Urban Minority Adolescents Research Articles

Explaining behavioral health differences in urban and rural sexual minority adolescents: A longitudinal investigation of minority stress in a diverse national sample of sexual minority adolescents: A longitudinal investigation of minority stress in a diverse national sample of sexual minority adolescents.

Experiences of sexuality-based discrimination (ie, minority stressors) against youth who identify as nonheterosexual (ie, sexual minority) have been associated with increased symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD) for sexual minority adolescents (SMA; ages 14-17). However, little is known about the experiences of SMA living in rural communities across the United States. Thus, the present study sought to examine differences in mental health patterns between urban and rural dwelling SMA, and to see whether these differences are, at least in part, explained by experiences of lifetime minority stress. A nationwide sample of SMA residing in the United States (N = 2,558; aged 14-17, M = 15.90 years, SD = 0.98) was recruited through purposive social media and respondent-driven sampling methods to complete a cross-sectional survey online. Measures included those of minority stress, urbanicity, and symptoms of anxiety, depression, and PTSD. Parallel multiple mediation (PMM) analysis was employed to test whether urbanicity was associated with anxiety, depressive, and PTSD symptoms through reported lifetime minority stress. On average, SMA living in rural areas significantly reported more lifetime minority stress, depressive, and PTSD symptoms than SMA living in urban settings. Results from our PMM analysis indicated that heightened experiences of lifetime minority stress indirectly linked the effects of living in rural areas on anxiety (b = -0.288, 95% CI = [-0.491, -0.085]), depressive (b = -0.158, 95% CI = [-0.270, -0.047), and PTSD symptoms PTSD (b = -0.349, 95% CI = [-0.596, -0.105]). The model accounted for 16.8%, 18%, and 24.1% of the variability in anxiety symptoms, depressive symptoms, and PTSD symptoms, respectively. SMA in our study who reside in rural areas reported elevated minority stress, depressive, and PTSD symptoms as compared to their urban dwelling peers. Our study found that lifetime experiences of minority stress fully mediated the relationship between urbanicity and both depressive and PTSD symptoms, and partially mediated the relationship between urbanicity and anxiety. These findings highlight the need to increase support for rural youth who are growing into adulthood and may find continuing challenges in their family, peer, and community relationships.

Psychosocial stress, sleep quality and interest in mind-body integrative health sleep intervention among urban adolescents in the school-based health setting

BackgroundMind-body integrative health (MBIH) interventions to improve adolescent sleep are lacking. The study characterized sleep quality and bedtime-related psychosocial stressors among urban minority adolescents, explored associations between demographics factors, stressors and sleep quality, and gauged interest in a MBIH sleep intervention. Materials and methods167 school-based health center (SBHC) patients (mean age = 16.3; 64 % female; 68 % Latino) participated in a needs assessment as part of a quality improvement project. They reported bedtime-related psychosocial stressors using items from the Adolescent Sleep Hygiene Scale (ASHS), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and interest in a MBIH-based sleep intervention. Chi-square and logistic regression examined associations between demographics, stressors, sleep quality, and interest in the intervention. Results67 % had poor sleep quality. Females, compared to males, had 2.23 higher odds (95 % Confidence Interval [CI]: 1.12, 4.42) of having poor sleep quality. Nearly 80 % experienced bedtime-related stressors (25 % experienced one stressor, 17 % two stressors and 37 % three or more stressors); relative to those reporting no stressors, those reporting 3+ stressors had 3.15 higher odds (95 % CI: 1.27, 7.84) of having poor sleep quality. Most (77 %) reported they would participate in an SBHC-based intervention that utilized MBIH modalities preferring both one-on-one and group sessions. ConclusionsUrban, predominantly Hispanic and Black, SBHC adolescent patients have poor sleep quality and report bedtime-related psychosocial stressors. Their interest in MBIH interventions to address sleep problems represents a unique opportunity for practitioners and complementary therapists to offer MBIH interventions to a population at high-risk for poor sleep quality.

Small-Groups Versus Full-Class Exergaming on Urban Minority Adolescents' Physical Activity, Enjoyment, and Self-Efficacy.

The effects of school-based exergaming interventions on adolescents' physical activity (PA) and psychosocial outcomes have been mixed. Researchers speculate this may be attributed to design issues. Therefore, this study examined differences in urban minority adolescents' PA, enjoyment, and self-efficacy during small-groups and full-class exergaming. Forty-seven urban minority adolescents (83% black; X¯age=11.8+1.3 y) completed two 15-minute exergaming sessions on the Xbox One Kinect Just Dance: (1)small groups (n = 3-4) and (2)full class (n = 23-24). Participants' time in sedentary behavior, light PA, and moderate to vigorous PA and steps were retrieved from ActiGraph GT3X+ accelerometers with enjoyment and self-efficacy assessed using validated surveys. Participants spent significantly more time in sedentary behavior (5.9 [5.2] min vs 3.5 [2.7] min, respectively: P < .001, d = 0.57) and less time in moderate-to-vigorous PA (2.1 [2.8] min vs 5.5 [2.2]min, respectively: P < .001, d = 0.85) during the full-class versus the small-groups session. Moreover, small-groups exergaming resulted in significantly higher steps than the full-class exergaming (504.2 [132.1] vs 387.8 [122.1], respectively: P = .01, d = 0.50) and significantly greater enjoyment (3.5 [1.1] vs 3.2 [1.0], respectively: P = .02, d = 0.37). There were no significant differences between sessions for time in light PA and self-efficacy. Small-groups exergaming appears ideal for promoting enjoyable PA at higher intensities and lower sedentary time in underserved minority adolescents.

Caregivers as gatekeepers: Professional mental health service use among urban minority adolescents.

Mental illness among adolescents frequently goes untreated, especially among low income and ethnic minority families. We sought to examine parent and adolescent psychological factors influencing mental health service use among 120 urban adolescents (82% African American, Age 13-18 years, M = 14.29, SD = 1.52) who had access to mental health treatment through their community primary care setting. We utilized structural equation modeling (SEM) to explore the independent and combined associations among parent and adolescent variables hypothesized to be associated with the youth's engagement in mental health treatment. Results showed that more than half (63.6%) of youth with clinically significant levels of symptoms were not currently engaged in treatment or seeking mental health services. One latent variable emerged: caregivers' perceptions of adolescent mental health problems (consisted of youth psychological symptoms, youth functional impairment, and strain on caregiver). Together with caregivers' attitude toward professional help, these two caregiver-reported variables, but not adolescents' attitude, were associated with higher likelihood of service utilization among adolescents. Findings suggest caregivers functioned as the "gatekeepers" to mental health services. We discuss findings' implications for engaging youth in mental health services as well as study limitations and future directions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Carotenoids, fatty acids and disease burden in obese minority adolescents with asthma

Paediatric obesity-related asthma causes high disease burden, is associated with metabolic abnormalities, has few therapeutic options, and disproportionately affects urban minority children. Although poor diet quality is linked to asthma, the association of nutritional status with disease burden among children with obesity-related asthma is not well understood. To quantify nutritional status, defined as concentrations of serum carotenoids and n-3 fatty acids, and its association with pulmonary function and metabolic markers among obese asthmatic children. We quantified serum carotenoids and fatty acids in a study cohort of 158 urban minority adolescents including 39 obese asthmatics, 39 healthy weight asthmatics, 38 obese controls and 42 healthy weight controls and compared between the groups. We correlated carotenoid and fatty acid levels with pulmonary function indices and with insulin resistance and dyslipidemia. Mean total carotenoids were lowest in obese asthmatic children (0.41μg/mL), lower than healthy weight asthmatics (0.52μg/mL, P<0.05) and healthy weight controls (0.60μg/mL, P<0.001). n-6/n-3 polyunsaturated fatty acid (PUFA) ratio also differed between the groups (P<0.05). Total carotenoids positively correlated with per cent-predicted FEV1 and inversely correlated with insulin resistance among obese asthmatics only. n-6/n-3 PUFA ratio inversely correlated with per cent-predicted FEV1 in obese asthmatics. Our findings suggest that carotenoids, which are lowest in obese asthmatic children, may have protective effects on metabolic health and pulmonary function among obese asthmatic children. Similarly, n-3 PUFA appear to be protective for pulmonary function.

The Social Context of Substance Use and Perceived Risk among Rhode Island Urban Minority Adolescents.

Our qualitative study examined how stresses of daily life affected substance use and perceived risk among Black and Hispanic adolescents. We conducted 11 focus groups with students aged 13-25 in public and alternative schools in Providence, Rhode Island, using Bourdieu's Social Practice theoretical approach to guide questioning and data analysis. Despite participants' frequent marijuana use, they perceived the emphasis society places on substance use as misguided, obfuscating the persistence of more critical problems such as stress and reduced opportunity resulting from neighborhood violence, poor schools, financial difficulties, and home troubles. Drug use appeared not to be a catalyst but a response. Our findings underscore the need for prevention strategies to address systemic racism and structural conditions limiting opportunities in young people's lives. Planners should explore adolescents' pragmatic decision-making contexts and ways that social, health, and community resources can together contribute to conditions where adolescents have opportunities to make healthful choices.

Patterns of time use among low-income urban minority adolescents and associations with academic outcomes and problem behaviors.

Time budgets represent key opportunities for developmental support and contribute to an understanding of achievement gaps and adjustment across populations of youth. This study assessed the connection between out-of-school time use patterns and academic performance outcomes, academic motivations and goals, and problem behaviors for 504 low-income urban African American and Latino adolescents (54% female; M = 16.6 years). Time use patterns were measured across eight activity types using cluster analysis. Four groups of adolescents were identified, based on their different profiles of time use: (1) Academic: those with most time in academic activities; (2) Social: those with most time in social activities; (3) Maintenance/work: those with most time in maintenance and work activities; and (4) TV/computer: those with most time in TV or computer activities. Time use patterns were meaningfully associated with variation in outcomes in this population. Adolescents in the Academic cluster had the highest levels of adjustment across all domains; adolescents in the Social cluster had the lowest academic performance and highest problem behaviors; and adolescents in the TV/computer cluster had the lowest levels of intrinsic motivation. Females were more likely to be in the Academic cluster, and less likely to be in the other three clusters compared to males. No differences by race or gender were found in assessing the relationship between time use and outcomes. The study's results indicate that time use patterns are meaningfully associated with within-group variation in adjustment for low-income minority adolescents, and that shared contexts may shape time use more than individual differences in race/ethnicity for this population.

Let Our Voices Be Heard: Urban Minority Adolescents Share Their Perspectives regarding Substance Abuse and HIV/AIDS Prevention Messages

This study explored the substance abuse and human immunodeficiency virus prevention needs of urban minority adolescents. Six 1-hour focus groups. Two high schools and two community-based organizations located in the city of Paterson, New Jersey. The sample included 41 African-American and Latino youth, ranging in ages from 13 to 18 years. Data were collected through six focus group interviews. Each group discussion was audio-recorded and transcribed. Qualitative software was then used to facilitate the processes of thematic analysis, until emergent themes transcended the data. To bolster the rigor and confirmability of analysis, additional researchers coded stratified selections of transcript. Study participants were able to identify the environmental threats and structural deficits impacting their city. Few of the youth were able to recognize substance abuse and HIV/AIDS prevention messages in their immediate surroundings. Additionally, most participants indicated that prevention messages must be delivered in authentic ways from relatable sources in order to resonate with their audience. Our findings emphasize the importance of infusing the adolescents' voices into the design and implementation of health promotion messages, which could serve to increase their receptivity and responsiveness, and the overall resonance of the interventions.

Association of pulmonary function with adiposity and metabolic abnormalities in urban minority adolescents.

Childhood obesity is a known risk factor for pulmonary diseases, likely due to obesity-mediated alteration of pulmonary function. Inflammation and mechanical fat load are two proposed causative mechanisms for altered pulmonary function among obese children; however, the association of metabolic abnormalities with pulmonary function among children is poorly understood. We investigated the independent association of truncal and general adiposity and metabolic abnormalities with pulmonary function in a sample of urban minority adolescents. Spirometry and lung volume indices were compared between adolescents with general (body mass index [BMI] > 95th percentile) or truncal adiposity (waist circumference > 90th percentile) and normal-weight (BMI < 85th percentile or waist circumference ≤ 90th percentile) and between those with metabolic abnormalities (homeostatic model assessment of insulin resistance [HOMA-IR] in the top quartile or high-density lipoprotein [HDL] < 40 mg/dl) and those with a normal metabolic profile. Obese adolescents had lower lung volumes, including residual volume (RV), RV/TLC ratio, expiratory reserve volume (ERV), and FRC, and higher inspiratory capacity (IC) than normal-weight adolescents, but did not differ in measures of lower airway obstruction, FEV1/FVC ratio, and mid-expiratory flow rate. Adolescents with high HOMA-IR had lower FEV1/FVC ratio, RV, RV/TLC ratio, ERV, and FRC and higher IC, whereas those with low HDL had lower FEV1/FVC and RV/TLC ratios. After adjusting for adiposity, HOMA-IR remained a predictor of ERV (β = -1.4; P = 0.02) and FEV1/FVC ratio (β = -0.5; P = 0.03), and HDL remained a predictor of FEV1/FVC ratio (β = 0.1; P = 0.01). General adiposity was a predictor of FRC (β = -0.5; P < 0.001), IC (β = 0.3; P < 0.001), RV (β = -0.8; P < 0.0001), and RV/TLC ratio (β = -0.2; P < 0.0001), and truncal adiposity was a predictor of RV (β = -20.3; P = 0.03) and FRC (β = -13.8; P = 0.004). Thus, adiposity and metabolic abnormalities were independent predictors of ERV, but only metabolic abnormalities independently predicted FEV1/FVC ratio. Although general adiposity predicted RV and RV/TLC ratio, truncal adiposity was predictive of RV and FRC, conferring additional risk above general adiposity. These results suggest that metabolic abnormalities and adiposity are independently associated with pulmonary function deficits among urban adolescents. Metabolic assessment of obese adolescents may identify those at risk of developing obesity-associated pulmonary morbidity.

Adolescent self-defined neighborhoods and activity spaces: Spatial overlap and relations to physical activity and obesity

Defining the proper geographic scale for built environment exposures continues to present challenges. In this study, size attributes and exposure calculations from two commonly used neighborhood boundaries were compared to those from neighborhoods that were self-defined by a sample of 145 urban minority adolescents living in subsidized housing estates. Associations between five built environment exposures and physical activity, overweight and obesity were also examined across the three neighborhood definitions. Limited spatial overlap was observed across the various neighborhood definitions. Further, many places where adolescents were active were not within the participants׳ neighborhoods. No statistically significant associations were found between counts of facilities and the outcomes based on exposure calculations using the self-defined boundaries; however, a few associations were evident for exposures using the 0.75mile network buffer and census tract boundaries. Future investigation of the relationship between the built environment, physical activity and obesity will require practical and theoretically-based methods for capturing salient environmental exposures.

Associations of obesity and asthma with functional exercise capacity in urban minority adolescents.

To examine the independent association of asthma and obesity and of their co-existence with functional exercise capacity among urban adolescents. One hundred eighteen Hispanic- and African-American adolescents including 33 obese asthmatics, 18 normal-weight asthmatics, 38 obese non-asthmatics, and 29 normal-weight non-asthmatics underwent anthropometric measures, 6-minute walk test (6MWT) as measure of functional exercise capacity and spirometry as measure of pulmonary function. The 6-minute walk distance (6MWD) was compared between the four study groups. The association of 6MWD with measures of lower airway obstruction, and measures of adiposity was assessed. The 6MWD was lower among the obese groups with the least distance covered by the obese asthmatic group (P = 0.02). In the obese asthmatic group, there was a negative correlation between 6MWD and body mass index (BMI) (r = -0.35, P = 0.03), but no association was noted with percent-predicted forced expiratory volume in the 1st second (FEV(1) ; r = 0.07, P = 0.70). Conversely, the 6MWD correlated with FEV(1) among normal-weight asthmatics (r = 0.45, P = 0.04) and normal-weight non-asthmatics (r = 0.4, P = 0.03), but was not associated with BMI in either of the two groups. After adjusting for age, height, gender, and ethnicity, BMI was noted to be a significant predictor (β -2.76, 95% CI -4.77 to -0.76, P < 0.01) of the 6MWD among the obese while percent predicted FEV(1) (β 1.87, 95% CI 0.28-3.45, P = 0.02) was a significant predictor among the normal-weight participants. Our findings suggest that among urban minority obese asthmatic adolescents, functional exercise capacity was associated with obesity, rather than pulmonary function.

Tap or Bottled Water: Drinking Preferences Among Urban Minority Children and Adolescents

The last decade has seen an increasing trend in consumer preference of bottled water over tap water. Little is known what type of water children and adolescents prefer for drinking and what their parents think of their community tap water. The study objective was to assess drinking water preferences, perceptions of the qualities of tap water and bottled water, and fluoride knowledge in an urban pediatric population. We conducted an anonymous survey of a convenience sample of caretakers of children and adolescents at an urban clinic regarding their preferences for tap or bottled water, their perceptions of the quality of tap and bottled water and their knowledge of fluoride. Of the 208 participants (79% African American, 9% Latino), 59% drank tap water, 80% bottled water. Only 17% drank tap water exclusively, 38% drank bottled water exclusively, 42% drank both. We found no significant differences in water preferences across age groups, from infancy to adulthood, or among ethnic groups. Ratings for taste, clarity, purity and safety were significantly higher for bottled water than tap water (P<0.001). Only 24% were aware of fluoride in drinking water. We conclude bottled water was preferred over tap water in an urban minority pediatric population. Perceptions of the qualities of water seemed to drive drinking preferences. Public health strategies are needed to increase public awareness of the impact of bottled water consumption on oral health, household budgets and the environment.

Step-Up: Promoting Youth Mental Health and Development in Inner-City High Schools

African American and Latino youth who reside in inner-city communities are at heightened risk for compromised mental health, as their neighborhoods are too often associated with serious stressors, including elevated rates of poverty, substance abuse, community violence, as well as scarce youth-supportive resources, and mental health care options. Many aspects of disadvantaged urban contexts have the potential to thwart successful youth development. Adolescents with elevated mental health needs may experience impaired judgment, poor problem-solving skills, and conflictual interpersonal relationships, resulting in unsafe sexual behavior and drug use. However, mental health services are frequently avoided by urban adolescents who could gain substantial benefit from care. Thus, the development of culturally sensitive, contextually relevant and effective services for urban, low-income African American and Latino adolescents is critical. Given the complexity of the mental health and social needs of urban youth, novel approaches to service delivery may need to consider individual (i.e., motivation to succeed in the future), family (i.e., adult support within and outside of the family), and community-level (i.e., work and school opportunities) clinical components. Step-Up, a high school-based mental health service delivery model has been developed to bolster key family, youth and school processes related to youth mental health and positive youth development. Step-Up (1) intervenes with urban minority adolescents across inner-city ecological domains; (2) addresses multiple levels (school, family and community) in order to target youth mental health difficulties; and (3) provides opportunities for increasing youth social problem-solving and life skills. Further, Step-Up integrates existing theory-driven, evidence-based interventions. This article describes Step-Up clinical goals, theoretical influences, as well as components and key features, and presents preliminary data on youth engagement for two cohorts of students.

Effects of a School-based Intervention for Urban Adolescents with Asthma

Asthma prevalence and morbidity are especially elevated in adolescents, yet few interventions target this population. To test the efficacy of Asthma Self-Management for Adolescents (ASMA), a school-based intervention for adolescents and medical providers. Three hundred forty-five primarily Latino/a (46%) and African American (31%) high school students (mean age = 15.1 yr; 70% female) reporting an asthma diagnosis, symptoms of moderate to severe persistent asthma, and asthma medication use in the last 12 months were randomized to ASMA, an 8-week school-based intervention, or a wait-list control group. They were followed for 12 months. Students completed bimonthly assessments. Baseline, 6-month, and 12-month assessments were comprehensive; the others assessed interim health outcomes and urgent health care use. Primary outcomes were asthma self-management, symptom frequency, and quality of life (QOL); secondary outcomes were asthma medical management, school absences, days with activity limitations, and urgent health care use. Relative to control subjects, ASMA students reported significantly: more confidence to manage their asthma; taking more steps to prevent symptoms; greater use of controller medication and written treatment plans; fewer night awakenings, days with activity limitation, and school absences due to asthma; improved QOL; and fewer acute care visits, emergency department visits, and hospitalizations. In contrast, steps to manage asthma episodes, daytime symptom frequency, and school-reported absences did not differentiate the two groups. Most results were sustained over the 12 months. ASMA is efficacious in improving asthma self-management and reducing asthma morbidity and urgent health care use in low-income urban minority adolescents.

Intergroup Contact and Evaluations of Race-Based Exclusion in Urban Minority Children and Adolescents

There is a dearth of published research on the role of intergroup contact on urban US ethnic minority children's and adolescents' evaluations of racial exclusion. The current investigation examined these issues in a sample of low-income minority 4th, 7th, and 10th grade (N = 129, 60% female) African American and Latino/a students attending predominately racial and ethnic minority US urban public schools. Using individual interviews, participants were presented with scenarios depicting three contexts of interracial peer exclusion (lunch at school, a sleepover party, and a school dance). Novel findings were that intergroup contact was significantly related to low-income urban ethnic minority youth's evaluations of the wrongfulness of race-based exclusion and their awareness of the use of stereotypes to justify racial exclusion. Further, significant interactions involving intergroup contact, context, age, and gender were also found. Findings illustrated the importance of intergroup contact for ethnic minority students and the complexity of ethnic minority children's and adolescents' judgments and decision-making about interracial peer exclusion.

Vitamin D Insufficiency Is Prevalent among Pregnant African American Adolescents

Study Objective Recent attention has focused on vitamin D insufficiency but few data exist on vitamin D status among pregnant minority youth. Design A screening study was undertaken in adolescents having prenatal blood samples drawn for other routine tests obtained during the second trimester (18 ± 1.8 week gestation, n = 44) or third trimester of pregnancy (28.4 ± 2.1 week gestation, n = 36). Serum 25- hydroxyvitamin D (25(OH)D) was measured and significant determinants of vitamin D insufficiency in this cohort were identified. Setting Urban prenatal clinic. Participants Eighty pregnant African American adolescents (≤ 18 y of age). Main Outcome Measure(s) Vitamin D status, STDs, hemoglobin, season, birth weight Results Serum 25(OH)D in this group averaged 21.6 ± 8 ng/mL (age 16.5 ± 1.1 y, n = 80), and did not significantly differ between the second (20.95 ± 8.2 ng/mL, n = 44) and third trimester cohorts (22.5 ± 7.9 ng/mL, n = 36). Vitamin D insufficiency (< 20 ng/mL) was evident in 46.25% and vitamin D deficiency (<15 ng/mL) was evident in 21.25% of those studied. Significant predictors of suboptimal vitamin D status included sampling during the winter months ( P = 0.004), lower hemoglobin concentration ( P = 0.019), and higher second trimester leptin levels ( P = 0.018). Inverse associations between 25(OH)D and bacterial vaginosis were evident when controlled for season of sampling ( P = 0.02, n = 80). Conclusions Vitamin D insufficiency was prevalent among urban pregnant minority adolescents. Further studies are needed to address the impact of this finding on maternal and neonatal calcium homeostasis and bone health.

Enhancing School Engagement in At-Risk, Urban Minority Adolescents Through a School-Based, Adult Mentoring Intervention

ABSTRACT The current study investigated whether a 5-month, adult mentoring intervention delivered by school personnel could enhance the school engagement of ninth grade urban minority adolescents. Compared to 20 at-risk students who did not receive an intervention, 20 at-risk students who were randomly assigned to mentoring exhibited significantly less decline during the first year of high school in perceived teacher support and decision making and were less likely to enter the discipline system. The effects were stronger and included sense of school belonging for participants who were “mentored as intended.” Moreover, mentee and mentor reports of relationship quality were associated with changes in mentored participants' school-related cognitions and behaviors. The findings indicate that adult mentoring may help to prevent normative declines in urban minority youths' school engagement.

Sex differences in overt aggression and delinquency among urban minority middle school students

Given the recent debate over whether differential pathways to overt aggression and delinquency exist between boys and girls, this study examined sex differences in overt aggressive and delinquent acts along with potential differences in precursors (anger, self-control, family disruption) to antisocial behaviors among a sample of urban minority adolescents ( N = 1559). Using a longitudinal design with data from 6th to 7th grade, results showed that girls had greater increases in rates of aggression relative to boys. Delinquency increased over time for both boys and girls, with boys consistently engaging in more delinquency. Girls and boys did not differ on the level of risk factors experienced except for a greater increase in anger over time for girls relative to boys. Across sex, anger and self-control predicted increases in both overt aggression and delinquency; family disruption also predicted increases in delinquency. Implications for subsequent studies on developmental process and preventive interventions are discussed.

The Role of Psychosocial Factors in the Transition to Substance Use: Are They Protective Among Urban Minority Adolescents?

Changes in psychosocial risk and protective factors associated with the onset of substance use were examined in a sample of 556 urban public school sixth graders. General linear modeling analyses indicated that students who did not use substances by the end of sixth grade consistently had higher scores on protective factors than did students who were already using substances at the beginning of sixth grade. Students who began to use during the school year were in flux with scores similar to nonusers at Time 1 and scores closer to early users by Time 2. These findings suggest that interventions which focus on skill enhancement during the transition to middle school may be effective at delaying the onset of substance use. Editors' Strategic Implications: The authors find the same protective factors in this urban, primarily African American sample that are typical in suburban, White samples. Developmentalists and school officials will find interesting the changing effects of protective factors against early substance use during the transitional sixth grade year.

Adolescents’ knowledge of and beliefs about herbs and dietary supplements: a qualitative study

Objective To explore adolescents’ knowledge of and beliefs about dietary supplements, including herbs, and over-the-counter (OTC) medications. Methods Eighteen focus groups with 81 adolescents in Monroe County, New York, explored teens’ familiarity with and beliefs about CAM, specifically dietary supplements. We asked about general health beliefs and opinions of OTC medications to provide a framework for understanding how dietary supplements are conceptualized. Groups were conducted with suburban adolescents, urban minority adolescents, adolescents with chronic illness, (asthma, eating disorders, and diabetes), and patients of complementary/alternative practitioners (“CAM practitioners”). Transcripts were analyzed for themes relating to prevention (“ staying healthy”) and treatment of illness (“ getting better”); direct quotations are used to illustrate adolescents’ views. Results Most adolescents are familiar with “herbal medicine,” “herbal remedies,” or “nutritional supplements,” and are able to name specific products or complementary/alternative medicine (CAM) therapies; however, many are unfamiliar with the term “alternative medicine.” Adolescents are more familiar with remedies or CAM therapies commonly used by people from their own cultural or ethnic background. Older suburban females and those with chronic illnesses are more familiar with herbs and supplements than other adolescents. Most supplement use is conceptually linked with treating illness rather than with preventive care. Conclusions Most adolescents are familiar with culturally based herbal products and nutritional supplements, used for treatment of illnesses, and not for preventive care. Providers and researchers should consider chronic illness status and culture/family tradition, and clarify terms, when asking adolescents about self-care, OTCs, or CAM.