Intervention Induced Changes on Parenting Practices,Youth Self-Pride and Sexual Norms to Reduce HIV-Related Behaviors Among Rural African American Youths

AIDS is the leading killer of African Americans between the ages of 25 and 44, many of whom became infected when they were teenagers or young adults. The disparity in HIV infection rate among African Americans youth residing in rural Southern regions of the United States suggests that there is an urgent need to identify ways to promote early preventive intervention to reduce HIV-related risk behavior. The Strong African American Families (SAAF) program, a preventive intervention for rural African American parents and their 11-year-olds, was specially designed to deter early sexual onset and the initiation and escalation of alcohol and drug use among rural African American preadolescents. A clustered-randomized prevention trial was conducted, contrasting families who took part in SAAF with control families. The trial, which included 332 families, indicated that intervention-induced changes occurred in intervention-targeted parenting, which in turn facilitated changes in youths’ internal protective processes and positive sexual norms. Long-term follow up assessments when youth were 17 years old revealed that intervention-induced changes in parenting practices mediated the effect of intervention-group influences on changes in the onset and escalation of risky sexual behaviors over 65 months through its positive influence on adolescents’ self-pride and their sexual norms. The findings underscore the powerful effects of parenting practices among rural African American families that over time serve a protective role in reducing youth’s risk behavior, including HIV vulnerable behaviors.     

Measuring Alcohol Expectancies in Youth

Beliefs about the consequences of using alcohol, alcohol expectancies, are powerful predictors of underage drinking. The Alcohol Expectancies Questionnaire-Adolescent form (AEQ-A) has been widely used to measure expectancies in youth. Despite its broad use, the factor structure of the AEQ-A has not been firmly established. It is also not known whether it assesses similar constructs (i.e., measurement invariance) between boys and girls. This article reports on a confirmatory factor analysis (CFA) of a shortened version of the AEQ-A with 310 youth, ages 10–16, to determine whether a two factor, positive and negative expectancy structure held for this sample and to test measurement invariance across gender. The results support evidence of a 2-factor, positive and negative structure for the abbreviated version of the AEQ-A and show that it assesses equivalent alcohol expectancy constructs among males and females. These findings have important implications for cognitive based approaches to alcohol prevention.Florida State University College of Social Work. She received her Ph.D. in Social Work from the University of North Carolina at Chapel Hill. Her major research interests are youth at risk, substance use prevention, and family engagement in prevention interventionsFlorida State University College of Medicine. She received her Ph.D. in Social Psychology from Arizona State University. Her major research interests are women's health, disease prevention, and health communication.Prevention Research Center, Pacific Institute for Research and Evaluation. She received her Ph.D. in Criminal Justice from the University at Albany. Her major research interests are family-based prevention strategies for adolescent alcohol, drugs, and sexual risk taking; women's alcohol, and other drug problems; prevention of young adult alcohol and drug abuse, risky sexual behavior, and violence.     

Adolescent Risk Behavior Subgroups: An Empirical Assessment

Theories and prior research have outlined a constellation of adolescent risk behaviors that tend to co-occur, reflecting a general pattern. Although their generality has largely been supported, there is some question about how to best study and portray the relationship among these behaviors. This study used data from a survey administered to high school youth (n = 2549, 38 schools). The general population sample comprised an even split between boys and girls, averaged roughly 16 years of age, and was 59% White and 10% Hispanic/Latino. Using latent class analysis, four subgroups, comprised of varying types and degrees of risky behavior, were identified. Specifically, there were two groups that “abstained” and “experimented” with risky behaviors and two others that had higher, but somewhat distinct, patterns of such activities. These groups were then examined in relation to youth characteristics (e.g., mental and physical health, school performance) and socio-environmental factors (e.g., social support, parental monitoring) that may be useful for better understanding “problem behavior syndrome” and development of prevention strategy.     

Psychological Distress,Substance Use,and HIV/STI Risk Behaviors Among Youth

Psychological distress has been inconsistently associated with sexual risk behavior in youth, suggesting additional factors, such as substance use, may explain this relationship. The mediating or moderating role of substance use on the relationship between psychological distress and sexual risk behaviors was prospectively examined over the four high school years in a sample of urban youth (N = 850; 80% African American; 50% female). Growth curve modeling was used to estimate changes in sexual risk across adolescence and to test its association to psychological distress symptoms and frequency of substance use. Substance use was associated with psychological distress. Greater psychological distress was associated with increased sexual intercourse frequency, decreased condom use, and increased number of partners. Substance use fully mediated the relationship between psychological distress and intercourse frequency and condom use, and partially mediated the relationship between psychological distress and number of partners. We found no differences in mediation by sex or race/ethnicity and no evidence to support moderation of psychological distress and substance use on sexual risk. Findings suggest that psychological distress is associated with sexual risk because youth with greater psychological distress are also more likely to use substances. Practical implications for adolescent HIV/STI prevention are discussed.     

Risky Sexual Behaviors in First and Second Generation Hispanic Immigrant Youth

Though official data document that Hispanic youth are at a great risk for early sexual intercourse, STDs, and teen pregnancy, only few etiological studies have been conducted on Hispanic youth; almost no work has examined potential generational differences in these behaviors, and thus, these behaviors may have been mistakenly attributed to cultural differences. The current study examined the relationships between maternal parenting (general communication, communication about sex, monitoring, support) and risky sexual behaviors, and potential moderating effects by immigration status and acculturation in 1st and 2nd generation Hispanic immigrant adolescents (N = 2,016) from the National Longitudinal Study of Adolescent Health (Waves I and II). Maternal communication about sex and maternal support emerged as key predictors of risky sexual behaviors across generational groups; neither immigration status nor acculturation moderated the maternal parenting constructs-risky sexual behaviors links. Furthermore, maternal parenting constructs and their relationships with risky sexual behaviors did not differ by generational groups.

Increased Substance Use and Risky Sexual Behavior Among Migratory Homeless Youth: Exploring the Role of Social Network Composition

Travelers are a migratory subgroup of homeless youth who may be especially prone to engaging in risky behavior. This study compared the substance use and sexual behavior of young homeless travelers and non-travelers to evaluate the extent and possible sources of travelers’ increased risk. Data came from face-to-face interviews with 419 homeless youth (36.6% female, 34.0% white, 23.9% African American, and 20.0% Hispanic) between the ages of 13 and 24 years (M = 20.1 years, SD = 2.5) who were randomly sampled from 41 shelters, drop-in centers, and street sites in Los Angeles. Travelers were almost twice as likely as non-travelers to exhibit recent heavy drinking, 37% more likely to exhibit recent marijuana use, and five times as likely to have injected drugs. Travelers also had more recent sex partners and were more likely to report having casual or need-based sexual partners and combining sex with substance use. Mediation analyses suggest that travelers’ deviant peer associations and disconnection to conventional individuals and institutions may drive their elevated substance use. Differences in sexual risk behaviors are likely attributable to demographic differences between the two groups. Overall, these differences between travelers and non-travelers suggest different service needs and the need for different service approaches.     

The Relative Importance of Mothers’ and Youths’ Neighborhood Perceptions for Youth Alcohol Use and Delinquency

Prior studies have examined the influence of neighborhood perceptions on youth outcomes, but few studies have examined whose report of neighborhoods, parents’ or youths,’ are most important in predicting youth outcomes. This study addresses the relative associations of youths’ and mothers’ neighborhood perceptions with youth alcohol use and delinquency. The sample includes 499 mother-child dyads (youth age: 10 to 16 [mean=13.3; SD=2]). Structural equation modeling showed that youths’ perceived neighborhood problems were significantly associated with their delinquency but not their alcohol use. However, mothers’ perceived neighborhood problems were not related to either youth alcohol use or delinquency, suggesting that youths’ perceptions are better indicators of youth behavior. Youth reports may reflect their activities in the neighborhood and their exposure to different forms of deviance, so youths’ reports would be better indicators of exposure to neighborhood risk. Challenges for prevention are discussed. NIAAA Postdoctoral Fellow and Associate Research Scientist at the School of Public Health, University of California, Berkeley, and the Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. Her research interests include psychosocial and environmental factors influencing youth problem behaviors. Interests are interventions for children with substance use or externalizing problems and their families. She is currently conducting alcohol, drug and other risky behavior prevention studies that include a focus on young adults in club settings as well as a variety of different family-based studies in different geographic regions (San Francisco Bay Area, Alaska, Thailand). Her work integrates both quantitative and qualitative research methods and centers on alcohol and other drug use, and related health issues among adolescents and young adults. She is especially interested in applying theoretical models of socially learned behaviors to populations with different cultural and social backgrounds     

Protective and Risk Factors Associated with Adolescent Boys’ Early Sexual Debut and Risky Sexual Behaviors

Protective and risk factors associated with rates of early sexual debut and risky sexual behaviors for a sample of low-income adolescent boys were examined using bioecological theory framed by a resiliency perspective. Protective processes examined include a close mother–son and father–son relationship, parental monitoring and family routines, as well as the adolescent boy’s academic achievement, expectations, and school recognition. The risk factors assessed were delinquent behaviors, if the adolescent was born to a teenage mother, family structure, monthly family income, risky neighborhood environments, family of origin welfare receipt, and maternal education. Waves one (1999) and two (2001) of Welfare, Children, and Families: A Three-City Study were used (N = 528; Wave 1 ages 10–14 years). Associations between early sexual debut and risky sexual behaviors with individual, family, school, and neighborhood protective and risk factors were addressed through a series of d-probit and Ordinary Least Squares multiple regression techniques. When protective and risk factors were addressed independently, academic achievement and parental monitoring protected adolescent boys from early sexual debut and risky sexual behaviors while drug and alcohol use and school problems placed them at risk for these behaviors. However, when the model is assessed together, early parental monitoring and academic achievement were shown to protect boys’ early sexual debut and risky sexual behaviors by reducing their delinquent behaviors, specifically early drug and alcohol use and school problems.

The Associations between Substance Use,Sexual Behavior,Deviant Behaviors and Adolescents’ Engagement in Sexting: Does Relationship Context Matter?

While prior research has identified multiple associations between engagement in sexting and risky behaviors, most existing studies do not take into account the contexts in which sexting occurs. The present study extends prior research by examining whether the associations between adolescents’ sexting behavior and engagement in substance use, sexual behaviors, and deviant behaviors differ depending on the relational context (within or outside of a romantic relationship) in which young people engage in sexting. Results from a survey of 1187 secondary school students (61.3% girls, n?=?728) between 16 and 22 years old (M?=?17.82 years; SD?=?0.88) revealed that sexting with a romantic partner is not a significant marker of engagement in risk behaviors. However, single youth who engage in sexting outside of a romantic relationship are more likely to report substance use, relative to their non-sexting counterparts. These findings underscore the need to use more nuanced measures to investigate sexting and for sexual education initiatives to integrate messages about substance use.     

Gender-Specific Relationships Between Depressive Symptoms, Marijuana Use, Parental Communication and Risky Sexual Behavior in Adolescence

A large body of research has identified correlates of risky sexual behavior, with depressive symptoms and marijuana use among the most consistent psychosocial predictors of sexual risk. However, substantially less research has examined the relationship between these risk variables and adolescent risky sexual behavior over time as well as the interaction of these individual-level predictors with family-level variables such as parenting factors. Additionally, most studies have been restricted to one index of risky sexual behavior, have not taken into account the complex role of gender, and have not controlled for several of the factors that independently confer risk for risky sexual behavior. Therefore, the current study investigated the association between depressive symptoms and parameters of parenting on marijuana use, number of sexual partners and condom usage measured 9 months later for both boys and girls. Participants were 9th and 10th grade adolescents (N = 1,145; 57.7 % female). We found that depressive symptoms may be a gender-specific risk factor for certain indices of risky sexual behavior. For boys only, marijuana use at Time 2 accounted for the variance in the relationship between depressive symptoms at Time 1 and number of partners at Time 2. Additionally, strictness of family rules at Time 1 was associated with the number of partners with whom girls engaged in sex at Time 2, but only among those with lower levels of depressive symptoms at Time 1. Results from the current investigation speak to the utility of examining the complex, gender-specific pathways to sexual risk in adolescents. Findings suggest that treatment of mental health and substance use problems may have important implications in rates of risky sexual behavior and, conceivably, controlling the high rates of serious individual and public health repercussions.     

Alcohol Use, Outcome Expectancies, and HIV Risk Status among American Indian Youth: A Latent Growth Curve Model with Parallel Processes

Alcohol use is cited as a risk factor for exposure to HIV infection through risky sexual behavior, especially among adolescents. From Social Cognitive Theory, positive outcome expectancies about the use of alcohol have often been presented as a critical aspect of alcohol use. Yet little is known about how they might be related to different aspects of HIV risk. Using latent growth curve modeling with data from 292 American Indian youth across seven years, both alcohol use and positive expectancies increased significantly; a lower-risk group showed significantly slower increases in both. Changes in alcohol use and outcome expectancies were significantly interrelated, providing support for reciprocal influence between the two constructs. Positive alcohol outcome expectancies may provide a preventive intervention point worthy of further consideration as influencing alcohol use and lowering HIV sexual risk among adolescents.Associate Professor at the University of Colorado at Denver and Health Sciences Center. She received her Ph.D. in Community Psychology from Michigan State University. Her major research interests are adolescent development among minority youth with an emphasis on positive and problem behaviors.Associate Professor at the University of Colorado at Denver and Health Sciences Center. She received her Ph.D. in Social Psychology from the University of Michigan. Her major research interests are in areas of American Indian mental health and services research.Assistant Professor at the University of Colorado at Denver and Health Sciences Center. She received her Ph.D. in Sociology from the University of Michigan. Her primary research interests are in demography and contextual effects of individual health behavior, with a special emphasis on adolescent development.In addition to the above people, the Project Team included Sonia Bauduy, Cathy A.E. Bell, Cecelia K. Big Crow, Dedra Buchwald, Nichole Cottier, Amy D. Dethlefsen, Ann Wilson Frederick, Ellen M. Keane, Shelly Hubing, Natalie Murphy, Angela Sam, Jennifer Settlemire, Jennifer Truel, and Frankee White Dress.     

The Longitudinal Relationships Between Rural Adolescents’ Prosocial Behaviors and Young Adult Substance Use

While many adolescents and young adults experiment with substances (e.g., alcohol, cigarette smoking, marijuana), recent research suggests that rural youth and young adults may be more at risk for substance use than their urban counterparts. This study was designed to examine the longitudinal relationships between rural adolescents’ prosocial behaviors and substance use in young adulthood. Furthermore, we examined the potential mediating effects of adolescent substance use, academic investment, and delinquency. Rural youth (N = 531; 263 girls) were surveyed in grades 10–12 (Time 1; M age = 16.17; SD = .91) and again in early adulthood (Time 2). Measures of prosocial behaviors, substance use, academic investment, and deviant activities were assessed at Time 1. At Time 2, measures of marijuana use, cigarette smoking, and getting drunk were administered. Overall, the findings showed that rural adolescents who frequently exhibit prosocial behaviors are less likely to engage in substance use in young adulthood than those who exhibit relatively low levels of prosocial behaviors. These findings indicate that prosocial behaviors may have positive health consequences, establishing behavioral trajectories that lead to lower levels of risky health behaviors in adulthood in rural populations.     

Substance Use Attitudes among Urban Black Adolescents: The Role of Parent,Peer, and Cultural Factors

This study examined the influence of perceived parental, peer, and cultural factors on Black American adolescent attitudes toward substance use. One-hundred-eight Black American youth (grades 9–12) from economically disadvantaged urban neighborhoods of New York, completed self-report measures on: (a) parent-child involvement, parental supervision, and parent attitudes toward high risk behaviors; (b) peer bonds and peer attitudes toward high risk behaviors; and (c) ethnic identity, parental racial socialization, and extended family support. Youth disapproval of substance use was positively associated with higher perceived levels of peer and parental disapproval of high risk behaviors, parental supervision, and ethnic identity. Youth who reported parental messages about racial discrimination without balanced parental messages about racial pride and racial equality were more likely to approve substance use. Assistant Professor in the Department of Preventive Medicine and Community Health, State University of New York Downstate Medical Center. Her research interests include socio-cultural factors in the prevention of youth substance use, sexual risk, and violence. Director, Center for Ethics Education and Marie Ward Doty Professor of Psychology at Fordham University. Current research interests include research ethics with vulnerable populations, including children and adolescents.     

Peer Rejection,Affiliation with Deviant Peers,Delinquency, and Risky Sexual Behavior

Risky sexual behavior poses significant health risks by increasing sexually transmitted infections and unintended pregnancies. Previous research has documented many factors related to risky sexual behavior. This study adds to the literature by proposing a prospective, developmental model of peer factors related to risky sexual behavior. Developmental pathways to risky sexual behavior were examined in a sample of 517 individuals (51 % female; 82 % European American, 16 % African American, 2 % other) followed from age 5–27. Structural equation models examined direct and indirect effects of peer rejection (assessed via peer nominations at ages 5, 6, 7, and 8), affiliation with deviant peers (assessed via self-report at ages 11 and 12), and delinquency (assessed via maternal report at ages 10 and 16) on risky sexual behavior (assessed via self-report at age 27). More peer rejection during childhood, affiliation with deviant peers during pre- adolescence, and delinquency in childhood and adolescence predicted more risky sexual behavior through age 27, although delinquency at age 16 was the only risk factor that had a significant direct effect on risky sexual behavior through age 27 above and beyond the other risk factors. Peer rejection was related to subsequent risk factors for girls but not boys. Peer risk factors as early as age 5 shape developmental pathways through childhood and adolescence and have implications for risky sexual behavior into adulthood.     

Adolescents Values Clarification and Development: A Model for Group Counseling

Youths involved with the juvenile justice and child welfare systems report higher rates of early initiation of sexual intercourse, more sexual partners, and lower rates of condom use compared with the general adolescent population. Such risky behaviors leave system-involved youths with volatile behavioral challenges and negative sexual health outcomes, such as unintended pregnancy. These effects can be attributed to detached support systems and a lack of early interventions, such as group therapy. This dynamic fosters further inquiry into asking, can delinquent teenagers who adopt a values clarification approach and understanding exhibit positive prosocial thoughts and behaviors? The intent of this paper is to discuss an alternative education program for pregnant, delinquent adolescents and young mothers allowed a social worker and his associates to implement a group counseling program. The counseling was intended to emphasize values clarification and values development. The counselors focused on attitudes, social views, and desired behaviors related to values. A unique aspect of the program was the development of a four-phase cognitive process related to values clarification and development. This process includes the discovery and awareness of values, the claiming and reclaiming of values, the acceptance of core values, and the appreciation and advocacy of the values phase. A content analysis methodology was used to analyze a self-report methods so that insights into cultural trends and experiences could be understood. Findings from the adoption of this program suggest a psychoeducation humanistic model can not only buffer teenage pregnancy risk and delinquency but also strengthen values and the moral development of troubled youth.     

Family Relationships and Adolescent Well-Being: Are Families Equally Protective for Same-Sex Attracted Youth?

Existing research suggests that sexual minority youth experience lower levels of well-being, in part because they perceive less social support than heterosexual youth. Sexual minority youth with strong family relationships may demonstrate resilience and increased well-being; however, it is also possible that the experience of sexual stigma may make these relationships less protective for sexual minority youth. Using two waves of data from the National Longitudinal Study of Adolescent Health, we explore the links between same-sex attraction, family relationships, and adolescent well-being in a sample of over 13,000 7th–12th grade adolescents (51 % female, 52 % non-Latino/a white, 17 % Latino, 21 % African American, and 7 % Asian). Specifically, we examine whether lower levels of parental closeness, parental involvement, and family support among same-sex attracted youth explain in part why these youth experience increased depressive symptoms and risk behaviors, including binge drinking, illegal drug use, and running away from home, relative to other-sex attracted youth. Second, we ask whether family relationships are equally protective against depressive symptoms and risk behaviors for same-sex attracted and other-sex attracted youth. We find that same-sex attracted youth, particularly girls, report higher levels of depressive symptoms, binge drinking, and drug use in part because they perceive less closeness with parents and less support from their families. Results also suggest that parental closeness and parental involvement may be less protective against risk behaviors for same-sex attracted boys than for their other-sex attracted peers. Findings thus suggest that interventions targeting the families of sexual minority youth should educate parents about the potentially negative effects of heteronormative assumptions and attitudes on positive adolescent development.     

Profiles of Problematic Behaviors Across Adolescence: Covariations with Indicators of Positive Youth Development

Previous analyses of data from the 4-H Study of Positive Youth Development (PYD) have examined concurrent trajectories of positive development and risk/problem behaviors among adolescents, finding complex and not necessarily inverse relationships among them. In this article, we expand on prior research by employing a person-centered approach to modeling risk behaviors, assessing development from approximately 6th grade through 12th grade among 4,391 adolescents (59.9 % female). Latent profiles involving the problematic behaviors of delinquency, depressive symptoms, substance use, sexual activity, disordered eating behaviors, and bullying were then assessed for concurrent relationships with the Five Cs of PYD: Competence, Confidence, Character, Caring, and Connection. We found six latent profiles, based primarily on mental health, aggression, and alcohol use, with significant differences in Confidence levels among many of the profiles, as well as some differences in the four other Cs. We discuss directions for future research and implications for application to youth policies and programs.     

Rural and Non-Rural African American Youth: Does Context Matter in the Etiology of Problem Behaviors?

The current study provides new information on the etiology of adolescent problem behaviors in African American youth by testing the importance of known predictors, namely parenting measures (monitoring, support, and communication), peers, and neighborhood characteristics across rural and non-rural developmental contexts. More specifically, the study examined whether rural versus non-rural developmental contexts moderated the relationships between known predictors and a variety of problem behaviors (alcohol use, drug use, delinquency, and violence). Data were collected from N = 687 rural and N = 182 non-rural African American adolescents (mean age = 15.8 years). Findings indicate that both parenting constructs and peer deviance had significant effects on problem behaviors and that these effects were consistent across rural and non-rural developmental contexts. The study results are discussed in terms of their implications for ecological frameworks for testing problem behavior etiology.

Adolescent Health Risk Profiles: The Co-Occurrence of Health Risks among Females and Males

This analysis examines the complexity of adolescent health risk behaviors using data from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative study of students. The current sample includes 12,955 students (6,626 females and 6,329 males) in grades 9 through 12. Cluster analysis was conducted separately by gender to examine the interrelationships among eight health risk behaviors: sexual activity, general alcohol use, binge drinking, cigarette use, marijuana use, other illicit drug use, fighting, and suicide. Four distinct clusters for females and males were identified based on their profiles of risk-taking behavior. Females and males both report low- and high-risk profiles, and a risk profile with high alcohol use and sexual activity. Females have two distinct risk profiles, one that is highest on every measure of risk compared to others and one that has high levels of fighting and suicide with little participation in substance use or sexual activity. Males have a distinct risk profile with particularly high rates of marijuana use and suicidal behaviors. Few distinctions exist between profiles based on sociodemographic characteristics.     

Social Networks of Homeless Youth in Emerging Adulthood

Little is known about the social networks of homeless youth in emerging adulthood despite the importance of this information for interventions to reduce health risks. This study examined the composition of social networks, and the risks and supports present within them, in a random sample of 349 homeless youth (33.4% female, 23.9% African American, 17.7% Hispanic) between the ages of 18 and 24. Social network members who were met on the street were among the most likely to be perceived as engaging in risky sex, as well as to engage in substance use with the youth. Youth were more likely to count on relatives and sex partners for support compared to other network members, but they also were more likely to use substances with sex partners and perceived them as engaging in risky sex. Interventions may need to recognize the importance of intimate relationships during the developmental stage of emerging adulthood by enhancing supportive bonds and reducing substance use and risky sex in these relationships.