Teasing and alcohol drinking among African American adolescents in Chicago's Southside: Implications for nursing practice.

OBJECTIVE: Guided by the routine activity theory, the current study proposes and tests pathways by which an absence of a capable guardian can contribute to interactions with motivated offenders and suitable targets, increasing the likelihood of teasing others and using alcohol. SAMPLE: The study participants consisted of 612 African American adolescents in four low-income neighborhoods in Chicago's Southside. MEASURES: Measures include alcohol use, absence of a capable guardian, the presence of a motivated offender, target suitability, and teasing. Covariates include age, biological sex, and government assistance. Analyses included descriptive statistics, correlation analysis, and structural equation modeling. RESULTS: The absence of a capable guardian variable positively correlated with the presence of a motivated offender. The presence of a motivated offender variable was positively associated with target suitability, which was positively related to teasing and alcohol use. The presence of a motivated offender and target suitability variables were positively associated with teasing and alcohol use. CONCLUSION: Findings highlight the importance of capable guardians and potentially have implications for nursing practice.

Does sexting predict sexual behaviors among adolescents? Gender and race effects.

INTRODUCTION: Sexting has emerged as a significant public health issue. Sexting is associated with substance use and other sexual behaviors, such as oral and vaginal sex (Houck et al., 2014; Temple & Choi, 2014). Current studies on sexting are often cross-sectional, limiting the ability to determine the temporal order of sexting and sexual behaviors. Additionally, studies focus on samples of young adults (Benotsch et al., 2013). The current study extends the literature by examining sexting and sexual behaviors longitudinally among adolescents and examines race and gender differences that play a role in sexting. METHODS: The current study utilizes a prospective, 4-year longitudinal study of 1240 adolescents (aged 11-17) living in the Midwestern United States. Overall, the sample was 10% Black males, 11% Black females, 34% White Males, 31% White females, and 15% identified as Other. Analysis includes an autoregressive model with cross-lagged effects in MPlus. RESULTS: Sexting (T1) predicted oral and sexual encounters (T4) for Black males, White males, and White females but not for Black females. Oral sex and sexual encounters (T4) did not predict any sexting (T1) for all groups. Therefore, analysis establishes sexting as an antecedent to sexual behaviors for Black males, White males, and White females. Sexting and sexual behaviors did not have a significant association for Black females. CONCLUSIONS: This study identifies sexting as a precursor to sexual behaviors among adolescents. Therefore, when tailoring programs for safe sex among these populations, focusing on sexting may reduce other sexual risky behaviors.

Attitudes about aggression and perpetration of Adolescent Dating Aggression: A cross-lagged panel model.

INTRODUCTION: Several cross-sectional and longitudinal studies have found associations between attitudes about aggression and aggressive behaviors. However, few studies examine all subtypes of Adolescent Dating Aggression (ADA)-physical, psychological/emotional, sexual, and stalking; occurring in person or electronically-and there is a paucity of longitudinal studies that follow adolescents over several years. METHODS: Middle school and high school students (N = 1240), in the Midwestern United States, participated in surveys one time per year for four years. Data from each year (Y1, Y2, Y3, & Y4) was used to conduct a cross-lagged panel analysis of attitudes about aggression and aggressive behaviors, among both cohorts. RESULTS: By Y4, approximately 46% of the middle school cohort and 60% of the high school cohort perpetrated some form of ADA. The cross-lagged panel analysis revealed significant cross-sectional associations in the middle school (Y1, Y2, & Y4) and high school (Y1 & Y2) cohorts. Aggressive behaviors were significantly associated with future aggressive behaviors for the middle and high school cohorts each year. Similarly, attitudes about aggression were significantly associated with attitudes in the following years for both cohorts. Among the middle school cohort, there were significant cross-lagged effects between aggressive behaviors in Y2 and attitudes about aggression in Y3, as well as aggressive behaviors in Y3 and attitudes about aggression in Y4. Among the high school cohort, a bidirectional association was found from Y2 to Y3. CONCLUSIONS: These findings suggest prevention programs should be implemented earlier, among middle school aged adolescents, and target factors beyond attitudes supporting aggression.

The influence of racial discrimination on smoking among young black men: A prospective analysis.

Racial discrimination is a documented risk factor for smoking among Black men; mechanisms of effect and protective processes remain to be investigated. This study examined the mediating effect of anger/hostility on the association between racial discrimination and smoking and the influence of protective social ties in buffering the effects of racial discrimination. Hypotheses were tested using longitudinal data from a study of 505 Black men ages 19-22. Data collected for the study occurred at three timepoints, each 12 months apart. Racial discrimination is associated with increases in cigarette smoking between baseline and follow-up. Anger/hostility partially mediated this association. Moderational analyses indicated that discrimination had little or no impact on men's smoking in the presence of protective social ties. Study findings suggest that supportive networks make crucial contributions to the reduction of cigarette smoking and feelings of anger within this population. Intervention developers should consider targeting relationship dynamics with supportive networks to understand coping mechanisms and to reduce substance use among young black men.

Racial Discrimination, Protective Processes, and Sexual Risk Behaviors Among Black Young Males.

Racial discrimination is a documented risk factor for sexual risk behaviors among young Black men. Mechanisms of effect and protective processes remain to be investigated. This study examined the mediating effect of emotional distress, self-regulation, and substance use on the association between racial discrimination and sexual risk behaviors. Sexual risk behaviors included in this study were inconsistent condom use and sexual concurrency (sexual partnerships that overlap overtime). The protective effect of protective social ties was also investigated. A sample of 505 heterosexually active men aged 19-22 years were recruited and surveyed for 3 time points. Men answered questions on racial discrimination, sexual risk behaviors, emotional distress, self-regulation, and substance use. Mediation and moderation models were tested. Racial discrimination (T1) significantly and positively predicted emotional distress (T2). Emotional distress, substance use, and self-regulation partially mediated the association between racial discrimination and sexual risk behaviors. Protective social ties attenuated the effects of emotional distress on substance use and self-regulation. Racial discrimination is an important context for sexual risk behaviors. Minority stress may translate to sexual risk behavior through psychosocial mediators, such as emotional distress, self-regulation, and substance use. Protective social ties may buffer against emotional distress to reduce substance use and increase self-regulation. The findings of this study can provide new insights through the investigation of risk and protective processes that influence sexual risk behaviors among young Black men.

Pathways to HIV-Related Behavior Among Heterosexual, Rural Black Men: A Person-Centered Analysis.

We investigated the psychosocial mechanisms linking personal and contextual risk factors to HIV-related behavior among 498 rural Black men. We characterized HIV-related behavior in terms of profile groups and hypothesized that contextual and personal risk factors (childhood adversity, community disadvantage, incarceration, and racial discrimination) would predict HIV-related behavior indirectly via two psychosocial mechanisms: impulsivity and negative relational schemas. Study results documented three HIV-related behavior profile groups. The Safer group reported low levels of risky behavior. The Risk-Taking group reported inconsistent condom use and elevated substance use. The Multiple Partners group reported the highest numbers of partners and relatively consistent condom use. Risk factors predicted profile groups directly and indirectly through psychosocial mechanisms. Impulsivity mediated the association between community disadvantage and membership in the risk-taking group. Negative relational schemas mediated the associations of childhood experiences and community disadvantage with membership in the multiple partners group. Specificity in pathways suggests the need for targeted interventions based on multidimensional characterizations of risk behavior.

AFRICAN AMERICAN STEPFATHER-STEPCHILD RELATIONSHIPS, MARITAL QUALITY, AND MENTAL HEALTH.

This study examined associations between stepfather-stepchild relationship quality, stepfathers' depressive symptoms, and two aspects of marriage: marital quality and positive marital interactions. Marital quality was assessed in terms of commitment, trust, passionate and friendship-based love, and happiness. Marital interactions were assessed in terms of intimacy, shared activities, and verbal communication. Using data collected from 149 recently married African American stepfathers, structural equation modeling revealed that when stepfathers reported more positive relationships with their stepchildren, they also reported more positive marital quality and a higher frequency of positive marital interactions (relationship solidifying activities), and that, in turn, was associated with stepfathers experiencing fewer depressive symptoms.

Adverse Childhood Experiences Predicting Psychological Distress among Black Youth: Exploring Self-Control as a Moderator.

Contextual risk factors, such as adverse childhood experiences (ACEs), have a significant impact on the mental health of Black youth. Surprisingly, few studies focus efforts specifically on Black youth. The present study investigates the influence of ACEs on psychological distress among Black youth. Additionally, guided by social cognitive theory, this study highlights emotional self-control as a protective mechanism against the negative consequences of ACEs. Our findings show that ACEs (T1) predicted psychological distress among Black youth a year later (T2). Emotional self-control emerged as a significant buffer of ACEs on the association with psychological distress. Thus, to prevent negative mental health outcomes for Black youth, it is imperative to focus prevention efforts on the crucial risk factors that affect healthy development. By working to increase emotional self-control among Black youth who suffered adverse childhood experiences, negative mental health outcomes over time can be reduced.

The Effects of Adverse Childhood Experiences on Internalizing and Externalizing Behaviors among Black Children and Youth.

There is limited research on the short-term effects of ACEs on Black children and youth. Black children and youth are disproportionately exposed to abuse, neglect, and other victimizations (Drake et al. 2009; Wade et al. Journal of Family Issues, 17(3), 283-316, 2014). Investigating ACEs will provide a broader understanding of childhood trauma on developmental processes. The current study investigates how ACES impacts psychological distress, substance use, and delinquency among Black children and youth. Hypotheses were tested using a subsample of longitudinal data from 265 participants who were recruited from six school districts in Southeast Michigan. ACEs at T1 significantly predicted depressive symptoms at T2 (ß = .19, p < .05), which in turn predicted substance use (ß = .20, p < .05), and delinquency (ß = .19, p < .05). Psychological distress also mediated the associations between ACEs and substance use, and delinquency. To engage youth in prevention/interventions and practice, it is important to understand the contexts in which they develop i.e. having knowledge on the specific type of victimization instances that Black youth may experience more than their peers as well as the social factors. Therefore, taking a trauma-informed approach that will acknowledge the adverse childhood experiences that youth went through and to understand how these experiences shape their development through adolescence may be efficacious.

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.

Condom Use in the Context of Main and Casual Partner Concurrency: Individual and Relationship Predictors in a Sample of Heterosexual African American Men.

Researchers have identified engagement in sexual concurrency, particularly when condom use is inconsistent, as a risk factor for HIV and other sexually transmitted infections. This risk is particularly salient in rural communities in which dense interconnection of sexual networks can promote the spread of sexually transmitted infections. The authors investigated individual and relationship factors that predict inconsistent condom use in the context of main and casual partner sexual concurrency among 176 rural African American men. The individual psychosocial factors investigated included impulsivity and anger/hostility. Relationship variables included fidelity expectations, criticism from partners, and relationship control in both main and casual relationships. No individual risk factors were associated with main partner inconsistent condom use; however, impulsivity and anger/hostility positively predicted inconsistent condom use with a casual partner. Relationship control in the main partnership predicted inconsistent condom use with the main partner. Criticism from the main partner positively predicted inconsistent condom use with a casual partner. Finally, expectations for a casual partner's fidelity positively predicted inconsistent condom use with that partner. These findings underscore the importance of considering the influence of one sexual partnership on behavior in another and of taking this complexity into account in the development of preventive interventions.

The Influence of Community Disadvantage and Masculinity Ideology on Number of Sexual Partners: A Prospective Analysis of Young Adult, Rural Black Men.

Young, rural Black men are disproportionately affected by sexually transmitted infections (STIs), a consequence, in part, of multiple sexual partnerships. We conducted a prospective study that examined the influence of masculinity ideology on changes in numbers of sexual partners in this population. We focused on a set of high-risk attitudes termed reputational masculinity. Community disadvantage during young adulthood was examined as a risk factor for reputational masculinity ideology, and vocational commitment was examined as a potential protective factor. The sample included 505 African American men ages 19 to 22 from high-poverty rural communities. Men reported their numbers of sexual partners during the past three months, masculinity ideology, community disadvantage, and vocational commitment. Follow-up data were collected 18 months after baseline assessment. Negative binomial modeling was used to test study hypotheses. Results indicated that community disadvantage was associated with increases in reputational masculinity during early adulthood, which in turn were linked to increases in numbers of sexual partners. Vocational commitment interacted with reputational masculinity to forecast numbers of sexual partners, attenuating the influence of reputational masculinity. Reputational masculinity and promotion of engagement with the workplace may be important targets for interventions designed to reduce sexual risk behavior.

New statin labeling requirements: an overview.

As pharmacists advocate for appropriate use of medications to ensure safety and efficacy for patients, labeling requirements for medications should be considered before patients start new therapies or make changes to their current therapies. In early 2012, the Food and Drug Administration released new mandatory labeling requirements for HMG-CoA reductase inhibitors (more commonly known as "statins") regarding hepatic dysfunction, cognitive impairment, and glycemic control. These requirements are based on a combination of studies, adverse-event reporting databases, and literature reviews. Pharmacists should be prepared to advocate for patient safety and be ready to inform patients and other health care providers of the new labeling requirements and the role pharmacists can play in altering current statin therapy.