Objective: Risk factors for adolescent alcohol use are typically conceptualized as individual and... more Objective: Risk factors for adolescent alcohol use are typically conceptualized as individual and interpersonal level factors; however, these factors do not fully explain adolescent drinking behavior. We used a socioecological model to examine the contribution of neighborhood factors in a risk and promotive model of adolescent alcohol use among urban high school youth (N = 711; 52% female; 82% African American; M = 18 years old). Method: Using a multilevel model, we considered the role of neighborhood disadvantage on youth alcohol use, after accounting for risk (e.g., peer and parental substance use) and promotive factors (e.g., social support and participation in prosocial activities). Results: Peer alcohol use and peer support were associated with more alcohol use, and maternal support was negatively associated with alcohol use. Despite signifi cant variation at the neighborhood level, neighborhood disadvantage was not directly associated with adolescent drinking. Conclusions: Our study contributes to a mixed body of literature on social context and adolescent health. Although our research highlights the importance of interpersonal relationships, we found no support for neighborhood infl uences. We conclude with future directions for research examining the link between adolescent drinking and neighborhood contexts. (J. Stud. Alcohol Drugs, 72,
Researchers have reported that network characteristics are associated with substance use behavior... more Researchers have reported that network characteristics are associated with substance use behavior. Considering that social interactions within online networks are increasingly common, we examined the relationship between online network characteristics and substance use in a sample of emerging adults (ages 18-24) from across the United States (N = 2,153; M = 21 years old; 47 % female; 70 % White). We used regression analyses to examine the relationship between online ego network characteristics (i.e., characteristics of individuals directly related to the focal participant plus the relationships shared among individuals within the online network) and alcohol use and substance use, respectively. Alcohol use was associated with network density (i.e., interconnectedness between individuals in a network), total number of peer ties, and a greater proportion of emotionally close ties. In sex-stratified models, density was related to alcohol use for males but not females. Drug use was associated with an increased number of peer ties, and the increased proportion of network members' discussion and acceptance of drug use, respectively. We also found that online network density and total numbers of ties were associated with more personal drug use for males but not females. Conversely, we noted that social norms were related to increased drug use and this relationship was stronger for females than males. We discuss the implications of our findings for substance use and online network research.
Researchers have found mixed support for documenting whether work is protective or harmful during... more Researchers have found mixed support for documenting whether work is protective or harmful during adolescence. This study examined the association between work and problem behaviors among African American youth (N = 592; 53% female; M = 14.8 years, SD = .60) followed from mid-adolescence to young adulthood over eight Waves (90% response rate over the first four Waves and a 68% response rate across all eight Waves). We explored three competing operationalizations of work: work history (never worked, worked), work intensity (no work, 20 h or less, and 21 h or over), and work trajectories (never worked, episodic work, stopped working, late starter, and consistent worker). Non-working youth reported higher marijuana use during young adulthood than their working counterparts. Nonworkers reported lower self-acceptance during young adulthood than those working greater number of hours per week. Differences in work trajectories for cigarette use, depression, and anxiety during adolescence imply that when and for how long youth work are also important factors to explore. Our findings lend tentative support to the work benefits perspective and suggest that the association between work and problem behaviors may depend on the work measure used. We discuss the implications of employing different work measures in adolescent research.
ABSTRACT Youth who interact in networks with higher concentrations of alcohol and other drug use ... more ABSTRACT Youth who interact in networks with higher concentrations of alcohol and other drug use (AOD) are more likely to use drugs than those with less AOD density in their social networks. Given that young adults' (YA) communicate frequently with peers online, it is vital to examine whether peer online network characteristics (e.g., network structure and AOD acceptability) are related to YA's AOD use. Using a web-version of Respondent-Driven Sampling (webRDS), we recruited a sample of YA (ages 18 to 24; N=2,845). Via a web-survey, participants answered questions regarding their AOD use (e.g., alcohol, marijuana and other drugs in past 30 days) and listed the top 5 individuals with whom they communicate most frequently online (alters; N=10,747). We characterized YA's peer online networks based on alter relationships (density) and alters' age, race/ethnicity, sex, and AOD acceptability. Using multivariate regression, we explored the relationship between YA's alcohol and marijuana use in the past 30 days and their online network characteristics. Over half of participants (62%) reported alcohol use in the past month, whereas 20% used marijuana. On average, the proportion of YA's peer online networks was 50% female, 73% White, and had a mean age of 20.7 years (SD = 2.7). Preliminary multivariate analyses suggest a relationship between YA's AOD use and their online network structures. We discuss our findings and highlight the importance of promoting online network-based AOD prevention programs for YAs in the United States, including whether tailoring prevention messages based on YA's online network composition is warranted.
American Journal of Community Psychology, Sep 1, 2004
Empowerment research has generally been limited to the individual level of analysis. Efforts to s... more Empowerment research has generally been limited to the individual level of analysis. Efforts to study empowerment beyond the individual require conceptual frameworks suggesting attributes that define the construct and guide its measurement. This paper presents an initial attempt to describe the nomological network of empowerment at the organizational level of analysis-organizational empowerment (OE). Intraorganizational, interorganizational, and extraorganizational components of OE are described. Implications for empowerment theory and practice are discussed.
The American journal of drug and alcohol abuse, Jan 17, 2016
Little is known about characteristic profiles of substance use - and their individual- and neighb... more Little is known about characteristic profiles of substance use - and their individual- and neighborhood-level correlates - among high-risk youth. To identify characteristic substance misuse profiles among youth entering an urban emergency department (ED) and explore how those profiles relate to individual- and community-level factors. Individual-level measures came from screening surveys administered to youth aged 14-24 at an ED in Flint, Michigan (n = 878); alcohol outlet and crime data came from public sources. Binary misuse indicators were generated by using previously established cut-points on scores of alcohol and drug use severity. Latent class analysis (LCA) identified classes of substance use; univariate tests and multinomial models identified correlates of class membership. Excluding non-misusers (51.5%), LCA identified three classes: marijuana-only (27.9%), alcohol/marijuana (16.1%), and multiple substances (polysubstance) (4.6%). Moving from non-misusers to polysubstance ...
Journal of Studies on Alcohol and Drugs, Jul 1, 2011
Objective: Risk factors for adolescent alcohol use are typically conceptualized as individual and... more Objective: Risk factors for adolescent alcohol use are typically conceptualized as individual and interpersonal level factors; however, these factors do not fully explain adolescent drinking behavior. We used a socioecological model to examine the contribution of neighborhood factors in a risk and promotive model of adolescent alcohol use among urban high school youth (N = 711; 52% female; 82% African American; M = 18 years old). Method: Using a multilevel model, we considered the role of neighborhood disadvantage on youth alcohol use, after accounting for risk (e.g., peer and parental substance use) and promotive factors (e.g., social support and participation in prosocial activities). Results: Peer alcohol use and peer support were associated with more alcohol use, and maternal support was negatively associated with alcohol use. Despite signifi cant variation at the neighborhood level, neighborhood disadvantage was not directly associated with adolescent drinking. Conclusions: Our study contributes to a mixed body of literature on social context and adolescent health. Although our research highlights the importance of interpersonal relationships, we found no support for neighborhood infl uences. We conclude with future directions for research examining the link between adolescent drinking and neighborhood contexts. (J. Stud. Alcohol Drugs, 72,
ABSTRACT Introduction: Sexting is a term used to describe sending sexually suggestive photos or m... more ABSTRACT Introduction: Sexting is a term used to describe sending sexually suggestive photos or messages online and may have lasting emotional, legal and sociological consequences. A PEW report suggested that over 20% of teens have sent and received sexts. Some scholars have cautioned that the increasing popularity of sexting may be the result of a lack of awareness of its potential dangers and consequences. Others have argued that sending sexts may be an emerging sexual behavior that may not have negative repercussions. This study explored the relationship between sexting and psychological correlates, including self-esteem, depression, and social support. Methods: Using an adapted web-version of Respondent-Driven Sampling (webRDS), we recruited a sample of U.S. YA (ages 18 to 24; N=3,400). We examined bivariate relationships between the variables, followed by multivariate regression models examining the relationships between sexting and youths' sociodemographic, psychological well-being, and sexual behavior. Results: 30% of respondents indicated that they had ever sent a sexually themed texts or nude photos. 40% of respondents indicated that they had ever received a sext. When combined, we found that 28% of respondents had both sent and received sexts. We found no differences by race, education, or sex in our analyses. We found no relationship between sexting and the psychological correlates in multivariate analyses. Conclusions:Our findings suggest that sexting is an emerging sexual behavior among youth. We discuss the findings of this study, highlighting the absence of associations between sexting and psychological well-being, and propose directions for sex education initiatives.
Time-limited acute stroke treatments are underused, primarily due to prehospital delay. One appro... more Time-limited acute stroke treatments are underused, primarily due to prehospital delay. One approach to decreasing prehospital delay is to increase stroke preparedness, the ability to recognize stroke, and the intention to immediately call emergency medical services, through community engagement with high-risk communities. Our community-academic partnership developed and tested "Stroke Ready," a peer-led, workshop-based, health behavior intervention to increase stroke preparedness among African American youth and adults in Flint, Michigan. Outcomes were measured with a series of 9 stroke and nonstroke 1-minute video vignettes; after each video, participants selected their intended response (primary outcome) and symptom recognition (secondary outcome), receiving 1 point for each appropriate stroke response and recognition. We assessed differences between baseline and posttest appropriate stroke response, which was defined as intent to call 911 for stroke vignettes and not c...
ABSTRACT Organized activities are central developmental settings for adolescents that may provide... more ABSTRACT Organized activities are central developmental settings for adolescents that may provide important opportunities to develop assets and promote positive development (Feldman & Matjasko, 2005; Mahoney, Larson, Eccles, & Lord, 2005; Mueller, Lewin-bizan, & Urban, 2011). Participation may be especially beneficial for youth in disadvantaged communities, as they may have limited access to the developmental opportunities provided by these activities (Elder & Conger, 2000; Mahoney et al., 2005). Additionally, activity participation may be a means to offset risks associated with living in a high-risk context (Gardner, Browning, & Brooks-Gunn, 2012). Yet, longitudinal research examining activity patterns of youth living in disadvantaged communities is limited. Furthermore, although researchers suggest that participation over time may be most beneficial to development and positive long term outcomes (Mahoney, Cairns, & Farmer, 2003; Zaff, Moore, Papillo, & Williams, 2003), patterns of participation among adolescents appear to vary (Metzger, Crean, & Forbes-Jones, 2009). Few researchers have explored heterogeneity within participation trajectories and factors associated with subgroup differences. In the current study we used growth mixture modeling with longitudinal data from African-American adolescents attending urban high schools in Flint, MI to identify subgroups of participation trajectories (Wave 1 N=681, mean age at wave 1=14.86 years, 51% female). We measure organized activity participation using psychological and behavioral engagement (Rose-Krasnor, 2009) across multiple contexts and over time. We examined how risk (e.g., substance use) and promotive factors (e.g., parent support) across ecological levels were related to these trajectories, accounting for factors associated with self-selection. Results suggested three participation trajectories: a low group decreasing over time, a consistent participation group and an increasing group. Parent support, GPA and parent’s education were associated with higher odds of being in the consistent participation group versus the low participation group. More substance use was associated with lower odds of being in the consistent or increasing versus low participation group. More parent support was associated with lower odds of being in the increasing versus consistent group. Peer behavior was not associated with class membership. Our results suggest that, taking into account demographic and self-selection factors, parent support and substance use at wave 1 are associated with participation trajectories during the high school years. Efforts to utilize organized activity participation to foster positive development among at-risk youth would benefit from addressing risk and promotive factors that may facilitate or inhibit participation over time in order to effectively utilize organized activity participation as a means to offset contextual risk.
ABSTRACT Background: The presence of risk and promotive factors may increase or decrease the like... more ABSTRACT Background: The presence of risk and promotive factors may increase or decrease the likelihood that adolescents will engage in physical or relational aggression (i.e., bullying). To date, most research has focused on single risk and promotive factors, without considering how the effects of cumulative risks and cumulative promotive factors influence physical and relational aggression. Methods: Hierarchical multiple regression was used to examine the association between cumulative risks and promotive factors and aggressive behaviors, and test two models of resilience (compensatory and risk-protective model) in a diverse sample of urban 7th grade youth (mean age = 13 years; N = 196; 60% female; 60% African American). Cumulative measures of risks and promotive factors included individual characteristics and peer, parental/familial, and school influences. Based on findings in the initial models, the association between cumulative risk and promotive factors and aggressive behavior was examined by race/ethnicity. Results: Higher cumulative risk was associated with higher levels of relational and physical aggression. Higher levels of promotive factors were associated with lower levels of physical and relational aggression, but did not moderate the association between cumulative risks and physical or relational aggression. Race/ethnic differences in the compensatory and risk-protective models by race/ethnicity will be discussed. Conclusions: Overall, our findings support a compensatory model of resiliency, but not a risk-protective model. Violence prevention programs focused on promotive factors may have a positive effect on adolescent aggressive behaviors. We will discuss the implications of our findings and its' application to the prevention of physical and relational aggression.
ABSTRACT Guided by Bronfenbrenner's (1979) ecological model, researchers are increasingly... more ABSTRACT Guided by Bronfenbrenner's (1979) ecological model, researchers are increasingly reporting the importance of considering how neighborhood environments may operate via more proximate mechanisms to influence individual health outcomes. In the current study, we tested a multilevel mediation model to examine how neighborhood characteristics may affect African American adolescents' mental health outcomes via their influence on adolescents' cumulative social support and perceptions of their neighborhood. Five hundred and seventy-one African American adolescents participated in the current study (mean age = 17.8, SD = .65; 52% female). Four neighborhood-level characteristics were assessed at the block group level using the 1990 US census data (US Census, 1990): percent of African American residents, residential stability, neighborhood poverty rate, and neighborhood unemployment rate. Our measure of social support was a cumulative measure that included support from four sources: mothers, fathers, peers, and natural mentorship. Five items were used to assess the extent to which participants felt their neighborhoods were supportive and cohesive (Buckner, 1988). Depressive and anxiety symptoms were assessed using the Brief Symptom Inventory (Dergatis & Spencer, 1982). We found significant indirect effects linking residence in communities with more African American and residentially stable residents with fewer symptoms of depression and anxiety among African American adolescent residents. We also found indirect effects connecting residence in communities with higher poverty and unemployment rates with more depressive and anxiety symptoms among participants. Implications of study findings for intervention and policy affecting urban, African American communities will be discussed.
Adolescents and young adults who use substances are at particularly high risk for contracting Hum... more Adolescents and young adults who use substances are at particularly high risk for contracting Human Immunodeficiency Virus (HIV). The Emergency Department (ED) is a critical location for HIV prevention for at-risk youth. To inform future interventions in the ED, this study identifies correlates of HIV risk behaviors among substance using youth seeking ED care. Among 600 14-24-year-olds with past 6-month drug use, bivariate correlates of HIV risk included: older age, female gender, depressive symptoms, alcohol use, marijuana use, other drug use, and dating, peer, and community violence. Regression analyses indicated that older age, marijuana use, and dating violence were positively related to HIV risk. Results suggest HIV prevention efforts for youth in the urban ED should address marijuana use and dating violence as well as sexual risk behaviors.
Identity-based conceptualizations of sexual orientation may not account adequately for variation ... more Identity-based conceptualizations of sexual orientation may not account adequately for variation in young women's sexuality. Sexual minorities fare worse in psychosocial markers of wellbeing (i.e., depressive symptoms, anxiety, self esteem, social support) than heterosexual youth; however, it remains unclear whether these health disparities exclusively affect individuals who adopt a sexual minority identity or if they also may be present among heterosexually-identified youth who report same-sex attractions. We examined the relationship between sexual attraction, sexual identity, and psychosocial wellbeing in the female only subsample (weighted, n = 391) of a national sample of emerging adults (age 18-24). Women in this study rated on a scale from 1 (not at all) to 5 (extremely) their degree of sexual attraction to males and females, respectively. From these scores, women were divided into 4 groups (low female/low male attraction, low female/high male attraction, high female/low male attraction, or high female/high male attraction). We explored the relationship between experiences of attraction, reported sexual identity, and psychosocial outcomes using ordinary least squares regression. The results indicated sexual attraction to be predictive of women's psychosocial wellbeing as much as or more than sexual identity measures. We discuss these findings in terms of the diversity found in young women's sexuality, and how sexual minority status may be experienced by this group.
Objective: Risk factors for adolescent alcohol use are typically conceptualized as individual and... more Objective: Risk factors for adolescent alcohol use are typically conceptualized as individual and interpersonal level factors; however, these factors do not fully explain adolescent drinking behavior. We used a socioecological model to examine the contribution of neighborhood factors in a risk and promotive model of adolescent alcohol use among urban high school youth (N = 711; 52% female; 82% African American; M = 18 years old). Method: Using a multilevel model, we considered the role of neighborhood disadvantage on youth alcohol use, after accounting for risk (e.g., peer and parental substance use) and promotive factors (e.g., social support and participation in prosocial activities). Results: Peer alcohol use and peer support were associated with more alcohol use, and maternal support was negatively associated with alcohol use. Despite signifi cant variation at the neighborhood level, neighborhood disadvantage was not directly associated with adolescent drinking. Conclusions: Our study contributes to a mixed body of literature on social context and adolescent health. Although our research highlights the importance of interpersonal relationships, we found no support for neighborhood infl uences. We conclude with future directions for research examining the link between adolescent drinking and neighborhood contexts. (J. Stud. Alcohol Drugs, 72,
Researchers have reported that network characteristics are associated with substance use behavior... more Researchers have reported that network characteristics are associated with substance use behavior. Considering that social interactions within online networks are increasingly common, we examined the relationship between online network characteristics and substance use in a sample of emerging adults (ages 18-24) from across the United States (N = 2,153; M = 21 years old; 47 % female; 70 % White). We used regression analyses to examine the relationship between online ego network characteristics (i.e., characteristics of individuals directly related to the focal participant plus the relationships shared among individuals within the online network) and alcohol use and substance use, respectively. Alcohol use was associated with network density (i.e., interconnectedness between individuals in a network), total number of peer ties, and a greater proportion of emotionally close ties. In sex-stratified models, density was related to alcohol use for males but not females. Drug use was associated with an increased number of peer ties, and the increased proportion of network members' discussion and acceptance of drug use, respectively. We also found that online network density and total numbers of ties were associated with more personal drug use for males but not females. Conversely, we noted that social norms were related to increased drug use and this relationship was stronger for females than males. We discuss the implications of our findings for substance use and online network research.
Researchers have found mixed support for documenting whether work is protective or harmful during... more Researchers have found mixed support for documenting whether work is protective or harmful during adolescence. This study examined the association between work and problem behaviors among African American youth (N = 592; 53% female; M = 14.8 years, SD = .60) followed from mid-adolescence to young adulthood over eight Waves (90% response rate over the first four Waves and a 68% response rate across all eight Waves). We explored three competing operationalizations of work: work history (never worked, worked), work intensity (no work, 20 h or less, and 21 h or over), and work trajectories (never worked, episodic work, stopped working, late starter, and consistent worker). Non-working youth reported higher marijuana use during young adulthood than their working counterparts. Nonworkers reported lower self-acceptance during young adulthood than those working greater number of hours per week. Differences in work trajectories for cigarette use, depression, and anxiety during adolescence imply that when and for how long youth work are also important factors to explore. Our findings lend tentative support to the work benefits perspective and suggest that the association between work and problem behaviors may depend on the work measure used. We discuss the implications of employing different work measures in adolescent research.
ABSTRACT Youth who interact in networks with higher concentrations of alcohol and other drug use ... more ABSTRACT Youth who interact in networks with higher concentrations of alcohol and other drug use (AOD) are more likely to use drugs than those with less AOD density in their social networks. Given that young adults' (YA) communicate frequently with peers online, it is vital to examine whether peer online network characteristics (e.g., network structure and AOD acceptability) are related to YA's AOD use. Using a web-version of Respondent-Driven Sampling (webRDS), we recruited a sample of YA (ages 18 to 24; N=2,845). Via a web-survey, participants answered questions regarding their AOD use (e.g., alcohol, marijuana and other drugs in past 30 days) and listed the top 5 individuals with whom they communicate most frequently online (alters; N=10,747). We characterized YA's peer online networks based on alter relationships (density) and alters' age, race/ethnicity, sex, and AOD acceptability. Using multivariate regression, we explored the relationship between YA's alcohol and marijuana use in the past 30 days and their online network characteristics. Over half of participants (62%) reported alcohol use in the past month, whereas 20% used marijuana. On average, the proportion of YA's peer online networks was 50% female, 73% White, and had a mean age of 20.7 years (SD = 2.7). Preliminary multivariate analyses suggest a relationship between YA's AOD use and their online network structures. We discuss our findings and highlight the importance of promoting online network-based AOD prevention programs for YAs in the United States, including whether tailoring prevention messages based on YA's online network composition is warranted.
American Journal of Community Psychology, Sep 1, 2004
Empowerment research has generally been limited to the individual level of analysis. Efforts to s... more Empowerment research has generally been limited to the individual level of analysis. Efforts to study empowerment beyond the individual require conceptual frameworks suggesting attributes that define the construct and guide its measurement. This paper presents an initial attempt to describe the nomological network of empowerment at the organizational level of analysis-organizational empowerment (OE). Intraorganizational, interorganizational, and extraorganizational components of OE are described. Implications for empowerment theory and practice are discussed.
The American journal of drug and alcohol abuse, Jan 17, 2016
Little is known about characteristic profiles of substance use - and their individual- and neighb... more Little is known about characteristic profiles of substance use - and their individual- and neighborhood-level correlates - among high-risk youth. To identify characteristic substance misuse profiles among youth entering an urban emergency department (ED) and explore how those profiles relate to individual- and community-level factors. Individual-level measures came from screening surveys administered to youth aged 14-24 at an ED in Flint, Michigan (n = 878); alcohol outlet and crime data came from public sources. Binary misuse indicators were generated by using previously established cut-points on scores of alcohol and drug use severity. Latent class analysis (LCA) identified classes of substance use; univariate tests and multinomial models identified correlates of class membership. Excluding non-misusers (51.5%), LCA identified three classes: marijuana-only (27.9%), alcohol/marijuana (16.1%), and multiple substances (polysubstance) (4.6%). Moving from non-misusers to polysubstance ...
Journal of Studies on Alcohol and Drugs, Jul 1, 2011
Objective: Risk factors for adolescent alcohol use are typically conceptualized as individual and... more Objective: Risk factors for adolescent alcohol use are typically conceptualized as individual and interpersonal level factors; however, these factors do not fully explain adolescent drinking behavior. We used a socioecological model to examine the contribution of neighborhood factors in a risk and promotive model of adolescent alcohol use among urban high school youth (N = 711; 52% female; 82% African American; M = 18 years old). Method: Using a multilevel model, we considered the role of neighborhood disadvantage on youth alcohol use, after accounting for risk (e.g., peer and parental substance use) and promotive factors (e.g., social support and participation in prosocial activities). Results: Peer alcohol use and peer support were associated with more alcohol use, and maternal support was negatively associated with alcohol use. Despite signifi cant variation at the neighborhood level, neighborhood disadvantage was not directly associated with adolescent drinking. Conclusions: Our study contributes to a mixed body of literature on social context and adolescent health. Although our research highlights the importance of interpersonal relationships, we found no support for neighborhood infl uences. We conclude with future directions for research examining the link between adolescent drinking and neighborhood contexts. (J. Stud. Alcohol Drugs, 72,
ABSTRACT Introduction: Sexting is a term used to describe sending sexually suggestive photos or m... more ABSTRACT Introduction: Sexting is a term used to describe sending sexually suggestive photos or messages online and may have lasting emotional, legal and sociological consequences. A PEW report suggested that over 20% of teens have sent and received sexts. Some scholars have cautioned that the increasing popularity of sexting may be the result of a lack of awareness of its potential dangers and consequences. Others have argued that sending sexts may be an emerging sexual behavior that may not have negative repercussions. This study explored the relationship between sexting and psychological correlates, including self-esteem, depression, and social support. Methods: Using an adapted web-version of Respondent-Driven Sampling (webRDS), we recruited a sample of U.S. YA (ages 18 to 24; N=3,400). We examined bivariate relationships between the variables, followed by multivariate regression models examining the relationships between sexting and youths' sociodemographic, psychological well-being, and sexual behavior. Results: 30% of respondents indicated that they had ever sent a sexually themed texts or nude photos. 40% of respondents indicated that they had ever received a sext. When combined, we found that 28% of respondents had both sent and received sexts. We found no differences by race, education, or sex in our analyses. We found no relationship between sexting and the psychological correlates in multivariate analyses. Conclusions:Our findings suggest that sexting is an emerging sexual behavior among youth. We discuss the findings of this study, highlighting the absence of associations between sexting and psychological well-being, and propose directions for sex education initiatives.
Time-limited acute stroke treatments are underused, primarily due to prehospital delay. One appro... more Time-limited acute stroke treatments are underused, primarily due to prehospital delay. One approach to decreasing prehospital delay is to increase stroke preparedness, the ability to recognize stroke, and the intention to immediately call emergency medical services, through community engagement with high-risk communities. Our community-academic partnership developed and tested "Stroke Ready," a peer-led, workshop-based, health behavior intervention to increase stroke preparedness among African American youth and adults in Flint, Michigan. Outcomes were measured with a series of 9 stroke and nonstroke 1-minute video vignettes; after each video, participants selected their intended response (primary outcome) and symptom recognition (secondary outcome), receiving 1 point for each appropriate stroke response and recognition. We assessed differences between baseline and posttest appropriate stroke response, which was defined as intent to call 911 for stroke vignettes and not c...
ABSTRACT Organized activities are central developmental settings for adolescents that may provide... more ABSTRACT Organized activities are central developmental settings for adolescents that may provide important opportunities to develop assets and promote positive development (Feldman & Matjasko, 2005; Mahoney, Larson, Eccles, & Lord, 2005; Mueller, Lewin-bizan, & Urban, 2011). Participation may be especially beneficial for youth in disadvantaged communities, as they may have limited access to the developmental opportunities provided by these activities (Elder & Conger, 2000; Mahoney et al., 2005). Additionally, activity participation may be a means to offset risks associated with living in a high-risk context (Gardner, Browning, & Brooks-Gunn, 2012). Yet, longitudinal research examining activity patterns of youth living in disadvantaged communities is limited. Furthermore, although researchers suggest that participation over time may be most beneficial to development and positive long term outcomes (Mahoney, Cairns, & Farmer, 2003; Zaff, Moore, Papillo, & Williams, 2003), patterns of participation among adolescents appear to vary (Metzger, Crean, & Forbes-Jones, 2009). Few researchers have explored heterogeneity within participation trajectories and factors associated with subgroup differences. In the current study we used growth mixture modeling with longitudinal data from African-American adolescents attending urban high schools in Flint, MI to identify subgroups of participation trajectories (Wave 1 N=681, mean age at wave 1=14.86 years, 51% female). We measure organized activity participation using psychological and behavioral engagement (Rose-Krasnor, 2009) across multiple contexts and over time. We examined how risk (e.g., substance use) and promotive factors (e.g., parent support) across ecological levels were related to these trajectories, accounting for factors associated with self-selection. Results suggested three participation trajectories: a low group decreasing over time, a consistent participation group and an increasing group. Parent support, GPA and parent’s education were associated with higher odds of being in the consistent participation group versus the low participation group. More substance use was associated with lower odds of being in the consistent or increasing versus low participation group. More parent support was associated with lower odds of being in the increasing versus consistent group. Peer behavior was not associated with class membership. Our results suggest that, taking into account demographic and self-selection factors, parent support and substance use at wave 1 are associated with participation trajectories during the high school years. Efforts to utilize organized activity participation to foster positive development among at-risk youth would benefit from addressing risk and promotive factors that may facilitate or inhibit participation over time in order to effectively utilize organized activity participation as a means to offset contextual risk.
ABSTRACT Background: The presence of risk and promotive factors may increase or decrease the like... more ABSTRACT Background: The presence of risk and promotive factors may increase or decrease the likelihood that adolescents will engage in physical or relational aggression (i.e., bullying). To date, most research has focused on single risk and promotive factors, without considering how the effects of cumulative risks and cumulative promotive factors influence physical and relational aggression. Methods: Hierarchical multiple regression was used to examine the association between cumulative risks and promotive factors and aggressive behaviors, and test two models of resilience (compensatory and risk-protective model) in a diverse sample of urban 7th grade youth (mean age = 13 years; N = 196; 60% female; 60% African American). Cumulative measures of risks and promotive factors included individual characteristics and peer, parental/familial, and school influences. Based on findings in the initial models, the association between cumulative risk and promotive factors and aggressive behavior was examined by race/ethnicity. Results: Higher cumulative risk was associated with higher levels of relational and physical aggression. Higher levels of promotive factors were associated with lower levels of physical and relational aggression, but did not moderate the association between cumulative risks and physical or relational aggression. Race/ethnic differences in the compensatory and risk-protective models by race/ethnicity will be discussed. Conclusions: Overall, our findings support a compensatory model of resiliency, but not a risk-protective model. Violence prevention programs focused on promotive factors may have a positive effect on adolescent aggressive behaviors. We will discuss the implications of our findings and its' application to the prevention of physical and relational aggression.
ABSTRACT Guided by Bronfenbrenner's (1979) ecological model, researchers are increasingly... more ABSTRACT Guided by Bronfenbrenner's (1979) ecological model, researchers are increasingly reporting the importance of considering how neighborhood environments may operate via more proximate mechanisms to influence individual health outcomes. In the current study, we tested a multilevel mediation model to examine how neighborhood characteristics may affect African American adolescents' mental health outcomes via their influence on adolescents' cumulative social support and perceptions of their neighborhood. Five hundred and seventy-one African American adolescents participated in the current study (mean age = 17.8, SD = .65; 52% female). Four neighborhood-level characteristics were assessed at the block group level using the 1990 US census data (US Census, 1990): percent of African American residents, residential stability, neighborhood poverty rate, and neighborhood unemployment rate. Our measure of social support was a cumulative measure that included support from four sources: mothers, fathers, peers, and natural mentorship. Five items were used to assess the extent to which participants felt their neighborhoods were supportive and cohesive (Buckner, 1988). Depressive and anxiety symptoms were assessed using the Brief Symptom Inventory (Dergatis & Spencer, 1982). We found significant indirect effects linking residence in communities with more African American and residentially stable residents with fewer symptoms of depression and anxiety among African American adolescent residents. We also found indirect effects connecting residence in communities with higher poverty and unemployment rates with more depressive and anxiety symptoms among participants. Implications of study findings for intervention and policy affecting urban, African American communities will be discussed.
Adolescents and young adults who use substances are at particularly high risk for contracting Hum... more Adolescents and young adults who use substances are at particularly high risk for contracting Human Immunodeficiency Virus (HIV). The Emergency Department (ED) is a critical location for HIV prevention for at-risk youth. To inform future interventions in the ED, this study identifies correlates of HIV risk behaviors among substance using youth seeking ED care. Among 600 14-24-year-olds with past 6-month drug use, bivariate correlates of HIV risk included: older age, female gender, depressive symptoms, alcohol use, marijuana use, other drug use, and dating, peer, and community violence. Regression analyses indicated that older age, marijuana use, and dating violence were positively related to HIV risk. Results suggest HIV prevention efforts for youth in the urban ED should address marijuana use and dating violence as well as sexual risk behaviors.
Identity-based conceptualizations of sexual orientation may not account adequately for variation ... more Identity-based conceptualizations of sexual orientation may not account adequately for variation in young women's sexuality. Sexual minorities fare worse in psychosocial markers of wellbeing (i.e., depressive symptoms, anxiety, self esteem, social support) than heterosexual youth; however, it remains unclear whether these health disparities exclusively affect individuals who adopt a sexual minority identity or if they also may be present among heterosexually-identified youth who report same-sex attractions. We examined the relationship between sexual attraction, sexual identity, and psychosocial wellbeing in the female only subsample (weighted, n = 391) of a national sample of emerging adults (age 18-24). Women in this study rated on a scale from 1 (not at all) to 5 (extremely) their degree of sexual attraction to males and females, respectively. From these scores, women were divided into 4 groups (low female/low male attraction, low female/high male attraction, high female/low male attraction, or high female/high male attraction). We explored the relationship between experiences of attraction, reported sexual identity, and psychosocial outcomes using ordinary least squares regression. The results indicated sexual attraction to be predictive of women's psychosocial wellbeing as much as or more than sexual identity measures. We discuss these findings in terms of the diversity found in young women's sexuality, and how sexual minority status may be experienced by this group.
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Papers by Marc Zimmerman