Does Physical Activity Confound Race Differences in Osteoarthritis-Related Functional Limitation?

OBJECTIVE: This study sought to determine the extent to which physical activity confounds the relation between race and the incidence of osteoarthritis (OA)-related functional limitation. METHODS: OA Initiative study participants with or at increased risk of knee OA who wore an accelerometer were included. Race was self-reported. Average time spent in moderate to vigorous physical activity (minutes per day) based on ActiGraph uniaxial accelerometer data was assessed. Functional limitation was based on the following: (1) inability to achieve a community walking speed (1.2 m/s) standard, (2) slow walking speed (<1.0 m/s), and (3) low physical functioning based on a Western Ontario and McMaster Universities OA Index (WOMAC) physical function score greater than 28 of 68. RESULTS: African American (AA) participants (n = 226), compared with White participants (n = 1348), had a higher likelihood of developing functional limitation based on various measures. When adjusted for time in moderate to vigorous physical activity, the association between AA race and inability to walk a community walking speed slightly decreased (from relative risk [RR] 2.15, 95% confidence interval [95% CI] 1.64-2.81, to RR 1.99, 95% CI 1.51-2.61). Association between AA race and other measures of functional limitation mildly decreased (slow walking speed: from RR 2.06, 95% CI 1.40-3.01, to RR 1.82, 95% CI 1.25-2.63; low physical functioning: from RR 3.44, 95% CI 1.96-6.03, to RR 3.10, 95% CI 1.79-5.39). When further adjusted for demographic and other clinical variables, only the association between race and low physical functioning (WOMAC) significantly decreased and no longer met statistical significance. CONCLUSION: Greater physical activity is unlikely to completely make up for race differences in OA-related functional limitation, and other barriers to health equity need to be addressed.

Comparing the prevalence of sexual behaviors and victimization among adolescents based on child welfare system involvement.

OBJECTIVE: Sexual behavior presents risks, particularly among vulnerable groups such as adolescents with child welfare system involvement. This study compares the prevalence of sexual behaviors and victimization among adolescents in Los Angeles County with and without child welfare system involvement. It examines associations between online and offline sexual behaviors and victimization. METHODS: The sample included middle and high school students (N = 2365) and high school students only (N = 1068) participating in the 2015 Los Angeles Youth Risk Behavior Survey (YRBS). Measures included child welfare system involvement with or without foster care placement, demographics (race, ethnicity, gender, age), in-person sexual behaviors (e.g., unsafe sex), online sexual behaviors (e.g., sent/received sext), and sexual victimization (forced sex, dating physical violence, dating sexual assault). Logistic regressions examined variability in sexual behaviors and victimization based on child welfare involvement, net of demographics. Path analyses associated online sexual behaviors with victimization and offline risk. RESULTS: Greater reported sexual behavior and victimization among foster care youths was found, relative to youths without child welfare system involvement (maximum OR = 9.8). Youth with child welfare system involvement but not placed in foster care reported more unsafe sex, sexting because of pressure, finding a sex partner online, having sex with a partner met online, and forced sex (maximum OR = 10.4). Sexting was associated with forced sex and dating sexual assault, finding a sexual partner online, and physical violence. CONCLUSIONS: Targeted prevention is needed for online and offline sexual risks and victimization among youth with child welfare system involvement.

Cumulative Violence Exposure and Alcohol Use Among College Students: Adverse Childhood Experiences and Dating Violence.

Multiple types of childhood adversities are risk factors for dating violence among college-age youth and in turn, dating violence is associated with alcohol use. This work quantitatively examines associations of childhood adversity and dating violence with alcohol use among college students using a cumulative stress approach. Multi-campus surveys were collected from March to December 2016 in four universities across the United States and Canada (n = 3,710). Latent class analysis identified patterns of childhood adversity and dating violence. Regression analyses investigated the associations of latent class patterns with past year number of drinks, alcohol use frequency, and problematic drinking. Latent class analysis produced seven classes: "low violence exposure" (18.5%), "predominantly peer violence" (28.9%), "peer violence and psychological child abuse" (10.8%), "peer and parental domestic violence" (9.9%), "peer and psychological dating violence" (17%), "peer and dating violence" (6.6%), and "childhood adversity and psychological dating violence" (8.3%). Compared to the "low violence exposure" group, "peer and psychological dating violence" (B = .114, p < .05), "peer and dating violence" (B = .143, p < .05), and "childhood adversity and psychological dating violence" (B = .183, p < .001) groups were significantly associated with problematic drinking. Results highlight how childhood adversity and dating violence contribute to problematic alcohol use, suggesting interventions that address both childhood adversity and dating violence may be most effective at reducing alcohol misuse among college students.

Adverse Childhood Experiences Among 3 Generations of Latinx Youth.

INTRODUCTION: The U.S. immigrant paradox shows worsening health across generations, with U.S.-born Latinx having poorer health outcomes than immigrants. Adverse childhood experiences are associated with increased health risk over the life course, warranting further investigation. This study examines adverse childhood experience distribution across generations in a community sample of first-, second-, and +third-generation Latinx youth. METHODS: Survey data were collected at 7 timepoints from 2005 to 2016; 1,303 participants completed follow-ups, including adverse childhood experiences, at Timepoint 5 (mean age=21.6 years). These analyses were performed in 2019. Adverse childhood experiences measured psychological, physical, and sexual abuse, and parental domestic violence, divorce, alcohol/drug use, mental illness, and incarceration. Adverse childhood experiences were operationalized as a continuous variable (number) and by 2 groups: household dysfunction and maltreatment. Associations between immigrant generation and adverse childhood experiences were analyzed in adjusted logistic and multiple regression models. RESULTS: Compared with +third-generation youth, first- (OR=0.49, 95% CI=0.27, 0.89) and second- (OR=0.43, 95% CI=0.26, 0.72) generation youth had lower odds of reporting household dysfunction. For first-generation youth, this was specific to living with an alcohol/drug user (OR=0.49, 95% CI=0.29, 0.81). In contrast to other adverse childhood experiences, first-generation youth had twice the odds of reporting sexual abuse (OR=2.01, 95% CI=1.04, 3.88) compared with +third-generation youth. CONCLUSIONS: Preventing health disparities among immigrant-origin youth requires understanding the impact of adverse childhood experiences on Latinx youth across generations. Results highlight associations among a Latinx youth community sample, suggesting variations in experiences across generations. Household factors in childhood may be key targets for interventions aimed at improving the outcomes observed in later generations for Latinx families.

Latent Class Analysis of Intimate Partner Violence Perpetration and Victimization among Latino Emerging Adults.

While there are known developmental consequences and correlates of intimate partner violence perpetration and victimization, research focused on bidirectional and multiple forms of partner violence among Latino emerging adults is needed. This longitudinal study identified latent classes of intimate partner violence perpetration and victimization patterns among emerging adult Latinos (N = 1060; 60.6% female). A second aim examined acculturation and cumulative substance use correlates in high school, as predictors of intimate partner violence perpetration and victimization classes in emerging adulthood. Average age of participants was 15.5 years in 10th grade and 22.7 years in emerging adulthood. We identified four distinct subgroups of intimate partner violence perpetration and victimization, with 22% of individuals identified in a violence perpetration and victimization subgroup. Cumulative heavy episodic drinking and marijuana use in high school predicted belonging to the psychological bidirectional intimate partner violence group rather than the group with no violence. Cumulative marijuana use in high school, predicted belonging to the sexual bidirectional partner violence group compared to the no violence group. Our study extends the literature across developmental periods among Latino youth. The findings have implications for early adolescent prevention strategies and promotion of healthy intimate relationships.

Longitudinal Predictors of Intimate Partner Violence Perpetration and Victimization in Latino Emerging Adults.

Despite the prevalence of intimate partner violence in emerging adulthood, literature focused on this life stage among Latinos remains limited. This longitudinal study examined acculturation; traditional gender role attitudes; use of alcohol, marijuana, and tobacco; and depressive symptoms in 10th grade as predictors of intimate partner violence perpetration and victimization among Latino emerging adults (N = 823; 58% female). Average age of participants was 15.5 years in 10th grade and 22.7 years in emerging adulthood. The results indicate important gender differences in intimate partner violence outcomes for Latino emerging adults. Higher U.S. acculturation predicted physical intimate partner violence perpetration among young men. More traditional gender role attitudes were significantly associated with psychological and physical intimate partner violence perpetration among male Latino emerging adults. Among Latinas, alcohol use in 10th grade predicted psychological perpetration and victimization in emerging adulthood. The findings have implications for developing gender- and ethnic-relevant prevention interventions focused on intimate partner violence among Latino adolescents and emerging adults.

Modelling possible causality in the associations between unemployment, cannabis use, and alcohol misuse.

BACKGROUND: There has been considerable interest in the extent to which substance use and unemployment may be related, particularly the causal pathways that may be involved in these associations. It has been argued that these associations may reflect social causation, in which unemployment influences substance use, or that they may reflect social selection, in which substance use increases the risk of becoming and remaining unemployed. The present study sought to test these competing explanations. METHODS: Data from the Christchurch Health and Development Study, featuring a longitudinal birth cohort, were used to model the associations between unemployment and both cannabis and alcohol. Data on patterns of unemployment, involvement with cannabis, and symptoms of alcohol use disorder were examined from ages 18-35 years. The associations between unemployment and both cannabis dependence and alcohol use disorder (AUD) were modelled using conditional fixed-effects regression models, augmented by time-dynamic covariate factors. RESULTS: The analyses showed evidence of possible reciprocal causal processes in the association between unemployment and cannabis dependence, in which unemployment of at least three months' duration significantly (p < 0.0001) increased the risk of cannabis dependence, and cannabis dependence significantly (p < 0.0001) increased the risk of being unemployed. Similar evidence was found for the associations between unemployment and AUD, although these associations were smaller in magnitude. CONCLUSIONS: The present findings support both social causation and social selection arguments, by indicating that unemployment plays a causal role in substance misuse, and that it is also likely that a reverse causal process whereby substance misuse increases the risk of unemployment.