Person explanatory multidimensional item response theory with the instrument package in R.

We present the new R package instrument to perform Bayesian estimation of person explanatory multidimensional item response theory. The package implements an exploratory multidimensional item response theory model and a higher-order multidimensional item response theory model, a type of confirmatory multidimensional item response theory. Explanation of person parameters is accomplished by fixed and random effect linear regression models. Estimation is carried out using Hamiltonian Monte Carlo in Stan. In this article, we provide a detailed description of the models; we use the instrument package to demonstrate fitting explanatory item response models with fixed and random effects (i.e., mixed modeling) of person parameters in R; and, we perform a simulation study to evaluate the performance of our implementation of the models.

Improved resilience following digital cognitive behavioral therapy for insomnia protects against insomnia and depression one year later.

BACKGROUND: While the negative consequences of insomnia are well-documented, a strengths-based understanding of how sleep can increase health promotion is still emerging and much-needed. Correlational evidence has connected sleep and insomnia to resilience; however, this relationship has not yet been experimentally tested. This study examined resilience as a mediator of treatment outcomes in a randomized clinical trial with insomnia patients. METHODS: Participants were randomized to either digital cognitive behavioral therapy for insomnia (dCBT-I; n = 358) or sleep education control (n = 300), and assessed at pre-treatment, post-treatment, and 1-year follow-up. A structural equation modeling framework was utilized to test resilience as a mediator of insomnia and depression. Risk for insomnia and depression was also tested in the model, operationalized as a latent factor with sleep reactivity, stress, and rumination as indicators (aligned with the 3-P model). Sensitivity analyses tested the impact of change in resilience on the insomnia relapse and incident depression at 1-year follow-up. RESULTS: dCBT-I resulted in greater improvements in resilience compared to the sleep education control. Furthermore, improved resilience following dCBT-I lowered latent risk, which was further associated with reduced insomnia and depression at 1-year follow-up. Sensitivity analyses indicated that each point improvement in resilience following treatment reduced the odds of insomnia relapse and incident depression 1 year later by 76% and 65%, respectively. CONCLUSIONS: Improved resilience is likely a contributing mechanism to treatment gains following insomnia therapy, which may then reduce longer-term risk for insomnia relapse and depression.

Firearm homicides among hispanics and white non-hispanics: measuring disparities.

Firearm homicides are increasing in the United States, and firearm homicides are a critical driver of racial health disparities. One such disparity that has received limited attention is excess firearm homicides among Hispanics, relative to White Non-Hispanics; comprehensively characterising this disparity is the purpose of this brief report. Using data from CDC WONDER, we examined temporal trends (2012-2021) in firearm homicide rate disparities between Hispanics and White Non-Hispanics in the U.S. Focusing on recently elevated rates (2018-2021), we estimated this disparity across demographics (gender, age, urbanicity, and race), and across U.S. states. These data clearly show nearly universal excess firearm homicide among Hispanics, relative to White Non-Hispanics, with larger differences among men, younger age groups, and in metropolitan areas. Similarly, nearly all states show higher rates of firearm homicide among Hispanics, relative to White Non-Hispanics, though the magnitude of the difference varies substantially.

Family functioning within the context of families with adolescent children in urban India.

Research on family functioning within given cultural contexts is needed. This study aims to describe salient dimensions of family functioning in two urban contexts in India and to examine differences in family functioning by sociodemographic groups. We measured differences in family functioning using cross-sectional survey questionnaire data collected from 13 to 15-year-old adolescents and one of their parents/primary caregivers in Mumbai (n = 843) and Kolkata (n = 913) during 2019-2020. We drew a multi-stage sample representative of neighborhoods and households in both cities. We assessed a multi-dimensional family functioning latent factor that included parent-reported measures (parent-adolescent communication, family cohesion, and parent monitoring of peers) and adolescent-reported measures (parent support, family cohesion, and parent supervision). Our results support an overall measure of family functioning manifested by multiple dimensions for parent- and adolescent-reported data. Families with male adolescents had worse adolescent-reported family functioning in Mumbai and parent-reported family functioning in Kolkata. Higher socioeconomic status was associated with better parent-reported family functioning in both cities and better adolescent-reported family functioning in Kolkata. Muslim religious identification in Kolkata and the Hindi native language in both cities were associated with better adolescent-reported family functioning. Our findings indicate heterogeneity in family functioning across demographic and social-cultural groups within the two urban contexts of India. This study may inform the development of culturally congruent prevention interventions for families with adolescents in India.

Neighbourhood tobacco retail access and tobacco use susceptibility in young adolescents in urban India.

BACKGROUND: Neighbourhood tobacco retail access may influence adolescent tobacco use. In India, we examined the association between neighbourhood tobacco retail access and cognitive risks for tobacco use during early adolescence. METHODS: In 2019-2020, a population-based sample (n=1759) of adolescents aged 13-15 years was surveyed from 52 neighbourhoods in Mumbai and Kolkata. Neighbourhood tobacco retail access was measured as the frequency of visits to tobacco retailers, mapped tobacco retailer density and perceived tobacco retailer density. We estimated associations between neighbourhood tobacco retail access and cognitive risks for tobacco use (perceived ease of access to tobacco, perceived peer tobacco use and intention to use tobacco). RESULTS: There was high neighbourhood tobacco retail access. Tobacco retailer density was higher in lower income neighbourhoods (p<0.001). Adolescent frequency of tobacco retailer visits was positively associated with cognitive tobacco use risks. Mapped tobacco retailer density was associated with perceived ease of access in Kolkata but not in Mumbai, and it was not associated with perceived peer tobacco use nor intention. Perceived tobacco retailer density was associated with perceived ease of access and perceived peer use, but not with intention. In Kolkata, higher perceived retailer density and frequency of tobacco retailer visits were negatively associated with perceived ease of access. CONCLUSIONS: Efforts to reduce neighbourhood tobacco retail access in India may reduce cognitive tobacco use risk factors in young adolescents. The frequency of tobacco retailer visits and perceived tobacco retailer density increased cognitive risks, though there were some exceptions in Kolkata that further research may explain.

Misuse of Prescription Medications among Individuals with Mobility Disability.

BACKGROUND: The ability of walking a quarter mile is predictive of subsequent disability, mortality, and health care costs. Individuals with mobility disability are at increased risk of chronic conditions and unmet care needs. Thus they may misuse prescription medications to self-medicate. OBJECTIVES: We aimed to explore the difference of misuse of four types of prescription medications (sedatives, tranquilizers, painkillers, depression medications) and overall misuse by mobility status and identify the correlates of overall misuse. METHODS: A national probability sample from the survey Midlife in the United States (MIDUS) was used to assess the difference in misuse by mobility status during 2011-2014. To assess the correlates of misuse, mobility status, usual source of care, unmet care needs, insurance coverage, sociodemographic variables, and clinical conditions were added to a survey weighted logistic regression model with backward selection. RESULTS: Compared to those without mobility disability, individuals with mobility disability had higher risk of misuse in most types of medications and in overall misuse. Mobility disability, lower education, unmarried status, the emergency room or public health clinic as the most often used care, pain, and depressed affect were identified as correlates of overall misuse of studied medications. CONCLUSIONS: Individuals with mobility disability are a vulnerable group susceptible to medication misuse, which warrants the urgent need for interventions to ameliorate misuse and reduce risks in this population.

Adolescent Exposure to Violence and Intimate-Partner Violence Mediated by Mental Distress.

Adolescent exposure to violence (ETV) is associated with multiple negative health outcomes. Despite evidence linking adolescent ETV with later experiences of physical, sexual and psychological intimate partner violence (IPV) victimization, more longitudinal evidence is needed, and potential explanatory mechanisms should be tested. We examine data collected over 17 years to analyze the mediating effects of mental distress and substance use on the association between cumulative ETV in adolescence and IPV in adulthood. Adolescent (M ages=15-18 years) ETV was associated with IPV outcomes in adulthood (M age=32 years). In parallel mediation models, mental distress in emerging adulthood (M ages=20-23 years) fully mediated the effect of adolescent ETV on later IPV outcomes. Although substance use predicted experience of IPV, it did not mediate the association between ETV and IPV. These findings have implications for understanding trajectories of risk following violence exposure and inform intervention work through identifying developmental periods where ETV contributes to later IPV victimization.

Longitudinal pathway from violence exposure to firearm carriage among adolescents: The role of future expectation.

INTRODUCTION: Exposure to violence is a risk factor for firearm carriage. Youth exposed to violence also have difficulty envisioning positive future outcomes (e.g., educational outcomes), which can increase the likelihood of firearm carriage over time. Researchers, however, have not yet examined whether changes in exposure to violence over time can influence the developmental trajectories of firearm carriage. To address this gap, we (1) examined the longitudinal association between exposure to violence and firearm carriage (grades 9 to 12) and then (2) examined whether changes in future expectations mediated this longitudinal association. METHOD: The longitudinal association between exposure to violence and firearm carriage through future expectations was examined among 850 adolescents from the Flint Adolescent Study. Participants were recruited from four high schools in a midwestern city in the United States. Parallel latent growth models and latent growth mediation models were estimated. RESULTS: A positive association was observed between the rate of change in exposure to violence and firearm carriage. Exposure to violence also indirectly increased the risk for firearm carriage over time by decreasing future expectation in the 9th grade. CONCLUSIONS: Our results support the idea that helping youth develop positive attitude about educational success may help reduce firearm carriage. Increasing positive expectations about future may help prevent firearm carriage within the context of violence exposure.

Aggressive-Depressive Trajectories in Childhood and Their Associations with Drinking Behaviors and Problems in Adolescence and Emerging Adulthood.

Research indicates that externalizing and internalizing pathways emanated in childhood are connected to later drinking behaviors; however, no study has investigated the contemporaneous effects of the two pathways using a person-centered approach that categorizes individuals based on their various developmental patterns. This study examined the distinct patterns of concurrent development of aggression and depressive symptoms in childhood and their associations with later drinking behaviors using data from a 15-year Taiwanese cohort since age 8 (N = 2854, 49% females). Group-based multi-trajectory modeling identified four aggressive-depressive trajectory groups: Moderate, Aggressive, Depressive, and Comorbid, which manifested a sequential risk gradient in alcohol use. Comorbid group, characterized by persistently high levels of aggression and depressive symptoms, has the highest levels of alcohol use and drinking problems and the earliest onset of drinking. Aggressive and Depressive groups have higher levels of alcohol use and earlier onset of drinking than Moderate group. These findings imply the importance of monitoring aggression and depressive symptoms simultaneously and continually in childhood to prevent later drinking.

Compliance with point-of-sale tobacco control policies and student tobacco use in Mumbai, India.

BACKGROUND: We measured how student tobacco use and psychological risk factors (intention to use and perceived ease of access to tobacco products) were associated with tobacco vendor compliance with India's Cigarettes and Other Tobacco Products Act provisions regulating the point-of-sale (POS) environment. METHODS: We conducted a population-based cross-sectional survey of high school students (n=1373) and tobacco vendors (n=436) in school-adjacent communities (n=26) in Mumbai, India. We used in-class self-administered questionnaires of high school students, face-to-face interviews with tobacco vendors and compliance checks of tobacco POS environments. Logistic regression models with adjustments for clustering were used to measure associations between student tobacco use, psychological risk factors and tobacco POS compliance. RESULTS: Compliance with POS laws was low overall and was associated with lower risk of student current tobacco use (OR 0.48, 95% CI 0.26 to 0.91) and current smokeless tobacco use (OR 0.40, 95% CI 0.21 to 0.77), when controlling for student-level and community-level tobacco use risk factors. Compliance was not associated with student intention to use tobacco (OR 0.50; 95% CI 0.21 to 1.18) and perceived ease of access to tobacco (OR 0.73; 95% CI 0.53 to 1.00). CONCLUSIONS: Improving vendor compliance with tobacco POS laws may reduce student tobacco use. Future studies should test strategies to improve compliance with tobacco POS laws, particularly in low-income and middle-income country settings like urban India.

Violence Exposure and Sexual Risk Behaviors for African American Adolescent Girls: The Protective Role of Natural Mentorship and Organizational Religious Involvement.

African American adolescent girls are at increased risk of being exposed to community violence and being diagnosed with a sexually transmitted infection. Fewer studies, however, have examined the protective roles of natural mentorship and organizational religious involvement as potential moderators that could lessen the effects of violence exposure on health risk behavior. Data from 273 African American ninth grade girls were used to test hypothesized independent and moderated-moderation models. Results suggest that natural mentorship and religious involvement were protective for girls who reported at least one mentor and moderate to high levels of religious involvement. Our findings may be relevant for community stakeholders and organizations that directly interact with religious institutions and community programs that focus on outreach to African American adolescent girls.

Perceived Peer Behavior and Parental Support as Correlates of Marijuana Use: The Role of Age and Gender.

INTRODUCTION: Parental support and perceptions of peer behavior on substance use are well-studied, but precisely how their associations vary as a function of age, and how those age-specific patterns vary by gender, remain unknown components of the developmental process underlying substance use. METHODS: Using data from an 18-year longitudinal study of predominantly African-American students at high-risk for high school dropout in Flint, Michigan (baseline average age = 14.8 years), we examined longitudinal associations between past 30-day marijuana use and three self-reported variables: perceived friend drug use, perceived friend aggression, parental support. We used varying-coefficient regression models to semiparametrically estimate how covariate effects on past 30-day marijuana use vary smoothly as a function of age; gender differences in these age-specific coefficient trajectories were also tested. RESULTS: In the unadjusted tests, the risk-enhancing effect of perceived friend drug use decreased with age in both genders, but the effect of perceived friend aggression varied only in females; in both cases, gender differences were not significant. In males, parental support had protective effects that decreased with age. The effect of both parental support differed in females, with less protective baseline effects and no evidence of age-variation. Adjusted models simultaneously including both friend and parental variables produced qualitatively similar results. CONCLUSIONS: Prevention strategies focusing on social exposures may be more effective if they are age- and gender-specific. In particular, interventions focusing on perceived peer behaviors may be more appropriate during adolescence, and those involving parental relationships may be more appropriate for males.

Racial discrimination and cortisol in African American emerging adults: The role of neighborhood racial composition.

OBJECTIVES: African American (AA) emerging adults may become more vulnerable to the consequences of racial discrimination (discrimination) as many begin to occupy racially mixed contexts. Little is known, however, about whether the effect of discrimination on cortisol concentration varies by neighborhood racial composition. We evaluated whether the percentage of White neighbors qualified the association between discrimination and overall cortisol concentration. METHOD: We used self-report data from the Flint Adolescent Study and block-level census data linked to the participant's home address. Our sample consisted of 241 AA emerging adults (56.8% Female; 19-22 year olds). We used multilevel regression analyses to evaluate whether the percentage of White neighbors modified the association between discrimination and overall cortisol concentration. RESULTS: Discrimination experienced in the past year, but not chronic discrimination was linked to lower cortisol concentrations among AA emerging adults living in neighborhoods with a high concentration of White neighbors. Specifically, past year discrimination was negatively associated among AAs residing in neighborhoods with 46.9% of White residents or higher. CONCLUSIONS: Our results lay the foundation for future research on racial health disparities by suggesting that contextual factors such as neighborhood racial composition can shape the influence race-based discrimination has on health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

More Than Just Keeping Busy: The Protective Effects of Organized Activity Participation on Violence and Substance Use Among Urban Youth.

Violence and substance use disproportionately affect African American youth in urban, disadvantaged communities. Expanding positive peer and adult connections is a mechanism by which organized activity participation may reduce risk of negative outcomes. We assessed if organized activity participation decreases the likelihood of later negative outcomes through expanding positive social connections using a parallel mediation model (Wave 1: N = 681; 50% female; Mage = 14.86 years; SD = 0.65). We found indirect effects from participation to cigarette use (b = -0.04, 95% CI: -0.07, -0.01) and violent behavior (b = -0.04; 95% CI: -0.07, -0.01) through positive peer connections. We did not find indirect effects through positive adult connections. This may be because of the notable influence of peers on negative outcomes during adolescence. Organized activities can help youth expand positive peer connections, which, in turn, reduces risk of later negative outcomes. Implications for prevention are discussed.

Cross-domain influences on youth risky driving behaviors: A developmental cascade analysis.

We apply a developmental cascade approach to study the longitudinal, cross-domain effects of negative family influence, deviant peer associations, and individual substance use on risky driving among a sample of low-income African American youth. Participants (N = 681) were followed from age 16 to age 21. Using structural equation modeling, we examined conceptual models of pathways to risky driving. Results indicated strong associations between domains within time points among negative family environment, deviant peer associations, individual substance use, and risky driving. Deviant peer associations were related to future risky driving. Alcohol and marijuana use also predicted later deviant peer relationships. The pathways were observed both between age 16 and 18 and between age 18 and 21. Consistent with the cascade hypotheses, we found that risks in one domain manifested as risks in the same domain across time in addition to spreading to other domains.

Family functioning and parent support trajectories and substance use and misuse among minority urban adolescents: a latent class growth analysis.

We sought to examine latent classes of family functioning and parent support trajectories during high school and whether these trajectories are associated with an increased risk of substance use and misuse among urban youth. A total of 850 adolescents (Mage = 15.1 years) were included in this study, assessed at baseline, 12-, 24-, and 36-months postbaseline, and completed self-report measures on past 30-day alcohol and marijuana use, binge drinking, and measures of family functioning and parent support. Latent class growth analysis revealed that trajectories of high family functioning and parent support are associated with a decreased risk of marijuana use. Findings may be helpful to inform family-based preventive interventions.

Positive Youth Development Approach to School Safety: A Comprehensive Conceptual Framework.

BACKGROUND: Youth violence, victimization, and bullying are pervasive in schools across the United States and are detrimental for learning and healthy development. K-12 school safety is an increasingly urgent issue to research and understand from multiple perspectives. Physical and psychological safety in school is linked to better student and school outcomes and is fundamental to fostering well-being and prosocial behavior. METHODS: Despite research demonstrating positive outcomes associated with school safety, there is no comprehensive conceptual model in the literature that considers precursors, strategies, mechanisms, and outcomes of school safety together. The current paper presents an equity-centered comprehensive model of school safety, which is intended as a holistic representation of the multiple factors and pathways that contribute to school safety and positive youth development. RESULTS: This model can guide research and practice through an equity-centered and comprehensive approach. This model can enable practitioners, researchers, and policymakers to make informed decisions and reach consensus regarding planning and decisions related to reducing violence and establishing supportive school environments. CONCLUSION: Our model suggests that a comprehensive approach can ensure the safety and well-being of students and staff. By thinking ecologically, schools, communities, and stakeholders can ensure that all aspects of the school context are included in school safety.

Understanding the Intersectionality of COVID-19 Racism, Mental Distress, Alcohol Use, and Firearm Purchase Behavior Among Asian Americans.

Firearm-related injuries are a major public health concern in the USA. Given the increased racism endured by Asian Americans during the COVID-19 pandemic, the current study aims to investigate the direct and indirect effects of racism, mental distress, and substance use on firearm purchase among Asian Americans. To fulfill this purpose, we collected data from a national sample of 916 Asian Americans in 2021. The study results showed that Asian Americans' racism experience is directly related to increased mental distress, substance abuse, and firearm purchase. Both mental distress and alcohol use were also linked to firearm purchase. It was found that racism links to more mental distress and increased alcohol use, which in turn link to increased firearm purchases. The findings add new information on how racism can have compounded effects on mental distress and alcohol use in addition to firearm-related risk behavior among Asian Americans and posing serious public health concerns.

Examining racism and firearm-related risks among Asian Americans in the United States during the COVID-19 pandemic.

Firearm-related injury is a major public health concern in the U.S. Experience of racism and discrimination can increase the risk of minority group members engaging in or being victims of firearm-related violence. Given the increased racism endured by Asian Americans during the COVID-19 pandemic, it is imperative to understand firearm-related behaviors in this population. The purpose of this study was to examine how Asian Americans' racism and discrimination experiences were related to firearm-related behaviors during the COVID-19 pandemic. Cross-sectional data were collected between December 2020 and January 2021 from a national sample of 916 Asian Americans. Measures included demographics, firearm-related risks, and three measures of racism/discrimination experiences since the start of the COVID-19 pandemic. Among individuals who purchased a gun since the start of the pandemic, 54.6% were first-time gun owners. Among household gun owners, 42.8% stored loaded guns and 47.1% stored guns unlocked. More than 38% of individual gun owners have carried a gun more frequently since the pandemic. After controlling for family firearm ownership and demographics, regression analyses showed that Asian Americans who experienced racial discrimination were more likely to purchase a gun and ammunition and intend to purchase more ammunition during the COVID-19 pandemic. AAs who perceived more cultural racism were more likely to purchase a gun. Individuals who reported higher anticipatory racism-related stress reported greater intent to purchase guns. Our findings suggest an urgent need to investigate further the compounded effects of racism, the COVID-19 pandemic, and firearm-related behaviors in this population.

Anonymous Reporting Systems for School-Based Violence Prevention: A Systematic Review.

IMPACT STATEMENT: Anonymous reporting systems (ARS) have been used as a violence prevention strategy in schools by providing a means for individuals within a school community to safely and securely report information about potential violence or concerns about mental health, for example, through an anonymous hotline or reporting app. Despite widespread implementation of ARS in schools, as well as mandates for reporting systems in schools in 21 states, there is limited evidence on the effectiveness of ARS for school violence prevention, and information about best practices for ARS implementation is lacking. This systematic review aims to summarize the current research on the effectiveness of ARS as a school safety and violence prevention strategy, which is an important step in building an evidence-base to guide schools and policymakers about best practices.