Publications

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.

An analysis of current model programmes for adults with neurodevelopmental disorders

An analysis of current model programmes for adults with neurodevelopmental disorders

Abstract: Programmes which offer integrated services were analysed to identify model international and domestic programmes serving adults with neurodevelopmental disorders. Programmes were assessed according to 11 need domains identified in a previous study: supervision, transportation, housing, communication, finances/employment opportunities, activities of daily living/instrumental activities of daily living training, socialisation opportunities, enhanced adult-centred medical care, psychological, medical equipment, and sexual health education. In addition, programmes which served adults within six diagnosis comprising intellectual disability (ID), autism spectrum disorder (ASD), cerebral palsy (CP), spina bifida (SB), Down syndrome (DS), and Prader-Willi syndrome (PWS) were considered. Only three international and three domestic programmes demonstrated the required criteria to be considered a comprehensive model programme. Identified model programmes provided at least eight of the 11 needs, while only two programmes served all identified domains. This study offers insight into the needs provided, which can be used to inform modifications and development of existing and new programmes. It illustrates the necessity for programmes to focus on social and sexual needs as much as medical and health services. Consequences of gaps in provided services can have direct implications on the biopsychosocial functioning of individuals with neurodevelopmental disorders including a lowered quality of life.

Agarwal, R., Maddux, M., Marolda, H., Quintana, J., Wagner, E., & Burke, S. (2020). An analysis of current model programmes for adults with neurodevelopmental disorders, International Journal of Disability, Development and Education, doi: 10.1080/1034912X.2020.1719048

 

A qualitative investigation to inform yoga intervention recruitment practices for racial/ethnic minority adolescents in outpatient mental health treatment

A qualitative investigation to inform yoga intervention recruitment practices for racial/ethnic minority adolescents in outpatient mental health treatment

Abstract: Yoga is recognized as an effective approach to improving overall physical and mental health; however, there may be perceived barriers to yoga participation, particularly among populations most at risk for mental health issues. We conducted qualitative formative research to help inform recruitment practices for a future study and to specifically understand the barriers and facilitators to engagement in yoga practice among racial/ethnic minority adolescents, as well as adolescents in outpatient mental health treatment.

Methods: Qualitative data were collected at a community health clinic that serves low income families in southeastern Florida. Using semi structured interviews with racial and ethnic minority adolescents between 12 and 17 years old, participants were asked about beliefs and perceptions about yoga, as well as recommendations on recruiting peers. A thematic analysis approach was used to identify and examine common themes.

Results: Twenty interviews were conducted and eight major themes emerged from the data. Themes were grouped as (1) Facilitators to recruitment and (2) Barriers to recruitment.

Interpretation: Advertising free yoga that emphasizes the social, physical, and mental benefits can help assuage negative perceptions of yoga and promote the advantages of yoga among teenagers. Having recruitment materials and modalities that highlight inclusivity of all genders and physical abilities in the yoga classes are also important in facilitating participation. Understanding perceptions of yoga, as well as perceived barriers and facilitators, among racially/ethnically diverse adolescents in outpatient mental health treatment, can assist recruitment efforts, increase yoga intervention participation, and ultimately, improve mental health outcomes for underserved populations.

Spadola, C. E., Varga, L. M., Fernandez, S. B., Clarke, R. D., Morris, S. L., Wagner, E. F., & Hospital, M. (2019). A qualitative investigation to inform yoga intervention recruitment practices for racial/ethnic minority adolescents in outpatient mental health treatment. EXPLORE, 16(1), 21-25. doi: 10.1016/j.explore.2019.07.011

 

Gap analysis of service needs for adults with neurodevelopmental disorders

Gap analysis of service needs for adults with neurodevelopmental disorders

Abstract: In Florida, the Agency for Persons with Disabilities provides waivers for adults with the following types of disabilities: intellectual disability, autism spectrum disorder, cerebral palsy, spina bifida, Down syndrome, and Prader–Willi syndrome. This review examined the peer-reviewed literature to indicate and assess the common needs for individuals with intellectual and developmental disabilities. Current models of service delivery, the efficacy of these services, and remaining gaps in the need fulfillment of individuals within the six diagnostic categorizations of interest were examined. Severity level within each diagnostic category was plotted on a matrix according to whether the needs of individuals were minimal, moderate, severe, or universal. The study found that sexual health education, socialization, and adult-focused medical care are universal needs among the six conditions. The study indicates that health-care professionals must work toward addressing the many unmet needs in comprehensive life span care services for adult individuals with neurodevelopmental disorders.

Burke, S., Wagner, E., Marolda, H., Quintana, J., & Maddux, M. (2019). Gap analysis of service needs for adults with neurodevelopmental disorders. The Journal of Intellectual Disabilities, 23(1):97-116. doi: 10.1177/1744629517726209

Music education as a path to positive youth development: An El Sistema-inspired program

Music education as a path to positive youth development: An El-Sistema-inspired program

Music Education as a Path to Positive Youth Development: An El Sistema-Inspired ProgramAbstract: The El Sistema music education philosophy links positive individual and social development through musical education. This study is a longitudinal examination of the impact of participation in an El Sistema-inspired program, the Miami Music Project, on positive youth development. We hypothesized that over the course of a school year, participation in ensemble-based after-school music programming would significantly enhance factors associated with positive youth development. Specifically, we evaluated social emotional constructs aligned with the Five Cs of Positive Youth Development: Competence, Confidence, Caring, Character, and Connection. Results revealed that participants showed significant increases across all five Cs over the course of the year. Additionally, findings showed that Miami Music Project students showed greater enhancements over time in Character, Competence and Caring when compared to a group of youth who did not participate in music education. This study presents empirical documentation of the numerous meaningful social and emotional enhancements that participation in an El Sistema-inspired program is engendering among youth. In this type of rigorous orchestral model of musical instruction, youth seem to acquire not only cognitive benefits but also a host of social and emotional enhancements, ostensibly from learning in an environment that requires disciplined social cohesion. These findings provide insight into the holistic approach foundational to the El Sistema philosophy and adds to our overall understanding of musical instruction in important ways.

Hospital, M.M., Morris, S.L., Wagner, E.F., & Wales, E. (2018). Music education as a path to positive youth development: An El Sistema-inspired program. Journal of Youth Development13(4), 149-163. doi:10.5195/jyd.2018.572

A qualitative examination of increased alcohol use after bariatric surgery among racially/ethnically diverse young adults

A qualitative examination of increased alcohol use after bariatric surgery among racially/ethnically diverse young adults

A Qualitative Examination of Increased Alcohol Use after Bariatric Surgery among Racially/Ethnically Diverse Young AdultsAbstract: Introduction – Mounting evidence suggests that bariatric surgery, or weight loss surgery (WLS), patients might be vulnerable to developing post-operative alcohol use problems. While the majority of published research offers information concerning the prevalence of problematic alcohol use post-WLS, the literature lacks comprehensive, qualitative explorations examining why alcohol misuse might emerge after WLS. Such data-driven hypotheses are needed to effectively target this emerging concern. Additionally, young adults and racial/ethnic minorities are both increasingly undergoing WLS and are at heightened risk for problems related to alcohol use. To date, these groups have been under-represented in study samples.

Methods: To address these important gaps in the literature, racially/ethnically diverse, young adult WLS patients who indicated a post-WLS increase in alcohol use (n = 12) participated in an individual, semi-structured qualitative interview. Data were analyzed through two coding cycles; an external audit of the emerging themes was also conducted to further ensure the trustworthiness of the data.

Results: Interviews revealed four major themes prompting an increase in alcohol use after WLS: (1) increased sensitivity to alcohol intoxication, (2) utilizing alcohol as a replacement self-soothing mechanism for food, (3) increase in socialization, and (4) utilizing alcohol as a coping mechanism. Conclusions By understanding the drivers of increases in alcohol use after WLS, precision-targeted pre- and post-surgical counseling interventions can be developed to address this emerging concern

Spadola, C.E., Wagner, E.F., Varga, L. M., Syvertsen, J.L., Cruz Munoz, N F., & Messiah, S.E. (2017). A qualitative examination of increased alcohol use after bariatric surgery among racially/ethnically diverse young adults. Obesity Surgery, (6), 1492. doi:10.1007/s11695-017-3022-x

Resilience in the context of fragility: Development of a multidimensional measure of child wellbeing within the Fragile Families dataset

Resilience in the context of fragility: Development of a multidimensional measure of child wellbeing within the Fragile Families dataset

Resilience in the context of fragility: Development of a multidimensional measure of child wellbeing within the Fragile Families datasetAbstract: This study sought to empirically develop a theoretically grounded multidimensional measure of child wellbeing (CWB) for research with at-risk families. The World Health Organization and UNICEF call for a multidimensional construct of child wellbeing, incorporating factors known to impact wellbeing (e.g., access to healthcare, childhood maltreatment, the incarceration of one’s primary caregiver). We analyzed data from the Fragile Families study in two separate steps: 1) confirmatory factor analysis (CFA) was conducted at each time point utilizing theoretically grounded multidimensional indicator of wellbeing available in the dataset, and 2) twosample t-tests and one-way ANOVAs, by sex and race/ethnicity, were conducted at each time point examining potential variation in wellbeing. The current measure of CWB included the following domains: material wellbeing, relationships, health and behavioral wellbeing, and environmental enrichment. CFA results revealed acceptable to excellent fit based on multiple fit indices (e.g., CFI, RMSEA). Our CWB measure did not significantly vary by sex but did differ by race at each wave. Non-Hispanic white participants consistently demonstrated the highest CWB, while non-Hispanic black children consistently demonstrated the lowest CWB. This study resulted in the creation a new multidimensional measure of CWB not previously available in the Fragile Families data. The measure developed in this study will allow prevention scientists to further examine the myriad of factors related to child wellbeing in this robust national dataset.

Fava, N.M., Li, T., Burke, S.L., & Wagner, E.F. (2017). Resilience in the context of fragility: Development of a multidimensional measure of child wellbeing within the Fragile Families dataset. Children & Youth Services Review81358-367. doi:10.1016/j.childyouth.2017.08.023

Social ecological determinants of substance use treatment entry among serious juvenile offenders from adolescence through emerging adulthood

Social ecological determinants of substance use treatment entry among serious juvenile offenders from adolescence through emerging adulthood

Social Ecological Determinants of Substance Use Treatment Entry Among Serious Juvenile Offenders From Adolescence Through Emerging AdulthoodAbstract/Purpose: To examine the social-ecological determinants of substance use treatment entry among serious juvenile offenders over a 7 year period. Using the social-ecological framework, relevant predictors of substance use from the literature were used to assess risk (and protective) factors at the individual, parental, peer and neighborhood level.

Method: Serious juvenile offenders (N=1354, Mage baseline=16.0 years, SD=1.14) were prospectively followed over 7 years (Mage Conclusion=23.0 years, SD=1.15). Cox regression with time invariant and time varying predictors was used to predict time to first substance use treatment entry.

Results: Results for each dimension, separately, varied slightly from the full model. In the full model peer delinquency, peer arrests, post-traumatic stress disorder (PTSD), impulse control, temperament, and emotional regulation remained salient risk (and protective) factors for treatment entry.

Conclusion: Associating with more deviant peers and having more of your peers arrested over the 7 year study period was associated with substantial increase in time to treatment entry. Furthermore, one of the strongest risk factors for treatment entry was a PTSD diagnosis. Treatment implications are discussed regarding peer affiliation and PTSD symptomology as well as potential neurological and biological contributors to increased risk for treatment entry.

Davis, J.P., Dumas, T.M., Wagner, E.F., & Merrin, G.J. (2016). Social ecological determinants of substance use treatment entry among serious juvenile offenders from adolescence through emerging adulthood. Journal of Substance Abuse Treatment718-15. doi:10.1016/j.jsat.2016.08.004