Preventing substance use among urban, African American youth: The potential of mentor-mentee conversations.

BACKGROUND: Early adolescence is a critical time for preventing substance use onset. Mentoring can help protect youth via social influence; however, little is currently known about direct mentor-mentee interactions around substance use. To investigate this topic, interviews were conducted with mentors to explore their comfort with, and perceived barriers and facilitators to, discussions about substance use with youth mentees. METHODS: Interviews were conducted with 26 adults serving as mentors to African American youth ages 12-14 in programs in the Baltimore/Washington, DC area. Themes were identified through qualitative analysis and pertained to comfort and engagement, commonly discussed topics, and barriers and facilitators. RESULTS: Although mentors expressed comfort with the idea of talking about substance use with their mentees, there also was an equally salient theme of having not actually done so beyond relatively cursory conversations. Salient expressed barriers to substance use discussions with mentees included fear of overstepping unclear boundaries in the mentor role and concern about having accurate information. Facilitators included training provided by programs, personal or familial experience with substance use, and concern with disparate legal ramifications for youth of color if caught in possession of, using, or selling drugs. Mentors also were in general agreement that a digital app could serve as a useful resource for discussing substance use with mentees. CONCLUSIONS: These results suggest mentors of urban youth of color may benefit from additional training and support for engaging them in discussions about substance use as well as useful topics to address in this regard.

Shift-and-persist coping and health among rural African American adolescents.

This study examines whether shift-and-persist coping, a coping strategy defined by accepting challenges and remaining hopeful for the future, is associated with psychosocial and physical health and/or moderates the effects of contextual stress (i.e., racial discrimination, financial strain) on health among African American adolescents living in the rural Southeastern United States. Participants (N = 299, 56% boys, Mage = 12.91) completed measures of shift-and-persist coping, contextual stress, and psychosocial and physical health. Shift-and-persist coping was generally associated with better health but did not buffer the effects of contextual stress. Results suggest that shift-and-persist coping may serve as a source of resilience among African American adolescents living in a context where many experience heightened contextual stress.

Strengths-Based Factors Related to Post-Traumatic Stress Problems in Black Youth with High Body Weights.

OBJECTIVE: Black youth with high body weights [BYHW; Body Mass Index (BMI)≥95th percentile] endure unique stressors (e.g., exposure to discrimination due to race and size) that may contribute to psychopathology. Factors that decrease mental health problems associated with these stressors have been underexamined in BYHW. The current study assessed how multisystemic resilience, weight-related quality of life (QOL), and discrimination were associated with post-traumatic stress problems in BYHW from the perspective of youth and their caregivers. METHODS: A total of 93 BYHW and one of their primary caregivers were recruited from a Midsouth children's hospital. Youth ranged in age from 11 to 17 years (Mage=13.94, SD = 1.89), were mostly girls (61.3%), and had CDC-defined BMI scores above the 95th percentile. Nearly all caregivers were mothers (91.4%; Mage=41.73 years, SD = 8.08). Youth and their caregivers completed measures of resilience, discrimination, weight-related QOL, and post-traumatic stress problems. RESULTS: Utilizing linear regression modeling, the youth model was significant [F(3, 89)=31.63, p<.001, Adj. R2=.50], with higher resilience (ß=-.23; p=.01) and lower discrimination (ß=.52; p<.001) associated with fewer post-traumatic stress problems. The caregiver regression model was also significant [F(2, 90)=10.45, p<.001, Adj. R2=.17], with higher weight-related QOL associated with lower post-traumatic stress problems (ß=-.37; p<.001). CONCLUSIONS: Findings illustrate differences in youth and caregiver perceptions of factors related to post-traumatic stress problems in BYHW. Youth emphasized both internal and external contributors to stress, while caregivers focused on internal variables. Such knowledge could be harnessed to develop strengths-based interventions that address health and well-being among BYHW.

Culture-Related Adaptive Mechanisms to Race-Related Trauma Among African American and US Latinx Youth.

African American and US Latinx families have faced over two centuries of systemic racism and discrimination, elevating risk for trauma, adversity, and disparities for their youth. These circumstances have compromised the health and well-being of many of these youth. However, many other African American and US Latinx youth are able to succeed despite these challenges. In recent years, scholars have begun to identify ways in which minoritized youth adapt and respond to adversity to become competent, well-functioning individuals. Drawing on two conceptual models of cultural resilience, one grounded in the study of African American youth and one grounded in the study of US Latinx youth, we summarize supportive research associated with each model. Using these conceptual models to guide our critical review of extant studies, we present an integrative review of work to guide the design of strength-based, cultural asset-centered research studies and preventive interventions targeting African American and US Latinx youth.

How Economic Stress Impacts Risky Sex among African American Adolescents.

Given the potential for unintended pregnancy and exposure to sexually transmitted infections, both of which can have long-term deleterious health consequences, the identification of predictors of adolescent risky sexual behavior remains an important line of inquiry. Although prior research has identified a variety of family and individual factors that are associated with risky sexual behavior, few studies have examined the role of family economic stress. The current study utilized three waves of data from a community sample of African American families with adolescents (N = 778, 54% girls, average age = 10.4 years old at Wave 1, 12.3 years old at Wave 2, 15.6 years old at Wave 3) to test the family stress model as an explanation of adolescent risky sexual behavior. Multi-group analyses examined gender differences in the family processes expected to link economic stress and risky sexual behavior. Unlike most studies utilizing this theoretical perspective, family structure was also taken into account. The results supported the propositions of the family stress model for boys and girls for both two-caregiver and single-mother households. Further, in single-mother households, maternal psychological distress continued to have a positive effect on adolescent risky sex even after taking into account the impact of parenting behaviors. Overall, the results suggest that economic stress ripples through the family system, increasing adolescent risky sexual behavior through its negative impact on family processes, highlighting the need for systemic policy changes rather than individual-level intervention/prevention efforts.

An Assessment of the Role of Parental Incarceration and Substance Misuse in Suicidal Planning of African American Youth and Young Adults.

Suicide rates among youth are increasing, and African American youth are becoming the most likely group to die by suicide in the USA. We utilized ecodevelopmental theory to investigate the relationship between parental incarceration and substance misuse and their association with suicidal planning in a sample of African American youth and young adults. Participants consisted of 190 African American youth and young adults living in public housing in a mid-Atlantic city in the USA who completed a youth health-risk behavior measure, and parental incarceration and substance misuse measures. Findings indicate males were significantly more likely than females to have devised a plan to die by suicide, especially if their mothers were incarcerated or their fathers had an alcohol problem. The findings of this study suggest several implications for health prevention and intervention efforts to reduce suicide-related risks among African American youth and young adults, including strategies that promote family-centered, evidence-based interventions that are culturally tailored to provide further insight into the best practices in suicide prevention.

Motivation to Move Out of the Community as a Moderator of Bullying Victimization and Delinquent Behavior: Comparing Non-Heterosexual/Cisgender and Heterosexual African American Adolescents in Chicago's Southside.

A growing body of research documents that bullying victimization is associated with delinquent behavior. There is an increasing need to better illuminate the factors that might moderate this relationship. This study examined whether the motivation to move out of low-resourced neighborhoods and sexual orientation/gender identity moderated the relationship between bullying victimization and delinquent behavior among a sample of 450 heterosexual and 91 non-heterosexual/cisgender African American youths. Measures considered were bullying victimization, delinquent behavior, sexual orientation/gender identity, motivation to move out, and family demographics. Sexual orientation/gender identity was not associated with youth delinquent behavior after controlling for covariates. Being motivated to move out moderated the association between bullying victimization and delinquent behavior. Sexual orientation/gender identity and being motivated to move out of low-resourced communities jointly contributed to the moderating effect between bullying victimization and delinquent behavior. For non-heterosexual/cisgender youth, bullying victimization is correlated with increased delinquent behavior for those with low motivation to move out of their communities compared with those with an average or higher level of motivation to stay. However, such a moderating effect was not shown for heterosexual youth.

"The Flow that Pushes you": Christocentric Reflections on the Compassion Expressed by African American Youths in Chicago Suffering Profound Disadvantage.

Youth beset by community violence, racism, and deep poverty experience profound suffering, and it is important to learn about their strengths to support them. To that end, we asked African American youths in Chicago what made social services provided to them by the Empowering Counseling Program meaningful to them. Their responses focused on the giving and receiving of compassion. To illuminate these youths' experiences, this study examines their understandings of compassion in light of scriptural references to compassion. In the Old Testament, compassion is a passionate, personal force and an essential virtue. Yahweh self-defines as the compassionate and merciful one. In the New Testament, compassion is the English translation of three different Greek words: splagchnizomai, eleos, and agape. Splagchnizomai signifies an inner experience of Jesus that compels him to heal, teach, and nourish people. Eleos refers to acts of mercy, a response to human sinfulness exemplified by Jesus' forgiveness, and is a capacity his followers must fulfill. Agape refers to God's nature, represented in Jesus, and is a potential in all persons. Themes that the scriptural references and the youths' data have in common are highlighted. In the narratives of both the youths and Scripture, compassionate responses address suffering and alienation with consolation, forgiveness, care, healing, and reconnection. Acts of compassion are to be extended to strangers as well as to friends and family and should always include respect for the autonomy and choices of others. Both the youths and Scripture regard compassion as a transforming liberation from stigma, social oppression, and terror, a life-giving process that brings hope and joy, and a commitment that endures across relationships and time.

Higher Diet Quality in African-American Adolescents Is Associated with Lower Odds of Metabolic Syndrome: Evidence from the NHANES.

BACKGROUND: Development of clinical risk factors linked to metabolic syndrome (MetS) in adolescence is associated with higher incidence of atherosclerotic cardiovascular events in adulthood. Given the increasing burden of obesity and MetS in African-American (AA) youth, there is a need to establish the relation of MetS with modifiable risk factors such as diet quality, because these data may enhance preventative and treatment approaches. OBJECTIVES: The purpose of this study was to assess diet quality, measured by the Alternative Healthy Eating Index 2010 (AHEI-2010) and the Dietary Approaches to Stop Hypertension (DASH) pattern score, in AA adolescents and youth (aged 12-21 y) from the NHANES, and to investigate the association of diet quality with MetS and its components. METHODS: This study is a cross-sectional analysis of NHANES data from the 2005-2016 cycles (n = 2459). Survey-weighted logistic regression models were used to assess the association of diet quality with the prevalence of MetS and individual cardiometabolic components [overweight/obesity, hypertensive blood pressure (BP), impaired fasting glucose, low HDL cholesterol, hypertriglyceridemia]. RESULTS: The mean ± SD AHEI-2010 score was 38.9 ± 9.7 and DASH pattern score was 21.8 ± 4.4, which is equivalent to 35% adherence to recommendations to achieve an optimal diet quality and 45% adherence to the DASH-style dietary pattern, respectively. Compared with those within the lowest quartile of DASH pattern score, individuals in the fourth quartile group had 0.63 (95% CI: 0.41, 0.97) times the odds of having hypertensive BP. Among individuals with complete clinical measures (n = 1007), individuals within the highest-quartile AHEI-2010 group had 0.25 (95% CI: 0.06, 0.99) times the odds of having MetS compared with those within the lowest quartile. CONCLUSIONS: Diet quality in US AA youth is low. Higher DASH pattern scores were associated with lower odds of hypertensive BP and higher AHEI-2010 scores were associated with lower odds of MetS.

Maternal caregiver's typologies and internalized behaviors in African American adolescents living in urban public housing.

AIMS: This study explores how variations in maternal caregiver types may be associated with adolescents' internalized behaviors (i.e., depressive symptoms) and resources (i.e., attitudes toward delinquent behaviors and efficacious beliefs). METHOD: Using a sample of 375 African American youth from public housing in three large US cities, we used Latent Profile Analysis to identify various maternal caregiver classes. Multinomial logistic regression analyses were conducted to assess whether youth can be correctly classified into maternal caregiver classes based on their internalized behaviors. RESULTS: Three maternal caregiver classes were identified. Results suggest youth living with high encouragement and high (supervision) maternal caregivers were associated with more conventional attitudes, higher self-efficacy, and lower depressive symptoms. CONCLUSION: Findings highlight how maternal caregivers can influence the internalizing behaviors of African American youth in US public housing. Individual, community, and system-level interventions can be leveraged to support the impact of these maternal caregivers.

Deeply Rooted: Maximizing the Strengths of a Historically Black University and Community-based Participatory Research to Understand Environmental Stressors and Trauma among Black Youth.

This paper explores a partnership between an HBCU (Historically Black Colleges and Universities) and a community to understand trauma given the high rates of reported violence among youth locally. The accumulative stress of living in high-stress, high-poverty environments coupled with the normative developmental tasks of adolescence is thought to place these youths at risk for negative mental and physical outcomes (Murry et al., 2011). The current research uses a community-based participatory research (CBPR) approach and developmental lens to better understand environmental stressors and subsequent trauma among Black youth. Specifically, the paper describes the recruitment, engagement, and equitable partnership between a youth advisory board (YAB), university research team, and community agencies advisory board (CAB). The current work is part of a larger research study designed to explore environmental stressors, coping, and social supports for Black youth residing in low-resource urban communities. The broad objective of the research is to develop a trauma-informed community intervention to improve adolescent mental health. The initial phase of this university-community research, which entails the YAB, CAB, and university discussion groups, is outlined in this paper. Community engagement and trust are key factors described in the literature when collaborating with communities of color. These themes were reiterated by research partners in this study. The research team created coding terms to identify themes from YAB and CAB transcript data, respectively. YAB themes regarding stressors centered around financial strain, anger, and loss/violence. CAB themes regarding adolescent mental health and resources centered around trauma, trust, and sustainability. Initial steps to utilize the themes identified thus far are described. The unique advantages of an HBCU and CBPR to address mental health disparities in ethnic minority communities are also highlighted.

A longitudinal examination of African American adolescent females detained for status offense.

INTRODUCTION: Behaviors like truancy, running away, curfew violation, and alcohol possession fall under the status offense category and can have serious consequences for adolescents. The Juvenile Justice and Delinquency and Prevention Act prohibited detaining status offenders. We explored the degree to which African American adolescent girls were being detained for status offenses and the connections to their behavioral health risks and re-confinement. METHODS: 188 African American girls (aged 13-17), recruited from detention facilities, were surveyed at baseline and 3-month follow-ups. Logistic regression models estimated the likelihood of longitudinal re-confinement, controlling for sexual and behavioral health risk factors. RESULTS: One third of the overall sample was detained for a status offense. Status offenders were exposed to higher peer risk profiles. At follow-up, nearly 39% of status offenders reported re-confinement. Compared to youth with other offenses, those who violated a court order (type of status offense) were 3 times more likely to be re-confined. Controlling for sexual and behavioral health risk factors, the odds of re-confinement was not statistically significant. CONCLUSION: Overall findings suggest that courts and detention facilities must devote specialized resources to addressing the socio-behavioral needs of African American girls with status offenses so as not to use detention as an intervention.

Daily multidimensional racial discrimination among Black U.S. American adolescents.

This study examined frequencies and psychological effects of daily racial discrimination experienced individually, vicariously, online, offline, and through teasing. Participants were 101 Black U.S. American adolescents for this ecological momentary assessment study that measured daily racial discrimination and 14-day depressive symptoms slopes. Confirmatory factor analyses specified subscales, t-test analyses compared subscale means, and hierarchical linear analyses tested associations between subscales and depressive symptoms slopes. Results showed that six subscales fit the data well: individual general, vicarious general, individual online, vicarious online, individual teasing, and vicarious teasing. Participants reported 5606 experiences of racial discrimination during the study and averaged 5.21 experiences per day across the six subscales. The two online subscales were more frequent than the offline subscales. Aside from online vicarious experiences, all subscales were positively associated with depressive symptoms slopes. Findings underscore the multidimensional, quotidian, and impactful nature of racial discrimination in the lives of Black adolescents in the U.S.

Understanding African American youth and adult perspectives on sex education in rural North Carolina.

African American youth in the US rural South are at elevated risk for poor sexual health outcomes, including sexually transmitted infections and teen pregnancy. Historically, the southeastern USA has lagged behind in providing comprehensive sexuality-based education in secondary school, which may contribute to poor reproductive and sexual health outcomes. This study aims to understand the perspectives of African American youth and adults on comprehensive sexuality-based education in rural North Carolina. Twenty-four individuals (12 youth and 12 adults) participated in both semi-structured interviews and small discussion groups. Data were analysed and coded using inductive and deductive approaches to thematic analysis. Results indicated that comprehensive sexuality-based education was highly desirable; however, current efforts were viewed as insufficient. While both young people and adults agreed that abstinence was the most desirable path for youth, participants also acknowledged young people's autonomy in engaging in sexual activity and suggested that comprehensive sexuality-based education was needed to protect against unintended consequences. The findings of this study have practical implications for addressing challenges associated with providing sexuality-based education to African American youth in rural communities and offers suggestions regarding directions for future research.

Maltreatment timing, HPA axis functioning, multigenic risk, and depressive symptoms in African American youth: Differential associations without moderated mediation.

Utilizing a large (N = 739), ancestrally homogenous sample, the current study aimed to better understand biological risk processes involved in the development of depressive symptoms in maltreated, African American children age 8-12 years. Maltreatment was independently coded from Child Protective Services records and maternal report. Self-reported depressive symptoms were attained in the context of a week-long, summer research camp. DNA was acquired from buccal cell or saliva samples and genotyped for nine polymorphisms in four hypothalamic-pituitary-adrenal (HPA)-axis-related genes: FKBP5, NR3C1, NR3C2, and CRHR1. Salivary cortisol samples were collected each morning (9 a.m.) and late afternoon (4 p.m.) throughout the week to assess HPA functioning. Results revealed that experiences of maltreatment beginning prior to age 5 were most predictive of depressive symptoms, whereas maltreatment onset after age 5 was most predictive of HPA axis dysregulation (blunted daytime cortisol patterns). Multigenic risk did not relate to HPA functioning, nor did it moderate the relationship between maltreatment and HPA activity. There was no mediation of the relationship between maltreatment and depressive symptoms by HPA dysfunction. Results are interpreted through a developmental psychopathology lens, emphasizing the principle of equifinality while carefully appraising racial differences. Implications for future research, particularly the need for longitudinal studies, and important methodological considerations are discussed.

Parent perceptions of restrictive feeding on the relationship between youth BMI z-score and weight control behavior use in African American youth: A mediational study.

BACKGROUND: Children with higher body weights engage in more healthy weight control behaviors (HWCBs) and unhealthy weight control behaviors (UWCBs) compared to healthy weight peers. Parent restrictive feeding (parental attempts to limit what and how much children eat in an effort to manage youth weight) has also been associated with youth weight. However, there is limited research on parental feeding practices among non-Caucasian samples, despite evidence that parental feeding may function differently across races. Therefore, the current study aimed to examine the mediating role of parent restrictive feeding on the relationship between youth body mass index (BMI) z-score and youth use of HWCBs and UWCBs among African American youth. METHODS: Measures were completed by youth (ages 10-13 years) and their parents at a pediatric primary-care appointment. Youth completed a weight control behavior questionnaire asking youth to answer whether or not they have engaged in specific behaviors to lose weight. Parents completed a questionnaire on parent-feeding practices. Youth height and weight were obtained from their medical records. RESULTS: Mediation models revealed parent restrictive feeding significantly mediated the relationship between youth BMI z-score and HWCB use, but not between youth BMI z-score and UWCB use. CONCLUSION: Results from the current study suggest parent restrictive feeding in African American populations may encourage health promoting youth weight management behaviors. Additional research is warranted to investigate how cultural factors may impact the relationships between parent restrictive feeding practices and youth weight control behaviors as there may be important clinical implications when working with diverse populations.

Gender-Typed Personality Qualities and African American Youth's School Functioning.

Numerous studies document sex differences in African American girls' and boys' academic achievement and motivation, but little is known about how the enactment of gender, such as in the forms of gendered behaviors, attitudes, or personal-social qualities, is related to school functioning. To advance understanding of African American adolescents' academic experiences, this study examined the longitudinal linkages between stereotypically feminine (i.e., expressive) and stereotypically masculine (i.e., instrumental) personality characteristics and school adjustment. The moderating effects of youth's ethnic identity and school racial composition also were tested. Participants were 352 African American youth (50.1% girls; mean age at Time 1 = 12.04 years; SD= 2.03) who participated in annual home interviews. Net of biological sex, expressive traits (kind, sensitive) were positively related to school self-esteem and school bonding for both girls and boys, but youth with higher levels of instrumentality (independent, competitive) exhibited sharper declines in academic achievement across adolescence. School racial composition moderated the effects of instrumentality at the between-person level, such that instrumentality was positively related to school self-esteem only for youth who attended schools with fewer African American students. These results highlight the importance of incorporating gendered personality traits, rather than biological sex alone, into theoretical accounts of African American youth's school functioning.

Impact of Prosocial Behavioral Involvement on School Violence Perpetration Among African American Middle School and High School Students.

The purpose of this study was to examine factors associated with school violence perpetration among African American youth. African American students in 7th through 12th grade (n = 7488) in schools within one Metropolitan area completed the Pride National Drug Survey. Chi square analyses revealed school violence perpetration significantly differed based on grade and prosocial behavioral involvement. Students in 7th-8th grade (54.7%) were more likely to engage in school violence in comparison to 9th-12th grade students (48.8%). Students with low prosocial behavior (52.8%) involvement were more likely than their counterparts (48.9%) to engage in school violence perpetration. Logistic regression also indicated females and 9th-12th students with low prosocial behavior involvement were significantly less likely than their counterparts to engage in school violence. Findings should be considered by health educators and prevention specialists when developing programs and efforts to prevent in school violence perpetration among African American students.

Moving Beyond Age: An Exploratory Qualitative Study on the Context of Young African American Men and Women's Sexual Debut.

African American youth continue to be disproportionately affected by HIV. Early sexual debut has been identified as a major determinant of HIV risk. However, emerging research suggests that the overarching context in which first sex occurs may have greater implications for sexual health than simply age alone. The purpose of this exploratory, qualitative study was to better understand the broader context of African Americans' sexual debut. In-depth, semi-structured interviews were conducted with 10 African American men and women aged 18-24 years. Thematic analysis was used to analyze the data. The mean age at sexual debut for the sample was 15.4 (SD = 3.3), and youth framed their sexual debut as positive (50%), negative (30%), and both positive and negative (20%). The majority of youth initiated pre-sex conversations with their partners to gauge potential interest in engaging in sexual activity, and all youth utilized at least one HIV/sexually transmitted infection and pregnancy prevention method. However, most youth failed to talk to their partners prior to sex about their past sexual histories and what the experience meant for their relationship. Key differences emerged between youth who framed the experience as positive and those who framed the experience as negative or both positive and negative in terms of their motivations for initiating sex (i.e., readiness to initiate sex, pressure, and emotionally safety) and post-sex emotions (i.e., remorse and contentment). Findings provide further support for examining the broader sexual context of African American's sexual debut. A more comprehensive understanding of sexual debut will aid in the development and tailoring of sexual risk reduction programs targeting African American youth.

Testing three pathways to substance use and delinquency among low-income African American adolescents.

OBJECTIVE: Mounting literature suggests that parental monitoring, risky peer norms, and future orientation correlate with illicit drug use and delinquency. However, few studies have investigated these constructs simultaneously in a single statistical model with low income African American youth. This study examined parental monitoring, peer norms and future orientation as primary pathways to drug use and delinquent behaviors in a large sample of African American urban adolescents. METHODS: A path model tested direct paths from peer norms, parental monitoring, and future orientation to drug use and delinquency outcomes after adjusting for potential confounders such as age, socioeconomic, and sexual orientation in a sample of 541 African American youth. RESULTS: Greater scores on measures of risky peer norms were associated with heightened risk of delinquency with an effect size that was twice in magnitude compared to the protective effects of future orientation. Regarding substance use, greater perceived risky peer norms correlated with the increased likelihood of substance use with a standardized effect size 3.33 times in magnitude compared to the protective effects of parental monitoring. CONCLUSIONS: Findings from this study suggest that interventions targeting risky peer norms among adolescent African American youth may correlate with a greater impact on reductions in substance use and delinquency than exclusively targeting parental monitoring or future orientation.