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1.
Tob Control ; 2022 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-36601779

RESUMO

INTRODUCTION: Studies show that tobacco use among sexual and gender minority (SGM) populations is disproportionately higher than heterosexual or cisgender populations. However, few studies have examined tobacco use among SGM subgroups by race/ethnicity or associations between SGM-specific discrimination and connection to SGM identity and tobacco use. METHODS: This study analysed survey data from 11 313 SGM (gay, lesbian, bisexual, other sexual minority or gender minority) young adults in the USA and reported current cigarette, e-cigarette, other tobacco (cigar, smokeless tobacco, hookah) and polytobacco use. We used multinomial logistic regression to estimate associations between (a) SGM subgroup, race/ethnicity, SGM-specific discrimination and SGM identity connection and (b) each tobacco use outcome (vs never use of tobacco). We conducted postestimation testing to assess predicted probabilities of tobacco use against the sample average. RESULTS: Lesbian females (particularly black lesbian females) had higher-than-average probability of polytobacco use. White bisexual and lesbian participants had higher-than-average probability of cigarette and e-cigarette use, respectively. Higher levels of discrimination were associated with polytobacco use. Higher levels of identity connectedness were protective against certain tobacco use behaviours among gender minority participants and participants with high levels of discrimination experience. CONCLUSIONS: We found variations in tobacco use by SGM subgroups overall and by race/ethnicity. Discrimination may be a risk factor for certain tobacco use behaviours. However, SGM identity connectedness may be protective against tobacco use among gender minority individuals and individuals experiencing SGM-specific discrimination. These findings can inform targeted approaches to reach SGM subgroups at greater risk of tobacco use.

2.
Subst Use Misuse ; 55(7): 1045-1053, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32024418

RESUMO

Background: Understanding which adolescents are at greatest risk for cigarettes and other tobacco products is critical to inform tailored and targeted interventions. Objectives: We used peer crowds (macro-level subcultures) to identify subgroups of adolescents at-risk for using and being open to using cigarettes; cigars, cigarillos, and little cigars (cigar products); hookah; e-cigarettes; any tobacco product; and multiple products. Methods: In 2017, youth ages 12-17 in five U.S. states completed cross-sectional surveys (n = 1,167). Participants provided data on cigarette use (experimentation) and openness to use (susceptibility); cigar product, hookah, and e-cigarette use (ever use) and openness to use (curiosity); and identification with five peer crowds (Alternative, Country, Hip Hop, Mainstream, Popular). We used chi-square tests to compare rates by peer crowd, and multivariate logistic regressions to assess odds of use and openness for each crowd (reference: Mainstream). Results: Risk differed by peer crowd. Hip Hop youth reported high rates of use, ranging from 12.8% (cigarettes) to 33.4% (e-cigarettes). Regressions revealed increased odds of use for Hip Hop compared to Mainstream for all products, especially cigar products and multi-product use. Popular (cigar products, e-cigarettes) and Alternative (cigarettes) demonstrated increased odds of use compared to Mainstream. We also observed elevated odds of cigarette openness among Alternative, Country, and Hip Hop youth, and of hookah openness among Hip Hop and Popular youth compared to Mainstream. Conclusions/Importance: Peer crowd-tailored cigarette education campaigns can be extended to address other tobacco product risk, especially for higher-risk peer crowds such as Hip Hop.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Cachimbos de Água , Produtos do Tabaco , Vaping , Adolescente , Criança , Estudos Transversais , Humanos , Uso de Tabaco
3.
Am J Public Health ; 107(3): 389-395, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28103067

RESUMO

Grounded on research showing that peer crowds vary in risk behavior, several recent health behavior interventions, including the US Food and Drug Administration's Fresh Empire campaign, have targeted high-risk peer crowds. We establish the scientific foundations for using this approach. We introduce peer crowd targeting as a strategy for culturally targeting health behavior interventions to youths. We use social identity and social norms theory to explicate the theoretical underpinnings of this approach. We describe Fresh Empire to demonstrate how peer crowd targeting functions in a campaign and critically evaluate the benefits and limitations of this approach. By replacing unhealthy behavioral norms with desirable, healthy lifestyles, peer crowd-targeted interventions can create a lasting impact that resonates in the target audience's culture.


Assuntos
Cultura , Promoção da Saúde/organização & administração , Grupo Associado , Prevenção do Hábito de Fumar , Adolescente , Criança , Feminino , Humanos , Masculino , Fumar/epidemiologia , Fumar/etnologia , Identificação Social , Normas Sociais , Estados Unidos , Adulto Jovem
4.
Health Educ Behav ; : 10901981241266846, 2024 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-39081048

RESUMO

Similar to national trends, in Illinois, fatal opioid overdoses have risen. Black men (35+) outrank all other racial subgroups for the highest rate of fatal opioid overdoses in the state. To address this, Prevention First and the Illinois Department of Human Services developed a public health education campaign to support increasing enrollment in recovery services, with a focus on Black men (35+). Self-reported Black participants with opioid use disorder (OUD) made up the analytic sample. Study goals were to understand lived experiences of the campaign audience; investigate knowledge, attitudes, and beliefs regarding OUD and treatment; explore perceived barriers and facilitators to treatment; and evaluate messaging that showcased medication-assisted recovery (MAR) as a viable tool for treatment and recovery. Interviews were recorded and transcribed for thematic analysis. Participants shared long and cyclical journeys of use and recovery. Participants had low levels of knowledge of available treatment options and struggled to imagine themselves in recovery because of the fear of cravings and withdrawal. Messaging that was realistic about the cyclical nature of recovery, showed the varying options for MAR, and addressed cravings and withdrawals were well received. These findings illustrate the importance of understanding an audience and involving them in campaign development to create messaging that promotes behavior change and sustained health. Through the Decision Blocks strategic framework, we discovered information gaps, barriers to treatment, and practical solutions to increase access to treatment for Black men with OUD that has been limited due to inequities caused by structural racism.

5.
Artigo em Inglês | MEDLINE | ID: mdl-36011746

RESUMO

To address a statewide need for obesity prevention, the Oklahoma Tobacco Settlement Endowment Trust launched Swap Up in 2021, a mass media nutrition education effort for teens, ages 13-18. Swap Up utilizes the SAVI messaging approach, an audience-centric message development framework that recognizes barriers to healthy living and offers realistic solutions. Five months into the campaign, an online survey was conducted (n = 200) to assess short-term program goals related to campaign delivery, engagement, and relevance. A secondary, long-term goal related to documenting and understanding self-reported changes in past month nutrition-related behaviors was also explored. A majority of participants (72%) reported aided awareness of the campaign brand logo/advertisements, and awareness (83%) of at least one main message. Nearly half (44%) of the participants reported at least one engagement with digital media. Main message recognition, perceived relevance, and self-reported nutritional behaviors were consistently highest among those reporting both campaign awareness and digital engagement. Ultimately, Swap Up reached and delivered nutrition education messages to Oklahoma teens within the first year of launch, as intended, and was associated with self-reported changes in recent behavior. This study provides evidence that SAVI offers a promising approach for nutrition education, and underscores why digital and social media engagement strategies are critical for mass media teen behavior change campaigns. Campaign implementation and evaluation are ongoing.


Assuntos
Promoção da Saúde , Internet , Adolescente , Educação em Saúde , Humanos , Meios de Comunicação de Massa , Oklahoma
6.
Artigo em Inglês | MEDLINE | ID: mdl-35162711

RESUMO

The prevalence rate of Cigar, Little Cigar, and Cigarillo (CLCC) use among youth rose above the rate of cigarettes for the first time in 2019, and Black and Hispanic youth remain disproportionately more susceptible and likely to use these products compared to White youth. Addressing this disparity through education requires a clearer understanding of the ways youth refer to, and group, CLCCs. Twenty-eight virtual focus groups with youth ages 13-17 (n = 105) were conducted across the U.S. Groups were split by race/ethnicity, with 14 Black and 14 Hispanic groups, and further divided by CLCC experimenters and susceptible users. Youth participants discussed CLCC use behaviors, harm and risk perceptions, and knowledge, attitudes, and beliefs about CLCC products. When shown photos of CLCC products during focus groups, youth across groups identified and labeled these products into four subcategories. Large cigars were universally labeled "cigars". Little cigars were unfamiliar and guessed to be cigarettes. Tipped cigarillos were synonymous with the brand Black and Mild and considered tobacco. Untipped cigarillos were most referred to as "blunts" and used with marijuana. Understanding the nuances of language and use patterns of CLCCs is critical to ensuring the accuracy of measurement and impact of public health communications.


Assuntos
Cannabis , Produtos do Tabaco , Adolescente , Hispânico ou Latino , Humanos , Nicotiana , Uso de Tabaco
7.
Cultur Divers Ethnic Minor Psychol ; 17(4): 432-6, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21910519

RESUMO

A feeling of belonging to an academic context is a critical determinant of academic achievement and persistence, particularly for students of color. Despite the fact that students of color are generally more susceptible to fluctuations in belonging uncertainty than White students, survey design can unintentionally mask this reality. We investigated whether context effects undermine the accurate assessment of belonging uncertainty in junior high and high school students (Study 1) and college students (Study 2). Considering one's ethnic identification (Study 1) and personal experiences with discrimination (Study 2) threatens sense of belonging in students of color, but not White students. Researchers should consider question order within surveys so as not to artificially mask belonging uncertainty in students of color.


Assuntos
Logro , Grupos Minoritários/psicologia , Identificação Social , Estudantes/psicologia , Adolescente , Adulto , Criança , Discriminação Psicológica , Feminino , Humanos , Masculino , Relações Raciais , Instituições Acadêmicas , Fatores Socioeconômicos , Estereotipagem , Incerteza , Estados Unidos , Universidades , Adulto Jovem
8.
Addict Behav Rep ; 10: 100204, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31388555

RESUMO

INTRODUCTION: Recent research has found that the Hip Hop peer crowd has a strong link to risky health behaviors, including tobacco use. The current study expands on previous research on the Hip Hop peer crowd by investigating the nuances of the effects on cigarette risk that Hip Hop identification has in combination with other peer crowds. METHODS: Targeted social media advertisements were used to recruit youth to complete an online survey. Participants (n = 4681) self-reported peer crowd identification via the I-Base Survey™, and cigarette smoking status. Smoking status was compared between peer crowd groups consisting of participants who had identification with only one peer crowd, and those who had identification with the Hip Hop peer crowd and one other crowd (i.e., Hip Hop dual peer crowd identification). RESULTS: Significant differences in cigarette status were observed among the dual and single peer crowd groups. Specifically, differences in cigarette Non-susceptible Non-triers and Experimenters demonstrated that youth who identified as Mainstream Only were at lowest risk while youth who identified as Hip Hop/Alternative had the highest rates of cigarette experimentation. There were no differences between peer crowd groups on proportions of Susceptible Non-triers. CONCLUSIONS: Examining dual peer crowd identifications provides a nuanced understanding of risk. Dual identification with Hip Hop seems to have differential effects compared to solo identification with other crowds, whereby Hip Hop identification may increase cigarette experimentation when combined with another peer crowd. Findings demonstrate the potential of considering multiple peer crowd identification to inform public education campaign development.

9.
Health Educ Behav ; 46(2): 286-294, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30353748

RESUMO

BACKGROUND: Peer crowds are macro-level, reputation-based subcultures with shared preferences, values, and behavior. The Country peer crowd has been the focus of tobacco industry research and marketing but has yet to be the primary focus of public health research. The current study explores the utility of Down and Dirty, a Social Branding tobacco education campaign, in changing Virginia Country teens' chewing tobacco-related attitudes and behavior. The relationship between chew use and Country peer crowd identification was also explored. METHOD: To evaluate the campaign, a cross-sectional survey was administered online for 3 years from 2014 to 2016. Responses were collected via social media advertisements targeting 13- to 18-year-old Country youth from Virginia (total n = 1,264). Participants reported peer crowd identification, chew-related attitudes and behavior, and campaign engagement and appeal. RESULTS: Compared with Wave 1, Waves 2 and 3 Country teens who engaged with Down and Dirty had greater odds of holding strong attitudes against chew. Among campaign-engaged Country teens, odds of chew use were lower at Waves 2 and 3, and lower odds were associated with liking the campaign. Related to chew prevalence, Country teens demonstrated greater odds of past 30-day chew use compared to non-Country teens, and higher Country identification was associated with greater odds of chew use. DISCUSSION: Down and Dirty is a promising intervention associated with positive attitudinal and behavioral outcomes for high-risk Country teens. Additionally, this study helps document tobacco-related behavioral patterns of the Country peer crowd, a priority for ongoing tobacco education, especially around chew.


Assuntos
Atitude Frente a Saúde , Promoção da Saúde/métodos , Uso de Tabaco/prevenção & controle , Tabaco sem Fumaça , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Grupo Associado , Inquéritos e Questionários , Virginia
10.
Am J Health Behav ; 43(4): 767-780, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31239019

RESUMO

Objectives: Adverse childhood experiences (ACEs) and adolescent peer crowds are associated with similar health risks, and both have been leveraged to inform interventions. In this study, we examined if ACEs and peer crowds are associated with each other, and their combined effect on health risks. Methods: A cross-sectional survey of adolescents (N = 1053) measured ACEs, peer crowd identification (Mainstream, Popular, Hip Hop, Country, Alternative), and risks (current cigarette, alcohol, and marijuana use, obesity, feeling sad/hopeless, making a suicide plan). Logistic regression explored ACEs as a predictor of peer crowd, and ACEs and peer crowds separately as risk predictors. Mediation explored peer crowd as a mediator of the relationship between ACEs and risks. Results: Experiencing 2+ ACEs was associated with increased odds of Alternative (AOR=2.38, 95% CI=1.53, 3.71) and Hip Hop (AOR=2.08, 95% CI=1.24, 3.51) peer crowd identification. ACEs level and peer crowd independently predicted risks. Finally, peer crowd identification was a partial mediator of the effect of ACEs on risks. Conclusions: ACEs and peer crowds are key predictors of adolescent health risks. Peer crowd-targeted interventions may lessen the long-term effects of ACEs by utilizing values-based, trauma-informed messaging to reduce ACEs-related risks.


Assuntos
Comportamento do Adolescente , Experiências Adversas da Infância/estatística & dados numéricos , Sintomas Afetivos/epidemiologia , Fumar Cigarros/epidemiologia , Uso da Maconha/epidemiologia , Obesidade Infantil/epidemiologia , Grupo Associado , Identificação Social , Ideação Suicida , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Risco , Consumo de Álcool por Menores/estatística & dados numéricos
11.
Addict Behav ; 82: 28-34, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29477904

RESUMO

INTRODUCTION: Peer crowds, peer groups with macro-level connections and shared norms that transcend geography and race/ethnicity, have been linked to risky health behaviors. Research has demonstrated that Hip Hop peer crowd identification, which is common among multicultural youth, is associated with increased risk of tobacco use. To address this, the FDA Center for Tobacco Products created Fresh Empire, the first national tobacco education campaign tailored for Hip Hop youth aged 12-17 who are multicultural (Hispanic, African American, Asian-Pacific Islander, or Multiracial). As part of campaign development, peer crowd (Hip Hop, Mainstream, Popular, Alternative, Country) and cigarette smoking status were examined for the first time with a nationally recruited sample. METHODS: Youth were recruited via targeted social media advertisements. Participants aged 13-17 (n = 5153) self-reported peer crowd identification via the I-Base Survey™ and cigarette smoking status. Differences in smoking status by peer crowd were examined using chi-square and followed up with z-tests to identify specific differences. RESULTS: Alternative youth were most at risk of cigarette smoking, followed by Hip Hop. Specifically, Hip Hop youth were significantly less likely to be Non-susceptible Non-triers than Popular, Mainstream, and Country youth, and more likely to be Experimenters than Popular and Mainstream youth. CONCLUSIONS: Representative studies show that Alternative is relatively small compared to other high-risk crowds, such as the Hip Hop peer crowd. The current research underscores the potential utility of interventions tailored to larger at-risk crowds for campaigns like Fresh Empire.


Assuntos
Diversidade Cultural , Dança/psicologia , Comportamentos de Risco à Saúde , Grupo Associado , Prevenção do Hábito de Fumar/métodos , Identificação Social , Adolescente , Estudos Transversais , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Masculino , Fumar/epidemiologia , Fumar/psicologia
12.
J Behav Health Serv Res ; 40(2): 169-79, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23370943

RESUMO

Housing First is a form of permanent supportive housing for chronically homeless consumers with mental health and substance abuse issues. In light of the model's growing popularity and wide diffusion, researchers and policy makers have identified a need to better understand its critical ingredients and the processes through which they affect consumer outcomes. Researchers used a bottom-up approach to understand the critical ingredients of Housing First within community-based programs. Interviews and focus groups were conducted with 60 informants (staff and consumers) across 4 "successful" Housing First programs. Qualitative analysis demonstrated six program ingredients to be essential: (1) a low-threshold admissions policy, (2) harm reduction, (3) eviction prevention, (4) reduced service requirements, (5) separation of housing and services, and (6) consumer education.


Assuntos
Pessoas Mal Alojadas/psicologia , Habitação Popular , Apoio Social , Feminino , Grupos Focais , Humanos , Masculino , Transtornos Mentais/psicologia , Transtornos Mentais/reabilitação , Meio-Oeste dos Estados Unidos , Estudos de Casos Organizacionais , Pesquisa Qualitativa , Seguridade Social , Transtornos Relacionados ao Uso de Substâncias/terapia
13.
Subst Abuse Treat Prev Policy ; 8: 16, 2013 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-23641860

RESUMO

BACKGROUND: The Housing First Model (HFM) is an approach to serving formerly homeless individuals with dually diagnosed mental health and substance use disorders regardless of their choice to use substances or engage in other risky behaviors. The model has been widely diffused across the United States since 2000 as a result of positive findings related to consumer outcomes. However, a lack of clear fidelity guidelines has resulted in inconsistent implementation. The research team and their community partner collaborated to develop a HFM Fidelity Index. We describe the instrument development process and present results from its initial testing. METHODS: The HFM Fidelity Index was developed in two stages: (1) a qualitative case study of four HFM organizations and (2) interviews with 14 HFM "users". Reliability and validity of the index were then tested through phone interviews with staff members of permanent housing programs. The final sample consisted of 51 programs (39 Housing First and 12 abstinence-based) across 35 states. RESULTS: The results provided evidence for the overall reliability and validity of the index. CONCLUSIONS: The results demonstrate the index's ability to discriminate between housing programs that employ different service approaches. Regarding practice, the index offers a guide for organizations seeking to implement the HFM.


Assuntos
Lista de Checagem/métodos , Usuários de Drogas/psicologia , Pesquisa sobre Serviços de Saúde/métodos , Pessoas Mal Alojadas/psicologia , Habitação Popular , Temperança , Diagnóstico Duplo (Psiquiatria) , Humanos , Habitação Popular/classificação , Habitação Popular/normas , Habitação Popular/estatística & dados numéricos , Reprodutibilidade dos Testes , Estados Unidos
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