RESUMO
BACKGROUND: There has been consistent epidemiological evidence of the association between drinking, alcohol dependence, and depression. However, most of the research has ignored potential diversity across Hispanic national subgroups. This study examines the prevalence of depression and explores its association with volume of drinking, age at first drink, binge drinking, and alcohol dependence across Mexican American, Puerto Rican, Cuban, and South/Central American Hispanic national groups. METHODS: Data from more than 19,000 Hispanic adults were obtained from the 2010 to 2012 National Survey on Drug Use and Health. Survey logistic regression methods were used to test for differences in the relationship between major depressive disorder (MDD) and alcohol consumption across national groups. RESULTS: The prevalence of MDD varied significantly across Hispanic national groups (χ(2) = 67.06, p < 0.001). Puerto Ricans (14%) and Mexican Americans (9%) were most likely to have MDD. Mexican Americans had the highest prevalence of alcohol dependence, volume of consumption, and youngest age at first drink compared to Puerto Ricans, Cuban Americans, and Central/South Americans. Multivariate results suggest that the odds of alcohol dependence were nearly 4 times greater among Hispanics with MDD compared to Hispanics who did not meet the criteria for MDD. Hispanic national origin did not modify the association between MDD and alcohol use. CONCLUSIONS: Although significant differences in the prevalence rates of MDD and alcohol-use measures emerged across Hispanic national groups, there was no evidence that the relationships between these measures were different across Hispanic national groups. Further research should investigate the root causes of these variable MDD prevalence rates to inform detection and intervention efforts targeted toward specific national groups.
Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Alcoolismo/etnologia , Transtorno Depressivo Maior/etnologia , Hispânico ou Latino , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/diagnóstico , Alcoolismo/psicologia , América Central/etnologia , Estudos Transversais , Cuba/etnologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Feminino , Inquéritos Epidemiológicos/métodos , Hispânico ou Latino/psicologia , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Porto Rico/etnologia , Distribuição Aleatória , América do Sul/etnologia , Adulto JovemRESUMO
BACKGROUND: This study examines the association between perceived neighborhood violence, perceived neighborhood collective efficacy, and binge drinking among Mexican Americans residing on the U.S.-Mexico border. METHODS: Data were collected from a multistage cluster sample of adult Mexican Americans residing in the U.S.-Mexico border areas of California, Arizona, New Mexico, and Texas (N = 1,307). The survey weighted response rate was 67%. Face-to-face interviews lasting approximately 1 hour were conducted in respondents' homes in English or Spanish. Path analysis was used to test whether collective efficacy mediated the impact of perceived neighborhood violence on binge drinking. RESULTS: Among 30+-year-old women, perceived neighborhood collective efficacy mediated the effects of perceived neighborhood violence on binge drinking in a theoretically predicted way: Lower perceptions of violence predicted an increased perception of collective efficacy, which in turn, predicted less binge drinking. Direct effects of violence perceptions on binge were nonsignificant. Younger 18- to 29-year-old women showed a similar (but nonsignificant) pattern of effects. Perceived collective efficacy also mediated the effects of perceived violence on binge drinking among men, but in opposite ways for older and younger men. Older men showed the same mediating effect as older women, but the effect reversed among younger men due to a strong, positive relation between collective efficacy and binge drinking. There were also age differences in the direct effect of violence perceptions on binge drinking: Perceptions of violence predicted more binge drinking among young men, but less among older men. CONCLUSIONS: These results highlight the complexity of people's responses to neighborhood characteristics in regard to their drinking. Young men in particular seem to react very differently to perceptions of collective efficacy than other groups. However, among both men and women, collective efficacy may come to play an increasingly important protective role in health outcomes with age.
Assuntos
Consumo Excessivo de Bebidas Alcoólicas/diagnóstico , Consumo Excessivo de Bebidas Alcoólicas/etnologia , Americanos Mexicanos/etnologia , Percepção , Características de Residência , Adulto , Arizona/etnologia , Consumo Excessivo de Bebidas Alcoólicas/psicologia , California/etnologia , Análise por Conglomerados , Feminino , Humanos , Masculino , Americanos Mexicanos/psicologia , México/etnologia , Pessoa de Meia-Idade , New Mexico/etnologia , Texas/etnologia , Adulto JovemRESUMO
BACKGROUND: Levels of drinking are unusually elevated among young adults on the U.S.-Mexico border, and this elevation can be largely explained by young border residents' unusually high frequency of bar attendance. However, this explanation complicates interpretation of high alcohol problem rates that have also been observed in this group. Because bar environments can lower the threshold for many types of problems, the extent to which elevated alcohol problems among young border residents can be attributed to drinking per se-versus this common drinking context-is not clear. METHODS: Data were collected from multistage cluster samples of adult Mexican Americans on and off the U.S.-Mexico border (current drinker N = 1,351). After developing structural models of acute alcohol problems, estimates were subjected to path decompositions to disentangle the common and distinct contributions of drinking and bar attendance to problem disparities on and off the border. Additionally, models were estimated under varying degrees of adjustment to gauge the sensitivity of the results to sociodemographic, social-cognitive, and environmental sources of confounding. RESULTS: Consistent with previous findings for both drinking and other problem measures, acute alcohol problems were particularly elevated among young adults on the border. This elevation was entirely explained by a single common pathway involving bar attendance frequency and drinking. Bar attendance did not predict acute alcohol problems independently of drinking, and its effect was not moderated by border proximity or age. The common indirect effect and its component effects (of border youth on bar attendance, of bar attendance on drinking, and of drinking on problems) were surprisingly robust to adjustment for confounding in all parts of the model (e.g., fully adjusted indirect effect: b = 0.11, SE = 0.04, p < 0.01). CONCLUSIONS: Bar attendance and associated increases in drinking play a key, unique role in the high levels of acute alcohol problems among the border's young adult population that cannot be entirely explained by sociodemographic or social-cognitive characteristics of young border residents, by contextual effects of bars on problems, or by broader neighborhood factors. Bar attendance in particular may represent an early modifiable risk factor that can be targeted to reduce alcohol problem disparities in the region.
Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Intoxicação Alcoólica/etnologia , Americanos Mexicanos/etnologia , Características de Residência , Adolescente , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/tendências , Intoxicação Alcoólica/diagnóstico , Intoxicação Alcoólica/psicologia , Alcoolismo/diagnóstico , Alcoolismo/etnologia , Alcoolismo/psicologia , Feminino , Humanos , Masculino , Americanos Mexicanos/psicologia , México/etnologia , Fatores de Risco , Estados Unidos/etnologia , Adulto JovemRESUMO
BACKGROUND: Rates of alcohol-related outcomes are sensitive to policy differences in politically distinct, adjacent territories. Factors that shape these cross-border effects, particularly when the policy differences are longstanding, remain poorly understood. We compared the ability of 2 classes of variables with theoretical relevance to the U.S.-Mexico border context-bar attendance and alcohol-related social-cognitive variables-to explain elevated drinking on the U.S. side of the border relative to other areas of the United States. METHODS: Data were collected from multistage cluster samples of adult Mexican Americans on and off the U.S.-Mexico border (current drinker N = 1,351). Structural equation models were used to test drinking context (frequency of bar attendance) and 6 different social-cognitive variables (including alcohol-related attitudes, norms, motives, and beliefs) as mediators of border effects on a composite drinking index. RESULTS: The border effect on drinking varied by age (with younger adults showing a stronger effect), consistent with previous findings and known risk factors in the region. Contrary to theoretical expectations, 6 different social-cognitive variables-despite relating strongly with drinking-were comparable in border and nonborder areas (within and across age) and played no role in elevated drinking on the border. Conversely, elevated drinking among border youth was mediated by bar attendance. This mediated moderation effect held after adjusting for potential sociodemographic and neighborhood-level confounders. CONCLUSIONS: Increased drinking among U.S.-Mexico border youth is explained by patterns of bar attendance, but not by more permissive alcohol-related social-cognitive variables in border areas: Border youth attend bars and drink more than their nonborder counterparts, despite having comparable alcohol-related beliefs, attitudes, norms, and motives for use. Alcohol's heightened availability and visibility on both sides of the border may create opportunities for border youth to drink that otherwise would not be considered.
Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Emigração e Imigração , Americanos Mexicanos/etnologia , Política Pública/legislação & jurisprudência , Pensamento , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Feminino , Humanos , Masculino , Americanos Mexicanos/psicologia , México/etnologia , Pessoa de Meia-Idade , Fatores de Risco , Estados Unidos/etnologia , Adulto JovemRESUMO
BACKGROUND: To determine the age of immigration at which the marked increase in risk for alcohol- and drug-use problems in adulthood is observed among Mexican American adults residing in 2 distinct contexts: the U.S.-Mexico border, and cities not proximal to the border. METHODS: We used 2 samples of Mexican American adults: specifically, 1,307 who resided along the U.S.-Mexico border, and 1,288 non-border adults who were interviewed as a part of the 2006 Hispanic Americans Baseline Alcohol Survey study. Survey logistic and Poisson regression methods were used to examine how immigration age during adolescence is related to alcohol- and drug-use behavior in adulthood. RESULTS: We found that participants who immigrate to the United States prior to age 14 have qualitatively different alcohol- and drug-related outcomes compared to those who immigrate later in life. Adults who immigrated at younger ages have alcohol- and drug-use patterns similar to those who were U.S.-born. Adults who immigrated at young ages and reside distal from the U.S.-Mexico border are at greater risk for alcohol and drug use than those who live in border contexts. CONCLUSIONS: Immigration from Mexico to the U.S. before age 14 results in alcohol- and drug-related behavior that mirrors the behavior of U.S.-born residents, and the alcohol- and drug-use effects were more pronounced among adults who did not reside proximal to the U.S.-Mexico border.
Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Usuários de Drogas/estatística & dados numéricos , Emigração e Imigração/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Distribuição por Idade , Fatores Etários , Consumo Excessivo de Bebidas Alcoólicas/etnologia , Feminino , Geografia Médica , Inquéritos Epidemiológicos , Humanos , Masculino , Americanos Mexicanos/psicologia , Fatores de Risco , Estados Unidos/epidemiologia , Estados Unidos/etnologiaRESUMO
BACKGROUND: This article examines age at first drink and adult drinking, binge drinking and DSM-5 alcohol use disorder (AUD) among U.S. Hispanic national groups. METHODS: Respondents come from 2 independent studies. The Hispanic Americans Baseline Alcohol Survey used a multistage cluster sample design to interview 5,224 individuals 18 years of age and older selected from the household population in Miami, New York, Philadelphia, Houston, and Los Angeles. Respondents in the border area (N = 1,307) constituted a household probability sample of Mexican Americans living on U.S. counties that border Mexico. In both surveys, data were collected during computer-assisted interviews conducted in respondents' homes. The Hispanic American Baseline Alcohol Survey and the border sample response rates were 76 and 67%, respectively. RESULTS: U.S.-born Hispanics begin drinking at a younger age than those who are foreign-born, independent of national group. Among foreign-born Hispanics, age of arrival in the United States is not associated with age at first drink. Results support the hypothesis that a younger age at first drink is associated with a higher mean volume of drinking, a higher probability of bingeing, and a higher probability of DSM-5 AUD. But the results do not show a clear pattern by which a particular national group would consistently show no associations or stronger associations between age at first drink and the alcohol-related outcomes under consideration. CONCLUSIONS: An earlier age at first drinking is positively associated with heavier drinking patterns among U.S. Hispanics. However, as in other areas of alcohol epidemiology, here too there is considerable variation in age at first drink and drinking across Hispanic national groups.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Hispânico ou Latino/estatística & dados numéricos , Adolescente , Fatores Etários , América Central/etnologia , Cuba/etnologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , México/etnologia , Porto Rico/etnologia , Fatores Sexuais , América do Sul/etnologia , Estados Unidos/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Health disparities research seeks to eliminate disproportionate negative health outcomes experienced in some racial/ethnic minority groups. This brief review presents findings on factors associated with drinking and alcohol-related problems in racial/ethnic groups. METHODS: Those discussed are as follows: (i) biological pathways to alcohol problems, (ii) gene × stress interactions, (iii) neighborhood disadvantage, stress, and access to alcohol, and (iv) drinking cultures and contexts. RESULTS: These factors and their interrelationships are complex, requiring a multilevel perspective. CONCLUSIONS: The use of interdisciplinary teams and an epigenetic focus are suggested to move the research forward. The application of multilevel research to policy, prevention, and intervention programs may help prioritize combinations of the most promising intervention targets.
Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Transtornos Relacionados ao Uso de Álcool/etiologia , Grupos Populacionais/genética , Estresse Psicológico , Consumo de Bebidas Alcoólicas/psicologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Cultura , Interação Gene-Ambiente , Humanos , Características de ResidênciaRESUMO
BACKGROUND: This paper examines the prevalence, the symptom profile, and the drinking and sociodemographic predictors of current (past 12 months) DSM-IV alcohol abuse and dependence among Mexican Americans living along the U.S.-Mexico border and those living in metropolitan areas away from the border. METHODS: Respondents in the non-border areas (primarily Houston and Los Angeles) constitute a multistage probability sample (N = 1,288) of these areas, interviewed as part of the 2006 Hispanic Americans Baseline Alcohol Survey (HABLAS). Respondents in the border area (N = 1,307) constitute a household probability sample of Mexican Americans living on the border. In both surveys, data were collected during computer-assisted interviews conducted in respondents' homes. The HABLAS and the border sample response rates were 76 and 67%, respectively. RESULTS: Although bivariate analyses revealed no overall differences between border and non-border locations, (negative) age trends were more pronounced on the border for male abuse and for dependence among both genders. Among females aged 18 to 29, border residence was linked to significantly higher rates of dependence. In multivariable analyses, the prevalence of male abuse declined more rapidly with age on the border than off the border. Other unique predictors of male abuse were Jewish/other religion and weekly volume of alcohol consumption. Being married or out of the workforce, attaining a higher education, having no religious preference, and weekly volume uniquely predicted female dependence. Age and weekly volume uniquely predicted male dependence. CONCLUSIONS: The prevalence of alcohol use disorders among Mexican Americans on and off the U.S.-Mexico border largely mirrors previously documented patterns of alcohol consumption in these areas. For young Mexican American women in particular, border residence is linked to heightened vulnerability to alcohol dependence.
Assuntos
Alcoolismo/etnologia , Americanos Mexicanos/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Escolaridade , Emprego , Feminino , Geografia , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Prevalência , Religião , Fatores de Risco , Distribuição por Sexo , Estados Unidos/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Acculturation to life in the United States is a known predictor of Hispanic drinking behavior. We compare the ability of 2 theoretical models of this effect-sociocultural theory and general stress theory-to account for associations between acculturation and drinking in a sample of Mexican Americans. Limitations of previous evaluations of these theoretical models are addressed using a broader range of hypothesized cognitive mediators and a more direct measure of acculturative stress. In addition, we explore nonlinearities as possible underpinnings of attenuated acculturation effects among men. METHODS: Respondents (N = 2,595, current drinker N = 1,351) were interviewed as part of 2 recent multistage probability samples in a study of drinking behavior among Mexican Americans in the United States. The ability of norms, drinking motives, alcohol expectancies, and acculturation stress to account for relations between acculturation and drinking outcomes (volume and heavy drinking days) were assessed with a hierarchical linear regression strategy. Nonlinear trends were assessed by modeling quadratic effects of acculturation and acculturation stress on cognitive mediators and drinking outcomes. RESULTS: Consistent with previous findings, acculturation effects on drinking outcomes were stronger for women than men. Among women, only drinking motives explained acculturation associations with volume or heavy drinking days. Among men, acculturation was linked to increases in norms, and norms were positive predictors of drinking outcomes. However, adjusted effects of acculturation were nonexistent or trending in a negative direction, which counteracted this indirect normative influence. Acculturation stress did not explain the positive associations between acculturation and drinking. CONCLUSIONS: Stress and alcohol outcome expectancies play little role in the positive linear association between acculturation and drinking outcomes, but drinking motives appear to at least partially account for this effect. Consistent with recent reports, these results challenge stress models of linear acculturation effects on drinking outcomes and provide (partial) support for sociocultural models. Inconsistent mediation patterns-rather than nonlinearities-represented a more plausible statistical description of why acculturation-drinking associations are weakened among men.
Assuntos
Aculturação , Consumo de Bebidas Alcoólicas/etnologia , Americanos Mexicanos/etnologia , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Arizona/etnologia , California/etnologia , Estudos Transversais , Feminino , Humanos , Masculino , Americanos Mexicanos/psicologia , New Mexico/etnologia , Cidade de Nova Iorque/etnologia , Pennsylvania/etnologia , Texas/etnologia , Estados Unidos/etnologiaRESUMO
BACKGROUND: The "prevention paradox," a notion that most alcohol-related problems are generated by nonheavy drinkers, has significant relevance to public health policy and prevention efforts. The extent of the paradox has driven debate over the type of balance that should be struck between alcohol policies targeting a select group of high-risk drinkers versus more global approaches that target the population at-large. This paper examines the notion that most alcohol problems among 4 Hispanic national groups in the United States are attributable to moderate drinkers. METHODS: A general population survey employing a multistage cluster sample design, with face-to-face interviews in respondents' homes was conducted in 5 metropolitan areas of the United States. Study participants included a total of 2,773 current drinkers 18 years and older. Alcohol consumed in the past year (bottom 90% vs. top 10%), binge drinking (binge vs. no binge), and a 4-way grouping defined by volume and binge criteria were used. Alcohol-related harms included 14 social and dependence problems. RESULTS: Drinkers at the bottom 90% of the distribution are responsible for 56 to 73% of all social problems, and for 55 to 73% of all dependence-related problems reported, depending on Hispanic national group. Binge drinkers are responsible for the majority of the social problems (53 to 75%) and dependence-related problems (59 to 73%), also depending on Hispanic national group. Binge drinkers at the bottom 90% of the distribution are responsible for a larger proportion of all social and dependence-related problems reported than those at the top 10% of the volume distribution. Cuban Americans are an exception. CONCLUSIONS: The prevention paradox holds when using volume-based risk groupings and disappears when using a binge-drinking risk grouping. Binge drinkers who drink moderately on an average account for more harms than those who drink heavily across all groups, with exception of Cuban Americans.
Assuntos
Alcoolismo/etnologia , Alcoolismo/prevenção & controle , Coleta de Dados/métodos , Etanol/intoxicação , Hispânico ou Latino/etnologia , Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/prevenção & controle , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Análise por Conglomerados , Comparação Transcultural , Feminino , Hispânico ou Latino/psicologia , Humanos , Masculino , Estados Unidos/etnologiaRESUMO
BACKGROUND: Multiple theoretical frameworks identify attitudes and expectancies as important predictors of alcohol behavior. Few studies have examined demographic predictors of these evaluative and belief-based cognitive mediators in the general population, and none have examined them in large-scale studies of Hispanics, a group at higher risk for drinking behavior and problems. This study probes the extent to which dimensions of attitudes and expectancies share common demographic predictors in a large sample of Puerto Ricans, Cuban-Americans, Mexican-Americans, and South/Central Americans. METHODS: The 2006 Hispanic Americans Baseline Alcohol Survey (HABLAS) used a multistage cluster sample design to interview 5,224 individuals randomly selected from households in Miami, New York, Philadelphia, Houston, and Los Angeles. This study focused on 2,773 respondents self-identified as current drinkers. Multiple linear regression was used to identify predictors of positive and negative dimensions of attitudes and expectancies, controlling for various background variables. RESULTS: Religious affiliation selectively predicted alcohol attitudes, with Catholics having more positive and fewer negative attitudes than other religious groups. Hispanic group selectively predicted alcohol expectancies, with Cuban-Americans having less positive and less negative expectancies than other groups. Being U.S.-born or male predicted more positive attitudes and expectancies, but birthplace and gender did not predict negative dimensions of attitudes or expectancies. Higher acculturation and more education were linked to a decreased tendency to agree with any item. Age was positively and negatively associated with negative expectancies and positive attitudes, respectively, and having never been married, higher income, and unemployment were each linked to fewer negative attitudes. CONCLUSIONS: Although there is some overlap, attitudes and expectancies are influenced by different sociodemographic variables. Positive and negative dimensions of those constructs also show distinct patterns of relations. Prevention and treatment programs targeting cognitive mediators of behavior should be mindful of these differential determinants and future modeling endeavors should incorporate them.
Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/psicologia , Comparação Transcultural , Inquéritos Epidemiológicos , Hispânico ou Latino/etnologia , Hispânico ou Latino/psicologia , Adulto , Atitude Frente a Saúde/etnologia , América Central/etnologia , Estudos Transversais , Cuba/etnologia , Feminino , Previsões/métodos , Humanos , Masculino , Americanos Mexicanos/etnologia , Americanos Mexicanos/psicologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Porto Rico/etnologia , Estados Unidos/etnologiaRESUMO
Factors associated with CES-D depression among Mexican Americans living on and off the U.S.-Mexico border are examined. Data are from two studies of Mexican American adults. The Border Survey conducted face-to-face interviews in urban U.S.-Mexico border counties of California, Arizona, New Mexico, and Texas (N = 1307). The non-border HABLAS survey conducted face-to-face interviews in Houston, Los Angeles, New York, Philadelphia, and Miami (N = 1288). Both surveys used a multistage cluster sample design with response rates of 67 and 76 %, respectively. The multivariate analysis showed that border residence and higher perceived neighborhood collective efficacy were protective for depression among men. Among men, lower education, unemployment, increased weekly drinking, and poor health status were associated with depression. Among women, alcohol-related problems and poorer health status were also associated with depression. Further examinations of how neighborhood perceptions vary by gender and how these perceptions influence the likelihood of depression are warranted.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Depressão/etnologia , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Aculturação , Adolescente , Adulto , Fatores Etários , Feminino , Nível de Saúde , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Estados Unidos , População Urbana/estatística & dados numéricos , Adulto JovemRESUMO
Fuzzy-trace theory is a theory of memory, judgment, and decision making, and their development. We applied advances in this theory to increase the efficacy and durability of a multicomponent intervention to promote risk reduction and avoidance of premature pregnancy and sexually transmitted infections. Seven hundred and thirty-four adolescents from high schools and youth programs in 3 states (Arizona, Texas, and New York) were randomly assigned to 1 of 3 curriculum groups: RTR (Reducing the Risk), RTR+ (a modified version of RTR using fuzzy-trace theory), and a control group. We report effects of curriculum on self-reported behaviors and behavioral intentions plus psychosocial mediators of those effects: namely, attitudes and norms, motives to have sex or get pregnant, self-efficacy and behavioral control, and gist/verbatim constructs. Among 26 outcomes, 19 showed an effect of at least 1 curriculum relative to the control group: RTR+ produced improvements for 17 outcomes and RTR produced improvements for 12 outcomes. For RTR+, 2 differences (for perceived parental norms and global benefit perception) were confined to age, gender, or racial/ethnic subgroups. Effects of RTR+ on sexual initiation emerged 6 months after the intervention, when many adolescents became sexually active. Effects of RTR+ were greater than RTR for 9 outcomes, and remained significantly greater than controls at 1-year follow-up for 12 outcomes. Consistent with fuzzy-trace theory, results suggest that by emphasizing gist representations, which are preserved over long periods and are key memories used in decision making, the enhanced intervention produced larger and more sustained effects on behavioral outcomes and psychosocial mediators of adolescent risk taking.
Assuntos
Comportamento do Adolescente/psicologia , Tomada de Decisões , Julgamento , Memória , Motivação , Comportamento de Redução do Risco , Comportamento Sexual/psicologia , Sexo sem Proteção/prevenção & controle , Adolescente , Feminino , Humanos , Masculino , Assunção de Riscos , Adulto JovemRESUMO
The Clinical Research Appraisal Inventory (CRAI) is a 92-item measure covering 10 domains of research self-efficacy. A known behavioral antecedent, reliable and valid measures of self-efficacy represent a potentially useful tool in the evaluation of research training program efficacy. However, few formal psychometric studies of this instrument exist. Using exploratory factor analysis, we examine the CRAI's dimensional structure in a new sample of clinical research trainees. In contrast to the multidimensional solutions reported previously, CRAI responses in the present sample were unambiguously one-dimensional (as suggested by a dominant single Eigenvalue and parallel analysis). This discrepant finding may reflect sample differences in research experience, as unlike previous studies, participants had all already obtained a professional degree. The CRAI's dimensional structure may coalesce into a smaller number of factors as research experience is acquired, and investigators should be mindful of this possibility in future studies of the instrument.
Assuntos
Pesquisa Biomédica/normas , Avaliação de Programas e Projetos de Saúde/normas , Pesquisadores/normas , Adulto , Pesquisa Biomédica/educação , Pesquisa Biomédica/métodos , Análise Fatorial , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde/métodos , Psicometria , Pesquisadores/educação , Pesquisadores/psicologia , Autoeficácia , Texas , Pesquisa Translacional Biomédica/educação , Pesquisa Translacional Biomédica/métodos , Pesquisa Translacional Biomédica/normasRESUMO
The purpose of this study is to identify enabling factors for treatment utilization for alcohol-related problems, and to evaluate how enabling factors vary by need for treatment, among two samples of Mexican American adults. These two distinct samples included 2,595 current and former drinkers (one sample included 787 U.S./Mexico border residents; the other sample included 740 Mexican Americans living in U.S. cities not proximal to the border). Need for treatment (alcohol disorder severity) and (male) gender were the primary correlates of treatment utilization; and there was no moderation in the enabling factors by need for treatment as "enablers" of utilization. Further theoretical and empirical research is necessary to determine which mechanisms are driving disparities in treatment utilization across racial/ethnic groups generally, and Hispanic national groups specifically.
Assuntos
Alcoolismo/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Americanos Mexicanos/psicologia , Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos , Adulto , Alcoolismo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Adulto JovemRESUMO
This chapter reviews selected epidemiologic studies on drinking and associated problems among US ethnic minorities. Ethnic minorities and the White majority group exhibit important differences in alcohol use and related problems, including alcohol use disorders. Studies show a higher rate of binge drinking, drinking above guidelines, alcohol abuse, and dependence for major ethnic and racial groups, notably, Blacks, Hispanics, and American Indians/Alaskan Natives. Other problems with a higher prevalence in certain minority groups are, for example, cancer (Blacks), cirrhosis (Hispanics), fetal alcohol syndrome (Blacks and American Indians/Alaskan Natives), drinking and driving (Hispanics, American Indians/Alaskan Natives). There are also considerable differences in rates of drinking and problems within certain ethnic groups such as Hispanics, Asian Americans, and American Indians/Alaskan Natives. For instance, among Hispanics, Puerto Ricans and Mexican Americans drink more and have higher rates of disorders such as alcohol abuse and dependence than Cuban Americans. Disparities also affect the trajectory of heavy drinking and the course of alcohol dependence among minorities. Theoretic accounts of these disparities generally attribute them to the historic experience of discrimination and to minority socioeconomic disadvantages at individual and environmental levels.
Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Transtornos Relacionados ao Uso de Álcool/etnologia , Etnicidade/etnologia , Grupos Minoritários , Inquéritos e Questionários , Consumo de Bebidas Alcoólicas/efeitos adversos , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Animais , Humanos , Estados Unidos/etnologiaRESUMO
The predominately Hispanic U.S.-Mexico border population is at an elevated risk for drinking and associated problems due to the area's low SES, poor services infrastructure, and drug-related violence. Among Mexican American residents, recent studies suggest this risk is particularly pronounced among younger age groups, and a key characteristic of this elevated risk involves crossing the border to drink in Mexico (where the legal drinking age is 18). However, few studies have compared the drinking behavior of U.S. residents who consume alcohol on the Mexico side of the border with those who do not. We address this gap in the present study. A multistage household probability sample of 1307 Mexican American border residents was interviewed about their drinking and associated problems over the past year. The survey response rate was 67%. Among current drinkers who reported going to Mexico in the past 12 months (N=468), 36.1% reported consuming alcohol in Mexico. Those who drank in Mexico reported significantly more drinks per week (12.8 versus 8.7, p<.05), were more likely to have binged (58.3% versus 35.4%, p<.001), and were more likely to report one or more alcohol problem (35.5% versus 19.5%, p<.01) than those who did not drink in Mexico. Among those who drank in Mexico, men reported significantly more drinks per day while in Mexico than women (6.2 versus 4.0, p<.001). Male gender and lower income were significant predictors of drinking in Mexico. These findings suggest that drinking in Mexico contributes to the heightened risk for drinking and associated problems seen in previous research among Mexican Americans living on the U.S.-Mexico border.
Assuntos
Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Americanos Mexicanos/estatística & dados numéricos , Viagem/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Arizona/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/etnologia , California/epidemiologia , Feminino , Geografia , Humanos , Renda/estatística & dados numéricos , Masculino , New Mexico/epidemiologia , Distribuição por Sexo , Texas/epidemiologia , Adulto JovemRESUMO
This paper examines driving under the influence (DUI) arrests and other related factors among Mexican Americans living in U.S.-Mexico border and non-border areas. Respondents in the non-border areas (primarily Houston and Los Angeles) constitute a multistage probability sample (N=1288) of these areas, interviewed as part of the 2006 Hispanic Americans Baseline Alcohol Survey (HABLAS). Respondents in the border area (N=1307) were interviewed between March 2009 and July 2010 and constitute a household probability sample of Mexican Americans living on the border. In both surveys, data were collected during computer assisted interviews conducted in respondents' homes. The HABLAS and the border sample response rates were 76% and 67%, respectively. Border or non-border residential location was not associated with self-reported DUI, 12 month DUI arrest, or lifetime DUI arrest. An increase in consumption of 5 drinks per week was associated with an 18% increase in the chance of self-reporting DUI and an 18% increase in the probability of a lifetime DUI arrest. Binge drinkers were more likely to self-report a DUI event (OR=2.85, 95% CI=1.61-5.03; p<.001) and a lifetime DUI arrest (OR=2.81; 95% CI=1.43-5.53, p<.01). Most respondents, independent of residential location, recognized DUI as a major problem affecting Hispanics. However, while most correctly identified the legal blood alcohol content to drive in their state as .08 g/dl or lower, approximately one third of individuals were unaware of the legal limit. Compared to their non-border counterparts, border men were more likely to identify a bar/tavern/club and border women were more likely to identify a friend or relative's home as the places of last drink before the most recent DUI trip originated. In conclusion, border and non-border Mexican Americans are not different regarding DUI rates. These rates are high in both groups, especially among men. Intervention strategies to decrease DUI should be implemented not only in drinking establishments but also with families.
Assuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Condução de Veículo/legislação & jurisprudência , Americanos Mexicanos/legislação & jurisprudência , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Intoxicação Alcoólica/epidemiologia , Atitude , Condução de Veículo/estatística & dados numéricos , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Feminino , Geografia , Humanos , Modelos Logísticos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Análise Multivariada , Características de Residência , Fatores de Risco , Fatores Sexuais , Estados Unidos/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: This study was conducted to examine discrepancies in alcohol consumption estimates between a self-reported standard quantity-frequency measure and an adjusted version based on respondents' typically used container size. METHOD: Using a multistage cluster sample design, 5,224 Hispanic individuals 18 years of age and older were selected from the household population in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey-weighted response rate was 76%. Personal interviews lasting an average of 1 hour were conducted in respondents' homes in either English or Spanish. RESULTS: The overall effect of container adjustment was to increase estimates of ethanol consumption by 68% for women (range across Hispanic groups: 17%-99%) and 30% for men (range: 14%-42%). With the exception of female Cuban American, Mexican American, and South/Central American beer drinkers and male Cuban American wine drinkers, all percentage differences between unadjusted and container-adjusted estimates were positive. Second, container adjustments produced the largest change for volume of distilled spirits, followed by wine and beer. Container size adjustments generally produced larger percentage increases in consumption estimates for the higher volume drinkers, especially the upper tertile of female drinkers. CONCLUSIONS: Self-reported alcohol consumption based on standard drinks underreports consumption when compared with reports based on the amount of alcohol poured into commonly used containers.
Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Bebidas Alcoólicas , Hispânico ou Latino/etnologia , Inquéritos e Questionários , Adulto , Consumo de Bebidas Alcoólicas/psicologia , América Central/etnologia , Análise por Conglomerados , Cuba/etnologia , Feminino , Hispânico ou Latino/psicologia , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Porto Rico/etnologia , América do Sul/etnologia , Estados Unidos/etnologiaRESUMO
This paper examines alcohol-related social problems among Mexican Americans living along the U.S.-Mexico border and in non-border areas. Interviews were conducted among Mexican Americans in the border regions of California, Arizona, New Mexico, and Texas (N=1307). Non-border respondents were interviewed primarily in Houston and Los Angeles (N=1288) as part of the Hispanic Americans Baseline Alcohol Survey (HABLAS). Both the border and HABLAS surveys employed multistage cluster sample designs (response rates were 67% and 76%, respectively). In the bivariate analysis, there were no significant differences between border and non-border areas in the proportion of those with one or more social problem. In non-border areas, the prevalence of alcohol problems did not differ significantly by age. However, along the border the prevalence of alcohol problems was significantly different across age groups, with 18 to 29year old men and women having the highest prevalence. The final models showed no residence effect on problem likelihood. Drinking was strongly associated with problems. Although young border residents had higher problem prevalence rates than older residents, the logistic regression models showed no effect of border residence on the likelihood of problems, indicating that problems are due to alcohol consumption, not the border environment. The border, however, did appear to influence more drinking among young people. Regardless of residence, alcohol treatment and preventive interventions tailored to Mexican Americans are essential and special attention should be focused on younger individuals near the border.