Stress Biomarkers in Black Youth: Exploring Psychological, Behavioral, and Socio-Ecological Correlates.

Exposure to chronic stress is a major public health concern. Black youth are vulnerable to chronic stress exposure given their overrepresentation in urban neighborhoods characterized by socio-ecological stressors. We contribute to this emerging body of knowledge by (1) investigating stress-induced variability in cortisol response patterns among Black youth, and (2) examining risk and protective factors associated with physiological stress responses. Salivary cortisol was collected from a community sample of 123 low-income Black youth ages 13 to 21. Latent class analysis (LCA) and logistic regression were utilized to identify discrete groups based on cortisol reactivity, and psychological, behavioral, and socio-ecological correlates of class membership. LCA supported a 2-class model of cortisol reactivity. Youth in class one were indicative of a normative stress response with mean cortisol awakening response of 0.38 µg/dL (SD = 0.19), 0.48 µg/dL (SD = 0.20) at time 2, and 0.44 µg/dL (SD = 0.20) at time 3. Youth in class two exhibited a blunted stress response with mean cortisol awakening response of 0.20 µg/dL (SD = 0.11), 0.21 µg/dL (SD = 0.09) at time 2, and 0.18 µg/dL (SD = 0.08) at time 3. Delinquent peer exposure and post-traumatic stress symptoms were negatively associated with blunted stress responses, while greater depressive symptoms were positively associated with blunted stress responses. Black youth displayed distinct physiological stress reactivity patterns. Interventions are needed to assist youth in coping with stress while transforming the upstream factors that give rise to adverse community conditions.

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.

Paternal Caregivers' Parenting Practices and Psychological Functioning among African American Youth Living in Urban Public Housing.

Structural factors associated with public housing contribute to living environments that expose families to adverse life events that may in turn directly impact parenting and youth outcomes. However, despite the growth in research on fathers, research on families in public housing has practically excluded fathers and the role fathers play in the well-being of their adolescents. Using a sample of 660 African American adolescents recruited from public housing, we examined the relationship between paternal caregivers' (i.e., fathers' and father figures') parenting practices and adolescents' depressive symptoms, attitudes toward deviance, and self-efficacy. Using a latent profile analysis (LPA), we confirmed a four-class model of paternal parenting practices ranging from high to low levels of monitoring and encouragement. Results from a one-way ANOVA indicated that paternal caregivers with high (compared to moderate) levels of encouragement and monitoring were associated with youth who reported less depressive symptoms, higher levels of self-efficacy, and less favorable attitudes toward deviance. Discriminant analysis results indicated that approximately half of the sample were correctly classified into two paternal caregiver classes. The findings provide evidence that some of these caregivers engage in parenting practices that support youths' psychological functioning. More research is needed to determine what accounts for the variability in levels of paternal encouragement and supervision, including environmental influences, particularly for paternal caregivers exhibiting moderate-to-low levels of paternal encouragement and monitoring.

Examining effects of food insecurity and food choices on health outcomes in households in poverty.

Evidence documenting effects of food assistance programs, household food insecurity, and nutrition knowledge on health outcomes is building. Using data from a sub-sample of adults who are 185% of the poverty line from the 2007-2008 National Health and Nutrition Examination Survey (N = 2,171), we examine whether household food insecurity, food stamp take-up, and use of informal food supports are associated with health risk among low-income households. Findings indicate that while nutrition knowledge provides protection against health risk in food secure households, the health benefits of nutrition knowledge were not evident in food insecure households. We discuss these findings in light of current policy and practice interventions that recognize the importance of providing healthy, affordable food options for food insecure households.

Correlates of the sex trade among African-American youth living in urban public housing: assessing the role of parental incarceration and parental substance use.

African-American youth are disproportionately affected by parental incarceration and the consequences of parental substance use. Many adapt to the loss of their parents to prison or drug addiction by engaging in sex-risk behavior, particularly the sex trade. These youth may engage in this risky behavior for a number of reasons. Although previous research has examined this issue, most of these studies have focused on runaway or street youth or youth in international settings. Empirical evidence on correlates of trading sex for money among urban African-American youth is practically missing. Using a sample of 192 African-American youth living in urban public housing, this paper attempts to rectify this gap in knowledge by assessing how individual and parental factors are related to the likelihood of a youth trading sex for money. The sample for this study reported a mean age of 19; 28 % reported having traded sex for money; 30 % had a father currently in prison; and 7 % reported having a mother currently in prison. Maternal incarceration and paternal substance use were associated with a higher likelihood of trading sex for money. Given the potential health risks associated with trading sex for money, understanding correlates of this behavior has important implications for the health of this vulnerable population of youth and urban health in general.

Individual and Peer Correlates of the Annual Frequency of Marijuana Use Among African American Adolescents Living in US Urban Public Housing Neighborhoods.

Marijuana is the most commonly used illegal drug in the United States. Urban minority youth reports the highest consumption. Using a sample of 550 African American youth living in public housing located in three large Northeastern US cities, this article examines individual and peer correlates of the annual frequency of marijuana use. Data were collected between the Fall of 2007 and the Spring of 2008. The sample reported a mean age of 15 with 48% being female. Pearson's bivariate correlation and sequential regression analysis were conducted. The model explained 35% of the variance. Limitations and implications are discussed.

Examining the Utility of the Early Childhood Development Index (ECDI) among Children in the Nigeria Context.

An estimated 6 million children under the age of five in Nigeria (out of nearly 31 million) risk not reaching their full developmental potential. The dearth of context-relevant measures poses a challenge to the planning and implementation of effective interventions. This study assesses the utility of the Early Childhood Development Index (ECDI) in Nigeria. We used the Multiple Indicator Cluster Surveys to track progress among 3- to 4-year-old children (n = 11,073); 3-year-old, 51%; female, 49%. Using random calibration samples, the results from psychometric tests indicate that while over half of the children were on track in their development based on the ECDI, the instrument had low to average internal consistency and weak face validity, suggesting an inadequacy in capturing ECD information of value. At the outset of the launch of the new ECDI2030, the results of this study point to the need for continued discourse and advocacy for the use of culturally appropriate measures of child development, and a child-centered community engagement approach. This is essential in ensuring accountability and responsive interventions for the children served and their families.

Anxiety sensitivity among Black youth: A cross-sectional analysis of the direct and indirect effects of community violence exposure, neighborhood risk, parenting practices, and peer effects.

Youth exposed to community violence and neighborhood stressors report devastating mental health consequences. Black youth are at greater risk and experience community violence at rates higher than other youth populations. An underexplored mental health consequence is anxiety sensitivity, the fear of experiencing anxiety-related symptoms, which contributes to maladaptive coping strategies and the development and severity of other mental health problems. This study utilized structural equation modeling (SEM) to examine socio-ecological risk and protective factors associated with community violence exposure and anxiety sensitivity among low-income Black youth. Survey data are from a sample of 320 Black youth residing in public and subsidized housing in a Northeastern city in the United States. Results indicated that neighborhood risk, parenting behaviors, and exposure to delinquent peers were indirectly associated with anxiety sensitivity, which occurred through community violence exposure. Additionally, neighborhood risks had direct effects on anxiety sensitivity. Results point to the need to incorporate social and environmental factors in interventions addressing anxiety sensitivity among Black youth in urban communities.

Asset ownership among households caring for orphans and vulnerable children in rural Zimbabwe: the influence of ownership on children's health and social vulnerabilities.

The high prevalence of human immunodeficiency virus/acquired immune deficiency syndrome in sub-Saharan Africa has resulted in a dramatic increase in orphans and vulnerable children (OVC) over the past decade. These children typically rely on extended family networks for support, but the magnitude of the crisis has resulted in traditional familial networks becoming overwhelmed and more economically and socially vulnerable. Previous research consistently demonstrates the positive influence of household asset ownership on children's well-being. Using data from impoverished households caring for OVC in rural Manicaland Province, Zimbabwe, this study explores the influence of household asset ownership on OVC health vulnerability (HV) and social vulnerability (SV). Findings indicate that asset ownership is associated with significantly lower SV, in terms of school attendance and birth registration. Yet, assets do not emerge as a direct influence of OVC HV as measured by disease and chronic illness, although having a chronically ill adult in the household increases HV. These findings suggest that asset ownership, specifically a combination of fixed and movable assets, may offset the influence of other risk factors for children's SV.

Assessing the Modified Neighborhood Cohesion Index Among African American Adolescents Living in Public Housing: An Exploratory and Confirmatory Factor Analysis.

Objective: African American youth are disproportionately overrepresented in low-resourced segregated urban neighborhoods. Consequently, they experience greater exposure to neighborhood risks and subsequent depressive symptoms. Neighborhood cohesion represents a protective factor for youth in such environments. However, the concept remains underexplored among African American youth. This study examines the psychometric properties of a modified version of the Neighborhood Cohesion Index (NCI) among African American youth living in public housing. Method: Psychometric properties were assessed through exploratory and confirmatory factor analyses using data from African American youth (N = 235) living in public housing in two large northeastern cities. Results: The EFA resulted in the use of a single-factor structure with two dropped items and good internal validity. Findings from the CFA indicated that model fit indices were unacceptable for chi-square and RMSEA (χ2 [62; N = 235] = 170.19, p < .001); RMSEA = 0.09 [90% CI: 0.071, 0.102]) but were acceptable for SRMR and CFI (SRMR = 0.06; CFI = 0.91) with three error covariances. Conclusions: The modified NCI is not ideal for assessing neighborhood cohesion among this understudied population. Future research should prioritize psychometric testing alongside cognitive interviewing, to provide a contextualized measure of neighborhood cohesion for this population.

Structural and Intermediary Social Determinants of Health and the Emotional and Behavioral Health of US Children.

Children grow up in homes where varying environmental and socioeconomic contexts have a bearing on their emotional and behavioral health (EBH). This study used data from a representative sample of the child supplement of the US National Health Information Survey (NHIS) and applied the social determinants of health (SDoH) framework to explore factors associated with child EBH. We conducted a path analysis of the child's EBH measured by the strengths and difficulties questionnaire (SDQ) from their macro and socioeconomic contexts, e.g., policy, household, and other health system risk factors. For children in the sample, aged 4 to 17 years old (n = 9205), most path relationships to child SDQ scores were statistically significant. The total effects from a child's visit to a mental health specialist (0.28) and child's age (0.22) had the highest coefficients to child SDQ scores. A modified model showed a better fit with X2 (4) = 22.124, RMSEA = 0.021, and 90% CI [0.013-0.03], CFI = 0.98. Findings indicate that child factors such as being older, the use of mental healthcare services, and family socioeconomic status were significantly associated with EBH, calling attention to the need for more responsive policy and behavioral health interventions that address household/familial and child-level factors, critical determinants of child wellbeing.

Exploring the influence of cultural participation on the subjective well-being of victims in Mexico.

Introduction: Considering the increasing incidence of crime in Mexico, it is necessary to understand the strategies that individuals utilize in response to victimization and the effects of this on their subjective well-being. Methods: A generalized structural equation modeling (GSEM) analysis with data from the 2012 Self-reported Well-Being Survey (BIARE, n = 10,654); dependent variables: subjective well-being (i.e., cognitive well-being and affective balance); independent variables: self-reported victimization (i.e., by domestic violence, community violence, and structural violence) and cultural participation (i.e., cultural attendance, engagement, and consumption). Results: Results show an overall positive and statistical influence of the cultural participation activities on the subjective well-being of victims of community and structural violence (but not of domestic violence), because, for those who reported higher levels of cultural participation, the probability of better subjective well-being were higher. Conclusions: Victims potentially coped and adapted to stressful and traumatic situations (i.e., experiences of victimization) via cultural participation activities. However, there are distinctive effects according to different forms of violence, which may be accounted for in formulating public policies related to victims. This has implications for scholars, policymakers, and practitioners in improving the general quality of life of victims and the general population.

Getting to zero HIV/AIDS in sub-Saharan Africa: Understanding perceptions of locals using the social determinants of health framework.

This study explored a community perception of the facilitators and inhibitors of Getting to Zero (GTZ) in rural Zambia, sub-Saharan Africa. Data were collected in 2017. We use the Social Determinants of Health framework to guide organisation of key themes emerging from semistructured, focus group interviews with community members (N = 52). Data were analysed through an iterative descriptive/thematic approach which allowed for the highlighting of key themes. Emerging themes point to the significance of (a) individual, (b) sociocultural, (c) environmental and (d) economic factors, for example, treatment adherence, gender norms, food security and access to health care as important in GTZ. Implications for policy, practise and scholarship are suggested.

Exposure to community violence and depressive symptoms: Examining community, family, and peer effects among public housing youth.

Exposure to community violence is an epidemic problem that causes debilitating effects on youth mental health. However, the relationships between violence exposure and youth mental health remain unclear when examining co-occurring socioecological risk and protective factors. The purpose of this study is to clarify the observed gaps in knowledge by utilizing structural equation modeling (SEM) to examine the mediating role of community violence exposure on the relationship between perceived neighborhood risk factors, parental behaviors, and peers on depressive symptoms in a sample of urban youth in low-income public housing communities (n = 320). Results indicate that community violence exposure and exposure to delinquent peers mediates the effects of perceived neighborhood risk and parenting behaviors on depressive symptoms. These findings suggest that while interventions that limit exposure to community violence and delinquent peers could reduce depressive symptoms, interventions that reduce community violence are essential to improve youth mental health.

Exposure to Violence and Posttraumatic Stress Among Youth in Public Housing: Do Community, Family, and Peers Matter?

This study examines the mediating roles of neighborhood risk factors, parental behaviors, and peers on the relationship between community violence exposure and posttraumatic stress in a sample of urban youth in low-income public housing communities. Data are from 320 African-American youth living in public housing in a northeastern city in the USA. Structural equation modeling was utilized to examine the stated relationships. Study results point to significant effects of violence exposure on posttraumatic stress in urban youth. While findings indicated indirect effects of neighborhood risk, parenting practices, and exposure to delinquent peers on posttraumatic stress, each of these paths operates through their relationship with violence exposure, with exposure to delinquent peers having the strongest mediating effect. Exposure to delinquent peers mediates the effects of neighborhood risks and parental behaviors on exposure to community violence, representing one potential intervention point to disrupt the deleterious effects of exposure to violence among youth. Our findings suggest interventions that address peer influence, and group norms may serve as protective factors against the risk of youth violence exposure. Overall, results highlight the co-occurring socioecological context of community violence exposure for youth living in public housing.

Assessing the moderating effects of anxiety sensitivity on antisocial behavior among urban African American youth.

African American adolescents are a vulnerable population, overrepresented in the juvenile justice system and underserved by mental health providers. Consequently, a disproportionate number of African American youth in the juvenile justice system have diagnosable mental health problems. This study investigates whether, among African American adolescents, the effects of attitude towards deviance, self-efficacy, and exposure to delinquent peers on antisocial behavior are moderated by anxiety sensitivity. A sample of 238 African American adolescents ages 13-19 from 3 public housing developments participated in this study. Results indicated that 40% of the adolescents reported no involvement in antisocial behaviors. Gender, anxiety sensitivity, and attitudes towards deviance were significant correlates of antisocial behavior. Interaction effects indicate that the relative impact of attitudes towards deviance and exposure to delinquent peers on antisocial behaviors is contingent upon adolescents' level of anxiety sensitivity. Implications for practice and future research are discussed.

Self-Efficacy, Religiosity, and Crime: Profiles of African American Youth in Urban Housing Communities.

Youth reporting independently elevated levels of religiosity and self-efficacy tend to abstain from externalizing behavior. However, little is known about the ways in which religiosity and self-efficacy interrelate to impact youth externalizing. Drawing from a sample of African American youth from public housing communities (N = 236), we use latent profile analysis to identify subtypes of youth based on self-reported religiosity and self-efficacy and, in turn, examine links with crime. Compared to youth in other subgroups, those classified as both highly religious and highly self-efficacious reported less involvement in minor and severe delinquency, but not violence.

Exploring Factors Associated with Educational Outcomes for Orphan and Abandoned Children in India.

India has more than 25 million orphan and abandoned children (UNICEF, 2012). The burden of care for these OAC is on caregivers that are often ill equipped to meet their needs due to inadequate assets. Previous studies suggest that in communities with limited resources, OAC residing with non-biological caregivers are more at risk than those fostered by a biological parent. This study explores the association of caregiver and child characteristics with OAC educational outcome in India. The analysis was conducted using hierarchical logistic regression. The findings have implications for practice and policy in the global child welfare field.

Understanding Effects of Flexible Spending Accounts on People with Disabilities: The Case of a Consumer-Directed Care Program.

This study set out to explore the saving behavior, barriers, and facilitators along with effects of participating in a consumer-directed care program among people with disabilities in the state of West Virginia (N = 29). Results suggest that respondents were able to save money through the program to enable them to purchase goods and services they needed to enhance their welfare and quality of life. Generally, items saved for fell into 3 broad categories: household equipment, individual functioning, and home modification. Facilitators and barriers to saving were also indicated and so were the benefits of program participation. Program and policy implications are presented.

Correlates of Food Security among Low-Resource Young People: An Assessment of Community Protective Factors within Public Housing Neighborhoods.

This paper assesses how and/or whether household and community factors are associated with self-reported food security among young people living in public housing (N=151). Results suggest that food security was negatively related to age, particularly to older youth. Also, household size-have many people in the household, household hardships, and household conflict were negatively related to food security. On the contrary, food security was positively related to community cohesion and the presence of the extended family within the public housing neighborhood. Findings seem to suggest that non-specialty food previsions (e.g., community cohesion and family networks) may be important in understanding food security among families living in public housing. A number of program and policy implications are presented.