Understanding the Intersectionality of COVID-19 Racism, Mental Distress, Alcohol Use, and Firearm Purchase Behavior Among Asian Americans.

Firearm-related injuries are a major public health concern in the USA. Given the increased racism endured by Asian Americans during the COVID-19 pandemic, the current study aims to investigate the direct and indirect effects of racism, mental distress, and substance use on firearm purchase among Asian Americans. To fulfill this purpose, we collected data from a national sample of 916 Asian Americans in 2021. The study results showed that Asian Americans' racism experience is directly related to increased mental distress, substance abuse, and firearm purchase. Both mental distress and alcohol use were also linked to firearm purchase. It was found that racism links to more mental distress and increased alcohol use, which in turn link to increased firearm purchases. The findings add new information on how racism can have compounded effects on mental distress and alcohol use in addition to firearm-related risk behavior among Asian Americans and posing serious public health concerns.

Firearm homicides among hispanics and white non-hispanics: measuring disparities.

Firearm homicides are increasing in the United States, and firearm homicides are a critical driver of racial health disparities. One such disparity that has received limited attention is excess firearm homicides among Hispanics, relative to White Non-Hispanics; comprehensively characterising this disparity is the purpose of this brief report. Using data from CDC WONDER, we examined temporal trends (2012-2021) in firearm homicide rate disparities between Hispanics and White Non-Hispanics in the U.S. Focusing on recently elevated rates (2018-2021), we estimated this disparity across demographics (gender, age, urbanicity, and race), and across U.S. states. These data clearly show nearly universal excess firearm homicide among Hispanics, relative to White Non-Hispanics, with larger differences among men, younger age groups, and in metropolitan areas. Similarly, nearly all states show higher rates of firearm homicide among Hispanics, relative to White Non-Hispanics, though the magnitude of the difference varies substantially.

Improved resilience following digital cognitive behavioral therapy for insomnia protects against insomnia and depression one year later.

BACKGROUND: While the negative consequences of insomnia are well-documented, a strengths-based understanding of how sleep can increase health promotion is still emerging and much-needed. Correlational evidence has connected sleep and insomnia to resilience; however, this relationship has not yet been experimentally tested. This study examined resilience as a mediator of treatment outcomes in a randomized clinical trial with insomnia patients. METHODS: Participants were randomized to either digital cognitive behavioral therapy for insomnia (dCBT-I; n = 358) or sleep education control (n = 300), and assessed at pre-treatment, post-treatment, and 1-year follow-up. A structural equation modeling framework was utilized to test resilience as a mediator of insomnia and depression. Risk for insomnia and depression was also tested in the model, operationalized as a latent factor with sleep reactivity, stress, and rumination as indicators (aligned with the 3-P model). Sensitivity analyses tested the impact of change in resilience on the insomnia relapse and incident depression at 1-year follow-up. RESULTS: dCBT-I resulted in greater improvements in resilience compared to the sleep education control. Furthermore, improved resilience following dCBT-I lowered latent risk, which was further associated with reduced insomnia and depression at 1-year follow-up. Sensitivity analyses indicated that each point improvement in resilience following treatment reduced the odds of insomnia relapse and incident depression 1 year later by 76% and 65%, respectively. CONCLUSIONS: Improved resilience is likely a contributing mechanism to treatment gains following insomnia therapy, which may then reduce longer-term risk for insomnia relapse and depression.

Family functioning within the context of families with adolescent children in urban India.

Research on family functioning within given cultural contexts is needed. This study aims to describe salient dimensions of family functioning in two urban contexts in India and to examine differences in family functioning by sociodemographic groups. We measured differences in family functioning using cross-sectional survey questionnaire data collected from 13 to 15-year-old adolescents and one of their parents/primary caregivers in Mumbai (n = 843) and Kolkata (n = 913) during 2019-2020. We drew a multi-stage sample representative of neighborhoods and households in both cities. We assessed a multi-dimensional family functioning latent factor that included parent-reported measures (parent-adolescent communication, family cohesion, and parent monitoring of peers) and adolescent-reported measures (parent support, family cohesion, and parent supervision). Our results support an overall measure of family functioning manifested by multiple dimensions for parent- and adolescent-reported data. Families with male adolescents had worse adolescent-reported family functioning in Mumbai and parent-reported family functioning in Kolkata. Higher socioeconomic status was associated with better parent-reported family functioning in both cities and better adolescent-reported family functioning in Kolkata. Muslim religious identification in Kolkata and the Hindi native language in both cities were associated with better adolescent-reported family functioning. Our findings indicate heterogeneity in family functioning across demographic and social-cultural groups within the two urban contexts of India. This study may inform the development of culturally congruent prevention interventions for families with adolescents in India.

Examining racism and firearm-related risks among Asian Americans in the United States during the COVID-19 pandemic.

Firearm-related injury is a major public health concern in the U.S. Experience of racism and discrimination can increase the risk of minority group members engaging in or being victims of firearm-related violence. Given the increased racism endured by Asian Americans during the COVID-19 pandemic, it is imperative to understand firearm-related behaviors in this population. The purpose of this study was to examine how Asian Americans' racism and discrimination experiences were related to firearm-related behaviors during the COVID-19 pandemic. Cross-sectional data were collected between December 2020 and January 2021 from a national sample of 916 Asian Americans. Measures included demographics, firearm-related risks, and three measures of racism/discrimination experiences since the start of the COVID-19 pandemic. Among individuals who purchased a gun since the start of the pandemic, 54.6% were first-time gun owners. Among household gun owners, 42.8% stored loaded guns and 47.1% stored guns unlocked. More than 38% of individual gun owners have carried a gun more frequently since the pandemic. After controlling for family firearm ownership and demographics, regression analyses showed that Asian Americans who experienced racial discrimination were more likely to purchase a gun and ammunition and intend to purchase more ammunition during the COVID-19 pandemic. AAs who perceived more cultural racism were more likely to purchase a gun. Individuals who reported higher anticipatory racism-related stress reported greater intent to purchase guns. Our findings suggest an urgent need to investigate further the compounded effects of racism, the COVID-19 pandemic, and firearm-related behaviors in this population.

Misuse of Prescription Medications among Individuals with Mobility Disability.

BACKGROUND: The ability of walking a quarter mile is predictive of subsequent disability, mortality, and health care costs. Individuals with mobility disability are at increased risk of chronic conditions and unmet care needs. Thus they may misuse prescription medications to self-medicate. OBJECTIVES: We aimed to explore the difference of misuse of four types of prescription medications (sedatives, tranquilizers, painkillers, depression medications) and overall misuse by mobility status and identify the correlates of overall misuse. METHODS: A national probability sample from the survey Midlife in the United States (MIDUS) was used to assess the difference in misuse by mobility status during 2011-2014. To assess the correlates of misuse, mobility status, usual source of care, unmet care needs, insurance coverage, sociodemographic variables, and clinical conditions were added to a survey weighted logistic regression model with backward selection. RESULTS: Compared to those without mobility disability, individuals with mobility disability had higher risk of misuse in most types of medications and in overall misuse. Mobility disability, lower education, unmarried status, the emergency room or public health clinic as the most often used care, pain, and depressed affect were identified as correlates of overall misuse of studied medications. CONCLUSIONS: Individuals with mobility disability are a vulnerable group susceptible to medication misuse, which warrants the urgent need for interventions to ameliorate misuse and reduce risks in this population.

Anonymous Reporting Systems for School-Based Violence Prevention: A Systematic Review.

IMPACT STATEMENT: Anonymous reporting systems (ARS) have been used as a violence prevention strategy in schools by providing a means for individuals within a school community to safely and securely report information about potential violence or concerns about mental health, for example, through an anonymous hotline or reporting app. Despite widespread implementation of ARS in schools, as well as mandates for reporting systems in schools in 21 states, there is limited evidence on the effectiveness of ARS for school violence prevention, and information about best practices for ARS implementation is lacking. This systematic review aims to summarize the current research on the effectiveness of ARS as a school safety and violence prevention strategy, which is an important step in building an evidence-base to guide schools and policymakers about best practices.

The Protective Effects of Social Support on Hypertension Among African American Adolescents Exposed to Violence.

African Americans develop hypertension earlier in life than Whites and the racial/ethnic disparities in blood pressure level can appear as early as adolescence. Violence victimization, a prevalent environmental stressor among inner-city youth, may play a role in such disparities. In a sample of inner-city youth in the United States, the current study examines the relationship between violence victimization and hypertension while investigating the role of social support in moderating that relationship. We analyzed eight waves of data from a longitudinal study of African American youth (n = 353, 56.7% female) from mid-adolescence (9th grade, mean age = 14.9 years old) to emerging adulthood (mean age = 23.1 years old) using probit regression. Higher levels of self-reported violence victimization during ages 14-18 was associated with more reports of hypertension during ages 20-23, after adjusting for sex, socioeconomic status, substance use, and mental distress. The relationship of violence victimization with hypertension was moderated by friends' support, but not parental support. The association between victimization and hypertension was weaker and non-significant among individuals with more peer support compared to those with less support. Researchers have reported many instances of associations of early violence exposure to later risk for hypertension; however, most have focused on childhood maltreatment or intimate partner violence. We extend these findings to violence victimization in an African American sample of youth from adolescence to early adulthood, while examining social support modifiers. The disparity in African American hypertension rates relative to Whites may partly be explained by differential exposure to violence. Our findings also suggest that having supportive friends when faced with violence can be beneficial for young adulthood health outcomes.

Neighbourhood tobacco retail access and tobacco use susceptibility in young adolescents in urban India.

BACKGROUND: Neighbourhood tobacco retail access may influence adolescent tobacco use. In India, we examined the association between neighbourhood tobacco retail access and cognitive risks for tobacco use during early adolescence. METHODS: In 2019-2020, a population-based sample (n=1759) of adolescents aged 13-15 years was surveyed from 52 neighbourhoods in Mumbai and Kolkata. Neighbourhood tobacco retail access was measured as the frequency of visits to tobacco retailers, mapped tobacco retailer density and perceived tobacco retailer density. We estimated associations between neighbourhood tobacco retail access and cognitive risks for tobacco use (perceived ease of access to tobacco, perceived peer tobacco use and intention to use tobacco). RESULTS: There was high neighbourhood tobacco retail access. Tobacco retailer density was higher in lower income neighbourhoods (p<0.001). Adolescent frequency of tobacco retailer visits was positively associated with cognitive tobacco use risks. Mapped tobacco retailer density was associated with perceived ease of access in Kolkata but not in Mumbai, and it was not associated with perceived peer tobacco use nor intention. Perceived tobacco retailer density was associated with perceived ease of access and perceived peer use, but not with intention. In Kolkata, higher perceived retailer density and frequency of tobacco retailer visits were negatively associated with perceived ease of access. CONCLUSIONS: Efforts to reduce neighbourhood tobacco retail access in India may reduce cognitive tobacco use risk factors in young adolescents. The frequency of tobacco retailer visits and perceived tobacco retailer density increased cognitive risks, though there were some exceptions in Kolkata that further research may explain.

The Longitudinal Association Between Exposure to Violence and Patterns of Health Risk Behaviors Among African American Youth.

PURPOSE: We investigate whether exposure to violence (ETV) during adolescence and emerging adulthood predicts engagement in chronic disease-related health risk behaviors years later among African Americans. DESIGN: A longitudinal study following youth from mid-adolescence (mean age = 14.8 years) to young adulthood (mean age = 32.0 years). SETTING: Flint, Michigan. SAMPLE: Four hundred forty-two African American (96.2%) and mixed African American and White (3.8%) participants. MEASURES: Outcomes were diet, smoking, drinking, and physical inactivity. Covariates were ETV, sex, mother's educational attainment, and substance use by siblings, peers, and parents. ANALYSIS: Latent profile analysis was conducted to identify distinct patterns of adult health risk behaviors and assess the association of youth ETV and identified patterns. RESULTS: Four latent profiles were identified: high substance use (n = 46; 10.41%), high overall risk (n = 71; 16.06%), low overall risk (n = 140; 31.67%) and inactive (n = 185, 41.86%). Relative to the low overall risk profile, ETV was associated with being in the high overall risk profile (b = 0.37, p = 0.04), but not other profiles. Female gender and higher maternal education were associated with being in the inactive profile compared to the low overall risk profile. Peer alcohol and tobacco use were associated with being in the high substance use profile. CONCLUSION: ETV during adolescence and emerging adulthood increased the risk of engagement in multiple health risk behaviors later in life.

Adolescent Exposure to Violence and Intimate-Partner Violence Mediated by Mental Distress.

Adolescent exposure to violence (ETV) is associated with multiple negative health outcomes. Despite evidence linking adolescent ETV with later experiences of physical, sexual and psychological intimate partner violence (IPV) victimization, more longitudinal evidence is needed, and potential explanatory mechanisms should be tested. We examine data collected over 17 years to analyze the mediating effects of mental distress and substance use on the association between cumulative ETV in adolescence and IPV in adulthood. Adolescent (M ages=15-18 years) ETV was associated with IPV outcomes in adulthood (M age=32 years). In parallel mediation models, mental distress in emerging adulthood (M ages=20-23 years) fully mediated the effect of adolescent ETV on later IPV outcomes. Although substance use predicted experience of IPV, it did not mediate the association between ETV and IPV. These findings have implications for understanding trajectories of risk following violence exposure and inform intervention work through identifying developmental periods where ETV contributes to later IPV victimization.

Perceived Neighborhood Characteristics and Experiences of Intimate Partner Violence: A Multilevel Analysis.

Within a lifetime, one in four women and more than one in 10 men will experience intimate partner violence (IPV). Researchers have begun to examine physical and social neighborhood risk factors of IPV, often using cross-sectional data. Most studies focus on risk or promotive factors. Often, neighborhood factors are studied through the lens of social disorganization theory, which focuses on how a neighborhood slips into a violent and crime-ridden place. Busy streets theory provides an alternative perspective, focusing on how building up community assets and resources may help create a safe and vibrant neighborhood. A conceptual approach that utilizes risk and promotive neighborhood variables may help develop new conceptual frameworks for understanding how context may decrease risk for, or moderate, the negative consequences of IPV. Using five waves of data from a 24-year longitudinal study, we employ multilevel linear regression models to examine the trajectory of IPV experiences in relation to positive perceptions of neighborhood, neighborhood cohesion, and informal social control in individuals aged 28 to 33 years. We control for the neighborhood and individual-level risk factors of alcohol consumption, drug use, observed neighborhood violence, and demographic factors of age, race, sex, and socioeconomic status. We found that positive perceptions of neighborhood, alcohol consumption, drug use, economic need, and observed neighborhood violence are associated with IPV. Levels of IPV risk were relatively constant within individuals across waves, but varied significantly between individuals. The measure of positive perceptions of neighborhood is derived from busy streets theory, which may be a useful conceptual framework for understanding how neighborhoods may contribute to positive social contexts that can protect residents from IPV experiences, and potentially other violent behavior. Additional research examining promotive social neighborhood features derived from busy streets theory may help expand our understanding of contextual factors that affect IPV.

Longitudinal pathway from violence exposure to firearm carriage among adolescents: The role of future expectation.

INTRODUCTION: Exposure to violence is a risk factor for firearm carriage. Youth exposed to violence also have difficulty envisioning positive future outcomes (e.g., educational outcomes), which can increase the likelihood of firearm carriage over time. Researchers, however, have not yet examined whether changes in exposure to violence over time can influence the developmental trajectories of firearm carriage. To address this gap, we (1) examined the longitudinal association between exposure to violence and firearm carriage (grades 9 to 12) and then (2) examined whether changes in future expectations mediated this longitudinal association. METHOD: The longitudinal association between exposure to violence and firearm carriage through future expectations was examined among 850 adolescents from the Flint Adolescent Study. Participants were recruited from four high schools in a midwestern city in the United States. Parallel latent growth models and latent growth mediation models were estimated. RESULTS: A positive association was observed between the rate of change in exposure to violence and firearm carriage. Exposure to violence also indirectly increased the risk for firearm carriage over time by decreasing future expectation in the 9th grade. CONCLUSIONS: Our results support the idea that helping youth develop positive attitude about educational success may help reduce firearm carriage. Increasing positive expectations about future may help prevent firearm carriage within the context of violence exposure.

Aggressive-Depressive Trajectories in Childhood and Their Associations with Drinking Behaviors and Problems in Adolescence and Emerging Adulthood.

Research indicates that externalizing and internalizing pathways emanated in childhood are connected to later drinking behaviors; however, no study has investigated the contemporaneous effects of the two pathways using a person-centered approach that categorizes individuals based on their various developmental patterns. This study examined the distinct patterns of concurrent development of aggression and depressive symptoms in childhood and their associations with later drinking behaviors using data from a 15-year Taiwanese cohort since age 8 (N = 2854, 49% females). Group-based multi-trajectory modeling identified four aggressive-depressive trajectory groups: Moderate, Aggressive, Depressive, and Comorbid, which manifested a sequential risk gradient in alcohol use. Comorbid group, characterized by persistently high levels of aggression and depressive symptoms, has the highest levels of alcohol use and drinking problems and the earliest onset of drinking. Aggressive and Depressive groups have higher levels of alcohol use and earlier onset of drinking than Moderate group. These findings imply the importance of monitoring aggression and depressive symptoms simultaneously and continually in childhood to prevent later drinking.

Positive Parenting Moderates the Effect of Socioeconomic Status on Executive Functioning: A Three-Generation Approach.

OBJECTIVE: While low parental socioeconomic status (SES) has been associated with lower levels of child executive functioning (EF), few have examined the intergenerational effect of SES on child EF across three generations. We adopt a resilience framework to investigate positive parenting as a protective factor in the intergenerational effect of low SES on child EF. METHODS: In a sample of 50 parents (70% female) and their oldest child (56% female, M age = 12.38) from the Flint Adolescent Study, we estimated the effect of grandparent SES on child EF (i.e., Animal Sorting, Inhibition, Inhibition Switching) and examined the protective role of positive parenting using a multivariate regression model. RESULTS: Lower levels of grandparent SES was associated with lower levels of cognitive flexibility (i.e., Animal Sorting), but not inhibition (i.e., Inhibition, Inhibition Switching), at low levels of positive parenting. CONCLUSION: These findings indicate the varied ways by which intergenerational SES may shape child EF. Further, positive parenting may offset the intergenerational influence of SES on child EF outcomes.

Violence Exposure and Sexual Risk Behaviors for African American Adolescent Girls: The Protective Role of Natural Mentorship and Organizational Religious Involvement.

African American adolescent girls are at increased risk of being exposed to community violence and being diagnosed with a sexually transmitted infection. Fewer studies, however, have examined the protective roles of natural mentorship and organizational religious involvement as potential moderators that could lessen the effects of violence exposure on health risk behavior. Data from 273 African American ninth grade girls were used to test hypothesized independent and moderated-moderation models. Results suggest that natural mentorship and religious involvement were protective for girls who reported at least one mentor and moderate to high levels of religious involvement. Our findings may be relevant for community stakeholders and organizations that directly interact with religious institutions and community programs that focus on outreach to African American adolescent girls.

Compliance with point-of-sale tobacco control policies and student tobacco use in Mumbai, India.

BACKGROUND: We measured how student tobacco use and psychological risk factors (intention to use and perceived ease of access to tobacco products) were associated with tobacco vendor compliance with India's Cigarettes and Other Tobacco Products Act provisions regulating the point-of-sale (POS) environment. METHODS: We conducted a population-based cross-sectional survey of high school students (n=1373) and tobacco vendors (n=436) in school-adjacent communities (n=26) in Mumbai, India. We used in-class self-administered questionnaires of high school students, face-to-face interviews with tobacco vendors and compliance checks of tobacco POS environments. Logistic regression models with adjustments for clustering were used to measure associations between student tobacco use, psychological risk factors and tobacco POS compliance. RESULTS: Compliance with POS laws was low overall and was associated with lower risk of student current tobacco use (OR 0.48, 95% CI 0.26 to 0.91) and current smokeless tobacco use (OR 0.40, 95% CI 0.21 to 0.77), when controlling for student-level and community-level tobacco use risk factors. Compliance was not associated with student intention to use tobacco (OR 0.50; 95% CI 0.21 to 1.18) and perceived ease of access to tobacco (OR 0.73; 95% CI 0.53 to 1.00). CONCLUSIONS: Improving vendor compliance with tobacco POS laws may reduce student tobacco use. Future studies should test strategies to improve compliance with tobacco POS laws, particularly in low-income and middle-income country settings like urban India.

Racial discrimination and cortisol in African American emerging adults: The role of neighborhood racial composition.

OBJECTIVES: African American (AA) emerging adults may become more vulnerable to the consequences of racial discrimination (discrimination) as many begin to occupy racially mixed contexts. Little is known, however, about whether the effect of discrimination on cortisol concentration varies by neighborhood racial composition. We evaluated whether the percentage of White neighbors qualified the association between discrimination and overall cortisol concentration. METHOD: We used self-report data from the Flint Adolescent Study and block-level census data linked to the participant's home address. Our sample consisted of 241 AA emerging adults (56.8% Female; 19-22 year olds). We used multilevel regression analyses to evaluate whether the percentage of White neighbors modified the association between discrimination and overall cortisol concentration. RESULTS: Discrimination experienced in the past year, but not chronic discrimination was linked to lower cortisol concentrations among AA emerging adults living in neighborhoods with a high concentration of White neighbors. Specifically, past year discrimination was negatively associated among AAs residing in neighborhoods with 46.9% of White residents or higher. CONCLUSIONS: Our results lay the foundation for future research on racial health disparities by suggesting that contextual factors such as neighborhood racial composition can shape the influence race-based discrimination has on health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).