Gay men report unique health disparities and service utilization trends compared to their heteros... more Gay men report unique health disparities and service utilization trends compared to their heterosexual peers including a lack of health-care participation which may lead to chronic health conditions. Limited research has been conducted analyzing group differences among gay men such as the influence of one's age cohort on disparities. The aim of this study was to examine the association age cohort has on health service utilization among gay men. A sample of 383 self-identified gay men was collected by the San Francisco Department of Public Health. Older men were less likely to have visited a medical provider in the past 12 months compared to middle-aged men (OR = 0.10; 95% CI [2.47, 39.8]) and younger men (OR = 0.35; 95% CI [1.28, 10.42]). However, older men were more likely to have a usual source of medical care compared to younger men (OR = 4.0; 95% CI [.05, .84]). Age cohort differences in health-care service utilization appear to exist among gay men. This study highlights add...
Bullying has a long-lasting effect on both victims and their perpetrators; however, there is litt... more Bullying has a long-lasting effect on both victims and their perpetrators; however, there is little literature dedicated to understanding the roles of sexual minority adolescents beyond being a victim or the specific types of bullying behaviors (verbal, relational, physical) in which sexual minority adolescents engage. Even less is known about the experiences of mostly heterosexual youth, as distinct from their lesbian, gay, and bisexual (LGB) peers. This exploratory study sought to identify sexual orientation differences in bullying behavior participation using a random cluster sample obtained from a county school district in the Southeastern United States. The sample included 3,463 middle and high school students from 66 schools. Four latent classes of bullies and victims emerged, with similar patterns of behaviors for heterosexual, mostly heterosexual, and LGB groups.
Prescription drug, e-cigarette, smokeless tobacco, and synthetic marijuana use has risen dramatic... more Prescription drug, e-cigarette, smokeless tobacco, and synthetic marijuana use has risen dramatically in the United States over the past decade. This paper investigates the use of risky substances among adolescents, and examines disparities between sexual minority (i.e., mostly heterosexual and lesbian, gay, bisexual; LGB) and heterosexual adolescents in use of novel and emerging substances. Given the public health risk and the imminence of these substances in the media, emerging drug use was examined in a county wide sample of adolescents in a Southern state. A probability sample of middle and high school students (N = 3012; ages 11-18) using random cluster methods was obtained in a mid-sized school district in the Southeastern United States. LGB adolescents reported higher past-30 day and lifetime use of cigarettes (AORs =2.77, 2.90, respectively), smokeless tobacco (lifetime only: AOR = 1.88), e-cigarettes (lifetime only; AOR = 1.92), alcohol (AORs = 1.7, 2.20), marijuana (AORs =...
Sexual minority adolescents are more likely than their heterosexual peers to use substances. This... more Sexual minority adolescents are more likely than their heterosexual peers to use substances. This study tested factors that contribute to sexual orientation disparities in substance use among racially and ethnically diverse adolescents. Specifically, we examined how both minority stress (i.e., homophobic bullying) and social norms (i.e., descriptive and injunctive norms) may account for sexual orientation disparities in recent and lifetime use of four substances: tobacco, alcohol, marijuana, and prescription drugs. A probability sample of middle and high school students (N=3012; aged 11-18 years old; 71.2% racial and ethnic minorities) using random cluster methods was obtained in a mid-size school district in the Southeastern United States. Sexual minority adolescents were more likely than heterosexual adolescents to use substances, experience homophobic bullying, and report higher descriptive norms for close friends and more permissive injunctive norms for friends and parents. Whil...
Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, Jan 9, 2015
We explored the relation between 8 domains of Hispanic stress and alcohol use and frequency of us... more We explored the relation between 8 domains of Hispanic stress and alcohol use and frequency of use in a sample of Hispanic adolescents between 11 and 19 years old (N = 901). Independent t tests were used to compare means of domains of Hispanic stress between adolescents who reported alcohol use and those who reported no use. In addition, multinomial logistic regression was used to examine whether domains of Hispanic stress were related to alcohol use and whether the relation differed by gender and age. Multiple imputation was used to address missing data. In the analytic sample, 75.8% (n = 683) reported no use and 24.2% (n = 218) reported alcohol use during the previous 30 days. Higher mean Hispanic stress scores were observed among youths who reported alcohol use during the previous 30 days in 5 domains: acculturation gap, community and gang violence, family economic, discrimination, and family and drug-related stress. Increased community and gang violence, family and drug, and acc...
Purpose: This research (1 K01 DA017276-05) investigated the twofold benefits of having high risk ... more Purpose: This research (1 K01 DA017276-05) investigated the twofold benefits of having high risk youth in community settings systematically make cultural adaptations to an evidence based curriculum (i.e., benefits to the curricula and benefits to the youth doing the adaptation process). Older youth (N=202) who have already initiated their drug use utilized their personal experiences in the re-creation of scenarios and videos in order to have a better fit with their communities. Methods: Utilizing instruction manuals and guidance, groups of youth made systematic changes to the curriculum and recreated videos in order to more appropriately fit their peer culture. Focus Groups and surveys were administered before and after adaptation processes. Results: Youth who adapt are easily engaged; animatedly discussing the payoffs and downsides of drugs and alcohol, but also that the groups that received the culturally adapted versions had better outcomes than those that received the original c...
Objective. Stress associated with family expectations and planning for the future are normative e... more Objective. Stress associated with family expectations and planning for the future are normative experiences of adolescence. However, Hispanic adolescents also face non-normative culturally specific stressors such as anti-immigrant attitudes, family separation issues, and negative public references toward their ethnic identity. Currently, there are few studies that identify how culturally specific stressors impact mental health, particularly among youth in clinical settings. The current study aimed to identify: (1) how cultural stressors differ for adolescents in clinical treatment compared to adolescents in the general population; (2) the association between cultural stress and depression, net the effects of gender; and (3) if group membership (e.g. clinical versus non-clinical setting) moderates the relationship between cultural stress and depression. Methods. The current study used data from the Hispanic Stress Inventory-Adolescent (HSI-A) Study, a NIMH funded study of 1,254 Hispa...
Background.Hispanic adolescents report the highest rates of crack, heroin and methamphetamine use... more Background.Hispanic adolescents report the highest rates of crack, heroin and methamphetamine use when compared to all other ethnic categories (Monitoring the Future, 2008). Over one-quarter of Hispanic adolescents also report using alcohol in the last 30 days (Pemberton et al., 2008) and exhibit high rates of HIV risk (Prado et al., 2006). Culturally specific stressors have been implicated in these outcomes, yet little research has examined how these stressors may have a differential and/or additive effect when considered simultaneously. Methods. The current study examined the relation between cultural stress and multiple risk behaviors in a sample of Hispanic adolescents (n=1087), 11-19 years old, from an NIMH funded study (5R44MH073180-03) that implemented random selection to recruit participants. Latent class analysis (LCA) was used to identify subgroups of Hispanic adolescents based on combinations of risk behaviors. Risk behaviors were operationalized using categorical measure...
Purpose: A comprehensive approach to preventing negative behavioral health outcomes in youth is b... more Purpose: A comprehensive approach to preventing negative behavioral health outcomes in youth is becoming increasingly emphasized (IOM, 2009). Many Latino youth are at increased risk for substance abuse, mental health concerns, unsafe sexual practices and HIV (Prado et al., 2006), and these outcomes have been empirically connected to individual, family and community-based stressors, including acculturation (Cervantes, Fisher, Cordova & Kilp, in press; IOM, 2009). Despite this knowledge, there is a lack of evidence-based approaches that target these outcomes by reducing stress in Latino families in a culturally relevant manner (Cervantes, Kappos, Duenas & Arellano, 2003). The current presentation discusses the process of and findings from an NIH-funded adaptation of Familia Adelante (FA) with 131 Latino families at 3 national study sites. FA is a twelve-session multi-risk reduction curriculum for Latino youth and their families (Cervantes, Goldbach & Santos, in press). The present wor...
Journal of child & adolescent substance abuse, 2014
The problem of substance use among older youth is of great concern, but has received little atten... more The problem of substance use among older youth is of great concern, but has received little attention in prevention research. This may be due to the perception that prevention programming is developmentally inappropriate for older youth who are actively experimenting with substances. This project examined the differential effectiveness of youth-driven adaptations of the evidence-based prevention program, keepin' it REAL (KiR). The participating sites included a juvenile justice day program, a homeless shelter, four alternative high schools, low-income housing programs, an LGBTQ youth center, and a youth group on the Texas-Mexico border. In the project's first phase, high risk youth in community settings tailored KiR workbooks and videos to increase the relevance for their peers, older adolescents who are likely to have already initiated drug use. The second phase of the study, discussed here in detail, evaluates the effectiveness of the adapted versions of KiR compared with ...
Cultural diversity & ethnic minority psychology, Jan 3, 2014
The purpose of the current study was to determine if, and how, Hispanic adolescents receiving cli... more The purpose of the current study was to determine if, and how, Hispanic adolescents receiving clinical treatment differ from their peers who are not in treatment on the 8 domains (family economic stress, cultural or educational stress, acculturation-gap stress, immigration stress, discrimination stress, family immigration stress, community or gang-related stress) of cultural stress (HSI-A), and if the relation between cultural stress domains and depressive symptomology differed by group membership (clinical vs. nonclinical). The sample included 1,254 Hispanic adolescents. The clinical sample had significantly higher scores of cultural stress (p < .05) and mean depression scores (< .001). All 8 domains of HSI-A stress were correlated with depression (p < .05). In the general linear models (GLM), only family economic, acculturation gap, family immigration, discrimination, and family drug stress had a unique effect on depression and effect varied by group. Acculturation gap st...
Purpose: Through the SAMHSA/CSAP Strategic Prevention Framework State Incentive Grant (SPF SIG), ... more Purpose: Through the SAMHSA/CSAP Strategic Prevention Framework State Incentive Grant (SPF SIG), the Texas Department of State Health Services (DSHS) implemented evidence-based environmental (community-level) strategies for the prevention of substance abuse among adolescents and young adults. These approaches focus on reducing the supply of alcohol to this target group through changing specific intervening variables, such as alcohol availability (via retail and social access), community norms and law enforcement, and the implementation of local and statewide policies related to alcohol. However, measuring individual perceptions on these intervening variables is difficult, as no previous measurement tool has been validated for statewide evaluation use. More specifically, there is no validated tool that uniquely measures the impact of environmental prevention strategies on individuals consumption patterns or on individual perceptions of community change. This poster presentation will ...
Journal of Gay & Lesbian Social Services, 2011
Historically, substance abuse prevention programs are created with samples that conform to the ma... more Historically, substance abuse prevention programs are created with samples that conform to the majority population. Research shows that substance use risk factors are higher for lesbian, gay, bisexual, and transgender (LGBT) youths (Eisenberg &amp;amp;amp;amp;amp;amp;amp;amp;amp; Wechsler, 2003), and LGBT youths report higher use of substances than their heterosexual counterparts (Lampinen, McGhee, &amp;amp;amp;amp;amp;amp;amp;amp;amp; Martin, 2006; Marshal et al., 2008; Russell, Truong, &amp;amp;amp;amp;amp;amp;amp;amp;amp;
Stress associated with acculturation and minority status among Hispanic youth is understudied. Us... more Stress associated with acculturation and minority status among Hispanic youth is understudied. Using survey data from the Hispanic Stress Inventory–Adolescent Version (HSI-A), we examined psychosocial stress across eight domains including family economic stress and acculturation-gap stress in a national sample of three generations (first, second, and third or higher) of Hispanic adolescents ( N = 1,263). Research questions addressed generation differences in frequency of stressor events (i.e., discrimination), appraisal of these events, and mental health symptoms. Results indicated that experiences of different categories of stress were significantly related to generation status. The first generation reported more stressors and greater stress appraisal than the third-generation adolescents. Similar levels of discrimination stress were reported by participants regardless of generation. The second-generation participants reported a greater number of Acculturation Gap Stressors than th...
Gay men report unique health disparities and service utilization trends compared to their heteros... more Gay men report unique health disparities and service utilization trends compared to their heterosexual peers including a lack of health-care participation which may lead to chronic health conditions. Limited research has been conducted analyzing group differences among gay men such as the influence of one's age cohort on disparities. The aim of this study was to examine the association age cohort has on health service utilization among gay men. A sample of 383 self-identified gay men was collected by the San Francisco Department of Public Health. Older men were less likely to have visited a medical provider in the past 12 months compared to middle-aged men (OR = 0.10; 95% CI [2.47, 39.8]) and younger men (OR = 0.35; 95% CI [1.28, 10.42]). However, older men were more likely to have a usual source of medical care compared to younger men (OR = 4.0; 95% CI [.05, .84]). Age cohort differences in health-care service utilization appear to exist among gay men. This study highlights add...
Bullying has a long-lasting effect on both victims and their perpetrators; however, there is litt... more Bullying has a long-lasting effect on both victims and their perpetrators; however, there is little literature dedicated to understanding the roles of sexual minority adolescents beyond being a victim or the specific types of bullying behaviors (verbal, relational, physical) in which sexual minority adolescents engage. Even less is known about the experiences of mostly heterosexual youth, as distinct from their lesbian, gay, and bisexual (LGB) peers. This exploratory study sought to identify sexual orientation differences in bullying behavior participation using a random cluster sample obtained from a county school district in the Southeastern United States. The sample included 3,463 middle and high school students from 66 schools. Four latent classes of bullies and victims emerged, with similar patterns of behaviors for heterosexual, mostly heterosexual, and LGB groups.
Prescription drug, e-cigarette, smokeless tobacco, and synthetic marijuana use has risen dramatic... more Prescription drug, e-cigarette, smokeless tobacco, and synthetic marijuana use has risen dramatically in the United States over the past decade. This paper investigates the use of risky substances among adolescents, and examines disparities between sexual minority (i.e., mostly heterosexual and lesbian, gay, bisexual; LGB) and heterosexual adolescents in use of novel and emerging substances. Given the public health risk and the imminence of these substances in the media, emerging drug use was examined in a county wide sample of adolescents in a Southern state. A probability sample of middle and high school students (N = 3012; ages 11-18) using random cluster methods was obtained in a mid-sized school district in the Southeastern United States. LGB adolescents reported higher past-30 day and lifetime use of cigarettes (AORs =2.77, 2.90, respectively), smokeless tobacco (lifetime only: AOR = 1.88), e-cigarettes (lifetime only; AOR = 1.92), alcohol (AORs = 1.7, 2.20), marijuana (AORs =...
Sexual minority adolescents are more likely than their heterosexual peers to use substances. This... more Sexual minority adolescents are more likely than their heterosexual peers to use substances. This study tested factors that contribute to sexual orientation disparities in substance use among racially and ethnically diverse adolescents. Specifically, we examined how both minority stress (i.e., homophobic bullying) and social norms (i.e., descriptive and injunctive norms) may account for sexual orientation disparities in recent and lifetime use of four substances: tobacco, alcohol, marijuana, and prescription drugs. A probability sample of middle and high school students (N=3012; aged 11-18 years old; 71.2% racial and ethnic minorities) using random cluster methods was obtained in a mid-size school district in the Southeastern United States. Sexual minority adolescents were more likely than heterosexual adolescents to use substances, experience homophobic bullying, and report higher descriptive norms for close friends and more permissive injunctive norms for friends and parents. Whil...
Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, Jan 9, 2015
We explored the relation between 8 domains of Hispanic stress and alcohol use and frequency of us... more We explored the relation between 8 domains of Hispanic stress and alcohol use and frequency of use in a sample of Hispanic adolescents between 11 and 19 years old (N = 901). Independent t tests were used to compare means of domains of Hispanic stress between adolescents who reported alcohol use and those who reported no use. In addition, multinomial logistic regression was used to examine whether domains of Hispanic stress were related to alcohol use and whether the relation differed by gender and age. Multiple imputation was used to address missing data. In the analytic sample, 75.8% (n = 683) reported no use and 24.2% (n = 218) reported alcohol use during the previous 30 days. Higher mean Hispanic stress scores were observed among youths who reported alcohol use during the previous 30 days in 5 domains: acculturation gap, community and gang violence, family economic, discrimination, and family and drug-related stress. Increased community and gang violence, family and drug, and acc...
Purpose: This research (1 K01 DA017276-05) investigated the twofold benefits of having high risk ... more Purpose: This research (1 K01 DA017276-05) investigated the twofold benefits of having high risk youth in community settings systematically make cultural adaptations to an evidence based curriculum (i.e., benefits to the curricula and benefits to the youth doing the adaptation process). Older youth (N=202) who have already initiated their drug use utilized their personal experiences in the re-creation of scenarios and videos in order to have a better fit with their communities. Methods: Utilizing instruction manuals and guidance, groups of youth made systematic changes to the curriculum and recreated videos in order to more appropriately fit their peer culture. Focus Groups and surveys were administered before and after adaptation processes. Results: Youth who adapt are easily engaged; animatedly discussing the payoffs and downsides of drugs and alcohol, but also that the groups that received the culturally adapted versions had better outcomes than those that received the original c...
Objective. Stress associated with family expectations and planning for the future are normative e... more Objective. Stress associated with family expectations and planning for the future are normative experiences of adolescence. However, Hispanic adolescents also face non-normative culturally specific stressors such as anti-immigrant attitudes, family separation issues, and negative public references toward their ethnic identity. Currently, there are few studies that identify how culturally specific stressors impact mental health, particularly among youth in clinical settings. The current study aimed to identify: (1) how cultural stressors differ for adolescents in clinical treatment compared to adolescents in the general population; (2) the association between cultural stress and depression, net the effects of gender; and (3) if group membership (e.g. clinical versus non-clinical setting) moderates the relationship between cultural stress and depression. Methods. The current study used data from the Hispanic Stress Inventory-Adolescent (HSI-A) Study, a NIMH funded study of 1,254 Hispa...
Background.Hispanic adolescents report the highest rates of crack, heroin and methamphetamine use... more Background.Hispanic adolescents report the highest rates of crack, heroin and methamphetamine use when compared to all other ethnic categories (Monitoring the Future, 2008). Over one-quarter of Hispanic adolescents also report using alcohol in the last 30 days (Pemberton et al., 2008) and exhibit high rates of HIV risk (Prado et al., 2006). Culturally specific stressors have been implicated in these outcomes, yet little research has examined how these stressors may have a differential and/or additive effect when considered simultaneously. Methods. The current study examined the relation between cultural stress and multiple risk behaviors in a sample of Hispanic adolescents (n=1087), 11-19 years old, from an NIMH funded study (5R44MH073180-03) that implemented random selection to recruit participants. Latent class analysis (LCA) was used to identify subgroups of Hispanic adolescents based on combinations of risk behaviors. Risk behaviors were operationalized using categorical measure...
Purpose: A comprehensive approach to preventing negative behavioral health outcomes in youth is b... more Purpose: A comprehensive approach to preventing negative behavioral health outcomes in youth is becoming increasingly emphasized (IOM, 2009). Many Latino youth are at increased risk for substance abuse, mental health concerns, unsafe sexual practices and HIV (Prado et al., 2006), and these outcomes have been empirically connected to individual, family and community-based stressors, including acculturation (Cervantes, Fisher, Cordova & Kilp, in press; IOM, 2009). Despite this knowledge, there is a lack of evidence-based approaches that target these outcomes by reducing stress in Latino families in a culturally relevant manner (Cervantes, Kappos, Duenas & Arellano, 2003). The current presentation discusses the process of and findings from an NIH-funded adaptation of Familia Adelante (FA) with 131 Latino families at 3 national study sites. FA is a twelve-session multi-risk reduction curriculum for Latino youth and their families (Cervantes, Goldbach & Santos, in press). The present wor...
Journal of child & adolescent substance abuse, 2014
The problem of substance use among older youth is of great concern, but has received little atten... more The problem of substance use among older youth is of great concern, but has received little attention in prevention research. This may be due to the perception that prevention programming is developmentally inappropriate for older youth who are actively experimenting with substances. This project examined the differential effectiveness of youth-driven adaptations of the evidence-based prevention program, keepin' it REAL (KiR). The participating sites included a juvenile justice day program, a homeless shelter, four alternative high schools, low-income housing programs, an LGBTQ youth center, and a youth group on the Texas-Mexico border. In the project's first phase, high risk youth in community settings tailored KiR workbooks and videos to increase the relevance for their peers, older adolescents who are likely to have already initiated drug use. The second phase of the study, discussed here in detail, evaluates the effectiveness of the adapted versions of KiR compared with ...
Cultural diversity & ethnic minority psychology, Jan 3, 2014
The purpose of the current study was to determine if, and how, Hispanic adolescents receiving cli... more The purpose of the current study was to determine if, and how, Hispanic adolescents receiving clinical treatment differ from their peers who are not in treatment on the 8 domains (family economic stress, cultural or educational stress, acculturation-gap stress, immigration stress, discrimination stress, family immigration stress, community or gang-related stress) of cultural stress (HSI-A), and if the relation between cultural stress domains and depressive symptomology differed by group membership (clinical vs. nonclinical). The sample included 1,254 Hispanic adolescents. The clinical sample had significantly higher scores of cultural stress (p < .05) and mean depression scores (< .001). All 8 domains of HSI-A stress were correlated with depression (p < .05). In the general linear models (GLM), only family economic, acculturation gap, family immigration, discrimination, and family drug stress had a unique effect on depression and effect varied by group. Acculturation gap st...
Purpose: Through the SAMHSA/CSAP Strategic Prevention Framework State Incentive Grant (SPF SIG), ... more Purpose: Through the SAMHSA/CSAP Strategic Prevention Framework State Incentive Grant (SPF SIG), the Texas Department of State Health Services (DSHS) implemented evidence-based environmental (community-level) strategies for the prevention of substance abuse among adolescents and young adults. These approaches focus on reducing the supply of alcohol to this target group through changing specific intervening variables, such as alcohol availability (via retail and social access), community norms and law enforcement, and the implementation of local and statewide policies related to alcohol. However, measuring individual perceptions on these intervening variables is difficult, as no previous measurement tool has been validated for statewide evaluation use. More specifically, there is no validated tool that uniquely measures the impact of environmental prevention strategies on individuals consumption patterns or on individual perceptions of community change. This poster presentation will ...
Journal of Gay & Lesbian Social Services, 2011
Historically, substance abuse prevention programs are created with samples that conform to the ma... more Historically, substance abuse prevention programs are created with samples that conform to the majority population. Research shows that substance use risk factors are higher for lesbian, gay, bisexual, and transgender (LGBT) youths (Eisenberg &amp;amp;amp;amp;amp;amp;amp;amp;amp; Wechsler, 2003), and LGBT youths report higher use of substances than their heterosexual counterparts (Lampinen, McGhee, &amp;amp;amp;amp;amp;amp;amp;amp;amp; Martin, 2006; Marshal et al., 2008; Russell, Truong, &amp;amp;amp;amp;amp;amp;amp;amp;amp;
Stress associated with acculturation and minority status among Hispanic youth is understudied. Us... more Stress associated with acculturation and minority status among Hispanic youth is understudied. Using survey data from the Hispanic Stress Inventory–Adolescent Version (HSI-A), we examined psychosocial stress across eight domains including family economic stress and acculturation-gap stress in a national sample of three generations (first, second, and third or higher) of Hispanic adolescents ( N = 1,263). Research questions addressed generation differences in frequency of stressor events (i.e., discrimination), appraisal of these events, and mental health symptoms. Results indicated that experiences of different categories of stress were significantly related to generation status. The first generation reported more stressors and greater stress appraisal than the third-generation adolescents. Similar levels of discrimination stress were reported by participants regardless of generation. The second-generation participants reported a greater number of Acculturation Gap Stressors than th...
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