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.

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.

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.

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.

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.

Safeguarding the Lives of Children Affected by Boko Haram: Application of the SAFE Model of Child Protection to a Rights-Based Situation Analysis.

The Boko Haram insurgency in northeast Nigeria is responsible for the highest number of lives lost in Africa in the past decade. The country has witnessed significant violations of the United Nations Convention on the Rights of the Child, which Nigeria has signed and ratified. For instance, Nigeria had the second-highest number of children recruited to armed groups and the third-highest number of abductions in 2018. Current humanitarian efforts primarily target camps for internally displaced persons, while state strategies focus mainly on addressing security through combatant-targeted interventions. However, there is a need for more rights-based, integrated, and multifaceted approaches to tackle the interrelated threats to the security of children and their families affected by the conflict. This paper uses the SAFE model of child protection-which examines the interrelatedness of safety, access, family, and education and economic security-to analyze the challenges of children and youth affected by the conflict. We highlight the need for a gendered approach; strategies that address poverty and cultural and governance barriers; and interdisciplinary, context-specific, and autonomous child protection systems. The paper calls for urgent and increased attention to the core rights and human security needs of these children to avoid a replay of negative outcomes of conflict, where the costs and consequences propagate a cycle of violence and disadvantage.

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.