Race/ethnic differences in the association of anxiety, depression, and discrimination with subsequent nicotine and cannabis use among young adults: A prospective longitudinal study.

INTRODUCTION: The shifting patterns in nicotine and cannabis use among young adults is taking place at a time when there is also increased reports of psychosocial stressors such as anxiety, depression, and everyday discrimination. Although race/ethnicity has been found to moderate the impact of psychosocial stressors, there is limited research examining the association of anxiety, depression, and discrimination with patterns of nicotine and/or cannabis product use among diverse young adults. METHODS: Data were from a longitudinal study of 2478 US young adults surveyed between 2019 and 2021. General estimating equation models were used to examine associations of self-reported psychological symptoms (depression, anxiety) and social stressors (discrimination) with substance use (any nicotine and cannabis product use; nicotine and cannabis vaping). RESULTS: Young adults from different racial/ethnic groups differed significantly in their depression and discrimination scores with young adults of color having higher mean scores. Overall, higher depression and everyday discrimination score was associated with increased odds of past 6-month use of any nicotine/tobacco and cannabis products. Higher generalized anxiety score increased odds of any nicotine/tobacco and dual nicotine and cannabis product use. Higher everyday discrimination score was associated with increased odds nicotine and cannabis vaping overall. Stratified models showed variation in associations among different racial/ethnic groups. CONCLUSIONS: Psychosocial stressors are associated with increased substance use odds among young adults. However, these stressors have a differential impact on substance use odds among young adults from different racial/ethnic contexts.

Association of self-reported use of cannabis for the purpose of improving physical, mental, and sleep health with problematic cannabis use risk.

BACKGROUND: Little is known about health-focused cannabis use purposes and their associations with risk for problematic cannabis use. This cross-sectional study examined three broad cannabis use purposes and association with risk for problematic use among young adult cannabis users who report using for > 1 health reasons. METHODS: Young adults completed an electronic survey as part of an ongoing study on substance use and health. Those who self-reported past 6-month use of ≥ 1 cannabis products-smoking, vaping, dabbing, eating, and blunts-were included in the analysis. Their purposes for use were coded into three categories: sleep, mental, and physical health. Problematic cannabis use (PCU) was measured with the three-level structure Cannabis Abuse Screening Test (CAST-3). Adjusted multivariable regression models were used to estimate use purposes associated with with problematic cannabis use at the p < 0.05 level. RESULTS: Participants (n = 954) were mostly female (63.94%) and Hispanic (54.93%). Mental health was the most endorsed reason (73.38%) for use among study sample. Among participants, 36.3% were classified as being at severe risk (CAST-3 score ≥ 8). There was a significant association between PCU risk and reporting cannabis use for physical health (p < 0.01), mental health, and sleep health (p < 0.01) purposes. Those who used cannabis for physical heath purposes had about four times the risk (adjusted relative risk ratio (aRRR) = 4.38, 95% CI = 3.06-6.69), those who used for mental health had about three times the risk (aRRR = 2.81, 95% CI = 1.86-4.72), and those who used for sleep health had almost two times the risk (aRRR = 1.83, 95% CI = 1.17-2.63) for severe PCU. CONCLUSION: All cannabis use purposes examined increased risk of problematic cannabis use. Physical health use purposes was associated with highest PCU risk. This study demonstrates the risk for cannabis use disorder associated with self-medicating with cannabis.

Human Capital Development Factors and Black Adolescent Tobacco and Cannabis Use.

INTRODUCTION: This study examined the association of four domains of human capital development (cognitive development, social and emotional development, physical health, and mental health) and exclusive and concurrent tobacco and cannabis use (TCU) among black youth. AIMS AND METHODS: Nationally representative annual cross-sectional data for black adolescents (12-17 years; N = 9017) in the National Survey on Drug Use and Health 2015-2019 were analyzed. Analyses examined the influence of human capital factors (cognitive development, social and emotional development, physical health, and mental health) on exclusive and concurrent TCU. RESULTS: In total, 50.4% were males; prevalence of 12-month tobacco use fluctuated insignificantly between 5.6% and 7.6% across survey years. Similarly, prevalence of 12-month cannabis use remained relatively stable around 13%, with no significant linear change. Prevalence of concurrent TCU also fluctuated insignificantly between 3.5% and 5.3%. Investment in cognitive development decreased the odds of tobacco (aOR = 0.58, p < .001), cannabis (aOR = 0.64, p < .001), and concurrent tobacco and cannabis (aOR = 0.58, p < .001) use. Similarly, investment in social and emotional development reduced the odds of tobacco (aOR = 086, p < .001), cannabis (aOR = 0.83, p < .001), and concurrent tobacco and cannabis (aOR = 0.81, p < .001) use. Good physical health reduced the odds of tobacco (aOR = 0.52, p < .1), cannabis (aOR = 0.63, p < .05), and concurrent TCU (aOR = 0.54, p < .05). Major depressive episodes increased the likelihood of cannabis use (aOR = 1.62, p < .001). CONCLUSIONS: Investment in cognitive, social, and emotional aspects of human capital development, and physical health among black youth is protective against TCU. Efforts to sustain human capital development among black adolescents may contribute to reducing TCU disparities. IMPLICATIONS: This is one of few studies to examine human capital development factors and their associations with TCU among black youth. Efforts to eliminate tobacco/cannabis-related disparities among black youth should also invest in social, emotional, cognitive, and physical health development opportunities.

E-Cigarette and Cannabis Use Patterns, Depression, and Suicide Behaviors Among US Youth: Analysis of 2019 Youth Risk Behavior Survey Data.

PURPOSE: To examine the associations of current electronic cigarette and cannabis use patterns with depression symptoms and suicidal ideation and behavior overall and stratified by sex among U.S. high school students. DESIGN: Quantitative, cross-sectional study. SETTING: The 2019 National Youth Risk Behavior Survey. SUBJECTS: 12,401 high school students in 9th-12th grade. MEASURES: Dependent variables were depression symptoms, suicidal ideation, suicide plan, suicide attempt, and suicide attempt-related injury. Independent variables were past 30 day e-cigarette and cannabis use patterns. Covariates included demographics, grade level, and other tobacco product use. ANALYSIS: Multivariable logistic regression models. RESULTS: Approximately 15.7% of students were exclusive e-cigarette users, 4.5% were exclusive cannabis users, and 16.4% were concurrent e-cigarette and cannabis users. Exclusive e-cigarette and cannabis users, and concurrent users were at increased odds (P < .05) of having depression symptoms, seriously considered attempting suicide, planning suicide, suicide attempt, and having suicide attempt-related injury compared to non-users. Female users, especially concurrent users, had higher odds of reporting depression symptoms (P < .01) and all suicidal ideation and behavior outcomes (P < .01) than female non-users, but results varied for male students. CONCLUSION: E-cigarette and cannabis use patterns significantly predicted depression symptomatology and suicidal ideation and behavior, with female students having higher odds. Results suggest the need for tailored interventions to address mental health and suicidality among U.S. adolescents, and especially female students.

Sociodemographic characteristics associated with hepatitis C virus infection in Vietnamese Americans: A cross-sectional analysis of community screening data.

BACKGROUND: Prevalence of hepatitis C virus (HCV) infection among Vietnamese Americans is reportedly high. Understanding the profile of those at greater risk of HCV in this ethnic population is a vital step to addressing this high prevalence. We hypothesize that certain sociodemographic characteristics increase the likelihood of having HCV in Vietnamese Americans. METHODS: Cross-sectional data from 2,497 Vietnamese Americans in Southern California who participated in a series of community hepatitis screening events organized by the Vietnamese American Cancer Foundation (VACF) were analyzed. Serological tests via immunoassays were used to determine whether the participant had hepatitis C antibodies (anti-HCV) to indicate a HCV infection. Sociodemographic characteristics as well as participants' reasons for screening were collected from questionnaires, and logistic regression models with odds ratios (ORs) and 95% confidence intervals (CIs) were used to quantify their associations with HCV infection. RESULTS: Approximately 5.8% of the study population was infected with HCV. Older adults and male participants had higher odds of being infected with HCV (e.g. OR = 2.90, 95% CI 1.25-6.76 for ages 70+ versus ages <40; OR = 2.57, 95% CI 1.79-3.69 for male versus female participants) as were those with a family history of HCV infection (OR = 2.74, 95% CI 1.57-4.78). In addition, perceived self-risk as a motivation for screening was significantly associated with HCV infection (OR = 1.88, 95% CI 1.26-2.78). CONCLUSIONS: This study identifies specific subgroups in the Vietnamese American community who would largely benefit from targeted interventions given their higher likelihood of having HCV. These interventions should emphasize improving HCV knowledge and promoting HCV self-risk assessment since awareness of one's own risk may motivate those likely to be infected to get screened.

Tobacco Smoke Exposure, School Engagement, School Success, and Afterschool Activity Participation Among US Children.

BACKGROUND: Tobacco smoke exposure (TSE), defined as secondhand smoke (SHS) and thirdhand smoke (THS), is associated with negative health consequences. This study's objective was to assess the associations between home TSE status and school engagement, school success, and afterschool activity participation among school-aged children. METHODS: We conducted a secondary analysis of 2018-2019 National Survey of Children's Health cross-sectional data. Children ages 6-11 years (N = 17,466) were categorized into home TSE groups: no home TSE; THS exposure only; and SHS and THS exposure. Weighted logistic and Poisson regression models were built. RESULTS: Compared to children with no home TSE, children with home THS exposure only and SHS and THS exposure were at decreased odds of being engaged in school (AOR = 0.69, 95%CI = 0.57, 0.83; AOR = 0.63, 95%CI = 0.41, 0.97, respectively), and at increased odds of having ≥1 school-to-home contact about child problems in school (AOR = 1.83, 95%CI = 1.50, 2.23; AOR = 1.58, 95%CI = 1.05, 2.37, respectively). Children with THS exposure only were at increased odds of missing ≥1 school day (AOR = 1.43, 95%CI = 1.13, 1.81). Children with THS exposure only (ARR = 0.90, 95%CI = 0.83, 0.96) and SHS and THS exposure (ARR = 0.74, 95%CI = 0.61, 0.89) were at reduced likelihood of participating in a higher number of afterschool activities. CONCLUSIONS: Children exposed to home tobacco smoke are at unique risk for poorer school engagement and success.

Vaping motivations: Association of behavioral inhibition and behavioral activation systems with nicotine and cannabis vaping among adolescents.

BACKGROUND: Despite copious information on the hazards of nicotine and cannabis, many adolescents report vaping nicotine and cannabis. To advance knowledge on the precursors of vaping behaviors, this study examined the association of behavioral inhibition system (BIS) and behavioral activation system (BAS) sensitivities with nicotine and cannabis vaping among adolescents. METHODS: Data were part of a longitudinal survey on substance use and mental health among adolescents and included 2,467 11th grade students from 10 public high schools in California. Participants completed a 20-item scale assessing BIS (one aspect) and BAS (three aspects: drive, fun-seeking, reward responsiveness) sensitivities at baseline and reported their past 30-day nicotine and cannabis vaping at baseline and again at 6-month follow-up. Unadjusted and adjusted (controlled for demographic characteristics and product-specific baseline vaping) regression models estimated vaping risk at follow-up by BIS/BAS scores at baseline. RESULTS: Bivariate analyses showed participants who vaped nicotine had significantly higher drive and fun-seeking scores (p < 0.05); and cannabis vapers had lower BIS and reward responsiveness scores (p < 0.05) compared to non-users. Higher fun seeking scores was associated with increased odds (OR = 1.15, 95 %CI = 1.03-1.29) of nicotine vaping and higher reward responsiveness scores reduced odds (OR = 0.89, 95 %CI = 0.79-0.99) of nicotine vaping. Higher scores on BIS was associated with decreased the odds (OR = 0.91, 95 %CI = 0.84-0.99) of cannabis vaping. CONCLUSION: Different behavioral motivations should be targeted when developing interventions designed to reduce nicotine and cannabis vaping among diverse adolescents.

E-cigarette and marijuana use and the attainment of obesity prevention guidelines among U.S. adolescents.

The study objectives were to examine the associations of exclusive and dual use of e-cigarettes and marijuana and the attainment of the "Let's Go! 5-2-1-0" obesity prevention guidelines and perceptions of weight status among U.S. adolescents. Data from the 2017 Youth Risk Behavior Survey, a school-based nationally representative cross-sectional study, were analyzed (N = 12,578). Participants were categorized based on their past 30-day e-cigarette and marijuana use as: non-users, exclusive e-cigarette users, exclusive marijuana users, and dual users. Adjusted logistic regression models were conducted. Of adolescents, 5.2% were exclusive e-cigarette users, 10.3% were exclusive marijuana users, and 7.4% were dual users. Compared to non-users, exclusive e-cigarette users were more likely (aOR = 1.55, 95%CI = 1.16-2.07) to meet the physical activity recommendation. Compared to dual-users, exclusive e-cigarette users were more likely (aOR = 1.47, 95%CI = 1.10-1.97) to meet the screen time recommendation. Compared to non-users, exclusive marijuana users were at increased odds to meet the fruit/vegetable recommendation (aOR = 1.33, 95%CI = 1.03-1.71), but were at decreased odds to meet the sugar-sweetened beverages recommendation (aOR = 0.81, 95%CI = 0.65-0.99). Compared to exclusive e-cigarette users, exclusive marijuana users were less likely to meet the screen time (aOR = 0.71, 95%CI = 0.54-0.93) and physical activity recommendations (aOR = 0.60, 95%CI = 0.43-0.84). Compared with dual users, exclusive marijuana users were more likely (aOR = 1.38, 95%CI = 1.01-1.88) to perceive themselves as slightly/very overweight. Compared to non-users, dual users were less likely to meet the sugar-sweetened beverages recommendation (aOR = 0.63, 95%CI = 0.46-0.87). Adolescent current marijuana users and dual users were less likely to meet obesity prevention guidelines. Prevention efforts are needed to reduce e-cigarette and marijuana use and increase adherence to these guidelines.

Self-Perceptions, Normative Beliefs, and Substance Use Associated With High School Girls Comparing Themselves to Peers.

BACKGROUND: We assessed whether self-descriptions, self-perceptions, perceived substance use of friends, and actual substance use were associated with high school girls' frequency of making social comparisons to peers. METHODS: We analyzed data from the Adolescent Health Risk Behavior Survey data for 357 high school girls using multinomial logistic regression. RESULTS: Compared to those who "never/rarely" made social comparisons, participants who self-described as fearing something constantly (p = .014) and forced to imitate the people they like (p = .009) were more likely to "usually" compare themselves to peers. Participants who described themselves as feeling forced to imitate the people they like (p = .022), were not the person they would like to be (p = .005), and did not remain calm under pressure (p = .010), were more likely to "often/always" make social comparisons. Participants who perceived themselves as unattractive (p = .034) and self-centered (p = .016) were more likely to "often/always" make social comparisons. Participants who perceived a larger proportion of friends use illicit drugs were less likely to "usually" make social comparisons (p = .027). Participants who perceived a larger proportion of friends drink alcohol were more likely to "often/always" make social comparisons (p = .018). CONCLUSIONS: Girls who perceive and describe themselves more negatively are at increased odds of making social comparisons to peers.

Concurrent E-cigarette and marijuana use and health-risk behaviors among U.S. high school students.

The use of electronic cigarettes (e-cigarettes) and marijuana remain prevalent problems among adolescents nationwide. We assessed current (past 30-day) exclusive e-cigarette use, exclusive marijuana use, and concurrent use with unintentional injury and violent behaviors, alcohol and other drug use behaviors, and sexual behaviors among U.S. high school students. We analyzed 2017 Youth Risk Behavior Survey data including 12,578 high school students nationwide. Multivariable logistic regression models were performed to compare these health-risk behaviors among exclusive e-cigarette users, exclusive marijuana users, and concurrent users with non-users among the overall sample, and then to compare exclusive e-cigarette users and exclusive marijuana users with concurrent users among current users only. All models adjusted for adolescent sex, grade, and race/ethnicity, and other tobacco product use. Approximately 77% of students were non-users, 5.2% were exclusive e-cigarette users, 9.9% were exclusive marijuana users, and 7.8% were concurrent users. Compared to non-users, exclusive e-cigarette users and exclusive marijuana users were more likely to engage in most negative health-risk behaviors associated with unintentional injuries and violence, alcohol and other drug use, and sexual behaviors. Among current users only, exclusive e-cigarette users and exclusive marijuana users were at reduced odds of engaging in most of these health-risk behaviors when compared to concurrent users of both substances. The relationship between exclusive and concurrent e-cigarette and marijuana use and health-risk behaviors highlights the importance of comprehensive educational efforts during high school. Findings suggest need for more studies on influence of e-cigarette and marijuana use on injury and violence risk among youth.

Correlates of Resilience in Hispanic Young Adults.

Research on health disparities among Hispanic/Latino populations has begun to look at resiliency as a key component to the health risk profile of Hispanics. However, there are still gaps in the research about the specific factors. This study sought to examine the relationship between factors in 4 primary domains-behavioral, psychological, social, and cultural-and resilience in Hispanic young adults. We used data from Project RED, which included 1503 Hispanic young adults. Results indicate that cultural factors (acculturation and cultural identity), psychological factors (depression, stress, and coping), and social connectedness are important determinants of resilience among Hispanic young adults.

Examining the Role of Weight Status and Individual Attributes on Adolescent Social Relations.

PURPOSE: Weight stigmatization during adolescence may compromise the development of social relations important for the development. This study examined the associations between weight status and likelihood of nomination (indegree) for five different social network types-friendship, romantic, admiration, succeed, and popularity. METHODS: Data for the study were from 1,110 tenth grade students (aged 11-19 years) from four high schools in one Los Angeles school district in 2010. Multiple Poisson regression analyses using generalized linear model were conducted to examine the relationship between weight status (underweight/normal weight/overweight measured with body mass index calculated from self-reported height and weight) and adolescents' indegree for the five different networks. RESULTS: Obese adolescents were significantly less likely to be nominated as romantic interest (odds ratio [OR]: .29, 95% confidence interval [CI]: .19-42), admired (OR: .80, 95% CI: .65-.97), or popular (OR: .71, 95% CI: .57-.88) compared with their normal weight peers. Overweight adolescents were also less likely to be nominated as a romantic interest (OR: .57, 95% CI: .42-.78) or popular (OR: .67, 95% CI: .53-.84) compared with those who were normal weight. Underweight adolescents were also less likely to be nominated as friends (OR: .76, 95% CI: .60-98), someone admired (OR: .61, 95% CI: .42-.89), likely to succeed (OR: .62, 95% CI: .44-.87), or popular (OR: .40, 95% CI: .25-.64). CONCLUSIONS: Our results suggest weight status is associated with being selected by peers into different types of adolescent networks. Underweight, overweight, and obese adolescents are at an increased risk for social isolation because of their weight. This may have a negative impact on their peer relations important for social development, self-esteem, and mental health.

Perceived Severity of Interrelated Cardiometabolic Risk Factors among U.S. College Students.

BACKGROUND: Cardiometabolic risk factors are related to the early onset of chronic health conditions. PURPOSE: To identify factors associated with perceptions about the severity of three interrelated cardiometabolic risks (i.e., high blood pressure, obesity, and cardiovascular disease) among U.S. college students. METHODS: Data were analyzed from 1,361 college students using an internet-delivered survey. Least squares regression models were fitted. Primary independent variables of interest were sex and cigarette smoking status. RESULTS: Relative to nonsmokers, smokers perceived high blood pressure (B=-0.09, P=0.001), obesity (B=-0.12, P<0.001), and cardiovascular disease (B=-0.12, P<0.001) to be significantly less severe. Across models, females perceived all three cardiometabolic risk factors to be more severe (P<0.005). Relative to non-Hispanic whites, Hispanic and Asian/Pacific Islander students perceived all three cardiometabolic risk factors to be less severe (P<0.002). Compared to normal weight students, overweight (B=0.41, P=0.039) and obese (B=-0.72, P<0.001) students reported higher severity perceptions about obesity only. DISCUSSION: There are discordances between perceived severity of interrelated cardiometabolic risks among college students by personal factors. TRANSLATION TO HEALTH EDUCATION PRACTICE: Smoking prevention and cessation interventions are needed to educate college students about cardiometabolic risks associated with cigarette smoking, especially among male and minority students.

Socio-Ecological Factors of Adolescent Substance Use in Nigeria: A Systematic Review of Literature.

Adolescent substance use is influenced by a multitude of socio-ecological factors ranging from intrapersonal to policy-related. We systematically searched electronic databases using variations and Boolean connections of substance use terms to identify literature on Nigerian adolescent substance use (alcohol, drugs, and tobacco). Using the social ecological model to organize findings from the review, we present the intrapersonal, interpersonal, institutional, community, and/or policy factors of substance use identified in the studies. Of the 13 studies reviewed, most examined only intrapersonal and interpersonal factors affecting Nigerian adolescent substance use, while none clearly examined the impact of other ecological levels (community and policy) on adolescent substance use. All the studies reviewed were cross-sectional, and none employed a sound theoretical framework to guide their inquiry. This review underscores the need for future theory-driven, longitudinal research that captures the dynamic nature of Nigerian adolescent substance use behaviors and other associated health-related behaviors, such as sexual behaviors and intentional/unintentional injuries.

Gender Differences in Socio-ecological Determinants of Alcohol Use Among Hispanic Adolescents.

BACKGROUND: Compared to other racial groups, Hispanic/Latino(a) adolescents experience higher rates of alcohol (ab)use and alcohol-related problems. Evidence suggests there are gender differences in alcohol use patterns indicating the likelihood of gender differences in how various determinants influence alcohol use among the genders. Assessing the mechanisms that contribute to Hispanic adolescents' alcohol use requires an understanding of the multidimensional social and environmental processes that operate together to impact their alcohol use. In this study, we examined socio-ecological determinants of Hispanic adolescent alcohol use by gender. METHODS: Data from 10th grade Hispanic/Latino(a) students (N = 781) from four high schools in Los Angeles were used to examine associations between socio-ecological characteristics and adolescent alcohol use by gender. RESULTS: Overall, 37.5% of participants reported past 30-day alcohol use. Among boys, alcohol use was associated with intrapersonal (not qualifying for reduced lunch), interpersonal (mother's education and peer drinking), and institutional (alcohol-prone school club membership) determinants. Among girls, alcohol use was associated with intrapersonal (academic achievement) and interpersonal (parent and peer alcohol use behavior) determinants. CONCLUSIONS: Prevention and intervention efforts need to take into consideration the gender differences in social-ecological risk and protective factors when designing educational or intervention programs and services targeted at Hispanic adolescents. This is crucial to addressing multi-component factors that influence their substance use behavior.

Health Disparities and the Heterogeneity of Blacks/African Americans in the United States: Why Should We Care?

Each year, millions of dollars are spent on research and public health interventions targeted toward reducing health disparities primarily among the "Black/African Americans" community, yet the progress made lags far behind the amount of money and effort spent. We hypothesize that part of the problem is that sociocultural factors play a significant role in disease prevention. Most studies and programs aggregate "Black immigrants" (BIs) and "African Americans" (AAs) as "Black/African American." This categorization assumes that the sociocultural determinants that influence BIs are the same as for AAs. BIs have health and mortality profiles that vary from AAs. This commentary aims to (1) introduce this idea in more depth and provide a brief scope of the problem, (2) provide scientific evidence of noteworthy differences between AAs and BIs in areas of sociodemographics, health behaviors, and health outcomes, (3) discuss implications of considering the Black/AA group as homogeneous and provide recommendations for disaggregation.

Insight into hepatitis B prevalence and risk factors among Vietnamese Americans: a cross-sectional analysis of data from a community-based screening program.

OBJECTIVES: The aims of our study were to describe current hepatitis B prevalence among Vietnamese Americans and to examine predictors of hepatitis B risk in this specific ethnic community. DESIGN: Cross-sectional analysis of data from a community-based screening program. SETTING: This analysis was based on hepatitis screening community events in Southern California. PARTICIPANTS: 2508 Vietnamese Americans in Southern California. OUTCOME MEASURES: Serological tests for hepatitis B surface antigen, hepatitis B surface antibody, and total hepatitis B core antibody were used to classify participants as one of four hepatitis B infection statuses: currently infected, previously infected, susceptible, or immune due to a previous hepatitis B vaccination. RESULTS: Across 2508 participants, 9.0% were currently infected with hepatitis B and 17.7% were at risk for hepatitis B. Females and those reporting a previous hepatitis B vaccination were at significant decreased risk of hepatitis B (OR=0.48, 95% CI 0.33 to 0.69 and OR=0.53, 95% CI 0.31 to 0.93, respectively) whereas those born outside of the USA and with a family history of the disease showed substantial increased risk (OR=13.36, 95% CI 1.62 to 110.05 and OR=4.68, 95% CI 2.66 to 8.22, respectively). Among those who reported a previous hepatitis B vaccination, less than half (42.9%) possessed the protective antibodies that result from a hepatitis B vaccination. CONCLUSIONS: Vietnamese Americans remain disproportionately burdened by hepatitis B. Public health efforts that focus on improving hepatitis B awareness and vaccination knowledge and that are tailored to specific high-risk subgroups, such as immigrants and those with infected family members, could help in addressing the disease's burden in this high-prevalence population.

Two Peas in a Pod? An Exploratory Examination Into Cancer-Related Psychosocial Characteristics and Health Behaviors Among Black Immigrants and African Americans.

Introduction. Most studies lump Black immigrants (BIs) and African Americans (AAs) as "Black/African American" during investigation. Such categorization assumes that the sociocultural determinants that influence BIs are the same as for AAs. This study attempts to disentangle the AA and BI subgroups to recognize the differences in cancer-related psychosocial characteristics and health behaviors. Methods. Merged data from the Health Information National Survey (2011-2017) were used. Two groups were created: those who identified as AA and those who identified as AA but were born outside the United States (BI). Between-group differences were assessed with Mann-Whitney U and chi-square tests. Results. Positive communication patterns with health care providers were significantly higher among AAs (M [mean] = 3.41, SD [standard deviation] = 0.68) compared with BIs (M = 3.28, SD = 0.71) (p = .004). A greater proportion of BIs indicated that their health was excellent (14.2%), compared with AAs (7.9%). AAs reported higher cancer family history (75.1%) than BIs (46.5%). More AAs had smoked at least 100 cigarettes in their lifetime (41.5%) than BIs (16.7%). BIs consumed significantly more fruits each day (M = 2.77, SD = 1.43) than AAs (M = 2.40, SD = 1.44) (p < .001). BIs also reported more physical activity (M = 2.62, SD = 2.15) than AAs (M = 2.37, SD = 2.18) (p = .030). AA women were more likely to have had a pap smear test (M = 2.07, SD = 1.44) compared with BI women (M = 1.73, SD = 1.21) (p = .002). Discussion. Evidence suggests the need to disentangle the "Black/African American" ethnic grouping. Lumping the BI populations together with the AAs, who have been in the United States for generations, may limit the ability to uncover and consequently address culturally driven disease prevention efforts and promote understanding of the biological, environmental, and psychosocial risk factors within Black heterogeneous populations.