Neighborhood Stress and Life Satisfaction: Is there a Relationship for African American Adolescents?

This study identified associations between perceived neighborhood stress and adolescents' perceptions of life satisfaction. African American adolescents aged 13-18 (n=1,658) from four matched, mid-sized cities in the northeastern and southeastern USA, completed a self-report questionnaire using an audio computer-assisted self-interview (ACASI). Analyses examined relationships between perceived neighborhood stress and perceived life satisfaction, while controlling for socioeconomic status (SES). Life satisfaction was found to be related to neighborhood stress for both males and females, with variability in neighborhood stress characteristics and in the magnitude of associations by gender. Further research should identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with perceived neighborhood stress to develop community-based and culturally-sensitive quality of life improvement/health promotion programs.

Can a Multilevel STI/HIV Prevention Strategy for High Risk African American Adolescents Improve Life Satisfaction?

Addressing adolescent sexual risk behaviors in the STI/HIV prevention literature is well documented; however, impacts from interventions on life satisfaction are relatively unexplored. This study examined data (n = 1658) from a randomized, multi-site, multi-level STI/HIV prevention intervention trial (Project iMPAACS) to determine whether increased protective and reduced sexual risk-taking behaviors associated with STI/HIV would also improve self-reported life satisfaction. Taking into account the nested study design and controlling for confounders, a mixed model ANOVA was performed where Total mean life satisfaction scores were analyzed at baseline and 3, 6, 12, and 18 months post-recruitment. Significance levels of 0.05 were used to determine significance and η 2 was used to assess effect size. We hypothesized that as intervention participants engaged in the intentional activity associated with increasing protective behaviors and reducing sexual risk-taking behaviors associated with STI/HIV, life satisfaction reports would also improve over the course of the intervention. A significant main effect for sex was detected (F = 5.19, p = .02, η 2 = .03), along with three interactions: between experimental condition and media intervention (F = 7.96, p = .005, η 2= .04); experimental condition, sex, and media intervention (F = 6.51, p = .01, η 2 = .04); and experimental condition, sex, assessment point, and media intervention (F = 3.23, p = .01, η 2 = .02). With the exception of the control condition, female life satisfaction reports improved from baseline assessments to 18-months post-recruitment, whereas male reports decreased. Project iMPPACS was not designed with the intent on improving participants' life satisfaction. However, study results suggest incorporating strategies to address subjective well-being into future adolescent STI/HIV risk-reduction interventions is beneficial for females and additional research is necessary for males.

Does Initiating Vaginal Sexual Intercourse During a Safer Sex Media Campaign Influence Life Satisfaction Among African American Adolescents?

PURPOSE: Addressing adolescent sexual risk behaviors in the STI/HIV prevention literature is well documented; however, intervention impacts on life satisfaction are relatively unexplored. This study is a secondary analysis of data (N = 1,658) from a randomized, multisite, multilevel safer sex media campaign (Project iMPPACS) analyzing life satisfaction across baseline and follow-up data collected from 2006 to 2008 among participants (mean age 15.08 years) who reported never having had vaginal sex at baseline (n = 787). METHODS: Participants were separated into groups based on whether they reported having vaginal sex (yes/no) at baseline. Then taking into account the nested study design and controlling for confounders, a mixed model repeated measures analysis of variance assessed whether differences in mean total life satisfaction (LS) were associated across time in the media and nonmedia study conditions separately by gender. RESULTS: A significant interaction between time and media condition was detected (p = .039) where mean total LS increased +.065 units from baseline (M = 5.364) to last contact in media cities and decreased -.084 units from baseline (M = 5.557) to last contact in nonmedia cities when controlling for the effect of initiating vaginal sex. No significant differences in LS at baseline were observed between media and nonmedia intervention cities. Results by gender suggest most positive change in LS was observed for females with mixed findings for males. CONCLUSIONS: Although Project iMPPACS was not designed with the intent on improving participants' life satisfaction, results advance the LS literature by demonstrating a temporal sequence for sexual risk taking and LS over time.

Depressive symptoms as a longitudinal predictor of sexual risk behaviors among African-American adolescents.

OBJECTIVE: Understanding individual level factors associated with sexual risk behaviors among African-American adolescents remains an important public health priority. The current secondary data analysis examined the longitudinal association between a baseline assessment of depressive symptoms and sexual risk behaviors reported 6 months later; the purpose was to determine whether the association of depressive symptoms to risky sex varies as a function of gender. A secondary aim was to examine self-efficacy for sex refusal and condom use assessed at a 3-month follow-up as mediators of the depressive symptoms-sexual risk relationship. METHODS: The sample consisted of 782 sexually active African-American adolescents (Mage = 15.3 years, SD = 1.08; 54% female) recruited to participate in a sexual health intervention trial. Data analyses focused on vaginal sex, and outcomes included: (a) sexual activity with 2 or more partners in the previous 3 months; (b) the relative frequency of condom use in the previous 3 months; (c) noncondom use at last occasion of sex; and (d) positive sexually transmitted infection (STI) screening. RESULTS: Depressive symptoms predicted sex with 2 more partners for female participants, but no other risk markers for the sample as a whole. However, there was a significant indirect effect of depressive symptoms on condomless sex via decreased condom use self-efficacy for both male and female adolescents. CONCLUSIONS: These findings have important implications for HIV/STI prevention, in which behavioral interventions may benefit from modules that include a focus on the influence of mood on self-efficacy for safer sex practices. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Relationship between disordered eating and self-identified sexual minority youth in a sample of public high school adolescents.

PURPOSE: To investigate the relationship between selected disordered eating behaviors and self-reported sexual minority status (gay/lesbian, bisexual, and unsure) among a representative sample of high school adolescents. METHODS: The 2013 Centers for Disease Control and Prevention (CDC)-sponsored Connecticut Youth Risk Behavior Survey was utilized (N = 2242). Unadjusted and adjusted logistic regression analyses, separated by gender, examined sexual minority adolescents (gay/lesbian, bisexual, and unsure) and selected eating behaviors. Analyses adjusted for race, age, cigarette use, binge drinking, organized school activity participation, body mass index (BMI), and depression. RESULTS: Gay males were significantly more likely to report exercising or eating less to lose weight in the unadjusted models (p < 0.05) and fasting, vomiting, and taking diet pills in both adjusted (p < 0.05) and unadjusted models (p < 0.01) when compared to the referent heterosexual males. Bisexual females were significantly more likely to report fasting, vomiting, and taking diet pills in the unadjusted model (p < 0.05) when compared to the referent heterosexual females and significantly less likely to report exercising or eating less to lose weight in the adjusted models (p < 0.05). CONCLUSIONS: Although additional studies are needed owing to small sample sizes, preliminary findings support previous research suggesting that high school-aged sexual minority youth subgroups are a priority target population for increased efforts to prevent disordered eating.

Problem Solving Reduces Sexual Risk Associated with Sensation Seeking, Substance Use, and Depressive Symptoms Among African-American Adolescents.

OBJECTIVE: African-American adolescents experience higher rates of sexually transmitted infections (STIs) compared to same-age Caucasian peers. Substance use, sensation seeking, and depression have all been linked to risky sexual practices. Theory suggests that problem-solving skills may help to buffer against these risk factors. METHOD: To test this hypothesis, we used data from African-American adolescents (N = 1018; M age = 16.7, SD = 1.1; 58% female) who participated in a prevention trial. RESULTS: Nearly half of the sample (47%) reported lifetime marijuana use, while 13% reported drug use prior to most recent sexual encounter. Sexual sensation seeking was directly associated with drug use prior to sex (ß = 1.13, b = 0.13,SE = 0.02, p < .001) and lower problem-solving skills (ß = -0.08, b = -0.06,SE = 0.02, p = .01). Problem-solving skills were associated with drug use prior to sex (ß = 0.92, b = -0.08, SE = 0.03, p = .004), such that those with greater problem-solving skills were less likely to report drug use prior to most recent sex. Lastly, problem solving skills mediated the association between sexual sensation seeking and drug use prior to sex, though the effect was small (ß = 0.01, 95% CI: .001, .01). CONCLUSIONS: Problem-solving skills can have a protective influence on risky behavior for adolescents. Future research might examine the utility of strengthening problem-solving skills in order to reduce STI/HIV risk among African American adolescents.

Is the Brief Multidimensional Student's Life Satisfaction Scale Valid and Reliable for African American Adolescents?

BACKGROUND: Health promotion/education strive to promote healthful conditions that improve quality of life1 based on the perceptions of those whose lives are affected.2-4 Though health promotion/education might have instrumental value in reducing risks for premature morbidity and mortality, their ultimate value lies in contributions to quality of life.1 Life satisfaction (LS) has been defined as an individual's assessment of their quality of life based upon personal criteria5,6 and linked to adolescent health risk behaviors7,8 and developmental assets.9. PURPOSE: We investigated the psychometrics of the Brief Multidimensional Students' Life Satisfaction Scale [BMSLSS] with an adolescent sample of African Americans (N=1,658) from four mid-sized cities in the United States (US). Reliability and validity of the BMSLSS has not been determined for samples of exclusively African American adolescents. METHODS: Data analysis included calculating mean ratings, standard deviations and effect sizes (Cohen's d) and inspecting the scale's internal structure, reliability, and relationships to other variables. RESULTS: Evidence of internal structure, internal consistency reliability, and hypothesized relationships to other variables for participants were determined. TRANSLATION TO HEALTH EDUCATION PRACTICE: The BMSLSS is a useful indicator of LS for research and health education assessment purposes among African American adolescents where brevity of psychometric measures is imperative.

African-American sexual minority adolescents and sexual health disparities: An exploratory cross-sectional study.

PURPOSE: To better understand sexual health disparities among African-American sexual minority adolescents. METHODS: African-American adolescents (N = 1120; mean age = 15.24 years) were recruited from 4 cities (Columbia, SC; Macon, GA; Providence, RI; Syracuse, NY) to a larger trial. The current analyses used data from the 18-month follow-up when adolescents reported on their sexual partnerships, condom use knowledge, self-efficacy and outcome expectancies for condom use, sexual risk behavior, and STI testing history. RESULTS: Compared with heterosexual adolescents, sexual minority adolescents reported more concerns about potential relationship harms resulting from safer sex negotiation. Sexual minority adolescents were also more likely to engage in riskier sexual behaviors, with females reporting more sexual partners and drug use prior to sex, and males reporting inconsistent condom use and higher rates of HIV. CONCLUSIONS: African-American sexual minority adolescents evidence disparities in sexual risk behavior and STI history that appear to result from interpersonal and relationship concerns. These concerns need to be targeted in sexual health interventions for sexual minority adolescents.

Aggressive and Violent Behavior and Emotional Self-Efficacy: Is There a Relationship for Adolescents?

BACKGROUND: In this cross-sectional study we explored relationships between aggressive and violent behaviors and emotional self-efficacy (ESE) in a statewide sample of public high school adolescents in South Carolina (N = 3836). METHODS: The US Centers for Disease Control and Prevention Youth Risk Behavior Survey items on aggressive and violent behavior items and an adolescent ESE scale were used. Logistic regression analyses and multivariate models constructed separately, revealed significant race by sex findings. RESULTS: Results suggest that carrying a weapon to school (past 30 days) and being threatened or injured with a gun, knife, or club at school (past 12 months) were significantly associated (p < .05) with reduced ESE for specific race/sex groups. CONCLUSIONS: Results have implications for school- and community-based mental health services and social and emotional learning and aggression/violence prevention programs for adolescents. Measures of ESE as a component of comprehensive assessments of adolescent mental health, social and emotional learning and aggressive/violent behaviors in fieldwork, research, and program-evaluation efforts should be considered.

Weight perceptions, disordered eating behaviors, and emotional self-efficacy among high school adolescents.

Although emotional disorders and disordered eating behaviors are known to be related, the relationship between emotional self-efficacy (ESE) and disordered eating is unknown. This study examined the relationship between ESE and disordered eating in a statewide sample of public high school adolescents (n=2566). The Centers for Disease Control Youth Risk Behavior Survey and an adolescent ESE scale were utilized. Logistic regression adjusted for key covariates explored the relationship between low ESE and disordered eating among selected race and gender groups. Self-perceived weight as underweight or overweight; and dieting, vomiting or taking laxatives, taking diet pills, and fasting to lose weight were each associated (p<.05) with lower levels of ESE for certain race/gender groups. Findings provide increased justification for tailoring disordered eating interventions and treatments to accommodate the highest risk groups. Measures of ESE should be considered for adolescent mental health assessments in fieldwork, research, and evaluation efforts.

Perceptions of Harm From Substance Use and Social Self-Efficacy Among Early Adolescents.

Researchers examined the association between perceptions of harm from substance use and social self-efficacy (SSE) in a sample of early adolescents in public middle schools ( n = 4,122). One-way analysis of covariance and post hoc tests were used to assess the relationships between perceptions of harm from tobacco, alcohol, marijuana, and cocaine use and SSE while controlling for the effects of grade, sex, race, and socioeconomic status. Effect sizes were calculated from the post hoc comparisons to estimate practical importance. Results suggest that lower perceptions of harm from each examined substance were significantly associated with lower SSE ( p < .0001). Effect sizes were of medium practical importance. Enhancing SSE in early adolescents may be an effective component of interventions designed to reduce perceptions of harm associated and subsequent substance use.

Lessons learned from the whole child and coordinated school health approaches.

BACKGROUND: The new Whole School, Whole Community, Whole Child (WSCC) model, designed to depict links between health and learning, is founded on concepts of coordinated school health (CSH) and a whole child approach to education. METHODS: The existing literature, including scientific articles and key publications from national agencies and organizations, was reviewed and synthesized to describe (1) the historical context for CSH and a whole child approach, and (2) lessons learned from the implementation and evaluation of these approaches. RESULTS: The literature revealed that interventions conducted in the context of CSH can improve health-related and academic outcomes, as well as policies, programs, or partnerships. Several structural elements and processes have proved useful for implementing CSH and a whole child approach in schools, including use of school health coordinators, school-level and district-level councils or teams; systematic assessment and planning; strong leadership and administrative support, particularly from school principals; integration of health-related goals into school improvement plans; and strong community collaborations. CONCLUSIONS: Lessons learned from years of experience with CSH and the whole child approaches have applicability for developing a better understanding of the WSCC model as well as maximizing and documenting its potential for impacting both health and education outcomes.

The effects of a mass media HIV-risk reduction strategy on HIV-related stigma and knowledge among African American adolescents.

HIV-related stigma undermines HIV prevention, testing, and treatment. Multipronged risk-reduction strategies may reduce stigma among African American adolescents. To test the effectiveness of a risk-reduction strategy in addressing stigma, 1613 African American adolescents from four mid-sized cities participated in a randomized control trial. Participants received a sexual-risk reduction [Focus on Youth (FOY)] or general health curriculum [Promoting Health Among Teens (PHAT)]. Two cities received a culturally-tailored media intervention. Participants completed baseline, 3-, 6-, and 12-month surveys to measure HIV-related stigma and knowledge. Analysis of covariance tested for stigma and knowledge differences by media city status and curriculum/media city status (PHAT media vs. PHAT non-media, FOY media vs. FOY non-media; FOY media vs. PHAT media; FOY non-media vs. PHAT non-media) at each measurement. Hierarchical linear modeling (HLM) determined stigma and knowledge differences over time. Media participants demonstrated greater HIV-related knowledge (p<0.10) at 6 months and lower stigma at 3 months (p<0.10). FOY media participants had lower 3-month (p<0.05) and 12-month (p<0.10) stigma scores than non-media FOY participants. FOY media and non-media participants had greater knowledge than PHAT for all intervals after baseline. FOY media had lower stigma than PHAT media after baseline for all intervals after baseline. HLM indicated greater knowledge slopes for the media group (p<0.05). FOY media participants had greater knowledge slopes (p<0.05) relative to non-media FOY participants and media PHAT participants (p<0.01). A combination of a HIV risk-reduction curriculum and culturally-tailored media demonstrated some effectiveness in reducing stigma. Future use of media in HIV-prevention should include and evaluate effects on stigma.

Neighborhood Condition and Geographic Locale in Assessing HIV/STI Risk Among African American Adolescents.

Although region and neighborhood condition's effect on HIV/sexually transmitted infection (STI) risk has been studied separately, there is little research examining their interplay. African American adolescents (n = 1,602) from four matched cities in the Northeastern and Southeastern US completed Audio Computer Assisted Self-Interviews and submitted biospecimen samples to detect Sexually Transmitted Infections (chlamydia, gonorrhea, and trichomonas). Logistic and negative binomial regressions determined HIV/STI risk differences by region, neighborhood stress, and stress-region dyads. Northeastern participants demonstrated lower HIV/STI risk while participants from higher stress neighborhoods exhibited greater risk. Relationships between neighborhood condition and ever having anal sex (p < 0.01), anal condom use (p < 0.05), and number of anal partners (p < 0.05) were significant in the Northeast only. Participants in unstressed Northeastern neighborhoods were less likely to have vaginal sex than those in comparable Southeastern neighborhoods (p < 0.05). Participants in unfavorable Northeastern neighborhoods had fewer anal partners than participants in comparable Southeastern neighborhoods (p < 0.01). In concert, neighborhood and region differentially affect HIV/STI risk.

Perceived Difficulty of Performing Selected HIV/AIDS Preventive Behaviors and Life Satisfaction: Is there a Relationship for African American Adolescents?

Research on the relationship between adolescent health risk behaviors, sexual risk behaviors in particular, and perceived life satisfaction is emerging. Some researchers suggest that life satisfaction has been a neglected component of adolescent health research. African American adolescents aged 13-18 (n = 1,658) from four matched, mid-sized cities in the northeastern and southeastern USA, completed a self-report questionnaire via Audio Computer Assisted Self-Interview. Analyses were conducted to examine relationships between perceived difficulty in performing HIV/AIDS preventive behavior and perceived life satisfaction, while controlling for socioeconomic status. Results suggest that perceived life satisfaction is related to perceived difficulty in performing HIV/AIDS preventive behaviors, for both males and females, with variability in the magnitude of associations by gender. Further research is necessary to identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with perceived difficulty in performing HIV/AIDS preventive behavior to develop gender-appropriate and culturally-sensitive quality of life/health promotion programs.

HIV-related stigma among African-American youth in the Northeast and Southeast US.

HIV-related stigma inhibits optimal HIV prevention and treatment among African-Americans. Regional differences in HIV/AIDS prevalence may be related to stigma among young African-Americans. Baseline data (N = 1,606) from an HIV prevention intervention were used to investigate regional differences in HIV-related stigma and knowledge among African-American adolescents in four midsized cities in the Northeastern and Southeastern US. Analyses indicated greater HIV-related stigma among adolescents from the Southeast relative to adolescents from the Northeast (F = 22.23; p < 0.0001). Linear regression indicated a negative relationship between HIV stigma and HIV knowledge (b = -0.65; p < 0.0001). Addressing HIV/AIDS in high prevalence locales should include efforts to reduce HIV-related stigma.

Emotional self-efficacy and alcohol and tobacco use in adolescents.

This study examined relationships between emotional self-efficacy (ESE) and alcohol and tobacco use in a statewide sample of public high school adolescents (n = 2,566). The Center for Disease Control Youth Risk Behavior Survey and an adolescent ESE scale were utilized. Logistic regression analyses indicated the presence of any significant race by gender associations between lower ESE and alcohol and tobacco use. Results suggest that alcohol and cigarette use was significantly associated (p ≤ .05) with lower levels of ESE for certain race/gender groups. Results have implications for school- and community-based mental health services and substance use prevention/education programs for adolescents. Measures of ESE as a component of comprehensive assessments of adolescent mental health in fieldwork, research, and substance abuse prevention/education program evaluation efforts should be considered.

Psychometrics of a brief measure of emotional self-efficacy among adolescents from the United States.

BACKGROUND: Preliminary data were collected to evaluate the psychometric properties of an emotional self-efficacy (ESE) measure in a sample of 3836 public high school adolescents who completed the Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Survey in South Carolina. METHODS: Principal axis factor analysis was followed by a 4-way between-groups analysis of variance (ANOVA) testing for differences in total score means on selected demographic estimates and their interactions. Relationships between total score and selected risk behaviors were examined through a series of 1-way ANOVA procedures and subsequent Tukey Honest Significant Difference (HSD) tests. RESULTS: Factor analysis results suggested that a 1-factor model best explained factor structure of the scale items (factor loadings .64 to .71, eigenvalue = 3.24, h(2) = .46). Girls reported a significantly higher mean total ESE rating than boys; White students reported a significantly higher mean total ESE rating than Black students. Statistically significant lower mean total ESE ratings were also noted for those who reported physical fighting, lifetime alcohol use, and sexual intercourse. CONCLUSION: This 7-item scale is a reliable measure and could aid school health researchers and mental health practitioners in psychosocial screening and as an outcome of social and emotional learning as a brief measure of adolescent ESE.

Effects of Promoting Health Among Teens on Dietary, Physical Activity and Substance Use Knowledge and Behaviors for African American Adolescents.

BACKGROUND: African Americans are disproportionately affected by cardiovascular disease and cancer. Health promotion interventions hold promise for reducing health disparities. PURPOSE: Promoting Health Among Teens (PHAT) is a brief, culturally tailored health education intervention to decrease cardiovascular disease and cancer risk for African Americans. This study evaluated the effects of PHAT for African American adolescents ages 14 to 17 in four eastern cities in the USA. METHODS: A randomized controlled design (N = 1,654) was used to determine differences in health knowledge, diet, physical activity, and substance use behaviors between PHAT participants and a sexual health promotion control group. Data were collected at baseline, three, six, and twelve months post intervention. Growth curve modeling was used to detect differences in health knowledge, dietary behaviors, physical activity, and substance use between PHAT and control group participants. RESULTS: PHAT participants had significantly greater knowledge gains but modest behavior changes compared to control group participants. DISCUSSION: PHAT is a promising intervention to increase knowledge and address selected health behaviors in African American youth. TRANSLATION TO HEALTH EDUCATION PRACTICE: Future attempts to execute PHAT should continue its emphasis on knowledge building while increasing intervention dosage and modifying length of time for intervention sessions.