Dorothy C. Browne

Risk of child abuse or neglect in a cohort of low-income children

The purposes of this research were to identify risk factors for reported child abuse or neglect and to examine the roles of stress and social support in the etiology of child maltreatment. Mothers of newborn infants with biomedical and sociodemographic risk factors were recruited from community and regional hospitals and local health departments in 42 counties of North and South Carolina selected for geographic distribution and for large numbers of such newborns. For every four such mothers, the next mother to deliver an otherwise normal newborn was sought. Mothers were interviewed shortly after giving birth, and state Central Registries of Child Abuse and Neglect were reviewed when each infant was 1 year of age. Eight hundred forty-two of 1,111 recruited mothers were successfully interviewed in their homes between March 1986 and June 1987. Seven hundred forty-nine North Carolina births who resided in the state more than 6 months were eligible for inclusion in the analysis. Logistic regression with backward elimination procedures was used in the analysis. Maternal education (p < .01), number of other dependent children in the home (p < .01), receipt of Medicaid (p < .01), maternal depression (p < .05), and whether the maternal subject lived with her own mother at age 14 years (p < .05) were the best predictors of a maltreatment report. Further examination revealed an interaction effect between stressful life events, as measured by life event scores, and social well-being (p < .01). For children born at risk for social and/or medical problems, extreme low income (participation in public income support programs), low maternal education, maternal depression, the presence of any other young children in the home, and a mothers separation at age 14 years from her own mother significantly predict child maltreatment reports in the first year of life. In addition, stressful life events, even if perceived positively, may increase or decrease the risk of maltreatment reports, depending upon the presence of social support.

Exploring Health Disparities in Integrated Communities: Overview of the EHDIC Study

Progress in understanding the nature of health disparities requires data that are race-comparative while overcoming confounding between race, socioeconomic status, and segregation. The Exploring Health Disparities in Integrated Communities (EHDIC) study is a multisite cohort study that will address these confounders by examining the nature of health disparities within racially integrated communities without racial disparities in socioeconomic status. Data consisted of a structured questionnaire and blood pressure measurements collected from a sample of the adult population (age 18 and older) of two racially integrated contiguous census tracts. This manuscript reports on baseline results from the first EHDIC site, a low-income urban community in southwest Baltimore, Maryland (EHDIC-SWB). In the adjusted models, African Americans had lower rates of smoking and fair or poor self-rated health than whites, but no race differences in obesity, drinking, or physical inactivity. Our findings indicate that accounting for race differences in exposure to social conditions reduces or eliminates some health-related disparities. Moreover, these findings suggest that solutions to the seemingly intractable health disparities problem that target social determinants may be effective, especially those factors that are confounded with racial segregation. Future research in the area of health disparities should seek ways to account for confounding from SES and segregation.

Peer Social Structure and Risk-Taking Behaviors Among African American Early Adolescents

This study investigated associations between peer status, peer group social influences, and risk-taking behaviors in an urban sample of 647 African American seventh-grade students. The highest rates of problem behaviors were seen in the controversial peer status group, or those youth who were both highly liked and highly disliked by other youth. Findings also revealed contrasting patterns of peer group leadership. The more conventional, positive leadership style predicted lower rates, and the less mainstream, unconventional style predicted higher rates of involvement in problem behaviors. Conventional leaders were most likely to be popular status youth, while unconventional leaders were mostly to be both controversial and popular status youth. Controversial status youth were also more likely to be involved in deviant peer groups. Results highlight the importance of controversial status students as key influence agents during early adolescence. We discuss the implications of these results for preventive interventions to reduce adolescent problem behaviors.

Violent behaviors in early adolescent minority youth: results from a "middle school youth risk behavior survey".

Objectives: To describe the prevalence and characteristics of violence and violence-related behaviors among six populations of U.S. minority adolescents in grades 6–8. Methods: Six thousand four hundred non-White adolescents were recruited from six sites that were part of a collaborative project. Surveys were administered either during the school day or at community facilities. All students at each site were asked 10 questions about recent violence-related behaviors (including use of threats, fighting, weapon carrying, and weapon use). Prevalence of each violence-related behavior was reported within and across sites, and stratified by race/ethnicity, gender, age, and other characteristics expected to influence the behaviors. Results: Sixty-six percent (66%) of the middle school students sampled reported being involved in some type of recent fighting and/or weapon-related behaviors. Sixty-one percent (61%) indicated some form of fighting behavior in the past 3 months (threatening to beat someone up, physical fighting, and/or being hurt in a fight). Thirty percent (30%) of participating youth reported one or more weapon-related behaviors (threatening to use a weapon, carrying a weapon, using a weapon, and/or being cut, stabbed or shot at). Reported gun carrying among males varied depending upon site, but was as high as 20%. Grade in school was positively associated with reported violent behaviors. Adolescents who reported living full-time with a parent or parent figure, and those who reported religious observance or beliefs, were less likely to report violence involvement. All violence-related behaviors were more common among male than female adolescents. Conclusions: Violence prevention efforts should begin in elementary school and continue throughout adolescence. Programs should be prepared to provide services or referrals to victims of violence, implement programs tailored toward females as well as males, and build partnerships with churches and other community organizations in which youth are involved.

Mediators of the Development and Prevention of Violent Behavior

The purpose of this investigation was to determine if the Aban Aya Youth Project, a culturally grounded intervention, produced differences in changes over time in core intervening variables (i.e., communal value orientation, empathy, violence avoidance efficacy beliefs) and whether these variables mediated intervention effects on the development of youth violent behavior. Fifth grade cohorts at 12 schools were randomly assigned to one of two intervention conditions or an attention placebo control condition and followed longitudinally through eighth grade. A total of 668 students (49% male) participated in the study. Mediation analyses suggested that both program conditions (as compared to the control condition) led to steeper increases over time in empathy which, in turn were related to reductions in the likelihood of violent behavior over time. No other significant program effects were detected, although changes over time in violence avoidance efficacy were associated with reduced likelihood of violent behavior. Findings are discussed in terms of theory development, program development and points of refinement of the Aban Aya Youth Project and implications for future research.

Minority health risk behaviors: an introduction to research on sexually transmitted diseases, violence, pregnancy prevention and substance use

Aims: The goal of this article is to introduce the Research on Sexually Transmitted Diseases, Violence, and Pregnancy Prevention Project (RSVPP), which represents one response of the National Institutes of Health to reduce health disparities in racial and ethnic populations. Methods: As part of this effort, seven independent projects were funded to design, implement, and evaluate community-based intervention strategies aimed at reducing risk behaviors among minority youth. The interventions and research designs varied across the sites; however, all sites included a common set of questions in their questionnaires. This study focuses on the lessons learned about community-based research across all sites. Results: Sites learned many lessons regarding community-based research, including: the value of building trust, the dynamic nature of communities, the intensive time and resources necessary for success, dissimilarities between researcher and community goals, the value of clear communication, the importance of recognizing the contribution of community members and expressing gratitude for their efforts; the difficulty of disseminating findings regarding sensitive topics, and the need for continuation of interventions. Conclusion: Community involvement posed challenges, but enhanced the quality of the implementation and the evaluation of the interventions. This special issue includes findings from the RSVPP sites.

Depressed mood and the effect of two universal first grade preventive interventions on survival to the first tobacco cigarette smoked among urban youth

INTRODUCTION As part of an evaluation of two first-grade, universal preventive interventions whose proximal targets were early learning and behavior, we investigated the influence of depressed mood, the interventions, and their interaction on survival to the first tobacco cigarette smoked through age 19. One intervention focused on improving teacher behavior management and instructional skills (Classroom-Centered, CC) as a means of improving student behavior and learning and the other on the family-school partnership (FSP). Variation in the relationship between depressed mood and first cigarette smoked by gender and grade was also examined. METHODS Self-reports of smoking behavior and depressed mood were collected on an annual basis from grade 6 through age 19. The present analyses were restricted to the 563 youth who had never smoked by grade 6, or 83% of the original sample of first grade participants. Discrete-time survival analysis was used to examine the effects of depressed mood and the interventions on survival to the first tobacco cigarette smoked. RESULTS Depressed mood was associated with reduced survival time to the first cigarette smoked (adjusted hazard ratio, aHR: 1.4; 95% CI: 1.1-1.9), whereas the CC intervention prolonged survival time (aHR: 0.8; 95% CI: 0.7-0.9). No significant variation in the effect of depressed mood on survival was found by gender or grade, nor was the effect of the CC intervention moderated by depressed mood. CONCLUSIONS Strategies to prevent tobacco cigarette smoking should include both a focus on depressed mood in adolescence as well as on early success in elementary school.

Drug Use and High-Risk Sexual Behaviors Among African American Men Who Have Sex With Men and Men Who Have Sex With Women

OBJECTIVES We investigated covariates related to risky sexual behaviors among young African American men enrolled at historically Black colleges and universities (HBCUs). METHODS Analyses were based on data gathered from 1837 male freshmen enrolled at 34 HBCUs who participated in the 2001 HBCU Substance Use Survey. The covariates of risky sexual behavior assessed included condom nonuse, engaging in sexual activity with multiple partners, and history of a sexually transmitted disease. RESULTS Young Black men who had sex with men were more likely to engage in risky sexual behaviors than were young men who had sex with women. Two additional factors, early onset of sexual activity and consumption of alcohol or drugs before sexual activity, were independently associated with modestly higher odds of sexual risk behaviors. CONCLUSIONS Services focusing on prevention of sexually transmitted diseases should be provided to all male college students, regardless of the gender of their sexual partners. Such a general approach should also address drug and alcohol use before sexual activity.

Difference in condom use among sexually active males at historically black colleges and universities.

Black men who have sex with men (MSM) and black men who have sex with both men and women (MSMW) may not perceive themselves to be part of the larger gay community and hence may not heed prevention messages aimed at the community. Objective and Participants: To better understand the participants behaviors, the authors examined differences in condom use between black MSM/W (including MSM and MSMW) and men who have sex with women (MSW) at historically black colleges and universities (HBCUs). Methods: A paper-and-pencil questionnaire survey investigated sexual behaviors of 1,865 freshmen from 35 HBCUs during the 2001-2002 school year. Results: MSM/W were about 0.37 times less likely to always use condoms compared with MSW (adjusted odds ratio = 0.63, 95% confidence interval = 0.42-0.95). Sexual behavior, age at survey, total family income, and religion were also associated with condom use. Conclusions: These findings offer new directions for sexually transmitted disease and HIV prevention aimed at a highly marginalized population that remains at high risk for infection.

Family violence and depressive symptomatology among incarcerated women

This study examines the potential association between witnessing parental violence as a child and later adult depressive symptomatology within a population that has received limited attention in the scientific literature, namely, incarcerated women. The Conflict Tactics Scale and the Center for Epidemiological Studies Depression Scale were administered to 60 women incarcerated in a maximum security prison in North Carolina. A majority of the women reported that they had witnessed verbally aggressive or physically violent interactions among the adult members in their families. Seventy percent of these women suffered from clinically relevant levels of depressive symptomatology. Stepwise multiple linear regression analysis revealed that increasing levels of reasoning conflict resolution strategies used in the womens families of origin were associated with decreasing levels of depressive symptomatology of the women, whereas increasing levels of physically violent conflict resolution strategies were associated with increasing levels of depressive symptomatology.