The role of peers and parents in predicting alcohol consumption among Chilean youth

This study estimated marginal associations of parent- and peer-related measures to examine the different patterns of lifetime ever-use and frequency of alcohol consumption among adolescents in Santiago, Chile (N=918). Probit and negative binomial models were applied to predict the probability of ever-use and the average number of drinks consumed in the past 30 days. Results supported the profound role of peer-relationships in the development of youth drinking behavior. Particularly, peer pressure seemed more important in predicting alcohol ever-use than the frequency of drinking. Simultaneously, parents, especially fathers, played a crucial protective role. Policies aimed at preventing various drinking patterns may be more effective if they not only focus on the targeted adolescents, but also reach out to peers and parents.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3906685/Accepted manuscrip

Does gender moderate associations between social capital and smoking? An Asian American study

Growing research finds that social capital is associated with smoking. However, most studies focus on white populations and do not take into account potential differences between genders. The present study examines the associations between social capital and self-report smoking status and assesses the moderating role of gender among a national representative sample of Asian American adults. Social capital consisted of measures of individual social connectedness (i.e. social ties with relatives and friends) and subjective evaluation of family and neighborhood environment (i.e. family and neighborhood cohesion, family conflict). Asian men were almost three times more likely to be current smokers than women (20.1% vs. 7.0%). Results of multivariate logistic regression analyses showed that family conflicts or higher levels of connectedness with family members were associated with increased odds of being a current smoker among Asian Americans as a whole. Further stratified analysis revealed significant gender differences in several aspects of social capital: there were stronger effects of social connectedness with family members on increasing the odds of smoking for women than for men. In addition, women who had closer connections to friends had greater odds of being current smokers, whereas the opposite was true for men. The findings of this study provide new evidence for the differential effects of social capital by gender, suggesting that more studies are needed to understand social capital’s effects in different racial/ethnic populations and the mechanisms by which the effects vary with gender.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374585/Accepted manuscrip

A study of the relationship between parental alcohol problems and alcohol Use among adolescent females in Republic of Korea

OBJECTIVES: The study was designed to test if alcohol use and alcohol-related problems among adolescent females are related to their parents' level of alcohol problems. METHODS: In 2001, a stratified sample of 2077 adolescent females, grades 10-11, from twelve female-only high schools located in a large metropolitan city in the Republic of Korea completed a questionnaire about alcohol use, parental attention, and parental alcohol consumption, and other risk and protective factors. Data were analyzed with chi-square and regression analyses. RESULTS: Nearly 63% of the student drinkers had experienced at least one to two alcohol-related problems in their lives. Two-thirds of all 2077 students indicated that at least one of their parents had an alcohol-related problem and that approximately 29% had experienced several problems. Results of random effects ordinal logistic regression analyses suggest a dose-response relationship between parental and youth alcohol-related problems. Youth who report having parents with some and many alcohol problems were 30% (Odds Ratios [OR] = 1.30; 95% Confidence Interval [CI] = 1.10 - 1.53) and 55% (OR = 1.55; 95%CI = 1.23 - 1.95) more likely to experience alcoholrelated problems than youth whose parents do not have alcohol problems, respectively, after statistically adjusting for important covariates. CONCLUSIONS: This study presents evidence that alcoholrelated problems among adolescent female students is highly prevalent. Also, the study findings reveal a high percentage of parents with alcohol problems, as reported by students. This study presents evidence of what might be a hidden problem among adults and youths in the Republic of Korea that merits serious attention

Relationship of birth order and gender with academic standing and substance use among youth in Latin America

Alfred Adler attempted to understand how family affects youth outcomes by considering the order of when a child enters a family (Adler, 1964). Adler's theory posits that birth order formation impacts individuals. We tested Adler's birth order theory using data from a cross-sectional survey of 946 Chilean youths. We examined how birth order and gender are associated with drug use and educational outcomes using three different birth order research models including: (1) Expedient Research, (2) Adler's birth order position, and (3) Family Size theoretical models. Analyses were conducted with structural equation modeling (SEM). We conclude that birth order has an important relationship with substance use outcomes for youth but has differing effects for educational achievement across both birth order status and gender.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3375868/Accepted manuscrip

Predictors of discordance among Chilean families

Parent-youth agreement on parental behaviors can characterize effective parenting. Although discordance in families may be developmentally salient and harmful to youth outcomes, predictors of discordance have been understudied, and existing research in this field has been mostly limited to North American samples. This paper addressed this literature gap by using data from a community-based study of Chilean adolescents. Analysis was based on 1,068 adolescents in Santiago, Chile. The dependent variable was discordance which was measured by the difference between parent and youth’s assessment of parental monitoring. Major independent variables for this study were selected based on previous research findings that underscore youth’s developmental factors, positive parental and familial factors and demographic factors. Descriptive and multivariate analyses were conducted to examine the prevalence and associations between youth, parental and familial measures with parent-youth discordance. There was a sizable level of discordance between parent and youth’s report of parental monitoring. Youth’s gender and externalizing behavior were significant predictors of discordance. Warm parenting and family involvement were met with decreases in discordance. The negative interaction coefficients between parental warmth and youth’s gender indicated that positive parental and familial measures have a greater effect on reducing parent-youth discordance among male youths. Results support the significance of positive family interactions in healthy family dynamics. Findings from this study inform the importance of services and interventions for families that aim to reduce youth’s problem behavior and to create a warm and interactive family environment.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4181713/Accepted manuscrip

Race/ethnicity and gender differences in drug use and abuse among college students

This study examines race/ethnicity and gender differences in drug use and abuse for substances other than alcohol among undergraduate college students. A probability-based sample of 4,580 undergraduate students at a Midwestern research university completed a cross-sectional Web-based questionnaire that included demographic information and several substance use measures. Male students were generally more likely to report drug use and abuse than female students. Hispanic and White students were more likely to report drug use and abuse than Asian and African American students prior to coming to college and during college. The findings of the present study reveal several important racial/ethnic differences in drug use and abuse that need to be considered when developing collegiate drug prevention and intervention efforts.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2377408/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2377408/Accepted manuscrip

Health implications of an immigration raid: findings from a Latino community in the midwestern United States.

Immigration raids exemplify the reach of immigration law enforcement into the lives of Latino community members, yet little research characterizes the health effects of these raids. We examined the health implications of an immigration raid that resulted in multiple arrests and deportations and occurred midway through a community survey of a Latino population. We used linear regression following principal axis factoring to examine the influence of raid timing on immigration enforcement stress and self-rated health. We controlled for age, sex, relationship status, years in the county in which the raid occurred, children in the home, and nativity. 325 participants completed the survey before the raid and 151 after. Completing the survey after the raid was associated with higher levels of immigration enforcement stress and lower self-rated health scores. Findings indicate the negative impact of immigration raids on Latino communities. Immigration discussions should include holistic assessments of health.UL1 TR000433 - NCATS NIH HH

Impact of early initiation versus national standard of care of antiretroviral therapy in Swaziland's public sector health system : study protocol for a stepped-wedge randomized trial

Background: There is robust clinical evidence to support offering early access to antiretroviral treatment (ART) to all HIV-positive individuals, irrespective of disease stage, to both improve patient health outcomes and reduce HIV incidence. However, as the global treatment guidelines shift to meet this evidence, it is still largely unknown if early access to ART for all (also referred to as "treatment as prevention" or " universal test and treat") is a feasible intervention in the resource-limited countries where this approach could have the biggest impact on the course of the HIV epidemics. The MaxART Early Access to ART for All (EAAA) implementation study was designed to determine the feasibility, acceptability, clinical outcomes, affordability, and scalability of offering early antiretroviral treatment to all HIV-positive individuals in Swaziland's public sector health system. Methods: This is a three-year stepped-wedge randomized design with open enrollment for all adults aged 18 years and older across 14 government-managed health facilities in Swaziland's Hhohho Region. Primary endpoints are retention and viral suppression. Secondary endpoints include ART initiation, adherence, drug resistance, tuberculosis, HIV disease progression, patient satisfaction, and cost per patient per year. Sites are grouped to transition two at a time from the control (standard of care) to intervention (EAAA) stage at each four-month step. This design will result in approximately one half of the total observation time to accrue in the intervention arm and the other half in the control arm. Our estimated enrolment number, which is supported by conservative power calculations, is 4501 patients over the course of the 36-month study period. A multidisciplinary, mixed-methods approach will be adopted to supplement the randomized controlled trial and meet the study aims. Additional study components include implementation science, social science, economic evaluation, and predictive HIV incidence modeling. Discussion: A stepped-wedge randomized design is a causally strong and robust approach to determine if providing antiretroviral treatment for all HIV-positive individuals is a feasible intervention in a resource-limited, public sector health system. We expect our study results to contribute to health policy decisions related to the HIV response in Swaziland and other countries in sub-Saharan Africa