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Cooley-Strickland M, Wyatt GE, Loeb TB, Nicholas LA, Smith-Clapham A, Hamman A, Abraham M, Scott EN, Albarran G. Need for Sexual, Reproductive, and Mental Health Promotion Among Diverse College Students in a COVID-19 Era. Clin Child Fam Psychol Rev 2023; 26:1077-1096. [PMID: 37934361 PMCID: PMC10640429 DOI: 10.1007/s10567-023-00460-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 11/08/2023]
Abstract
In 2020, the COVID-19 pandemic forced unprecedented disruptions in higher education operations. While the adverse mental health effects experienced by college students due to these changes are well documented, less is known about the impact on their sexual and reproductive health (SRH), and the reciprocal relationships between SRH and mental health among adolescents and emerging adults. This position paper reviews existing literature on the effects of the COVID-19 pandemic on SRH, sexual violence, unintended pregnancy, sexually transmitted illness and human immunodeficiency virus rates and highlights issues specific to college-aged males, females, racial/ethnic and sexual minorities, and individuals with disabilities. The need to conceptualize SRH as an integral component of normal development, overall health, and well-being in the context of COVID-19 is discussed. The need to prioritize the design and implementation of developmentally appropriate, evidence-based SRH interventions specifically targeting college students is identified. Furthermore, an intergenerational approach to SRH that includes parents/caregivers and/or college faculty and staff (e.g., coaches, trainers) could facilitate comprehensive SRH prevention programming that enhances sexual violence prevention training programs currently mandated by many colleges. Policies and programs designed to mitigate adverse pandemic-related exacerbations in negative SRH outcomes are urgently needed and should be included in mainstream clinical psychology, not only focused on preventing unwanted outcomes but also in promoting rewarding interpersonal relationships and overall well-being. Recommendations for clinical psychologists and mental health researchers are made.
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Affiliation(s)
- Michele Cooley-Strickland
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA.
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Gail E Wyatt
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Tamra Burns Loeb
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Lisa A Nicholas
- Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Amber Smith-Clapham
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Amina Hamman
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Misha Abraham
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Enricka Norwood Scott
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
| | - Graciela Albarran
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024-1759, USA
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Opara I, Lardier DT, Boyd D, Boateng ACO, Brawner BM. The Association Between Racial Attitudes, Alcohol Use and Mood Disorders Among Black Adolescents. JOURNAL OF PREVENTION (2022) 2023; 44:85-104. [PMID: 36156761 PMCID: PMC9892305 DOI: 10.1007/s10935-022-00706-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 02/04/2023]
Abstract
Alcohol is the most widely used substance among adolescents. Although Black adolescents use alcohol at lower rates than White adolescents, Black adolescents tend to have worse outcomes. This includes higher rates of mood disorders and criminal justice involvement associated with alcohol use and misuse compared to any other racial group. Black adolescents are also more likely to experience racial discrimination and be exposed to traumatic events within their communities, which may increase their chances of using substances. Understanding the relationship between racial attitudes (towards one's own group and others) and substance use and mental health can provide unique and meaningful insight into prevention programming for Black adolescents. Yet, these concepts have been understudied. To fill this gap, we examined the association between racial attitudes and alcohol use and mood disorders in Black adolescents in Philadelphia, PA (N = 154). We used the revised Adolescent Survey of Black Life to measure pro-Black (positive attitudes toward being Black and factors related to Black people), anti-White (negative attitudes toward White people due to experiences of racism and discrimination) and racism awareness (recognition of racism) domains. Logistic regression analyses were conducted to test the associations. Results showed that: higher pro-Black attitudes were associated with a lower odds of mood disorder (odds ratio [OR] = 0.72, 95% CI = 0.55, 0.89); and higher racism awareness was associated with an increased odds of alcohol use (OR = 1.18, 95% confidence interval [CI] = 1.06, 1.29). Findings provide preliminary support for interventions and policies for Black adolescents that bolster positive racial identity and eliminate experiences of racism as alcohol use and mood disorder prevention strategies.
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Affiliation(s)
- Ijeoma Opara
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, USA.
- Center for Interdisciplinary Research On AIDS, School of Public Health, Yale University, New Haven, USA.
| | - David T Lardier
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, USA
| | - Donte Boyd
- Center for Interdisciplinary Research On AIDS, School of Public Health, Yale University, New Haven, USA
- School of Social Work, Ohio State University, Columbus, USA
| | | | - Bridgette M Brawner
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, USA
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Weser V, Opara I, Budge M, Duncan L, Fernandes CSF, Hussett-Richardson S, Sands B, Hieftje K. Pilot-testing a Multiplayer HIV and Sexually Transmitted Infection Prevention Video Game Intervention for Black Adolescent Girls: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e43666. [PMID: 36689272 PMCID: PMC9903186 DOI: 10.2196/43666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Black adolescent girls aged between 14 and 19 years are more likely than White girls to be diagnosed with a sexually transmitted infection (STI). As STI diagnosis is associated with an increase in the risk for HIV acquisition, an early intervention specifically tailored to Black adolescent girls is warranted. A web-based video game intervention has the potential to reach this demographic. Because studies of social and behavioral determinants of disease demonstrate the protective role of peer group structures on individual outcomes, a multiplayer game can facilitate opportunities to exchange and evaluate information, learn social norms, develop behavioral skills, and allow peers to influence attitudes and behavior. No prior research has examined the feasibility of a web-based multiplayer game intervention for this population. OBJECTIVE This study describes the protocol for a randomized controlled trial (RCT) pilot-testing the feasibility, acceptability, and limited efficacy of a multiplayer game-based intervention for increasing HIV and STI testing and condom use in Black adolescent girls. METHODS We enrolled 79 Black adolescent girls aged 14 to 19 years residing in the United States into a 2-arm parallel RCT. The intervention is a theory-based, community-informed, multiplayer game that can be played with peers on the web using videoconferencing software. The goal of the game is to empower Black adolescent girls to make healthy decisions regarding dating, relationships, and sex, thus reducing HIV and STI infection. Control condition participants received a list of resources after playing a time and attention control game. All study procedures were conducted via the internet. We conveniently sampled Black adolescent girls using web-based advertisements. Study assessments occurred at enrollment, 1 week, 1 month, and 4 months after enrollment. The primary outcome of this study is increased HIV and STI testing by Black adolescent girls. Secondary outcomes include increased condom use, self-efficacy to use condoms, positive attitudes toward condom use, intentions, harm perceptions, HIV and STI and pre-exposure prophylaxis knowledge, positive sexual norms, sexual communication with partners, and reduced incidence of sexual risk behaviors associated with HIV and STI transmission. Secondary outcomes also included assessment of intervention feasibility and acceptability. RESULTS From February to April 2022, a total of 79 Black adolescent girls were enrolled, with 40 (51%) having been randomized into the intervention condition and 39 (49%) into the control condition. At baseline, participant ages ranged from 14 to 19 (mean 16.4, SD 1.23) years. CONCLUSIONS Web-accessible game interventions overcome common impediments of face-to-face interventions presenting a unique opportunity to reach Black adolescent girls and improve their sexual health and self-efficacy. Trial data will provide information about the limited efficacy of the intervention and inform future web-based studies and a larger RCT aimed at improving the sexual health of Black adolescent girls. TRIAL REGISTRATION ClinicalTrials.gov NCT04108988; https://clinicaltrials.gov/ct2/show/NCT04108988. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43666.
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Affiliation(s)
| | - Ijeoma Opara
- Yale School of Public Health, New Haven, CT, United States
| | - Mariana Budge
- Yale School of Medicine, New Haven, CT, United States
| | - Lindsay Duncan
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | | | | | - Brandon Sands
- Yale School of Medicine, New Haven, CT, United States
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Maker Castro E, Wray-Lake L, Cohen AK. Critical Consciousness and Wellbeing in Adolescents and Young Adults: A Systematic Review. ADOLESCENT RESEARCH REVIEW 2022; 7:499-522. [PMID: 35582551 PMCID: PMC9101980 DOI: 10.1007/s40894-022-00188-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/07/2022] [Indexed: 05/13/2023]
Abstract
Youth experiencing systemic oppression(s) face heightened challenges to wellbeing. Critical consciousness, comprised of reflection, motivation, and action against oppression, may protect wellbeing. Wellbeing here refers to mental, socioemotional, and physical health. The aim of this systematic review was to synthesize research on the relationship between critical consciousness and wellbeing among adolescents and young adults (ages 12-29). Five databases (PsycInfo, PsychArticles, ERIC, Sociological Abstracts, and PubMed) were searched systematically using keyword searches and inclusion/exclusion criteria; 29 eligible studies were included. Results demonstrated that the critical consciousness and wellbeing relationship varied by critical consciousness dimension and age. The studies of adolescents most often focused on racial/ethnic marginalization and found critical motivation most strongly associated with better wellbeing. The studies of young adults focused on young adult college students and identified mixed results specifically between activism and mental health. Study methods across age spans were primarily quantitative and cross-sectional. Research on critical consciousness and wellbeing can benefit from studies that consider multiple critical consciousness dimensions, use longitudinal approaches, and include youth experiencing multiple and intersecting systems of privilege and marginalization.
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Affiliation(s)
- Elena Maker Castro
- School of Education and Information Sciences, Division of Human Development and Psychology, University of California, Los Angeles, Moore Hall, 457 Portola Plaza, 90095 Los Angeles, CA United States
| | - Laura Wray-Lake
- School of Public Affairs, Department of Social Welfare, University of California, Los Angeles, Los Angeles, CA United States
| | - Alison K. Cohen
- School of Medicine, Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA United States
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Opara I, Lardier DT, Garcia-Reid P, Reid RJ. Testing the Factor Structure of the Brief Sense of Community Scale among Black Girls and the Relationship with Ethnic Identity, Empowerment and Social Support. CHILDREN AND YOUTH SERVICES REVIEW 2021; 127:106095. [PMID: 34305217 PMCID: PMC8294162 DOI: 10.1016/j.childyouth.2021.106095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Research on Psychological Sense of Community (SOC) among Black girls are limited due to lack of validated measures for this group. Using confirmatory factor analysis (CFA), the first and second-order factor structure of the Brief Sense of Community Scale (BSCS) used to measure Psychological SOC was examined using a sample of Black girls from an urban community (N = 340). Using a regression-based approach, the second-order five-factor model of the BSCS was also examined with intrapersonal psychological empowerment (PE), social support, and ethnic identity as conceptually related variables. Findings support that: (1) psychological SOC can be conceptualized and measured through four dimensions among Black girls; and (2) intrapersonal PE, social support, and ethnic identity were significantly associated with SOC.
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Affiliation(s)
- Ijeoma Opara
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, Center for Interdisciplinary Research on AIDS at Yale School of Public Health
| | - David T Lardier
- Department of Individual, Family, and Community Education, University of New Mexico, Department of Psychiatry and Behavioral Sciences, University of New Mexico
| | - Pauline Garcia-Reid
- Department of Family Science and Human Development, Montclair State University
| | - Robert J Reid
- Department of Family Science and Human Development, Montclair State University
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Opara I, Lardier DT, Durkee MI, Garcia-Reid P, Reid RJ. Ethnic Identity as a Moderator Between HIV Knowledge, Viral Hepatitis Knowledge, and Psychological Antecedents Among Racial-Ethnic Minority Youth Living in an Urban Community. J Racial Ethn Health Disparities 2021; 9:1298-1307. [PMID: 34041704 DOI: 10.1007/s40615-021-01069-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/27/2021] [Accepted: 05/18/2021] [Indexed: 11/25/2022]
Abstract
Racial-ethnic minority youth between the ages of 13 and 24 in the USA are disproportionately impacted by HIV. Low HIV knowledge and psychological antecedents such as low perception of risk and low sexual negotiation skills have all been associated with HIV risk behaviors; however, the role of ethnic identity on these factors is unclear in the literature. Ethnic identity, which is a critical part of identity development among racial-ethnic minority youth, has been found to be a protective factor in risk-taking behaviors. However, limited research is available on the role of ethnic identity in HIV prevention research among youth. For this study, data were collected as part of a larger HIV prevention education program using a sample of 564 students of color (Meanage = 16.30, standard deviation [SD] = 1.26; 67.4% Hispanic, 29.5% Black) from an underserved northeastern US urban community. We examined whether ethnic identity moderated the relationship between psychological antecedents (e.g., perception of risk and sexual negotiation skills), gender, and viral hepatitis knowledge on HIV knowledge. Findings revealed that ethnic identity significantly moderated the relationship between psychological antecedent variables and HIV knowledge by strengthening these associations as ethnic identity increased. Female adolescents were also more likely to have higher levels of HIV knowledge than males. Findings provide support for cultural and gender-specific prevention programs for racial-ethnic minority youth that seek to reduce HIV risk behaviors by increasing ethnic identity, particularly in under-resourced communities.
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Affiliation(s)
- Ijeoma Opara
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, CT, USA.
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT, USA.
| | - David T Lardier
- Department of Individual, Family, and Community Studies, University of New Mexico, Albuquerque, NM, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Myles I Durkee
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Pauline Garcia-Reid
- Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
| | - Robert J Reid
- Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
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Lardier DT, Opara I, Reid RJ, Garcia-Reid P, Herrera A, Cantu I. Increasing HIV/AIDS knowledge among urban ethnic minority youth: Findings from a community-based prevention intervention program. JOURNAL OF HIV/AIDS & SOCIAL SERVICES 2021; 20:76-96. [PMID: 34177389 PMCID: PMC8225251 DOI: 10.1080/15381501.2021.1910097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/05/2021] [Accepted: 03/08/2021] [Indexed: 06/13/2023]
Abstract
HIV (Human Immunodeficiency Virus)/AIDs (Acquired immunodeficiency syndrome) prevention and research are imperative. Prevention-intervention programming is minimal in low-income communities of color. Additional research is needed that uncovers points of support and prevention to increase HIV knowledge and awareness and limit new HIV infections among adolescents of color. This study presents preliminary findings from a community-based HIV/AIDS, substance abuse, and viral hepatitis (VH) prevention education intervention for ethnic minority youth in a northeastern urban community. We evaluated HIV/AIDS knowledge and factors associated with knowledge. Participants (N = 599) completed a baseline survey followed by an exit survey measuring HIV/AIDS knowledge. Exit survey findings indicated that there was an increase in HIV/AIDs knowledge. Multivariate regression analyses showed that change scores in VH knowledge accuracy, sexual negotiation skills, risk perception, and ethnic identity were positively associated with change in HIV/AIDs knowledge score. The development and implementation of HIV/AIDS knowledge interventions can be crucial in alleviating new infections in the U.S.
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Affiliation(s)
- David T. Lardier
- Department of Individual, Family, and Community Studies, University of New Mexico, Albuquerque, NM, USA
- Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Ijeoma Opara
- Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, CT, USA
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT, USA
| | - Robert J. Reid
- Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
| | - Pauline Garcia-Reid
- Department of Family Science and Human Development, Montclair State University, Montclair, NJ, USA
| | - Andriana Herrera
- Department of Public Health, Montclair State University, Montclair, NJ, USA
| | - Irene Cantu
- Department of Individual, Family, and Community Studies, University of New Mexico, Albuquerque, NM, USA
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