Bibliography
Bibliography — Communities of Color
This section contains articles that address
factors associated with health behavior and health status
and strategies to improve health among minority children
and adolescents.
Research
A Psychoeducational Program to Prevent Aggressive Behavior Among Japanese Early Adolescents
Mikayo Ando, Takashi Asakura, Shinichiro Ando, and Bruce Simons-Morton
Health Education & Behavior, Oct 2007; vol. 34: 765 - 776.
This study evaluates the impact of a school-based intervention program on aggressive behavior among junior high school students in Japan. One hundred and four seventh-graders were enrolled in the program and completed Time 1, Time 2, and Time 3 surveys. The program was implemented in two classes between Time 1 and Time 2 surveys (the first treatment group) and in two other classes between Time 2 and Time 3 surveys (the delayed treatment group). The program included four weekly lessons related to problem solving, stress management, and communication. The initial intervention group reported a significant increase in appropriate relationships with classmates. Aggressive behavior significantly decreased from Time 1 to Time 3 in both groups and from Time 2 to Time 3 in the delayed treatment group, but no treatment group effect was noted. Additional modification of the program may be needed to achieve decreases in aggressive behavior.
Ethnicity and Diet of Children: Development of Culturally Sensitive Measures
Mozhdeh B. Bruss, Brooks Applegate, Jackie Quitugua, Rosa T. Palacios, and Joseph R. Morris
Health Education & Behavior, Oct 2007; vol. 34: 735 - 747.
Obesity is a growing global concern. Examining dietary habits of individuals can facilitate the development of important prevention approaches, which are needed to decrease the incidence of obesity and other related diseases and improve quality of life indices. Because food preferences and dietary habits vary across cultures, it is essential that prevention programs are based on specific populations. Using both ethnographic and quantitative methods, food-consumption patterns were investigated among 1,125 children in the Commonwealth of the Northern Mariana Islands. Differences were observed related to food frequency, age of children, and grade level. Exploratory factor analyses suggested that the individual foods were best organized into food-consumption groups that reflected cultural characteristics rather than more commonly referenced food organizational systems. In addition to developmental differences in food consumption patterns, results suggest that the ethnicity of parents may play a role in the diet of children.
Project ÒRÉ: A Friendship-Based Intervention to Prevent HIV/STI in Urban African American Adolescent Females
M. Margaret Dolcini, Gary W. Harper, Cherrie B. Boyer, and Lance M. Pollack
Health Education & Behavior, Jun 2009; vol. 0: 1090198109333280v1.
There is an urgent need for continued innovation in the design of HIV/STI prevention interventions for African American females, a group at high risk for STIs and HIV. In particular, attention to social development and to culture is needed. The present study reports on a group randomized controlled trial of a friendship based HIV/STI prevention intervention delivered at community-based centers in four San Francisco neighborhoods (n = 2, experimental; n = 2, control). This brief program focuses on youth and their friendship group (N = 264). Program outcomes vary by age at 3-month follow-up, evidencing decreases in risky sex in the oldest group (p ≤ .05), decreases in multiple partners in the middle age group (p ≤ .05), and increases in HIV testing in the youngest group (p = .05). Findings extend recent work on the efficacy of interventions to reduce sexual risk for racial and ethnic minority youth.
Sustaining a School-Based Prevention Program: Results From the Aban Aya Sustainability Project
Michael C. Fagen and Brian R. Flay
Health Education & Behavior, Feb 2009; vol. 36: 9 - 23.
Sustaining effective school-based prevention programs is critical to improving youth and population-based health. This article reports on results from the Aban Aya Sustainability Project, an effort to sustain a school-based prevention program that was tested via a randomized trial and targeted violence, drug use, and risky sex-related behaviors among a cohort of 5th-grade African American children followed through 10th grade. Sustainability project health educators trained parent educators to deliver the Aban Aya prevention curriculum in five schools, and project researchers studied the resultant curricular implementation and relations between the research and school-based teams. Study results showed uneven implementation across the five schools that we largely attributed to parent educator preparation and parent educator-health educator relations. These and related results are discussed to answer the study's primary research question: How viable was the sustainability project's parent-centered approach to sustaining a school-based prevention program?
Youth Audience Segmentation Strategies for Smoking-Prevention Mass Media Campaigns Based on Message Appeal
Brian S. Flynn, John K. Worden, Janice Yanushka Bunn, Anne L. Dorwaldt, Scott W. Connolly, and Takamaru Ashikaga
Health Education & Behavior, May 2007;
Mass media interventions are among the strategies recommended for youth cigarette smoking prevention, but little is known about optimal methods for reaching diverse youth audiences. Grades 4 through 12 samples of youth from four states (n = 1,230) rated smoking-prevention messages in classroom settings. Similar proportions of African American, Hispanic, and White youth participated. Impact of audience characteristics on message appeal ratings was assessed to provide guidance for audience segmentation strategies. Age had a strong effect on individual message appeal. The effect of gender also was significant. Message ratings were similar among the younger racial/ethnic groups, but differences were found for older African American youth. Lower academic achievement was associated with lower appeal scores for some messages. Age should be a primary consideration in developing and delivering smoking-prevention messages to youth audiences. The unique needs of boys and girls and older African American adolescents should also be considered.
Physical Activity Attitudes, Preferences, and Practices in African American, Hispanic, and Caucasian Girls
Mira Grieser, Maihan B. Vu, Ariane L. Bedimo-Rung, Dianne Neumark-Sztainer, Jamie Moody, Deborah Rohm Young, Stacey G. Moe,
Health Education & Behavior, Feb 2006; Vol. 33 (1): 1-12.
Physical activity levels in girls decline dramatically during adolescence, most profoundly among minorities. To explore ethnic and racial variation in attitudes toward physical activity, semi-structured interviews (n = 80) and physical activity checklists (n = 130) are conducted with African American, Hispanic, and Caucasian middle school girls in six locations across the United States. Girls from all groups have similar perceptions of the benefits of physical activity, with staying in shape as the most important. Girls have similar negative perceptions of physical activity, including getting hurt, sweating, aggressive players, and embarrassment. Chores, running or jogging, exercises, and dance are common activities for girls regardless of ethnicity. Basketball, swimming, running, and dance are commonly cited favorite activities, although there are slight differences between ethnic groups. The results suggest that factors other than ethnicity contribute to girls’ physical activity preferences and that distinct interventions may not be needed for each ethnic group.
Indian Youth Speak About Tobacco: Results of Focus Group Discussions With School Students
Arima Mishra, Monika Arora, Melissa H. Stigler, Kelli A. Komro, Leslie A. Lytle, K. Srinath Reddy, and Cheryl L. Perry,
Health Education & Behavior, Jun 2005; Vol. 32, No. 3: 363-379
This article discusses the findings of Focus Group Discussions (FGDs) that were conducted as a formative assessment for Project MYTRI (Mobilizing Youth for Tobacco Related Initiatives in India), a randomized, multi-component, school-based trial to prevent and control tobacco use among youth in India. Forty-eight FGDs were conducted with students (N = 435) in sixth and eighth grades in six schools in Delhi, India. Key findings include: (a) students in government schools reported as “consumers” of tobacco, whereas students in private schools reported as “commentators”; (b) parents and peers have a strong influence on youth tobacco use; (c) chewing gutkha is considered less harmful and more accessible than smoking cigarettes; (d) schools are not promoting tobacco control activities; and (e) students were enthusiastic about the role government should play in tobacco control. These findings are being used to develop a comprehensive intervention program to prevent and control tobacco use among Indian youth.
Applying Community-Based Participatory Research Principles to the Development of a Smoking-Cessation Program for American Indian Teens:“ Telling Our Story”
Kimberly Horn, Lyn McCracken, Geri Dino, and Missy Brayboy
Health Education & Behavior, Feb 2008; vol. 35: - 69.
Community-based participatory research pro vides communities and researchers with opportunities to develop interventions that are effective as well as accept able and culturally competent. The present project responds to the voices of the North Carolina American Indian (AI) community and the desire for their youth to recognize tobacco addiction and commercial cigarette smoking as debilitating to their health and future. Seven community-based participatory principles led to the AI adaptation of the Not On Tobacco teen-smoking cessation pro gram and fostered sound research and meaningful result s among an historically exploited population. Success was attributed to values-driven, community-based principles that (a) assured recognition of a community-driven need, (b) built on strengths of the tribes, (c) nurtured partner ships in all project phases, (d) integrated the community’s cultural knowledge, (e) produced mutually beneficial tools/products, (f) built capacity through co-learning and empowerment, (g) used an iterative process of development, and (h) shared findings/ knowledge with all partners.
Estimates of Intraclass Correlation for Variables Related to Behavioral HIV/STD Prevention in a Predominantly African American and Hispanic Sample of Young Women
Sherri L. Pals, Brenda L. Beaty, Samuel F. Posner, and Sheana S. Bull
Health Education & Behavior, Feb 2009; vol. 36: pp. 182 - 194.
Studies designed to evaluate HIV and STD prevention interventions often involve random assignment of groups such as neighborhoods or communities to study conditions (e.g., to intervention or control). Investigators who design group-randomized trials (GRTs) must take the expected intraclass correlation coefficient (ICC) into account in sample size estimation to have adequate power; however, few published ICC estimates exist for outcome variables related to HIV and STD prevention. The Prevention Options for Women Equal Rights (POWER) study was a GRT designed to evaluate a campaign to increase awareness and use of condoms among young African American and Hispanic women. The authors used precampaign and postcampaign data from the POWER study to estimate ICCs (unadjusted and adjusted for covariates) for a variety of sexual behavior and other variables. To illustrate the impact of ICCs on power, the authors present sample-size calculations and demonstrate how ICCs of differing magnitude will affect estimates of required sample size.
Ecodevelopmental x Intrapersonal Risk: Substance Use and Sexual Behavior in Hispanic Adolescents
Guillermo J. Prado, Seth J. Schwartz, Mildred Maldonado-Molina, Shi Huang, Hilda M. Pantin, Barbara Lopez and Jose Szapocznik
Health Education and Behavior 2009; 36; 45 originally published online Mar 6, 2008;
Hispanic adolescents are a rapidly growing population and are highly vulnerable to substance abuse and HIV infection. Many interventions implemented thus far have been “one size fits all” models that deliver the same dosage and sequence of modules to all participants. To more effectively prevent substance use and HIV in Hispanic adolescents, different risk profiles must be considered. This study’s purpose is to use intrapersonal and ecodevelopmental risk processes to identify Hispanic adolescent subgroups and to compare substance use rates and sexual behavior by risk subgroup. The results indicate that a larger proportion with high ecodevelopmental risk (irrespective of the intrapersonal risk for substance use) report lifetime and past 90-day cigarette and illicit drug use. In contrast, a larger proportion with high intrapersonal risk for unsafe sex (irrespective of ecodevelopmental risk) report early sex initiation and sexually transmitted disease incidence. Implications for intervention development are discussed in terms of these Hispanic adolescent subgroups.
Tobacco Control Policy Advocacy Attitudes and Self-Efficacy Among Ethnically Diverse High School Students
Amelie G. Ramirez, Luis F. Velez, Patricia Chalela, Jeannie Grussendorf, and Alfred L. McAlister
Health Education & Behavior, Aug 2006; vol. 33: 502 - 514.
This study applied self-efficacy theory to assess empowerment to advocate on behalf of tobacco control policies. The Youth Tobacco Survey with added policy advocacy self-efficacy, attitudes, and outcome expectations scales was given to 9,177 high school students in Texas. Asians showed the lowest prevalence of experimentation and current smoking, followed by African Americans. Anglo-Europeans had higher rates of current smoking. Latino male students had the highest experimentation and current smoking rates. Policy advocacy self-efficacy was higher among African Americans. Latinos scored lowest. Asians had the highest level of approval for tobacco control policies. African Americans had the highest scores in policy advocacy outcome expectations, followed by Asians and Latinos. Anglo-Europeans scored lowest. Students who had never tried smoking had the highest scores in all three scales, with a decreasing trend as the frequency of smoking increased. Associations with smoking status remained significant when controlling by gender and ethnicity.
A Brief, Low-Cost, Theory-Based Intervention to Promote Dual Method Use by Black and Latina Female Adolescents: A Randomized Clinical Trial
Carol Roye, Paula Perlmutter Silverman, and Beatrice Krauss
Health Education & Behavior, Aug 2007; vol. 34: 608 - 621.
HIV/AIDS disproportionately affects young women of color. Young women who use hormonal contraception are less likely to use condoms. Brief, inexpensive HIV-prevention interventions are needed for high-volume clinics. This study was a randomized clinical trial of two interventions: (a) a video made for this study and (b) an adaptation of Project RESPECT counseling. Four hundred Black and Latina teenage women completed a questionnaire about their sexual behaviors and were randomly assigned to (a) see the video, (b) get counseling, (c) see the video and get counseling, or (d) receive usual care. At 3-month follow-up, those who saw the video and received counseling were 2.5 times more likely to have used a condom at last intercourse with their main partner than teens in the usual care group. These differences did not persist at 12-month follow-up. This suggests that a brief intervention can positively affect condom use in the short term.
The Dose-Response Relationship of Adolescent Religious Activity and Substance Use: Variation Across Demographic Groups
Kenneth J. Steinman, Amy K. Ferketich, and Timothy Sahr
Health Education & Behavior, Feb 2008; vol. 35: 22 - 43.
This article addresses two inconsistent findings in the literature on adolescent religious activity (RA) and substance use: whether a dose-response relationship characterizes the association of these variables, and whether the association varies by grade, gender, ethnicity, family structure, school type, and type of substance. Multinomial logistic regression analyses of a large, diverse data set of high school students in metropolitan Colum bus, Ohio (n = 33,007), found marked differences in alcohol, marijuana, and cigarette use among youths who never, occasionally, or regularly participated in RA. Weekly RA was consistently associated with less sub -stance use, yet occasional RA some times was associated with greater use. Four groups accounted for variations in the RA-sub stance use relationship: African American youths, younger White youths, 12th-grade White males, and 12th-grade White females. Researchers should avoid assuming the RA-sub stance use relationship is dose-response and consider the implications of this complexity for theory and practice.
Practice
This section contains articles addressing the effectiveness and practical application of child and adolescent school health programs and policies for minority children and adolescents.
Kids Identifying and Defeating Stroke (KIDS): Development and Implementation of a Multiethnic Health Education Intervention to Increase Stroke Awareness Among Middle School Students and Their Parents
Kathleen Mullen Conley, Jennifer Juhl Majersik, Nicole R. Gonzales, Katherine E. Maddox, Jennifer K. Pary, Devin L. Brown, Lemuel A. Moyé, Nina Espinosa, James C. Grotta, and Lewis B. Morgenstern
Health Promotion Practice, Mar 2008; vol. 0: 1524839907309867v1.
The Kids Identifying and Defeating Stroke (KIDS) project is a 3-year prospective, randomized, controlled, multiethnic school-based intervention study. Project goals include increasing knowledge of stroke signs and treatment and intention to immediately call 911 among Mexican American (MA) and non-Hispanic White (NHW) middle school students and their parents. This article describes the design, implementation, and interim evaluation of this theory-based intervention. Intervention students received a culturally appropriate stroke education program divided into four 50-minute classes each year during the sixth, seventh, and eighth grades. Each class session also included a homework assignment that involved the students’ parents or other adult partners. Interim-test results indicate that this educational intervention was successful in improving students’ stroke symptom and treatment knowledge and intent to call 911 upon witnessing a stroke compared with controls. The authors conclude that this school-based educational intervention to reduce delay time to hospital arrival for stroke shows early promise.
Steps to a Healthier Anishinaabe, Michigan: Strategies for Implementing Health Promotion Programs in Multiple American Indian Communities
Catherine Carmel Edgerly, Shannon S. Laing, Anya-Victoria G. Day, Paulina M. Blackinton, Noel L. Pingatore, Richard T. Haverkate, and Julia F. Heany
Health Promotion Practice, Apr 2009; vol. 10: 109S - 117S.
American Indians experience significant health disparities compared to the general U.S. population. The Steps to a Healthier Anishinaabe program adopted a unique framework to implement health promotion intervention activities in multiple American Indian communities in Michigan. By enabling each community to tailor interventions to their specific culture and health priorities, the program is characterized by a culturally competent and community-driven approach to decrease the impact of chronic diseases on the health of Michigan's American Indians. This article describes the community-based framework and argues that multisite, community-tailored health promotion programs are a promising approach to reducing health disparities in minority populations.
Ethnic Disparities in Youth Access to Tobacco: California Statewide Results, 1999-2003
Hope Landrine, Irma Corral, Elizabeth A. Klonoff, Jennifer Jensen, Kennon Kashima, Norval Hickman, and Jonathan Martinez
Health Promotion Practice, May 2008; vol. 0: 1524839908317230v1.
The authors examined the role of youth ethnicity in youth access to tobacco with large, random samples of stores and large samples of ethnically diverse youths for the first time. From 1999 through 2003, White, Black, Latino, and Asian youths made 3,361 cigarette purchase attempts (approximately 700 per year) statewide. Analyses revealed that Black youths had significantly higher access than other youths and that access rates for Black and Asian (but not Latino or White) youths exceeded the Synar-mandated ≤ 20%. Clerks who failed to demand youth proof of age identification (ID) sold 95% of the tobacco that youths received and sold significantly more often to minorities and to girls, whereas clerks who demanded youth ID sold equally infrequently to all youths. These findings highlight significant ethnic disparities in youth access to tobacco and imply that those might be eliminated by policies and interventions that increase clerk demands for youth ID.
Physical Activity Among Minority Populations: What Health Promotion Practitioners Should Know—A Commentary
Sarah M. Lee
Health Promotion Practice, Oct 2005; Vol. 6 (4): 447-452.
Leisure time and moderate-level physical activity participation in the United States is low among the majority of the population. Minority populations are especially inactive and report having fewer opportunities and access to be physically active. Physical activity programs utilizing a strong health promotion framework (including needs assessment, program plan and design, program implementation, and evaluation) are limited, particularly among minority populations. The purpose of this article is to discuss the importance of physical activity, briefly review and describe current literature, identify the need for physical activity programs among minority populations, and relate the concepts of a health promotion framework to physical activity programs that are usable among practitioners. The article also provides health promotion practitioners with various resources for improving physical activity programs.
Acknowledging Adult Bias: A Focus-Group Approach to Utilizing Beauty Salons as Health-Education Portals for Inner-City Adolescent Girls
Alexis Lieberman and Diana Harris
Health Promotion Practice, Apr 2007; vol. 8: 205 - 213.
To assess the feasibility of using beauticians as health literacy agents and beauty salons as health-education portals for adolescent, inner-city, African American girls, the authors conducted focus groups with 25 women: salon clients, salon owners, and medical students. Facilitators to program development included (a) beautician-client relationships, (b) teens’ access to health information, and (c) beauticians as information resources. Barriers included (a) adult opinions of teen behaviors, (b) teen mistrust of adults, and (c) low health literacy of beauticians. In developing a health-education program for this population, beauticians and salons may be excellent health information agents and portals if barriers including beautician poor health literacy, adolescent mistrust in adults, and adults’ anti-adolescent bias are improved. Program implementation must not solely focus on teens but should also include adult salon users, with the goal of reaching the teens first through these adults and, with time and trust, reaching the teens directly.
Culturally Responsive Health Promotion in Puerto Rican Communities: A Structuralist Approach
María Idalí Torres, David X. Marquez, Elena T. Carbone, Jeanne-Marie R. Stacciarini, and Jennifer W. Foster
Health Promotion Practice, Apr 2008; vol. 9: 149 - 158.
This literature review discusses the value of the structuralist approach as an integrated theoretical and methodological framework for participatory cultural assessments designed to capture the cultural dynamics of those affected by health disparities. Drawing from principles of the Lévi-Straussian strand of structural anthropology found in contemporary cultural studies, and using the Puerto Rican cultural experience as an example, the authors present the distinction between deep and surface structures of cultural knowledge and meaning and highlight information-processing and behavioral systems influenced by the complexity of cognitive and social representations of cultural structures. To understand and address the deeply rooted web of ideology, norms, and practices that influence health decision making and behavioral responses, the authors show the need for ethnographic narrative inquiry beyond surface manifestations of culture. Finally, the authors discuss the implications of the structuralist approach for culturally responsive health education and other health promotion interventions.
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