Faculty Bibliography

INTRODUCTION/BACKGROUND:This community-led research study protocol emphasises placing black youth impacted by the legal system, their families and their communities at the forefront of substance use treatment development research and decision-making. The study, the Cultural Adaptation of a Substance Use Treatment (CAST) Project, challenges traditional top-down approaches to treatment creation, advocating for a grassroots model that centres community knowledge, values and active participation. METHODS AND ANALYSIS/METHODS:The CAST project is a US-based mixed-methods study with an exploratory design that examines the impact of racial discrimination on substance use in black youth impacted by the legal system. The study participants are black youth impacted by the legal system (N=15), parents of black youth impacted by the legal system (N=10) and community members who serve black youth (N=10) (total N=35 study participants). Study participants from each group (youth, parents and community members) will participate in three separate focus groups, respectively, to provide feedback on the culturally responsive content needed to best support black youth impacted by the legal system around substance use and mental health. The eight-step Assess, Decision, Adaptation, Production, Topical Expert, Integration, Training, Testing framework will be used as a guide to inform adaptations to the Motivational Enhancement Therapy and Cognitive Behavioural Therapy (MET/CBT12) for black youth impacted by the legal system. Once the cultural adaptation process has been completed, the study will conclude with an open feasibility and accessibility trial of the culturally adapted MET/CBT12 manual. The primary outcomes of this study are the feasibility and acceptability of the culturally adapted manual, measured by treatment attendance and participant feedback. Secondary outcomes include reductions in substance use and discrimination distress, and improvements in mental health symptoms. ETHICS AND DISSEMINATION/BACKGROUND:This study was approved by the Institutional Review Board (IRB) at the University of California, San Francisco (IRB Protocol Number: 23-40126). All study procedures will be conducted in accordance with the ethical standards outlined by the institutional review board. The results from this study will be shared through peer-reviewed publications, academic conferences, community forums and policy briefs to support broader implementation of culturally adapted adolescent substance use interventions that address discrimination-related stress and substance use among black individuals impacted by the legal system. TRIAL REGISTRATION NUMBER/BACKGROUND:NCT06003725.

Understanding the heterogeneous experiences of violence experienced by Black and Latina women over the life course is critical to prevention. We identified four physical violence trajectories experienced by 361 Black and Latina women followed from ages 14 to 39: low/none (44.0%), persistent-moderate (36.8%), peak in the 20s (11.9%), and persistent-high (7.2%) violence exposure. Childhood abuse predicted membership in the three violence-exposed groups, whereas parental closeness, school academic orientation, and neighborhood safety were protective factors. Public health interventions aimed at preventing childhood trauma and ensuring safe interpersonal relationships and environments for girls to thrive are urgently needed.

OBJECTIVE:Poor sleep and obstructive sleep apnea (OSA) are prevalent among transportation workers. METHODS:45 transportation workers from worksites in the Northeast US completed surveys assessing 1) sleepiness, 2) OSA, and 3) OSA stage of change, then participated in focus groups or interviews. RESULTS:Participants were 93.2% male, 90.1% white non-Hispanic. 77.8% scored high risk for OSA, while 11.1% of those at risk reported an OSA diagnosis. Only 31.4% of high risk participants reported having contemplated OSA evaluation or treatment. Qualitative themes pertained to difficulty unwinding, uncertain work hours, fears about and barriers to OSA treatment, and misinformation about OSA. CONCLUSIONS:Results reveal a high prevalence of OSA risk and a low rate of diagnosis and OSA readiness to change. We identify themes for future interventions to improve awareness about OSA among transportation workers.

BACKGROUND:Asian American (AA) young adults face a looming diet-related non-communicable disease crisis. Interactions with family members are pivotal in the lives of AA young adults and form the basis of family-based interventions; however, little is known on the role of these interactions in shared family food behaviors. Through an analysis of 2021 nationwide survey data of 18-35-year-old AAs, this study examines how the quality of family member interactions associates with changes in shared food purchasing, preparation, and consumption. METHOD/METHODS:Interaction quality was assessed through 41 emotions experienced while interacting with family, and was categorized as positive (e.g., "I look forward to it"), negative (e.g., "I feel annoyed"), and appreciation-related (e.g., "I feel respected") interactions. Participants were also asked how frequently they ate meals, ate out, grocery shopped, and cooked with their family. RESULTS:Among the 535 AAs surveyed (47.6% East Asian, 21.4% South Asian, 22.6% Southeast Asian), 842 unique family interactions were analyzed; 43.5% of interactions were with mothers, followed by siblings (27.1%), and fathers (18.5%). Participants most frequently ate meals with their family (at least daily for 33.5% of participants), followed by cooking (at least daily for 11.3%). In adjusted analyses, an increase in shared food behaviors was particularly associated with positive interactions, although most strongly with cooking together and least strongly with eating meals together; significant differences between ethnic subgroups were not observed. CONCLUSION/CONCLUSIONS:Findings revealed the importance of family interaction quality when leveraging family relationships to develop more tailored, impactful AA young adult dietary interventions.

Problem alcohol use is prevalent among women who experience male-perpetrated intimate partner violence (IPV). However, the pathways by which this occurs remain poorly understood and understudied among African American women. This study sought to examine context-specific social and psychological mediators of this association. Using structural equation modeling (SEM), we tested a conceptual framework predicting problem alcohol use within 3 months of experiencing physical and/or sexual IPV. The sample included 508 young African American women (median age 21, interquartile range 19-22 years). A modified SEM met prespecified global and local fit index criteria. The model identified four indirect paths from IPV to problem alcohol use. Three of the paths were through the endorsement of drinking contexts: negative coping, social drinking, and intimate drinking. Negative coping and social drinking emerged as the most salient pathways (β = .431, 95% CI [0.107, 0.754]; β = .472 [0.103, 0.841], respectively). A fourth path operated via depressive symptomatology and negative coping. The model predictors explained 35% of the variance in problem alcohol use; findings were consistent with full mediation of IPV and problem drinking. These findings increase the understanding of problem alcohol use among African American women who experience IPV and identify modifiable context-specific risk factors for problem alcohol use. Interventions to reduce problem drinking could incorporate trauma-informed counseling, as part of integrated IPV and substance use care, to reduce depressive symptomatology and enhance drinking refusal skills in response to situational drinking.

Sleep difficulties and misuse of drugs/alcohol have been associated with suicidal ideation in young people. Using cross-sectional representative surveys of adolescents in the United States, we conducted adjusted logistic regression modeling to assess the relationships between sleep difficulties, substance use, and suicidal ideation among adolescents with a history of depression (n = 38,418) between 2015 and 2020. Sleep difficulties were associated with thinking about (aOR=1.6,95%CI:1.3-1.9), planning (aOR=1.8,95%CI:1.2-2.6), or attempting (aOR=1.7,95%CI:1.2-2.5) suicide. In those reporting alcohol abuse/dependence, sleep difficulties were associated with attempting suicide (aOR=3.1,95%CI:1.2-8.5). In those reporting illicit drug abuse/dependence, sleep difficulties were associated with thinking about (aOR=2.1,95%CI:1.1-4.1) and attempting (aOR=2.2,95%CI:1.2-4.1) suicide.

In the United States, Black men who have sex with men (BMSM) represent the most vulnerable population for HIV infection. A potential vaccine could ultimately be the most effective HIV prevention strategy. Understanding the factors that may adversely affect HIV vaccine acceptance among BMSM is critical. We conducted two online surveys with BMSM; one recruited 432 respondents, and another recruited 204. Respondents completed a demographic assessment and questions derived from health behavior change theories and the relevant empirical literature. The two surveys yielded similar results. The findings indicate that vaccine uptake self-efficacy, perceived likelihood of important others receiving the vaccine, and susceptibility to HIV were related to intentions to receive a future HIV vaccine. Other potentially important variables include perceived HIV stigma, response efficacy, how much one conceals one's sexual orientation, and perceived HIV discrimination. Future research and health communication campaigns should consider these factors in potential HIV vaccine programs.

OBJECTIVE/UNASSIGNED:Young Latinas and Black women drink less than women of other racial/ethnic groups but experience more alcohol-related problems in midlife. This study aims to identify modifiable factors to prevent adult onset of alcohol use disorder (AUD) in this population. METHODS/UNASSIGNED:Data were collected at six time points as part of the Harlem Longitudinal Development Study from 365 Latinas (47%) and Black (53%) women (mean age at time 1 = 14, standard deviation 1.3). Structural equation modeling was used to test hypothesized pathways from childhood physical and sexual abuse to AUD via depressive mood, anxiety disorders, and somatic complaints in the 20s. We also tested the moderation effect of the high school academic environment by including in the structural equation model two latent variable interaction terms between the school environment and each of the abuse variables. RESULTS/UNASSIGNED: = -9.56, 95% CI [-13.95, -5.17]) in the early 20s. CONCLUSIONS/UNASSIGNED:Our findings underscore the need to invest in early violence prevention interventions and in education to ensure equitable access to quality, academically oriented, and safe schools.

Foreign-born (first-generation) South Asians face a growing diet-related chronic disease burden. Little is known about whether the adult US-born (second-generation) children of South Asian immigrants can provide unique insights as changemakers in their parents' dietary behaviors. This study aims to assess how second-generation South Asians describe and influence the dietary behaviors of their parents. Between October and November 2020, 32 second-generation South Asians [mean age 22.4 (SD 2.9), 53% female] participated in online interviews centered around factors involved in their (and their parents) eating behaviors. Thematic analysis revealed three types of parental dietary drivers (socioecological factors that impact the dietary choices of parents): goal-oriented (i.e., parents' dietary intentionality), capacity-related (e.g., environmental barriers) and sociocultural (cultural familiarity, religion and traditions). Participants described three major mechanisms of influence: recommending new foods, cooking for parents, and bringing new foods home. These influences primarily occurred in the household and often involved participants leveraging their own nutritional knowledge and preferences to expand dietary diversity and healthier behaviors among their parents. Evidence suggests that second-generation South Asians may act as powerful agents of dietary change within their households and can provide novel insights to help address and overcome sociocultural, linguistic, and other structural barriers to better understanding and intervening in the health of the South Asian community.

African American men who have sex with men (MSM) are disproportionately impacted by HIV and may benefit from the development of an HIV vaccine. African American MSM are adversely affected by discrimination as a function of both their race and sexual behaviors. This may further increase the challenges associated with persuading them to adopt an HIV vaccine. Developing a knowledge base characterizing African American MSM HIV vaccine perceptions, attitudes, and concerns may help strengthen how healthcare providers and other health stakeholders describe and discuss the advent of an HIV vaccine. This study assessed the knowledge, attitudes, beliefs, and intentions related to HIV vaccination among African American MSM. This study comprised 432 African American MSM, 18-64 years, residing in the United States. Vaccine intention was defined as how likely it is that an individual would adopt an HIV vaccine if a vaccine was available and it was 90% effective against HIV, easy to obtain, free, and had few side effects. Relative to African American MSM who intend to delay receiving an HIV vaccination, controlling for age, education, and income, early vaccine adopters who had received ≥ 2 COVID-19 vaccinations and who had high WHO HIV Vaccine Positive Attitude Scale scores were, respectively, 3.2 times and 2.4 times more likely to report the intention to vaccinate within one year. Early vaccine adopters were also 2.4 times more likely to feel that HIV prevention support discriminates against African American MSM. Those reporting three or more sexual partners and medical mistrust were, respectively, 60% and 59% more likely to report the intention to delay HIV vaccination. The lack of a knowledge base on HIV vaccine perceptions and acceptability is a missed opportunity to provide guidance on how stakeholders, such as health providers and policymakers, should address HIV vaccine hesitancy once this crucial vaccine is licensed. The key factors affecting vaccine adoption are valuable in developing and implementing campaigns to enhance the HIV vaccine coverage in this vulnerable population.