Gender Equality, Drinking Cultures and Second-Hand Harms from Alcohol in the 50 US States.

BackgroundGender inequality and cultures of binge drinking may increase the risk of second-hand harms from alcohol.MethodsUsing the 2014-2015 National Alcohol Survey and 2015 National Alcohol's Harm to Others Survey (N = 7792), we examine associations of state-level gender equality measures (contraceptive access, abortion rights, women's economic equality) and binge drinking cultures (rates of men's and women's binge drinking) with individual-level indicators of second-hand harms by drinking strangers and partners/spouses.ResultsIn main effects models, only male binge drinking was associated with greater odds of harms from drinking strangers. There were significant interactions of gender equality with male binge drinking: High male binge drinking rates were more strongly associated with stranger-perpetrated harms in states low on contraceptive access or abortion rights compared to states high on these measures. Conversely, male binge drinking was more strongly associated with spouse/partner-perpetrated second-hand harms in states with more economic equality, compared to states lower on this measure.ConclusionsDetrimental effects of high male binge drinking rates may be modified by gender equality. Targeted interventions may reduce alcohol-related harms experienced by women in states with high rates of male binge drinking. Restrictions in access to contraception and abortion may exacerbate harms due to men's drinking

Examining How Neighborhood Disadvantage Influences Trajectories of Adolescent Violence: A Look at Social Bonding and Psychological Distress

To understand how neighborhoods influence the development of youth violence, we investigated intrapersonal mediators of the relationship between neighborhood disadvantage and youth violence trajectories between ages 11 and 18. The hypothesized mediators included indicators of social bonding (belief in conventional values, involvement in school activities, religious engagement, and commitment to traditional goals) and psychological distress

The Development of Aggression During Adolescence: Sex Differences in Trajectories of Physical and Social Aggression Among Youth in Rural Areas

Few studies have examined the development of social aggression over time or described trajectories of aggressive behaviors for youth living in rural areas. We compared the timing and patterns of physical and social aggression and examined sex differences in development using five waves of in-school surveys administered over 2.5 years. The sample (N=5151) was 50.0% female, 52.1% white and 38.2% African-American. At baseline the average age was 13.1 years. Multilevel growth curve models showed that physical and social aggression followed curvilinear trajectories from ages 11 to 18, with increases in each type of aggression followed by subsequent declines. Physical aggression peaked around age 15; social aggression peaked around age 14. Boys consistently perpetrated more physical aggression than girls, but the trajectories were parallel. Girls and boys perpetrated the same amount of social aggression at all ages. We discuss implications for prevention programming to address the marked increases in both types of aggression observed during early adolescence

Sex Differences in the Effects of Neighborhood Socioeconomic Disadvantage and Social Organization on Rural Adolescents' Aggression Trajectories

We determined whether effects of neighborhood socioeconomic disadvantage on trajectories of aggression were moderated or mediated by neighborhood social organization and examined sex differences in neighborhood effects for rural adolescents. We used five waves of survey data collected over 2.5 years linked with neighborhood data from interviews with parents and the U.S. Census. The sample (N = 5118) was 50.1% female, 52.0% white and 38.3% African-American; average age at baseline was 13.1 years. Multilevel growth curve models for both girls and boys showed no significant interactions between neighborhood socioeconomic disadvantage and indicators of social organization. Neither sample showed evidence of mediated effects. In main effects models, neighborhood disadvantage was associated with the average aggression trajectory for girls. For boys, the effects of neighborhood socioeconomic disadvantage and social disorganization appeared to be confounded with each other. Neighborhood disadvantage is detrimental for rural girls regardless of the level of social organization

Impact of the policy environment on substance use among sexual minority women

Background: Sexual minority women (SMW) are at greater risk for heavy episodic drinking, frequent marijuana use, and tobacco use than heterosexual women. Because past research has suggested the political and social environment may influence disparities in substance use by sexual orientation, this study examined associations of the U.S. state-level policy environment on substance use by SMW. Methods: A total of 732 SMW participants were recruited from two national online panels: a general population panel (n = 333) and a sexual minority-specific panel (n = 399). Past year substance use was defined by number of days of heavy episodic drinking (HED; 4+ drinks in a day), weekly tobacco use (once a week or more vs. less or none), and weekly marijuana use (once a week or more vs. less or none). Comprehensive state policy protection was defined by enactment of five policies protecting rights of sexual minorities. Regression models compared substance use outcomes for SMW living in states with comprehensive policy protections to SMW living in states with fewer or no protections. Models also assessed the impact of state policies related to alcohol (state monopoly on alcohol wholesale or retail sales), tobacco (state enactment of comprehensive smoke-free workplace laws) and marijuana (legalization of purchase, possession, or consumption of marijuana for recreational use). Results: Comprehensive policy protections were associated with fewer HED days. Recreational marijuana legalization was associated with higher odds of weekly use. Conclusions: Findings underscore the importance of policy protections for sexual minorities in reducing substance use, particularly HED, among SMW

Associations of Neighborhood and Family Factors with Trajectories of Physical and Social Aggression During Adolescence

Adolescents develop within multiple contexts that synergistically influence their behavior and health. To understand the simultaneous influence of neighborhood and family contexts on adolescents, this study examined relationships of neighborhood socioeconomic disadvantage, neighborhood social disorganization, family conflict, parent-child bonding and parental control with trajectories of physical and social aggression. The sample included 5,118 adolescents between ages 11 and 18 (50% female, 52% Caucasian) living in predominantly rural areas. Multilevel growth curve models showed an interaction between neighborhood disadvantage, family conflict and gender on the physical aggression trajectories. The interaction suggested more rapid processes of both increase in and desistance from physical aggression over time for boys with high neighborhood disadvantage and high family conflict, as well as a higher starting point, more gradual increase and slower process of desistance over time for girls in similar neighborhood and family contexts. Less parent-child bonding and less parental control also were associated with higher initial levels of physical aggression. For social aggression, an interaction between family conflict and gender showed girls with high family conflict had the highest initial levels of social aggression, with a more gradual increase over time for these girls compared to their male counterparts in high-conflict families or their female counterparts in low-conflict families. Less parent-child bonding was associated with higher initial levels and a faster increase over time of social aggression, and less parental control was associated with higher initial levels of social aggression. The findings suggest early family-based interventions may help prevent perpetration of both physical and social aggression during adolescence

Comparing substance use outcomes by sexual identity among women: Differences using propensity score methods

Background: Differences in alcohol, tobacco, and other drug (ATOD) use by sexual identity vary across samples of women recruited using different sampling methods. We used propensity score (PS) weighting methods to address two methodological questions: (1) Do disparities between sexual minority women (SMW) and heterosexual women persist when differences in risk and protective factors are similarly distributed between groups, and (2) Does accounting for SMW-specific resiliency factors impact differences between non-probability samples of SMW? Methods: Four samples included SMW from a longitudinal study with a nonprobability sample (n = 373), a national general population panel sample (n = 373), and a national LGBTQ-specific panel sample (n = 311), as well as a national probability sample of heterosexual women (n = 446). Between-groups analyses using double-robust PS weighted models estimated differences in ATOD use under hypothetical conditions in which samples have similar risk and protective factors. Results: After PS weighting, imbalance in confounders between SMW and heterosexual samples was substantially reduced, but not eliminated. In double-robust PS weighted models, SMW samples consistently had significantly greater odds of drug use than heterosexuals, with odds from 8.8 to 5.6 times greater for frequent marijuana use and 4.8–3.2 greater for other drug use. Few differences between SMW samples in ATOD outcomes or other variables remained after PS weighting. Conclusion: Relative to heterosexual women, disparities in marijuana and other drug use among SMW are evident regardless of sampling strategy. The results provide some reassurance about the validity of large nonprobability samples, which remain an important recruitment strategy in research with SMW

Evaluating Neighborhood, Social, and Genetic Influences on Precursors of Alcohol Use Risk Behavior in African American Adolescents

Background: Using a socioecological framework, we examined neighborhood and social stressors in concert with genetic risk for alcohol dependence in relation to externalizing behaviors, important precursors to alcohol-related problems. Methods: We used data from African American adolescents and their caregivers in the Gene, Environment, and Neighborhood Initiative, a subsample of the Mobile Youth and Poverty Study. Participants for the current analyses included 112 adolescents who reported ever having at least one full drink of alcohol. Empirical Bayes scores were used to estimate neighborhood-level violence and transitions. Multivariate models tested main effects and then interactions of family stressors, discrimination, and genetic risk with the neighborhood variables. Results: In the main effects model, adolescent externalizing behaviors were positively associated with greater family stressors, more racial discrimination experiences, and genetic liability, while neighborhood variables were nonsignificant. We found three significant interactions. Specifically, the joint effects of neighborhood violence and transitions and between these neighborhood variables and family stressors were significantly associated with externalizing behaviors. Conclusions: Our findings suggest genetic liability and complex interactions between neighborhood context and social stressors are important contributors that should be considered in the development of early prevention programs for adolescents who live in economically disadvantaged areas

Examining the differential protective effects of women\u27s spirituality and religiosity on alcohol and marijuana use by sexual identity

The current study explored how religiosity and spirituality may differentially influence substance use by sexual identity based on a sample of adult sexual minority women (SMW; n = 437 lesbian; n = 323 bisexual) relative to a heterosexual comparison sample (n = 636). We examined three questions: (1) whether spirituality was differentially associated with alcohol and marijuana use by sexual identity; (2) whether religiosity was differentially associated with alcohol and marijuana use by sexual identity; (3) whether observed differences between spirituality or religiosity and substance use by sexual identity persisted after adjusting for religious environment. Measures included spirituality (importance of spirituality), religiosity (importance of religion, attending religious services), and past year substance use (alcohol use disorder [AUD], any marijuana use, and regular marijuana use). Higher levels of spirituality were associated with increased odds of AUD among both lesbian and bisexual respondents relative to heterosexuals. Higher levels of religiosity among lesbian participants were associated with increased odds of AUD relative to heterosexuals with higher levels of religiosity. Consistent with theories of minority stress, findings suggest that spirituality and religiosity are less protective for SMW than heterosexual women and, in some cases, may contribute to greater risk of substance use

Challenges of Virtual RDS for Recruitment of Sexual Minority Women for a Behavioral Health Study

Respondent-driven sampling (RDS) is an approach commonly used to recruit nonprobability samples of rare and hard-to-find populations. The purpose of this study was to explore the utility of phone- and web-based RDS methodology to sample sexual minority women (SMW) for participation in a telephone survey. Key features included (i) utilizing a national probability survey sample to select seeds; (ii) web-based recruitment with emailed coupons; and (iii) virtual processes for orienting, screening, and scheduling potential participants for computer-assisted telephone interviews. Rather than resulting in a large diverse sample of SMW, only a small group of randomly selected women completed the survey and agreed to recruit their peers, and very few women recruited even one participant. Only seeds from the most recent of two waves of the probability study generated new SMW recruits. Three RDS attempts to recruit SMW over several years and findings from brief qualitative interviews revealed four key challenges to successful phone- and web-based RDS with this population. First, population-based sampling precludes sampling based on participant characteristics that are often used in RDS. Second, methods that distance prospective participants from the research team may impede development of relationships, investment in the study, and motivation to participate. Third, recruitment for telephone surveys may be impeded by multiple burdens on seeds and recruits (e.g., survey length, understanding the study and RDS process). Finally, many seeds from a population-based sample may be needed, which is not generally feasible when working with a limited pool of potential seeds. This method may yield short recruitment chains, which would not meet key RDS assumptions for approximation of a probability sample. In conclusion, potential challenges to using RDS in studies with SMW, particularly those using virtual approaches, should be considered