African American Adolescent Females Research Articles

“They're scared that somebody's gonna judge them”: Female African American youth in foster care's perspectives on sexual and reproductive health communication with caregivers

BackgroundObtaining accurate information is critical for youth's sexual and reproductive health (SRH). Youth not in foster care often learn about SRH from their biological parents. Separated from their biological parents, youth in care depend on healthcare providers and caregivers for SRH information. However, they often receive insufficient information and feel unsupported in meeting their needs for SRH information. PurposeThis study explored female African American adolescents in foster care's perspectives on effective SRH communication with caregivers to help them avoid sexual risks. MethodsA qualitative study was conducted using semi-structured interviews. We used purposive sampling to recruit 16 adolescents aged 18 to 20 years old with a history of foster care placement. The transcribed interviews underwent inductive thematic analysis. The Positive Youth Development theory underpinned this research. ResultsTwo prominent themes emerged: establishing a relationship and preferred communication approach. Youth reported that for caregivers to engage in effective SRH communication, they must first establish a relationship by being aware of the youth's childhood trauma, building trust, having patience, and being vulnerable. Youth also appreciated caregivers who ensured comfortability and were honest and straightforward. DiscussionCaregivers should be trained on adverse childhood experiences, trauma-informed approaches, SRH knowledge, and communication. Implications to practiceHealthcare providers should make use of the time spent with youth and discuss SRH topics during clinical encounters. This time spent with youth may be their only chance to obtain accurate SRH information. Youth's perspectives regarding communication about SRH should be implemented in future SRH communication interventions.

Exploring African American Adolescent Females’ Sexual Health Beliefs: A Qualitative Secondary Data Analysis

Purpose The aim of this study was to gain insight into the sexual beliefs of African American adolescent females and yield greater evidence for reframing the methods used to communicate sexual health education information to educators. Design and methods This is a secondary data analysis of a qualitative descriptive study. One-on-one interviews were conducted with 36 African American females ages 12–14. The qualitative data were analyzed using exploratory deductive thematic analysis. Results Three themes emerged from the analysis: (a) perceptions of sexual health education, (b) threat of adverse sexual health outcomes, and (c) perceptions of condom usage. Overall, adolescents had basic sexual health knowledge and accurately appraised their risk for adverse sexual health outcomes. Many adolescents perceived the biggest disadvantage of condom usage was condom ineffectiveness. The greatest barrier to condom usage was male opposition. Adolescents perceived the threat of adverse sexual health outcomes, but the perceived benefits of condom usage in preventing pregnancies and STIs may not outweigh the disadvantages and barriers described by the adolescents. Conclusion The adolescents in this study had knowledge about pregnancies and STIs but lacked the skills necessary to enact safer sex practices.

Role of Taste Receptor Gene Variations (SNPs) on Diet Quality in Adolescent Females

The prevalence of pediatric obesity has increased over the past 40 years and the rate in females 6 to 19 years old is currently over 19%. This profound increase in obesity is predicted to negatively impact health and result in multiple obesity‐related comorbidities in adulthood. Obesity disproportionately affects ethnic minorities with a higher percentage of adolescent African‐American females (~29%) with obesity compared to non‐Hispanic, white females (~15%). The overconsumption of highly palatable, energy dense, foods are linked to obesity and single nucleotide polymorphisms (SNP) from taste genes are linked to alterations in taste perception and food choices. SNPs are associated with higher rates of obesity and altered fat perception (CD36; fat), higher caloric intake from sugar (TAS1R2; sweet) and increased energy intake (TAS2R38, bitter). An enhanced understanding of genetic, environmental, and behavioral factors contributing to excess weight in adolescents is paramount. Therefore, the goal of the current study was to investigate the intersection of genotype (rs1761667 of CD36 (AA), rs35874116 of TAS1R2 (TT) and rs713598 of TAS2R38 (CC)) and phenotype on diet intake and quality in adolescent African‐American and white females. Genotype was determined by allelic discrimination assay in females (10‐16 years old; n=142) enrolled in the Translational Investigation of Growth and Everyday Routines in Kids (TIGER Kids) Study. Anthropometrics and 24‐hour dietary recalls were conducted for each participant and Healthy Eating Index (HEI) scores, a measure of diet quality, were calculated. The effect of race and genetic variation was assessed using a two‐way ANOVA. Based on allelic discrimination assays, the expression rates of CD36 AA, TAS1R2 TT and TAS2R38 CC in white females (27.7%, 45.0%, 38.3%, respectively) and African‐American females (15.3%, 37.3%, 31.0%, respectively) were determined. Preliminary results indicated that BMI percentiles were higher in African‐American females across all genotypes (p<.05) and moderately affected by TAS2R38 genotype (p<.06). CD36 and race differentially affected HEI for added sugar, total vegetable, greens and beans, whole grain, seafood and plant protein and total HEI, (p<.05). TAS1R2 and race differentially affected HEI‐added sugar (p<.05). TAS2R38 significantly affected HEI‐sodium and total protein (p<.05) and TAS2R38 and race differentially affected HEI for total vegetables, fruits, and whole fruits (p<.09). Fat and sugar intake (g) were positively correlated with SNPs previously associated with altered fat perception (CD36 AA), sugar intake (TAS1R2 TT) and overall energy intake (TAS2R39 CC) in white (p<.05), but not African‐American females, suggesting that the effects of taste receptor SNPs on the relationship between fat and sugar intake differs by race. Overall, the results from these analyses support the intersection between race and genetic variation on HEI, and suggest that SNPs in taste receptor genes differently affect diet quality in adolescent females. Further understanding of the role of taste receptor SNPs on food choices and diet quality is needed to better tailor dietary interventions in the pediatric population.

The Influence of Colorism on the Hair Experiences of African American Female Adolescents

This article addresses the prevalence of colorism among the hair care narratives of African American female adolescents. Eleven interviews were conducted to explore the connection between hair and sense of self and self-esteem. During data collection and analysis, the theme surrounding colorism emerged, as many participants discussed its influence on hair, recalling traumatic hair and colorist experiences. This article focuses on the analysis of these narratives using the colorist-historical trauma framework. Three themes emerged: (1) colorist experiences; (2) perceptions of good hair; and (3) the influence of White beauty standards. These themes reflect how participants conceptualized the implications of colorism and its impact on their psychosocial and emotional well-being. The article highlights how colorism is embedded in their lived experiences and how participants combated the presence of colorism perpetuated by family, peers, and society, to embrace their identities. The article outlines the implications of collective efforts to decolonize hair and promote healing and liberation through actions such as the natural hair movement, legal efforts to protect hairstyle preferences in schools and the workplace, and overall awareness of the perception of Black women in media. It also discusses shifts in attitudes, perspectives, and beliefs regarding hair among younger generations.

“I'm not Gonna Die Because of an STD”: Female African American Adolescents' Perspectives on how they Protected Themselves from Sexual Risks While in Foster Care

PurposeYouth in foster care are at greater risk for engaging in sexual behaviors that increase their odds of experiencing negative sexual and reproductive health (SRH) outcomes. The purpose of this qualitative study was to describe challenges faced by female African American adolescents in foster care as they tried to protect themselves from SRH risks and protective beliefs and behaviors to avoid these risks. Design and methodsSemi-structured interviews were conducted with 16 female African American adolescents, ages 18–20 years, with a history of foster care placement during adolescence. Purposive sampling was done to recruit participants from a metropolitan area in Virginia. Transcribed interviews underwent inductive thematic analysis. This paper focuses on the theme of protection from SRH risks and its subthemes of challenges that made it difficult to avoid sexual risks and protective beliefs and behaviors that facilitated avoidance of those risks. ResultsParticipants reported yearning for connection, partners' desire to not use condoms, and judgmental caregivers as challenges. Protective beliefs and behaviors included open communication with their caregivers about SRH, abstinence, contraceptive use, and participants' desire to be healthy. ConclusionsStudy findings shed light on protective beliefs and behaviors female youth in foster care used to safeguard themselves from negative SRH outcomes. Youth at times lacked agency in sexual decision-making and contraceptive use. Practice implicationsFindings highlight the importance of sexual relationships and partner communication related to contraceptive use, and offering trauma-informed interventions, including culturally sensitive counseling regarding long acting reversible contraception.

Using ADAPT-ITT to Modify a Telephone-Based HIV Prevention Intervention for SMS Delivery: Formative Study.

BackgroundAfrican American adolescent females are disproportionately affected by sexually transmitted infections (STIs) and HIV. Given the elevated risk of STIs and HIV in African American women, there is an urgent need to identify innovative strategies to enhance the adoption and maintenance of STI and HIV preventive behaviors. Texting is a promising technology for creating preventive maintenance interventions (PMIs) that extend the efficacy of the original intervention. However, little guidance in public health literature is available for developing this type of application.ObjectiveThis paper describes a formative pilot study that incorporates user experience methods to design and test PMI texts for Afiya, an original evidence-based intervention (EBI) specifically designed for African American adolescent females. This study aims to describe the adaptation process of health educator–led phone calling to text-based communication.MethodsThe formative process followed the assessment, decision, adaptation, production, topical experts-integration, training, testing (ADAPT-ITT) framework for adapting EBIs and using them in a new setting, for a new target population or a modified intervention strategy. This study presents the details of how the phases of the ADAPT-ITT framework were applied to the design of the adaptation. An advisory board was constituted from the target population, consisting of 6 African American women aged 18-24 years, participating in formative activities for 12 weeks, and involving components of the PMI design. As Afiya included a telephone-based PMI, developers of the original Afiya phone scripts crafted the initial design of the SMS-based texts and texting protocol. The advisory board participated in the 1-day Afiya workshop, followed by 4 weeks of texting PMI messages and a midcourse focus group, followed by 4 more weeks of texting PMI messages, ultimately ending with a final focus group. At the advisory board’s request, this phase included an optional, additional week of text-based PMI messages.ResultsThe methods provided a rich source of data and insights into the fundamental issues involved when constructing SMS-based PMI for this target population and for this EBI. Prior contact and context are essential as the health educator was identified as a key persona in the process and the messages were situated in the original (workshop) context. Narrative adaptations for personas emerged from advisory board discussions. Suggestions on how to expand the PMI to current, specific social contexts indicated that the use of narrative analysis is warranted.ConclusionsThe use of existing EBIs incorporating telephone-based PMI scripts facilitated the initial design of the texts, with a subsequent narrative analysis of the advisory board data providing additional adjustments given the actual context. Additional examination of the advisory board feedback revealed that personas would offer insight into and opportunities for a persona-specific modification of texting narratives.

“It was only me against the world.” Female African American Adolescents’ perspectives on their sexual and reproductive health learning and experiences while in foster care: Implications for positive youth development

Female African American adolescents experience high rates of sexually transmitted infections and unintended pregnancies. However, little is known about the sexual and reproductive health (SRH) needs of youth in foster care. This study explored the experiences of female African American/Black youth in foster care related to their SRH disparities and needs. The purposive sample was 16 female adolescents, ages 18–20 years old, with a history of foster care placement. Participants were recruited from a metropolitan area in Virginia. This study used a qualitative descriptive design with semi-structured in-depth interviews lasting an average of 1 h. The transcribed interviews underwent inductive thematic analysis, and four prominent themes emerged: caregiver barriers, facilitators, sources of information, and recommendations for caregivers. Results indicated that youth felt unsupported, relied on their strengths to seek information related to SRH, and provided their advice on communication about SRH with youth. The findings from this study will provide direction on how caregivers, health-care workers, social services staff, and community members can better support the SRH needs of young women in foster care.

Meeting Kids Where They Are At-A Substance Use and Sexual Risk Prevention Program via Telemedicine for African American Girls: Usability and Acceptability Study.

BackgroundRural African American youth lack access to drug and sexual risk–taking prevention programs available in more urban areas. Recent data indicate that rural youth now use substances at higher rates and at younger ages than their urban peers.ObjectiveThis study aims to evaluate the initial usability and acceptability of a low-cost, technology-based approach to delivering effective, culturally tailored, integrated substance use disorder (SUD) and HIV risk behavior prevention programs to African American female youth to inform the use of this intervention via telemedicine for rural youth.MethodsEffective SUD prevention strategies and emotion regulation skills were integrated into an existing evidence-based HIV risk reduction program culturally tailored for African American female adolescents—Sisters Informing, Healing, Living, and Empowering (SIHLE)—and delivered to 39 African American female youth via group telehealth. The evaluation of the resulting program, 12-session SIHLEplus, was completed by 27 girls who also completed self-report measures that assessed sexual risk behaviors (eg, number of partners and age of sex initiation), substance use, exposure to traumatic events, and emotion regulation.ResultsThe descriptive and qualitative results of the pilot study demonstrate the initial usability and acceptability of delivering evidence-based prevention successfully via telehealth to help address health disparities in this vulnerable population.ConclusionsAlthough more research is needed, the findings from this study suggest that SIHLEplus has demonstrated initial usability and acceptability.

Reproductive Coercion Among African American Female Adolescents: Associations with Contraception and Sexually Transmitted Diseases.

Background: Among adolescents, racial disparities in reproductive health outcomes persist. The question of whether reproductive coercion (RC) influences these outcomes has received increased attention. Little is known about whether RC is independently associated with contraceptive use and having a sexually transmitted disease (STD) among African American female adolescents. Materials and Methods: Survey data for self-identified African American young women 14-19 years of age (n = 735) who accessed services at a publicly funded clinic were used to assess the extent of RC, the association between RC and other forms of intimate partner violence (IPV), and whether RC was independently associated with contraceptive use and an STD diagnosis. Results: Approximately 20% of participants had experienced RC; there was a statistically significant bivariate association between RC and other forms of IPV. In multivariate analyses, experiencing two or more forms of RC (vs. not experiencing any RC) was associated with reduced odds of contraceptive use in the past 3 months (adjusted odds ratio [aOR] = 0.46; 95% confidence interval [CI] = 0.24-0.76) and with increased odds of having an STD (aOR = 2.43; 95% CI = 2.35-4.37). Experiencing only one type of RC and experiencing other forms of IPV were not associated with the outcomes. Although ease of partner communication (aOR = 0.94; 95% CI = 0.80-0.98) was associated with having an STD, few other psychosocial variables were associated with the outcomes. Conclusions: RC is associated with reduced contraceptive use and increased STDs among African American adolescent women. Interventions to prevent and respond to RC that engage adolescent women and men are needed.

Changes in externalizing and internalizing symptoms among African American female adolescents over 1 year following a mother-daughter sexual health intervention.

African American female adolescents face disparities compared with White peers in the interrelated areas of mental health symptoms and sexually transmitted infection (STI) acquisition. IMARA (Informed, Motivated, Aware and Responsible about AIDS) is a group-based mother-daughter intervention addressing these factors among African American teenagers. Previous work demonstrated that female adolescents who received IMARA were 43% less likely than controls to evidence a new STI at 1 year. This report aimed to provide the 1st test of IMARA on externalizing and internalizing symptoms and an exploratory analysis of whether symptom improvements were associated with the protective effect of treatment against future STIs. Female African Americans aged 14-18 years (M = 16; N = 199) were randomly assigned to IMARA or a health promotion control group matched for time and structure. They completed the Youth Self-Report of externalizing and internalizing symptoms at baseline and at 6 and 12 months and were tested for STIs at baseline and 12 months; positive cases were treated. Hierarchical linear modeling tested symptom change over time, including the moderating effects of baseline symptoms. Among participants who entered with high versus lower externalizing symptoms, those who received IMARA showed a slightly greater decrease in externalizing scores relative to the control (p = .035). For these youth, symptom improvements appeared to be associated with IMARA's protective effect against new STIs. Treatment was not associated with internalizing symptom change (p > .05). IMARA shows promise in modestly reducing self-reported externalizing symptoms, although only for participants with high scores at baseline. The possibility that externalizing symptom improvement is linked with reduced STI acquisition warrants future examination. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Think Inside the Box: the Heterogeneity of "in Risk" Among "at Risk" Female African American Adolescents in North Carolina.

An abundance of research investigates the health of often referred to as "at risk" or "high risk" youth from underserved communities and usually racial/ethnic minorities. These ubiquitous terms relate to poverty, violence, and unsafe behaviors (e.g., sex without condoms, alcohol, and drug use). This analysis distinguished the heterogeneity of risks among African American female adolescents recruited for an intervention study from underserved communities in North Carolina. Eligibility included: ages 16-19, considered or dropped out of school, never completed high school, and during the past 3months had sex with a male partner and used drugs or alcohol. A variable was created to represent the continuum of risk comprised of history of homelessness, or trading sex, or current heavy alcohol and marijuana use. Participants fell into 0, 1, or 2-3 categories. Ordinal logistic regression estimated the odds of adverse poor outcomes by category. Linear regression estimated reduction in material and emotional support by category. Of the 237 participants, 59.5%, 27.8%, and 12.7% were in 0, 1, or 2-3 categories, respectively. Relative to adolescents in 0 categories, participants in other categories were more likely to report food insecurity (OR = 3.27, 95%CI [1.8, 5.94]); past arrest (OR = 3.56 [2.08, 6.09]); run away (OR = 3.30 [1.79, 6.10]); multiple sex partners (2.97 [1.61, 5.48]); and vaginal/anal sexual abuse (OR = 3.21[1.73, 5.96]). Material and emotional support was significantly lower for participants in 2-3 risk categories. Vague use of "at risk" fails to recognize the heterogeneity of experiences and needs of underserved African American youth.

Do African American Male and Female Adolescents Differ in Technological Engagement?: The Effects of Parental Encouragement and Adolescent Technological Confidence

African Americans, especially African American women, remain one of the most underrepresented groups in technology-based degrees and careers. However, little is known about whether gender differences permeate African American adolescents’ engagement in technology in earlier development, such as in middle and high school (ages 12–18). Drawing on an ecological and intersectional framework, we examined if African American male and female adolescents differed in technological engagement and what contextual factors affected their engagement. We hypothesized that parental encouragement would be associated with greater technological confidence in adolescents, which would be linked to more experiences with and interests in technology. Further, we investigated if these associations would vary by adolescents’ and parents’ gender. Survey data from 1041 African American parent-adolescent dyads highlighted that adolescents had less experience and interest with technical activities than with creative activities, especially among female adolescents. More parents encouraged adolescent sons but limited daughters to use technology, yet female adolescents reported greater technological confidence. Moderated mediation analyses revealed that adolescents’ technological confidence mediated the positive association between parental encouragement and adolescents’ technological engagement across all parent-adolescent dyads, but with some nuances. Our findings suggest that prospective gender studies and educational programs should consider the influences of parenting and gender on promoting African American adolescents’ technological involvement and confidence.

217. “I'm Not Gonna Die Because of an STD”: Female African American Adolescents’ Perspectives on How they Protected Themselves from Sexual Risks While in Foster Care

Vulnerable youth with a history of adverse childhood experiences (ACEs) are at greater risk for negative sexual and reproductive health (SRH) outcomes. Many of these youth are placed into foster care and lack supportive relationships to help them navigate life. Researchers tend to focus on adolescents’ deficits and do not often seek youths’ perspectives about their strengths. The purpose of this qualitative descriptive study was to explore and describe how female African American youth with a history of foster care placement protect themselves from SRH risks from their perspectives.

A longitudinal examination of African American adolescent females detained for status offense

IntroductionBehaviors like truancy, running away, curfew violation, and alcohol possession fall under the status offense category and can have serious consequences for adolescents. The Juvenile Justice and Delinquency and Prevention Act prohibited detaining status offenders. We explored the degree to which African American adolescent girls were being detained for status offenses and the connections to their behavioral health risks and re-confinement. Methods188 African American girls (aged 13–17), recruited from detention facilities, were surveyed at baseline and 3-month follow-ups. Logistic regression models estimated the likelihood of longitudinal re-confinement, controlling for sexual and behavioral health risk factors. ResultsOne third of the overall sample was detained for a status offense. Status offenders were exposed to higher peer risk profiles. At follow-up, nearly 39% of status offenders reported re-confinement. Compared to youth with other offenses, those who violated a court order (type of status offense) were 3 times more likely to be re-confined. Controlling for sexual and behavioral health risk factors, the odds of re-confinement was not statistically significant. ConclusionOverall findings suggest that courts and detention facilities must devote specialized resources to addressing the socio-behavioral needs of African American girls with status offenses so as not to use detention as an intervention.

Asthma status moderates the relationship between neighbourhood disadvantage and obesity in African American adolescent females.

SummaryIntroductionSignificant health disparities exist in asthma and obesity for African American youths. Successful interventions present an opportunity to address these disparities but require detailed study in order to ensure generalizability. This study investigated the intersection of obesity, neighbourhood disadvantage, and asthma.MethodsData were extracted from 129 African American females ages 13 to 19 years (mean = 15.6 years [SD = 1.9]). Obesity was measured via body mass index (BMI). Asthma status was based on clinical diagnosis and/or results of the International Study of Asthma and Allergies during Childhood (ISAAC) questionnaire. The concentrated disadvantage index (CDI) assessed neighbourhood disadvantage.ResultsFindings showed that 21.5% (n = 28) of participants were clinically defined as having asthma, 76.2% (n = 99) had obesity, and 24.9% (n = 31) were classified without obesity. The mean BMI was 35.1 (SD = 9.1) and the mean CDI was 1.0 (SD = 0.9). CDI and obesity were significantly associated in participants without asthma, but not in those with asthma. Multivariable linear regression results showed a significant interaction between CDI and asthma (t value = 2.2, P = .03).ConclusionIn sum, results from this study found that asthma moderated the relationship between neighbourhood disadvantage and obesity.

Promoting the Resiliency of African American Teens Experiencing Ambiguous Loss

ABSTRACTA disproportionate number of African American youth experience childhood adversity and situations of loss, including parental incarceration and divorce, while navigating racial discrimination. Ambiguous loss theory offers a conceptual framework to understand these experiences as losses of relationships, stability, and social validation due to parental behaviors. Theoretically and culturally informed interventions are needed to help adolescents cope with ambiguous loss. This article describes a psychoeducational group intervention for female African American adolescents experiencing ambiguous loss that aims to promote resilience and coping rather than promote closure following loss.

A Cross-Sectional Study to Understand 3D Facial Differences in a Population of African Americans and Caucasians.

Objective The purpose of this cross-sectional retrospective study was to use three-dimensional surface imaging to determine gender dimorphism and facial morphological changes from adolescence to adulthood in African American and Caucasian populations. Materials and Methods Three-dimensional images were captured and the total sample size included 371 subjects. Images were combined using Rapidform 2006 Plus Pack 2 software to produce a male and female facial average for each population. Comparisons were conducted within the following categories: (1) gender comparison within each race, (2) adult and adolescent comparison within each race, and (3) adult and adolescent comparison between the races. Results Adolescent gender comparisons within each race showed high percentages of similarity. However, adult females in both races showed more prominent periorbital, malar, and nasolabial regions and less prominent lower forehead, nose, and lower face compared with adult males of the same race. African American adult females showed increase in length and width of the face, increased nasal tip projection, and decreased periorbital regions compared with African American adolescent females. Welsh adult females had an increase in the nose and chin projection compared with Welsh adolescent females. Adult males of both races had increase in nose and chin projection, increase in length and width of the face, and decreased periorbital, malar, and nasolabial regions compared with adolescent males of the same race. African American adolescents had a wider alar base, more protrusive lips, and periorbital regions, and less prominent nose and chin compared with the Welsh adolescents. African American adults also had a wider alar base; more protrusive lips and periorbital regions; a broader face; and more retrusive chin, nose, nasolabial region; and lower forehead compared with Welsh adults. Conclusions Few differences were noted between genders within the same racial groups during adolescence. However, changes became more distinct in adulthood. From adolescence to adulthood, facial morphologies were similarly matched within the gender for females; however, there were significant changes for males. Lastly, facial morphology patterns tend to be established early in life.

Sexual Decision-Making and African American Adolescent Females

The aim of this research was to explore the factors that influence the sexual decision-making process of African American female adolescents. The phenomenological research design was grounded in black feminist theory to capture the lived experiences of the phenomenon. Data was collected during semi-structured interviews with twelve participants. Bracketing of researcher assumptions was used to demonstrate dependability, credibility, and coherence of the data reduction and analysis. Open coding allowed the researcher to generate a list of broad domains to create a codebook. The researcher used a recursive method of data collection and analysis; the codebook guided independent coding of each transcribed interview. Themes that described the factors that impact the sexual decision-making process of African American adolescent females emerged and included: (a) peer relationships; (b) media influence; and (c) the mother–daughter relationship. Practice and research implications for school counselors and researchers regarding the factors that influence the decision-making of adolescent girls of color are discussed.

Community Violence Exposure, Sleep Disruption, and Insulin Resistance in Low-Income Urban Adolescents.

Exposure to violence, which is experienced at disproportionally higher levels by black versus white youth, is associated with disruptions in sleep and elevated cardiovascular risk. Further, poor sleep hygiene is associated with insulin resistance. However, research to date examining disruptions in sleep and cardiovascular risk in African-American adolescents has not taken the impact of exposure to violence into account, nor considered how gender might affect patterns of association. The present study addressed this gap by testing a path model linking exposure to community violence, sleep disruption, and insulin resistance in a sample of African-American adolescents and evaluating model fit across gender. African-American adolescents (N = 107; 56% female; Mage = 14.29, SD = 1.17) completed structured interviews at home and provided a blood sample after fasting overnight. The model fit connecting exposure to violence with sleep disruption and insulin resistance, adjusting for depressive symptoms and body mass index z score, was excellent. Multiple group analysis indicated gender differences in model fit. Path analysis revealed significant positive associations between exposure to violence and sleep disruption and sleep disruption and insulin resistance for females but not males. These data indicate that low-income, urban African-American female adolescents who witness violence and experience sleep disruptions may already be at elevated risk for health problems compared with their male counterparts. Additional research should attempt to replicate and explicate the underlying reasons for the gender differences observed here, with the goal of improving health and disrupting the path leading to health disparities.

Marijuana Use and Depressive Symptoms; Gender Differences in African American Adolescents.

Introduction: This study aimed to examine gender differences in the bidirectional associations between marijuana use and depressive symptoms among African American adolescents. The study also tested gender differences in the effects of socioeconomic status, maternal support, and friends’ drug use on adolescents’ depressive symptoms and marijuana use.Methods: This is a secondary analysis of the Flint Adolescent Study (FAS). Six hundred and eighty one African American adolescents (335 males and 346 females) were followed for 3 years, from 1995 (mean age 16) to 1997 (mean age 19). Depressive symptoms (Brief Symptom Inventory) and marijuana use were measured annually during the follow up. We used multi-group latent growth curve modeling to explore the reciprocal associations between depressive symptoms and marijuana use over time based on gender.Results: Baseline marijuana use was predictive of an increase in depressive symptoms over time among male but not female African American adolescents. Baseline depressive symptoms were not predictive of an increase in marijuana use among male or female adolescents.Conclusion: Study findings suggest that male African American adolescents who use marijuana are at an increased risk of subsequent depressive symptoms. Interventions that combine screening and treatment for marijuana use and depression may be indicated for African American male adolescents.