Pre-pregnancy Weight and Racial-Ethnic Disparities in Pregnancy-Associated Conditions in the State of Georgia: A Population-Based Study

INTRODUCTION

We investigate racial-ethnic disparities in pre-pregnancy obesity and pregnancy weight gain, which are known to increase the risk of pregnancy-associated conditions.

METHODS

We used 4-year (2017-2020) combined Georgia Pregnancy Risk Assessment Monitoring System data (N = 3208) to investigate racial-ethnic disparities in the incidence of gestational hypertension (GHT), gestational diabetes mellitus (GDM), and postpartum depression (PPD) and their associated risk with pre-pregnancy overweight/obesity after controlling for demographic and other confounders using regression modeling. The geographic distributions of hypertension and PPD rates at the county level were compared to the patterns of racial-ethnic populations and hospitals.

RESULTS

The PPD rates were higher among Asian (17.6), Hispanic (14.4), and Black (14.3); GDM was highest among Asian (16.0) mothers; and GHT was the highest among Black (11.7) followed by White mothers (9.0). Pre-pregnancy overweight and obese conditions increased the odds of hypertension in Black (2 ½ times) and White (> 3 ½ times) mothers. Premature birth increased the odds of hypertension (2-3 times) in all mothers. Pre-pregnancy weight also increased the odds of GDM (3-7 times) in these racial groups. Premature birth increases the odds twice as likely for PPD in Hispanic and White mothers. The convergence of high PPD and hypertension rates with high proportions of racial and ethnic minorities, and lack of hospital presence, indicates areas where healthcare interventions are required.

CONCLUSIONS

These findings underscore the importance of promoting a healthy pre-pregnancy weight to reduce the burden of maternal morbidity and pregnancy outcomes in general. More comprehensive prenatal monitoring using technological interventions for self-care has a great promise of being effective in maintaining a healthy pregnancy.

Communicating the risk of contracting Zika virus to low income underserved pregnant Latinas: A clinic-based study

OBJECTIVE

Frequent travel between the Southern border states in the USA, Mexico, and Latin American countries increases the risk of the Zika virus (ZIKV) spread. Patient education on virus transmission is fundamental in decreasing the number of imported cases, particularly among pregnant women.

METHODS

The study used cross-sectional methodology to investigate information sources and knowledge concerning the ZIKV virus among 300 under-served pregnant Latinas recruited from prenatal care clinics in the North Texas region. Bivariate and multiple logistic regression models were used to investigate associations between the primary outcomes and patient characteristics.

RESULTS

Physicians, nurses, and families are the major sources for pregnancy information, while media/internet (65%) and physician/nurse (33%) are the main sources for ZIKV information. Less than one-half of the mothers reported that their physician/nurse did not discuss safe sexual practices or inquired about their sexual practices. A considerable proportion of women from the community clinic were neither warned nor queried about travel to ZIKV risk countries. There is an overall understanding of Zika virus transmission, symptoms, complications, and recommended guidelines. Younger age and single mother status are risk factors for lack of ZIKV knowledge. Foreign-born mothers are 2.5-3.0 times more likely to have knowledge on disease transmission, symptoms, and microcephaly condition. While, younger mothers (18-24) are less likely to have knowledge of ZIKV infection symptoms (fever, rash and pink eye) and transmission of infection via unprotected sexual (vaginal, anal, or oral) behavior, compared to older mothers.

CONCLUSIONS

Interventions are needed to heighten the knowledge of ZIKV, particularly among women of reproductive age and their male partners in the community health care setting. Our study underscores the need for health care providers to be trained in delivering messages to enhance risk perception during health emergencies to vulnerable and underserved families (lower economic background, language ability, and culture). During health emergencies, clinics must disseminate crucial information via multi modalities to ensure messages reach the targeted patients.

Acculturation, Drinking, and Intimate Partner Violence among Hispanic Couples in the United States: A Longitudinal Study

This article examines the 5-year association between acculturation, drinking, and maleto-female partner violence and female-to-male partner violence among Hispanic couples in the United States. A national representative sample of Hispanic couples 18 years of age or older was interviewed in 1995 and 2000. Both members of the couple were independently interviewed. Differences in prevalence rates of male-to-female partner violence and female-to-male partner violence, incidence, and recurrence across acculturation groups are not significant. Drinking is associated with acculturation among women. Couples with mixed acculturation level (high-medium) are less at risk for maleto-female partner violence. An increase of five standard drinks per week in men’s drinking decreases the risk of female-to-male partner violence by 10%. Acculturation level at Time 1 is not associated with male-to-female partner violence and female-to-male partner violence status 5 years later.

Attitudes and behaviors towards risky driving among adolescents in Saudi Arabia

Background and Objectives

The main objective of the paper is to investigate perceptions and attitudes of school youth concerning risky driving behaviors (i.e.: Tafheet) in Saudi Arabia.

Design and Setting

This was a school-based cross-sectional study of adolescents in Riyadh that employed a multistage probability sampling scheme.

Subjects and Methods

The self-administered survey included questions adapted from the school-based studies conducted by the Centers for Disease Control and Prevention in the United States. The survey inquired about adolescents' behaviors and attitudes toward driving, perceptions of school and family, and leisure time activities.

Results

Nearly 40% of the students surveyed reported engaging in the risky driving behavior called Tafheet. Fifty-one percent of those who engage in dangerous activities also reported engaging in Tafheet. A higher proportion (70%) among those who believe Tafheet is a talent or a cool activity also engaged in Tafheet. Multivariate analyses indicate that students who are willing to engage in dangerous activities even when they are known to be dangerous (OR = 2.7; 95% CI = 1.55–4.72), those who think there is no harm in not wearing seat belts are at higher speeds (OR = 2.77; 95% CI = 1.24–6.21), and those who use a mobile telephone while driving are nearly three times (OR = 2.96; 95% CI = 1.41–6.23) at risk for engaging in Tafheet. Lack of respect towards traffic laws is also a risk factor.

Conclusion

Our study unequivocally points to pro-attitudes and behavior including a daring personality, not wearing a seat belt and using a mobile telephone while driving are significant factors associated with risky driving activity. Our study calls for a strategic intervention plan to change the culture of risky driving through a structured and stringent driving curriculum in school settings. A curriculum of this nature is currently non-existent in the Kingdom of Saudi Arabia (KSA). Multilevel and multifaceted interventions may hold great promise in reducing unintended motor vehicle injuries and changing the culture as a whole.

Sociodemographic characteristics and sexual behavior as risk factors for human papillomavirus infection in Saudi Arabia

OBJECTIVES

To determine the prevalence and the sociodemographic characteristics and sexual behavior risk factors for human papillomavirus (HPV) infection in a hospital-based cohort of women in Saudi Arabia.

METHODS

Cervical specimens and questionnaire data were collected from women attending clinics in Riyadh, Saudi Arabia. Cervical specimens were examined for abnormal cytology using a standard Pap test and for the presence of HPV-DNA using PCR and reverse line blot hybridization tests.

RESULTS

Approximately 73% of the 400 women tested were Saudi nationals. Nearly 50% were under 40 years old (range 22-80 years, mean±standard deviation 41.20±10.43 years). Approximately 17% of the women were HPV-positive. The most commonly detected HPV types were HPV-18 (34%) and HPV-16 (19%), with multiple infections detected in 10% of positive specimens. Multivariate analyses revealed that smoking and multiple partners were significant risk factors for HPV infection (p<0.01).

CONCLUSIONS

Because of societal challenges and an unsubstantiated assumption of low HPV prevalence, few studies have examined sociodemographic characteristics or sexual behaviors associated with HPV in Saudi women. However, a high prevalence of HPV infection was found, with smoking and multiple partners as significant risk factors, in this hospital-based cohort of predominantly Saudi women.

Student, school, parent connectedness, and school risk behaviors of adolescents in Saudi Arabia

Background and Objectives

School-related risk behaviours, such as school absenteeism, and engaging in violence on school property are scarcely addressed in the Kingdom. The study investigated select school behaviours, including school absenteeism, engaging in fights, and discipline for misconduct at school as well as their association with the school environment, school and home connectedness.

Design and setting

A school-based cross-sectional study.

Materials and methods

A total of 1668 students were selected from high schools in Riyadh on the basis of geographical location (North, South, Middle) and type of school. In each geographical area, the two largest public schools, one private school and one international school were selected. Classrooms with a free period were selected at random, and all of the students in select classrooms were eligible to participate in the study. The study employed a self-administered survey that inquired about school behaviours and student connectedness with their parents and school.

Results

Nearly 54% of students skipped school or cut classes for at least 1 h, and out of those students who skipped school, 37% of students skipped school for 1-3 h and 20% of students skipped school for 3 or more hours during the month prior to the survey. Thirty-eight percent of students engaged in fights on school property at least once during the past or current academic year. In addition, 37% of students were disciplined for engaging in school fights, theft or damaging school property at least once.Absenteeism increased with grade, while engaging in school fights and discipline for misconduct decreased with grade. A significantly higher proportion of males exhibited these behaviors, and students who exhibited these behaviors reported significantly lower levels of school connectedness and parental monitoring. Regression analyses suggested that school-student connectedness reduced the odds for all three risk behaviors examined in this study. Parental monitoring reduced the odds for absenteeism, and school policies reduced student involvement in school fights.

Conclusion

This study highlights the need to develop strategies to enhance the best practices in school settings to promote positive student behavior and school achievement. Schools and parents should be encouraged to work as a team and to recognize the importance of school connectedness in improving positive student behavior and outcomes.

Conceptual framework and quantification of population vulnerability for effective emergency response planning

OBJECTIVE

The study focused on the methodological advancement and analytical approach of using multilevel data to define population vulnerability and risk in bioemergency disaster planning.

METHODS

The authors considered two types of vulnerabilities, transportation vulnerability that stems from lack of access to transportation (public or private) and communication vulnerability that stems from unavailability of needed language-specific communication resources. The authors used Transit Authority general transit feed data and the American Community Survey 5-year estimate data (2006-2010 summary files) to quantify these vulnerabilities. These data were integrated with Topologically Integrated Geographic Encoding and Referencing (TIGER) data for spatial analysis. A response plan was generated for Tarrant County, TX, and deemed feasible before consideration of vulnerable populations.

RESULTS

The results point to the importance of integrating geographical and population demographic features that represent potential barriers to the optimum distribution and utilization of resources into the analysis of response plans. An examination of transportation vulnerabilities indicate that, of those vulnerable in Tarrant County, nearly 23,000 individuals will be at-risk of not being able to reach the Point Of Dispensing (POD) to obtain services as they are beyond walking distance to the POD and lack access to transportation resources. The analysis of language vulnerability depicts an uneven distribution resulting in nonuniform demand at PODs for translation resources. There are more than 11,000 at-risk households in the South East region of Tarrant County alone that are truly in need of translation services.

CONCLUSIONS

The authors demonstrated that multiple vulnerabilities at each POD can be quantified by aggregating the vulnerability at the available granularity (ie, all blocks or block groups) in a given service area. The quantification of vulnerability at each service area facilitates a POD-based at-risk analysis for the response plan. Disparities stemming from social, behavioral, cultural, economic, and health characteristics of diverse subpopulations could induce the need for additional targeted resources to support emergency response efforts.

The dimensionality and measurement properties of alcohol outcome expectancies across Hispanic national groups

This study examines the psychometric properties of alcohol expectancies among Hispanic subgroups. Face-to-face interviews were conducted as part of the 2006 Hispanic Americans Baseline Alcohol Survey (HABLAS), which employed a multistage cluster sample design. A total of 5224 individuals (18+ years of age) representing four Hispanic national groups (Puerto Ricans, Cuban Americans, Mexican Americans, and South/Central Americans) were selected at random from the household population in five metropolitan areas (Miami, New York, Philadelphia, Houston, and Los Angeles). Alcohol expectancies included 18 items covering positive (e.g., laugh more, become more talkative) and negative dimensions (e.g., become aggressive, lose control) when alcohol is consumed. Confirmatory factor models replicated a previously proposed three-factor dimensional structure with a substantial majority of items exhibiting measurement invariance across Hispanic national group and gender. Items covering social extroversion were an exception, showing a lack of invariance for female Cuban and South/Central Americans. Latent mean differences across groups were detected for expectancies concerning emotional fluidity, and the pattern of differences largely mirrored known differences in alcohol consumption patterns. Results suggest that caution should be exercised in interpreting differences in expectancies concerning social extroversion across Hispanic groups, and additional work is needed to identify indices of this construct with invariant measurement properties. However, measures of emotional/behavioral impairment and emotional fluidity expectancies can be validly compared across gender and Hispanic national groups.

Alcohol/drug exposure, HIV-related sexual risk among urban American Indian and Alaska Native Youth: evidence from a national survey

BACKGROUND

Migration of the native populations from reservations to the urban areas has resulted in mixed ethnicities of American Indian/Alaskan Native (AIAN) children. Minority youth require special attention and services in urban schools as they disproportionately experience poverty, low educational attainment, unemployment, and single-parent status.

METHODS

We used 2005 and 2007 Youth Risk Behavior Survey data to examine alcohol/drug use patterns and their association with sexual risk taking among AIAN only (single-racial) and biracial youth in combination with White, African American, or Hispanic ethnicities (N = 1178).

RESULTS

Overall, one half of the students were sexually active, with significantly higher rates among males; AIAN-Black students initiated sex earlier than the other groups. Condom nonuse is higher among AIAN-Whites (>50%) compared to one third of AIAN-Hispanics and one fourth of AIAN-Blacks. Nearly 10% of all students, except AIAN-Blacks, reported lifetime use of heroin/meth. Sexual behavior was significantly associated with episodic drinking. Students with Hispanic background have twice the odds of being sexually active compared to AIANs.

CONCLUSIONS

Our findings underscore growing health care needs and targeted prevention initiatives for mixed racial underserved native youth. Urban school settings have potential to deliver services and offer alcohol/drug prevention programs to address the needs of mixed racial native urban youth. Using the School Based Health Clinic model has been successful; we need to reform prevention approaches to accommodate needs of multiracial urban native youth.

Neighborhood characteristics as predictors of male to female and female to male partner violence

This article examines the association between neighborhood characteristics at the census tract-level, couples' perceived neighborhood social cohesion and informal social control, and male-to-female (MFPV) and female-to-male (FMPV) partner violence in the United States. Data come from a second wave of interviews (2000) with a national sample of couples 18 years of age and older who were first interviewed in 1995. The path analysis shows that poverty is associated with perceived social cohesion and perceived social control as hypothesized. However, there is no significant mediation effect for social control or social cohesion on any type of violence. In the path analysis, Black ethnicity is associated with social cohesion, which is associated with MFPV. Intimate partner violence (IPV), as a form of domestic violence, may not be as concentrated in high-poverty neighborhoods as criminal violence. IPV may be more determined by personal and dyadic characteristics than criminal violence.

The Hispanic Americans Baseline Alcohol Survey (HABLAS): Alcohol consumption and sociodemographic predictors across Hispanic national groups

OBJECTIVE

To examine differences in alcohol consumption among Hispanic national groups in the United States [Puerto Ricans, Mexican, Cuban, and Dominican South Central (D/SC) Americans] and identify sociodemographic predictors of drinking and binge drinking (four drinks for women and five for men in a 2-hr period).

METHOD

The study used a household probability sample of adult Hispanics in five metropolitan areas in the United States. Comprehensive data on alcohol consumption were collected. Analyses included bivariate and multivariate regression techniques.

RESULTS

Puerto Rican and Mexican American men reported higher drinking rates, weekly consumption, and binge drinking than D/SC and Cuban Americans. Women drank significantly less than men. Mexican American women reported the highest abstention rate (61%); Puerto Rican women drank more per week and binged more frequently compared with their counterparts in other groups. Puerto Rican origin, initiating drinking during high school years (<18), and male gender (US- or foreign-born) were significant predictors of weekly alcohol consumption. Being younger, being single, Puerto Rican or D/SC American origin, initiating drinking at <18 years, being a US- or foreign-born male and being a US-born female were significant predictors of binge drinking.

CONCLUSIONS

There are considerable differences in drinking behavior across Hispanic national groups as well as between men and women. Results underscore the need to recognize heterogeneity in drinking practices while designing effective prevention interventions in the community.

Sociodemographic predictors of pattern and volume of alcohol consumption across Hispanics, Blacks, and Whites: 10-year trend (1992-2002)

BACKGROUND

There have been limited trend studies examining variations on the patterns of alcohol consumption among Whites, Blacks, and Hispanics in the United States. The current paper reports national trends in drinking patterns, volume of drinking (number of drinks per month), binge drinking, and drinking to intoxication among Blacks, Whites, and Hispanics over a period of 10 years and identifies sociodemographic predictors of these behaviors across the 3 ethnic groups.

METHODS

Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population.

RESULTS

Trends varied across different dimensions of drinking and ethnic groups. There were no statistically significant differences in the mean number of drinks consumed per month among men and women in any of the 3 ethnic groups between 1992 and 2002, but there was a significant rise in the proportion of current drinkers in both genders and in all 3 ethnic groups. Multivariate analysis indicated that, compared to Whites in 1992, Blacks and Hispanics did not increase their volume of drinking, but Whites did. Drinking 5 or more drinks in day at all did not increase between 1992 and 2002, but drinking 5 or more drinks at least once a month was more likely for all groups in 2002 compared to Whites in 1992. Drinking to intoxication at all was more likely among Whites in 2002 than 1992, but drinking to intoxication at least once a month was more likely among Whites and Blacks in 2002 than 1992.

CONCLUSION

The only common trend between 1992 and 2002 across both genders and 3 ethnic groups was a rise in the proportion of drinkers. There was also a rise in drinking 5 or more drinks in a day (Whites, Blacks, and Hispanics) and drinking to intoxication (Whites and Blacks), but this was limited to those reporting such drinking at least once a month. The reasons for these changes are many and may involve complex sociodemographic changes in the population. It is important for the field to closely monitor these cross-ethnic trends in alcohol consumption.

Intimate partner violence and alcohol consumption

OBJECTIVE

To estimate the prevalence of intimate partner violence and alcohol consumption during episodes of violence.

METHODS

Cross-sectional study with a multi-stage probability sample, representative of the Brazilian population. Sample was comprised of 1,445 men and women, married or cohabitating, interviewed between November 2005 and April 2006. Interviews were conducted in the interviewees' homes, using a standardized closed questionnaire. Rates of prevalence of intimate partner violence were estimated and chi-square tests were used to assess gender differences in this prevalence.

RESULTS

General prevalence of intimate partner violence was 10.7% in men and 14.6% in women. Men consumed alcohol in 38.1% of cases and women in 9.2%. As regards perception of alcohol consumption by intimate partner, men reported their female partners consumed alcohol in 30.8% of episodes of violence, while women reported that their male partners consumed it in 44.6% of episodes.

CONCLUSIONS

Women were more frequently involved in mild and serious episodes of violence (perpetration, victimization or both) than men. The fact that episodes of violence reported were four times more frequent in intoxicated men enables the assumption that prevention of intimate partner violence may be promoted by public policies aimed at reducing alcohol consumption.

Depression among couples in the United States in the context of intimate partner violence

This paper examines the relationship between intimate partner violence and depression. A multicluster random household sample of U.S. couples was interviewed as part of a five-year national longitudinal study (response rate = 72%). Depression was assessed with the CES-D. The multivariate analyses for men showed that the odds of depression did not vary significantly by type of male-to-female (MF) or female-to-male (FM) aggression. Men who engaged in infrequent binge drinking, compared to those who never binged, were less likely to be depressed, as were men with greater collective efficacy. For women, the multivariate analysis, showed that FM aggression (psychological: minor and severe, and physical) was associated with a greater likelihood of depression. Exposure to parental violence was also associated with depression. Women may experience depression as the result of psychological and physical aggression even if they are the perpetrators of such aggression.

Intimate partner violence and contribution of drinking and sociodemographics: the Brazilian National Alcohol Survey

PURPOSE

To estimate prevalence rates of intimate partner violence (IPV) among Brazilian couples and to assess the contribution of drinking and sociodemographic factors to the risk of IPV.

METHODS

A sample consisting of 1,445 married or cohabitating males and females in the Brazilian population was interviewed. The survey response rate was 66%.

RESULTS

The analyses indicate 10.7% and 14.6% prevalence, respectively for male-to-female and female-to-male IPV. Males were drinking in 38.1% of IPV events and females in 9.2%. The male's partner was drinking in 30.8% and the females' partner in 44.6% of IPV acts. Bivariate associations between violence and sociodemographics were found for age groups, household monthly income and educational level. Logistic regression analysis indicate that younger age for both male and female partners, men with no religious affiiliation and women who are homemakers are significant predictors of violence.

CONCLUSION

This survey provides important information to further IPV research in Brazil.

Hispanic Americans Baseline Alcohol Survey (HABLAS): alcohol-related problems across Hispanic national groups

OBJECTIVE

The purpose of this study was to examine the prevalence and correlates of alcohol-related problems across four Hispanic national groups: Mexican Americans, Puerto Ricans, Cuban Americans, and South/Central Americans.

METHOD

Using a multistage cluster sample design, 5,224 individuals ages 18 years and older were selected from the household population of five U.S. metropolitan areas: Miami, New York, Philadelphia, Houston, and Los Angeles.

RESULTS

Cuban Americans had the lowest prevalence of alcohol-related problems. Significant differences across national group for zero versus two or more problems and for one versus two or more problems existed among men. Puerto Rican women were most likely to report two or more problems. The presence of zero versus two or more problems varied significantly across groups. There was variation in problem type across national groups among both men and women. Regression analyses showed that all groups were more likely than Cuban Americans to report two or more problems (vs zero) (Puerto Ricans: odds ratio [OR] = 2.02, p < .05; Mexican Americans: OR = 2.92, p < or = .01; South/Central Americans: OR = 2.12, p < or = .01). Being U.S. born (vs foreign born) increased the likelihood of experiencing one (OR = 1.57, p < .05) and two or more problems (OR = 1.95, p < or = .01). The volume of consumption was associated with problems (one problem: OR = 1.16, p < or = .01; two or more problems: OR = 1.31, p < or = .01). Heavy episodic drinking less than once a month was associated with two or more problems (OR = 6.15, p < or = .01). Heavy episodic drinking one or more times a month was associated with one problem (OR = 1.74, p < or = .01) and two or more problems (OR = 3.18, p < or = .01).

CONCLUSIONS

It is important to recognize that Hispanics are not a homogenous group.

Ethnicity, age, and trends in alcohol-related driver fatalities in the United States

OBJECTIVE

To evaluate the 8-year ethnic-specific declining trend in the proportion of alcohol-impaired driver deaths in the United States.

METHODS

We used the Fatality Analysis Reporting System (FARS), which is a census of all fatal motor vehicle collisions occurring in public properties in all 50 states, the District of Columbia, and Puerto Rico since 1975. For this study we only focused on driver fatalities. Data on ethnicity were not included in the FARS database until 1999, limiting the analysis to the years 1999-2006.

RESULTS

The proportion of alcohol-impaired driver deaths was higher among males compared to females, with Hispanics constituting the highest proportion in all age groups. During the past 8 years, only the decline in the proportion of alcohol-impaired driver deaths among male Hispanics 16-20 years old and male Whites 21-64 years old were significant. We were not able to identify any significant declining trend in the corresponding proportions among other age groups, or among female drivers, regardless of their age category.

CONCLUSION

Though existing strategies have seemed to be successful in preventing an uptrend in alcohol-related fatal collisions in the country, their effectiveness in decreasing such incidents has been limited. Future studies should identify the factors that might influence the effectiveness of current anti-drunk driver policies.

Agreement on reporting of physical, psychological, and sexual violence among white, black, and Hispanic couples in the United States

This article examines agreement on reports of male-to-female and female-to-male psychological, physical, and sexual violence among White, Black, and Hispanic couples in the United States. Using a probability sample, separate face-to-face interviews were conducted in respondents' homes with both members of 1,025 intact couples living in the 48 contiguous states. The overall survey response rate was 72%. Results indicate that agreement on each of the three types of violence is low, independent of perpetrator's gender and ethnicity. Kappa coefficients of agreement range from .07 to .48. Higher agreement is obtained for psychological violence, followed by physical and sexual violence. Depending on the type of violence, between 30% (psychological aggression) and 90% (sexual coercion) of events would not have been identified if identification required agreement between partners. Logistic analysis shows that the severity of violence is the only variable that increases the likelihood of agreement across the three types of violence.

The Hispanic Americans Baseline Alcohol Survey (HABLAS): the association between birthplace, acculturation and alcohol abuse and dependence across Hispanic national groups

Hispanics are heterogeneous in national origin, evidenced by wide ranges of alcohol abuse and dependence rates across different Hispanic national groups. This paper examines associations between 12-month rates of DSM-IV alcohol abuse and dependence with birthplace and acculturation. The 2006 Hispanic Americans Baseline Alcohol Survey, using a multistage cluster sample design, interviewed 5224 adults (18+ years) in five selected U.S. metropolitan areas: Miami, New York, Philadelphia, Houston, and Los Angeles. Comprehensive data on drinking behavior were collected and the analyses include bivariate and multivariate regression techniques. Alcohol abuse and dependence rates were higher among U.S.-born Puerto Ricans and South/Central Americans compared to their foreign-born counterparts, while no such differences were found for Cuban and Mexican Americans. Overall, those with higher acculturation report higher rates of abuse and dependence (statistically significant only for abuse among Puerto Ricans). Risk factors for abuse include being male and being in the high acculturation group. Risk factors for dependence include being male, being Puerto Rican or Mexican American, having less than a college education, and being U.S.-born. Hispanics were found to share several common risk factors with the larger U.S. population for abuse and dependence, such as male gender, lower education, and lower income.

The Hispanic Americans baseline alcohol survey: alcoholic beverage preference across Hispanic national groups

BACKGROUND

U.S. Hispanics come from many countries in Latin America, which can lead to different beverage preferences in the United States. This paper examines choice for drinking wine, beer, and liquor across 4 Hispanic national groups: Mexican Americans, Puerto Ricans, Cuban Americans, and South/Central Americans.

METHODS

A sample of 5,224 individuals 18 years of age and older was selected using multistage cluster procedures from the household population in 5 metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey weighted response rate was 76%. Face-to-face interviews lasting 1 hour on average were conducted in the respondents' homes either in English or Spanish.

RESULTS

Among men, beer drinkers consume the highest mean number of drinks per week in all national groups. Among women, this is true only of Puerto Ricans and Mexican Americans. Among men who drink beer, beer drinking constitutes 52 to 72% of total alcohol consumption. Among women who drink beer, beer consumption is associated with 32 to 64% of total consumption. Beer is the beverage most associated with binge drinking among Puerto Rican and Mexican American women, while among Cuban Americans and South/Central Americans this is seen for wine. Regression analyses showed no significant differences by national group in the likelihood of drinking 2 or fewer drinks (vs. no drinks) of wine, beer, or liquor. Puerto Ricans were more likely (OR = 1.47; 95% CI = 1.00-2.14) than Cuban Americans to drink 3 or more drinks (compared with no drinks) of beer. There was no association between the likelihood of binge drinking and Hispanic national group.

CONCLUSIONS

Beverage preference across Hispanic national groups is similar. Beer is the preferred beverage. Alcohol control policies such as taxation and control of sales availability should apply equally to beer, liquor, and wine. Prevention interventions directed at different Hispanic national groups in the United States can be relatively uniform in their focus on the dangers associated with drinking different types of alcoholic beverages.

Childhood family violence and perpetration and victimization of intimate partner violence: findings from a national population-based study of couples

PURPOSE

We sought to examine the relation between childhood family violence and intimate partner violence (IPV).

METHODS

We surveyed 1615 couples from the U.S. household population by using multistage cluster sampling. Childhood family violence measures included moderate and severe child physical abuse and witnessing interparental threats or physical violence. IPV was categorized as nonreciprocal male-to-female partner violence (MFPV), nonreciprocal female-to-male partner violence (FMPV), reciprocal IPV (MFPV and FMPV), and no IPV. We used multinomial logistic regression to estimate unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) between childhood family violence and IPV.

RESULTS

Men who experienced moderate (adjusted OR [AOR] 3.9, 95% CI, 1.3-11.8) or severe (AOR 4.5, 95% CI: 1.1-19.3) child physical abuse were at increased risk of nonreciprocal MFPV; a male history of severe childhood physical abuse or witnessing interparental violence was associated with a twofold increased risk of reciprocal IPV. Women who witnessed interparental threats of violence (AOR 1.9, 95% CI, 0.8-4.6) or interparental physical violence (AOR 3.4, 95% CI, 1.5-7.9) in childhood were at increased risk of nonreciprocal FMPV. Women exposed to any type of childhood family violence were more than 1.5 times as likely to engage in reciprocal IPV. Many strong positive ORs had CIs compatible with no association.

CONCLUSION

We provide new evidence that childhood family violence is associated with an increased risk of nonreciprocal and reciprocal IPV. Treatment providers and policy makers should consider childhood family violence history in both men and women in the context of IPV.

The Hispanic Americans baseline alcohol survey (HABLAS): DUI rates, birthplace, and acculturation across Hispanic national groups

OBJECTIVE

This article examines the association between birthplace, acculturation, and self-reported driving under the influence of alcohol (DUI), 12-month and lifetime DUI arrest rates among Mexican Americans, Puerto Ricans, Cuban Americans, and South/Central Americans in the U.S. population.

METHOD

Using a multistage cluster sample design, 5,224 adults (18 years of age or older) were interviewed from households in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles.

RESULTS

Birthplace was not associated with DUI, 12-month DUI arrest rates, or lifetime DUI arrest rates. Mexican Americans in the medium- and high-acculturation groups were more likely to engage in DUI. A higher proportion of U.S.-born than foreign-born respondents as well as those in the high-acculturation group, irrespective of national origin, reported having been stopped by police when driving. U.S.-born Cuban Americans, Mexican Americans, and South/Central Americans thought they could consume a higher mean number of drinks before their driving is impaired compared with those who are foreign born.

CONCLUSIONS

There are considerable differences in DUI-related behavior across Hispanic national groups. U.S.-born Hispanics and those born abroad, but not those at different levels of acculturation, have equal risk of involvement with DUI.

The Hispanic Americans Baseline Alcohol Survey (HABLAS): rates and predictors of alcohol abuse and dependence across Hispanic national groups

OBJECTIVE

The primary purpose of this article is to report 12-month prevalence rates and predictors of alcohol abuse and dependence among Mexican Americans, Cuban Americans, Puerto Ricans, and South/Central Americans living in the United States.

METHOD

Using a multistage cluster sample design, a total of 5,224 individuals 18 years of age and older were selected from the household population in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey weighted response rate was 76%. Personal interviews lasting an average of 1 hour were conducted in respondents' homes either in English or Spanish.

RESULTS

There is considerable heterogeneity in rates of abuse and dependence across these national groups, with Mexican American and Puerto Rican men having higher rates than Cuban American and South/Central American men. The rates of dependence for Mexican American and Puerto Rican men are also higher than those for men in the U.S. general population. Further, although the highest rates of abuse and dependence are among those in their 20s, the rate decline with age is not as strong as in the U.S. population. Thus, Hispanics at older ages (40-49, 50-59) are at considerably more risk of dependence and its health consequences than the U.S. general population. This is particularly true of Puerto Rican and Mexican American men.

CONCLUSIONS

Future analysis must take this heterogeneity into consideration by conducting national group-specific analysis. Prevention efforts must also be guided by these findings, which suggest that Puerto Ricans and Mexican Americans are at higher risk for abuse, dependence, and the associated consequences than the other two groups of U.S. Hispanics.

The Hispanic Americans Baseline Alcohol Survey (HABLAS): Rates and predictors of DUI across Hispanic national groups

This paper examines rates of self-reported driving under the influence (DUI) of alcohol and 12-month and lifetime DUI arrest rates among Mexican Americans, Puerto Ricans, Cuban Americans and South/Central Americans in the U.S. population. Using a multistage cluster sample design, a total of 5224 individuals 18 years of age and older were selected from the household population in five metropolitan areas of the U.S.: Miami, New York, Philadelphia, Houston and Los Angeles. The survey weighted response rate was 76%. Among men, 21% of Mexican Americans, 19.9% of South/Central Americans, 11.6% of Puerto Ricans and 6.9% of Cuban Americans reported DUI. Rates were lower among women, ranging from 9.7% for Mexican Americans to 1.3% for Cuban Americans. Mexican American men had the highest 12-month arrest rate (1.6%) and the highest lifetime arrest rate (11.2%). Drinkers who reported DUI were heavier drinkers than those not reporting DUI according to a variety of indicators. However, most DUI incidents involved non-alcohol-dependent drivers. Mexican Americans and South Central/Americans, men, younger drivers, those with less than high school education, those with higher income and higher alcohol consumption were more likely to report DUI and DUI arrests. These findings show that Hispanic national groups in the U.S. are diverse regarding drinking and DUI-related experiences.

Acculturation, drinking, and alcohol abuse and dependence among Hispanics in the Texas-Mexico border

BACKGROUND

Acculturation has been linked to an increased prevalence of alcohol-related problems. However, most of the research has been conducted with Hispanic populations in metropolitan areas of the United States, none of which is on the U.S.-Mexico border. This study examines the association between acculturation, heavy episodic drinking, and DSM-IV alcohol abuse and dependence among Hispanics in the Texas-Mexico border.

METHODS

The study used data from a survey conducted (2002 to 2003) along the Texas-Mexico border and included 472 male and 484 female Hispanic adults from El Paso, the Rio Grande Valley, and colonias. Based on the Acculturation Rating Scale for Mexican Americans-II scale, respondents were coded into 4 acculturation categories: "very Mexican oriented,""Mexican bicultural,""Anglo bicultural," or "very Anglo/Anglicized.".

RESULTS

Acculturation was related to lower rates of alcohol use disorders among men and a higher frequency of heavy episodic drinking among women. Multivariate analyses indicate that men who report heavy episodic drinking and those who are "very Mexican,""bicultural Mexican," or "bicultural Anglo" are more at higher risk for alcohol abuse and/or dependence compared with "very Anglo/Anglicized" men. For women, acculturation level did not predict alcohol disorders. Statistical analyses included testing for bivariate associations and multivariate logistic regression predicting heavy episodic drinking alcohol abuse or dependence.

CONCLUSIONS

This study suggests that acculturation has different effects on drinking for men and women. This finding needs some attention as literature also indicates that women drink more and may develop more alcohol-related problems as they acculturate. This increase in women's drinking is probably because of U.S. society's more liberal norms governing female drinking. The "bimodal" distribution of risk, in which only men in "very Anglo" group are at a lower risk than the others, may be unique to the Border. The association between acculturation and alcohol use disorders does not appear to be linear and the effect of acculturation is not uniform on individuals' drinking behavior.

Acculturation stress, drinking, and intimate partner violence among Hispanic couples in the U.S

This article examines the cross-sectional association between acculturation, acculturation stress, drinking, and intimate partner violence (IPV) among Hispanic couples in the U.S. The data being analyzed come from a multicluster random household sample of couples interviewed as part of the second wave of a 5-year national longitudinal study. The overall survey response rate for the second wave is 72%. Participants are Hispanic couples 18 years of age or older (N = 387). Results show that, among men, lower acculturation is positively associated with higher acculturation stress, which is directly related to a greater likelihood of involvement in IPV. These associations are also present among women. However, data for women show an additional path linking higher levels of acculturation directly to IPV. Drinking is not associated with IPV, independent of gender. Acculturation, directly or through acculturation stress, increases the likelihood of IPV.

Sexual aggression among White, Black, and Hispanic couples in the U.S.: alcohol use, physical assault and psychological aggression as its correlates

This article examines the prevalence of sexual aggression and its association with alcohol and other forms of violence, such as physical abuse and psychological aggression, in a national sample of married and cohabiting couples. These couples were part of a longitudinal study conducted in 1995 and 2000. The analyses include 406 White, 232 Black, and 387 Hispanic couples interviewed in 2000. Male-to-female sexual aggression rates ranged from 11% to 23% and female-to-male aggression rates ranged from 5.5% to 13.5%. Insisting on having sex without use of physical force and having sex without a condom are the two most frequently reported types of sexual aggression across all ethnic groups. Male and female perpetrated sexual aggression rates among Black couples were over 2 times the rate of White couples. Male perpetrated severe psychological aggression is a significant predictor of male sexual aggression. Female perpetrated severe psychological aggression predicted female sexual aggression. The study findings underscore the importance of addressing alcohol use and the presence of psychological abuse in the light of preventing other forms of violence including sexual aggression among couples.

Decisions under uncertainty: a computational framework for quantification of policies addressing infectious disease epidemics

Emerging infectious diseases continue to place a strain on the welfare of the population by decreasing the population's general health and increasing the burden on public health infrastructure. This paper addresses these issues through the development of a computational framework for modeling and simulating infectious disease outbreaks in a specific geographic region facilitating the quantification of public health policy decisions. Effectively modeling and simulating past epidemics to project current or future disease outbreaks will lead to improved control and intervention policies and disaster preparedness. In this paper, we introduce a computational framework that brings together spatio-temporal geography and population demographics with specific disease pathology in a novel simulation paradigm termed, global stochastic field simulation (GSFS). The primary aim of this simulation paradigm is to facilitate intelligent what-if-analysis in the event of health crisis, such as an influenza pandemic. The dynamics of any epidemic are intrinsically related to a region's spatio-temporal characteristics and demographic composition and as such, must be considered when developing infectious disease control and intervention strategies. Similarly, comparison of past and current epidemics must include demographic changes into any effective public health policy for control and intervention strategies. GSFS is a hybrid approach to modeling, implicitly combining agent-based modeling with the cellular automata paradigm. Specifically, GSFS is a computational framework that will facilitate the effective identification of risk groups in the population and determine adequate points of control, leading to more effective surveillance and control of infectious diseases epidemics. The analysis of past disease outbreaks in a given population and the projection of current or future epidemics constitutes a significant challenge to Public Health. The corresponding design of computational models and the simulation that facilitates epidemiologists' understanding of the manifestation of diseases represents a challenge to computer and mathematical sciences.

Dating violence victimization: associated drinking and sexual risk behaviors of Asian, Native Hawaiian, and Caucasian high school students in Hawaii

Ethnic minority groups such as Asian/Pacific Islanders (APIs) and native populations in Hawaii are seldom studied in the area of intimate relationships. Using the 1999 Hawaii Youth Risk Behavior Survey, this study examined gender and ethnic differences in experiencing physical dating violence and whether drinking (early initiation, binge drinking), unsafe sexual behaviors (early initiation, multiple partners, use of alcohol and drugs with sex, history of sexual abuse), and suicidality constitute risk for victimization among APIs, Native Hawaiian (NH), and Caucasian high school students in multiethnic state of Hawaii. The final analysis included 559 boys and 683 girls. The overall rate of experiencing physical violence was 7.8% with both genders reporting similar rates (boys 7.6%, girls 8.0%). Although not significantly different, NH students reported a higher rate (11.6%) than Caucasians (7.3%) and APIs (6.5%). Significant bivariate associations were found between victimization and many of the risk factors. Regression analyses indicated that students 16 years or older were nearly 3 times more at risk for experiencing dating violence. The risk was 8-fold if youth were sexually active by age 13 compared to those who abstained. The risk is 3-fold for those who reported prior sexual abuse. Early initiation of drinking (<12 years) and suicidality doubled the risk of being a victim. Clearly, the study highlights the risk of experiencing dating violence when a teen engages in sex very early or uses alcohol. Schools must routinely educate youth about various forms of dating violence, the effects of engaging in early sex, and drinking. Screening adolescents for associated risk factors such as drinking and depression is crucial to identify victimization. Dating violence is an antecedent for adult partner violence. Thus, by reducing youth dating violence, we may consequently reduce the incidence of adult partner violence.

The epidemiology of drinking among women of child-bearing age

OBJECTIVES

To estimate the prevalence of drinking, binge drinking (4 or more drinks), and alcohol abuse and dependence and to identify predictors of heavier drinking among women of child-bearing age (18-44 years).

METHODS

Subjects are part of a national multistage random sample from the 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

RESULTS

Binge drinking, abuse, and dependence are higher in younger (<30 years) pregnant and nonpregnant women. Among pregnant women, binge drinking is highest among Whites; alcohol abuse and dependence rates are relatively low and similar in all racial/ethnic groups. Among nonpregnant women, Whites and mixed race women have the highest rates of binge drinking. Alcohol abuse and dependence are highest among Native Hawaiian/Pacific Islanders, followed by Native American/Alaska Native women. Women who are White, younger (21-29 years), single, or cohabiting and with a higher income (> 40,000 US dollars) are at a higher risk for heavier drinking.

CONCLUSIONS

Drinking and heavier drinking remain at high levels among women of child-bearing age. Prevention efforts must be comprehensive and should target pregnant women who are drinking and those who could become pregnant and are drinking at high-risk levels.

Estimating the number of American children living in partner-violent families

The number of American children living in partner-violent households was estimated from a nationally representative sample of 1,615 dual-parent households. Approximately 15.5 million American children were estimated to live in families in which partner violence had occurred at least once in the previous year, with 7 million estimated to live in families in which severe partner violence had occurred. The prevalence of partner violence was higher among couples with children than among couples without children.

Adolescent alcohol use and suicide indicators among adolescents in Hawaii

Research on suicide has focused on gender, age, ethnicity, and psychiatric profiles. However, few studies have examined alcohol use and its relationship to suicide among Native Hawaiians and other Asian American/Pacific Islanders. This study analyzes data from the 1997 and 1999 Hawaii Youth Risk Behavior Survey to examine whether alcohol problems increase the risk for suicide indicators (as evidenced by responses to questions asking whether an individual has considered, planned, attempted, or required treatment for a suicide attempt). Drinking pattern was the best predictor for all suicide indicators. School and community-based programs can help to increase an adolescent's knowledge about the consequences of alcohol use and prevention of suicide.

The 5-year course of intimate partner violence among White, Black, and Hispanic couples in the United States

This article examines the 5-year incidence, prevalence, and recurrence of intimate partner violence (IPV) among White, Black, and Hispanic intact couples in the United States. A national multistage household probability sample of couples, age 18 years or older, was interviewed in 1995 with a response rate of 85%, and reinterviewed in 2000 with a response rate of 72%. Results indicate that the incidence and recurrence of IPV are higher for Blacks and Hispanics than for Whites. Compared to Whites, Hispanics are 2.5 times more likely to initiate IPV between baseline and follow-up and Blacks are 3.7 times more likely to report IPV at baseline and follow-up. Couples reporting severe IPV in 1995 are more likely than others to report severe IPV at follow-up. The rate of recurrence for severe IPV among Black and Hispanic couples is 6 and 4 times higher, respectively, than the rate among Whites. The results suggest that Blacks and Hispanics may be more affected by IPV.

Unidirectional and bidirectional intimate partner violence among White, Black, and Hispanic couples in the United States

This article describes the rates and risk factors of unidirectional and bidirectional intimate partner violence (IPV) among White, Black and Hispanic couples in the US. Subjects constitute a multistage area probability sample representative of married and cohabiting couples from the 48 contiguous United States. Results indicate that most couples reporting violence engage in bidirectional IPV. Blacks are more likely than Whites to report bidirectional IPV. In addition, severe unidirectional and bidirectional IPV are more common among Blacks and Hispanics. The results also indicate that predictors of IPV vary depending on whether it is unidirectional or bidirectional. Unidirectional female-to-male IPV and bidirectional IPV are more associated with the characteristics of the female. In contrast, the occurrence of unidirectional male-to-female IPV is associated with a single risk factor, male childhood physical abuse. These findings highlight the importance of distinguishing different types of IPV and have important epidemiological and prevention implications.

Drinking, alcohol problems and the five-year recurrence and incidence of male to female and female to male partner violence

BACKGROUND

This study examined the 5-year incidence and recurrence of male to female (MFPV) and female to male partner violence (FMPV) as well as their relationship with drinking and alcohol problems among intact couples in the United States.

METHODS

A national sample of couples 18 years of age or older were interviewed in 1995 and again in 2000.

RESULTS

Recurrence is slightly higher for FMPV (44%) than MFPV (39%), whereas incidence rates are similar for these two types of violence (MFPV, 5.7%; FMPV, 6%). Cross-tabulations show that a higher frequency of drinking five or more drinks on occasion is positively associated with the overall occurrence of MFPV and with both the recurrence and the overall occurrence of FMPV. Male alcohol problems are associated with a higher recurrence of MFPV and higher overall MFPV. Female alcohol problems are associated with incidence of FMPV. In multivariate analysis, black ethnicity, male unemployment, and severe physical abuse during childhood are associated with recurrence of MFPV. Black ethnicity, male unemployment, male employment status as "retired/other," female age, and couples in which the female drinks more are associated with recurrence of FMPV. Incidence of MFPV is associated with cohabitation, Hispanic ethnicity, and man's observation of violence between parents. Male unemployment, male observation of violence between parents, and man's drinking volume predict incidence of FMPV.

CONCLUSIONS

Volume of drinking is the only alcohol indicator associated with intimate partner violence once the effects of other factors are controlled in multivariate analysis. Both MFPV and FMPV are areas of health disparity across whites, blacks, and Hispanics. Factors of risk that predict recurrence and incidence can be identified and used in prevention efforts.

Poisoning hospitalizations among Texas adolescents: age and gender differences in intentional and unintentional injury

Using 1999 Hospital Discharge Data, this study examines age and gender differences in the pattern of poisoning hospitalizations of Texas youngsters (N = 1246) aged 10 through 17 years and investigates self-inflicted poisoning as a function of age and gender. Nearly three quarters of poisoning admissions are girls and two thirds of admissions are older children (aged 15 through 17 years). Analgesics and psychotropic drugs are the two most common agents used. Nearly 1 in 3 admissions among younger children aged 10 through 14 years and 1 in 2 among older children are due to analgesics, with a higher proportion of female admissions. One quarter of admissions among both age groups are due to psychotropic drugs, with nearly equal proportions of boys and girls. Intentional poisoning admissions are significantly higher among girls in both age groups. Older children are 1 1/2 times more likely than younger children, and girls are 2 times more likely than boys to be at risk for self-inflicted poisoning admissions. Fifty-three percent of female and 39% of male self-inflicted poisoning admissions are due to analgesics. Psychotropic drugs caused 29% of male and 21% of female self-inflicted admissions. Accidental and intentional poisoning is a public health concern requiring intervention. Residents in family practice and pediatrics need increased training to become proactive in educating adolescents and their parents about the dangers of drug overdosing.

Alcohol use and intimate partner violence as predictors of separation among U.S. couples: a longitudinal model

OBJECTIVE

The purpose of this study was to investigate the relationship between partner violence (male-to-female and female-to-male) and heavy drinking (consuming five or more drinks per occasion) and the effect of this relationship on marital separation.

METHOD

Married and cohabiting couples were selected through multistage random probability sampling from U.S. households. In 1995, 1,635 couples were interviewed; 1,392 of these couples were re-interviewed in 2000. The final analysis included couples who were still married or living with the same partner (intact n = 1,136) from the baseline, and couples who had broken up (nonintact n = 191) sometime during the 5-year follow-up period.

RESULTS

The findings indicate that couples who reported female-perpetrated violence, female alcohol-related problems and male heavy-drinking episodes (one to three times a month) were 2.5-3 times more at risk for separation. On the other hand, female heavy drinking (one to three times a month) is less likely to predict separation. Cohabiting couples are also more at risk for separation than married couples. Couples with longer relationships are less at risk for separation.

CONCLUSIONS

Marital counseling, therapy or intervention programs must address issues pertaining to partner violence and alcohol use among couples while concurrently providing information about healthy relationships and helping couples develop skills to attain them. The importance of preventing partner violence is increasingly recognized in the field of public health.

Ethnic differences in the estimates of children exposed to alcohol problems and alcohol dependence in the United States

OBJECTIVE

This study was undertaken to estimate the number of children nationwide exposed to an adult who has alcohol problems (AP) or alcohol dependence (AD) and to examine ethnic differences in the number of children exposed.

METHOD

The study used survey data from the 1995 National Alcohol Survey, which constituted a nationally representative sample of household members 18 years of age and older in the 48 contiguous states, were randomly selected, with oversamples of blacks and Hispanics. A total of 4925 subjects were interviewed, with a response rate of 77%. The questionnaire asked about AP and AD in the previous 12 months. Rates from the survey and data from the U.S. 2000 Census were used to calculate the estimates.

RESULTS

Overall, 11.6 million children (16%) were exposed to one or more AP and 2.1 million children (3%) were exposed to AD. A higher proportion, nearly 19%, of both black and Hispanic children as compared with 14.5% of white children were exposed to AP. Significantly higher proportions of black (5.2%) and Hispanic (4.9%) compared with white (2.0%) children were exposed to AD.

CONCLUSIONS

A large number of children are being exposed to at least one adult suffering from alcohol problems or dependence. Black and Hispanic children are disproportionately affected by these problems.

Ethnic variation in drinking, drug use, and sexual behavior among adolescents in Hawaii

This study examined ethnic differences in substance use and sexual behavior and whether drinking and drug use constitute risk factors for unsafe sexual practices among Native Hawaiian (NH), Caucasian, and Asian/Pacific Islander (API) high school students in Hawaii. A secondary data analysis of the Youth Risk Behavior Survey (1997 and 1999) using a representative sample of 2,657 students in 9-12 grades was performed. Chi-square tests for bivariate associations and multivariate regression analyses were conducted to identify predictors. NHs were more sexually active, initiated sex earlier, and tended to have multiple partners. Alcohol lifetime use was higher in NH, Caucasians, and males. NHs were more likely to initiate drinking by age 12 and engage more in episodic drinking. Non-episodic or episodic drinkers and students who use drugs were at risk to engage in sexual activity, have multiple partners, and use alcohol/drugs during sex. Risk was two times higher for substance use during sex if drinking was initiated at age 10 or younger compared to 15 years or older. Compared to abstainers, the risk doubled for lifetime multiple partners if drinking was initiated at ages 13-14. Overall, females were more sexually active. Because drinking was associated with sexual initiation and risky behavior, adverse effects of alcohol must be addressed in programs targeting underage drinking, thus helping youth delay or minimize sexual activity and prevent other associated problems. Intervention efforts should enhance life skills that endorse abstinence from alcohol and drug use.

Characteristics of non-respondents in a US national longitudinal survey on drinking and intimate partner violence

AIMS

To identify non-respondents' characteristics in a longitudinal household survey of intimate partner violence and drinking among United States couples.

DESIGN

Multistage probability sampling procedure with over-samples from black and Hispanic populations. A total of 1635 couples 18 years of age or older were interviewed at baseline (1995) for a response rate of 85%. Five years later, 1392 respondents were re-interviewed, with a response rate of 72%.

MEASUREMENTS

Sociodemographic variables, drinking volume and pattern, drug use, intimate partner violence, exposure to parental violence and childhood physical abuse.

FINDINGS

Among men, those who are younger, those who did not graduate from high school, those who are unemployed and those who are drinkers are more likely to be among the non-respondents. Among women, those who are 40-49 years of age are two times more likely than those aged 50 years or older to be among non-respondents. Also, women who reported experiencing abuse during their childhood are less likely to be among non-respondents compared with those who were not victimized. Gender-specific regression models accounted for only 5% of the variance in the response status variable, even after the inclusion of a comprehensive range of predictors in the model.

CONCLUSIONS

A low proportion of the variance in survey participation was explained by the variables included in the analysis, suggesting that sociodemographic, drinking-related and violence-related variables might not be the main factors determining participation in the survey.

Rural-urban differences in the distribution of parent-reported risk factors for substance use among young adolescents

PURPOSE

We examined rural-urban differences in cumulative risk for youth substance use. A recent report [National Center on Addiction and Substance Abuse (CASA) 2000] found that the rural-urban distribution of substance use and known risk factors for substance use differed; in many cases rural youth showed higher levels of use, as well as higher levels of risk factors. The current investigation, while not directly examining substance use, further examined rural-urban differences in the distribution of risk factors for youth substance use, based on information from parent reports.

METHOD

Study 1 data were collected from a random sample of Midwestern parents (n = 339) with a young adolescent between the ages of 11 and 13 years. Study 2 data were collected from a second sample of Midwestern parents (n = 593).

RESULTS

Analyses of rural-urban comparisons demonstrated higher levels of cumulative risk among rural youth. An evaluation of the sensitivity of the analysis to rural-urban classification schemes indicated that the findings were robust, but that there was some minor variation in rural-urban differences by classification scheme.

IMPLICATIONS

Results contribute to an explanation of findings from earlier reports of rural-urban differences in substance use, and suggest directions for future research on rural-urban distributions of youth risk factors.

Effects of list organization and retrieval cues on children's delayed recall

Developmental differences in recall were investigated as a function of mode of presentation (blocked vs. random), recall condition (cued vs. noncued), and time of recall (immediate vs. delayed). Ninety-six second graders and 96 fourth graders were the subjects, and the stimuli were 20 pictured items from five categories. Data on three dependent variables (item recall, category recall, and clustering score) were analyzed. Immediate recall was better than delayed recall, the fourth graders' overall performance was superior to that of the second graders, and the blocked presentation of items and the presence of retrieval cues at recall enhanced recall and organization in recall. Furthermore, an analysis of a three-way interaction on two dependent measures indicated that, in the noncued condition, immediate recall was better than delayed recall for children in both grades. However, in the cued condition, the fourth graders performed better during delayed recall than during immediate recall, whereas the second graders did better during immediate recall than during delayed recall.