Assessing the association between safety perceptions and communication about sex and drugs among Black adolescents exposed to adversity.

The present study examined the association between safety perceptions and communication with a trusted adult about sex and drugs among Black adolescents exposed to adverse childhood experiences (ACEs) and the role of gender as a potential moderator in this association. Data were drawn from a small, randomized control pilot test of an adapted evidence-based intervention conducted from 2022 to 2023 in Baltimore, Maryland. The sample included 57 Black adolescents who had been exposed to ACEs (Mage = 15.14 years, SD = 0.81l; 47.4% female, 52.6% male). Information about safety perceptions, health communication, health behaviors, and demographic characteristics was measured using an electronic survey at baseline. Group differences by gender emerged among ACEs and substance use behaviors. Safety perceptions were significantly associated with communication with a trusted adult, B = 0.31, SE = 0.24, p = .039. As youth felt more unsafe, their communication with a trusted adult about sex and drugs increased; this association did not differ by gender. Health communication was also associated with ACEs. Black adolescents living with a parent with mental health challenges reported increased communication, B = 0.60, SE = 0.20, p = .005, whereas youth experiencing homelessness had reduced health communication, B = -0.63, SE = 0.24, p = .012. A lack of perceived safety significantly impacts health communication; however, having trusted adults outside of the home, school, and neighborhood can serve as a protective factor in reducing substance use and sexual risk-taking among this population.

Using the intervention mapping for adaption framework to adapt an evidence-based sexual health intervention for youth affected by trauma.

BACKGROUND: Children exposed to household challenges (i.e., parental substance use, incarceration, and mental illness) are among the groups most vulnerable to sexual risk-taking in adolescence. These behaviors have been associated with a range of negative outcomes later in life, including substance abuse, low educational attainment, and incarceration. Adapting an evidence-based intervention (EBI) to be suitable for this population is one strategy to address the needs of this group. METHODS: In this study, we describe the use of the Intervention Mapping for Adaption (IM-Adapt) framework to adapt an evidence-based, sexual health intervention (Focus on Youth with Informed Children and Parents). We describe the actions taken at each step of the IM-Adapt process which are to assess needs, search for EBIs, assess fit and plan adaptions, make adaptions, plan for implementation and plan for evaluation. RESULTS: Key changes of the adapted intervention include the incorporation of trauma-informed principles and gender inclusive language, standardization of the session length, and modernization of the content to be more appropriate for our priority population. CONCLUSIONS: The adapted intervention shows promise toward meeting the behavioral health needs of Black youth exposed to household challenges. Our process and approach can serve as a model for researchers and practitioners aiming to extend the reach of EBIs.

Virtual Implementation of a Photovoice Project With Youth in Baltimore During the COVID-19 Pandemic.

This article describes the virtual implementation of Photovoice activities conducted as part of a project that sought to gather youths' perspectives on neighborhood and housing conditions, community redevelopment, and health and well-being in Baltimore. We discuss the original in-person design and how activities were implemented virtually, in light of coronavirus disease 2019 (COVID-19) physical distancing guidelines. Challenges to virtual implementation included establishing rapport with youth and families during recruitment and data collection, encouraging active participation during discussion sessions, and varying technological skills among youth. Facilitators of virtual implementation included partnering with a community organization, piloting virtual sessions to assess participant's technology skills, and providing various ways for youth to participate during discussion sessions, engage in group activities, and receive hands-on instruction. This article showcases the ways in which virtual implementation of Photovoice activities can be successfully implemented with youth and provides recommendations for future Photovoice projects that include virtual activities.

"It's on every corner": assessing risk environments in Baltimore, MD using a racialized risk environment model.

Physical, social, economic, and political environments can increase harm and risk among people who use drugs. These factors may be exacerbated in urban environments with a history of systemic inequality toward African Americans. However, racialized risk environment models have rarely been used within substance use research. To fill this gap, the current qualitative study sought to describe the racialized risk environment of an African American sample of 21 adults with a history of illicit drug use living in Baltimore, MD. Semi-structured interviews were conducted. Data were analyzed using qualitative content analysis to identify themes related to illicit drug use, neighborhood context, violence, social interactions, and income generation. Themes related to the physical (e.g., the increased visibility of drug markets), social (e.g., normalization of drug use within social networks), and economic (e.g., financial hardships) risk environments emerged from this sample. These perceptions and themes can aid in developing and refining substance use programming within racialized settings.

Maintaining Community-engaged Research with Young People in A Virtual setting.

BACKGROUND: Partnering with young people to conduct research is fundamental to community mobilization. Recent restrictions on in-person interactions and engagement presented limitations for continued partnership with young people. OBJECTIVE: To present a practical strategy and lessons learned to facilitate community-engaged research with youth in a virtual setting. METHODS: Based on youth engagement tenets, the TEAM (tailor the compensation package, ensure meetings are accessible, accommodate personal needs, and maintain the structure of in-person meetings) strategy was used to adapt the partnership to a virtual setting. LESSONS LEARNED: Three lessons are discussed 1) the importance of maintaining social connectedness, 2) maximizing flexibility, and 3) focusing on creativity and competency building. CONCLUSIONS: The COVID pandemic forced researchers to rethink previous engagement practices that relied heavily on in-person interactions to be sustainable. The TEAM strategy is one way to successfully adapt practices and engage young people in virtual settings.

When a house is never a home: Housing instability among youth affected by parental drug abuse.

BACKGROUND: The negative consequences of parental substance abuse are significant and longstanding for children. Among other risks, these youth are more likely to experience housing instability. The most common predictor of a child not living with their biological parent is parental substance use. Research shows that these youth are at higher risks of housing instability; however, little is known about their housing experiences, from their perspective. This study explored the housing experiences of youth affected by parental substance abuse. PARTICIPANTS AND SETTING: Fourteen African American young adults ages 18 to 24 years old who identified having at least one biological parent with a history of substance use participated in this study. The study is based in Baltimore, MD, USA; an urban city with one of the highest rates of drug overdose and substantial disadvantage. METHODS: In-depth interviews were conducted among fourteen young adults (18-24) affected by parental drug use to discuss their housing experiences throughout childhood and adolescence. Five research team members developed a codebook, double coded all transcripts and analyzed inductively using a qualitative content analytic approach. RESULTS: Three themes emerged to characterize housing experiences: frequent housing transitions, repeated trauma exposures related to housing instability, and the lasting effects of housing instability. CONCLUSION: The residual impacts of parental substance use have caused youth to experience the toxic stress and trauma associated with housing instability. It is important that young people have safe, stable and reliable housing to promote child health and normative development.