Risk-taking and abusive behaviors among ethnic minorities

An Exploratory Study of the Sexual Health Knowledge and Attitudes of Asian Male Student Sojourners in New Zealand

This study looked into the sexual and general health attitudes of Asian male student sojourners in New Zealand. The following issues on sexual and general health were probed: level of awareness, views and perceptions, levels of knowledge, main sources of information, and cultural factors in seeking health information. An Internet-mediated survey was employed to gather data on this sensitive topic. Sixty-six participants from Waikato, Massey, Canterbury, and Otago Universities answered the questionnaire. In addition, key-informant interviews with health providers were conducted to provide additional data. Data from the survey indicated a high level of health awareness concerning both general and sexual health maintenance, but there was cultural reluctance to discuss health issues, especially sexual health. General and sexual health matters were regarded as highly personal and sensitive, which they discussed with close associates. Findings from the study suggest the need for culturally appropriate approaches to improve Asian male students' access to health services.

The Roles of Counseling Psychologists in Reducing Health Disparities

This article presents an overview of the health disparities problem that exists among individuals from ethnic minority and low-income backgrounds and their majority counterparts. The argument is made that the involvement of counseling psychologists in addressing this health disparities problem presents an opportunity for the field to remain true to its commitment to prevention, multiculturalism, and social justice while becoming more competitive in the health care and health promotion fields. This article highlights the prevalence of health disparities and identifies the primary factors contributing to these disparities. In addition, the roles and approaches that counseling psychologists can adopt to help alleviate this problem are specified.

Identifying Crosscultural Differences in the Effectiveness of an Information and Free Child Seat Rental Program

Porirua (a suburb in Wellington, New Zealand) is a problem area for child restraint use and has been targeted by a variety of government-initiated, and largely ineffective, traffic safety campaigns in recent years (e.g., Gouldsbury, 1999). The present study attempted to increase child restraint use in cars at two Porirua Kindergartens, one predominantly Pacific Nations (Kindergarten A), and the other predominantly New Zealand European (Kindergarten B), by providing parents with information packages and vouchers for free child seat rental. An increase in correct child seat use was not observed at either kindergarten, although all unrestrained children observed during baseline at the predominantly New Zealand European kindergarten changed to wearing seat belts after the intervention. This finding suggests that income limitations per se are not the primary factor maintaining child seat non-use. Discussion focuses on the contradictory findings provided by both previous survey and observational research on the effect of ethnicity and income on child seat use. Potential crosscultural differences in the existence and salience of verbal community effects that may maintain child seat use through the avoidance of social punishment contingencies from other parents within the kindergarten are considered as one possible explanation for the present findings.

Psychosocial correlates of HIV sexual protective behavior among Puerto Rican women residing in the Bronx, New York

In this study, correlates of HIV sexual protective behavior, in the form of condom use, were examined within a population of urban women identified as at increased heterosexual risk for HIV infection. Hierarchical regression analyses were used to analyze data collected via structured interviews for 187 Puerto Rican women recruited from the waiting areas of a comprehensive health clinic in the Bronx, New York. Increased condom use with primary partners was associated with higher levels of mastery, more non-Hispanic acculturation, and greater adherence to traditional female gender roles. Increased condom use with nonprimary partners was associated with higher HIV/AIDS prevention self-efficacy. Thus, primary versus nonprimary relationships appeared to represent distinct contexts for HIV sexual risk behavior, with implications for different intervention strategies based upon relationship contexts for Latina women.

Cultural predictors of physical and mental health status among Mexican American women: a mediation model

This study, using secondary data analysis, examined a mediation model of acculturation and ethnic pride as predictors of physical and mental health outcomes in a sample of 561 Mexican American women. Factors postulated as mediators were family support and religiosity. Systematic across-group comparison analyses were conducted to examine sources of differences in the mediation model between immigrant and non-immigrant women. The results partially supported the hypothesized mediation model, indicating that family support, but not religiosity, was a significant mediator in the relationship between ethnic pride and mental health problems. In addition, as differences between immigrant and non-immigrant women were observed only in the variables means, but not in the factor loadings or regression paths, the model tested may capture a common psychosocial process that affects these women and their health outcomes. Overall, this study offers important implications for future research and the design of intervention programs for Mexican American women.

African-American crack abusers and drug treatment initiation: barriers and effects of a pretreatment intervention

BACKGROUND

Individual and sociocultural factors may pose significant barriers for drug abusers seeking treatment, particularly for African-American crack cocaine abusers. However, there is evidence that pretreatment interventions may reduce treatment initiation barriers. This study examined the effects of a pretreatment intervention designed to enhance treatment motivation, decrease crack use, and prepare crack abusers for treatment entry.

METHODS

Using street outreach, 443 African-American crack users were recruited in North Carolina and randomly assigned to either the pretreatment intervention or control group.

RESULTS

At 3-month follow-up, both groups significantly reduced their crack use but the intervention group participants were more likely to have initiated treatment.

CONCLUSION

The intervention helped motivate change but structural barriers to treatment remained keeping actual admissions low. Policy makers may be interested in these pretreatment sites as an alternative to treatment for short term outcomes.

Culture & Risk Taking in Adolescentsʼ Behaviors

Adolescents constitute the only segment of the population in the United States that has not seen a decrease in its mortality and morbidity over the last 4 decades. The Centers for Disease Control and Prevention has identified six risk-taking behaviors that place adolescents at risk: unintentional injuries and violence, tobacco use, alcohol and other drug use, sexual behaviors, unhealthy dietary behaviors, and physical inactivity. This list is of particular concern for the increasingly diverse racial and ethnic youth of America who have been disproportionately affected by both morbidity and mortality from risk behaviors. To effectively care for this segment of the population, healthcare professionals need to become culturally competent. In so doing, it is also important to recognize traditional cultural values, and to acknowledge personal attributes of adolescents to promote healthy lifestyle choices and deter risk-taking behaviors.

The uncharted waters of emotion: ethnicity, trait emotion and emotion expression in older adults

Emotions are central to contemporary theories of health, and a growing body of psychological research has shown emotion and emotion regulatory styles to be predictive of health outcomes. Yet despite these clear links and the fact that patterns of emotion and expression are partially a product of culture, there is a meager literature on the emotional characteristics of different ethnic groups. Even where ethnicity has been investigated in emotions research, it has typically been operationalized in such a way that within-group differences are obscured with most individuals assigned to broad ethnic categories, such as non-Hispanic White, or Black. In the present study we draw on data from a multi-ethnic sample of 755 community-dwelling older adults to parse a picture of the emotional characteristics of three of the largest and most culturally distinct ethnic groups in the Northeastern United States: African Americans, West Indians (Jamaicans), and Eastern Slavs (Russians and Ukrainians) from the former Soviet Republic, as well as a comparison group of US-born European Americans. As predicted, there were striking differences in nine of 10 trait emotions as well as in levels of emotion expressed during conflict. The findings are discussed in terms of emotion socialization and implications for prediction and intervention in psychosocial models of emotions, emotion regulation, and health in older ethnic populations.

HIV sexual risk behavior among Puerto Rican women

We examined the association of primary or nonprimary sexual partner relationship status on sexual risk behaviors, including condom use, among Latina women who are at self-disclosed increased heterosexual risk for human immunodeficiency virus (HIV) infection. Data were collected via structured interviews of 187 Puerto Rican women, aged 18-35, who attended a health clinic in the Bronx, New York. Approximately 13% of participants reported sexual activities with both primary and nonprimary sexual partners during the 6 months prior to the interview. Primary or nonprimary sexual partner status was associated with significant differences in frequency of condom use during anal sex and oral-penile sex, with more frequent condom use reported during these sexual activities with nonprimary sexual partners. Thus, potential contextual differences associated with primary or nonprimary relationship status may represent important factors to consider when designing interventions to facilitate HIV-protective behaviors among populations of urban women identified at increased heterosexual risk for HIV infection.

Antecedents of injury among youth in agricultural settings: a longitudinal examination of safety consciousness, dangerous risk taking, and safety knowledge

PROBLEM

Injuries are the leading cause of death for adolescents in the United States.

METHODS

This study longitudinally examined three psychological mediators of injury among 3,081 youths in agricultural settings: (a) safety consciousness, (b) dangerous risk taking, and (c) safety knowledge. These variables are examined within a nomological network of contextual variables.

RESULTS

Cross-sectional results revealed that safety consciousness and dangerous risk taking were the strongest predictors of reported injury at Time 1 and Time 2. Safety knowledge had an unexpected negative association with injury, albeit weak. As predicted, participating in safety activities was positively associated with safety consciousness, and time spent working was strongly associated with safety knowledge. Furthermore, self-esteem had both positive and negative safety outcomes, suggesting a more complex functioning. Males exhibited fewer safety cognitions than females as predicted. Longitudinal data also revealed that injury at Time 1 and dangerous risk taking were the strongest predictors of Time 2 injury.

IMPACT ON INDUSTRY

Results from this study emphasize the importance of assessing dangerous risk-taking perceptions when attempting to predict future injuries.

Sexual behaviour of second generation Moroccan immigrants balancing between traditional attitudes and safe sex

Young Moroccan Islamic immigrants are balancing the challenges of modern society and the influences of their cultural and social backgrounds. Prevention and information programs need insights into their knowledge, attitudes and behaviour concerning choice of partner, sexuality, contraception, STD and AIDS prevention. In a qualitative research project, Moroccan adolescents were invited to focus groups. The results show the specific influence of family, religion and tradition, the importance of virginity at marriage for girls, and the "almost evidence" of premarital coitus for boys. These adolescents have limited knowledge of contraceptives, STD and AIDS. Some boys pretend to perform safe sex in certain "unfixed" circumstances but show no concern about the possible risks for future virgin spouses. Most of the girls do not consider safe sex before or after marriage. There is a taboo on homosexuality.

"Being dealt with as a whole person." Care seeking and adherence: the benefits of culturally competent care

The purpose of this study is to characterize the relationship between identity and health care experiences (including antiretroviral therapy utilization) among HIV-positive sexual minority males. This qualitative study used grounded theory with data collection occurring through focus groups and interviews. A questionnaire was used to complete a demographic profile. The study included 47 HIV positive participants from three minorities: gay men, bisexual men and transgendered persons, gender identifying as female and or living as women. Sessions elicited information on: (1) general experiences with health care, (2) experiences with HIV antiretroviral therapies and issues surrounding access, and (3) adherence to these therapies and identity in relation to health care. These textual data revealed three themes: (1) the importance of sexual identity and its social and cultural context, (2) the differences in the health concerns between the sexual minorities and (3) a wide spectrum of experiences with the health care system that provide information surrounding the access to and adequacy of health care. Successful health care providers are aware of different issues that may play a role in the provision of health care to these sexual minorities. Providers awareness of sexual and social identity and the related different cultural values, beliefs and custom enhance care seeking and therapeutic adherence. For sexual minorities, primary care remains the most important entry point into the health care system. Cultural competence of care providers can foster patient's care seeking and adherence to treatment.

Self-reported weapon ownership, use, and violence experience among clients accessing an inner-city sexually transmitted disease clinic

Little is known about the extent to which people who access public health care settings own/carry weapons and experience/perpetrate acts of violence. The purpose of this study was to describe weapon ownership and violence experiences of persons attending an inner-city sexually transmitted disease clinic. Face-to-face interviews were administered to 245 clients to assess weapon ownership, types of weapons carried, and experiences as victims or perpetrators of violent acts. Overall, 43.7% reported experience of carrying a weapon at some point in their lives. More men chose to carry guns; more women chose to carry knives or mace. Participants reported experiencing alarming levels of violence in the previous year: 30.5% experienced beatings, 23.9% reported being threatened with a gun, and 18.9% reported forced, unwanted sex. Persons with a history of carrying weapons were significantly more likely to report being both victims and perpetrators of violence. Persons who experienced violence in the previous month were significantly more likely to be diagnosed with an STD. Results show that STD clinics represent yet another setting wherein interventions to curb the extent of violence might be appropriate, and strategies to assist and protect those experiencing violence are needed.

HIV Infection and Related Risk Behaviours in a Disadvantaged Youth Institution of São Paulo, Brazil

In order to study the prevalence of HIV and related risky behaviours among disadvantaged youth, we interviewed and bled, between December 1994 and April 1995, 1122 young males and 93 young females who were serving time in FEBEM, a state institution that cares for homeless and offender youth of São Paulo, Brazil. Our questionnaire covered the following areas: sexual practices and use of illicit drugs; knowledge of HIV and STDs and their prevention; and myths and beliefs about AIDS. Seroprevalence of HIV was assessed and related with risk-taking behaviours by means of uni-, bi- and multivariate analysis. We found 2.6% of the males and 10.3% of the females to be positive to HIV. The prevalence of hepatitis C virus (HCV) antibodies resulted in 5.9% for males and 4.6% for females, respectively. The risk for parenterally transmitted HIV among the males was higher than that for sexually related transmission. The inverse relationship was found among the females.

Adolescent use of illicit drugs other than marijuana: how important is social bonding and for which ethnic groups?

We predicted Grade 12 use of illicit drugs other than marijuana ("hard" drugs) from characteristics at Grade 10, examining the protective value of social bonds and testing whether certain social bonds have greater importance for some racial/ethnic groups. We also explored the association of previous substance use with later "hard" drug use when social bonds and a broad range of other personal and environmental variables are statistically controlled. Bonds with family were inversely related to any use of illicit drugs other than marijuana; various forms of prior use were positively related to both any and frequent use. However, variables other than social bonds and prior use were equal or stronger predictors of both outcomes. Some differences were obtained across racial groups: African-Americans were less likely to use illicit drugs other than marijuana, Mexican-Americans were more affected by family factors than were other groups, and Asian-Americans were more affected by school failure. Implications for prevention are discussed.

Health risk behaviors of Texas students attending dropout prevention/recovery schools in 1997

This study determined prevalence of health risk behaviors of 9th through 12th grade students attending dropout prevention/recovery alternative schools in Texas in 1997. Participants were 470 youth whose health risk behaviors were assessed using the Youth Risk Behavior Survey in an anonymous, self-administered format. Behaviors measured included frequency of weapon-carrying and fighting, suicide-related behaviors, substance use, and sexual behaviors. A substantial percentage of alternative school students reported participating in behaviors that placed them at acute or chronic health risk. Differences in the prevalence of risk behaviors were noted by gender, racial/ethnic, and age subgroups. In addition, alternative school students frequently engaged in multiple risk behaviors. These findings suggest a need for comprehensive school-based health education/intervention programs to reduce the prevalence of risk behaviors in populations of alternative school students.