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.

Crisis Interventions in Schools: A Systematic Review.

This systematic review synthesizes research on school-based crisis intervention protocols, descriptions, and evaluations. We performed a comprehensive literature search, and 60 studies met the inclusion criteria for this review. We found an overwhelming lack of evaluation studies (n=3), suggesting that interventions are being administered post-crises without evaluation. The most frequently named crisis intervention model was the Prevent/Prepare, Reaffirm, Evaluate, Provide and Respond, and Examine (PREPaRE) model (n=6). All evaluation studies in the sample were observational, and most adopted qualitative methods of evaluation. Future studies are needed to evaluate crisis interventions to measure the fidelity, reliability, and effectiveness of such interventions.

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.