Mildred M. Maldonado-Molina

Trajectories of Delinquency among Puerto Rican Children and Adolescents at Two Sites

This study examined the trajectories of delinquency among Puerto Rican children and adolescents in two cultural contexts. Relying on data from the Boricua Youth Study, a longitudinal study of children and youth from Bronx, New York, and San Juan, Puerto Rico, a group-based trajectory procedure estimated the number of delinquency trajectories, whether trajectories differed across contexts, and the relation of risk and protective factors to each. Five trajectories fit the Bronx sample, and four fit the San Juan sample. Differences and similarities were observed. The Bronx sample had a higher rate of delinquency and sensation seeking and violence exposure strongly discriminated offender trajectories. In San Juan, the results were substantively the same. Thus, while the youth lived in different contexts, and the nature and level of delinquency varied across the sites, the effects of most risk factors were more similar than different.

What Accounts for Differences in Substance Use Among U.S.-Born and Immigrant Hispanic Adolescents?: Results from a Longitudinal Prospective Cohort Study

PURPOSE The current study was conducted to ascertain whether the effects of nativity (i.e., U.S. born vs. immigrant) on Hispanic adolescent substance use is mediated by ecological processes such as family functioning, school connectedness, and perceived peer substance use. METHODS The effects of family, peer, and school processes on adolescent substance use were examined in a nationally representative sample of 742 (358 male, 384 female) Hispanic youth (mean age = 15.9; SD = 1.8). RESULTS Results from a structural equation model indicated that the higher rates of substance use among U.S.-born Hispanics (compared with foreign-born Hispanics) are partially mediated by perceived peer substance use (as measured by the adolescent). The results also showed that perceived peer substance use and school connectedness mediate the relationship between family processes and substance use, suggesting that family processes may offset some of the deleterious effects of negative peer selection on adolescent substance use. CONCLUSION These findings imply that public health behavioral interventions to prevent substance use among both U.S.-born and foreign-born Hispanics may need to attend to multiple ecological processes, including family, school, and peers.

Effects of alcohol tax increases on alcohol-related disease mortality in Alaska: time-series analyses from 1976 to 2004.

OBJECTIVE We evaluated the effects of tax increases on alcoholic beverages in 1983 and 2002 on alcohol-related disease mortality in Alaska. METHODS We used a quasi-experimental design with quarterly measures of mortality from 1976 though 2004, and we included other states for comparison. Our statistical approach combined an autoregressive integrated moving average model with structural parameters in interrupted time-series models. RESULTS We observed statistically significant reductions in the numbers and rates of deaths caused by alcohol-related disease beginning immediately after the 1983 and 2002 alcohol tax increases in Alaska. In terms of effect size, the reductions were -29% (Cohens d = -0.57) and -11% (Cohens d = -0.52) for the 2 tax increases. Statistical tests of temporary-effect models versus long-term-effect models showed little dissipation of the effect over time. CONCLUSIONS Increases in alcohol excise tax rates were associated with immediate and sustained reductions in alcohol-related disease mortality in Alaska. Reductions in mortality occurred after 2 tax increases almost 20 years apart. Taxing alcoholic beverages is an effective public health strategy for reducing the burden of alcohol-related disease.

The Relationship Between Marijuana Use and Intimate Partner Violence in a Nationally Representative, Longitudinal Sample

Intimate partner violence is a significant public health problem, as these behaviors have been associated with a number of negative health outcomes including illicit drug use, physical injury, chronic pain, sexually transmitted diseases, depression, and posttraumatic stress disorder. The current study examined the association between marijuana use and intimate partner violence using a longitudinal survey of adolescents and young adults ages 15 to 26 years. Data were obtained from 9,421 adolescents in the National Longitudinal Study of Adolescent Health (Add Health) Waves 1 through 4 (1995-2008). Marijuana use was measured in the past year at each wave and participants were categorized as “users” or “nonusers.” Partner violence was constructed using six items (three pertaining to victimization and three concerning perpetration) from Wave 4 (2007-2008). Using these six items, participants were categorized as “victims only,” “perpetrators only,” or “victims and perpetrators.” Survey multinomial regression was used to examine the relationship between marijuana use and intimate partner violence. Consistent use of marijuana during adolescence was most predictive of intimate partner violence (OR = 2.08, p < .001). Consistent marijuana use (OR = 1.85, p < .05) was related to an increased risk of intimate partner violence perpetration. Adolescent marijuana use, particularly consistent use throughout adolescence, is associated with perpetration or both perpetration of and victimization by intimate partner violence in early adulthood. These findings have implications for intimate partner violence prevention efforts, as marijuana use should be considered as a target of early intimate partner violence intervention and treatment programming.

Drug Use/Abuse Prevalence, Etiology, Prevention, and Treatment in Hispanic Adolescents: A Cultural Perspective

The purpose of this article is to provide an overview of the state of drug abuse research among Hispanic adolescents in the areas of prevalence, etiology, prevention, and treatment from a cultural perspective. Cultural and acculturation-related processes are central to the understanding of the epidemiology, etiology, prevention, and treatment of drug use among Hispanic adolescents. Culture is also embedded within each of the efficacious interventions for Hispanic adolescents, suggesting that integrating Hispanic cultural symbols and values is an important element in preventing and treating drug use and related problem behaviors in this population. The recommendations presented in this article, along with existing work in the fields of epidemiology, risk protection, prevention, and treatment, will help to reduce the health disparities in drug use and related problem behaviors in this vulnerable and rapidly growing segment of the U.S. population.

Change in Cognitive Capabilities in the Oldest Old: The Effects of Proximity to Death in Genetically Related Individuals Over a 6-Year Period.

Change in cognitive abilities was assessed over a 6-year period in a sample of monozygotic and same-sex dizygotic twin pairs (N = 507 individuals), aged 80 and older (mean age = 83.3 years: SD = 3.1). who remained nondemented over the course of the study. Latent growth models (LGMs) show that chronological age and time to death are consistent predictors of decline in measures of memory, reasoning, speed, and verbal abilities. Multivariate LGM analysis resulted in weak and often negative correlations among rates of change between individuals within twin pairs, indicating greater differential change within twin pairs than occurs on average across twin pairs. These findings highlight several challenges for estimating genetic sources of variance in the context of compromised health and mortality-related change.

Abrupt decline in oxycodone-caused mortality after implementation of Florida's Prescription Drug Monitoring Program.

BACKGROUND In Florida, oxycodone-caused deaths declined substantially in 2012. Multiple important law enforcement, pharmaceutical, policy, and public health actions occurred concurrently, including implementation of a statewide Prescription Drug Monitoring Program (PDMP). The effects of the PDMP on oxycodone-caused mortality in Florida were evaluated. METHODS A time-series, quasi-experimental research design with autoregressive integrated moving average (ARIMA) statistical models, including internal and external covariates. Data included 120 repeated monthly observations. Monthly counts of oxycodone-caused deaths, obtained from the Florida Medical Examiners Commission (MEC) was the outcome variable. Models included market-entry of tamper-resistant oxycodone HC1 controlled release tablets (OxyContin(®)), enforcement crackdowns (Operation Pill Nation), and regulation by FL House Bill 7095, measured by the monthly count of Florida pain management clinics closed. Two approaches were used to test the PDMPs hypothesized effect: (1) a binary indicator variable (0=pre-implementation, 1=post-implementation), and (2) a continuous indicator consisting of the number of PDMP queries by health care providers. RESULTS Oxycodone-caused mortality abruptly declined 25% the month after implementation of Floridas PDMP (p=0.008). The effect remained after integrating other related historical events into the model. Results indicate that for a system-wide increase of one PDMP query per health care provider, oxycodone-caused deaths declined by 0.229 persons per month (p=0.002). CONCLUSIONS This is the first study to demonstrate that the PDMP had a significant effect in reducing oxycodone-caused mortality in Florida. Results have implications for national efforts to address the prescription drug epidemic.

Sex Differences in Trajectories of Offending Among Puerto Rican Youth

Although sex is one of the strongest correlates of crime, contentions remain regarding the necessity of sex-specific theories of crime. The current study examines delinquent trajectories across sex among Puerto Rican youth socialized in two different cultural contexts (Bronx, United States; and San Juan, Puerto Rico). Results indicate similar substantive offending trajectories across males and females within each cultural context, that males exhibit a higher frequency of offending and higher levels of risk factors for delinquency, and more similarities than differences in how risk/protective factors relate to patterns of offending across male versus female youth. Study limitations and implications for sex-specific criminological theories are also discussed.

An Empirical Test of Ecodevelopmental Theory in Predicting HIV Risk Behaviors Among Hispanic Youth

Ecodevelopmental theory is a theoretical framework used to explain the interplay among risk and protective processes associated with HIV risk behaviors among adolescents. Although ecodevelopmentally based interventions have been found to be efficacious in preventing HIV risk behaviors among Hispanic youth, this theory has not yet been directly empirically tested through a basic research study in this population. The purpose of this cross-sectional study was to empirically evaluate an ecodevelopmentally based model using structural equation modeling, with substance use and early sex initiation as the two outcomes of the ecodevelopmental chain of relationships. The sample consisted of 586 Hispanic youth (M age = 13.6; SD = 0.75) and their primary caregivers living in Miami, Florida. Adolescent, parent, and teacher reports were used. The results provided strong support for the theoretical model. More specifically, the parent—adolescent acculturation gap is indirectly related both to early sex initiation and to adolescent substance use through family functioning, academic functioning, perceived peer sexual behavior, and perceived peer substance use. Additionally, parent’s U.S. orientation is associated with adolescent substance use and adolescent sex initiation through social support for parents, parental stressors, family functioning, academic functioning, and perceived peer sexual behavior and substance use. These findings suggest that HIV risk behaviors may best be understood as associated with multiple and interrelated ecological determinants.

Ecodevelopmental × Intrapersonal Risk: Substance Use and Sexual Behavior in Hispanic Adolescents

Hispanic adolescents are a rapidly growing population and are highly vulnerable to substance abuse and HIV infection. Many interventions implemented thus far have been “one size fits all” models that deliver the same dosage and sequence of modules to all participants. To more effectively prevent substance use and HIV in Hispanic adolescents, different risk profiles must be considered. This studys purpose is to use intrapersonal and ecodevelopmental risk processes to identify Hispanic adolescent subgroups and to compare substance use rates and sexual behavior by risk subgroup. The results indicate that a larger proportion with high ecodevelopmental risk (irrespective of the intrapersonal risk for substance use) report lifetime and past 90-day cigarette and illicit drug use. In contrast, a larger proportion with high intrapersonal risk for unsafe sex (irrespective of ecodevelopmental risk) report early sex initiation and sexually transmitted disease incidence. Implications for intervention development are discussed in terms of these Hispanic adolescent subgroups.