guided, whole school change process sought to make students feel more safe, connected, and valued by: changes in teaching practices, orientation processes, professional development of staff, recognition and reward mechanisms, elevating student voice, and strategies to involve greater proactivity and participation. We conducted risk behaviour surveys in grades 10 to 12 before the intervention and 2 years afterwards, and social network analyses with the staff. Changes in health and health risk behaviours were assessed using chi-square. Interactions between the intervention and gender and between the intervention and school engagement were assessed using interaction terms in logistic regression models. Changes in the density of relationships among staff were tested with methods analogous to paired t-tests. RESULTS Like Gatehouse, there was no statistically significant reduction in depressive symptoms or bullying, though the trend was in that direction. Among girls, there was a statistically significant decrease in low school engagement (45% relative reduction), and decreases in drinking (46% relative reduction), unprotected sex (61% relative reduction) and poor health (relative reduction of 73%). The reduction in drinking matched the national trend. Reductions in unprotected sex and poor health went against the national trend. We found no statistically significant changes for boys. The effects coincided with statistically significant increases in the densities of staff networks, indicating that part of the mechanism may be through relationships at school. CONCLUSIONS A non-specific, risk protective intervention in the social environment of the school had a significant impact on a cluster of risk behaviours for girls. Results were remarkably like reports from similar school environment interventions elsewhere, albeit with different behaviours being affected. It may be that this type of intervention activates change processes that interact highly with context, impacting different risks differently, according to the prevalence, salience and distribution of the risk and the interconnectivity of relationships between staff and students. This requires further exploration.
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Affiliation(s)
- Penelope Hawe
- O'Brien Institute of Public Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4N6, Canada.
- The Australian Prevention Partnership Centre and Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Lyndal Bond
- Centre for Excellence in Intervention and Prevention Science, 15-30 Pelham Street, Carlton, VIC, 3053, Australia.
| | - Laura M Ghali
- The Ability Hub, 3rd Floor, 3820-24th Ave NW, Calgary, AB, T3B 2X9, Canada.
| | - Rosemary Perry
- O'Brien Institute of Public Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4N6, Canada.
| | - Colleen M Davison
- Department of Public Health Sciences, Queens University, Carruthers Hall, Office 203, 62 Fifth Field Company Lane, Kingston, ON, K7L 3N6, Canada.
| | - David M Casey
- Alberta Health Services, Centre 15, 1509 Centre Street SW, Calgary, AB, T2G 2E6, Canada.
| | - Helen Butler
- Faculty of Education and Arts, Melbourne Campus (St Patricks), Australian Catholic University, Mary Glowrey Building, 115 Victoria Parade, Fitzroy, VIC, 3065, Australia.
| | - Cynthia M Webster
- Department of Marketing and Management, Macquarie University, Sydney, NSW, 2109, Australia.
| | - Bert Scholz
- Brooks Composite High School, Box 849, 650 - 4th Avenue, Brooks, AB, T1R 0Z4, Canada.
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20
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Sterrett EM, Dymnicki AB, Henry D, Byck GR, Bolland J, Mustanski B. Predictors of co-occurring risk behavior trajectories among economically disadvantaged African-American youth: contextual and individual factors. J Adolesc Health 2014; 55:380-7. [PMID: 24755141 PMCID: PMC4143450 DOI: 10.1016/j.jadohealth.2014.02.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 01/01/2014] [Accepted: 02/28/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE African-American youth, particularly those from low-income backgrounds, evidence high rates of negative outcomes associated with three problem behaviors, conduct problems, risky sexual behavior, and substance use. This study used a contextually tailored version of problem behavior theory (PBT) to examine predictors of the simultaneous development of problem behaviors in this specific cultural group. METHODS Sociocontextual and individual variables representing four PBT predictor categories, controls protection, support protection, models risk, and vulnerability risk, were examined as predictors of co-occurring problem behaviors among economically disadvantaged African-American adolescents (n = 949). Specifically, the likelihood of following three classes of multiple problem behavior trajectories spanning ages 12-18, labeled the "early experimenters," "increasing high risk-takers," and "adolescent-limited" classes, as opposed to a "normative" class, was examined. RESULTS Among other findings, controls protection in the form of a more stringent household curfew at age 12 was related to a lower likelihood of being in the "early experimenters" and "increasing high risk-takers" classes. Conversely, vulnerability risk manifested as stronger attitudes of violence inevitability was associated with a higher likelihood of being in the "early experimenters" class. However, the PBT category of support protection was not associated with risk trajectory class. More distal neighborhood-level manifestations of PBT categories also did not predict co-occurring behavior problems. CONCLUSION Guided by an incorporation of contextually salient processes into PBT, prevention programs aiming to decrease co-occurring problem behaviors among low-income African-American adolescents would do well to target both proximal systems and psychological constructs related to perceived security throughout adolescence.
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Affiliation(s)
- Emma M Sterrett
- Kent School of Social Work, University of Louisville, Louisville, Kentucky.
| | | | - David Henry
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois
| | - Gayle R Byck
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - John Bolland
- College of Human Environmental Sciences, University of Alabama, Birmingham, Alabama
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
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