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Biomedical subjects

Ann Stueve

Publications and source records attributed to Ann Stueve.

14 recordsLinked to original sources

Rethinking the bystander role in school violence prevention.

Public concerns about school shootings and safety draw attention to the role bystanders can play in preventing school violence. Although school violence prevention plans are often required, there is little guidance about whether these should address the roles of bystanders and what actions bystanders should take in different circumstances, from more common instances of bullying and fighting to rare, but potentially lethal, threats and use of weapons. Literature pertaining to bystanders is reviewed and applied to the school setting. The definition of bystander is expanded, including parents, teachers, and other school staff as well as youths and those who have information about potential violence as well as those who witness its occurrence. Barriers preventing bystanders from taking positive actions are discussed. The authors call on health promotion researchers and practitioners to work with school communities to identify norms, attitudes, and outcome expectancies that shape bystander behaviors to inform prevention efforts.

Helping Behavior↗

Aggressive behaviors in early adolescence and subsequent suicidality among urban youths.

PURPOSE: To examine the association of aggressive behaviors during early adolescence with subsequent suicidality among inner-city males and females. METHODS: Seven hundred sixty nine African-American and Latino males and females were surveyed about their involvement in aggressive behaviors in 8th grade and again during 11th grade, when suicidality was assessed. Logistic regression was used to examine the influence of middle-school aggression on subsequent suicidality, controlling for demographic and social characteristics and 8th grade depressive symptoms and substance use. At 8th grade, 43% of males and 32% of females reported a recent fight, 33% of males and 19% of females carried a knife, 8% of males and 7% of females used a knife to cut or stab someone, and 15% of males and 4% of females carried a gun. At 11th grade, 24% of males and 29% of females scored high on suicidality, indicating suicidal thoughts, plans, or attempt. RESULTS: Females scoring high on aggression were significantly more likely to report suicidality at 11th grade, controlling for demographic and social factors, early depressive symptoms, and substance use. For males, high depressive symptoms and substance use at 8th grade were related to suicidality, but not earlier aggressive behavior. CONCLUSION: Urban girls who engage in physical aggression in middle school are at risk for subsequent inner-directed violence, including suicidal thoughts and behaviors. To address adolescents' mental health needs, attention must be paid to connections between externally and internally directed forms of violence over time, and whether warning signs of suicidality may differ by gender and require different intervention.

Adolescent↗

Saving Sex for Later: an evaluation of a parent education intervention.

CONTEXT: Initiation of sexual intercourse prior to high school is prevalent among inner-city black and Hispanic youths, and has multiple negative health and social consequences. A promising strategy for addressing early adolescent sexual activity is parent education that addresses normal pubertal changes and the challenges of becoming a teenager. METHODS: A 2003-2005 randomized trial to test the effectiveness of Saving Sex for Later, a parent education program presented on three audio CDs, enrolled 846 families with fifth- and sixth-grade students in seven New York City schools. Parent and youth surveys were conducted at baseline and three months postintervention. Multivariate logistic and linear regression analyses were performed to assess relationships between youth and parent outcomes and treatment condition. RESULTS: At follow-up, parents in the intervention group were significantly more likely than controls to score high on indexes of communication with children about targeted risk behaviors, self-efficacy to discuss pubertal development and sexuality, and perceived influence over youths' behaviors (odds ratios, 1.9-2.5). Youths in the intervention condition were more likely than controls to report high family support, and reported more family rules and fewer behavioral risks. Family support and rules partially mediate the relationship between treatment condition and behavioral risks. CONCLUSION: Saving Sex for Later is a promising intervention for promoting youths' sexual abstinence. The intervention may also be effective in enhancing positive parenting practices among parents who are typically difficult to reach because of economic hardship, full schedules and complicated lives.

Adolescent↗

Early alcohol initiation and subsequent sexual and alcohol risk behaviors among urban youths.

OBJECTIVES: We examined relations between early alcohol use and subsequent alcohol and sexual risk behaviors among urban adolescents. METHODS: A total of 1034 African American and Hispanic youths completed surveys assessing alcohol and sexual behaviors at 7th and 10th grade. After we controlled for early sexual initiation, we examined relations between early drinking and subsequent alcohol and sexual behaviors. RESULTS: Early drinking was associated with alcohol and sexual risks through mid-adolescence. Early drinkers were more likely to report subsequent alcohol problems, unprotected sexual intercourse, multiple partners, being drunk or high during sexual intercourse, and pregnancy. Among females, early drinking was also related to sexual initiation and recent sexual intercourse. CONCLUSIONS: Prevention programs should address combined risks of early alcohol use and sexual intercourse, especially where levels of HIV and other sexually transmitted infections are elevated.

Adolescent↗

Trends in sexual risk-taking among urban young men who have sex with men, 1999-2002.

As part of an HIV prevention study, 15-25 year-old young men who have sex with men (YMSM) were surveyed in community settings annually from 1999 to 2002. Data are presented from six comparison communities in the study; these communities recruited Latinos (Jackson Heights, NYC; San Gabriel Valley, CA), African Americans (Atlanta, GA); Asians/Pacific Islanders (San Diego, CA); and primarily white men (Detroit, MI and Twin Cities, MN). Men were asked about unprotected anal intercourse (UAI) in the past three months with male partners. The prevalence of UAI reported in these six communities ranged 27-35% in 1999, compared with 14% to 39% in 2002. Significant reductions in UAI over time were observed in Jackson Heights and San Gabriel Valley. A quadratic trend was noted in Detroit, with a significant increase in UAI from 1999 to 2000 followed by a significant decrease in UAI from 2000 to 2002. There was a nonsignificant increase in UAI in the Twin Cities, and no significant trends in UAI in Atlanta or San Diego. Behavioral trends among YMSM vary considerably across subpopulations and highlight the necessity of local behavioral surveillance and culturally tailored prevention efforts for specific racial and ethnic groups.

Adolescent↗

Sexual behaviors and risks among bisexually- and gay-identified young Latino men.

This research compares patterns of sexual behavior and sexual risk of bisexually- and gay-identified Latino young men who have sex with men (YMSM). Four hundred forty-one Latino YMSM were surveyed at community venues in New York City. Twenty-two percent of the sample identified as bisexual, and 78% identified as gay. Bisexually-identified men were more likely to report having had multiple male sex partners in the last 3 months and less likely to report being exclusively involved with a main male partner. They were also approximately 3 1/2 times more likely to report unprotected insertive anal intercourse at last sexual contact with a nonmain male partner and more likely to report being high at last contact with both main and nonmain male partners. Findings suggest that prevention programs need to address the particular sexual risk patterns of bisexually-identified Latino YMSM that place them at risk of both HIV infection and transmission.

Adolescent↗

Risk and resiliency factors influencing suicidality among urban African American and Latino youth.

For decades, suicide rates among minority African American and Latino young people have been stable and, when compared with Whites, relatively low. This is no longer the case, underscoring the need for documenting and understanding the problem of suicidality in this population. We report on the prevalence and predictors of suicidality among 879 urban adolescents in the Reach for Health study. All youth resided in economically disadvantaged neighborhoods; 69% were African American, 16% Latino, and 15% reported mixed or other ethnicity. In the past year, 15% had seriously considered suicide; 13% had made a suicide plan, 11% had attempted suicide at least once, and 4% reported multiple attempts. Risk factors significantly related to suicidal ideation are being female, having basic needs unmet, engaging in same-gender sex, and depression. Resiliency factors include family closeness and, marginally, religiosity. Risk factors related to reports of suicide attempts are being female, being Hispanic, and depression; family closeness is strong resiliency factor. Family composition, ethnic identity, coping style, peer support, and school attachment are not significant correlates of suicidal ideation or attempts.

Adaptation, Psychological↗

Using peer recruitment and OraSure to increase HIV testing.

We describe a community-based pilot study to boost HIV testing in a minority community through social network recruitment and a noninvasive HIV testing methodology. Over an 11-month period, the number of test takers at the intervention site increased by 71.7%, and the proportions of test takers with risk factors similar to those of peer recruiters (heterosexual sex and multiple partners) increased by 24.2% and 19.5%, respectively. At a comparison site, testing remained stable, while the proportion of test takers reporting heterosexual sex and multiple partners decreased by 42.5% and 21.8%, respectively. The use of a social network recruitment strategy in combination with an oral HIV test shows promise in increasing testing and in targeting populations.

Attitude to Health↗

Long-term influence of sexual norms and attitudes on timing of sexual initiation among urban minority youth.

This study assessed whether sexual norms and attitudes expressed during early adolescence by minority youth from economically disadvantaged urban areas produce a sustained influence on the timing of sexual initiation. African American and Latino youth attending three middle schools were enrolled in the Reach for Health study in seventh grade and followed from an average age of 12.2 to 16.1 years. Some 849 respondents answered the question, "Have you ever had sexual intercourse" at four time points: fall seventh, spring seventh, spring eighth, and spring 10th grade. Culturally tailored scales assessed sex norms and outcome expectancies, sexual responsibility, and refusal attitudes at fall seventh grade. Influence of these norms and attitudes in early adolescence on timing of first reported sexual intercourse was examined using ANOVA controlling for gender. At fall seventh grade, 30.7% of boys and 7.7% of girls reported sexual intercourse; by spring 10th grade, the figures were 74.8% and 56.4%, respectively. Those reporting greater peer involvement in sex and more positive sex outcome expectancies were more likely to have initiated sex by fall seventh grade. Through 10th grade, the higher the scores on peer norms (f = 41.08, p < .0001) and outcome expectancies (f = 5.87, p = .002) at entry into seventh grade, the earlier the timing of initiation. Higher scores on sex responsibility at baseline were associated with delayed sexual intercourse (f = 7.36, p < .001), as are refusal attitudes (f = 15.62, p < .0001). Despite significant gender differences in timing of initiation and mean scale scores, these relationships were similar for males and females. Findings suggest the importance of addressing sexual norms and attitudes of minority youth in interventions to delay early sexual initiation in urban environments where this risk is high. Given their sustained influence on timing of sexual initiation, such interventions must begin prior to middle school and continue through mid-adolescence, years when early sexual experience can lead to negative health and social outcomes.

Adolescent↗

Long-term reductions in sexual initiation and sexual activity among urban middle schoolers in the reach for health service learning program.

PURPOSE: To evaluate the sustained effectiveness of a middle school service learning intervention on reducing sexual initiation and recent sex among urban African-American and Latino adolescents from 7th grade through the 10th grade. METHODS: During the fall of seventh grade and again in eighth grade, students were randomly assigned by classroom to participate either in community youth service (CYS) or not (controls). Service learning is an educational strategy that couples meaningful service in the community with classroom instruction. Students in both intervention and control conditions received classroom health lessons. Surveys were conducted at seventh grade baseline and at the end of 10th grade, approximately 2 years after intervention. Self-reported sexual behaviors of youths who had participated in CYS were compared with those of controls receiving classroom curriculum alone (n = 195). RESULTS: CYS participants were significantly less likely than controls to report sexual initiation (2 years CYS, odds ratio [OR] = 0.32; 1 year, OR = 0.49) as well as recent sex (2 years CYS, OR = 0.39; 1 year CYS, OR = 0.48). Among those who were virgins at seventh grade, 80% of males in the curriculum-only condition had initiated sex, compared with 61.5% who received 1 year of CYS, and 50% who received 2 years. Among females, the figures were 65.2%, 48.3%, and 39.6%, respectively. CONCLUSION: A service learning intervention that combines community involvement with health instruction can have a long-term benefit by reducing sexual risk taking among urban adolescents.

Adolescent↗

Ethnic and gay community attachments and sexual risk behaviors among urban Latino young men who have sex with men.

Culturally relevant prevention programs are required to reduce HIV risk exposure of Latino young men who have sex with men (YMSM). As part of Hermanos Jóvenes, 465 Latino YMSM were surveyed at community venues of New York City outside the gay-identified area of lower Manhattan. We examined factors that influence ethnic and gay community attachments; the association between community attachments and social support in sexual matters; and the relationship between levels of attachment, social support in sexual matters, and sexual risk behaviors. Sixty-eight percent felt closely connected to their ethnic community; about 34% were highly attached to both neighborhood and New York City gay communities. Greater social support in sexual matters was associated with ethnic and gay community attachments. Latino YMSM connected to their ethnic community were about 40% less likely to report recent unprotected anal intercourse (UAI) with a male partner, and 60% less likely to have engaged in UAI during the last sexual contact with a nonmain male partner. Gay community attachment was not significantly related to risk behaviors. Findings point to the importance of ethnic ties and involving ethnic community organizations in HIV prevention efforts.

Acculturation↗

Being high and taking sexual risks: findings from a multisite survey of urban young men who have sex with men.

Adolescent and young adult males who have sex with men (MSM) remain at high risk of HIV infection. Many sexual risk factors have been identified, yet the role of substance use remains controversial. We assess the extent to which urban young MSM report being "high" on drugs or alcohol during sex and the association between being "high" and unprotected anal intercourse (UAI). During summer 2000, 3,075 MSM aged 15-25 years completed a 20-minute interview for the Community Intervention Trial for Youth Project. Participants were asked about their last sexual contact with main and nonmain partners, including whether they were "high on drugs or alcohol." 18.6% of MSM with a main partner reported being high during their last sexual encounter; 25.0% reported UAI. Among men with a nonmain partner, 29.3% reported being high, and 12.3% reported UAI. Being high was associated with unprotected receptive anal intercourse with nonmain partners (odds ratio = 1.66, p = .02). HIV prevention should include messages about the potential dangers of drinking and drug use in situations where sexual encounters with nonmain partners may occur.

Adolescent↗

Normalization of violence among inner-city youth: a formulation for research.

A causal model is formulated for the thesis that in inner-city youth exposed to high levels of violence, cognitions that normalize violence mitigate affective effects of exposure while increasing risk for violent behavior, thus perpetuating violence in the very process of adapting to it psychologically. Gender differences in the cognitive normalization of violence may explain gender differences in affective and behavioral effects of exposure. Empirical studies are needed to directly test this model.

Adaptation, Psychological↗

Adolescent suicidality and adult support: the reach for health study of urban youth.

OBJECTIVE: To examine suicidality among urban youth and its relationship to patterns of adult support. METHODS: Study surveyed 879 adolescents. Suicide ideation and attempts, perceived adult support, family and formal network availability, and network activation were assessed. RESULTS: Only half of those reporting a suicide attempt had spoken with an adult about their distress. Suicide attempters were more likely than nonattempters to report they would not go to family members in the future, although they were more likely to report a past discussion. CONCLUSION: Improving communication among youth, families, and service providers should be a focus of suicide prevention planning.

Adolescent↗