Engaging Young Black Males in Sexual and Reproductive Health Care: A Review of the Literature.

Young Black males (YBM) ages 18 to 24 years are more at risk of contracting sexually transmitted infections (STIs) and have a substantially greater need for sexual reproductive health (SRH) services than other groups. Despite this significant need, the extant literature does not provide a comprehensive picture of how YBM seek preventive care services (e.g., STI testing). Therefore, the purpose of this review is to address YBM's SRH access and use of STI/HIV testing and screening in this population, with a specific emphasis on young heterosexual Black males, by identifying barriers and facilitators of engaging with SRH care. An electronic search was performed using Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, PubMed, and Scopus online databases. Keywords were adapted to each database and included variations of "Black males," "sexual reproductive healthcare services," "youth (18-24 years old)," and "healthcare access and utilization." Studies from the review reported that barriers to engaging in SRH care included lack of health insurance, ideas of masculinity that conflict with SRH care, stigma related to accessing services, and lack of knowledge regarding available services and care options. The top facilitators for utilizing SRH care were engagement on behalf of health clinics, confidence gained from social support, access to quality health care in one's community, and trust in the health care system and providers. This review contributes to the current state of the science and is important to the improvement of high-quality services for this population, including respect, choice in care, confidentially, and compassion.

Nurse Leaders' Response to Civil Unrest in the Urban Core.

Inequalities in society, culture, and finance have resulted in civil unrest, rioting, and intentional violence throughout our history. Nowhere is this currently more apparent than in the cities of Ferguson and Baltimore. It is not the civil unrest itself, but the resulting rioting and intentional violence that can create a disaster situation. This increases the care burden of health care providers during times when the governmental structure may be overwhelmed or functioning in a less than optimal manner. Beginning with the death of Michael Brown, civil unrest over the last 2 years has necessitated a closer examination of the role nurse leaders play in preparing their staff and facilities for potential results of this civil unrest. The similarities between the results of rioting and violence and natural disaster are obvious, but the differences are significant. Without adequate preparation, providers may not offer the appropriate response. Attention to the 10 "musts" for preparedness for civil unrest will facilitate a planning process and provide for a better response and recovery when communities face these issues.

Childhood sexual abuse and two stages of cigarette smoking in African-American and European-American young women.

OBJECTIVE: The aim of the current study was to determine whether the higher rates of childhood sexual abuse (CSA) but lower rates of cigarette smoking in African-American vs. European-American women can be explained in part by a lower magnitude of association between CSA and smoking in African-American women. METHODS: Data were drawn from a same-sex female twin study of substance use (n=3521; 14.3% African-American). Cox proportional hazards regression analyses using CSA to predict smoking initiation and progression to regular smoking were conducted separately by race/ethnicity. Co-twin status on the smoking outcome was used to adjust for familial influences on smoking (which may overlap with family-level influences on CSA exposure). RESULTS: After adjusting for co-twin status, CSA was associated with smoking initiation in European Americans (hazard ratio (HR)=1.43, 95% confidence intervals (CI): 1.26-1.62) and with smoking initiation ≤16 in African Americans (HR=1.70, CI: 1.26-2.29). CSA was associated with regular smoking onset ≤15 in European Americans (HR=1.63, CI: 1.21-2.18), with no change in HR after adjusting for co-twin status. In the African-American subsample, the HR for CSA was reduced to non-significance after adjusting for co-twin status (from HR=3.30, CI: 1.23-8.89 to HR=1.16, CI: 0.71-1.92 for regular smoking ≤15). CONCLUSIONS: CSA is associated with moderate elevation in risk for initiating smoking among African-American and European-American women. By contrast, CSA is associated with elevated risk for (adolescent onset) regular smoking only in European-American women. Furthermore, there is significant overlap between risk conferred by CSA and familial influences on regular smoking in African-American but not European-American women.

Interim evaluation of a university-community collaboration to address methamphetamine use in a rural Missouri community.

BACKGROUND: Methamphetamine use remains a significant public health problem. A multifaceted problem requires a collaborative effort. OBJECTIVES: Community partners and university faculty collaborated to address meth use in a rural Missouri county. The objectives for this collaboration were to a) support current community partnerships by working with parents and teachers to incorporate a sustainable drug education curriculum in an elementary school and b) provide learning opportunities for senior nursing students. METHODS: Various strategies were used in the collaboration, including focus groups with school personnel and piloting the curriculum in a local school. RESULTS: Community members and university faculty worked together in all stages of the collaboration. The collaboration allowed the community to continue and expand its efforts in reducing methamphetamine use. Community and university team members are working together to expand the implementation in additional grades. CONCLUSIONS: A real-world community problem can be addressed through a university-community collaboration.

Motivators to engage in health promotion activities by low-income black fathers.

There has been increasing concern about the health status of low-income Black fathers. Little is known about their motivators to participate in health promotion activities. This descriptive qualitative research study explored these motivators. Focus groups were used to gather the data. Themes included avoiding specific diseases, helping others, a personal desire to learn, and modeling positive behaviors. These findings provide baseline data that might be used to develop community interventions targeting this group. Additional work will focus on validating these results and further exploration of some of the motivators verbalized by these participants.

Motivators and barriers to participating in health promotion behaviors in Black men.

There is limited research examining the health promotion behaviors (HPBs) of low-income Black men. This study examined the relationship between HPBs, and motivators and barriers to participating in these behaviors in Black men (N = 107), aged 21 to 56. Using descriptive statistics, more than 96% of the participants reported they were motivated because of the desire to be healthy. Canonical correlation analysis and conditional random forest were used to determine the importance of individual motivators and barriers. Canonical correlation analysis yielded one interpretable canonical variate that explained 39.5% of the variance in sets of motivators and barriers, and health promotion lifestyle variables. Men with fewer motivators and more barriers took less responsibility for their health, participated in less physical activity, and reported less spiritual growth. Having too many things to do and not knowing what to do best predicted participation in HPBs.

Health-related quality of life and health-promoting behaviors in black men.

This study examined the health-related quality of life and health-promoting behaviors in a convenience sample of low-income black men. Almost three-fourths reported their overall health as good or better. However, the mean number of recent (that is, past 30 days) mentally unhealthy days was 13.12, and more than half reported frequent (> or =14) mentally unhealthy days. There were strong correlations between mentally unhealthy days and various health-promoting behaviors. The contrast between participants' overall health and mental health is disconcerting. Implications for social work practice with low-income black men to improve health promotion are discussed.

Early drinking and its association with adolescents' participation in risky behaviors.

BACKGROUND: Adolescent alcohol use is a significant public health problem. Drinking before 13 years of age is correlated to the use of illicit drugs and other risky behaviors, such as cigarette smoking. OBJECTIVE: The purpose of this research was to examine the relationship between adolescents' early alcohol use and participation in risky behaviors such as smoking marijuana and cigarettes, as well as risky sexual behaviors. STUDY DESIGN: Respondents for this cross-sectional secondary analysis came from a sample of 809 racially diverse adolescents in a community-based study examining familial influences on offspring outcomes. RESULTS: Early-onset drinking, compared with nondrinking, was significantly related to participating in many of the risky behaviors. Many of the relationships persisted in the multivariable models that adjusted for demographic characteristics. CONCLUSIONS: Early drinking was associated with participation in various risky behaviors (e.g., multiple sexual partners, unprotected intercourse), which may negatively alter an adolescent's future. Screening should focus on the co-occurrence of such behaviors.

Neighborhood disorder, individual protective factors, and the risk of adolescent delinquency.

Traditionally, violent and delinquent behaviors have been addressed by the criminal justice system, with the focus being secondary and tertiary interventions. During the last decade, the focus on violence as a public health issue has increased. The purpose of this research was to examine how individual protective factors for adolescent delinquency varied according to neighborhood quality. The researcher conducted a secondary data analysis, using data from the National Youth Survey A total of 1,621 adolescents comprised the sample. The majority of the respondents participated in some type of delinquent behavior, with more Blacks reporting participation in violent behaviors. There was a positive relationship between academic history and no participation in delinquent behavior. The regression model for violent delinquency accounted for 10% of the variance in the disordered neighborhoods. Primary prevention efforts, commonly used by public health nurses, should be aimed at eliminating risk factors such as those found in disordered neighborhoods.