Anxiety sensitivity among Black youth: A cross-sectional analysis of the direct and indirect effects of community violence exposure, neighborhood risk, parenting practices, and peer effects.

Youth exposed to community violence and neighborhood stressors report devastating mental health consequences. Black youth are at greater risk and experience community violence at rates higher than other youth populations. An underexplored mental health consequence is anxiety sensitivity, the fear of experiencing anxiety-related symptoms, which contributes to maladaptive coping strategies and the development and severity of other mental health problems. This study utilized structural equation modeling (SEM) to examine socio-ecological risk and protective factors associated with community violence exposure and anxiety sensitivity among low-income Black youth. Survey data are from a sample of 320 Black youth residing in public and subsidized housing in a Northeastern city in the United States. Results indicated that neighborhood risk, parenting behaviors, and exposure to delinquent peers were indirectly associated with anxiety sensitivity, which occurred through community violence exposure. Additionally, neighborhood risks had direct effects on anxiety sensitivity. Results point to the need to incorporate social and environmental factors in interventions addressing anxiety sensitivity among Black youth in urban communities.

Examining the Utility of the Early Childhood Development Index (ECDI) among Children in the Nigeria Context.

An estimated 6 million children under the age of five in Nigeria (out of nearly 31 million) risk not reaching their full developmental potential. The dearth of context-relevant measures poses a challenge to the planning and implementation of effective interventions. This study assesses the utility of the Early Childhood Development Index (ECDI) in Nigeria. We used the Multiple Indicator Cluster Surveys to track progress among 3- to 4-year-old children (n = 11,073); 3-year-old, 51%; female, 49%. Using random calibration samples, the results from psychometric tests indicate that while over half of the children were on track in their development based on the ECDI, the instrument had low to average internal consistency and weak face validity, suggesting an inadequacy in capturing ECD information of value. At the outset of the launch of the new ECDI2030, the results of this study point to the need for continued discourse and advocacy for the use of culturally appropriate measures of child development, and a child-centered community engagement approach. This is essential in ensuring accountability and responsive interventions for the children served and their families.

Stress Biomarkers in Black Youth: Exploring Psychological, Behavioral, and Socio-Ecological Correlates.

Exposure to chronic stress is a major public health concern. Black youth are vulnerable to chronic stress exposure given their overrepresentation in urban neighborhoods characterized by socio-ecological stressors. We contribute to this emerging body of knowledge by (1) investigating stress-induced variability in cortisol response patterns among Black youth, and (2) examining risk and protective factors associated with physiological stress responses. Salivary cortisol was collected from a community sample of 123 low-income Black youth ages 13 to 21. Latent class analysis (LCA) and logistic regression were utilized to identify discrete groups based on cortisol reactivity, and psychological, behavioral, and socio-ecological correlates of class membership. LCA supported a 2-class model of cortisol reactivity. Youth in class one were indicative of a normative stress response with mean cortisol awakening response of 0.38 µg/dL (SD = 0.19), 0.48 µg/dL (SD = 0.20) at time 2, and 0.44 µg/dL (SD = 0.20) at time 3. Youth in class two exhibited a blunted stress response with mean cortisol awakening response of 0.20 µg/dL (SD = 0.11), 0.21 µg/dL (SD = 0.09) at time 2, and 0.18 µg/dL (SD = 0.08) at time 3. Delinquent peer exposure and post-traumatic stress symptoms were negatively associated with blunted stress responses, while greater depressive symptoms were positively associated with blunted stress responses. Black youth displayed distinct physiological stress reactivity patterns. Interventions are needed to assist youth in coping with stress while transforming the upstream factors that give rise to adverse community conditions.

Assessing the Modified Neighborhood Cohesion Index Among African American Adolescents Living in Public Housing: An Exploratory and Confirmatory Factor Analysis.

Objective: African American youth are disproportionately overrepresented in low-resourced segregated urban neighborhoods. Consequently, they experience greater exposure to neighborhood risks and subsequent depressive symptoms. Neighborhood cohesion represents a protective factor for youth in such environments. However, the concept remains underexplored among African American youth. This study examines the psychometric properties of a modified version of the Neighborhood Cohesion Index (NCI) among African American youth living in public housing. Method: Psychometric properties were assessed through exploratory and confirmatory factor analyses using data from African American youth (N = 235) living in public housing in two large northeastern cities. Results: The EFA resulted in the use of a single-factor structure with two dropped items and good internal validity. Findings from the CFA indicated that model fit indices were unacceptable for chi-square and RMSEA (χ2 [62; N = 235] = 170.19, p < .001); RMSEA = 0.09 [90% CI: 0.071, 0.102]) but were acceptable for SRMR and CFI (SRMR = 0.06; CFI = 0.91) with three error covariances. Conclusions: The modified NCI is not ideal for assessing neighborhood cohesion among this understudied population. Future research should prioritize psychometric testing alongside cognitive interviewing, to provide a contextualized measure of neighborhood cohesion for this population.

Structural and Intermediary Social Determinants of Health and the Emotional and Behavioral Health of US Children.

Children grow up in homes where varying environmental and socioeconomic contexts have a bearing on their emotional and behavioral health (EBH). This study used data from a representative sample of the child supplement of the US National Health Information Survey (NHIS) and applied the social determinants of health (SDoH) framework to explore factors associated with child EBH. We conducted a path analysis of the child's EBH measured by the strengths and difficulties questionnaire (SDQ) from their macro and socioeconomic contexts, e.g., policy, household, and other health system risk factors. For children in the sample, aged 4 to 17 years old (n = 9205), most path relationships to child SDQ scores were statistically significant. The total effects from a child's visit to a mental health specialist (0.28) and child's age (0.22) had the highest coefficients to child SDQ scores. A modified model showed a better fit with X2 (4) = 22.124, RMSEA = 0.021, and 90% CI [0.013-0.03], CFI = 0.98. Findings indicate that child factors such as being older, the use of mental healthcare services, and family socioeconomic status were significantly associated with EBH, calling attention to the need for more responsive policy and behavioral health interventions that address household/familial and child-level factors, critical determinants of child wellbeing.

Exposure to community violence and depressive symptoms: Examining community, family, and peer effects among public housing youth.

Exposure to community violence is an epidemic problem that causes debilitating effects on youth mental health. However, the relationships between violence exposure and youth mental health remain unclear when examining co-occurring socioecological risk and protective factors. The purpose of this study is to clarify the observed gaps in knowledge by utilizing structural equation modeling (SEM) to examine the mediating role of community violence exposure on the relationship between perceived neighborhood risk factors, parental behaviors, and peers on depressive symptoms in a sample of urban youth in low-income public housing communities (n = 320). Results indicate that community violence exposure and exposure to delinquent peers mediates the effects of perceived neighborhood risk and parenting behaviors on depressive symptoms. These findings suggest that while interventions that limit exposure to community violence and delinquent peers could reduce depressive symptoms, interventions that reduce community violence are essential to improve youth mental health.

Exposure to Violence and Posttraumatic Stress Among Youth in Public Housing: Do Community, Family, and Peers Matter?

This study examines the mediating roles of neighborhood risk factors, parental behaviors, and peers on the relationship between community violence exposure and posttraumatic stress in a sample of urban youth in low-income public housing communities. Data are from 320 African-American youth living in public housing in a northeastern city in the USA. Structural equation modeling was utilized to examine the stated relationships. Study results point to significant effects of violence exposure on posttraumatic stress in urban youth. While findings indicated indirect effects of neighborhood risk, parenting practices, and exposure to delinquent peers on posttraumatic stress, each of these paths operates through their relationship with violence exposure, with exposure to delinquent peers having the strongest mediating effect. Exposure to delinquent peers mediates the effects of neighborhood risks and parental behaviors on exposure to community violence, representing one potential intervention point to disrupt the deleterious effects of exposure to violence among youth. Our findings suggest interventions that address peer influence, and group norms may serve as protective factors against the risk of youth violence exposure. Overall, results highlight the co-occurring socioecological context of community violence exposure for youth living in public housing.

Resident-Led Neighborhood Development to Support Health: Identifying Strategies Using CBPR.

Evidence suggests that where people live, learn, work, and play affects a range of health outcomes for children and adults. Differential access to social, economic, and environmental supports puts some community members at greater risk, leading to disparities in health and well-being. The 2014 release of the For the Sake of All report highlighted persistent health disparities for African Americans in St. Louis, Missouri, and their social and economic impacts on the St. Louis region. This study extends this work by developing partnerships with community organizations and neighborhood residents to address health disparities. Community-based participatory research (CBPR) methods were utilized to engage partners in a 10-month research process to address community concerns that impact health. Seven community residents, neighborhood researchers, engaged in workshops to learn about the research process and used techniques to gather information to implement action strategies. Neighborhood researchers selected 14 vacant lots to implement their action plan, which included visions for repurposing the land into a community park, produced a report for dissemination, and organized a community action forum to communicate their findings. This study highlights a promising approach to promote healthy communities and health equity by empowering neighborhood residents using participatory methodologies.