David Córdova

Intergroup and Within-Group Perceived Discrimination Among U.S.-Born and Foreign-Born Latino Youth

Despite the deleterious mental health and health consequences experiences of perceived discrimination can have on ethnic and racial minorities in the United States, a dearth of qualitative studies exist to develop a better understanding of such experiences. As part of a larger study examining psychosocial stress events, and in an effort to fill this gap, this study sought to explore stressful life experiences of intergroup and within-group perceived discrimination among a heterogeneous sample of U.S.-born and foreign-born Latino youth (n = 170) residing in Los Angeles, California, and Trenton, New Jersey. Focus group methodology was implemented, and data were analyzed using grounded theory and constant comparison method. Findings suggest that Latino youths’ experiences of intergroup and within-group discrimination vary by nativity status and region of the United States. Findings may be helpful for researchers, practitioners, and others working with Latino youth.

Trends in the disapproval and use of marijuana among adolescents and young adults in the United States: 2002–2013

Abstract Background: Despite policy changes related to the use and distribution of marijuana in cities and states across the country, few studies have examined changes in disapproval and use of marijuana among American youth. Objectives: To examine trends in disapproval and use of marijuana among adolescents and young adults in the United States. Method: We employed nationally representative data spanning the period of 2002–2013. Analyses were based on self-reported measurements from 105,903 younger adolescents (aged 12–14); 110,949 older adolescents (aged 15–17); and 221,976 young adults (aged 18–25). Results: Between 2002 and 2013 the proportion of adolescents aged 12–14 reporting “strong disapproval” of marijuana use initiation increased significantly from 74.4–78.9%. Concurrently, a significant decrease in past 12-month marijuana use (OR = 0.98, 95% CI = 0.97–0.99) was observed among younger adolescents. No significant trend was observed for marijuana use disapproval among adolescents aged 15–17 between 2002 and 2013. Yet a significant (OR = 0.99, 95% CI = 0.98–0.99) decrease in the past 12-month marijuana use was observed (2002 = 26.2%, 2013 = 21.9%) among this group. Among young adults (aged 18–25), a substantial decrease – from 40.5% in 2002 to 22.6% in 2013 – was observed in the proportion reporting “strong disapproval” of marijuana use initiation; however, increases in the past 12-month use were relatively small among young adults (Δ = 2.21) but statistically significant (OR = 1.02, 95% = 1.01–1.02). Conclusions: Changes are underway in the perception and use of marijuana among American youth. However, changes differ in important ways among youth from distinct developmental subgroups.

Effects of a family intervention in reducing HIV risk behaviors among high-risk Hispanic adolescents: A randomized controlled trial

OBJECTIVE To determine the efficacy of a family intervention in reducing human immunodeficiency virus (HIV) risk behaviors among Hispanic delinquent adolescents. DESIGN Randomized controlled trial. SETTING Miami-Dade County Public School System and Miami-Dade Countys Department of Juvenile Services, Florida. PARTICIPANTS A total of 242 Hispanic delinquent youth aged 12 to 17 years and their primary caregivers completed outcome assessments at baseline and 3 months after intervention. INTERVENTION Participants were randomized to either Familias Unidas (120 participants), a Hispanic-specific, family intervention designed to reduce HIV risk behaviors among Hispanic youth, or a community practice control condition (122 participants). MAIN OUTCOME MEASURES Self-reported measures included unprotected sexual behavior, engaging in sex while under the influence of alcohol and/or drugs, number of sexual partners, and incidence of sexually transmitted diseases. Family functioning (eg, parent-adolescent communication, positive parenting, and parental monitoring) was also assessed via self-report measures. RESULTS Compared with community practice, Familias Unidas was efficacious in increasing condom use during vaginal and anal sex during the past 90 days, reducing the number of days adolescents were under the influence of drugs or alcohol and had sex without a condom, reducing sexual partners, and preventing unprotected anal sex at the last sexual intercourse. Familias Unidas was also efficacious, relative to community practice, in increasing family functioning and most notably in increasing parent-adolescent communication and positive parenting. CONCLUSION These results suggest that culturally tailored, family-centered prevention interventions may be appropriate and efficacious in reducing HIV risk behaviors among Hispanic delinquent adolescents. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01257022.

The Hispanic Stress Inventory--Adolescent Version: a culturally informed psychosocial assessment.

A 2-phase study was conducted to develop a culturally informed measure of psychosocial stress for adolescents: the Hispanic Stress Inventory--Adolescent Version (HSI-A). Phase 1 involved item development through the collection of open-ended focus group interview data (n = 170) from a heterogeneous sample of Hispanic youths residing in the southwest and northeast United States. In Phase 2, we examined the psychometric properties of the HSI-A (n = 1,651), which involved the use of factor analytic procedures to determine the underlying scale structure of the HSI-A for foreign-born and U.S.-born participants in an aggregated analytic approach. An 8-factor solution was established, with factors that include Family Economic Stress, Acculturation-Gap Stress, Culture and Educational Stress, Immigration-Related Stress, Discrimination Stress, Family Immigration Stress, Community and Gang-Related Stress, and Family and Drug-Related Stress. Concurrent, related validity estimates were calculated to determine relations between HSI-A and other measures of child psychopathology and behavioral and emotional disturbances. HSI-A total stress appraisal scores were significantly correlated with both the Childrens Depression Inventory and the Youth Self Report (p < .001). Reliability estimates for the HSI-A were conducted, and they yielded high reliability coefficients for most factor subscales, with the HSI-A total stress appraisal score reliability alpha at .92.

Do the Effects of a Family Intervention on Alcohol and Drug Use Vary by Nativity Status

To examine whether the intervention effects of Familias Unidas, compared to community practice, on Hispanic adolescent alcohol and drug use varies by nativity status (i.e., U.S.-born and foreign-born). A total of 213 eighth grade Hispanic adolescents with behavior problems and their primary caregivers were assigned randomly to one of two conditions: Familias Unidas or Community Control. Participants were assessed at baseline and at 6, 18, and 30 months post baseline. Results showed that, the effects of Familias Unidas on alcohol use was moderated by nativity status. Specifically, Familias Unidas was efficacious in preventing/reducing alcohol use for U.S.-born youth, but not foreign-born. No moderating effects were found for drug use. These findings suggest that prevention interventions may be more efficacious in preventing/reducing alcohol use among certain Hispanic adolescent subgroups.

Do Parent–Adolescent Discrepancies in Family Functioning Increase the Risk of Hispanic Adolescent HIV Risk Behaviors?

In the family-based prevention science literature, family functioning, defined as positive parenting, parental involvement, family cohesion, family communication, parental monitoring of peers, and parent-adolescent communication, has been shown to ameliorate HIV risk behaviors in Hispanic youth. However, the majority of studies have relied solely on parent or adolescent reports and we know very little about parent-adolescent family functioning discrepancies. Therefore, the purpose of this study was to examine whether and to what extent parent-adolescent discrepancies in family functioning increased the risk of HIV risk behaviors, including substance use and sexual risk behaviors, and whether these associations vary as a function of acculturation and youth gender. A total of 746 Hispanic 8th grade youth and their primary caregivers were included in the study. Structural equation modeling findings indicate that parent-adolescent family functioning discrepancies are associated with an increased risk of Hispanic adolescent HIV risk behaviors, including lifetime and past 90-day alcohol and illicit drug use, and early sex initiation. In addition, study findings indicate that results vary by acculturation and youth gender. Findings are discussed in the context of existing family-based research and practice in preventing and reducing HIV risk behaviors among Hispanic youth and their families.

Predicting Condom Use Attitudes, Norms, and Control Beliefs in Hispanic Problem Behavior Youth The Effects of Family Functioning and Parent–Adolescent Communication About Sex on Condom Use

Hispanic problem behavior youth are at an increased risk of engaging in HIV risk behaviors, including low condom use. However, relatively little research has examined factors that affect condom use in this population. Although research indicates that family processes, such as higher levels of family functioning and open parent–adolescent communication about sex, and condom use attitudes, norms, and control beliefs as depicted by the theory of planned behavior have an effect on condom use behaviors, the combination of the two factors has received minimal attention. The purpose of this study was to examine the effect of family functioning on condom use intentions and behaviors through communication about sex and condom use attitudes, parental norms, and control beliefs. A cross-sectional study of 171 predominately male (73.1%) sexually active Hispanic problem behavior adolescents (mean age = 14.88 years) was conducted. Structural equation modeling was used to test the study hypothesis. Findings largely support the overall model and suggest that family functioning had an indirect effect on condom use intention and behavior through communication about sex, condom use attitudes, and control beliefs. Family functioning, however, did not have an indirect effect on condom use intention and behavior through communication about sex and parental norms. Implications for prevention science and future research are discussed.

Developmental Trajectories of Acculturation: Links With Family Functioning and Mental Health in Recent-Immigrant Hispanic Adolescents

The present study was designed to examine acculturative changes, and their effects on mental health and family functioning, in recent-immigrant Hispanic adolescents. A sample of 302 Hispanic adolescents was assessed five times over a 2½-year period. Participants completed measures of Hispanic and U.S. practices, collectivist and individualist values, and ethnic and U.S. identity at each time point. Baseline and Time 5 levels of mental health and family functioning were also assessed. Latent class growth analyses produced two-class solutions for practices, values, and identifications. Adolescents who increased over time in practices and values reported the most adaptive mental health and family functioning. Adolescents who did not change in any acculturation domain reported the least favorable mental health and family functioning.

The Role of Attitudes, Family, Peer and School on Alcohol Use, Rule Breaking and Aggressive Behavior in Hispanic Delinquent Adolescents

OBJECTIVE: The purpose of this study was to examine ecodevelopmental risk factors associated with alcohol uses, rule breaking and aggressive behaviors among Hispanic delinquent adolescents. Specifically, this study tests the effect of attitudes, family, peer, and school bonding on alcohol use, rule breaking and aggressive behaviors in Hispanic delinquent youth. METHODS: A sample of 235 heterogeneous Hispanic delinquent adolescents was recruited through referrals from the Miami-Dade Countys Department of Juvenile Services and from the Miami-Dade County Public School system. Logistic regression methods were utilized to examine the independent effect of each risk factor (attitudes, family, peer, school) and to determine the extent to which these factors are associated with alcohol use, rule breaking and aggressive behaviors. RESULTS: Family functioning was inversely and significantly related to past 90-day alcohol use in univariate regression (β = -.24, p = .035) but was not significant in multiple regression (β = -0.09, p = .556). Peer alcohol use (β = 2.02, p<0.001) and poor alcohol attitudes (β =0.59, p=0.006) were positively and significantly related to past 90-day alcohol use in the final model. Poor alcohol attitudes, family functioning, peer alcohol use, and school bonding were all significantly related to both rule breaking and aggressive behaviors in the final model. CONCLUSIONS: Findings highlight the importance of identifying risk factors at multiple levels to prevent/reduce alcohol use, rule breaking and aggressive behaviors among Hispanic delinquent youth.

Ecodevelopmental and Intrapersonal Moderators of a Family Based Preventive Intervention for Hispanic Youth: A Latent Profile Analysis

Hispanic adolescents are disproportionately affected by externalizing disorders, substance use and HIV infection. Despite these health inequities, few interventions have been found to be efficacious for this population, and even fewer studies have examined whether the effects of such interventions vary as a function of ecodevelopmental and intrapersonal risk subgroups. The aim of this study was to determine whether and to what extent the effects of Familias Unidas, an evidence-based preventive intervention, vary by ecodevelopmental and intrapersonal risk subgroups. Data from 213 Hispanic adolescents (mean age = 13.8, SD = 0.76) who were enrolled in a randomized clinical trial evaluating the relative efficacy of Familias Unidas on externalizing disorders, substance use, and unprotected sexual behavior were analyzed. The results showed that Familias Unidas was efficacious over time, in terms of both externalizing disorders and substance use, for Hispanic youth with high family ecodevelopmental risk (e.g., poor parent-adolescent communication), but not with youth with moderate ecodevelopmental or low ecodevelopmental risk. The results suggest that classifying adolescents based on their family ecodevelopmental risk may be an especially effective strategy for examining moderators of family-based preventive interventions such as Familias Unidas. Moreover, these results suggest that Familias Unidas should potentially be targeted toward youth with high family ecodevelopmental risk. The utility of the methods presented in this article to other prevention scientists, including genetic, neurobiological and environmental scientists, is discussed.