Unplanned hysterectomy: a comprehensive analysis of race, ethnicity, sociodemographic factors, pregnancy complications, and cardiovascular disease risk factors.

OBJECTIVE: To understand the risk of unplanned hysterectomy (UH) in pregnant women better in association with maternal sociodemographic characteristics, cardiovascular disease (CVD) risk factors, and current pregnancy complications. DESIGN: Using Florida birth data from 2005 to 2014, we investigated the possible interactions between known risk factors of having UH, including maternal sociodemographic characteristics, maternal medical history, and other pregnancy complications. Logistic regression models were constructed. Adjusted odds ratios and 95% confidence intervals were reported. RESULTS: Several interactions were observed that significantly affected odds of UH. Compared to non-Hispanic White women, Hispanic minority women were more likely to have an UH. The overall risk of UH for women with preterm birth (<37 weeks) and concurrently had premature rupture of membranes (PRoM), uterine rupture, or a previous cesarean delivery was significantly higher than women who delivered to term and had no pregnancy complications. Women who delivered via cesarean who also had preeclampsia, PRoM, or uterine rupture had an overall increased risk of UH. Significantly decreased risk of UH was seen for Black women less than 20 years old, women of other minority races with either less than a high school degree or a college degree or greater, women of other minority races with PRoM, and women with preterm birth and diabetes compared to respective reference groups. CONCLUSIONS: Maternal race, ethnicity, CVD risk factors, and current pregnancy complications affect the risk of UH in pregnant women through complex interactions that would not be seen in unadjusted models of risk analysis.

Methodologies used in studies examining substance abuse, violence and HIV/AIDS (SAVA) constructs using a syndemic framework: a scoping review.

The syndemic theoretical framework has been used in health disparities research to explain several co-occurring epidemics, particularly in populations facing disparate health conditions. A prominent example of this is seen in Singer's Substance Abuse, Violence and HIV/AIDS (SAVA) syndemic theory. However, even though numerous studies support some of the theoretical underpinnings of the SAVA syndemic, the empirical applications of the theory remain methodologically underdeveloped. The current review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR), to present the state of the science of methodologies examining SAVA constructs using the syndemic framework. Seven bibliographic databases were searched with no language or date restrictions. Studies were synthesized by author, year of publication, study location, total sample size, study population, SAVA outcomes, analytic method of SAVA measurement, intervention type, level of influence, disease interaction and concentration, main findings of the study, and possible future areas of research. Our search yielded a total of 967 articles, and 123 were included in the review. Methodologic and statistical innovation is needed to elevate the impact of syndemic theory for elucidating the synergistic effects of determinants leading to health disparities.

A qualitative community health assessment of HIV prevention awareness in a semi-rural Latinx seasonal farm working community in South Florida.

This article explores HIV awareness and prevention in a Latinx seasonal farmworker community of south Miami-Dade County in the USA. The study took place as part of a larger community assessment that aimed to determine community needs and resources related to substance abuse, violence and HIV in the Latinx seasonal farmworker communities of south Miami-Dade County, with a particular focus on fathers' and their male sons' relationships. The study collected data on HIV knowledge and prevention, healthcare-seeking behaviours, cultural norms, and communication barriers about HIV prevention between fathers and sons. Data were collected through in-depth interviews with community leaders, two focus groups with social and health services providers, and four focus groups involving fathers and their adolescent sons. A deductive approach to data analysis was undertaken. Five major themes were identified: (1) HIVrelated knowledge and perception; (2) HIV prevention strategies; (3) barriers and needs for tailored preventive health and care services in the community; (4) stress over sex-related communication; and (5) the dominance of traditional masculine gender norms in the household and the community.

Alcohol use among adult recent Latino/a immigrants: the role of stress, forced migration, and adherence to traditional gender roles.

Background: Previous research conducted among Latino/a immigrants has shown the underlying effect that exposure to stress after immigrating to the U.S. (i.e. health access, racial/ethnic discrimination, and language barriers) has on alcohol use patterns. However, given the demographic shifts in recent immigrants, understanding the influence of stress before (i.e. poverty, healthcare, and educational opportunities) and after immigration on their alcohol use (i.e. alcohol consumption and drinking behaviors in the past 12 months) in the context of migration and traditional gender roles is warranted.Objectives: To examine the (a) cumulative effects of pre- to post-immigration stress, (b) respective moderating effects of traditional gender roles, and (c) forced migration on alcohol use for men and women.Methods: Hierarchical multiple regression and moderation analyses were conducted on a cross-sectional sample of 529 (N = 268 men, N = 261 women) adult (18-34 years) from recent Latino/a immigrants in South Florida.Results: Gender had a statistically significant difference on alcohol use, (F 527) = 18.68, p < .001, with men (p = 4.36 ± SE =.22) reporting higher alcohol use than women (p = 3.08 ± SE =.20). Post-immigration stress (ß = .12, p = .03) but not pre-migration stress had a statistically significant association with alcohol use. There is no interaction effect by traditional gender roles and forced migration on the associations between pre- to post-immigration stress and alcohol use.Conclusion: Results suggest that post-immigration stress may be a reasonable intervention target to mitigate alcohol use among recent Latino/a immigrants, particularly among men.

Alcohol Use Severity among Hispanic Emerging Adults: Examining Intragroup Marginalization, Bicultural Self-Efficacy, and the Role of Gender within a Stress and Coping Framework.

Most research on cultural stressors and alcohol has focused on intercultural stressors. Continuing to exclude intracultural stressors (e.g., intragroup marginalization) from alcohol research will yield a biased understanding of the experiences of Hispanics living in a bicultural society. As we amass more studies on intracultural stressors, research will be needed to identify mutable sociocultural factors that may mitigate the association between intracultural stressors and alcohol. To address these limitations, we examined the association between intragroup marginalization and alcohol use severity and the extent to which gender and bicultural self-efficacy may moderate this association. A convenience sample of 200 Hispanic emerging adults ages 18-25 (men = 101, women = 99) from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey. Data were analyzed using hierarchical multiple regression and moderation analyses. Higher intragroup marginalization was associated with higher alcohol use severity. Gender functioned as a moderator whereby intragroup marginalization was associated with higher alcohol use severity among men, but not women. Also, higher social groundedness functioned as a moderator that weakened the association between intragroup marginalization and alcohol use severity. Role repertoire did not function as a moderator. Our findings are significant because they enhance the reliability of the association between intragroup marginalization and alcohol use severity, and the moderating effect of gender in this respective association. This emerging line of research suggests that alcohol interventions targeting Hispanics may have a significant limitation by not accounting for intracultural stressors.

Vibration-Based Smart Sensor for High-Flow Dust Measurement.

Asphalt mixes comprise aggregates, additives and bitumen. The aggregates are of varying sizes, and the finest category, referred to as sands, encompasses the so-called filler particles present in the mixture, which are smaller than 0.063 mm. As part of the H2020 CAPRI project, the authors present a prototype for measuring filler flow, through vibration analysis. The vibrations are generated by the filler particles crashing to a slim steel bar capable of withstanding the challenging conditions of temperature and pressure within the aspiration pipe of an industrial baghouse. This paper presents a prototype developed to address the need for quantifying the amount of filler in cold aggregates, considering the unavailability of commercially viable sensors suitable for the conditions encountered during asphalt mix production. In laboratory settings, the prototype simulates the aspiration process of a baghouse in an asphalt plant, accurately reproducing particle concentration and mass flow conditions. The experiments performed demonstrate that an accelerometer positioned outside the pipe can replicate the filler flow within the pipe, even when the filler aspiration conditions differ. The obtained results enable extrapolation from the laboratory model to a real-world baghouse model, making it applicable to various aspiration processes, particularly those involving baghouses. Moreover, this paper provides open access to all the data and results used, as part of our commitment to the CAPRI project, with the principles of open science.

Alcohol use severity among recent Latino immigrants: Associations of acculturation, family history of alcohol use and alcohol outcome expectancies.

Having a family history of alcohol (FH+) use is a well-documented risk factor for alcohol use and alcohol related problems. However, there are limited studies examining the impact of FH + on current alcohol use among Latino immigrants. This study aimed to determine the influence of having a FH + on current alcohol use among Latino immigrants and the influence of alcohol outcome expectancies (AOEs) and acculturation on this relationship. This is a longitudinal secondary data analysis of data from the Recent Latino Immigrant Study (RLIS), the first community-based cohort study to examine pre- to post-immigration alcohol use trajectories of young adult Latino immigrants. Linear mixed models were performed to assess the association between various pre- and post-immigration factors and alcohol use among Latino immigrants. There were 518 young adult Latino immigrants with 18.7% reporting a FH + with those with a FH + having higher mean AUDIT score compared to those without (4.74 vs. 3.81; p = 0.028). Positive AOEs were associated with increase AUDIT scores. FH + individuals with greater positive AOEs experienced higher AUDIT scores compared to FH- individuals. Family cohesion was protective against alcohol use while endorsement of Americansism was associated with increased alcohol use. Theses results provide the framework for more in-depth exploration regarding the influences of FH+, AOEs, and acculturation have on the alcohol use among Latino immigrants. Future longitudinal research studies should account for whether traditional cultural values mediate or moderate the relationship between a FH+, AOE, and alcohol use of Latino immigrants.

Ethnic Discrimination and Self-rated Health among Hispanic Emerging Adults: Examining the Moderating Effects of Self-esteem and Resilience.

Exposure to ethnic discrimination has been conceptualized as a sociocultural stressor that is associated with lower self-rated health. However, this association remains understudied among Hispanics and less is known about constructs that may mitigate the effects of ethnic discrimination on self-rated health. Accordingly, this study aimed to (a) examine the association between ethnic discrimination and self-rated health among Hispanic emerging adults (ages 18-25), and (b) examine the extent to which self-esteem and resilience may moderate this association. A convenience sample of 200 Hispanic emerging adults from Arizona (n=99) and Florida (n=101) was recruited to complete a cross-sectional survey. Data were analyzed using hierarchical multiple regression and moderation analyses. Results indicate that higher ethnic discrimination was associated with lower self-rated health. Moderation analyses indicated that self-esteem functioned as a moderator that weakened the association between ethnic discrimination and self-rated health; however, resilience did not function similarly as a moderator. This study adds to the limited literature on ethnic discrimination and self-rated health among Hispanics and highlights that psychological factors, such as enhancing self-esteem, may help buffer the adverse effects of ethnic discrimination on health outcomes.

Depressive symptoms among recent Latinx immigrants in South Florida: The role of premigration trauma and stress, postimmigration stress, and gender.

In the past decade, recent Latinx immigrants (RLIs) from South and Central America have arrived in the United States seeking asylum from countries affected by war, political upheaval, and high crime and poverty rates. The premigration stress and trauma they experience are further compounded by postimmigration stress due to discrimination, lack of access to health care, and financial instability. Evidence suggests RLIs who experience such stress and trauma have an increased risk of developing depressive symptoms. We examined the combined effect of premigration stress and trauma and postimmigration stress on postimmigration depressive symptoms; we also explored the moderating effect of gender. Hierarchical multiple regression and moderation analyses were conducted on a cross-sectional sample of 540 young adult RLIs (age range: 18-34 years, 50.2% men) in South Florida. Higher levels of postimmigration stress, ß = .37, p < .001, were associated with increased postimmigration depressive symptoms. No significant associations emerged between premigration stress and trauma and postimmigration depressive symptoms. Moderation analyses revealed no significant interaction effect of gender. Post hoc analyses indicated that country/region of origin moderated the relation between postimmigration stress and depressive symptoms such that the association was stronger among Venezuelan, ß = 1.51, p < .001; other South American, ß = 1.06, p < .001; and Central American/Mexican RLIs, ß = 1.38, p < .001, compared with Caribbean RLIs, ß = .45, p  = .122. These findings suggest that interventions focused on addressing postimmigration stress early in the immigration process can potentially lower subsequent depressive symptoms among RLIs.

Associations between gender norms and HIV self-efficacy among Latina immigrants in a farmworker community.

Latina immigrant farmworkers are a vulnerable and understudied population that face a host of socio-cultural and structural barriers that place them at risk for HIV infection. Cultural factors, including traditional gender roles (egalitarian and marianismo) that frequently inhibit communication between partners and promote rigid roles, may particularly affect self-efficacy for HIV prevention among this population.Objective: This study examines the impact of women's gender norms on HIV knowledge and safe sex negotiation skills, along with the moderating influence of HIV self-efficacy among Latina immigrants in a farmworker community.Design: The current cross-sectional analysis study examines data from a sample (N = 157) of mostly undocumented Latina immigrant farmworkers in South Miami-Dade County, Florida. Analysis was performed on secondary data obtained from baseline collected on an intervention pilot study. Measures of traditional American (egalitarian) and Latina (marianismo) gender norms, HIV self-efficacy, and HIV knowledge, as well as key demographic variables were collected.Results: Findings revealed higher American (egalitarian) gender norms directly and indirectly predict higher HIV prevention factors. Additionally, HIV self-efficacy did not mediate effects of marianismo on HIV risk.Conclusion: Findings conclude that HIV prevention can be especially challenging due to socio-cultural and traditional gender norms faced by Latinas in farm working communities and that such norms should be taken into account when developing and adapting culturally appropriate interventions to reduce HIV related risk behaviors for Latinas residing in urban or farm working communities.

Prescription Drug and Cannabis Use among Recent Latinx Immigrants Pre- and Post-Immigration to the US.

Introduction: Shifts in the sociopolitical context of Latin America have led to steep increases in recent Latinx immigrants (RLI) arriving in the US within the context of forced migration. Yet, little is known about how adverse experiences of RLIs before and after immigration may impact their health including drug use. The purpose of this study was to examine prescription drug and cannabis use before and just after immigration among RLIs and how this drug use is influenced by pre-and post-immigration factors. Methods: This study utilized baseline data from a study examining pre- to post-immigration drinking and driving trajectories among RLI in the United States (US). Baseline criteria included: self-identifying as a Latinx immigrant, 18 - 34 years old, who recently immigrated from a Latin American country. Multivariate logistic regression was conducted to determine predictors of drug use both prior to and after immigrating. Results: There were 540 RLI, 50.2% male and 47.8% subjected to forced migration. Prescription and illicit drug use decreased post-immigration with sedatives being the most common. Higher levels of education was associated with increased odds of pre-immigration prescription drug use and cannabis use. Those experiencing forced migration were more likely to engage in prescription drug use before and after immigration, while no associations were found for cannabis use. Conclusion: Findings suggest a need for increased substance use and mental health services among RLIs arriving within the context of forced migration. More research is needed to understand the trajectories of drug use among RLI as their time in the US increases.

Influences of immigration stress and occupational exploitation on Latina seasonal workers' substance use networks: a qualitative study.

US female Latina seasonal farm workers (LSW) are a medically underserved community experiencing severe health disparities. We explored the relationship between alcohol and prescription medication, and LSW social networks using a qualitative approach. In 2015, this study used convenience sampling to recruit 28 LSWs in South Florida for three focus group discussions in Spanish. Focus groups were translated to English for analysis, which employed a general inductive approach. Themes included prescription medication distribution within networks, spirituality/religion practice with friends and family, and alcohol use with friends. Substance abuse prevention and treatment interventions should account for the unique needs of LSW.

HIV testing intentions and cognitive reappraisal among Latino emerging adults.

Negative emotions related to HIV testing may influence an individual's intentions to test for HIV. However, emotion regulation strategies such as cognitive reappraisal which involves reframing the meaning of an event to modify one's emotional response to it may potentially help to regulate these emotions and facilitate decisions to get tested for HIV. In this exploratory study, we examined the association between cognitive reappraisal and HIV testing intentions and whether this association differs by gender. Cross-sectional data were collected from a convenience sample of 157 Latino emerging adults aged 18-25 years living in Arizona and Florida through an online survey. Hierarchical logistic regression models were used to analyze the data. Results indicated that cognitive reappraisal was significantly associated with HIV testing intentions (aOR: 1.44, 95% CI:1.04-1.99) and that this association was specific to females (aOR: 2.48, 95% CI: 1.39-4.43). Our results demonstrate the potential of cognitive reappraisal to facilitate HIV testing intentions among females. HIV prevention interventions should incorporate cognitive reappraisal training to regulate and adapt to the negative emotions associated with HIV testing in efforts to increase HIV testing.

Associations of Objective and Perceived Neighborhood Ethnic Density on Hazardous Alcohol Use among Latinx Emerging Adults.

Background/Purpose: Emerging adulthood is an important time where substance use often peaks. Neighborhood Latinx ethnic density could be protective against negative health behaviors. Most studies on neighborhood ethnic density have focused on census-level aggregate measures, however perception of the neighborhood ethnic density could differ from objectively measured neighborhood density. This study investigated the effects of neighborhood ethnic density, both perceived ethnic and objectively measured ethnic density, on hazardous alcohol use among Latinx emerging adults in Maricopa County Arizona and Miami-Dade County Florida by gender. Methods: 200 Latinx emerging adults residing in Arizona and Florida completed a cross-sectional survey. Inclusion criteria were being age 18-25, self-identify as Latinx, and currently living in Maricopa County or Miami-Dade County. Data were analyzed using multivariate logistic regression and moderation analyses. Results: There was a statistically significant difference between perceived and objective ethnic density (Kappa = 0.353, p < 0.001). When ethnic density was measured objectively, alcohol use severity was statistically significantly lower for individuals living in highly ethnically dense neighborhoods (OR: 0.34, 95% CI: 0.12, 0.92). However, this association was only found for women in moderation analyses. There was no statistically significant association between perceived ethnic density and alcohol use severity. Conclusion: The present study found a statistically significant decrease in alcohol use severity among Latinx emerging adults who live in highly ethnically dense neighborhoods after adjusting for covariates. Future research should investigate the potential mechanisms in which these neighborhoods protect against alcohol use severity among Latinx emerging adults.

Exposure to ethnic discrimination in social media and symptoms of anxiety and depression among Hispanic emerging adults: Examining the moderating role of gender.

METHOD: Two hundred Hispanic emerging adults from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey, and data were analyzed using hierarchical multiple regression and moderation analyses. RESULTS: Higher social media discrimination was associated with higher symptoms of depression and generalized anxiety. Moderation analyses indicated that higher social media discrimination was only associated with symptoms of depression and generalized anxiety among men, but not women. CONCLUSION: This is likely the first study on social media discrimination and mental health among emerging adults; thus, expanding this emerging field of research to a distinct developmental period.

Socio-Cultural Subgroups of Latina/o Immigrants: A Latent Profile Analysis.

Socio-cultural factors, such as familismo, social support, machismo, and multigroup ethnic identity, are strongly associated with Latina/o immigrants' alcohol misuse and depressive symptoms. However, research has rarely explored whether unobserved groups of Latina/o immigrants with similar socio-cultural factors exist. Latent Profile analysis can illuminate which subgroups to target, or which socio-cultural factors need to be supported, to have an impact on the prevention and treatment of alcohol use and/or depression in the Latina/o immigrant population. Cross sectional data from on ongoing longitudinal investigation was utilized (N= 518 Latina/o adults living in Miami-Dade County, Florida and have immigrated to the US within one year prior to assessment). Latent Profile Analyses (LPA) were conducted utilizing validated measures of familismo, social support, neighborhood collective efficacy, ethnic identity, machismo, caballerismo, and marianismo. The LPA revealed three, significantly different profiles: (1) low socio-cultural protection (n=155, 29.98%), (2) high socio-cultural protection (n=21, 4.06%), and (3) high socio-, low-cultural protection (n=341, 65.96%). Profile membership was associated significantly with immigrant documentation status, education level, and past family history of substance use. Results indicate that Latina/o immigrants in the low socio-cultural protection group had significantly higher alcohol use compared to high socio-, low cultural protection group. No significant differences were found for depressive symptoms. We discuss implications of our findings and encourage researchers to continue to unpack the complexities associated with socio-cultural factors and Latina/o mental and behavioral health. Specifically, research should focus on socio-cultural factors can provide protection from negative health outcomes and increase resiliency among this population.

Neighborhood and health-related outcomes: a study of adult Latinas of Caribbean and South and Central American descent in Miami.

The present study investigated neighborhood effects on substance use, mental and medical health, and health-care access. We used data collected from a sample of adult Latinas of Caribbean and South and Central American descent in 2011. The findings indicate that for adult Latinas, concentrated disadvantage in neighborhoods is associated with increased risk of alcohol misuse and inability to obtain prescription drugs due to lack of money, while Hispanic/immigrant concentration in neighborhoods is associated with fewer mental disorder symptoms. Individual age, criminal justice involvement, religious involvement, intimate partner violence, and employment are also associated with one or more health-related outcomes. We provided practice implications for macro and micro social work practice. Future research is needed to examine the mechanism underlying the negative association between neighborhood Hispanic/immigrant concentration and mental disorder symptoms.

Self-efficacy and HIV testing among Latino emerging adults: examining the moderating effects of distress tolerance and sexual risk behaviors.

Latino emerging adults in the United States are at a high risk of HIV and have a low prevalence of HIV testing. This study examined the association between self-efficacy for HIV testing, distress tolerance and lifetime history of HIV testing, and tested the moderating effect of distress tolerance and sexual risk behaviors on the association between self-efficacy and lifetime history of HIV testing. Data were collected from a cross-sectional sample of 157 Latino emerging adults aged 18-25 using an online survey and were analyzed using hierarchical logistic regression and moderation analyses. We found that 62.8% of those engaging in sexual risk behaviors had ever been tested for HIV. Participants that reported higher levels of self-efficacy (aOR=3.49, 95%CI: 1.78-6.83) were more likely to have ever been tested for HIV in their lifetime. There was a statistically significant three-way interaction among self-efficacy for HIV testing, distress tolerance and sexual risk behaviors (b=2.76, 95%CI: .52, 5.00, p=.016). This interaction suggests that among those that reported any sexual risk behaviors, higher levels of self-efficacy were associated with lifetime history of HIV testing only at higher levels of distress tolerance. Further research is warranted to determine how self-efficacy and distress tolerance work together among high-risk groups to promote HIV testing.

Depressive Symptoms and Resilience among Hispanic Emerging Adults: Examining the Moderating Effects of Mindfulness, Distress Tolerance, Emotion Regulation, Family Cohesion, and Social Support.

Emerging adulthood has been described as a difficult stage in life and may be particularly stressful for Hispanic emerging adults who are disproportionately exposed to adversity and chronic sociocultural stressors. To better prevent and treat depressive disorders among Hispanic emerging adults, more research is needed to identify and understand modifiable determinants that can help this population enhance their capacity to offset and recover from adversity and sociocultural stressors. As such, this study aimed to (1) examine the association between resilience and depressive symptoms among Hispanic emerging adults, and (2) examine the extent to which intrapersonal resources (e.g., mindfulness, distress tolerance, emotion regulation strategies) and interpersonal resources (e.g., family cohesion, social support) moderate the association between resilience and depressive symptoms. To examine these aims, 200 Hispanic emerging adults (ages 18-25) from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey, and data were analyzed using hierarchical multiple regression and moderation analyses. Findings from the hierarchical multiple regression indicate that higher resilience was associated with lower depressive symptoms. Findings from the moderation analyses indicate that family cohesion, social support, and emotion regulation strategies (e.g., cognitive reappraisal and expressive suppression) functioned as moderators; however, mindfulness and distress tolerance were not significant moderators. Findings from this study add to the limited literature on resilience among Hispanics that have used validated measures of resilience. Furthermore, we advance our understanding of who may benefit most from higher resilience based on levels of intrapersonal and interpersonal resources.

Trends in participation in teen pregnancy and STI prevention programming, 2002-2016.

Programs designed to help youth prevent early/unwanted pregnancy and sexually transmitted infection (STI) have been shown to yield a positive impact on youth behavior and key outcomes. However, recent evidence suggests that youth participation in prevention programming for health-risk behavior may be declining. The aim of the present study is to provide up-to-date information on the national trends in adolescent participation in prevention programming targeting early pregnancy and STI in the United States. We examined fifteen years of cross-sectional data (2002-2016, N = 234,803) from the National Survey on Drug Use and Health. Our main outcome was youth self-reported (no/yes) past-year participation in a pregnancy or STI prevention program. Survey adjusted prevalence estimates and logistic regression analysis were used to examine trends in participation. Youth participation in pregnancy and STI prevention programming decreased significantly from a high of 15% in 2003 to a low of 7% in 2016. Representing a 53% proportional decline in youth participation, this downward trend was significant even when controlling for age, gender, race/ethnicity, household income, and urbanicity (AOR: 0.947, 95% CI: 0.943-0.951). The downward trend in participation was observed across racial/ethnic subgroups. A consistent pattern of differences in prevalence was observed with African-American youth reporting the highest levels of participation followed by Hispanic, and then White youth. It is incumbent upon concerned citizens, scientists, and policymakers to push for change that can shift the trend line in adolescent participation in teen pregnancy and STI prevention programming to an upward tilt.