Perceived discrimination,traditional practices,and depressive symptoms among American Indians in the upper midwest

American Indian adults are thought to experience significant depressive symptoms at rates several times higher than adults in the general population, yet we know very little about factors associated with depressive symptoms among this under studied group. Many researchers have argued that depressive symptoms are associated with conflicts between American Indian traditional cultural values, practices, and beliefs and those of the majority culture. This report, based on a sample 287 American Indian adults from the upper Midwest, takes into account two measures of cultural effects: perceived discrimination, as one indicator of culture conflict, and traditional practices, as a measure of cultural identification. The results indicate that discrimination is strongly associated with depressive symptoms among American Indian adults and that engaging in traditional practices is negatively related to depressive symptoms. Moreover, interaction effects between perceived discrimination and traditional practices indicate that engaging in traditional practices buffers the negative effects of discrimination among those who regularly participate in them.     

Gender and racial/ethnic differences in predicting adolescent sexual risk: athletic participation versus exercise

Though often conflated, informal physical exercise and organized athletic participation have very different implications for adolescent sexual risk outcomes. The purpose of this research is to disaggregate strenuous exercise from sports, examine how each is associated with sexual risk, and explain the observed differences using the conceptual lens of cultural resource theory. Using a nationally representative sample of over 16,000 public and private high school students, we employ logistic regression to test hypotheses about the gender-specific and race-specific effects of strenuous exercise and athletic participation on adolescent sexual risk behavior. The results show that both forms of physical activity buffer sexual risk for girls. Strenuous exercise is associated with increased odds of sexual risk for boys. Sports and race interact to influence boys' sexual risk outcomes: Athletic participation is associated with lowered odds of sexual risk for white male adolescents, but heightened odds of sexual risk for black male adolescents.     

Quality improvement in patient distribution at a major university student health center

Healthcare in a major university setting poses unusual challenges and great opportunities. Two traditionally challenging areas in patient distribution are the initial intake of allergy/immunization patients and the triage of outpatients in the general medical clinic. The authors describe the use of the FOCUS-PDCA quality improvement (QI) problem-solving process for each situation. After identifying major problems, the health center established cross-functional teams of experts representing the allergy/immunization and general medical clinics. The teams analyzed the problems with a flow chart and undertook studies to further elucidate causes and potential solutions. They listed potential solutions in order of priority and submitted them to the student health center director for review and initiation. Each team then used the PDCA (plan-do-check-act) cycle to put approved solutions into effect. Permanent improvements made in each area resulted in a more effective and efficient patient distribution system, favorable staff comment, and greater patient satisfaction.     

Mining the Data: Analyzing the Economic Implications of Mining for Nonmetropolitan Regions

Extractive industries such as logging and mining are generally expected to bring significant economic benefits to rural regions, but a growing number of findings have now challenged that common expectation. Still, it is not clear whether the findings of less–than–desirable economic outcomes are isolated or representative. In this article, we assemble literally all of the relevant quantitative findings on mining that we have been able to identify in published and/or technical literature from the United States. In the interest of rigor, we limit the assessment to cases in which strictly nonmetropolitan mining regions are compared against other nonmetropolitan regions and/or against those regions’ own experiences over time. Overall, 301 findings meet the criteria for inclusion. Contrary to the long–established assumptions, but consistent with more recent critiques, roughly half of all published findings indicate negative economic outcomes in mining communities, with the remaining findings being split roughly evenly between favorable and neutral/indeterminate ones. Positive findings are more likely to be associated with incomes than with poverty or (especially) unemployment rates, and they are more likely to come from the western United States, where much of the mining involves relatively large, new coal strip mines. Over half of all positive findings come from the years prior to 1982. In virtually all other categories, the plurality or majority of findings have been negative. When the patterns of findings are subjected to one–sample means tests, the only way to produce a significantly positive outcome is by combining all neutral/indeterminate findings with the positive ones, while focusing exclusively on incomes; by contrast, in the case of poverty or unemployment rates—as well as for the overall body of findings—the results are consistently and significantly negative, whether the neutral/indeterminate findings are combined with negative ones or omitted from the equations altogether. Until or unless future studies produce dramatically different findings, there appears to be no scientific basis for accepting the widespread, “obvious” assumption that mining will lead to economic improvement.     

Measures of Multigroup Segregation

In this paper we derive and evaluate measures of multigroup segregation. After describing four ways to conceptualize the measurement of multigroup segregation—as the disproportionality in group (e.g., race) proportions across organizational units (e.g., schools or census tracts), as the strength of association between nominal variables indexing group and organizational unit membership, as the ratio of between–unit diversity to total diversity, and as the weighted average of two–group segregation indices—we derive six multigroup segregation indices: a dissimilarity index (D), a Gini index (G), an information theory index (H), a squared coefficient of variation index (C), a relative diversity index (R), and a normalized exposure index (P). We evaluate these six indices against a set of seven desirable properties of segregation indices. We conclude that the information theory index H is the most conceptually and mathematically satisfactory index, since it alone obeys the principle of transfers in the multigroup case. Moreover, H is the only multigroup index that can be decomposed into a sum of between– and within–group components.     

Selected health behaviors that influence college freshman weight change

OBJECTIVE AND PARTICIPANTS: The authors investigated the effect of physical activity (PA), fruit and vegetable intake, and alcohol use on 6-month weight change in 193 college freshmen (78.8% white, 88.2% women, 94.5% on a meal plan). METHODS: The authors administered a Web-based survey in fall 2002 (baseline) and spring 2003 (follow-up). RESULTS: There was an overall average weight gain of 2.5 lbs (p < .05), although only 57% reported weight gain (M = 7.1 lbs). Fruit and vegetable intake decreased (p = .034), alcohol use increased (p > .05), and PA was unchanged. Weight gain for students with body mass indexes (BMI) > or =25 kg/m2 was nearly twice that of students with BMIs < 25 (p < .05). Students with low-frequency baseline PA were twice as likely to be overweight. Follow-up data showed that students reporting > or = 4 sessions per week (ie, high frequency) of low-intensity PA were twice as likely to have healthy BMIs as students engaging in low- and moderate-frequency PA. CONCLUSIONS: PA interventions should target freshmen with BMIs > or = 25.     

Condom use negotiation in heterosexual African American adults: responses to types of social power-based strategies

This study examined gender differences and preferences in the use of and response to six different styles of condom use negotiation with a hypothetical sexual partner of the opposite gender. Participants were 51 heterosexually active African American adults attending an inner-city community center. Participants completed a semistructured qualitative interview in which they were presented with six negotiation strategies based on Raven's 1992 Power/Interaction Model of Interpersonal Influence. Results showed that female participants responded best to referent, reward, and legitimate strategies, and worst to informational tactics. Male participants responded best to reward strategies, and worst to coercion to use condoms. Further, responses given by a subset of participants indicated that use of negotiation tactics involving coercion to use condoms may result in negative or angry reactions. Response to strategies may vary with the value of the relationship as viewed by the target of negotiation. Implications for HIV prevention efforts are discussed.     

African American males in foster care and the risk of delinquency: the value of social bonds and permanence

Juvenile delinquency remains a significant problem for child welfare systems throughout the United States. Victims of child abuse and neglect are more likely relative to children in the general population to engage in delinquency (Ryan & Testa, 2005; Widom, 1989). Although the magnitude of this relationship is not fully understood (Zingraff, Leiter, Myers, & Johnsen, 1993), the risk of delinquency is particularly high for African American males, adolescents, and children in substitute care settings. Unfortunately little is known about the factors that connect the experiences of maltreatment and delinquency. This lack of knowledge makes it nearly impossible to decrease the risk of delinquency for children in foster care. To improve the understanding of juvenile delinquency in the child welfare system, the current study tests aspects of social control theory within the context of foster care. We focus specifically on the effects of foster parent-foster child attachment, commitment, and permanence. The results indicate that strong levels of attachment decrease the risk of delinquency for youth in foster care. Involvement with religious organizations also decreases the risk of delinquency. In contrast, perceptions of placement instability, placement with relatives, and school suspensions are associated with an increased risk of delinquency.     

Predicting ecstasy use among young people at risk: a prospective study of initially ecstasy-naive subjects

Our aim is to identify predictors of first-time ecstasy use in a prospective study among young people at risk. As part of the multidisciplinary Netherlands XTC Toxicity Study (NeXT), we monitored 188 subjects aged > or = 18 who were ecstasy-naive at baseline but seemed likely to start taking ecstasy in the near future. After an 11- to 26-month follow-up period, 160 respondents remained (85.1%; mean age 21.0 years, 58.1% females): 65 who took ecstasy at least once (ecstasy users) and 95 non-users. At baseline and four times during follow-up, respondents completed self-report questionnaires. Cox regression analysis was used to examine the effects of baseline respondent characteristics on incident ecstasy use. Development of peer group ecstasy use was analyzed by logistic regression. Intention to use ecstasy, low education, and current weekly cannabis use independently increased the hazard rate for first ecstasy use. Although ecstasy use among peers at baseline was not a predictor, the proportion of ecstasy users with ecstasy-using peers increased markedly during the study. Our results suggest that targeted prevention activities should focus in particular on young people who have strong intentions to take ecstasy, especially if they are also regular smokers of cannabis.     

The effect of alternative staff time data collection methods on drug treatment service cost estimates

Although a limited number of service cost estimates exist, no study has evaluated how differences in the method used to collect the staff time allocation across treatment services contribute to differences in service cost estimates. Three alternative data collection methods for estimating service-level costs in methadone treatment programs were evaluated: key informants, staff surveys, and staff diaries. We analyzed data from 25 methadone clinics across the United States. Results indicate that for the three primary services offered at methadone clinics—individual counseling, group counseling, and methadone dosing—no statistically significant differences exist in the mean estimates of costs per session across programs. Of the other five services analyzed, we found no statistically significant differences in two of the mean costs per session and a small but statistically significant difference in another service. We found large and statistically significant differences in mean costs for two services, initial patient assessment and initial medical services. Although there is no gold standard available to judge which method is the best to use, we concluded that the key informant method yields more reliable cost estimates compared with the staff methods and is less burdensome to both the treatment programs and to researchers. Our findings suggest that the key informant method is the preferred method for costing substance abuse treatment services.