Profiles of acculturation among Hispanics in the United States: links with discrimination and substance use.

PURPOSE: Recent research suggests that acculturation is a multifaceted construct with implications for substance use among Hispanics. However, few, if any, studies examining profiles of acculturation have been conducted using national samples. Moreover, no cluster-based studies have examined how acculturation relates to discrimination and substance use disorders among Hispanics in the United States. METHODS: The present study, employing Wave 2 data on Hispanics (n = 6,359) from the National Epidemiologic Survey of Alcohol and Related Conditions, aims to address these gaps. We use latent profile analysis to identify profiles of acculturation among Hispanics in the United States and, in turn, examine the relationships between membership in these profiles and experiences of discrimination and the prevalence of substance use disorders. RESULTS: A five-class solution was the optimal modeling of the data. Classes were identified as Class 1: Spanish-dominant/strongly separated (17 %), Class 2: Spanish-dominant/separated (18 %), Class 3: bilingual/bicultural (33 %), Class 4: English-dominant/bicultural (16 %), and Class 5: English-dominant/assimilated (16 %). Bilingual/bicultural Hispanics (Class 3) reported the highest prevalence of discrimination (31 %). Spanish-language dominant Hispanics (Classes 1 and 2) reported the lowest prevalence of substance use disorders. Significant differences in the prevalence of substance use disorders were observed between the bilingual/bicultural (Class 3) and English-dominant/assimilated classes (Class 5), but no differences were noted between the two English-dominant classes (Classes 4 and 5). CONCLUSIONS: Study findings indicate that acculturation is heterogeneous in its expression among Hispanics and suggest that Hispanics who maintain their Spanish-language capacity are at a substantially lower risk for a variety of substance use disorders.

Smoking Trajectories Among Monoracial and Biracial Black Adolescents and Young Adults.

INTRODUCTION: Cigarette smoking trajectories were assessed among monorace Blacks, Black-American Indians, Black-Asians, Black-Hispanics, and Black-Whites. METHOD: We used a subsample of nationally representative data obtained from the National Longitudinal Study of Adolescent Health (Add Health). The sample consisted of adolescents who were in Grades 7 - 12 in 1994, and followed across four waves of data collection into adulthood. Wave 4 data were collected in 2007-2008 when most respondents were between 24 and 32 years old. Respondents could report more than one race/ethnicity. Poisson regression was used to analyze the data. RESULTS: We found distinct smoking trajectories among monorace and biracial/ethnic Blacks, with all groups eventually equaling or surpassing trajectories of Whites. The age of cross-over varied by gender for some subgroups, with Black-American Indian males catching up earlier than Black-American Indian females. Black-White females smoked on more days than monorace Black females until age 26 and also smoked more than Black-White males between ages 11 and 29 years. Black-Hispanic males smoked on more days than Black-Hispanic females from ages 11 to 14. The results of the interaction tests also indicated different smoking trajectories across SES levels among White, Black, and Black-White respondents. CONCLUSION: Significant heterogeneity was observed regarding smoking trajectories between monoracel and biracial/ethnic Blacks. Knowledge of cigarette smoking patterns among monorace and biracial/ethnic Black youth and young adults extends our understanding of the etiology of tobacco use and may inform interventions.

Unheard Voices: African American Fathers Speak about their Parenting Practices.

Researchers have called for qualitative investigations into African American fathers' parenting practices that consider their social context and identify specific practices. Such investigations can inform the way we conceptualize African American fathers' parenting practices, which can in turn contribute to prevention interventions with at-risk youth. We conducted semi-structured, qualitative interviews about parenting with 30 self-identified, African American, biological fathers of pre-adolescent sons at-risk for developing aggressive behaviors, depressive symptoms, or both. Fathers provided descriptions of their parenting practices, which were at times influenced by their environmental context, fathers' residential status, and masculine ideologies. Our systematic analysis revealed four related themes that emerged from the data: managing emotions, encouragement, discipline, and monitoring. Of particular note, fathers in the current sample emphasized the importance of teaching their sons to manage difficult emotions, largely utilized language consistent with male ideologies (i.e., encouragement rather than love or nurturance), and engaged in high levels of monitoring and discipline in response to perceived environmental challenges and the developmental needs of their sons. The findings provide deeper insight into the parenting practices of African American fathers who are largely understudied, and often misunderstood. Further, these findings highlight considerations that may have important implications for father-focused prevention interventions that support African American fathers, youth, and families.

The biracial Asian population in California: an examination of health profiles and chronic conditions.

OBJECTIVES: To examine health outcomes and chronic conditions for the biracial Asian population in California. We hypothesized that the biracial population will display intermediate (or an average of) outcomes in comparison to their monoracial counterparts. DESIGN: The study was cross-sectional. After adjusting for sociodemographic variables, multivariable regression models predicted health outcomes (ie, diabetes, heart disease, high blood pressure, disability status, BMI, and general health) and compared health outcomes among various (mono- and bi-) racial and ethnic groups. PARTICIPANTS: Data were collected from 238,897 adult (aged ≥ 18 years) respondents after merging iterations of the California Health Interview Survey (CHIS) administered in 2001, 2003, 2005, 2007, and 2009. RESULTS: Multivariate results revealed that Whites reported better health overall than biracial Asians and other monoracial groups. Biracial Asians displayed BMI ranges that were intermediate between their monoracial constituents. CONCLUSIONS: BMI is a more proximal health outcome and is more sensitive to lifestyles and behaviors. As a result, BMI may be a better indicator than chronic diseases in showing that biracial Asians have adopted health behaviors and practices that fall between their mono-racial counterparts. Future epidemiological research should examine the prevalence of more proximal health outcomes among biracial Asians and assess how it differs by developmental age.

Gender roles and acculturation: relationships with cancer screening among Vietnamese American women.

The aim of this study was to examine the influence of demographic variables and the interplay between gender roles and acculturation on breast and cervical cancer screening outcomes among Vietnamese American women. Convenience sampling was used to recruit 100 Vietnamese women from the Richmond, VA, metropolitan area. Women were recruited to participate in a larger cancer screening intervention. All participants completed measures on demographic variables, gender roles, acculturation, and cancer screening variables. Findings indicated that traditional masculine gender roles were associated with increased self-efficacy for breast and cervical cancer screening. Higher levels of acculturation were associated with higher probability of having had a Papanicolaou test. In addition, acculturation moderated the relationship between traditional female gender roles and cancer screening variables. For highly acculturated women, higher levels of feminine gender roles predicted higher probability of having had a previous clinical breast exam and higher levels of self-efficacy for cervical cancer screening, while the opposite was true for lower acculturated women. The findings of this study indicate the important roles that sociodemographic variables, gender roles, and acculturation play in affecting health attitudes and behaviors among Vietnamese women. These findings also help to identify a potentially high-risk subgroup and existing gaps that need to be targeted by preventive interventions.

The role of acculturation and collectivism in cancer screening for Vietnamese American women.

The aim of this study was to examine the influence of demographic variables and the interplay between collectivism and acculturation on breast and cervical cancer screening outcomes among Vietnamese American women. Convenience sampling was used to recruit 111 Vietnamese women from the Richmond, VA, metropolitan area, who participated in a larger cancer screening intervention. All participants completed measures on demographic variables, collectivism, acculturation, and cancer-screening-related variables (i.e., attitudes, self-efficacy, and screening behavior). Findings indicated that collectivism predicted both positive attitudes and higher levels of self-efficacy with regard to breast and cervical cancer screening. Collectivism also moderated the relationship between acculturation and attitudes toward breast cancer screening such that for women with low levels of collectivistic orientation, increasing acculturation predicted less positive attitudes towards breast cancer screening. This relationship was not found for women with high levels of collectivistic orientation. The current findings highlight the important roles that sociodemographic and cultural variables play in affecting health attitudes, self-efficacy, and behavior among Vietnamese women. The findings potentially inform screening programs that rely on culturally relevant values in helping increase Vietnamese women's motivation to screen.

Developmental trajectories of alcohol use among monoracial and biracial Black adolescents and adults.

OBJECTIVE: The present study investigates developmental trajectories of alcohol use from early adolescence to adulthood by age and race/ethnicity among White, Black, Black-American Indian, Black-Hispanic, and Black-White individuals and associated sociodemograhphic correlates. METHOD: We used a subsample of nationally representative data obtained from the National Longitudinal Study of Adolescent Health (Add Health). The analytic sample consisted of 15,278 individuals in Wave 1 (ages 11 to 21 years). The sample consists of adolescents who were in Grades 7-12 at wave one and who were followed across four waves of data collection into adulthood. Respondents could report more than one race/ethnicity. RESULTS: We find distinct alcohol trajectories among monoracial and biracial/ethnic Blacks with all groups showing a cross-over or catch-up effect. Black-White adults demonstrated a cross-over effect by surpassing the alcohol drinking rates of Whites in adulthood, Black-American Indians showed a within-group catch-up effect by surpassing the alcohol drinking rates of monoracial and biracial/ethnic Blacks in adulthood, and monoracial Blacks were most likely to be non-drinkers in adulthood. We also show gender, socioeconomic status, and household structure differences in impact on alcohol use among monoracial and biracial/ethnic Blacks. CONCLUSIONS: Significant heterogeneity is observed regarding alcohol trajectories between monoracial and biracial/ethnic Blacks.

Epidemiology of drug use among biracial/ethnic youth and young adults: results from a U.S. population-based survey.

This study estimates the prevalence of cigarette, alcohol, and marijuana use in a nationally representative sample of monoracial/ethnic and biracial/ethnic youth and young adults. The authors consider 16 racial/ethnic categories and used four waves of data from the National Longitudinal Study of Adolescent Health. The analysis sample consists of 20,745 individuals in Wave 1. The primary statistical methodology used in the present study is logistic regression with sample weights. Findings suggest that participants who self-report two races/ethnicities have prevalence rates that are intermediate to those of the two corresponding monoracial/ethnic rates. For example, Black-American Indians reported cigarette smoking rates that were significantly lower than rates reported by American Indians but significantly higher than rates reported by Blacks. Groups with the highest prevalence of cigarette smoking at Wave 1 were American Indian, White-American Indian, White, and Multiracial (people reporting three or more races/ethnicities). Groups with the highest prevalence of alcohol drinking at Wave 1 were White-American Indian, Multiracial, Hispanic, White, and White-Hispanic. Groups with the highest prevalence of marijuana smoking at Wave 1 were Black-Asian and American Indian. The authors found an interaction effect between race/ethnicity and socioeconomic status. Lower-class SES status may serve as a risk factor for biracial/ethnic adolescents while upper-class SES may serve as a protective factor for these youth. In general, biracial/ethnic individuals have prevalence rates that are intermediate to those of the two corresponding monoracial/ethnic rates.

Family Factors and Mediators of Substance Use Among African American Adolescents.

This study uses a sample of 424 African American 8th- and 12th-grade students (mean age = 16.55; 65.1% girls) in the United States to examine how family protective factors explain cultural and school protective factors that prevent substance use. Questionnaires were administered between 2007 and 2009. Using structural equation modeling, results indicated that cultural and school factors partially mediated the relationship between family factors and lifetime substance use. School factors fully mediated the relationship between cultural factors and lifetime substance use. The findings suggest that parents promote cultural attributes, which in turn promotes school achievement, and in turn contributes to lower substance use. Limitations of the study, and implications for future research and prevention programs are discussed.

Beyond traditional gender roles and identity: does reconceptualisation better predict condom-related outcomes for African-American women?

African-American women continue to be at high risk for HIV and better prevention efforts are needed. The current paper sought to investigate the relationship between gender roles and condom-related outcomes among African American women. The sample consisted of 398 African-American women, who were administered a survey that contained measures of condom-related outcomes and gender role beliefs. We factor analysed their responses and three domains emerged: caretaking/mindful, interpersonal sensitivity and persistent/active coping. Results indicated that the interpersonal sensitivity domain was a significant predictor of condom use and intention with higher interpersonal sensitivity scores associated with less condom use and intentions. The persistent/active coping domain was a significant predictor of condom negotiation efficacy and condom use with higher scores in this domain associated with more condom negotiation efficacy and use. Results suggest that re-conceptualisations offer a better understanding of underlying traits that may influence condom-related outcomes for this population.

Father Involvement, Dating Violence, and Sexual Risk Behaviors Among a National Sample of Adolescent Females.

This study explored the relationship between the involvement of biological fathers and the sexual risk behaviors and dating violence/victimization and/or perpetration of adolescent girls. The data used in this cross-sectional analysis were drawn from the second wave of the public release of the National Longitudinal Study of Adolescent Health. Only adolescents who reported their biological sex as female, reported a history of being sexually active, and reported having a romantic partner in the previous 18 months were selected (N = 879). This study focused on overall positive sexual behaviors and use of contraception. Structural equation modeling (SEM) was used to best utilize capacity for dealing with latent variables and to test for possible mediation effects. The analysis demonstrated main effects of dating violence and father involvement on sexual behaviors. The more dating violence an adolescent girl experiences, the less likely she is to engage in healthy sexual behaviors. Likewise, the more involvement the biological father has in a woman's life, the more likely she is to engage in positive sexual behaviors. Perceived father involvement was associated with risky sexual behaviors among sexually experienced adolescent girls. Dating violence was directly associated with risky sexual behaviors among sexually experienced adolescent girls, particularly non-White girls. Future studies should use longitudinal models and test theoretically and empirically guided potential mediators. Future studies should also consider father figures such as step-fathers and grandfathers in addition to biological fathers, as having a father figure may be a stronger predictor of adolescent sexual behaviors than having a biological connection.

Racial differences in parenting style typologies and heavy episodic drinking trajectories.

OBJECTIVE: This study examines racial differences between Whites and Blacks in the association of parenting style typologies with changes in heavy episodic drinking from adolescence to young adulthood. METHOD: The analytic sample consists of 9,942 adolescents drawn from the National Longitudinal Study of Adolescent Health, which followed respondents from ages 12 to 31 years. Confirmatory factor analysis and factor mixture modeling are used to classify parenting style typologies based on measures of parental acceptance and control. Heavy Episodic Drinking (HED) trajectories are evaluated using a zero-inflated Poisson multigroup latent growth curve modeling approach. RESULTS: The mixture model identified 4 heterogeneous groups that differed based on the 2 latent variables (parental acceptance and control): balanced (65.8% of the sample), authoritarian (12.2%), permissive (19.4%), and uninvolved or neglectful (2.7%). Regardless of race, we found that at age 12 years, children of authoritarian parents have a higher probability of not engaging in HED than children of parents with balanced, permissive, or neglectful parenting styles. However, among Black youth who reported HED at age 12, authoritarian parenting was associated with greater level of HED at age 12 but a less steep increase in level of HED as age increased yearly as compared with balanced parenting. For White adolescents, uninvolved, permissive, and authoritarian parenting were not associated with a greater level of HED as age increased yearly as compared with adolescents exposed to balanced parenting. CONCLUSION: The influence of parenting styles on HED during adolescence persists into young adulthood and differs by race for youth engaging in HED.

Everyday discrimination and mood and substance use disorders: a latent profile analysis with African Americans and Caribbean Blacks.

BACKGROUND: Perceived discrimination is a major source of health-related stress. The purpose of this study was to model the heterogeneity of everyday-discrimination experiences among African American and Caribbean Blacks and to identify differences in the prevalence of mood and substance use outcomes, including generalized anxiety disorder, major depressive disorder, alcohol-use disorder, and illicit drug-use disorder among the identified subgroups. METHOD: The study uses data from the National Survey of American Life obtained from a sample of African American and Caribbean Black respondents (N=4,462) between 18 and 65 years. RESULTS: We used latent profile analysis and multinomial regression analyses to identify and validate latent subgroups and test hypotheses, yielding 4 classes of perceived everyday discrimination: Low Discrimination, Disrespect and Condescension, General Discrimination, and Chronic Discrimination. Findings show significant differences exist between the Low Discrimination and General Discrimination classes for major depressive disorder, alcohol-use disorder, and illicit drug-use disorder. Moreover, we find significant differences exist between the Low Discrimination and Chronic Discrimination classes for the four disorders examined. Compared with the Chronic Discrimination class, members of the other classes were significantly less likely to meet criteria for generalized anxiety disorder, major depressive disorder, alcohol-use disorder, and illicit drug-use disorder. CONCLUSIONS: Findings suggest elevated levels of discrimination increase risk for mood and substance-use disorders. Importantly, results suggest the prevalence of mood and substance-use disorders is a function of the type and frequency of discrimination that individuals experience.

Attention Deficit Hyperactivity Disorder symptoms and smoking trajectories: race and gender differences.

PURPOSE: This study examined the influence of Attention Deficit Hyperactivity Disorder (ADHD) symptoms severity and directionality (hyperactive-impulsive symptoms relative to inattentive symptoms) on trajectories of the probability of current (past month) smoking and the number of cigarettes smoked from age 13 to 32. Racial and gender differences in the relationship of ADHD symptoms and smoking trajectories were also assessed. METHODS: A subsample of 9719 youth (54.5% female) was drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health). Cohort sequential design and zero-inflated Poisson (ZIP) latent growth modeling were used to estimate the relationship between ADHD directionality and severity on smoking development. RESULTS: ADHD severity's effect on the likelihood of ever smoking cigarettes at the intercept (age 13) had a greater impact on White males than other groups. ADHD severity also had a stronger influence on the initial number of cigarettes smoked at age 13 among Hispanic participants. The relationships between ADHD directionality (hyperactive-impulsive symptoms relative to inattentive symptoms) and a higher number of cigarettes smoked at the intercept were stronger among Hispanic males than others. Gender differences manifested only among Whites. CONCLUSION: ADHD severity and directionality had unique effects on smoking trajectories. Our results also highlight that the risk of ADHD symptoms may differ by race and gender.

Perceived discrimination, depressive symptoms, and substance use in young adulthood.

Perceived discrimination is an important health-related stressor. As suggested by the stress-coping model, substance use often serves as a means to reduce the negative effects of perceived discrimination. This study uses data from the National Survey of American Life-Adults to examine the structural relationship of perceived discrimination and depressive symptoms with lifetime and recent substance use among African American and African Caribbean young adults. Respondents (N=1910) were 18-35 years old. Compared with African Caribbeans, African Americans report significantly higher levels of depressive symptoms and both lifetime and recent substance use. Multiple-group structural equation modeling is used to evaluate model fit and test hypothesized models. Results show good fit of the hypothesized models in both African Americans and African Caribbeans. Full measurement and structural invariance is found across ethnicity. Mediation models explain 18.5% and 47.4% of the variance in lifetime substance use for African Americans and African Caribbeans, respectively, and 23.5% and 35.0% of the variance in recent substance use for African Americans and African Caribbeans, respectively. Mediation tests indicate depressive symptoms partially mediate the relationship between perceived discrimination and lifetime substance use and fully mediated this relationship for recent substance use. This study is the first to demonstrate a positive association between perceived racial discrimination and substance use among African Caribbean young adults. Study findings illuminate the influence of perceived discrimination on substance use and the mechanisms of this relationship among African American and African Caribbean young adults.

Substance use disorders among first- and second- generation immigrant adults in the United States: evidence of an immigrant paradox?

OBJECTIVE: A growing number of studies have examined the "immigrant paradox" with respect to the use of licit and illicit substances in the United States. However, there remains a need for a comprehensive examination of the multigenerational and global links between immigration and substance use disorders among adults in the United States. METHOD: The present study, using data from the National Epidemiologic Survey on Alcohol and Related Conditions, aimed to address these gaps by comparing the prevalence of substance use disorders of first-generation (n = 3,338) and second-generation (n = 2,515) immigrants with native-born American adults (n = 15,733) in the United States. We also examined the prevalence of substance use disorders among first-generation emigrants from Asia, Africa, Europe, and Latin America in contrast to second-generation and native-born Americans. RESULTS: The prevalence of substance use disorders was highest among native-born Americans, slightly lower among second-generation immigrants, and markedly lower among first-generation immigrants. Adjusted risk ratios were largest among individuals who immigrated during adolescence (ages 12-17 years) and adulthood (age 18 years or older). Results were consistent among emigrants from major world regions. CONCLUSIONS: Consistent with a broad body of literature examining the links between the immigrant paradox and health outcomes, results suggest that nativity and age at arrival are significant factors related to substance use disorders among first- and second-generation immigrants in the United States.

Age of first cigarette, alcohol, and marijuana use among U.S. biracial/ethnic youth: a population-based study.

This study examines age of first cigarette, alcohol, and marijuana use among self-identified biracial youth, using data from the National Longitudinal Study of Adolescent Health (Add Health). We found an intermediate biracial phenomenon in which some biracial youth initiate substance use at ages that fall between the initiation ages of their 2 corresponding monoracial groups. When controlling for the covariates, our findings show that White-Asian biracial youth begin smoking marijuana and drinking alcohol at earlier ages than Whites and engaging in all forms of substance use at earlier ages than Asian youth. Results indicate that White-American Indian youth start smoking cigarettes at earlier ages than all biracial and monoracial groups. Our findings underscore the need for future research to examine substance-use initiation and progression among biracial/ethnic youth.

Empathy and drug use behaviors among African-American adolescents.

The current study proposed that empathy may indirectly play a protective role for adolescents in drug use behaviors and that this relationship will be mediated by self-regulatory strategies found in drug refusal efficacy. We predict that empathy will be linked to prosocial behavior and aggression, though we do not believe that they will mediate the relationship between empathy and drug use. The sample included 498 African-American adolescents in the 6th, 7th, and 8th grade. The results of structural equation modeling provided support for our hypotheses. Empathy was significantly and positively associated with drug refusal efficacy and prosocial behavior. Empathy was negatively associated with aggression. Drug refusal efficacy was negatively related to past 30-day drug use, providing evidence for the fully mediating role of drug refusal self-efficacy on empathy and past 30-day drug use. Consistent with our predictions, aggression and prosocial behavior were not significantly associated with past 30-day drug use. These findings may be useful in the context of programming efforts for drug prevention.

Risk and Protective Factors for Alcohol and Marijuana Use among African-American Rural and Urban Adolescents.

The purpose of this study was to examine individual, family, peer, and community risk and protective factors associated with past-30-days alcohol and marijuana use among African-American adolescents living in rural and urban communities. This study used data collected from 907 tenth- and twelfth-grade African-American students who completed the 2005 Community Youth Survey. Peer and individual risk=protective factors were more influential for urban youths while family and community risk=protective factors were more influential for rural youths. This pattern held for alcohol and marijuana use. Implications for substance use prevention programming are discussed.

Post-tobacco master settlement agreement: policy and practice implications for social workers.

The 1998 Tobacco Master Settlement Agreement (MSA) was developed between states and tobacco manufacturers to settle the states' lawsuits against tobacco manufacturers and recover tobacco health-related costs. States won billions of dollars and concessions regarding how tobacco products could be advertised. The purpose of the MSA was to prevent cigarette smoking and compensate for health expenses incurred in the treatment of tobacco smoking-related illnesses. Twelve years after the settlement, it is clear that MSA monies have been gravely diverted from tobacco prevention and cessation programs to balance budgets. The authors' review indicates that increases in funding for state tobacco prevention and cessation programs reduce tobacco use across all populations. Implications for social policy and social work practice are offered.