Preventing Alcohol Use Among Urban American Indian Youth: The Seventh Generation Program

SUMMARY

In comparing alcohol use between American Indian and non-Indian youth, the age at first involvement with alcohol is younger, the frequency and amount of drinking are greater, and negative consequences are more common for Indians. This article presents the results from the first phase of an innovative alcohol prevention program targeting urban Indian youth. Urban Indian youth were chosen as the participants since the majority of the roughly two million American Indians now live in urban areas. The Seventh Generation Program described in this article is unique in that it blends mainstream prevention approaches with American Indian culture to produce a program that is culturally sensitive to and appropriate for the urban Indian community in which it was developed. A quasi-experimental research design was used to evaluate the Generation Program.     

Behavioral health correlates of exposure to community violence among African-American adolescents in Chicago

AimsThough public health researchers are more aware of behavioral health concerns among African American youth, few studies have explored how exposure to community violence may be related to adverse youth concerns. This study examines the relationship between exposure to community violence and mental health problems, substance use, school engagement, juvenile justice involvement, and STI risk behaviors.MethodsA total of 638 African American adolescents living in predominantly low-income, urban communities participated in the study by completing self-report measures on exposure to community violence, mental health, school engagement proxies, substance use, delinquency markers and sexual risk behaviors.ResultsAdolescents who reported higher rates of exposure to community violence were significantly more likely to report poorer mental health, delinquent behaviors, a history of juvenile justice involvement, lower school bonding and student-teacher connectedness. These youth were also significantly more likely to use alcohol, cigarettes, and illicit substances, and engage in sexual risk behaviors.ConclusionsFindings suggest that there is a critical need for culturally relevant prevention and intervention efforts for African American adolescents who are frequently exposed to community violence.     

Step-Up: Promoting Youth Mental Health and Development in Inner-City High Schools

African American and Latino youth who reside in inner-city communities are at heightened risk for compromised mental health, as their neighborhoods are too often associated with serious stressors, including elevated rates of poverty, substance abuse, community violence, as well as scarce youth-supportive resources, and mental health care options. Many aspects of disadvantaged urban contexts have the potential to thwart successful youth development. Adolescents with elevated mental health needs may experience impaired judgment, poor problem-solving skills, and conflictual interpersonal relationships, resulting in unsafe sexual behavior and drug use. However, mental health services are frequently avoided by urban adolescents who could gain substantial benefit from care. Thus, the development of culturally sensitive, contextually relevant and effective services for urban, low-income African American and Latino adolescents is critical. Given the complexity of the mental health and social needs of urban youth, novel approaches to service delivery may need to consider individual (i.e., motivation to succeed in the future), family (i.e., adult support within and outside of the family), and community-level (i.e., work and school opportunities) clinical components. Step-Up, a high school-based mental health service delivery model has been developed to bolster key family, youth and school processes related to youth mental health and positive youth development. Step-Up (1) intervenes with urban minority adolescents across inner-city ecological domains; (2) addresses multiple levels (school, family and community) in order to target youth mental health difficulties; and (3) provides opportunities for increasing youth social problem-solving and life skills. Further, Step-Up integrates existing theory-driven, evidence-based interventions. This article describes Step-Up clinical goals, theoretical influences, as well as components and key features, and presents preliminary data on youth engagement for two cohorts of students.     

An Ecological Assessment of Drug-Related Problem Situations for American Indian Adolescents of the Southwest

This study examined difficult situations related to drug and alcohol use as identified by American Indian youth in the South-west. Sixty-two contextually based items were developed from focus group data, and were administered to 71 American Indian youth. The items measured the frequency in which youth experienced specific drug-related situations, as well as the perceived difficulty in resisting drug use offers in those situations: The results indicated that the most frequent and difficult drug and alcohol situations occurred primarily with friends or cousins at their homes or after school. Implications for culturally specific assessment, prevention, and treatment are discussed.     

“WHAT ABOUT THE CHILDREN?” The Psychological and Social Well‐Being of Multiracial Adolescents

We used the National Longitudinal Study of Adolescent Health (Add Health) to examine the social and psychological well-being of multiracial adolescents. Using two different measures of multiracial identity, we investigated the ways in which these adolescents compare to their monoracial counterparts on five outcomes: depression, seriously considering suicide, feeling socially accepted, feeling close to others at school, and participating in extracurricular activities. We found that multiracial adolescents as a group experience some negative outcomes compared to white adolescents, but that this finding is driven by negative outcomes for those with American Indian and white heritage. We found no consistent evidence, however, that multiracial adolescents as a group face more difficulty in adolescence than members of other racial and ethnic minority groups. The results were similar, whether the multiracial population is defined by self-identification or by their parents' racial identifications.     

Acculturation,Gender Disparity,and the Sexual Behavior of Asian American Youth

Asian American youth are less likely to be sexually active than adolescents from other ethnic groups; however, with acculturation, they may adopt the more liberal sexual norms of American society. Moreover, owing to differing parental expectations for sons and daughters about sexuality, gender disparity might exist in the adoption of American sexual norms. This article used the proportional hazards model and the generalized estimating equations Poisson model to examine how acculturation influences the initiation of sexual intercourse and the number of sexual partners. The results show that acculturation leads to more liberal sexual mores among Asian American youth. However, despite what might be expected from the sexual double standard, the models show that more acculturated females, as indicated by their use of English at home, had an earlier onset of sexual intercourse and a higher number of sexual partners. This is the opposite of what would be predicted by the sexual double standard theory. This might be due to the fact that Asian females tend to be more socially accepted by the host society than Asian males. Information on partners shows that Asian American females have more diversified racial backgrounds than their male counterparts. They are also more likely to have older sexual partners.     

Perceived discrimination and early substance abuse among American Indian children

This study investigated internalizing and externalizing symptoms as potential mediators of the relationship between perceived discrimination and early substance abuse among 195 American Indian 5 through 8 graders from three reservations that share a common culture (e.g., language, spiritual beliefs, and traditional practices) in the upper Midwest. The findings indicated that, although perceived discrimination contributed significantly to internalizing symptoms among the adolescents, internalizing symptoms were unrelated to early substance abuse. Rather, the effects of perceived discrimination on early substance abuse were mediated by adolescent anger and delinquent behaviors. The results are discussed in terms of the consequences of perceived discrimination on the development of American Indian early adolescents.     

Testing the Model Minority Stereotype: Youth Behaviors across Racial and Ethnic Groups

Using data from a large nationally representative sample of adolescents attending school, this study tests the stereotype that youth of Asian Pacific Islander ethnicity (API) are the model minority. The results suggest that, except for substance use, API American youth do not report fewer delinquent behaviors than white youth; in fact, API American youth report slightly higher numbers of aggressive offenses than white youth, and female API American youth report greater numbers of nonaggressive offenses than white female youth. Also, API American youth report higher rates of nonaggressive offenses and substance use than do black youth. The mental health and social service needs of API American youth are thus at least as great as those of white youth. The need for such services increases with the length of residency in the United States.     

Adolescents' Self-Reported Substance Risks and Need to Talk About Them in Mental Health Counseling

Summary

Although adolescents seeking mental health services may not consider them related, the prevalent co-morbidity of substance use and mental health problems makes it imperative that practitioners find ways of engaging troubled youth about substance issues. Based on their responses to a clinical self-assessment questionnaire (Adquest), this study shows that mental health service applicants are willing to disclose their substance use behaviors and are open to talking about them to intake workers. Age and gender differences in substance use patterns and willingness to talk are explored.     

An Ecological Assessment of Drug-Related Problem Situations for American Indian Adolescents of the Southwest

ABSTRACT

This study examined difficult situations related to drug and alcohol use as identified by American Indian youth in the Southwest. Sixty-two contextually based items were developed from focus group data, and were administered to 71 American Indian youth. The items measured the frequency in which youth experienced specific drug-related situations, as well as the perceived difficulty in resisting drug use offers in those situations. The results indicated that the most frequent and difficult drug and alcohol situations occurred primarily with friends or cousins at their homes or after school. Implications for culturally specific assessment, prevention, and treatment are discussed.     

The role of close friends in African American adolescents' dating and sexual behavior

This study examined the role of close friends in the sexual lives of African American adolescents. Fifteen African American adolescents residing in an urban neighborhood participated in individual in-depth qualitative interviews. The findings suggest that close friends play a critical role in the dating and sexual behaviors of inner-city African American adolescents, as they appear to serve as socializing agents that impact how adolescents conceptualize and socially construct dating and sexual roles and behaviors. Close friends also play a significant role in acquiring new dating and sexual partners and in determining the course of dating and sexual relationships. Although females and males expressed similar expectations regarding sexual fidelity and condom use, they differed with regard to their method and process of talking with friends about dating and sex, their shared social constructions about dating and sexual roles and expectations, and their perceptions of the meaning of dating. We discuss the implications of the findings in terms of involving close friends in interventions focused on improving the sexual health of African American adolescents. Future directions for research with African American adolescents and sexuality are also discussed.     

Friends don't let friends ...or do they? Developmental and gender differences in intervening in friends' ATOD use

This study focused on the strategies adolescents endorsed for situations in which friends were experimenting with alcohol, tobacco, and other drugs. Four hypothetical vignettes (concerning a friend smoking, using drugs, getting drunk at a party, or deciding whether to attend a party with alcohol and drugs) were presented to 2697 5th-12th graders. Whereas younger students were more likely to choose proactive strategies (talking to the friend or an adult or ending the friendship), older students were more inclined to say they would ignore a friend's smoking and drug use although they would take the car keys away from a friend drinking alcohol. Among those 13 years old and older, the more dangerous the substance, the more inclined the youth were to intervene. Females were more inclined than males to talk to friends about smoking, drinking, and drugs and less inclined to ignore the behaviors or stop being a friend.     

Effects of an Expressive Art Intervention with Urban Youth in Low-Income Neighborhoods

Various forms of expressive arts are known to have associations with positive academic, social, and behavioral outcomes in addition to offering important therapeutic benefits for children and adolescents. However, very limited knowledge has been developed regarding specific expressive arts interventions for promoting positive youth development and preventing problematic behaviors in youth from urban, low socioeconomic neighborhoods. Therefore, the purpose of the current study was to expand the nascent research area in arts interventions by evaluating an expressive art intervention offered to youth through a positive youth development program located in several public housing neighborhoods. Quasi-experimental design was applied to test the impact of a poetry-focused art intervention on self-reported perceptions of academics, social competence, and multicultural attitudes of a culturally diverse sample of 40 urban sixth to eighth grade youth. Participants were recruited through a positive youth development program located in the public housing neighborhoods where they reside. Pre and post data were collected. Prior to the arts intervention, there were no statistically significant differences between the youth on self-report measures of academic capacity and social competence. The first group of youth who participated in the intervention reported enhanced capacity on all three measures when compared to peers who had not yet participated in the program. However, the second group of youth to receive the program showed no statistically significant gains when compared to their peers who received the intervention first. The study provides compelling support to further explore the efficacy of expressive arts on influencing attributes of positive youth development among urban adolescents. In addition, the study offers valuable insights into the process and complexities involved in developing agency partnerships and conducting research on after-school programs.     

The Role of Social Performance and Physical Attractiveness in Peer Rejection of Socially Anxious Adolescents

This study addressed the role of social performance and physical attractiveness in the link between social anxiety and peer rejection in first‐time social situations. Recordings of 20 high and 20 low socially anxious adolescents giving a speech were rated by unfamiliar peers (N = 534) with regard to desire for future interaction (lower scores indicating rejection), social performance, and physical attractiveness; trained adult raters also evaluated social performance. Findings showed high interrelations between the different peer ratings and moderate correlations between adult and peer ratings. High socially anxious students were more rejected and social performance and physical attractiveness partly mediated the link between social anxiety and rejection. The findings may have important implications for socially anxious youth entering new social situations.     

Re-examining child welfare's response to ICWA: Collaborating with community-based agencies to reduce disparities for American Indian/Alaska Native children

Many state and county child protection systems (CPS) are attempting to reduce the documented disproportionality in out of home placement rates for American Indian/Alaska Native children. This article presents a case example of collaboration between Colorado CPS and an urban American Indian family services agency that was intended to impact this disproportionality. The Denver Indian Family Resource Center created and evaluated a family preservation model that includes both direct services to Native families and CPS-level systemic interventions designed to reduce out-of-home placement. Direct services addressed family stressors and caregiver substance abuse and mental health issues, and incorporated Native cultural values. Systemic interventions focused on collaborative partnerships and provided CPS with practical ways to comply with the Indian Child Welfare Act. Agency data showed an increase in the number of children remaining at home or with extended family. Statewide data showed a decrease in the disparity ratio for placement of Native children compared to White children.     

Identity Formation of American Indian Adolescents: Local,National, and Global Considerations

A conceptual model is presented that approaches identity formation of American Indian adolescents according to 3 levels of social contextual influence—local, national, and global—relative to types of identity, dynamics of identity, and sources of influence. Ethnic identity of American Indians is embedded within the local cultural milieu and encompasses an array of dimensions organized around identification, connection, and culture/spirituality. The national or societal level brings additional complexities according to bicultural, multicultural, and hybrid types of identity. There is little known about the global implications of identity formation for American Indian adolescents, but a review of the construct of indigenous identity provides some guidance along with examination of identity formation of indigenous youth in other parts of the world. Suggestions for research are provided throughout the paper, and theoretical implications for the broader topic of American Indian identity formation are provided with particular discussion of indigenous psychologies.     

Lesbian,Gay, Bisexual,Sexual-Orientation Questioning Adolescents Seeking Mental Health Services

Summary

Lesbian, gay, bisexual, and sexual-orientation questioning (LGBQ) adolescents have many of the same health needs as straight adolescents. In addition, they must learn to manage a stigmatized identity that may create confusion, anxiety, and emotional turbulence for them. Beyond stigma, LGBQ youth are often found to be at higher risk for substance abuse, violence, depression, suicide, and sexual health problems. Based on responses given by urban adolescents seeking mental health services to a clinical self-assessment questionnaire (Adquest), this article examines the relationship between sexual identity and risk factors related to safety, health, sex, substance use, family and friends, worries, and their desire to talk about these in counseling. Findings indicate that LGBQ youth are at higher risk than straights, and express greater desire to talk about substance use, health, their personal lives, and their friends. Mental health practitioners working with these young persons must properly assess and address their risks by creating a sense of community and safe environment for open discussion.     

Cultural Identity and Acculturation Preferences Among South Asian Adolescents in Britain: An Exploratory Study

The study reported in this article is part of a wider research project on the adaptation of South Asians in Britain. It examines and compares the acculturation attitudes and cultural identity of Indian and Pakistani second‐generation adolescents Indian (Punjabi Sikh and Gujarati Hindu) and Pakistani (Muslim) in Britain. The research project integrates a social psychological approach to ethnic identity, Berry’s (Cross‐cultural Perspectives. Nebraska Symposium on Motivation, 1990) acculturation strategy and stress models, and Phinney’s (Journal of Early Adolescence, 9 , 1989:34) model of ethnic identification. There were 240 adolescents, aged 13–18 years, with an even split between the genders. Results from this study suggested that the majority of Indian youth adopted integration strategies as opposed to Pakistani Muslims who adopted a separation strategy. Cultural identity is a term used to include both ethnic and national identities. Ethnic identity scores were high for Indian and Pakistani adolescents. National identity was more important for Indian adolescents but ethnic identity was more important than national identity for all groups. Perceived discrimination was related to acculturation strategies.     

Psychosocial,Motivational, and Contextual Profiles of Youth Reporting Different Patterns of Substance Use During Adolescence

This research examined patterns of substance use and academic factors among a sample of 733 African‐American and European‐American adolescents from a metropolitan area. First, youth were classified into 11th grade high, moderate, or no substance use groups and classified as users, initiators, desistors, and nonusers based on eighth and 11th grade use. Nonusers did not differ in eighth grade from 11th grade moderate users and initiators over time. Eighth graders who reported misbehavior and having low‐achieving friends were more likely to be high 11th grade users and users at both grades. Direct achievement effects were not found; however, interactions indicated achievement was protective when paired with having fun at school, high task value, and low levels of socioeconomic status (SES); and was a risk factor when paired with positive self regard, low fun at school and high SES. Cluster analyses indicated the most prevalent group of substance users reported high grades, social reasons for going to school, and having friends who do well in school.     

Preventing substance abuse and relationship violence: Proof-of-concept evaluation of a social,multi-user,tablet-based game

Increasing evidence suggests that using technology and Internet-based methods in prevention programming can be an efficacious delivery practice. This literature implies that applying digital technologies to prevention may provide a unique opportunity to carry out interventions with reliability and in a manner that is more appealing and suitable to youth. This exploratory study reports on a proof-of-concept evaluation of Choices & Consequences, a substance abuse and relationship violence prevention program that integrates digital technologies and devices with game-based behavior change techniques. Six focus groups (N = 44) were conducted with youth living in a Southwestern city. Results suggest that youth preferred various aspects of this prevention game to traditional methods. They especially liked that the game was engaging and that they were able to learn in both formal and informal environments, that is interacting with each other and a facilitator or playing the game on their own. Results also found that youth learned many lessons while playing the game and they believe the game may help prevent substance abuse and relationship violence among the target population of early adolescents. Thus, this research suggests that prevention programs for youth that combine interactive methods, mobile technology, social networking, and competitive gaming could be a strong alternative to traditional delivery methods.