SOCIAL NETWORKS, DRUG USE, AND DRUG ABUSE HELP-SEEKING: A TEST OF THE NETWORK EPISODE MODEL AMONG AFRICAN AMERICAN WOMEN

Untreated substance use disorders are a major public health concern that has costly consequences at both the societal and individual level. Identifying the characteristics and resources of those who seek help for substance abuse problems in order to inform more effective intervention and treatment techniques is therefore an important research objective. Using the Network Episode Model (NEM) as a theoretical framework, this dissertation examines both substance abuse help-seeking (i.e. inpatient/outpatient treatment and 12-Step meeting attendance) and patterns of drug use over time among low-income African American women, with a special focus on the role of the social network system in shaping these outcomes. Drawing on social network theory, critical race theory, and health service utilization research, this test of the Network Episode Model addresses the relative absence of work examining the connections between network characteristics and help-seeking in multiply marginalized groups. The core relationships proposed by the NEM are systematically tested using longitudinal data gathered for the Black Women in the Study of Epidemics Project (N=643). Findings of multilevel models indicate strong support for the Network Episode Model. Specifically, measures of social influence, social control, and social integration significantly predict both patterns of drug use and help-seeking. Importantly, having contact with and receiving health advice from a physician emerged as a significant predictor of a number of positive outcomes, including quitting or abstaining from illicit drug use during the study and attending 12-Step meetings. Results also reveal that experiences specifically related to low-income African American women’s multiply marginalized status – such as experiencing gendered racism – significantly predict patterns of drug use over the study timeframe and may be an important risk factor for substance abuse. In all, this research reveals the important contributions of both traditional predictors and social network predictors on substance abuse help-seeking and patterns of drug use over time. Conclusions suggest that given the limited financial and material resources of multiply marginalized groups, learning how to mobilize or effectively build upon available social network resources to encourage substance abuse treatment may be a particularly fruitful strategy to explore

"Does this Look Infected to You?" Social Network Predictors of Dental Help-Seeking Among Mexican Immigrants

Compared to U.S. born Latinos, Mexican immigrants (MAs) have diminished health care access and face substantial barriers to accessing needed dental health services. However, little research has examined how MAs social networks shape their use of dental health services. Using data from 332 Mexican immigrants to the Midwest, this research examines the significance of individual and egocentric network characteristics on two measures of dental health service utilization. Findings reveal that network size, network dental service utilization, and the frequency with which MAs discuss acute problems with network ties, positively correspond to use of oral health services. Conversely, embeddedness in networks where ties hassle egos about dental issues and have low levels of dental health knowledge correspond to lower odds of using these services. This research is among the first to use ego network data and methods to examine the ways network characteristics shape oral health behaviors among this underserved population

African American Female Offender\u27s Use of Alternative and Traditional Health Services After Re-Entry: Examining the Behavioral Model for Vulnerable Populations

This is the first known study to use the Gelberg-Andersen Behavioral Model for Vulnerable Populations to predict African American women\u27s use of three types of health services (alternative, hospitalization, and ambulatory) in the 18 months after release from prison. In the multivariate models, the most robust predictors of all three types of service utilization were in the vulnerable theoretical domains. Alternative health services were predicted by ethnic community membership, higher religiosity, and HIV/HCV. Hospitalizations were predicted by the lack of barriers to health care and disability. Ambulatory office visits were predicted by more experiences of gendered racism, a greater number of physical health problems, and HIV/HCV. Findings highlight the importance of cultural factors and HIV/HCV in obtaining both alternative and formal health care during community re-entry. Clinicians and policymakers should consider the salient role that the vulnerable domain plays in offender\u27s accessing health services

Examining the Associations of Racism, Sexism, and Stressful Life Events on Psychological Distress among African-American Women

African-American women may be susceptible to stressful events and adverse health outcomes as a result of their distinct social location at the intersection of gender and race. Here, racism and sexism are examined concurrently using survey data from 204 African-American women residing in a southeastern U.S. urban city. Associations among racism, sexism, and stressful events across social roles and contexts (i.e., social network loss, motherhood and childbirth, employment and finances, personal illness and injury, and victimization) are investigated. Then, the relationships among these stressors on psychological distress are compared, and a moderation model is explored. Findings suggest that racism and sexism are a significant source of stress in the lives of African-American women and are correlated with one another and with other stressful events. Implications for future research and clinical considerations are discussed. (APA PsycInfo Database Record (c) 2016 APA, all rights reserved

Rapamycin administration in humans blocks the contraction-induced increase in skeletal muscle protein synthesis

Muscle protein synthesis and mTORC1 signalling are concurrently stimulated following muscle contraction in humans. In an effort to determine whether mTORC1 signalling is essential for regulating muscle protein synthesis in humans, we treated subjects with a potent mTORC1 inhibitor (rapamycin) prior to performing a series of high-intensity muscle contractions. Here we show that rapamycin treatment blocks the early (1–2 h) acute contraction-induced increase (∼40%) in human muscle protein synthesis. In addition, several downstream components of the mTORC1 signalling pathway were also blunted or blocked by rapamycin. For instance, S6K1 phosphorylation (Thr421/Ser424) was increased post-exercise 6-fold in the control group while being unchanged with rapamycin treatment. Furthermore, eEF2 phosphorylation (Thr56) was reduced by ∼25% post-exercise in the control group but phosphorylation following rapamycin treatment was unaltered, indicating that translation elongation was inhibited. Rapamycin administration prior to exercise also reduced the ability of raptor to associate with mTORC1 during post-exercise recovery. Surprisingly, rapamycin treatment prior to resistance exercise completely blocked the contraction-induced increase in the phosphorylation of ERK1/2 (Thr202/Tyr204) and blunted the increase in MNK1 (Thr197/202) phosphorylation. However, the phosphorylation of a known target of MNK1, eIF4E (Ser208), was similar in both groups (P > 0.05) which is consistent with the notion that rapamycin does not directly inhibit MAPK signalling. We conclude that mTORC1 signalling is, in part, playing a key role in regulating the contraction-induced stimulation of muscle protein synthesis in humans, while dual activation of mTORC1 and ERK1/2 stimulation may be required for full stimulation of human skeletal muscle protein synthesis