A Qualitative Exploration on Risk and Protective Factors of Substance Use Among Black Adolescent Girls.

OBJECTIVE: While Black adolescent girls use drugs at much lower rates than White and Hispanic girls, Black adolescent girls often have worse health outcomes due to drug use. This study seeks to highlight the voices of Black adolescent girls in order to understand their unique risk factors for substance use and misuse. METHODS: Utilizing the intersectionality and ecological systems theoretical frameworks, the research team conducted twelve focus groups among a sample of Black adolescent girls (N = 62) between the ages of 13-18 (M = 15.6 years SD = 1.50). RESULTS: Thematic analysis was conducted to analyze the participant narratives. Four main themes arose: 1) stereotypes of Black adolescent girls; 2) the role of the physical and social environment (feeling unsafe in neighborhoods where they reside); 3) using drugs as a coping mechanism; 4) input on prevention programming for girls with a sub-theme involving family as a protective factor. DISCUSSION: Study findings deepen our qualitative understanding of risk and protective factors for substance use among Black adolescent girls. These findings provide insight on girls' lived experiences for researchers and intervention development to create and implement substance abuse prevention programs that are race- and gender-specific for Black adolescent girls.

Learning from community-based HIV prevention to inform control and mitigation of the COVID-19 pandemic.

The current COVID-19 pandemic and the likelihood of future viral pandemics demonstrate a need for strategic prevention campaigns that integrate biomedical, structural, and behavioral interventions within larger scale comprehensive public health initiatives. In Human Immunodeficiency Virus (HIV) prevention, community-based efforts have resulted in reductions in transmission rates, increases in testing, increases in biomedical prevention uptake, and increased engagement in secondary and tertiary prevention efforts. In this paper, we review three community-based strategies (health communication, accessible screening, and accessible prevention resources) that have demonstrated effectiveness in HIV prevention and offer recommendations for utilizing these strategies in the COVID-19 pandemic. For example, health communication strategies have positively influenced HIV testing behavior, sex communication, and condom use among HIV negative individuals and treatment initiation, treatment adherence, and retention in care among people living with HIV. In addition, studies have shown that improving accessibility of HIV screening and prevention resources in community venues such as schools, pharmacies, mobile-testing sites, churches, hair salons, and bars is useful for increasing the uptake of HIV testing, especially among disproportionately affected populations and those deemed hard to reach. Despite differences in modes of transmission, it is plausible that a synergistic multilevel response with emphasis on community-based efforts could lead to similar outcomes for the current COVID-19 pandemic and future viral pandemics. Community-based prevention strategies offer an opportunity to integrate, and bolster disconnected and siloed initiatives that achieve limited impacts independently.

Adolescent Polysubstance Use and Co-Occurring Weapon Carrying, Bullying Victimization, and Depressive Symptomology: Patterns and Differences in the United States.

Adolescent substance use commonly co-occurs with poor mental health, bullying victimization and risky behaviors that may lead to violence. The purpose was to describe the United States (US) national prevalence of polysubstance use and co-occurring characteristics and associated demographic characteristics among youth. Middle and high school students in the 2019 CDC YRBS survey reported their demographics and current ( ≥ 1 days in the last 30 days) substances used (alcohol, cigarette, e-cigarette, cannabis); polysubstance combinations were generated. Cross-sectional weighted logistic regression estimated odds of polysubstance use and frequent use ( ≥ 6 days in the last 30 days) by weapon carrying, depressive symptoms, bullying victimization, and demographics. Mean age of the sample was 16 years, 51% were boys, 51% were non-Hispanic White. While accounting for 21% of the sample, 22-40% of Multiracial youth reported polysubstance use and frequent use. Odds of frequent polysubstance use (all combinations) were highest for weapon carrying youth.

Assessing the Prevalence Rates of Internalizing Symptomatology Among Multiracial Adolescents in the United States: A Systematic Review.

This systematic review aimed to investigate the prevalence of internalizing symptomatology among Multiracial adolescents in the United States and to report on the methods utilized to measure Multiracial race and internalizing symptoms. A comprehensive search was conducted in Ovid MEDLINE, Embase, APA PsycInfo, and Web of Science Core Collection. The search was confined to peer-reviewed studies reporting the prevalence of any internalizing symptom among Multiracial adolescents between 10 and 24 years in the United States. Study selection, data abstraction, and quality assessments were managed by four team members. Between 2000 and 2023, nine studies provided prevalence estimates and used various methods to measure Multiracial race and internalizing symptoms. Prevalence estimates displayed considerable variability depending on symptom examined and measurement method utilized. For all internalizing symptomatology, estimates ranged between 7.5 and 55.2%; for depressive symptomatology, estimates ranged between 12.8 and 51.0%. No information on the prevalence of anxiety symptoms alone were provided. This review represents a pioneering attempt to report the prevalence of internalizing symptomatology among Multiracial adolescents in the United States, revealing significant gaps in current knowledge and methodological inconsistencies in the field. There exists a need for more comprehensive epidemiological research with this growing population.

Addressing Gendered Racism Against Black Girls Using a Strengths-Based Empowerment-Intersectional Framework for Sexual Health and Substance Use Prevention Programming.

Although Black girls use substances at lower rates than boys and girls from various other racial groups, they tend to have worse health outcomes associated with substance use that can also impact their sexual health. The association between substance use and sexual risk behaviors is usually attributed to lack of access to quality health care and lack of culturally specific prevention programming and treatment options tailored to this group. Accordingly, the theoretical frameworks for health promotion for Black girls often focus on addressing deficits, ignoring the powerful and intersecting social forces that can impact identity, agency, and behavioral options. Key among these forces is gendered racism. We propose a strengths-based conceptual framework to address and challenge gendered racism as a critical foundation for promoting health and wellbeing for Black girls. Our approach integrates Intersectionality Theory and Empowerment Theory, with psychological and intrapersonal empowerment identified as critical mediators of behavior and health outcomes, supported by protective factors of positive racial identity and gendered racial socialization. This framework has been developed with and for Black girls but can be adapted for health promotion efforts with other minoritized groups.

Sociopolitical control as a mediator between ethnic identity and social support on 30-day drug use among black girls.

While Black girls have lower rates of drug use, they face worse health and wellbeing consequences associated with drug use. Understanding which strengths-based factors serve as buffers to limit adverse outcomes related to drug use among Black girls is essential for prevention. This study investigated the mediating role of sociopolitical control on drug use among Black girls (n = 340). Using path analysis, models were tested to include the variables of interest. Sociopolitical control (e.g. leadership competency and policy control) significantly mediated the relationship between ethnic identity and social support on drug use. Implications from this study may consider bolstering empowerment-based strategies in drug use prevention for Black girls.

Teaching Note-#BlackGirlsMatter and the Social Work Curriculum: Integrating Intersectionality Within Social Work Education.

Black girls in the United States face a double or triple jeopardy that places them at risk compared to White girls and other ethnic minority girls. Furthermore, their voices and experiences are often ignored and not discussed fully within the social work classrooms. Since the social work profession is founded on social justice and equity, we urge educators to center the experiences of Black girls within their curriculum by recognizing their experiences within the context of power, privilege and oppression. This teaching note presents intersectionality as a framework for teaching social work students about working effectively with Black girls by focusing on their unique social location. Specifically, we provide strategies that engage social work students through case studies using qualitative research, student reflections, educational videos, and guest speakers. By using an intersectionality lens, social work curriculums can provide an important foundation for students to understand the nuanced ways that Black girls develop and experience the world.

Schools' Neighborhoods and Characteristics: Implications for Standardized Academic Achievement in Passaic, NJ's Elementary, Middle and High Schools.

Schools in urban neighborhoods receive less funding, have less programming, and have poorer infrastructure. Such disparities may impede academic outcomes among youth. This study used publicly available data to examine the association between school characteristics and surrounding neighborhood environment on educational outcomes across three academic years among 132 schools in Passaic County, New Jersey. Further, we assessed how schools' socioeconomic status could buffer the effects of a school's neighborhood disadvantage on academic outcomes. Results supported compound deprivation theory highlighting that lower-performing schools were located in lower-resourced neighborhoods. Further, school characteristics and neighborhood resource deprivation were associated with lower math, English, and science academic performance. Additionally, we found that associations between neighborhood resources and math and science academic outcomes were strongest in schools with greater economic support. We provide implications for research and practice by identifying multi-faceted approaches to challenge educational disparities addressing school and neighborhood-level disadvantages to improve educational outcomes for youth.

A latent profile analysis of psychological sense of community and ethnic identity among racial-ethnic minority young adults from the southwestern United States.

Among young adults fof color, both sense of community and ethnic identity, as developmental processes, have been associated with wellness, empowerment, and civic action. Additional research is needed that provides empirical support for the connection between psychological sense of community and ethnic identity on outcomes that relate to human development such as intrapersonal psychological empowerment, civic engagement, and depression symptoms. The current study of young adults of color (N = 243; 70% Hispanic/Chicano(a)/Spanish and 10% American Indian/Native American; 70% female) investigates heterogeneity according to dimensions of psychological sense of community and the ethnic identity construct. Latent profile analyses (LPA) were conducted. Using LPA, five profile groups emerged. Profile group differences were present on reported levels of intrapersonal psychological empowerment, civic engagement, and depression symptoms. Majority of sample participants were classified with moderate to high psychological sense of community and ethnic identity. Findings provide insights for efforts on developing community belongingness based on ethnic group identity and engaging young adults in civic life.

The brief sense of community scale: Testing dimensionality and measurement invariance by gender among Hispanic/Latinx youth.

Psychological sense of community is defined as feelings of belongingness and a shared belief that community members will meet one another's needs. Psychological sense of community has four dimensions: membership, influence, needs fulfillment, and emotional connection. In this study, multigroup confirmatory factor analysis was used to examine the first and second-order factor structure of the brief sense of community scale (BSCS) between male and female Hispanic/Latinx adolescents from an urban community (N = 947). To help validate the BSCS model, the second-order factor model was tested with regression to predict the measures of intrapersonal psychological empowerment and ethnic identity, as constructs conceptually related to psychological sense of community. Findings support that: (1) psychological sense of community can be measured through the BSCS and as a four-factor model among Hispanic/Latinx youth, supporting McMillan and Chavis's (1986) original theoretical discussions; (2) while no differences between genders were present at the model-level, there was path-specific variation; and (3) intrapersonal psychological empowerment and ethnic identity were associated with psychological sense of community.

Measuring Intrapersonal Psychological Empowerment and Ethnic Identity: Highlighting Strengths of Urban Black Girls.

Limited research has examined intrapersonal psychological empowerment (PE) among Black girls solely. This study aims to fill a gap in empowerment literature by examining the factor structure of the Sociopolitical Control Scale for Youth (SPCS-Y) among Black girls (N = 377) between the ages of 14-17 years old. We also examine the association with ethnic identity as a conceptually related variable. Structural equation modeling (SEM) was used to examine the factorial validity of the abbreviated, eight-item SPCS-Y among Black girls. Results support the two-dimensional factor structure of the abbreviated SPCS-Y among Black girls, as well as the association intrapersonal PE has with ethnic identity. Findings provide preliminary support for the empirical and theoretical relationship between intrapersonal PE and ethnic identity among Black girls.

Feeling Invisible and Unheard: A Qualitative Exploration of Gendered-Racist Stereotypes Influence on Sexual Decision Making and Mistreatment of Black Teen Girls.

Gendered racism can impact how Black teen girls perceive themselves in relation to the world and influence their behaviors. This form of discrimination tends to manifest in stereotypes that promote the victimization and mistreatment of Black teen girls. This qualitative study, using Black feminist thought through a Black Girlhood lens as a guiding framework, aims to understand how Black teen girls are affected by gendered-racist stereotypes and how these stereotypes impact sexual decision making among this group. Using a sample of (N = 27) Black teen girls, three major themes arose: (1) experiencing the effects of racist-sexist stereotypes, (2) feeling powerless and invisible due to stereotypes, and (3) navigating the pressure to have sex due to stereotypes. Implications for this study include incorporating elements of Black Feminist Thought through a Black girlhood lens within prevention programing while also providing Black teen girls with the tools to challenge negative stereotypes with support from adult allies in school and family settings.

What happens when we ask? A phenomenological focus group on HIV prevention and sexual health education among emancipated foster care youth.

Youth of color who have recently been emancipated from foster care are among the most vulnerable group at risk for having poor sexual health outcomes. It is essential for researchers to understand how emancipated foster care youth receive messages about safe sex and HIV/STI prevention in order to tailor health promotion activities for this group. This study presents a strengths-based view of emancipated foster care youth of color who developed an empowering, arts-based campaign to prevent HIV in their community using Youth Participatory Action Research (Y-PAR) methods. The project was led by 10 emancipated foster care youth who participated in two focus groups that centered on understanding their knowledge of HIV. Five major themes emerged from the focus group. Implications for researchers include incorporating safe spaces for youth to develop ideas that can result in empowering activities relating to prevention.

Intrapersonal psychological empowerment profiles on ethnic identity, social support, and lifetime drug use among Hispanic adolescent girls.

The abbreviated Sociopolitical Control Scale for Youth (SPCS-Y) factor structure, used to measure intrapersonal psychological empowerment, was tested among a sample of Hispanic adolescent girls (N = 490). Confirmatory factor analysis and latent class analyses were conducted, and five distinct cluster groups emerged. Multivariate analysis of covariance was used to examine conceptually related variables and support the two-factor structure and validity of the scale. Participants with higher levels of intrapersonal psychological empowerment also had high social support, ethnic identity, and lower levels of alcohol and drug use. Findings support the use of the scale on Hispanic adolescent girls and contribute to alcohol and drug use prevention research.

Strong Black Women: Linking Stereotypes, Stress, and Overeating Among a Sample of Black Female College Students.

This qualitative study examines how the "Strong Black Woman" (SBW) label can have potentially negative health effects for African American/Black women that contribute to eating disorders. This study addresses the gap in literature on racial disparities that are present in understanding eating disorders that contribute to obesity and obesityrelated issues. Through semi-structured individual interviews conducted with (N = 11) Black female higher education students, participants were able to discuss how disorganized overeating patterns were associated with the emotional stress of being labeled a Strong Black Woman. Findings provide implications to clinicians, educators, and researchers by identifying stress inducing factors heightened by racist and sexist microaggressions that contribute to the mental and physical health of Black women. This study also adds to the limited literature on the intersection of racism and sexism that contribute to poor health outcomes in Black women.

Countering Educational Disparities Among Black Boys and Black Adolescent Boys from Pre-K to High School: A Life Course-Intersectional Perspective.

Accounts of educational opportunity gaps for Black boys are overwhelmingly focused on later years of development. Achievement and discipline disparities are evident across their lifespan. Life course and intersectionality theories were used to develop a framework for understanding obstacles Black boys face during their preschool through high school years. Outlining the cumulative impact of threats and protective factors for their academic success provides insight for supporting Black boys at various developmental stages. Implications include tools for families, educators, and practitioners. This perspective will enhance the collective understanding of the resiliency of Black boys and support their educational success throughout the life course.

Impact of Race and Socioeconomic Status on Outcomes in Patients Hospitalized with COVID-19.

BACKGROUND: The impact of race and socioeconomic status on clinical outcomes has not been quantified in patients hospitalized with coronavirus disease 2019 (COVID-19). OBJECTIVE: To evaluate the association between patient sociodemographics and neighborhood disadvantage with frequencies of death, invasive mechanical ventilation (IMV), and intensive care unit (ICU) admission in patients hospitalized with COVID-19. DESIGN: Retrospective cohort study. SETTING: Four hospitals in an integrated health system serving southeast Michigan. PARTICIPANTS: Adult patients admitted to the hospital with a COVID-19 diagnosis confirmed by polymerase chain reaction. MAIN MEASURES: Patient sociodemographics, comorbidities, and clinical outcomes were collected. Neighborhood socioeconomic variables were obtained at the census tract level from the 2018 American Community Survey. Relationships between neighborhood median income and clinical outcomes were evaluated using multivariate logistic regression models, controlling for patient age, sex, race, Charlson Comorbidity Index, obesity, smoking status, and living environment. KEY RESULTS: Black patients lived in significantly poorer neighborhoods than White patients (median income: $34,758 (24,531-56,095) vs. $63,317 (49,850-85,776), p < 0.001) and were more likely to have Medicaid insurance (19.4% vs. 11.2%, p < 0.001). Patients from neighborhoods with lower median income were significantly more likely to require IMV (lowest quartile: 25.4%, highest quartile: 16.0%, p < 0.001) and ICU admission (35.2%, 19.9%, p < 0.001). After adjusting for age, sex, race, and comorbidities, higher neighborhood income ($10,000 increase) remained a significant negative predictor for IMV (OR: 0.95 (95% CI 0.91, 0.99), p = 0.02) and ICU admission (OR: 0.92 (95% CI 0.89, 0.96), p < 0.001). CONCLUSIONS: Neighborhood disadvantage, which is closely associated with race, is a predictor of poor clinical outcomes in COVID-19. Measures of neighborhood disadvantage should be used to inform policies that aim to reduce COVID-19 disparities in the Black community.

A Spatial Analysis of Alcohol Outlet Density Type, Abandoned Properties, and Police Calls on Aggravated Assault Rates in a Northeastern U.S. City.

Background: Community-based research and prevention scholarship has shown a growing interest in examining the impact of the ecological structure of neighborhoods on community violence. Ecological structures such as higher numbers of alcohol outlets and abandoned/vacant properties in geographically dense, poor, and socially isolated communities are critically important to consider. Further, disadvantaged urban communities are burdened by greater police presence with limited or no abatement in crime or violence. Purpose: Using Geographic Information Systems (GIS) mapping, spatial analysis techniques, and a negative binomial regression analyses, this study investigated the relationships between alcohol outlet density consisting of license C (i.e., combined on and off premises establishments) and license D (i.e., off premises establishments such as liquor stores), abandoned properties, and police calls to service on aggravated assault rates in a Northeastern United States urban city. Results: Negative binomial regression analysis results showed that license C alcohol outlet density count (IRR = 1.36, 95% CI = 1.08, 2.11), license D alcohol outlet density count (IRR = 1.13, 95% CI = 1.01, 1.30), abandoned property count (IRR = 1.28, 95% CI = 1.01, 2.01), and police call to service counts (IRR = 1.24, 95% CI = 1.01, 1.50) were positively associated with aggravated assault rates. Analyses controlled for census data characteristics. Conclusions: The link between alcohol outlet density and violent crime has been established in public health research. However, this study represents an important contribution in recognizing the unique relationships between license C and license D alcohol outlet density, abandoned properties, and police calls to service with aggravated assaults in an urban neighborhood. Conclusions are drawn for policy and practice.

Testing the Factor Structure of the Brief Sense of Community Scale among Black Girls and the Relationship with Ethnic Identity, Empowerment and Social Support.

Research on Psychological Sense of Community (SOC) among Black girls are limited due to lack of validated measures for this group. Using confirmatory factor analysis (CFA), the first and second-order factor structure of the Brief Sense of Community Scale (BSCS) used to measure Psychological SOC was examined using a sample of Black girls from an urban community (N = 340). Using a regression-based approach, the second-order five-factor model of the BSCS was also examined with intrapersonal psychological empowerment (PE), social support, and ethnic identity as conceptually related variables. Findings support that: (1) psychological SOC can be conceptualized and measured through four dimensions among Black girls; and (2) intrapersonal PE, social support, and ethnic identity were significantly associated with SOC.