Publications

Feasibility, acceptability and preliminary impact of mindfulness-based yoga among Hispanic/Latinx adolescents

Feasibility, acceptability and preliminary impact of mindfulness-based yoga among Hispanic/Latinx adolescents

Background: The Hispanic/Latinx population constitutes the fastest growing ethnic/racial minority group in the United States (U.S.). Compared to their non-Hispanic/Latinx White counterparts, Hispanic/Latinx youth experience more depression and anxiety, and have more unmet mental health needs (88% vs 76%). Emerging research supports the psychological and physical benefits of mind-body awareness training to enhance well-being and mental health, but almost no studies have recruited ethnic/racial minority samples. Purpose: The current study examined the feasibility, acceptability and preliminary impact of a mindfulness-based yoga program among Hispanic/Latinx public high school students. Procedures: Participants (N = 187) were recruited from a local public high school in a large multi-ethnic urban school district in the Southeast U.S. and participated in 6 weekly hour-long sessions of mindfulness-based yoga. Participants completed assessments at pretest and one month after program completion. Main Findings: The sample was predominantly Hispanic/Latinx (95%) and female (64%), on average 15.2 years old (SD = 1.3), and 51% were born outside the U.S. Participants reported on average a 14.2% reduction in depressive symptoms (pretest mean = 5.51, posttest mean = 4.73, p = .032, Cohen’s d = 0.2), a 14.9% reduction in anxiety symptoms (pretest mean = 9.90, posttest mean = 8.42, p = .005, Cohen’s d = 0.2), and a 21.9% reduction in stress (pretest mean = 9.66, posttest mean = 7.54, p < .001, Cohen’s d = 0.5). Conclusion: These findings provide support for the effectiveness of a mindfulness-based yoga program for Hispanic/Latinx adolescents, a medically underrepresented group experiencing significant mental health disparities.

Clarke, R. D., Morris, S. L., Wagner, E. F., Spadola, C. E., Bursac, Z., Fava, N. M., & Hospital, M. M. (2021). Feasibility, acceptability and preliminary impact of mindfulness-based yoga among Hispanic/Latinx adolescents. EXPLORE. doi:10.1016/j.explore.2021.03.002

Multidimensional conceptualization of identity and psychopathology: Assessing mental health disparities from an intersectional and dimensional framework

Multidimensional conceptualization of identity and psychopathology: Assessing mental health disparities from an intersectional and dimensional framework

Abstract: Black, Indigenous, and People of Color (BIPOC) currently constitute 40% of the US population and will become the majority by 2045. Current mental health systems have not sufficiently accounted for disparities, inequities, and social determinants impacting BIPOC lives. We outline several advances that could improve mental health disparities research. Research on BIPOC requires mental health assessment accurately capturing multiple facets of one’s identity, taking into account the complexities of multifaceted historical oppression. Assessing (personality) psychopathology in a dimensional and hierarchical manner could provide greater insight into mental health disparities between diverse identity individuals. We encourage studying moderators that are protective assets for BIPOC—such as resiliency and community factors—as opposed to deficit-dominant, category-based, and majority-dominant assessments.

Langwerden, R. J., Thompson, M. G., & Wagner, E. F. (2021). Multidimensional conceptualization of identity and psychopathology: Assessing mental health disparities from an intersectional and dimensional framework. Personality and Mental Health, 1– 16. doi: 10.1002/pmh.1519

A review investigating the relationship between cannabis use and adolescent cognitive functioning

A review investigating the relationship between cannabis use and adolescent cognitive functioning

Given varying state-level laws regarding cannabis use, the objective of the review was to summarize contemporary literature on the relationship between adolescent cognitive function and academic performance with cannabis use. Frequency and quantity of cannabis use were associated with decreased functional connectivity of the brain. Earlier age at cannabis initiation and more frequent use was associated with poorer executive control and academic performance. Social determinants such as minimal parental monitoring, peer use and low social cohesion were associated with more frequent adolescent use. Race/ethnicity and residence were other factors influencing cannabis use. To prevent cannabis use disorders among adolescents, interventions should aim to prevent early initiation that can lead to chronic use in youth who may be more at risk.

Cyrus, E., Coudray, M. S., Kiplagat, S., Mariano, Y., Noel, I., Galea, J. T., … & Wagner, E. (2021). A review investigating the relationship between cannabis use and adolescent cognitive functioning. Current Opinion in Psychology, 38(38-48). doi: 10.1016/j.copsyc.2020.07.006.

 

Sacred Connections: A university-tribal clinical research partnership for school-based screening and brief intervention for substance use problems among Native American youth

SACRED Connections: A university-tribal clinical research partnership for school-based screening and brief intervention for substance use problems among Native American youth

Abstract: Native American (NA) youth report higher rates of alcohol, marijuana, and drug use than U.S. adolescents from any other racial/ethnic group. Addressing this health disparity is a significant research priority across public health, minority health, and dissemination and implementation (D&I) sciences, underscoring the need for empirically-based interventions tailored for NA youth. Effective D&I with NA youth incorporates NA cultural values and involves tribal elders and stakeholders. SACRED Connections (NIDA R01DA02977) was a university-tribal research partnership that utilized a culturally derived Native-Reliance theoretical framework and a community-based participatory research (CBPR) approach. A significant objective of this randomized controlled trial was to close D&I gaps utilizing the RE-AIM Model and National Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care Standards (HHS, 2019). Findings of this 5-year RCT revealed a statistically significant protective relationship between Native Reliance and baseline lifetime and past month alcohol and marijuana use; additionally, the likelihood of reporting marijuana use at 3 months post-intervention was significantly lower among the active condition than among the control condition. Implementation of a developmentally and NA culturally tailored brief protocol revealed: partnering with Native Americans and utilizing CBPR facilitated engagement with this hard-to-reach, underserved community; age and culture are associated with substance use severity among NA teens; a culturally adapted Motivational Interviewing (MI) brief intervention may be effective in reducing marijuana use among NA youth; the Native Reliance theory proved useful as a framework for working with this population; and RE-AIM proved helpful in conceptualizing health equity promoting D&I.

Morris, S.L., Hospital, M.M., Wagner, E.F., Lowe, J., Thompson, M.G., Clarke, R., Riggs, C. (2021). Sacred Connections: A university-tribal clinical research partnership for school-based screening and brief intervention for substance use problems among Native American youth. Journal of Ehnic & Cultural Diversity in Social Work, 30(1):149-162. doi: 10.1080/15313204.2020.1770654

Recovery in Special Emphasis Populations

Recovery in special emphasis populations

Special emphasis populations in the current context can be defined as groups experiencing health disparities resulting in elevated risk to health, safety, and well-being from drinking alcohol. Individuals from marginalized minority populations often encounter barriers to accessing and receiving effective alcohol treatment due to social inequities and disadvantaged life contexts, which also may adversely affect recovery from alcohol use disorder (AUD). Recovery from AUD often involves the adoption of a stable non-drinking lifestyle (sobriety), increased health and well-being, and increased social connection. Although there has been considerable work on AUD epidemiology among special emphasis populations, little research exists directly examining recovery among racial/ethnic minority populations and/or sexual and gender minority populations. The current narrative review hopes to spark scholarly interest in this critically neglected area. This article opens with a review of special emphasis populations and their alcohol-related risks. Next, definitions of recovery, Alcoholics Anonymous, and culturally adapted recovery models for racial/ethnic minority populations are explored. This is followed by a discussion of factors that may particularly influence recovery among marginalized minority populations. This narrative review concludes with a discussion of research priorities for promoting health equity through studies focused on understanding and supporting recovery from AUD among marginalized minority populations.

Wagner, E. F., & Baldwin, J. A. (2020). Recovery in Special Emphasis Populations. Alcohol Research: Current Reviews40(3). doi:10.35946/arcr.v40.3.05

Evaluating Research Centers in Minority Institutions: Framework, Metrics, Best Practices, and Challenges

Evaluating Research Centers in Minority Institutions: Framework, metrics, best practices, and challenges

Abstract: The NIH-funded Research Centers in Minority Institutions (RCMI) program is currently funding 18 academic institutions to strengthen the research environment and contribution to health disparities research. The purpose of this multiphase mixed-methods study was to establish a uniform evaluation framework for demonstrating the collective success of this research consortium. Methods included discussions of aims and logic models at the RCMI Evaluators’ Workshop, a literature review to inform an evaluation conceptual framework, and a case study survey to obtain evaluation-related information and metrics. Ten RCMIs participated in the workshop and 14 submitted responses to the survey. The resultant RCMI Evaluation Conceptual Model presents a practical ongoing approach to document RCMIs’ impacts on health disparities. Survey results identified 37 common metrics under four primary categories. Evaluation challenges were issues related to limited human resources, data collection, decision-making, defining metrics, cost-sharing, and revenue-generation. There is a need for further collaborative efforts across RCMI sites to engage program leadership and community stakeholders in addressing the identified evaluation challenges and measurement. Program leadership should be engaged to apply the Evaluation.

Sy, A., Hayes, T., Laurila, K., Noboa, C., Langwerden, R. J., Andújar-Pérez, D. A., … & Penn, T. (2020). Evaluating Research Centers in Minority Institutions: Framework, Metrics, Best Practices, and Challenges. International Journal of Environmental Research and Public Health, 17(22), 8373. doi: 10.3390/ijerph17228373

 

Getting their feet in the door: Communication cues to action for HIV testing and condom use behaviors among Hispanic/Latinx college students

Getting their feet in the door: Communication cues to action for HIV testing and condom use behaviors among Hispanic/Latinx college students

Abstract: Hispanic/Latinx youth in the U.S. are disproportionately affected by HIV, and are in need of culturally, linguistically, and developmentally tailored HIV prevention programs focused on expanding routine screening and environmental prevention efforts. With SAMHSA support, we implemented an HIV prevention campaign targeting 18- to 24-year-old Hispanic/Latinx college students. Based on formative feedback, both traditional communication and social media channels were employed to motivate students to seek free-of-charge on-campus HIV testing. Participants’ attitudes regarding the benefits of and confidence in condom use were also examined. From 2015 to 2018, 1406 Hispanic 18-24 year olds received an on-campus HIV test; for nearly half, this was their first HIV test ever. Among first time testers, the reasons for not getting tested sooner included that over 70% thought they were unlikely to have an HIV infection, over 20% said they did not know where to get tested, and 10% reported being afraid to find out their status. Moreover, participants reported a variety of cues to seeking testing: just under half reported printed flyers, on-campus lawn signs, and word-of-mouth, and almost 15% reported social media. Repeat testers (n = 717) were significantly more likely than first time testers to report hearing about HIV testing through social media. There were significant gains from baseline to the 1-month follow-up in both perceived advantages of condom use and confidence in condom use. Our study showed that messages conveyed through traditional communication channels remain important and serve as cues to seek HIV testing for Hispanic/Latinx college students, especially those who have never before been tested.

Clarke, R. D., Fernandez, S. B., Morris, S. L., Howard, M., Wagner, E. F., & Wales, E. (2020). Getting their feet in the door: communication cues to action for HIV testing and condom use behaviors among Hispanic/Latinx college students. The Journal of Primary Prevention, 1-11. doi:10.1007/s10935-020-00610-3

The impact of COVID-19 on African American communities in the United States

The impact of COVID-19 on African American communities in the United States

Purpose: The purpose of this ecological study was to understand the impact of the density of African American (AA) communities on coronavirus disease 2019 (COVID-19) prevalence and death rate within the three most populous counties in each U.S. state and territory (n=152).

Methods: An ecological design was employed for the study. The top three most populous counties of each U.S. state and territory were included in analyses for a final sample size of n=152 counties. Confirmed COVID-19 cases and deaths that were accumulated between January 22, 2020 and April 12, 2020 in each of the three most populous counties in each U.S. state and territory were included. Linear regression was used to determine the association between AA density and COVID-19 prevalence (defined as the percentage of cases for the county population), and death rate (defined as number of deaths per 100,000 population). The models were adjusted for median age and poverty.

Results: There was a direct association between AA density and COVID-19 prevalence; COVID-19 prevalence increased 5% for every 1% increase in county AA density (p<0.01). There was also an association between county AA density and COVID-19 deaths; the death rate increased 2 per 100,000 for every percentage increase in county AA density (p=0.02).

Conclusion: These findings indicate that communities with a high AA density have been disproportionately burdened with COVID-19. To help develop effective interventions and programs that address this disparity, further study is needed to understand social determinants of health driving inequities for this community.

Cyrus, E., Clarke, R., Hadley, D., Bursac, Z., Trepka, M. J., Dévieux, J. G., … & Wagner, E. F. (2020). The impact of COVID-19 on African American communities in the United States. Health Equity4(1), 476-483. doi:10.1089/heq.2020.0030

Health Disparities

Health Disparities

Marginalized and medically underserved minority populations experience higher than average rates of illness, impairment, and death. These health and longevity disadvantages are referred to as health disparities, which are a function of social injustices. While the health risks and health problems experienced by minority individuals may be modifiable through conventional health psychology practices, the long‐term elimination of health disparities is dependent on social change. Key conceptualizations for health disparities include contextual exposures, a life‐course approach, and the consequences of discrimination, intersectionality, and residential segregation. Several historical and current examples illustrate the complex realities facing marginalized communities and serve as a call to action for health psychology scholars.

Ward‐Peterson, M., & Wagner, E. F. (2020). Health Disparities. In Paul, R.H., Salminen, L E., Heaps, J., & Cohen, L. M. (Eds), The Wiley Encyclopedia of Health Psychology, (pp. 51-59). Wiley Press.