Demographic and sociocultural risk factors for adulthood weight gain in Hispanic/Latinos: results from the Hispanic Community Health Study / Study of Latinos (HCHS/SOL).

BACKGROUND: United States (US) Hispanic/Latinos experience a disproportionate burden of obesity, which may in part be related to demographic or sociocultural factors, including acculturation to an US diet or inactive lifestyle. Therefore, we sought to describe the association between adulthood weight histories and demographic and sociocultural factors in a large diverse community-based cohort of US Hispanic/Latinos. METHODS: We estimated the effect of several factors on weight gain across adulthood, using multivariable linear mixed models to leverage 38,759 self-reported current body weights and weight histories recalled for 21, 45 and 65 years of age, from 15,203 adults at least 21 years of age at the baseline visit of the Hispanic Community Health Study/Study of Latinos (2008-2011). RESULTS: The average rate of weight gain was nearly 10 kg per decade in early adulthood, but slowed to < 5 kg a decade among individuals 60+ years of age. Birth cohort, gender, nativity or age at immigration, Hispanic/Latino background, and study site each significantly modified the form of the predicted adulthood weight trajectory. Among immigrants, weight gain during the 5 years post-migration was on average 0.88 kg (95% CI: 0.04, 1.72) greater than the weight gain during the 5 years prior. The rate of weight gain appeared to slow after 15 years post-migration. CONCLUSIONS: Using self-reported and weight history data in a diverse sample of US Hispanic/Latinos, we revealed that both demographic and sociocultural factors were associated with the patterning of adulthood weight gain in this sample. Given the steep rate of weight gain in this population and the fact that many Hispanic/Latinos living in the US immigrated as adults, efforts to promote weight maintenance across the life course, including after immigration, should be a top priority for promoting Hispanic/Latino health and addressing US health disparities more broadly.

Testing the Nurturing Environments Framework on Youth Violence across Ethnically and Geographically Diverse Urban and Rural Samples of Adolescents.

Although research advocates for comprehensive cross sector youth violence prevention efforts, mobilizing across sectors to translate scientific recommendations into practice has proven challenging. A unifying framework may provide a foundational step towards building a shared understanding of the risk and protective factors that impact youth violence. We conducted two empirical tests of the nurturing environment framework on youth violence across ethnic and geographically diverse rural and urban adolescent samples. Results show that overall the characteristics of nurturing environments are associated with lower levels of aggression and violence. In addition, minimizing exposure to socially toxic conditions had the strongest associations with lower aggression and violence. Findings were supported across both samples, suggesting that this framework may apply in urban and rural, economically disadvantaged contexts.

Assessment of adolescent optimism: Measurement invariance across gender and race/ethnicity.

INTRODUCTION: Optimism is viewed as an important resource for resilience and is associated with various wellbeing outcomes, yet few measures of optimism have been validated for use with adolescents. The aim of this study was to (a) test the factor structure invariance of the School Success Profile Success Orientation scale across gender and four racial/ethnic groups and (b) estimate group-level differences in optimism. METHODS: Data from a diverse sample of adolescents (N = 2063; mean 12.3 years; 52% female) from the southeastern United States were examined using multiple-group confirmatory factor analysis. Models for configural, metric, and scalar invariance were tested using WLSMV estimation in Mplus. RESULTS: Confirmatory factor analysis supported the hypothesized one-factor model and indicated scalar invariance across gender and the four racial/ethnic (i.e., African American, Caucasian, Hispanic/Latino, Native American) groups. Cross-group comparisons of latent factor means indicated statistically significant differences in self-reported optimism. Female respondents reported higher optimism than males. Among the four racial/ethnic groups, African American youth reported the highest optimism levels. Native American youth reported higher optimism than Caucasian and Hispanic/Latino youth. CONCLUSIONS: Results suggest the Success Orientation scale is appropriate for many assessment and evaluation purposes, including the assessment of optimism across gender and race/ethnicity and the investigation of substantive questions regarding cross-cultural differences in adolescents' expectations of the future.

Parenting Wisely Six Months Later: How Implementation Delivery Impacts Program Effects at Follow-Up.

We evaluated the effectiveness of the Parenting Wisely (PW) program 6 months post intervention and assessed differences based on delivery format. Using a quasi-experimental design, parents (N = 311) participated in the PW program in one of five formats (i.e., parents-only intensive workshop, parents-only 5-week group, parents and adolescents 5-week group, parent and adolescent online, and parent-only online format). An additional 53 parents served as a comparison group. We used the McMaster Family Assessment Device, the Child Behavior Checklist, and the Violent Behavior Checklist to measure family functioning, parenting, and adolescent behavior. Relative to the comparison group, at 6 month follow-up parents who participated in PW reported increases in confidence in their parenting skills, decreases in conflicts with their adolescents, and decreases in adolescent externalizing and violent behavior. Mechanisms of change analyses supported the conceptual model that program effects were related to child behavior changes by influencing positive parenting and decreasing negative family dynamics. PW effectiveness did not vary substantially by delivery format, except for the intensive workshop format, which was less effective than other formats. These findings extend research on PW to include evidence of sustained program effects on adolescent externalizing and violent behaviors in an ethnically diverse, socioeconomically disadvantaged sample. Study findings are relevant to agencies and clinicians who are seeking to implement an evidence-based, flexible parent-training program.

Accuracy of Self-reported Weight in Hispanic/Latino Adults of the Hispanic Community Health Study/Study of Latinos.

BACKGROUND: Previous US population-based studies have found that body weight may be underestimated when self-reported. However, this research may not apply to all US Hispanics/Latinos, many of whom are immigrants with distinct cultural orientations to ideal body size. We assessed the data quality and accuracy of self-reported weight in a diverse, community-based, US sample of primarily foreign-born Hispanic/Latino adults. METHODS: Using baseline data (2008-2011) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), we described the difference between contemporaneous self-reported and measured current body weight (n = 16,119) and used multivariate adjusted models to establish whether the observed trends in misreporting in potential predictors of inaccuracy persisted after adjustment for other predictors. Last, we described the weighted percentage agreement in body mass classification using either self-reported or measured weight (n = 16,110). RESULTS: Self-reported weight was well correlated with (r = 0.95) and on average 0.23 kg greater than measured weight. The range of this misreporting was large and several factors were associated with misreporting: age group, gender, body mass categories, nativity, study site by background, unit of self-report (kg or lb), and end-digit preference. The percentage agreement of body mass classification using self-reported versus measured weight was 86% and varied across prevalent health conditions. CONCLUSIONS: The direction of misreporting in self-reported weight, and thus the anticipated bias in obesity prevalence estimates based on self-reported weights, may differ in US Hispanic/Latinos from that found in prior studies. Future investigations using self-reported body weight in US Hispanic/Latinos should consider this information for bias analyses.See video abstract at, http://links.lww.com/EDE/B276.

Family dynamics and aggressive behavior in Latino adolescents.

OBJECTIVES: Despite high prevalence rates and evidence that acculturation is associated with adolescent behavioral and mental health in Latino youth, little research has focused on aggressive behavior for this population. The aim of the current study was to fill this research gap by examining the influence of several aspects of family functioning, including parent-adolescent conflict, parent worry, and parent marital adjustment, on aggression among Latino adolescents. METHOD: Data come from the Latino Acculturation and Health Project (LAHP), a longitudinal investigation of acculturation in Latino families in North Carolina and Arizona. Hierarchical linear modeling was used to estimate a longitudinal rater effects model of adolescent aggression as reported by 258 Latino adolescents each paired with 1 parent for a total of 516 participants across 4 time points over a span of 18 months. RESULTS: Results indicated a general decline in aggression over the study window. In addition, parent-adolescent conflict and parent worry predicted higher adolescent aggression whereas parent marital adjustment predicted lower adolescent aggression. CONCLUSIONS: The salience of family risk factors for aggression among Latino adolescents is discussed. (PsycINFO Database Record

An Investigation of Relational Risk and Promotive Factors Associated with Adolescent Female Aggression.

Despite growing trends in adolescent female aggression, much adolescent aggression research has focused on males to the exclusion of their female counterparts. Using relational-cultural and social role theories, the current study identifies the risk and promotive factors associated with adolescent female aggression. Using data from the Rural Adaptation Project (a 5 year longitudinal panel study of youth from two rural, ethnically diverse, low income counties in North Carolina), a 2-level hierarchical linear model was estimated (N = 3580). Internalizing symptoms, association with delinquent friends, peer pressure, and parent-child conflict emerged as risk factors whereas teacher support was a significant promotive factor. Results suggest that interventions should focus on negative relationships in both the parent and peer domains and underscore the need for mental health services for aggressive girls.

Negative Bystander Behavior in Bullying Dynamics: Assessing the Impact of Social Capital Deprivation and Anti-social Capital.

Bystanders witness bullying, but are not directly involved as a bully or victim; however, they often engage in negative bystander behavior. This study examines how social capital deprivation and anti-social capital are associated with the likelihood of engaging in negative bystander behavior in a sample (N = 5752) of racially/ethnically diverse rural youth. Data were collected using an online, youth self-report; the current study uses cross sectional data. Following multiple imputation, a binary logistic regression with robust standard errors was run. Results partially supported the hypothesis and indicated that social capital deprivation in the form of peer pressure and verbal victimization and anti-social capital in the form of delinquent friends, bullying perpetration, verbal perpetration, and physical perpetration were significantly associated with an increased likelihood of engaging in negative bystander behavior. Findings highlight the importance of establishing sources of positive social support for disenfranchised youth.

The Impact of Teen Court on Rural Adolescents: Improved Social Relationships, Psychological Functioning, and School Experiences.

Teen Court is a prevention program aimed at diverting first time juvenile offenders from the traditional juvenile justice system and reintegrating them into the community. Few studies have examined if Teen Court impacts adolescent functioning. We examined how Teen Court participation impacted psychosocial functioning, social relationships, and school experiences in a sample of 392 rural Teen Court participants relative to two comparison samples, one from the same county as Teen Court (n = 4276) and one from a neighboring county (n = 3584). We found that Teen Court has the potential to decrease internalizing symptoms, externalizing behavior, violent behavior, parent-adolescent conflict, and delinquent friends, and increase self-esteem and school satisfaction.

Multi-level risk factors and developmental assets associated with aggressive behavior in disadvantaged adolescents.

The current study examined multilevel risk factors and developmental assets on longitudinal trajectories of aggressive behavior in a diverse sample of rural adolescents. Using ecological and social capital theories, we explored the impact of positive and negative proximal processes, social capital, and contextual characteristics (i.e., school and neighborhood) on adolescent aggression. Data came from the Rural Adaptation Project, which is a 5-year longitudinal panel study of more than 4,000 middle and high school students from 40 public schools in two rural, low income counties in North Carolina. A three-level HLM model (N = 4,056 at Wave 1, 4,251 at Wave 2, and 4,256 at Wave 3) was estimated to predict factors affecting the change trajectories of aggression. Results indicated that negative proximal processes in the form of parent-adolescent conflict, friend rejection, peer pressure, delinquent friends, and school hassles were significant predictors of aggression. In addition, social capital in the form of ethnic identity, religious orientation, and school satisfaction served as buffers against aggression. Negative proximal processes were more salient predictors than positive proximal processes. School and neighborhood characteristics had a minimal impact on aggression. Overall, rates of aggression did not change significantly over the 3-year study window. Findings highlight the need to intervene in order to decrease negative interactions in the peer and parent domains.

Longitudinal Risk and Protective Factors Associated with Internalizing and Externalizing Symptoms Among Male and Female Adolescents.

Using ecological theory and the peer socialization model, the current study identified risk and protective factors associated with internalizing and externalizing symptoms across ecological domains. It was hypothesized that the constellation of risk and protective factors within the peer microsystem would vary by gender: future optimism and negative peer influence were expected to be significant risk/protective factors for males, whereas peer victimization was expected to be significant risk factors among females. Using four waves of data, three-level hierarchical linear models were estimated for males and females. Results revealed that negative peer influence was a particularly salient risk factor for both internalizing and externalizing behaviors among males, although future optimism did not emerge as a significant protective factor. In addition, as hypothesized, peer victimization indicators were significant risk factors for females. Parent-child conflict was also significantly and positively associated with both internalizing and externalizing symptoms for males and females. Implications are discussed.

Perceived Peer Delinquency and Externalizing Behavior Among Rural Youth: The Role of Descriptive Norms and Internalizing Symptoms.

Little research has examined the way in which perceptions of peer behavior (i.e., descriptive norms) influence externalizing behavior among rural adolescents. Using a social norms framework, the current study examined gender differences in the relationship between perceived delinquency among friends and externalizing behavior in a sample of rural adolescents. Based on previous research, the authors proposed that adolescents experience negative emotional responses when they believe that their peers are engaging in delinquency, which subsequently influences externalizing behavior. Consequently, internalizing symptoms were explored as a mediator of the relationship between perceived friend delinquency and externalizing behavior. Data came from the NC-ACE Rural Adaptation Project, a longitudinal panel study of adolescents in two rural, economically disadvantaged counties with exceptional racial/ethnic diversity (29 % White, 25 % African American, 25 % American Indian, 12 % Mixed Race/Other, 9 % Hispanic/Latino). Using multiple group structural equation modeling (N = 3489; 51 % female), results indicated that perceived friend delinquency was significantly related to externalizing behavior and this relationship did not vary by gender. Internalizing symptoms fully mediated the relationship between perceived friend delinquency and externalizing behavior and the path between perceived friend delinquency and internalizing symptoms was stronger for males. Implications of these relationships for prevention and intervention programming for externalizing behavior were highlighted.

Constructing "Packages" of Evidence-Based Programs to Prevent Youth Violence: Processes and Illustrative Examples From the CDC's Youth Violence Prevention Centers.

This paper describes the strategic efforts of six National Centers of Excellence in Youth Violence Prevention (YVPC), funded by the U.S. Centers for Disease Control and Prevention, to work in partnership with local communities to create comprehensive evidence-based program packages to prevent youth violence. Key components of a comprehensive evidence-based approach are defined and examples are provided from a variety of community settings (rural and urban) across the nation that illustrate attempts to respond to the unique needs of the communities while maintaining a focus on evidence-based programming and practices. At each YVPC site, the process of selecting prevention and intervention programs addressed the following factors: (1) community capacity, (2) researcher and community roles in selecting programs, (3) use of data in decision-making related to program selection, and (4) reach, resources, and dosage. We describe systemic barriers to these efforts, lessons learned, and opportunities for policy and practice. Although adopting an evidence-based comprehensive approach requires significant upfront resources and investment, it offers great potential for preventing youth violence and promoting the successful development of children, families and communities.

The effects of positive and negative parenting practices on adolescent mental health outcomes in a multicultural sample of rural youth.

The quality of parent-child relationships has a significant impact on adolescent developmental outcomes, especially mental health. Given the lack of research on rural adolescent mental health in general and rural parent-child relationships in particular, the current longitudinal study explores how rural adolescents' (N = 2,617) perceptions of parenting practices effect their mental health (i.e., anxiety, depression, aggression, self-esteem, future optimism, and school satisfaction) over a 1 year period. Regression models showed that current parenting practices (i.e., in Year 2) were strongly associated with current adolescent mental health outcomes. Negative current parenting, manifesting in parent-adolescent conflict, was related to higher adolescent anxiety, depression, and aggression and lower self-esteem, and school satisfaction. Past parent-adolescent conflict (i.e., in Year 1) also positively predicted adolescent aggression in the present. Current positive parenting (i.e., parent support, parent-child future orientation, and parent education support) was significantly associated with less depression and higher self-esteem, future optimism, and school satisfaction. Past parent education support was also related to current adolescent future optimism. Implications for practice and limitations were discussed.

Prosocial Bystander Behavior in Bullying Dynamics: Assessing the Impact of Social Capital.

Individuals who observe a bullying event, but are not directly involved as a bully or victim, are referred to as bystanders. Prosocial bystanders are those individuals who actively intervene in bullying dynamics to support the victim and this prosocial behavior often ends the bullying. The current study examines how social capital in the form of social support, community engagement, mental health functioning, and positive school experiences and characteristics is associated with the likelihood of engaging in prosocial bystander behavior in a large sample (N = 5752; 51.03% female) of racially/ethnically diverse rural youth. It was hypothesized that social capital would be associated with an increased likelihood of engaging in prosocial bystander behavior. Following multiple imputation, an ordered logistic regression with robust standard errors was run. The hypothesis was partially supported and results indicated that social capital in the form of friend and teacher support, ethnic identity, religious orientation, and future optimism were significantly associated with an increased likelihood of engaging in prosocial bystander behavior. Contrary to the hypothesis, a decreased rate of self-esteem was significantly associated with an increased likelihood of engaging in prosocial bystander behavior. The findings highlight the importance of positive social relationships and community engagement in increasing prosocial bystander behavior and ultimately decreasing school bullying. Implications were discussed.

A Longitudinal Evaluation of the Positive Action Program in a Low-Income, Racially Diverse, Rural County: Effects on Self-Esteem, School Hassles, Aggression, and Internalizing Symptoms.

Positive Action is a school-based program that aims to decrease problem behaviors (e.g., violence, substance use) and increase positive behaviors (e.g., school engagement, academic achievement). Although a number of studies have shown that Positive Action successfully achieves these goals, few studies have evaluated the program's effectiveness in rural schools. Given that rural youth are at an increased risk for risky behaviors (e.g., violence, substance use), this is a critical gap in the existing Positive Action research base. The current study assesses the impact of Positive Action on change rates of self-esteem, school hassles, aggression, and internalizing symptoms in a group (N = 1246, 52% female) of ethnically/racially diverse (27% White, 23% African American, 12% mixed race/other, 8% Latino, 30% as American Indian) middle school youth (age range 9-20) located in two violent, low-income rural counties in North Carolina. One county engaged in Positive Action over the 3-year study window while the other county did not. Following multiple imputation and propensity score analysis, 4 two-level hierarchical linear models were run using each of the outcome measures as dependent variables. The results indicate that the program generates statistically significant beneficial effects for youth from the intervention county on self-esteem scores and school hassles scores. Although the program generates beneficial effects for intervention youth on the change in aggression scores, the finding is not statistically significant. The finding on the change in internalizing scores shows a non-significant detrimental effect: the youth from the comparison county have lower internalizing scores than those from the intervention county. Implications are discussed.

Familial influences on internalizing symptomatology in Latino adolescents: an ecological analysis of parent mental health and acculturation dynamics.

The aim of this study was to examine if family system dynamics (e.g., parent mental health, marriage quality, conflict, and cohesion) that have often been overlooked when studying Latino families play a more important role in predicting adolescent internalizing symptoms than acculturation processes. Data comes from the Latino Acculturation and Health Project, a longitudinal investigation of acculturation in Latino families in North Carolina and Arizona (Smokowski & Bacallao, 2006, 2010). Researchers conducted in-depth, community-based interviews with 258 Latino adolescents and 258 of their parents in metropolitan, small-town, and rural areas. Interviews were conducted at four time points at intervals of approximately 6 months. Parent and adolescent ratings of the adolescent's internalizing symptoms were used as the dependent variable in a longitudinal hierarchical linear model with a rater effects structure. Results showed that parent-adolescent conflict and parent mental health (fear/avoidance of social situations and humiliation sensitivity) were significant predictors of adolescent internalizing symptoms. Acculturation scales were not significant predictors; however, internalizing symptoms decreased with time spent in the United States. Females and adolescents from lower socioeconomic status families reported more internalizing symptoms, while participants who had been in the United States longer reported fewer internalizing symptoms. Implications were discussed.

Multilevel risk factors and developmental assets for internalizing symptoms and self-esteem in disadvantaged adolescents: modeling longitudinal trajectories from the Rural Adaptation Project.

The current study filled significant gaps in our knowledge of developmental psychopathology by examining the influence of multilevel risk factors and developmental assets on longitudinal trajectories of internalizing symptoms and self-esteem in an exceptionally culturally diverse sample of rural adolescents. Integrating ecological and social capital theories, we explored if positive microsystem transactions are associated with self-esteem while negative microsystem transactions increase the chances of internalizing problems. Data came from the Rural Adaptation Project, a 5-year longitudinal panel study of more than 4,000 middle school students from 28 public schools in two rural, disadvantaged counties in North Carolina. Three-level hierarchical linear modeling models were estimated to predict internalizing symptoms (e.g., depression, anxiety) and self-esteem. Relative to other students, risk for internalizing problems and low self-esteem was elevated for aggressive adolescents, students who were hassled or bullied at school, and those who were rejected by peers or in conflict with their parents. Internalizing problems were also more common among adolescents from socioeconomically disadvantaged families and neighborhoods, among those in schools with more suspensions, in students who reported being pressured by peers, and in youth who required more teacher support. It is likely that these experiences left adolescents disengaged from developing social capital from ecological microsystems (e.g., family, school, peers). On the positive side, support from parents and friends and optimism about the future were key assets associated with lower internalizing symptoms and higher self-esteem. Self-esteem was also positively related to religious orientation, school satisfaction, and future optimism. These variables show active engagement with ecological microsystems. The implications and limitations were discussed.

Ecological correlates of depression and self-esteem in rural youth.

The current study examines individual-, social-, and school-level characteristics influencing symptoms of depression and self-esteem among a large sample (N = 4,321) of U.S. youth living in two rural counties in the South. Survey data for this sample of middle-school students (Grade 6 to Grade 8) were part of the Rural Adaptation Project. Data were analyzed using ordered logistic regression. Results show that being female, having a low income, and having negative relationships with parents and peers are risk factors that increase the probability of reporting high levels of depressive symptoms and low levels of self-esteem. In contrast, supportive relationships with parents and peers, high religious orientation, ethnic identity, and school satisfaction increased the probability of reporting low levels of depressive symptoms and high levels of self-esteem. There were few school-level characteristics associated with levels of depressive symptoms and self-esteem. Implications are discussed.

Ethnic identity and mental health in American Indian youth: examining mediation pathways through self-esteem, and future optimism.

Mental health functioning in American Indian youth is an understudied topic. Given the increased rates of depression and anxiety in this population, further research is needed. Using multiple group structural equation modeling, the current study illuminates the effect of ethnic identity on anxiety symptoms, depressive symptoms, and externalizing behavior in a group of Lumbee adolescents and a group of Caucasian, African American, and Latino/Hispanic adolescents. This study examined two possible pathways (i.e., future optimism and self-esteem) through which ethnic identity is associated with adolescent mental health. The sample (N = 4,714) is 28.53% American Indian (Lumbee) and 51.38% female. The study findings indicate that self-esteem significantly mediated the relationships between ethnic identity and anxiety symptoms, depressive symptoms, and externalizing behavior for all racial/ethnic groups (i.e., the total sample). Future optimism significantly mediated the relationship between ethnic identity and externalizing behavior for all racial/ethnic groups and was a significant mediator between ethnic identity and depressive symptoms for American Indian youth only. Fostering ethnic identity in all youth serves to enhance mental health functioning, but is especially important for American Indian youth due to the collective nature of their culture.