Islander Youth Research Articles

Exploring Youths’ Offers to Use E-Cigarettes in Rural Hawai‘i: A Test Development and Validation Study

The purpose of this study is to describe the development and initial validation of a survey focused on problematic situations involving e-cigarette use by rural Native Hawaiian and Pacific Islander (NHPI) youths. A 5-phase approach to test development and validation was used. In Phase 1 (Item Generation), survey items were created from a series of focus groups with middle school youths on Hawai‘i Island (N = 69). In Phase 2 (Item Refinement and Selection), situational items were reduced to 40 e-cigarette offer situations that were selected for inclusion in the survey. In Phase 3 (Item Reduction), items were administered to 257 youths from 11 middle, intermediate, or multi-level public or public-charter schools on Hawai‘i Island. Exploratory factor analysis indicated the presence of three factors accounting for 50% of the variance: E-Cigarette Offers from Friends (24%), E-Cigarette Offers from Non-Friends (16%), and Coercive Pressure to Use E-Cigarettes (10%). Hypothesized relationships between offer situations and e-cigarette use were partially confirmed, supporting the construct validity of the survey. This survey helps to fill the scientific and practice gap in measuring ecodevelopmental risk and protection for e-cigarette use and has implications for e-cigarette use prevention with rural, NHPI, and/or Indigenous youth populations.

Project Yarn Circle: development and pilot evaluation of a cultural connection suicide prevention program for Aboriginal and Torres Strait Islander young people

ABSTRACT Background Aboriginal and Torres Strait Islander young people experience markedly higher suicide mortality than non-Indigenous youth in Australia, yet there is little evidence of effective preventative strategies. Many are misaligned to the needs of First Nations young people due to a lack of consideration of protective factors such as community and cultural connection. Objective To date no research has examined whether increasing cultural connectedness may reduce Aboriginal and Torres Strait Islander youth suicidality. The current study outlines the development, implementation, and pilot evaluation of Project Yarn Circle, a school-based suicide prevention initiative utilising cultural education and connection. Method Project Yarn Circle was piloted by an Indigenous owned and managed youth mental health organisation, delivering 5 weekly sessions to 276 young people at 9 schools in Southeast Queensland, Australia, between 2019 and 2023. Sessions connected students to cultural knowledge and practices (stories, painting, dance, Indigenous languages) with Elders and local cultural knowledge facilitators. Results Pre- and post-program evaluation questionnaires completed 6–8 weeks apart found that participants had significantly lower suicidal ideation (GHQ-18-SS), pre 7.16, post 6.61, p = .043 higher positive ideation/reasons for living (PANSI-PI) pre 22.44, post 23.60, p = .009, and higher self-esteem (RSES) pre 16.55, post 23.60, p = .005. Analyses of cultural connectedness items co-designed for this evaluation study and validated using Exploratory Factor Analysis found that students demonstrated greater cultural identity clarity, peer cultural competence, strength from culture, salience of cultural continuity and sense of belonging. Conclusions These findings provide new evidence towards utilising cultural connectedness as an intervention mechanism in Indigenous youth suicide prevention.

Relationships between social determinants of health and healthy body composition among Aboriginal and Torres Strait Islander youth in the Next Generation: Youth Well-being study.

Little is currently known about the relationships between body composition and the social determinants of health among Aboriginal and Torres Strait Islander youth in Australia, which could help inform policy responses to address health inequities. This study aimed to explore the relationship between various social factors and healthy body mass index (BMI) and waist/height ratio (WHtR) among Aboriginal and Torres Strait Islander youth aged 16-24 years. Baseline survey data from 531 participants of the 'Next Generation: Youth Well-being study' were used. Robust Poisson regression quantified associations between healthy body composition and self-reported individual social factors (education, employment and income, government income support, food insecurity, home environment, relationship status, racism), family factors (caregiver education and employment) and area-level factors (remoteness, socioeconomic status). Healthy body composition was less common among those living in a crowded home (healthy WHtR aPR 0.67 [0.47-0.96]) and those receiving government income support (healthy BMI aPR 0.74 [0.57-0.95]). It was more common among those with tertiary educated caregivers (healthy BMI aPR 1.84 [1.30-2.61]; healthy WHtR aPR 1.41 [1.05-1.91]) and those in a serious relationship (healthy BMI aPR 1.33 [1.02-1.75]). Social factors at the individual and family level are associated with healthy body composition among Aboriginal and Torres Strait Islander youth. SO WHAT?: The findings of this study highlight the potential for health benefits for youth from policies and programs that address social inequities experienced by Aboriginal and Torres Strait Islander people in Australia.

Adult Familial Influences on Rural Native Hawaiian and Pacific Islander Youths’ E-Cigarette Use

Background: Over the past decade, youth e-cigarette use has grown into a national epidemic, with Native Hawaiian and Pacific Islander (NHPI) youths’ rates among some of the highest in the nation. Family factors significantly contribute to NHPI youths’ decisions to engage in or resist substance use, yet few studies have specifically examined familial influences on NHPI youths’ substance use decision-making and behaviors. Objective: The objective of this study is to examine adult familial influences on rural NHPI youths’ decisions to engage in e-cigarette use. Method: Seventeen gender-specific focus groups with NHPI youths (N = 69) from eight public schools on Hawai’i Island were conducted. Results: Two family-related themes emerged from the data: 1) parental substance use permissiveness, and 2) family normalization of e-cigarette use. Conclusions: Examining adult familial contributors to NHPI youths’ e-cigarette use needs to be part of a comprehensive effort to address NHPI health and substance use disparities. Prevention interventions should be explicit in addressing the family and relational context of NHPI youths’ substance use.

Suicide Rates Among Asian American and Pacific Islander Youths—A Cause for Alarm

Suicide Rates Among Asian American and Pacific Islander Youths—A Cause for Alarm

National Trends in Suicide Among Asian American or Pacific Islander Youth

National Trends in Suicide Among Asian American or Pacific Islander Youth

Utilizing an Intersectional Approach to Examine Experiences of Hunger Among Adolescents During COVID-19: Considering Race/Ethnicity, Sexual Identity, and Employment Disparities in a Nationally Representative Sample.

This study examines correlates of experiences of hunger among adolescents in the United States (U.S) by the intersectionality of race/ethnicity with sociodemographic characteristics (gender, sexual identity, and adolescent/parent job loss) with the aim of identifying subgroups most at risk for hunger during the COVID-19 pandemic. This cross-sectional study uses nationally representative data from the Adolescent Behaviors and Experiences Survey (ABES) collected from January to June 2021. The analytic sample was high school students aged 14-17 with complete data (n = 6023). Descriptive statistics, bivariate, and multivariate logistic regression models were used to examine associations between sociodemographic factors and hunger (1-item measure) among adolescents during the pandemic for the analytic sample and stratified by race/ethnicity. The prevalence of hunger was 24.1% for the analytic sample and was highest among American Indian/Alaskan Native/Other Pacific Islander youth (37.2%), followed by non-Hispanic Black (31.8%) and Hispanic (28.4%) youth, and lowest among Non-Hispanic White youth (18.6%). In the analytic sample, there were significant differences in experiences of hunger by race/ethnicity, sexual identity, and adolescent/parent job loss during the pandemic (p < 0.05). When stratified by race/ethnicity, there were differential associations of hunger with sexual identity, and adolescent/parent job loss. These findings provide evidence of differential experiences of hunger during the pandemic among adolescents by sociodemographic factors. Results highlight the need for taking an intersectional approach when examining issues such as hunger. Future policies and programs should be mindful of factors associated with hunger and should prioritize using an equity-informed approach when engaging with multiply-marginalized adolescents.

Pubertal Timing Across Asian American, Native Hawaiian, and Pacific Islander Subgroups

Earlier puberty is associated with adverse health outcomes, such as mental health issues in adolescence and cardiometabolic diseases in adulthood. Despite rapid growth of the Asian American, Native Hawaiian, and Pacific Islander populations in the US, limited research exists on their pubertal timing, potentially masking health disparities. To examine pubertal timing among Asian American, Native Hawaiian, and Pacific Islander children and adolescents by disaggregating ethnic subgroups. This retrospective cohort study included Asian American, Native Hawaiian, and Pacific Islander youths aged 5 to 18 years assessed for pubertal development at Kaiser Permanente Northern California, a large, integrated health care delivery system. Follow-up occurred from March 2005, through December 31, 2019. Data were analyzed in October 2023. Race and ethnicity, categorized into 11 ethnic subgroups: Asian Indian, Chinese, Filipino, Japanese, Korean, Native Hawaiian and Pacific Islander, Other South Asian, Other Southeast Asian, Vietnamese, multiethnic, and multiracial. Pubertal timing was determined using physician-assessed sexual maturity ratings (SMRs). Outcomes included the median age at transition from SMR 1 (prepubertal) to SMR 2 or higher (pubertal) for onset of genital development (gonadarche) in boys, breast development (thelarche) in girls, and pubic hair development (pubarche) in both boys and girls. In this cohort of 107 325 Asian American, Native Hawaiian, and Pacific Islander children and adolescents (54.61% boys; 12.96% Asian Indian, 22.24% Chinese, 26.46% Filipino, 1.80% Japanese, 1.66% Korean, 1.96% Native Hawaiian and Pacific Islander, 0.86% Other South Asian, 3.26% Other Southeast Asian, 5.99% Vietnamese, 0.74% multiethnic, and 22.05% multiracial), the overall median ages for girls' pubarche and thelarche were 10.98 years (95% CI, 10.96-11.01 years) and 10.13 years (95% CI, 10.11-10.15 years), respectively. For boys' pubarche and gonadarche, median ages were 12.08 years (95% CI, 12.06-12.10 years) and 11.54 years (95% CI, 11.52-11.56 years), respectively. Differences between subgroups with earliest and latest median age at onset were 14 months for girls' pubarche, 8 months for thelarche, 8 months for boys' pubarche, and 4 months for gonadarche. In general, Asian Indian, Native Hawaiian and Pacific Islander, and Other South Asian subgroups had the earliest ages at onset across pubertal markers, while East Asian youths exhibited the latest onset. Restricting to those with healthy body mass index did not substantially change the findings. In this cohort study of Asian American, Native Hawaiian, and Pacific Islander children and adolescents, pubertal timing varied considerably across ethnic subgroups. Further investigation is warranted to assess whether these differences contribute to observed health disparities in adulthood, such as type 2 diabetes and cardiovascular diseases.

Racial and Ethnic Disparities in All-Cause and Cause-Specific Mortality Among US Youth

Mortality rates in US youth have increased in recent years. An understanding of the role of racial and ethnic disparities in these increases is lacking. To compare all-cause and cause-specific mortality trends and rates among youth with Hispanic ethnicity and non-Hispanic American Indian or Alaska Native, Asian or Pacific Islander, Black, and White race. This cross-sectional study conducted temporal analysis (1999-2020) and comparison of aggregate mortality rates (2016-2020) for youth aged 1 to 19 years using US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. Data were analyzed from June 30, 2023, to January 17, 2024. Pooled, all-cause, and cause-specific mortality rates per 100 000 youth (hereinafter, per 100 000) for leading underlying causes of death were compared. Injuries were classified by mechanism and intent. Between 1999 and 2020, there were 491 680 deaths among US youth, including 8894 (1.8%) American Indian or Alaska Native, 14 507 (3.0%) Asian or Pacific Islander, 110 154 (22.4%) Black, 89 251 (18.2%) Hispanic, and 267 452 (54.4%) White youth. Between 2016 and 2020, pooled all-cause mortality rates were 48.79 per 100 000 (95% CI, 46.58-51.00) in American Indian or Alaska Native youth, 15.25 per 100 000 (95% CI, 14.75-15.76) in Asian or Pacific Islander youth, 42.33 per 100 000 (95% CI, 41.81-42.86) in Black youth, 21.48 per 100 000 (95% CI, 21.19-21.77) in Hispanic youth, and 24.07 per 100 000 (95% CI, 23.86-24.28) in White youth. All-cause mortality ratios compared with White youth were 2.03 (95% CI, 1.93-2.12) among American Indian or Alaska Native youth, 0.63 (95% CI, 0.61-0.66) among Asian or Pacific Islander youth, 1.76 (95% CI, 1.73-1.79) among Black youth, and 0.89 (95% CI, 0.88-0.91) among Hispanic youth. From 2016 to 2020, the homicide rate in Black youth was 12.81 (95% CI, 12.52-13.10) per 100 000, which was 10.20 (95% CI, 9.75-10.66) times that of White youth. The suicide rate for American Indian or Alaska Native youth was 11.37 (95% CI, 10.30-12.43) per 100 000, which was 2.60 (95% CI, 2.35-2.86) times that of White youth. The firearm mortality rate for Black youth was 12.88 (95% CI, 12.59-13.17) per 100 000, which was 4.14 (95% CI, 4.00-4.28) times that of White youth. American Indian or Alaska Native youth had a firearm mortality rate of 6.67 (95% CI, 5.85-7.49) per 100 000, which was 2.14 (95% CI, 1.88- 2.43) times that of White youth. Black youth had an asthma mortality rate of 1.10 (95% CI, 1.01-1.18) per 100 000, which was 7.80 (95% CI, 6.78-8.99) times that of White youth. In this study, racial and ethnic disparities were observed for almost all leading causes of injury and disease that were associated with recent increases in youth mortality rates. Addressing the increasing disparities affecting American Indian or Alaska Native and Black youth will require efforts to prevent homicide and suicide, especially those events involving firearms.

Exploring Native Hawaiian and Pacific Islander Youths' E-Cigarette Resistance Strategies: Implications for Tobacco Product Use Prevention

Abstract: This study examined the e-cigarette and vaping resistance strategies used by Native Hawaiian and Pacific Islander (NHPI) youths in rural Hawai'i. Focus groups ( N = 17) were conducted in eight geographically dispersed elementary, middle/intermediate, and multilevel schools in low-income communities on Hawai'i Island. Sixty-nine youths (67% NHPI, Mage = 12.5 years) participated in this study. The resistance strategies discussed across the greatest number of groups were "refuse" (saying no), "explain" (providing reasons for vaping refusal), "avoid" (avoiding people or places where e-cigarettes were used), and "leave" (walking away from a situation where e-cigarettes were being used). Participants described the challenges in using these strategies within contexts characterized by widespread peer and family vaping and strong social demands to use e-cigarettes. The findings suggest the need for multi-level interventions based on youths' resistance strategies to meaningfully reduce youth vaping use in rural and/or NHPI communities.

Native Hawaiian and Pacific Islander Youth Substance Use Prevention in Rural Hawai'i.

Native Hawaiian and Pacific Islander Youth Substance Use Prevention in Rural Hawai'i.

“Allowing Space for Voice…All Our Voices”: Understanding Ho‘ouna Pono Implementation Through Educational Leadership Perspectives in Rural Hawai‘i Schools

Epidemiological research over the past two decades has highlighted substance use disparities that affect Native Hawaiian and Pacific Islander youth, and the lack of effective approaches to address such disparities (Okamoto et al. in Asian American Journal of Psychology 10(3):239–248, 2019). The Ho‘ouna Pono curriculum is a culturally grounded, teacher-implemented, video-enhanced substance use prevention program that has demonstrated efficacy in rural Hawaiʻi in a large-scale trial (Okamoto in Asian American Journal of Psychology 10(3):239–248, 2019). Despite its potential to ameliorate health disparities and address youth substance use, prevention programs such as Ho‘ouna Pono have been poorly disseminated and implemented across Hawaiʻi, raising the question: Why are effective prevention programs not used in communities that most need them? The present study used concept mapping to understand previously identified implementation barriers and develop implementation strategies for Ho‘ouna Pono. Seven Hawaiʻi Department of Education (HIDOE) educational leaders and administrators sorted Ho‘ouna Pono implementation barriers (e.g., “There is a lack of HIDOE funding to support prevention curricula”), named concepts, and rated barriers’ perceived impact and difficulty. Multidimensional scaling and cluster analysis yielded a five-cluster solution: (1) Kumu (Hawaiian word for teacher) Controlled, (2) School Level Buy-in, (3) Curriculum, (4) Student Attitudes + Mindsets (Family + Community), and (5) Policy. Participant ratings identified eight high-impact and low-difficulty barriers. Discussion revealed important intersections among barriers indicating the need for coordinated and cross-level implementation strategies to support Ho‘ouna Pono sustainment. Brainstormed implementation strategies using participants’ own language highlighted a need for participatory methods in school settings to bidirectionally share ways to best sustain substance use prevention programs.

Breaking the Silence: An Epidemiological Report on Asian American and Pacific Islander Youth Mental Health and Suicide (1999-2021).

Limited studies have focused on recent trends in Asian American and Pacific Islander (AAPI) youth suicide. This study aimed to evaluate epidemiological trends in AAPI youth suicide and reports of depressive symptoms among Asian and Pacific Islander youth in the USA. This cross-sectional study analyzed mortality data from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) and reports of depressive symptoms from the Youth Risk Behaviour Surveillance System (YRBSS). Data from 1999 to 2021 were analyzed for suicide rates and methods used among AAPI youth aged 5-24 years. YRBSS data from 1991 to 2021 were analyzed for depressive symptoms reported by Asian American (AA) 9th-12th graders. From 1999 to 2021, 4747 AAPI youth died by suicide in the USA. Rates of suicide doubled from 3.6 to 7.1 per 100,000 during 1999-2021, with an increasing trend observed from 2014 onwards. The most common methods of suicide deaths in this population were suffocation, firearms and poisoning. Rates of suicide were higher among AA males than females, although more AA females reported depressive symptoms, including suicidal planning and attempts. This study shows a concerning increase in suicide rates among AAPI youth over 1999-2021. Suffocation, firearms and poisoning were the most common methods used. While more AAPI males died by suicide, AA females reported higher rates of depressive symptoms. These findings highlight the urgent need for targeted prevention strategies and clinical interventions for this vulnerable population. The study also emphasizes the importance of addressing mental health stigma to improve reporting and support for Asian American, Native Hawaiian and Pacific Islander (AANHPI) youth.

Abstract MP57: Universal and Targeted Lipid Screening in Youth Living With Overweight or Obesity

Background: Current NHLBI Expert Panel guidelines recommend universal screening once between 9-11 years and, again, between 17-21 years. Targeted screening is recommended for 2 years and older with a) obesity, or b) overweight AND personal or family history of obesity-related co-morbidities. The present study compares compliance with current lipid screening guidelines by race/ethnicity and socioeconomic status (SES). Methods: Using electronic health record data for n=300,776 youth between 2 and 17 years of age from Kaiser Permanente Southern California and a BMI-for-age &gt;=85 th percentile, HR for the ordering of a lipid screening according to the current guidelines were calculated for both, universal screening and targeted screening at any age for children living with obesity with and without comorbid conditions such as diabetes, hypertension, and non-alcoholic fatty liver disease (NAFLD) and adjusted for age, sex, BMI-for-age class (overweight, moderate obesity between 95 th and 1.2 x 95 th percentile, obesity &gt;= 1.2 x 95 th percentile of BMI-for-age), and comorbid conditions (diabetes, hypertension, and NAFLD). Results: The average age of the cohort was 8.6 (SD 5.7) years with 49.4% Hispanic, 25.0% White, 7.3% Black, and 9.3% Asian/Pacific Islander youth, 19.8% with state-subsidized insurance. Of these, 13.2 of youth lived with obesity between 95 th and 1.2 x 95 th percentile, and 5.2% &gt;= 1.2 x 95 th percentile of BMI-for-age. For 43.1% of youth, a universal lipid screening was ordered as recommended. The aHR for universal screening was 1.23 (1.21-1.26) for Hispanic, 1.15 (1.11-1.19) for Black, 1.27 (1.23, 1.31) for Asian/PI youth compared to white youth, 1.05 (1.03-1.07) for youth with state-subsidized insurance compared to those without. Among youth living with obesity, targeted screening was ordered as recommended for 38.1% of youth with 23.8%, 68.1%, and 61.6% for 2-8, 9-17, and 15-17 year olds respectively. The aHR for targeted screening was 1.58 (1.58-1.61) for youth living with obesity &gt;= 1.2 x 95 th percentile of BMI-for-age compared to those between 95 th and 1.2 x 95 th percentile, 1.08 (1.06-1.10) for youth with state-subsidized insurance compared to those without, 1.57 (1.49-1.65) for youth with diabetes, and 1.11 (1.04-1.20) for youth with NAFLD compared to those without. The aHR for targeted screening did not vary by race/ethnicity. Conclusions: In this integrated health care system, universal and targeted screening missed about 50% of youth living with overweight or obesity. While universal screening rates were higher for minority youth and lower SES, targeted screening rates were driven by obesity severity and comorbid conditions than race or SES.

Aboriginal and Torres Strait Islander youth suicide mortality and previous mental health, suicidality and service use in Queensland, Australia, from 2001 to 2021

BackgroundThe current study aimed to compare current suicide rates, trends, previous treatment, suicidality and mental health diagnoses for First Nations and non-Indigenous young people who died by suicide. MethodsAge-specific suicide rates (ASSRs) were calculated per 100,000 persons/year using suicides aged 10–19 years in the Queensland Suicide Register. Rate Ratios (RRs) and 95 % CIs compared ASSRs for First Nations and non-Indigenous youth dying by suicide in Queensland, Australia, from 2001 to 2018. Risk ratios (RiskR) with 95 % CIs compared characteristics between First Nations and non-Indigenous youth suicides. Joinpoint regression was used to identify any changes in trends and annual percentage change (APC) in suicides with 95 % CIs. ResultsThe First Nations youth ASSR was 24.71 deaths per 100,000 persons/year, 4.5 times the non-Indigenous ASSR (95 % CI = 3.74–5.38, p < 0.001). Both non-Indigenous and First Nations suicide trends were stable with no joinpoints (APC: 0.3 %, 95 % CI: −1.6-2.2, p = 0.78; APC: 0.9 %, 95 % CI: −0.2-2.1, p = 0.11). Less than a quarter (23.9 %) of First Nations young people had ever received mental health treatment, significantly fewer than non-Indigenous youth (RiskR = 0.80, 95 % CI = 0.71–0.90, p < 0.001). Similarly, in the three months preceding their death, only 14.5 % of First Nations young people had received mental health treatment (RiskR = 0.89, 95 % CI = 0.83–97, p = 0.015). LimitationsReported mental illness, suicidality and help-seeking could be underreported due to concealment from family or police. ConclusionsThe current study finds no change in the gap between the First Nations and Non-Indigenous youth suicide rates nor evidence of decrease in the First Nations youth suicide rate. There is a need for alternative approaches to Indigenous youth suicide prevention, such as assertive outreach models outside of traditional triage and mental health systems to proactively build trusting relationships with young people in communities to identify young people needing support.

What Matters to Aboriginal and Torres Strait Islander Youth (WM2Y): a study protocol to develop a national youth well-being measure

IntroductionAdolescents face challenges associated with unprecedented environmental, social and technological changes. The impacts of colonisation, intergenerational trauma, racism and socioeconomic disadvantage intensify these challenges for many Aboriginal and Torres Strait...

Codesigning enhanced models of care for Northern Australian Aboriginal and Torres Strait Islander youth with type 2 diabetes: study protocol

IntroductionPremature onset of type 2 diabetes and excess mortality are critical issues internationally, particularly in Indigenous populations. There is an urgent need for developmentally appropriate and culturally safe models of...

Cannabis Use and Its Impact on Mental Health in Youth in Australia and the United States: A Scoping Review.

Cannabis is a widely used substance among the youth population, with an estimated 2.8% currently smoking cannabis. Its popularity is growing due to the perception of its harmless nature and lack of dependence. However, this increase in use has been linked to mental health issues, especially since its partial decriminalisation in some part of the United States and Australia. The objective of this scoping review was to investigate the mental health impact of cannabis use among young people in Australia and the United States. A scoping review was conducted according to the Joanna Briggs Institute (JBI) protocol, and articles were searched from ProQuest Central and EBSCO Host (MEDLINE and CINAHL databases). A total of 24 articles were analysed, including systematic reviews, meta-analyses, and cohort, longitudinal, and cross-sectional studies. The findings indicate that cannabis use is associated with depression, psychosis, suicide, cannabis use disorder, dependence, decline in cognitive function, and the development of externalising behaviour, particularly attention deficit hyperactivity disorder. However, the relationship between cannabis use and anxiety is equivocal. Mental health issues were more prevalent with increased frequency, duration, intensity, and type of use. Female, minority, LGBTQI, African American, Aboriginal, and Torres Strait Islander youth and the age of onset of cannabis use were significant factors for the development of mental health problems. The increasing prevalence of cannabis use among high school and college students suggests the need for intervention by teachers, parents, and community health professionals to make them aware of its potential negative mental health outcomes. Moreover, policy-level interventions by the government are required to discourage young people from using cannabis.

The social drivers of health for Native Hawaiian and Pacific Islander youth in the United States

ObjectivesTo describe the social drivers of health and health status of Native Hawaiian and Pacific Islander (NHPI) youth in the US. MethodsThis is a cross-sectional analysis of the 2014 NHPI National Health Interview Survey (NHIS) which surveyed about 3,000 NHPI households, including 1,428 NHPI youth (884 0–12 yo, 421 13–17 yo, and 123 18–21 yo). We described domains of social drivers of health (SDoH), health conditions, and associations of income and food insecurity with body mass index (BMI) for NHPI youth. ResultsNHPI youth come from households with a wide range in income. Approximately 20% of the cohort were food insecure. Among 18–21 yo, 10% report chronic medical conditions (5% with prediabetes). 33% of 13–17 yo and 52% of 18–21 yo were overweight/ obese. For 13–17 yo, lower income was associated with higher BMI. There was no association between food insecurity and BMI for any age group. ConclusionsOverweight/ obesity are highly prevalent among NHPI youth which is concerning for development of diabetes, hypertension, cardiovascular and kidney disease. Health efforts should focus on SDoH, obesity prevention and management for NHPI youth.

Mothers and sportsmen: The gendered and racialised nature of role model selection for Aboriginal and/or Torres Strait Islander youths

AbstractThis article seeks to understand who Aboriginal and Torres Strait Islander children select as role models, and the reasons underlying these choices. Drawing data from Wave 8 of the Longitudinal Study of Indigenous Children, it comprises a sample of 307 children (169 male and 138 female) aged between 10.5 and 12 years at the time of data collection. Content analysis was used to analyse survey responses regarding two questions pertaining to role models, the analytical process being underpinned by Indigenous standpoint theory. The findings show that participants tended to select role models correlating with their gender and who were Indigenous or people of colour. For boys, most selected Indigenous sportsmen, whilst girls more evenly selected mothers, women from the entertainment industry, and sportswomen. The reasons why these individuals were selected were similar for boys and girls: the role model's ability, mastery and/or competency in a given field. These findings are important for educators and schools in guiding Aboriginal and Torres Strait Islander youths in their educational and career choices, and for policymakers in creating campaigns and pathways into fields where Indigenous persons are underrepresented.