non-Latino White Participants Research Articles

The effects of race, ethnicity, and gender on predictors of asthma medication adherence among early high school students

ABSTRACT We evaluated the moderating effects of gender on predictors of asthma medication adherence, and whether the moderating effects of gender differed by race and ethnicity. Adolescents with asthma(N = 62) on daily medication and their caregivers were enrolled in a longitudinal investigation of family asthma management across the transition to high school. Participants were on average 13.7 years old (SD = 0.6) and 62.7% were male. Forty percent were non-Latino white (NLW), 23.7% Black/African American, and 37.3% Latino. Adherence was objectively monitored. Family cohesion and medication beliefs were assessed at 8th and 10th grades. Favorable medication beliefs were associated with higher adherence among males, and higher family cohesion was related to higher adherence among females. Gender effects were moderated by race and ethnicity. Males had lower adherence than females among NLW participants and Latino participants. Among Black participants, males had higher adherence relative to females. Intersectional aspects of adolescent race, ethnicity, and gender may relate to medication adherence during the high school transition.

Racial, Ethnic, and Nativity Disparities in Physical Activity and Sedentary Time among Cancer Prevention Study-3 Participants.

Understanding racial/ethnic and nativity disparities in physical activity (PA) is important, as certain subgroups bear a disproportionate burden of physical inactivity-related diseases. This descriptive study compared mean leisure-time moderate-to-vigorous intensity physical activity (LTMVPA) by race/ethnicity and nativity. The Cancer Prevention Study-3 (78.1% women; age, 47.9 ± 9.7 yr) includes 4722 (1.9%) Asian/Pacific Islander; 1232 (0.5%) Black/Indigenous (non-White) Latino; 16,041 (6.5%) White Latino; 9295 (3.8%) non-Latino Black; 2623 (1.1%) Indigenous American; and 210,504 (85.7%) non-Latino White participants across the United States and Puerto Rico. Participants completed validated LTMVPA and 24-h time use surveys at enrollment (2006-2013). Differences in LTMVPA across race/ethnicity and nativity were examined by ANCOVA with paired Tukey tests adjusting for age and sex. The proportion of time spent sitting, sleeping, and on PA by race/ethnicity was also compared. There were significant differences in LTMVPA by race/ethnicity (race main effect, P < 0.001; nativity, P = 0.072; interaction, P < 0.001). Pairwise comparisons showed that White participants born abroad were the most active (23.8 MET-h·wk-1) and non-White Latino participants born abroad were the least active (17.9 MET-h·wk-1). Among Latinos, participants born in Puerto Rico were 6.6-7.3 MET-h·wk-1 less active than participants born in Mexico, the United States/Canada, or other countries. There were variations in time use by race/ethnicity, with the largest difference in time spent sitting while watching TV. Black participants spent 14.8% of the day (~3.5 h) sitting watching TV, which was 78 min longer than Asian/Pacific Islander participants. This study suggests that there are differences in LTMVPA accumulation by race, ethnicity, and nativity. Results can be used to identify demographic groups that may benefit from culturally tailored PA interventions.

Racial and gender inequities in the implementation of a cannabis criminal justice diversion program in a large and diverse metropolitan county of the USA

BackgroundDiversion programs are considered alternatives to the arrest and incarceration of non-violent drug offenders, including those found in possession of smaller amounts of cannabis in states with prohibitive laws. Despite the progressive nature of such programs, the inability to complete diversion program requirements can often result in greater involvement with the criminal justice system than traditional case adjudication. Few studies have evaluated racial group differences in cannabis diversion program completion. MethodsThe current study examined a sample of 8323 adult participants in Harris County, Texas’ Marijuana Misdemeanor Diversion Program (MMDP) between March 2017 and July 2019. Gender, age, and race/ethnicity were examined as predictors of program completion and time to completion using Chi square, Kruskal Wallis tests, and Cox proportional hazard regression models. ResultsBoth males and African Americans were over-represented (80 % and 50 %, respectively) among participants of Harris County’s MMDP. African American (HR = 0.782, 95 % CI [.735–.832], p < .001) and Latino American MMDP participants (HR = .822, 95 % CI [.720–.937], p = .003) had significantly lower odds of MMDP completion and a longer interval to program completion as compared to non-Latino White participants. ConclusionsThe current study identified racial/ethnic and gender disparities in a large county’s cannabis diversion program. These findings may be related to law enforcement disparities which disproportionately target males and people of color. Findings may serve to inform the continued reform of the criminal justice system, particularly laws relating to cannabis.

Abstract 3350: Not letting the cancer take any more than it had from me: Latina mothers surviving cancer in the Paso del Norte border region

Abstract Cancer survivorship research has largely focused on non-Latino white participants, with fewer studies exploring survivorship in multi-ethnic groups. The goal of this study was to explore the experiences of Latina mothers living with cancer in the southwest U.S.-Mexico border region. Diagnosed mothers were asked to describe their (i) challenges to coping with cancer, (ii) facilitators to coping with cancer, and (iii) types and sources of social support for coping with their cancer. Nine Latina mothers, most of whom reported non-localized cancer diagnoses, participated in focus groups or individual interviews in a pilot study. We conducted a secondary analysis of the verbatim transcripts using inductive content analysis adapted from a grounded theory framework. Coding to consensus, systematic peer debriefing, and maintaining an audit trail protected trustworthiness of study results. The core construct Not letting the cancer take any more than it had from me, is grounded in three domains reflecting their challenging position as Latina mothers under the age of 50 living with various types and stages of cancer in a resource-challenged border region. The first domain, Having the most difficult time of my life, was composed of three categories that covered their struggles with cancer treatment (i.e. feeling like treatment is worse than the disease, being scared to look in the mirror, and feeling very alone). The second domain, Figuring out how to live day-by-day, was composed of two categories that captured the impact of cancer on their homes and their need for instrumental support (i.e. being especially challenging on my family and home life and needing other things). The last domain, Giving me the strength to fight and carry on, was composed of the remaining six categories that revealed how the mothers garnered all the resources available to them to physically and mentally overcome the stress of cancer and its treatment (getting support and compassion from medical staff, friends, family, their children, and other cancer patients; trusting God; and not letting the cancer stop them). Latina mothers under the age of 50 living with diverse cancer types and stages on the U.S.-Mexico border described the complexity of factors influencing their survivorship experience and the strategies they used to move forward. Results highlighted the importance of assessing cancer survivorship experiences across cancer types, age groups, regions, and diverse racial/ethnic groups. These findings can be used to develop targeted approaches to improve the quality of survivorship among Latinas. Citation Format: Clara Reyes, Rebecca Palacios, Karoline Sondgeroth, Frances Lewis. Not letting the cancer take any more than it had from me: Latina mothers surviving cancer in the Paso del Norte border region [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3350.

Predictive Utility of Alcohol Use Disorder Symptoms Across Race/Ethnicity

Research has shown differences in alcohol use and problems across race/ethnicity. This study examines whether there are differential effects of alcohol use disorder (AUD) symptoms on drinking outcomes across race/ethnicity. Data from 1483 patients admitted to a hospital for treatment of an injury were utilized (19% Black, 45% non-Latino White, and 36% Latino). AUD symptoms and race/ethnicity reported at baseline and their interaction were the predictor variables. Drinking patterns and associated problems measured at the 6- and 12-month follow-up were the outcome variables of interest. Linear regression was the analytic method employed. Endorsement of “spending a great deal of time to obtain, use, or recover from effects of drinking,” “craving,” “failure to fulfill major role obligations,” and “alcohol use in physically hazardous situations” at baseline was associated with greater levels of subsequent alcohol use and alcohol-related problems at both 6- and 12-month follow-ups, regardless of race/ethnicity. Endorsement of “important social, occupational, or recreational activities given up because of drinking” was differentially associated with greater alcohol-related problems at both 6- and 12-month follow-ups dependent on race/ethnicity. Follow-up analyses indicated that this symptom was a significant predictor of alcohol problems among Latino and Black participants, but not non-Latino White participants. Brief interventions targeting these AUD symptoms could increase the effectiveness of brief motivational interventions among different racial/ethnic groups.

The effects of supported employment in Latino consumers with severe mental illness.

Despite the large number of Latinos living in the United States, little research has evaluated the effectiveness of different vocational rehabilitation programs for individuals with severe mental illness in this rapidly growing minority population. This article presents a secondary analysis of a randomized, controlled trial comparing supported employment with 2 other vocational rehabilitation programs in 3 ethnic/racial groups of participants with severe mental illness: Latinos, non-Latino African Americans, and non-Latino Whites. The data were drawn from a previously published randomized, controlled trial comparing supported employment with standard vocational rehabilitation services and a psychosocial clubhouse program in persons with severe mental illness (Mueser et al., 2004), including 64 Latinos, 91 non-Latino African Americans, and 43 non-Latino Whites. Comparisons were made between the 3 groups at baseline on demographic characteristics, clinical and psychosocial functioning, and quality of life. Within each ethnic/racial group, competitive employment and all paid employment outcomes were compared between the 3 vocational rehabilitation programs over the 2-year study period. At baseline, the Latino participants had lower levels of education and disability income, were less likely to have worked competitively over the previous 5 years, had more severe symptoms, and worse psychosocial functioning than the non-Latino African American or non-Latino White participants. Latinos randomized to supported employment had better competitive and all-paid work outcomes than those assigned to either standard services or the psychosocial clubhouse program, similar to the non-Latino consumers. Rates of competitive work for consumers in supported employment were comparable across all 3 racial/ethnic groups. Supported employment is effective at improving competitive work in Latinos with severe mental illness. Efforts should be made to increase access to supported employment in the growing population of Latinos with severe mental illness.

Measurement equivalence of the Revised Helping Alliance Questionnaire across African American and non-Latino White substance using adult outpatients

Analyses of the effectiveness of substance abuse treatments across racial/ethnic groups should ensure that outcome measures have the same conceptual meaning (i.e., measurement equivalence) across groups. Because racial groups differ in perceptions and experiences of the therapeutic alliance, this study investigated measurement equivalence properties of the Revised Helping Alliance Questionnaire (HAq-II) across racial groups. The sample included 138 African American and 133 non-Latino White participants, age 18–64years, who participated in a randomized clinical trial investigating the effectiveness of Motivational Enhancement Therapy in the National Institute on Drug Abuse Clinical Trials Network. Results demonstrated configural invariance and two forms of metric invariance (weak and strong/scalar), suggesting that conceptualizations of therapeutic alliance and overall levels of endorsement of therapeutic alliance are comparable across racial groups. The groups indicated partial, strict metric nonequivalence. No studies to date reported measurement equivalence properties of the HAq-II. Findings support valid measurement and interpretation of HAq-II outcomes.

The Harvard/Brown Anxiety Research Project-Phase II (HARP-II): Rationale, methods, and features of the sample at intake

We describe the rationale, method, and intake demographic and clinical findings of the Harvard/Brown Anxiety Research Project-Phase II (HARP-II). HARP-II is the first prospective, observational, longitudinal study to describe the characteristics and course of anxiety in African American, Latino, and Non-Latino White individuals. Participants met criteria for at least one of the following disorders: Generalized Anxiety Disorder, Social Phobia, Panic Disorder with or without Agoraphobia, Agoraphobia without history of Panic Disorder, Post-traumatic Stress Disorder. Initial intake data, collected between 2004 and 2011, are presented for 165 African American, 150 Latino, and 172 Non-Latino White participants. Participants evidenced substantial psychiatric comorbidity (mean number of Axis I disorders=3.4), and moderate to severe symptoms and functional impairment. HARP-II will examine clinical course, in the context of potential socio-cultural and individual moderators (e.g., discrimination, acculturation, negative affect). Results should lead to improved understanding, prognostics, and treatment of anxiety in diverse populations.

Investigation of racial and ethnic disparities in service utilization among homeless adults with severe mental illnesses.

This study examined whether there are service disparities among homeless adults with severe mental illnesses, a vulnerable population with a high level of unmet need. Data were collected at baseline for 6,829 black, Latino, and non-Latino white participants in the Access to Community Care and Effective Services and Support study. Outcome variables were measures of utilization of psychiatric outpatient, housing, and case management services in the previous 60 days. The sample was divided into white-black and white-Latino cohorts. Within each cohort, participants were stratified into comparable groups by propensity scores that estimated log-odds of being black or Latino as a function of several confounding variables. White-black and white-Latino differences in mean number of visits (a measure of intensity) and in the mean probability of at least one visit (a measure of access) were subsequently estimated for each of the three services. The composition of the sample was 50% black, 6% Latino, and 44% white. Service utilization was low for the three services regardless of race-ethnicity. On multivariate analyses of service utilization in the previous 60 days, blacks made fewer psychiatric outpatient visits than whites (mean difference=.46, 95% confidence interval [CI]=.10 to .81]), yet Latinos had more case management visits than whites (mean difference=-.51, CI=-1.03 to -.05]). Analyses of access did not reveal racial-ethnic disparities. Whereas blacks used psychiatric outpatient services less frequently than whites, hence experiencing a service disparity, Latinos used case management services more than whites did. Possible contributors and clinical and methodological implications of these results are discussed.

Investigation of Racial and Ethnic Disparities in Service Utilization Among Homeless Adults With Severe Mental Illnesses

This study examined whether there are service disparities among homeless adults with severe mental illnesses, a vulnerable population with a high level of unmet need. Data were collected at baseline for 6,829 black, Latino, and non-Latino white participants in the Access to Community Care and Effective Services and Support study. Outcome variables were measures of utilization of psychiatric outpatient, housing, and case management services in the previous 60 days. The sample was divided into white-black and white-Latino cohorts. Within each cohort, participants were stratified into comparable groups by propensity scores that estimated log-odds of being black or Latino as a function of several confounding variables. White-black and white-Latino differences in mean number of visits (a measure of intensity) and in the mean probability of at least one visit (a measure of access) were subsequently estimated for each of the three services. The composition of the sample was 50% black, 6% Latino, and 44% white. Service utilization was low for the three services regardless of race-ethnicity. On multivariate analyses of service utilization in the previous 60 days, blacks made fewer psychiatric outpatient visits than whites (mean difference=.46, 95% confidence interval [CI]=.10 to .81]), yet Latinos had more case management visits than whites (mean difference=-.51, CI=-1.03 to -.05]). Analyses of access did not reveal racial-ethnic disparities. Whereas blacks used psychiatric outpatient services less frequently than whites, hence experiencing a service disparity, Latinos used case management services more than whites did. Possible contributors and clinical and methodological implications of these results are discussed.

Are Latinos really less likely to be smokers? Lessons from Oregon

Our objective was to identify factors associated with current cigarette smoking among Latino adults in Oregon. We used data from 1,356 Latino participants and, for comparison, 18,593 non-Latino White participants in the 2000-2002 Oregon Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is a random-digit-dialed, cross-sectional survey of noninstitutionalized, English- or Spanish-speaking adults who live in Oregon households with a telephone. We examined relationships between current smoking and gender, age, education, and survey language (a measure of acculturation) among Latinos and used the .05 level of significance. The prevalence of current smoking was significantly lower among Latinos (18.1%) than non-Latino Whites (20.8%). Latino men were significantly more likely than Latina women to be smokers (23.1% vs. 11.4%), and some evidence indicated that less education was associated with smoking among Latino men. Taking the survey in English was strongly and significantly associated with smoking among Latina women: Smoking prevalence was 20.5% among those taking the survey in English and 3.3% for those taking it in Spanish. Our results suggest that the lower smoking prevalence among Latinos was driven by Latina women taking the survey in Spanish. Hence, it is essential for tobacco control programs to examine their local Latino smoking prevalence by gender and acculturation to avoid incorrectly concluding that Latinos are at decreased risk. Although programs for Latinos should reinforce protective aspects of Latino culture, decreasing the smoking prevalence in the U.S. mainstream culture might mitigate the negative impact of acculturation on smoking behaviors.