African American Young Adults Research Articles

Evaluation of a community-informed multimedia intervention to increase PrEP awareness and intention among African American young adults

ABSTRACT Despite the benefits of pre-exposure prophylaxis (PrEP) in preventing HIV and its potential for reducing racial/ethnic HIV inequities, PrEP remains underutilized among African Americans who may benefit from it. Factors of PrEP uptake include awareness and acceptability of this prevention strategy among this group, yet few community-informed interventions have been developed and evaluated to address these challenges. Thus, this study evaluates the effectiveness of a community-informed, six-month multimedia campaign (print, digital media, internet radio, social media) for African American young adults (age 18–29) in Louisville, Kentucky to increase PrEP awareness and PrEP use intentions. Pretest surveys, posttest surveys, and digital analytic metrics were used to determine campaign effectiveness. Logistic regressions indicate increased PrEP awareness over time (p ≤ 0.0001) and greater PrEP intention among participants reporting greater campaign affinity (p ≤ 0.05). Campaign digital analytic performance was similar to or exceeded that of industry competitors (e.g., healthcare organizations). Findings indicate that a community-informed multimedia campaign increased PrEP use intentions among those exhibiting greater campaign affinity (the extent to which participants report a favorable view of the campaign) and demonstrated similar or greater effectiveness in digital elements as industry competitors at a cost-effective price. Future studies should incorporate community-engaged approaches in developing health communication products for greater PrEP acceptability and efficiency. Trial registration: ClinicalTrials.gov identifier: NCT0355959.

Outreach for Young Adult African Americans with Risk Factors for Stroke.

Research suggests that younger adult African American people (age 18-35 years) have more than double the risk of having a stroke than White people. Stroke risk education is lacking for this cohort; there is a dearth of materials that are targeted and focused for young adult African Americans. There is also little research on developing and testing age and culturally appropriate health literate materials that may help this population better understand personal risk factors for stroke. The aim of this study was to understand factors to guide creating and disseminating plain language health messages about stroke risk awareness among young adult African Americans. African American participants age 18 years and older completed an online survey (N = 413). Descriptive statistics, one-way analysis of variance, and two-step cluster analyses were used to evaluate stroke risk awareness, perceived risk of stroke, message creation factors, and online health information seeking behavior. Open-ended survey items described modifiable and non-modifiable reasons for perceived risk of stroke. Participants reported differences on overall stroke risk factor awareness by perceived risk of stroke was significant (F[2, 409] = 4.91, p = .008) with the very low/low group (M = 1.66, p < .01), showing significantly lower overall stroke risk factor awareness compared to the moderate and high/very high groups. Both respondents who thought their stroke risk was very low/low and moderate/high/very high commented about family history (54.1% and 45.9%, respectively) as the reason and 88.2% of very low/low commented that they did not have risk factors for stroke because they were young. Cluster analysis indicated the Mostly Clear Preferences cluster was more likely to select mostly/very on positive, informational, and long-term messages and medical authority sources. The largest of three clusters reported medical sources as the highest rated source for both finding and trusting health information (47.2%, n = 195). Young adult African Americans have a scarce understanding of modifiable stroke risk factors; health education materials should focus on positive information messaging that shows a long-term result and is presented by a medical authority. We did not observe any age or sex differences among the data, which suggests different message modalities may not be needed. [HLRP: Health Literacy Research and Practice. 2024;8(1):e38-e46.].

Acute inflammation elicits decreased blood pressure but similar arterial stiffness in young African American adults.

African Americans (AA) have a higher risk for cardiovascular disease (CVD) as compared to their White (W) counterparts. CVD is characterized by increased blood pressure (BP), arterial stiffness and systemic inflammation. An acute inflammatory stimulus may explain physiological manifestations responsible for amplified CVD in AA that are not apparent at rest. The purpose of this study was to evaluate central and peripheral BP, central and local arterial stiffness, and indices of pulse wave morphology in young healthy AA and W participants in response to acute inflammation. Concentrations of the inflammatory cytokine interleukin-6 (IL-6) and measures of central and peripheral BP, central arterial stiffness (carotid-femoral pulse wave velocity (cfPWV)), local carotid arterial stiffness (β-stiffness, elastic modulus (Ep)), and indices of pulse wave morphology were assessed in 28 participants (21±2years, AA: n = 11) at baseline (BL), 24h and 48h post-inflammation. Changes in IL-6 concentrations (ΔIL-6) were significantly greater at 24h as compared to 48h post-inflammation (0.652±0.644 vs. -0.146±0.532pg/μl, P≤0.0001). Among AA participants, central and peripheral diastolic BP were significantly decreased at 24h post-inflammation as compared to BL (aortic diastolic BP: -4±4mmHg, P=0.016; brachial diastolic BP: -4±4mmHg, P=0.014). AA participants also experienced a significant decrease in central and peripheral mean arterial BP at 48h post-inflammation as compared to BL (aortic mean arterial pressure: -4±4mmHg, P=0.009; brachial mean arterial pressure: -4±4mmHg, P=0.012). Despite haemodynamic changes, there were no differences in central or local carotid arterial stiffness or indices of pulse wave morphology.

Pain Self-Management Skills, Self-Efficacy, and Help-Seeking Tendencies Among African American Young Adults With Acute Pain

Pain Self-Management Skills, Self-Efficacy, and Help-Seeking Tendencies Among African American Young Adults With Acute Pain

Pain Self-Management Skills, Self-Efficacy, and Help-Seeking Tendencies Among African American Young Adults With Acute Pain

Pain Self-Management Skills, Self-Efficacy, and Help-Seeking Tendencies Among African American Young Adults With Acute Pain

Conflicting Associations among Bioelectrical Impedance and Cardiometabolic Health Parameters in Young White and Black Adults.

The purpose of this cross-sectional evaluation was to determine the associations between raw bioelectrical impedance and cardiometabolic health parameters in a sample of young non-Hispanic White and African American adults. A total of 96 (female: 52, male: 44) non-Hispanic White ( n = 45) and African American adults ( n = 51) between the ages of 19 and 37 yr (22.7 ± 3.83 yr) completed several fasted assessments including resting systolic blood pressure (rSBP), blood glucose (FBG), blood lipids, and bioelectrical impedance spectroscopy. Bioelectrical impedance spectroscopy-derived measurements included phase angle, bioimpedance index (BI), impedance ratio (IR), reactance index (XCi), fat-free mass (FFM), FFM index (FFMi), and absolute (a) and relative (%) total body water (TBW) and extracellular (ECF) and intracellular fluid (ICF). All bioelectric variables were collected at 50 kHz other than IR (250 kHz/5 kHz). Multiple regressions were conducted and adjusted for sex, age, and body mass index. rSBP was positively, and HDL was inversely, associated with all bioelectrical impedance and absolute hydration variables (all P ≤ 0.050) other than XCi for rSBP and XCi and FFMi for HDL. rSBP ( P < 0.001) was inversely, and HDL ( P = 0.034) was positively, associated with IR. FBG was positively associated with BI, XCi, FFM, TBWa, and ECFa (all P < 0.050). Metabolic syndrome severity was positively associated with BI, FFM, TBWa, and ECFa for women (all P ≤ 0.050) and with ICFa for African American women ( P = 0.016). Given the rapid increase in the prevalence of cardiometabolic health risks among young adults and the broad use of bioelectrical impedance in practice, the conflicting associations we observed in this age group suggest that bioelectrical impedance parameters should be used with caution in the context of cardiometabolic health risks and age.

Longitudinal Associations between Homelessness and Substance Use: Investigating Demographic Differences for Young Adults in Treatment

Objective: To examine prospective, bidirectional associations between homelessness and substance use frequency among young adults receiving substance use treatment in the United States. We also investigated potential differences across demographic subgroups. Methods: Young adults (N = 3717, Mage = 20.1, 28% female, 7.3% sexual/gender minority, and 37% non-Hispanic White) receiving substance use treatment in the U.S. completed assessments at intake, 3 months, 6 months, and 12 months post-intake. Latent growth curve models with structured residuals (LGC-SR) were used to examine cross-lagged associations between homeless days and frequency of substance use and associated problems. Models were stratified by sex, race/ethnicity, and sexual and/or gender minority status. Results: Overall, days spent homeless ( μ slope = −0.19, p = 0.046) and substance use frequency ( μ slope 1 = −6.19, p < 0.001) significantly decreased during treatment, with no significant cross-lagged associations between homeless days and substance use frequency. However, results differed by race and ethnicity. For non-Hispanic White young adults, greater substance use at treatment entry was associated with steeper declines in homeless days between-persons ( ϕ standardized = −0.14, p = 0.04). For African Americans, homeless days at treatment entry were associated with greater increases in substance use between-persons ( ϕ standardized = 0.29, p = 0.04). No significant differences were found by sex or sexual/gender minority status. Conclusions: Despite overall declines in homelessness and substance use during treatment, these outcomes may unfold differently for non-Hispanic White and African American young adults. More support may be needed for African American young adults reporting homelessness at treatment entry.

Sociocultural and structural influences on HIV Pre-Exposure Prophylaxis (PrEP) Engagement and Uptake among African American Young adults

BackgroundPre-exposure prophylaxis (PrEP) demonstrates effectiveness in decreasing new cases of HIV. However, few African Americans use PrEP, despite being disproportionately impacted by HIV. Understanding the influence of sociocultural and structural factors on PrEP use among multiple priority groups of African Americans, including but not limited to men who have sex with men, may improve PrEP engagement and uptake. The social ecological model (SEM) as a framework guided the understanding of how these factors operate on multiple levels to influence PrEP use among this population.MethodsThis study derived data from the Afya PrEP study consisting of eleven focus groups (N = 63) with 18-29-year-old African American sexual and gender minority and heterosexual individuals at heightened behavioral vulnerability to HIV. We employed constructivist grounded theory processes to inductively analyze the data. A pooled kappa score of 0.90 indicated excellent inter-rater agreement.ResultsFactors impacting PrEP engagement among African American young adults included: (1) Community/social network influences; (2) medical mistrust; (3) stigma; (4) PrEP availability and accessibility, which had two sub-categories: (a) cost and (b) where to obtain PrEP; and (5) PrEP engagement strategies, which had two sub-categories: (a) current AIDS service organizations’ PrEP engagement practices and (b) recommended future PrEP engagement strategies. Categories one through three represent sociocultural factors, and categories four and five represent structural factors that influence perceptions and attitudes of African American young adults regarding PrEP.ConclusionOur study highlights sociocultural and structural factors that act as barriers and facilitators to PrEP engagement. The SEM guided the understanding of how these factors operated on multiple levels. One of the sociocultural factors, community/social network influences operated at the interpersonal level of the SEM; the other two, stigma and medical mistrust, operated at the community level. The structural factors (PrEP availability, accessibility, and engagement strategies) operated at the institutional/organizational level. Thus, multi-level interventions are warranted to improve PrEP engagement among various African American young adult priority groups.

Correlates of Psychological Distress Among African American Young Adults During the COVID-19 Pandemic

The COVID-19 pandemic disproportionately affects African Americans in the United States, including disparate rates of mortality and higher mental health consequences compared to Whites. However, African American young adults are underrepresented in the literature examining psychological distress (i.e., anxiety and depression) during the COVID-19 pandemic. Factors associated with psychological distress are important to examine among African American young adults during the pandemic to better inform culturally appropriate mental health interventions during times of increased uncertainty and isolation. The present study, grounded in the transactional theory of stress and coping, was a secondary analysis of 420 African American young adults exploring gender, age, coping, fear of missing out (FOMO), and COVID-19 news exposure as correlates of anxiety and depression. Results showed that gender, age, level of resilient coping, and experiences of FOMO were associated with psychological distress. Therefore, interventions to reduce psychological distress among African American young adults may need to focus on younger individuals and women, identify adaptive coping skills during times of significant change, and target individuals who experience FOMO.

0848 Total sleep time, wake after sleep onset, and inflammation predict obesity in young adult African Americans

Abstract Introduction Sleep is vital to maintaining psychological and physiological health. Poor sleep is associated with adverse health outcomes, including obesity. Studies have shown that African Americans disproportionately suffer from poor sleep and the adverse health outcome associated with obesity. We aimed to determine if sleep quality and peripheral inflammation are significant predictors of obesity in a young adult African American sample. Methods Participants were healthy adults with a body mass index of less than 40 between 18- 35 who self-identified as Black or African American and completed a protocol consisting of in-lab polysomnography, ambulatory monitoring and a morning blood draw. Height and weight were collected to derive body mass index (BMI). Total sleep time (TST), wake after sleep onset (WASO), sleep onset latency (SOL), and sleep efficiency (SE) were derived from in-home actigraphy. Venipuncture was used to collect blood samples within 15 minutes of awakening. Once samples were processed, interleukin-6 (IL-6) levels were detected and quantified using enzyme-linked immunosorbent assays (ELISA). Results Significant correlations were found between BMI, WASO, TST, SE, and IL-6. A forward stepwise linear regression was used to identify possible predictors of BMI out of the following candidate variables: TST, SE, WASO, and IL-6. At each step, variables were chosen according to their contribution to the model's R^2. The p-value threshold of 0.05 was used to set a limit on the total number of variables included in the final model. TST, WASO, and IL6 were the significant predictors in the final model that accounted for 26% of the variance in BMI (∆R2 = .260, p&amp;lt;.001). Regression coefficients suggest that IL-6 (β =.388), TST (β= -.234), and WASO (β=.205) predict obesity. Conclusion Total sleep time and wake after sleep onset are modifiable protective and risk factors that appear to be significant contributors to obesity in urban-residing young African Americans. Support (if any) This research was supported by the NIHLB grants R01HL087995 and R01HL136626 and to Dr. Thomas A. Mellman and NCATS grant for a Clinical Translational Science Award UL1-TR001409.

0338 A Naturalistic within and between Subjects Comparison of the effects of Cannabis on Sleep among Young Adult, African Americans

Abstract Introduction Cannabis use is increasing, despite limited knowledge of its potential benefits and adverse effects. Reducing sleep disturbance appears to be a frequent motivation for nighttime cannabis use yet its effects on sleep are poorly documented. We leveraged data from an observational study of urban residing young adult African Americans where pre-bedtime cannabis use was variably endorsed with digital ecological momentary assessment (EMA) to conduct within and between subjects’ comparisons of sleep with and without preceding cannabis use. Methods Participant were recruited from an ongoing observational study that enrolls African Americans living in urban environments. 20 participants endorsed cannabis use on some but not all nights and were included in the within subjects’ comparison. 25 participants who used cannabis on 2 or more nights were compared with 28 participants who did not endorse prebedtime substance use. Total sleep time (TST), and wake after sleep onset WASO were derived from actigraphy monitoring; sleep quality (SQ) (scale: 1 “not at all rested”-10 “very rested”) and time in bed (TIB) were obtained from the EMA. Results While TST and WASO were very similar in both conditions and groups, within subjects’ SQ was superior on nights without cannabis (7.2 + 1.7 vs. 6.4 + 2.2, t=2.2, p=.04) and cannabis users spent more time in bed (minutes) than their non-cannabis using counterparts (447.6 + 77.1 vs. 373.6 + 66.1; t= 2.4, p=.04). Conclusion Among urban residing young African American adults, cannabis does not appear to improve sleep. Support (if any) This research was supported by the NIHLB grant R01HL136626 to Dr. Thomas A. Mellman.

Anxiety, depression and global distress among African American young adults with uncontrolled asthma

Background Anxiety and depression are mental health disorders that are often comorbid with asthma. Urban African American young adults with asthma often experience increased risk of anxiety and depression. Objective To explore relationships between symptoms of psychological distress and asthma-related anxiety with asthma outcomes among urban African American young adults with poorly controlled persistent asthma. Methods A secondary analysis of baseline data from a larger study of 141 African American young adults with uncontrolled persistent asthma was examined. Participants completed the Brief Symptom Inventory (BSI-18), Youth Asthma-related Anxiety Scale, Asthma Control Test (ACT), a daily diary to assess asthma symptoms; and number of asthma attacks. Spirometry assessed airway obstruction. Generalized linear models tested associations. Results In multivariable models testing, higher somatization scores were significantly associated with lower ACT scores (adjusted β = −0.49; 95% CI = −0.69, −0.28; p < 0.01), and higher symptoms (adjusted β = 0.39; 95% CI = 0.14, 0.65; p < 0.01). After adding asthma-related anxiety to the model, the somatization subscale and asthma-related anxiety were significantly associated with ACT scores (adjusted β = −0.36; 95% CI = −0.57, −0.15; p < 0.01), (adjusted β = −0.32; 95% CI = −0.50, −0.14; p < 0.01), respectively. Asthma-related anxiety was also significantly associated with asthma attacks (adjusted β = 0.24; 95% CI = 0.05, 0.43; p < 0.05). Conclusion This study suggests, asthma-related anxiety may differ from general anxiety and be related to poorly controlled asthma among African American young adults.

“A Different Perspective”: Topics Discussed During African American Father-Daughter Sexual Health Communication

&lt;i&gt;African American youth and young adults are disproportionately burdened by HIV and sexually transmitted infections. Although African American parent-child sexual health communication has been shown to reduce adolescent sexual risk-taking behavior, much more is known about mother-child and father-son sexual health communication than father-daughter sexual health communication. The current study explores what sexual health topics African American father-daughter dyads discuss with one another, and which topics are perceived to have the greatest impact on youths’ sexual risk behavior. Seven father-daughter dyads (N=7) and an additional five daughters (n=5) completed individual in-depth semi structured interviews. Daughters were aged 19-21 (M=20.3) years and fathers were aged 52-60 (M=56.7) years. Thematic analysis revealed five themes including: challenging topics to discuss, easy topics to discuss, topics on the continuum, desired topics of communication, and topics with greatest impact on behavior. Although participants shared that discussing sexual health is considered culturally taboo and can be challenging when criticized, several topics were easy to discuss universally, and several topics were both challenging and easy to discuss depending on the context of the conversation and depth of content covered. Sexual health communication was largely perceived as positively impacting daughters’ behaviors and daughters expressed wanting to have these conversations. Study findings can inform future intervention development by indicating which sexual health topics should be prioritized during father-daughter communication given their perceived positive impact. Future research is needed to explore how best to support father-daughter dyads in discussing sexual health topics perceived as challenging.&amp;nbsp; &lt;/i&gt;

Abstract P651: Assessing the Pathway Between Health Care Utilization and Hypertensive Outcomes Among Young Adult African American Medicaid Beneficiaries in Delaware

Introduction: African Americans have been studied to underutilize medical care in comparison to other groups due to a variety of factors, including lack of access and medical mistrust, both attributable long-standing systemic oppression. Thus, African Americans bare a disproportionate burden of chronic conditions, including hypertension, which is more than two times more prevalent among African Americans in comparison to other groups. To date, the health care utilization behaviors of African American young adults, ages 18-30, are understudied. Addressing this relationship in a young sample may be informative in fostering long-term improvement of health outcomes for African Americans. Question: Among African Americans aged 18-30. is there an association between hypertension diagnosis and recent receipt of a general adult medical exam? Methods: We conducted a cross-sectional case control study using data from a sample of African American Medicaid recipients living in Delaware, aged 18-30. Following an assessment of demographic characteristics, we performed logistic regression adjusted for gender and zip code to investigate the association between hypertension diagnosis and receipt of a general adult medical exam within the study period. Results: Among patients aged 18-30, those with hypertension (n=2,506) had 1.4 times the odds of reporting to have received a general adult medical exam during the study period when compared to those without hypertension (n=24526; p&lt;.0001). The difference between the mean number of visits between strata (.379 vs. .302) is statistically significant (p&lt;.0001). Conclusion: Our findings suggest that young adult African American patients living with hypertension are more likely to have a general adult medical exam during the study period than clients of the same age group without hypertension. We believe this may implicate that those with poorer health tend to seek care more often, though further research is needed to better understand motivations for seeking care. Improved understanding of the pathway between health care utilization and hypertension through a younger lens will be critical in targeting self-advocacy programs that address aversion to care-seeking behaviors for generations to come.

Developing culturally-adapted mobile mental health interventions: a mixed methods approach.

Black young adults suffer from psychological distress at either similar or greater rates than that of White Americans, yet they are seven times less likely to have access to or receive effective treatments. Fortunately, mobile-health (mHealth) technology may transform mental health services and address disparities in mental healthcare. The current study utilized focus groups of Black young adults to inform the development of culturally-adapted mHealth using quantitative and qualitative approaches. The study utilized a mixed-methods approach, in that qualitative (i.e., mini focus groups, n=11) and quantitative methods (i.e., self-report surveys) were used to explore the research questions. Participants included African American young adults (n=38, Mage =21). Participants completed self-report questionnaires prior to focus group facilitation. Correlational analyses were used to answer the quantitative research questions, and thematic analysis was used to answer the qualitative research questions. The qualitative findings highlighted that sociocultural experiences impact mental health and treatment seeking attitudes. Despite these findings, participants highlighted a variety of desired features and content that should be incorporated into future culturally-adapted mHealth interventions. Participants also highlighted both positive and negative aspects of current mHealth technologies for mental health. Finally, the study found that on average, participants had positive attitudes towards mental health, mental health treatments, and utilizing mHealth for mental health. Participants also had strong desires for culturally-adapted mHealth interventions. Bivariate correlations also revealed significant associations between vicarious online racial discrimination and mHealth attitudes, as well as racial identity and mHealth attitudes. In summary, the current study highlights that there is an urgent need for mHealth technology for mental health symptoms for African American young adults and presents a variety of features, content, and design/development considerations for future researchers.

Living through their first pandemic: Mississippi young adults reveal COVID-19 concerns and challenges

Objective: The study aimed to understand the perceptions, knowledge, information sources, and coping skills pertaining to COVID-19 among two groups of African American young adults. Participants: African American ages 18–29 years enrolled in Historically Black Colleges and Universities and non-college enrolled young adults in Mississippi were the participants. Methods: Focus groups were conducted from February through May 2021. The qualitative data were analyzed using thematic analysis. Results: Findings suggest the college students faced anxiety and stress from the loss of loved ones and the college experience. Non-college enrolled young adults dealt with maintaining employment, pros and cons of taking the vaccine to continue work, and handling the frequent flow of information. Conclusion: The study highlights the importance of ensuring that reliable and trustworthy health promotion and health crisis prevention information, resources, and coping tools are available in the environments in which young adults live, learn, and work.

A Qualitative Exploration of Various Stigmas Impacting HIV Pre-Exposure Prophylaxis (PrEP) Uptake Among African American Young Adults.

Pre-exposure prophylaxis (PrEP) has promise for reducing racial/ethnic HIV disparities; yet, acceptance among African Americans remains low. PrEP-related stigmas may impact uptake, but this is understudied. This study examines mechanisms by which stigma impacts PrEP acceptance among various priority African American populations. Focus group data from 63 African American young adults (aged 18-29 years) in Louisville, Kentucky, explore how various stigmas impact attitudes toward PrEP. Data were analyzed using grounded theory analytic techniques. PrEP stigma, HIV stigma, sexual behavior stigma, and homophobia/transphobia individually reduce PrEP uptake. These stigmas also interact synergistically to undermine PrEP acceptance. Key challenges resulting from various stigmas and their interactions include medical hesitancy, lack of perceived susceptibility based on gender and sexuality, the role of gender norms in HIV prevention, and deprioritizing HIV prevention due to social rejection. Interventions to increase awareness, destigmatize PrEP, remediate social marginalization related to identity, HIV status, and gendered perceptions of sexual risk, as well as more focus on diverse priority groups, are needed to present PrEP as a viable HIV prevention option for African American communities. More research is needed to optimize strategies that address stigma and increase acceptance of novel HIV prevention technologies.

Sex differences in saliva-based DNA methylation changes and environmental stressor in young African American adults.

Low socioeconomic status neighborhood exposure to stress and violence may be sources of negative stimuli that poses significant health risks for children, adolescents and throughout the life course of an individual. The study aims to investigate if aberrant epigenetic DNA methylation changes may be a potential mechanism for regulating neighborhood exposures and health outcomes. Exposure to environmental stressors identified in 98 young African American (AA) adults aged 18-25 years old from the Washington D.C., area were used in the study. We correlated the association between stress markers; cortisol, CRP, IgG, IGA, IgM, and self-reported exposure to violence and stress, with quantitative DNA methylation changes in a panel of gene-specific loci using saliva DNA. In all participants studied, the exposure to violence was significant and negatively correlated with DNA methylation of MST1R loci (p = 0.032; r = -0.971) and nominally significant with NR3C1 loci (p = 0.053; r = -0.948). In addition, we observed significant and negative correlation of DNA methylation changes of LINE1 (p = 0.044; r = -0.248); NR3C1 (p = 0.017; r = -0.186); MSTR1 (p = 0.022; r = -0.192); and DRD2 (p = 0.056; r = -0.184; albeit nominal significant correlation) with IgA expression. On the other hand, we observed a significant and position correlation of DNA methylation changes in DRD2 (p = 0.037; r = 0.184) with IgG expression. When participants were stratified by sex, we observed in AA young male adults, significant DNA methylation changes of MST1R (p< 0.05) and association with exposure to violence and IgG level. We also observed significant DNA methylation levels of DRD2 (p< 0.05) and association with IgA, IgG, and cortisol level. Furthermore, we observed significant DNA methylation changes of NR3C1 (p< 0.05) with stress, IgA, and IgG in the male participants only. On the other hand, we only observed significant and a positive association of IgG with DNA methylation levels of ESR1 (p = 0.041) in the young AA female participants. Our preliminary observation of significant DNA methylation changes in neuronal and immune genes in saliva samples supports our recently published genome-wide DNA methylations changes in blood samples from young AA male adults indicating that saliva offers a non-invasive means for DNA methylation prediction of exposure to environmental stressors in a gender-specific manner.

Exploring Motivations for COVID-19 Vaccination Among Black Young Adults in 3 Southern US States: Cross-sectional Study.

BackgroundFew studies have focused on attitudes toward COVID-19 vaccination among Black or African American young adults (BYA) in the Southern United States, despite high levels of infection in this population.ObjectiveTo understand this gap, we conducted an online survey to explore beliefs and experiences related to COVID-19 vaccination among BYA (aged 18-29 years) in 3 southern states.MethodsWe recruited 150 BYA to participate in an online survey as formative research for an intervention to address vaccine hesitancy in Alabama, Georgia, and North Carolina from September 22, 2021, to November 18, 2021. Participants were recruited through social media ads on Facebook, Twitter, Instagram, and YouTube. Additionally, we distributed information about the survey through organizations working with BYA in Alabama, Georgia, and North Carolina; our community partners; and network collaborations. We used measures that had been used and were previously validated in prior surveys, adapting them to the context of this study.ResultsRoughly 28 (19%) of the participants had not received any doses of the COVID-19 vaccine. Half of the unvaccinated respondents (n=14, 50%) reported they wanted to wait longer before getting vaccinated. Motivators to get vaccinated were similar between unvaccinated and vaccinated respondents (eg, if required, to protect the health of others), but the main motivator for those vaccinated was to protect one’s own health. Among unvaccinated individuals, reasons for not receiving the COVID-19 vaccine included concern about vaccine side effects (n=15, 54%) and mistrust of vaccine safety (n=13, 46%), of effectiveness (n=12, 43%), and of the government’s involvement with vaccines (n=12, 43%). Experiences of discrimination (n=60, 40%) and mistrust of vaccines (n=54, 36%) were common overall. Among all respondents, those who said they would be motivated to get vaccinated if it was required for school, work, or travel were more likely to endorse negative beliefs about vaccines compared to those motivated for other reasons.ConclusionsMistrust in COVID-19 vaccine safety and efficacy is common among BYA in the Southern United States, irrespective of vaccination status. Other motivators, such as safety of family and community and vaccination requirements, may be able to tip the scales toward a decision to be vaccinated among those who are initially hesitant. However, it is unclear how vaccine requirements among BYA in the South affect trust in the government or health care in the long term. Interventions that include BYA in vaccination messaging and programs may more proactively build feelings of trust and combat misinformation.

Exploring the associations between discrimination, coping, skin tone, and the psychosocial health of young adults of color

Although valuable strides have been made in linking racial and ethnic discrimination to health outcomes, scholars have primarily used between-person methodological approaches, which assess the implications of reporting high or low mean levels of discrimination. Alternatively, within-person approaches assess the implications of intraindividual variation, or acute changes, in an individual's exposure to discrimination. These approaches pose two fundamentally different questions about the association between discrimination and health, and empirical work that disaggregates these effects remains scarce. Scholars have also called for research exploring whether sociocultural factors-such as race-related coping and skin tone-contour these associations. To address gaps in extant literature, the current study examined 1) how an individual's average level of exposure to discrimination (between-person) and weekly fluctuations in these encounters (within-person) relate to psychosocial health and 2) whether race-related coping (confrontational and passive coping) and skin tone moderate these associations. Analyses were conducted using weekly diary data from African American and Latinx young adults (n = 140). Findings indicated that reporting higher mean levels of exposure to discrimination and encountering more discrimination than usual on a given week were both associated with poorer psychosocial health. Results also suggest that the efficacy of young adults' coping mechanisms may depend on their skin tone and the nature of the discriminatory events encountered.