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CORK Bibliography: African-Americans

42 citations. January 2009 to present

Prepared: September 2009

Ames S; Stevens S; Schroeder D; Werch C; Carlson J; Kiros GE et al. Nondaily tobacco use among Black and White college undergraduates: A comparison of nondaily versus daily tobacco users. Addiction Research & Theory 17(2): 191-204, 2009. (24 refs.)

Little is known about how the characteristics of college undergraduate nondaily tobacco users compare to daily tobacco users. We conducted a survey to compare the sociodemographic, tobacco use, psychological, and alcohol-related factors between nondaily versus daily tobacco users in a sample of Black and White college undergraduates aged 18-24 years (N = 1623). Of this sample, 301 (18.5%) participants reported using tobacco in the previous 30 days. Of the participants reporting tobacco use in the past 30 days, 50 (16.6%) participants reported nondaily use and 21 (7.0%) participants reported daily use. Findings revealed that nondaily tobacco users were more likely than daily tobacco users to deny that use of tobacco has had a detrimental impact on their health (p 0.001). Additionally, nondaily cigarette smokers reported a lower level of dependence than daily smokers (p 0.001). White racial status and daily tobacco use was associated with cigarette smoking (p 0.05), while Black racial status and nondaily tobacco use was associated with cigar smoking (p 0.05). Use of more than one type of tobacco product was associated with White racial status (p 0.05) and male gender (p 0.001). Our findings expand what is known about undergraduate nondaily tobacco users and provides valuable data for designing interventions for these individuals.

Brody GH; Beach SRH; Philibert RA; Chen YF; Lei MK; Murry VM et al. Parenting moderates a genetic vulnerability factor in longitudinal increases in youths' substance use. Journal of Consulting and Clinical Psychology 77(1): 1-11, 2009. (87 refs.)

The authors used a longitudinal, prospective design to investigate a moderation effect in the association between a genetic vulnerability factor, a variable nucleotide repeat polymorphism in the promoter region of 5HTT (5-HTTLPR), and increases in youths' substance use. The primary study hypothesis predicted that involved-supportive parenting would attenuate the link between the 5-HTTLPR polymorphism and longitudinal increases in substance use. African American youths residing in rural Georgia (N = 253, mean age = 11.5 years) provided 4 waves of data on their own substance use; the mothers of the youths provided data on their own parenting practices. Genetic data were obtained from youths via saliva samples. Latent growth curve modeling indicated that 5-HTTLPR status (presence of I or 2 copies of the s allele) was linked with increases in substance use over time; however, this association was greatly reduced when youths received high levels of involved-supportive parenting. This study demonstrates that parenting processes have the potential to ameliorate genetic risk.

Brook JS; Koppel J; Pahl K. Predictors of DSM and Fagerstrom-defined nicotine dependence in African American and Puerto Rican young addults. Substance Use & Misuse 44(6): 809-822, 2009

This study examined the psychosocial predictors of nicotine dependence, as defined by a variant of the criteria employed in the DSM-IVspecifically that of the University of Michigan Composite International Diagnostic Interview (UM-CIDI)and the Fagerstrom Test for Nicotine Dependence (FTND). The study was conducted with a community sample of African American and Puerto Rican young adults (N = 475; mean age = 26). Predictor variables included physiologically based psychosocial (i.e., depressive symptoms and family problems with smoking) as well as social-behavioral psychosocial (i.e., rebelliousness and partner's problems with smoking) predictors of nicotine dependence. Using multiple regression analyses, UM-CIDI-defined dependence was predicted by each of the four psychosocial variables, while FTND-defined dependence was predicted only by the social-behavioral variables. These findings bear out the disparate dimensions of nicotine dependence each measure taps. Research and clinical implications of the findings are discussed, and the study's limitations are noted.

Brook JS; Saar NS; Zhang CS; Brook DW. Familial and non-familial smoking: Effects on smoking and nicotine dependence. Drug and Alcohol Dependence 101(1-2): 62-68, 2009. (44 refs.)

Background: This study examined the relative impact of familial and non-familial smoking on participant smoking and nicotine dependence. Methods: This is a longitudinal study of 838 African American and Puerto Rican participants who were interviewed four times in their homes over a 15-16-year period (1990, 1994-1996, 2000-2001, and 2004-2006). Results: Parental smoking during adolescence had a direct positive path to peer smoking during adolescence, which in turn had a direct positive path to participant smoking during the mid-twenties. In addition to the direct path between participant smoking in the mid-twenties and participant nicotine dependence during the late twenties, there was an indirect effect mediated by the partner's problems resulting from smoking during the late twenties. Conclusions: This research demonstrates the key role the social environment plays in smoking and nicotine dependence. Both familial and non-familial smoking were significantly related to smoking and nicotine dependence. Public health implications suggest the importance of targeting prevention and treatment policies based on the participants' stage of development. During adolescence the focus should be on parental and peer smoking, whereas during the twenties attention might be paid to their own smoking and that of their partners.

Brown LS; Kritz S; Muhammad A; Bini EJ; Goldsmith RJ; Robinson J et al. Disparities in health services for HIV/AIDS, hepatitis C virus, and sexually transmitted infections: Role of substance abuse treatment programs. Journal of Addiction Medicine 3(2): 95-102, 2009. (26 refs.)

Objectives: This report focused upon the availability of infection-related health services in substance abuse treatment programs with and without addiction services tailored for special populations (women and non-white populations). Methods: In a cross-sectional, descriptive design, treatment program administrators across the United States within the National Drug Abuse Treatment Clinical Trials Network provided information on program characteristics, the availability of infection-related services (4 medical services and 3 nonmedical services for human immunodeficiency virus, hepatitis C virus, and sexually transmitted infections), and barriers to providing infection-related services. Results: Of 319 programs, 209 submitted surveys (84% response rate). Of these, 80% provided addiction services for special populations. Programs providing addiction services designed for at least one special population, were more likely to provide infection-related health services, especially human immunodeficiency virus-related education (94% vs 85%, P = 0.05) and patient counseling (76% vs 60%, P = 0.03) and were more likely to include outpatient addiction services (86% vs 57% P < 0.001) and outreach and support services (92%, vs 70%, P = 0.01). Barriers to providing infection-related services included funding (cited by 48.3%-74.7% of programs), health insurance (cited by 28.9%-60.8%, of programs), and patient acceptance (cited by 23.2%-54.3% of programs). Conclusions: Despite many barriers, infection-related healthcare is available in programs with addiction treatment services tailored for special populations, especially for African Americans and Latino Americans. Tailoring substance abuse treatment along with reducing barriers to infection-related care represent public health interventions with potential to reduce the burdens and disparities associated with these infections.

Browne DC; Clubb PA; Wang Y; Wagner F. Drug use and high-risk sexual behaviors among African American men who have sex with men and men who have sex with women. American Journal of Public Health 99(6): 1062-1066, 2009. (43 refs.)

Objectives. We investigated covariates related to risky sexual behaviors among young African American men enrolled at historically Black colleges and universities (HBCUs). Methods. Analyses were based on data gathered from 1837 male freshmen enrolled at 34 HBCUs who participated in the 2001 HBCU Substance Use Survey. The covariates of risky sexual behavior assessed included condom nonuse, engaging in sexual activity with multiple partners, and history of a sexually transmitted disease. Results. Young Black men who had sex with men were more likely to engage in risky sexual behaviors than were young men who had sex with women. Two additional factors, early onset of sexual activity and consumption of alcohol or drugs before sexual activity, were independently associated with modestly higher odds of sexual risk behaviors. Conclusions. Services focusing on prevention of sexually transmitted diseases should be provided to all male college students, regardless of the gender of their sexual partners. Such a general approach should also address drug and alcohol use before sexual activity.

Businelle MS; Kendzor DE; Costello TJ; Cofta-Woerpel L; Li YS; Mazas CA et al. Light versus heavy smoking among African American men and women. Addictive Behaviors 34(2): 197-203, 2009. (48 refs.)

The majority of smoking cessation research has focused on heavy smokers. African Americans are less likely than the general population to be heavy smokers. Thus, little is known about the smoking and psychosocial characteristics of lighter African Americans smokers. The present study compared the baseline demographic, smoking, and psychosocial characteristics of light (5-10 cigarettes per day; n = 86) and moderate to heavy (> 10 cigarettes per day; n = 286) AA smokers enrolled in a smoking cessation clinical trial. Results indicated no differences between groups on demographic variables. However, light smokers were less dependent on smoking, reported more previous quit attempts, and had higher self-efficacy to quit than moderate to heavy smokers. On a measure of withdrawal, light smokers reported less pre-quit craving and less difficulty concentrating than moderate to heavy smokers. In addition, light smokers reported lower perceived stress, fewer symptoms of depression, and greater positive affect than African Americans moderate to heavy smokers. These findings highlight important similarities and differences between African Americans light smokers and moderate to heavy smokers, and have implications for the treatment of African Americans smokers.

Chisolm DJ; Mulatu MS; Brown JR. Racial/ethnic disparities in the patterns of co-occurring mental health problems in adolescents in substance abuse treatment. Journal of Substance Abuse Treatment 37(2): 203-210, 2009. (28 refs.)

This study examines disparities in co-occurring mental health and substance use problems by race/ethnicity to inform the development of culturally appropriate treatment approaches. Using pooled clinical data collected with the Global Assessment of Individual Needs, we identified racial/ethnic and other factors associated with co-occurring internalizing problems, externalizing problems, and the combination thereof in adolescents in federally funded treatment facilities. Results show that after controlling for demographic and socioenvironmental factors, African Americans, Hispanics, and mixed-race adolescents were more likely than Whites to have co-occurring internalizing problems. African Americans and Native Americans were less likely than Whites to have externalizing problems and to have combined internalizing and externalizing problems. Presence of co-occurring problems was also associated with victimization, homelessness, and family substance abuse. These results indicate that co-occurring mental health problems vary by race/ethnicity, and therefore, refined approaches are needed for culturally appropriate care of patients.

Dauber S; Hogue A; Paulson JF; Leiferman JA. Typologies of alcohol use in White and African American adolescent girls. Substance Use & Misuse 44(8): 1121-1141, 2009. (46 refs.)

This study examined typologies of alcohol use among 2,948 White and African American adolescent girls using data from the National Longitudinal Study of Adolescent Health. Self-report data were collected on frequency and quantity of alcohol use, negative consequences, and high-risk drinking behaviors, as well as co-occurring internalizing and externalizing problems. Latent class analysis revealed a four-group typology for white girls and a three-group typology for African American girls. Problematic drinkers reported having more internalizing and externalizing problems in both racial groups. The study's limitations and implications are discussed.

El-Bassel N; Caldeira NA; Ruglass LM; Gilbert L. Addressing the unique needs of African American women in HIV prevention. American Journal of Public Health 99(6): 996-1001, 2009. (82 refs.)

African American women continue to be disproportionately affected by the HIV/AIDS epidemic, yet there are few effective HIV prevention interventions that are exclusively tailored to their lives and that address their risk factors. Using an ecological framework, we offer a comprehensive overview of the risk factors that are driving the HIV/AIDS epidemic among African American women and explicate the consequences of ignoring these factors in HIV prevention strategies. We also recommend ways to improve HIV prevention programs by taking into consideration the unique life experiences of adult African American women.

Fagan P; Brook JS; Rubenstone E; Zhang CS; Brook DW. Longitudinal precursors of young adult light smoking among African Americans and Puerto Ricans. Nicotine & Tobacco Research 11(2): 139-147, 2009. (59 refs.)

Studies have consistently documented the importance of examining light smoking among African American and Latino adolescent and adult smokers. Little is known, however, about the psychosocial antecedents of adolescent and young adult light smoking in these racial/ethnic minority groups. This study examined the longitudinal interrelationships and pathways leading to light smoking among African Americans (n = 288) and Puerto Ricans (n = 262). Specifically, we assessed parental factors, perceived discrimination, peer smoking, personality factors, and light smoking in late adolescence as precursors to light smoking among African American and Puerto Rican young adults. The results of structural equation modeling showed that a history of greater parental smoking, less parental educational attainment, and more perceived discrimination were each mediated by peer smoking and the youth's maladaptive personality and behavior in late adolescence. The youth's maladaptive personality and behavioral characteristics and light smoking in late adolescence, in turn, predicted light smoking in young adulthood. There were no significant racial/ethnic or gender differences in the pathways to light smoking. Findings highlight the longitudinal pathways to light smoking among African Americans and Puerto Ricans. The results suggest that effective prevention and cessation programs must address peer and parental social influences, perceived discrimination, and especially, emotional and behavioral problems in late adolescence to reduce light smoking among late adolescents and young adults in these racial/ethnic groups.

Francis SA; Lam WK; Cance JD; Hogan VK. What's the 411? Assessing the feasibility of providing African American adolescents with HIV/AIDS prevention education in a faith-based setting. Journal of Religion and Health 48(2): 164-177, 2009

This study examines African American faith based leaders' attitudes and beliefs about providing HIV prevention education and services to adolescents. Using a convenience sample, we identified priority adolescent health issues, attitudes about abstinence messages, and willingness to provide and participate in HIV prevention. Leaders identified drugs, gangs, alcohol, sex, and pregnancy as priority health issues affecting youth in their institutions. Leaders' strongly preferred to emphasize abstinence messages. Although leaders were willing to provide youth with health education, they were not willing to discuss specific behaviors associated with HIV transmission. African American churches provide a venue to reach African American youth; however, there are limitations to relying on faith-based HIV prevention services. HIV prevention education should continue to be supplemented via parents, schools, and public health agencies.

Francis SA; Liverpool J. A review of faith-based HIV prevention programs. (review). Journal of Religion and Health 48(1): 6-15, 2009. (22 refs.)

HIV disproportionately affects people of color, suggesting a need for innovative prevention programs and collaborations as part of prevention efforts. African Americans have close ties to the church and faith-based organizations. African American faith communities were slow to address HIV prevention, but in recent years, they have become more involved in such activities. This study reviews the empirical literature on faith-based HIV prevention programs among African American populations. Several successful faith-based/public health collaborations are identified, and the limitations and strengths of faith-based prevention programs are discussed. Recommendations are provided for developing effective faith-based/public health collaborations.

Gelernter J; Kranzler HR; Panhuysen C; Weiss RD; Brady K; Poling J et al. Dense genomewide linkage scan for alcohol dependence in African Americans: Significant linkage on chromosome 10. Biological Psychiatry 65(2): 111-115, 2009. (43 refs.)

Background: Alcohol dependence (AD) is costly to societies worldwide, moderately heritable, and genetically complex. Risk loci in several populations have been identified with genetic linkage analysis. To date, there has been no published linkage study of alcohol dependence focused on African Americans (AAs). Methods: We completed a genomewide linkage scan with approximately 6000 single nucleotide polymorphism markers to map loci increasing risk for DSM-IV alcohol dependence in a set of 238 small nuclear families ascertained on the basis of multiple individuals affected with cocaine or opioid dependence. Model free linkage analysis was completed with Merlin software. A modified marker set was used to avoid bias due to markers in strong linkage disequilibrium. Results: We identified a genomewide-significant linkage to markers near 117.2 centiMorgans on chromosome 10q23.3-24.1 (logarithm of odds score 3.32; p = 5.0E-05; empirical genomewide p = .033). Conclusions: These data add to the growing evidence for locations for alcohol dependence risk loci and provide the first linkage evidence for such a locus in the African American population.

Hatcher SS; Toldson IA; Godette DC; Richardson JB. Mental health, substance abuse, and HIV disparities in correctional settings: Practice and policy implications for African Americans. Journal of Health Care for the Poor and Underserved 20(2, Supplement S): 6-16, 2009

Mental health challenges, substance use disorders, and HIV/AIDS disproportionately affect Black people in correctional settings. Culturally responsive practice and equitable policy is predicated upon research that explores the burden, prevalence, and mortality of these public health concerns on the health and social well-being of African Americans in the correctional setting. This paper has three sections: (1) mental health; (2) substance abuse; and (3) HIV/AIDS. Each section summarizes current treatment issues unique to correctional settings, and provides recommendations for enhancing programs and policy to meet the needs of Black people who have been arrested, detained, incarcerated, paroled, or released. Further, we make recommendations for how interdisciplinary researchers and health care/treatment providers can engage in science-guided advocacy to address these issues and reduce related disparities experienced by people of African ancestry.

Ho MK; Mwenifumbo JC; Al Koudsi N; Okuyemi KS; Ahluwalia JS; Benowitz NL et al. Association of nicotine metabolite ratio and CYP2A6 genotype with smoking cessation treatment in African-American light smokers. Clinical Pharmacology and Therapeutics 85(6): 635-643, 2009. (48 refs.)

Cytochrome P450 2A6 (CYP 2A6) is the main nicotine (NI C)-metabolizing enzyme in humans. We investigated the relationships between CYP2A6 genotype, baseline plasma trans-3'-hydroxycotinine/cotinine (3HC/COT) (a phenotypic marker of CYP 2A6 activity), and smoking behavior in African-American light smokers. Cigarette consumption, age of initiation, and dependence scores did not differ among 3HC/COT quartiles or CYP2A6 genotype groups. Slow metabolizers (SMs; both genetic and phenotypic) had significantly higher plasma NI C levels, suggesting that cigarette consumption was not reduced to adjust for slower rates of NI C metabolism. Individuals in the slowest 3HC/COT quartile had higher quitting rates with both placebo and NIC gum treatments (odds ratio 1.85, 95% confidence interval (CI) 1.08-3.16, P = 0.03). Similarly, the slowest CYP2A6 genotype group had higher quitting rates, although this trend did not reach significance (odds ratio 1.61, 95% CI 0.95-2.72, P = 0.08). The determination of the 3HC/COT ratio, and possibly CYP2A6 genotype, may be useful in the future for personalizing the choice of smoking cessation treatment in African-American light smokers.

Janakiraman V; Gantz M; Maynard S; El-Mohandes A. Association of cotinine levels and preeclampsia among African-American women. Nicotine & Tobacco Research 11(6): 679-684, 2009. (18 refs.)

Although prior studies have shown that smoking reduces preeclampsia risk, the relationship between nicotine level and preeclampsia risk is not known. Our objective was to study the effects of smoking on the incidence of preeclampsia in African-American women using cotinine, a quantitative marker of nicotine. We performed a secondary analysis of data collected prospectively in Project District of Columbia Healthy Outcomes of Pregnancy Education. Our study included 724 African-American women. Self-reported smoking, cotinine levels, and pregnancy outcomes were examined. Some 18% of participants were smokers. Women with salivary cotinine levels greater than 200 ng/ml had infants with lower birth weights and a higher incidence of small-for-gestational-age infants than women with cotinine levels of 200 ng/ml or less. Exact logistic regression analysis revealed that women with salivary cotinine levels greater than 200 ng/ml had a significantly lower incidence of preeclampsia, compared with women with cotinine levels of 200 ng/ml or less, in unadjusted analysis (odds ratio [OR] = 0.16, 95% CI = 0-0.90). After controlling for age, parity, and medical comorbidities, the trend was observed, but the effect was no longer significant (adjusted odds ratio [AOR] = 0.19, 95% CI = 0-1.11). We found no significant differences in preeclampsia rates using lower cutoffs of cotinine exposure. We did not observe a decrease in preeclampsia incidence at low or moderate cotinine levels. Women with the highest cotinine levels may have a decreased risk for preeclampsia, although this effect was not significant after controlling for other risk factors.

Jerome RC; Halkitis PN; Coley MA. Methamphetamine use patterns among urban Black men who have sex with men. Culture, Health & Sexuality 11(4): 399-413, 2009. (42 refs.)

The present study investigates patterns of methamphetamine, contexts of use and sources for purchasing methamphetamine in a sample of gay, bisexual and heterosexually identified Black men who have sex with men living in NEW York City. Participants reported using multiple substances and used, on average, nine days within the last 30 days. They spent an average of US$159 per month on methamphetamine and a median of US$398 on all substances. Frequency of monthly methamphetamine use was related to the use of powdered cocaine and alcohol use, but not to the use of other substances. Black men who have sex with men primarily used in private venues, such as at home or in the homes of friends, and reported obtaining methamphetamine from multiple sources. Men who reported exchanging sex for methamphetamine reported greater use in public venues, such as sex clubs, sex parties and circuit parties. Findings from the present study may be critical in establishing culturally-appropriate treatment modalities for Black men who have sex with men who use methamphetamine.

Jerome RC; Halkitis PN. Stigmatization, stress, and the search for belonging in black men who have sex with men who use methamphetamine. Journal of Black Psychology 35(3): 343-365, 2009. (53 refs.)

Black men who have sex with men (BMSM) continue to be disproportionately affected by HIV. Methamphetamine use has been identified as a source of HIV risk in gay and bisexually identified men, Yet the relationship between methamphetamine use and sexual risk among BMSM specifically remains unclear The goal of this qualitative study was to investigate psychological, contextual, and developmental factors informing methamphetamine use and HIV risk behavior among a sample of heterosexual, gay, and bisexual BMSM (N = 52) in New York City. Methamphetamine use and sexual risk were associated with stress induced by stigmatization arising from and within larger dominant White gay culture, Stigmatization incurred within the community. internalized homophobia, and stress induced by living under the shadow of the perceived inevitability of contracting HIV as BMSM. Methamphetamine use was associated with venues where participants could be sheltered from experiences of racism, homophobia, and dominant hegemonic images of Black masculinity, while exploring and developing same-sex desires, thereby instilling a sense of community belonging. Suggestions for culturally appropriate strategies for treating both methamphetamine use and HIV risk behaviors among BMSM are discussed.

Joseph JG; El-Mohandes AAE; Kiely M; El-Khorazaty MN; Gantz MG; Johnson AA et al. Reducing psychosocial and behavioral pregnancy risk factors: Results of a randomized clinical trial among high-risk pregnant African American women. American Journal of Public Health 99(6): 1053-1061, 2009. (67 refs.)

Objectives. We evaluated the efficacy of a primary care intervention targeting pregnant African American women and focusing on psychosocial and behavioral risk factors for poor reproductive outcomes (cigarette smoking, second-hand smoke exposure, depression, and intimate partner violence). Methods. Pregnant African American women (N = 1044) were randomized to an intervention or usual care group. Clinic-based, individually tailored counseling sessions were adapted from evidence-based interventions. Follow-up data were obtained for 850 women. Multiple imputation methodology was used to estimate missing data. Outcome measures were number of risks at baseline, first follow-up, and second follow-up and within-person changes in risk from baseline to the second follow-tip. Results. Number of risks did not differ between the intervention and usual care groups at baseline, the second trimester, or the third trimester. Women in the intervention group more frequently resolved some or all of their risks than did women in the usual care group (odds ratio = 1.61; 95% confidence interval = 1.08, 2.39; P = .021). Conclusions. In comparison with usual care, a clinic-based behavioral intervention significantly reduced psychosocial and behavioral pregnancy risk factors among high-risk African American women receiving prenatal care.

Kerr WC; Patterson D; Greenfield TK. Differences in the measured alcohol content of drinks between black, white and Hispanic men and women in a US national sample. Addiction 104(9): 1503-1511, 2009. (26 refs.)

Aims: To measure and describe drink alcohol content differences between Hispanic, non-Hispanic white and non-Hispanic black men and women in the United States. Design: A telephone survey re-interview of 397 respondents who participated originally in the 2005 National Alcohol Survey, of whom 306 provided complete information on home drinks. Setting: United States. Participants: Adults aged 18 years and older from across the United States. Measurements: Direct measurement by respondents of simulated drink pours in respondents' own glassware using a provided beaker and reported beverage brands were used to calculate drink alcohol content. Findings: Black men were found to have the largest overall mean drink alcohol content at 0.79 oz (23 ml) of alcohol. This was significantly larger than the mean for white men or for black women and added 30% to black men's monthly alcohol intake when applied to their reported number of drinks. Spirits drinks were found to be particularly large for men. Multivariate models indicated that drink alcohol content differences are attributable more to income and family structure differences than to unmeasured cultural factors tied to race or ethnicity per se. Models predicting alcohol-related consequences and dependence indicate that adjusting drink alcohol content improves model fit and reduces differences between race/ethnicity defined groups. Conclusions: Differences in drink alcohol content by gender, race/ethnicity and beverage type choice should be considered in comparisons of drinking patterns and alcohol-related outcomes. Observed differences can be explained partially by measured characteristics regarding family structure and income.

Keyes KM; Geier T; Grant BF; Hasin DS. Influence of a drinking quantity and frequency measure on the prevalence and demographic correlates of DSM-IV alcohol dependence. Alcoholism: Clinical and Experimental Research 33(5): 761-771, 2009. (84 refs.)

Recent research suggests that adding a quantity/frequency alcohol consumption measure to diagnoses of alcohol use disorders may improve construct validity of the diagnoses for Diagnostic and Statistical Manual of Mental and Behavior Disorders (DSM-V). This study explores the epidemiological impact of including weekly at-risk drinking (WAD) in the DMS-IV diagnostic definition of alcohol dependence via 3 hypothetical reformulations of the current criteria. The sample was the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample with 43,093 adults aged > 18 in the U.S interviewed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule IV. The current (DSM-IV) definition of alcohol dependence was compared with 4 hypothetical alcohol dependence reformulations that included WAD: (1) WAD added as an eighth criteria; (2) WAD required for a diagnosis; (3) adding abuse and dependence criteria together, and including WAD with a 3 of 12 symptom threshold; (4) adding abuse and dependence criteria together, and including WAD with a 5 of 12 symptom threshold. The inclusion of at-risk drinking as an eighth criterion of alcohol dependence has a minimal impact on the sociodemographic correlates of alcohol dependence but substantially increases the prevalence of dependence (from 3.8% to 5.0%). At-risk drinking as a required criterion or as part of a diagnosis that combines abuse with dependence criteria with a higher threshold (5+ criteria) decreases prevalence and has a larger impact on sociodemographic correlates. Blacks, Hispanics, and women are less likely to be included in diagnostic reformulations that include WAD, whereas individuals with low-income and education are more likely to remain diagnosed. Including WAD as either a requirement of diagnosis or as an additional criterion would have a large impact on the prevalence of alcohol dependence in the general population. The inclusion of a quantity/frequency requirement may eliminate false positives from studies of alcohol disorder etiology and improve phenotype definition for genetic association studies by reducing heterogeneity in the diagnosis, but may also reduce eligibility for treatment services among women and racial/ethnic minorities compared.

Larson CO; Schlundt DG; Patel K; Wang H; Beard K; Hargreaves MK. Trends in smoking among African-Americans: A description of Nashville's REACH 2010 initiative. Journal of Community Health 34(4): 311-320, 2009. (36 refs.)

African Americans bear a disproportionate burden of tobacco related morbidity and mortality despite smoking less than their Caucasian counterparts. Nashville's REACH 2010 initiative developed community partnerships to promote awareness, education and participatory programs to prevent and decrease smoking among residents of the northern geographic area of Nashville, TN, a majority African American community. A social-ecological model provided the framework for interventions used during a 5 year period that included: (a) community level strategies to increase awareness and knowledge about the effects of smoking; (b) individual level strategies to enlist and train community members to become advocates, lead smoking cessation classes and encourage current smokers in quit attempts; and (c) strategies directed to changing policy through education and partnership building. Smoking prevalence among residents was examined from 2001 through 2005 based on data from the Nashville CDC REACH 2010 Risk Factor Survey and the Tennessee CDC Behavioral Risk Factor Survey. Tests for linear trends indicated a significant decreasing trend (P < .02) of daily smoking and smoking uptake (P < .03) in North Nashville. In contrast to our community an increasing trend was observed in quitting smoking (P < .01). No trends were significant for African Americans in Tennessee. This study suggests that consistent, multiple and multi-level strategies targeted to an African American community may impact smokers who are not ready to quit but willing to reduce their level of smoking. This study underscores the importance of developing and implementing community wide campaigns to address the needs of African Americans.

Levran O; Londono D; O'Hara K; Randesi M; Rotrosen J; Casadonte P et al. Heroin addiction in African Americans: A hypothesis-driven association study. Genes, Brain and Behavior 8(5): 531-540, 2009. (55 refs.)

Heroin addiction is a chronic complex disease with a substantial genetic contribution. This study was designed to identify gene variants associated with heroin addiction in African Americans. The emphasis was on genes involved in reward modulation, behavioral control, cognitive function, signal transduction and stress response. We have performed a case-control association analysis by screening with 1350 variants of 130 genes. The sample consisted of 202 former severe heroin addicts in methadone treatment and 167 healthy controls with no history of drug abuse. Single nucleotide polymorphism (SNP), haplotype and multi-SNP genotype pattern analyses were performed. Seventeen SNPs showed point-wise significant association with heroin addiction (nominal P < 0.01). These SNPs are from genes encoding several receptors: adrenergic (ADRA1A), arginine vasopressin (AVPR1A), cholinergic (CHRM2), dopamine (DRD1), GABA-A (GABRB3), glutamate (GRIN2A) and serotonin (HTR3A) as well as alcohol dehydrogenase (ADH7), glutamic acid decarboxylase (GAD1 and GAD2), the nucleoside transporter (SLC29A1) and diazepam-binding inhibitor (DBI). The most significant result of the analyses was obtained for the GRIN2A haplotype G-A-T (rs4587976-rs1071502-rs1366076) with protective effect (P-uncorrected = 9.6E- 05, P-corrected = 0.058). This study corroborates several reported associations with alcohol and drug addiction as well as other related disorders and extends the list of variants that may affect the development of heroin addiction. Further studies will be necessary to replicate these associations and to elucidate the roles of these variants in drug addiction vulnerability.

Marsh JC; Cao DC; Guerrero E; Shin HC. Need-service matching in substance abuse treatment: Racial/ethnic differences. Evaluation and Program Planning 32(1): 43-51, 2009. (61 refs.)

This study examines the impact of ancillary health and social services matched to client needs in substance abuse treatment for African Americans, Latinos and Whites. The study uses data collected from 1992 to 1997 for the National Treatment Improvement Evaluation Study, a prospective cohort study of substance abuse treatment programs and their clients. The analytic sample consists of 3142 clients (1812 African Americans, 486 Latinos, 844 Whites) from 59 treatment facilities. Results show that racial/ethnic minorities are underserved compared to Whites in the substance abuse service system. Different racial/ethnic groups come into treatment with distinct needs and receive distinct services. Although groups respond differentially to service types, substance abuse counseling and matching services to needs is an effective strategy both for retaining clients in treatment and for reducing post-treatment substance use for African Americans and Whites. Receipt of access services was related to reduced post-treatment substance use for Latinos. Study findings are relevant to planning special services for African Americans and Latinos.

Muilenburg JL; Latham T; Annang L; Johnson WD; Burdell AC; West SJ et al. The home smoking environment: Influence on behaviors and attitudes in a racially diverse adolescent population. Health Education & Behavior 36(4): 777-793, 2009. (32 refs.)

Although studies indicate that public policy can influence the decrease in smoking behaviors, these policies have not necessarily transferred to home environments at the same rate. The authors surveyed 4,296 students in a southern urban area. African American students were 76.3% of the respondents and Caucasians accounted for 23.7%. African American homes are less likely to have full bans on smoking inside the home. Home smoking bans impact smoking behaviors, acceptance of smoking, susceptibility to smoking, smoking beliefs, and motivation to quit smoking. Along with home smoking bans, there are differences among African American and Caucasian youth in smoking exposure, behaviors, beliefs, and motivation to quit smoking. This study suggests that particularly in African American youth, educational efforts should be directed toward more restrictive home smoking policies to thwart the initiation of smoking in adolescents and to encourage positive attitudes toward smoking behaviors.

Nasim A; Belgrave FZ; Corona R; Townsend TG. Predictors of tobacco and alcohol refusal efficacy for urban and rural African-American adolescents. Journal of Child & Adolescent Substance Abuse 18(3): 221-242, 2009. (69 refs.)

This study sought to determine the relative contributions of individual, family, peer, and community risk and promotive factors in explaining alcohol and tobacco refusal attitudes among 227 African-American adolescents (ages 12 to 17) from urban and rural areas. Hierarchical linear regression (HLR) results revealed differences in the predictive value of risk and promotive factors with respect to tobacco and alcohol refusal attitudes. Specifically, individual and peer risk factors were predictive of tobacco refusal attitudes among youths. Individual, peer, and family risk, and promotive factors were predictive of adolescents' alcohol refusal attitudes. Community factors were not significant predictors of youths' ability to refuse tobacco and alcohol, after controlling for more proximal influences. Future research should consider other psychosocial influences within an ecological framework that may account for additional variance in substance use altitudes among African-American adolescents.

Nehl EJ; Blanchard CA; Peng CYJ; Rhodes RE; Kupperman J; Sparling PB et al. Understanding nonsmoking in African American and Caucasian college atudents: An application of the theory of planned behavior. Behavioral Medicine 35(1): 23-29, 2009. (24 refs.)

Few studies have considered whether psychological determinants of nonsmoking among college students vary by ethnicity. The authors tested the theory of planned behavior (TPB) to explain differences in nonsmoking intentions of 238 African American and 197 Caucasian college students who completed an in-class TPB questionnaire and a smoking assessment I week later After removing 35 students who reported smoking at the baseline assessment, regressions were used to examine ethnic effects on TPB constructs when predicting nonsmoking intentions. Caucasians had statistically significant higher nonsmoking intentions than African Americans. Further subjective norms for Caucasians and attitudes for African Americans had small but significant relations to intention, but perceived behavioral control (PBC) was a strongly significant predictor for both ethnic groups. However, the prediction of nonsmoking intentions was not statistically moderated by ethnicity for any of the TPB constructs. This study suggests that the TPB may aid in understanding collegiate nonsmoking intentions and help begin to explain differences in smoking on the basis of ethnicity. Last, because of strong associations shown in this study, PBC should be considered when developing ethnic-specific smoking interventions in college students.

Pampel FC. The persistence of educational disparities in smoking. Social Problems 56(3): 526-542, 2009. (76 refs.)

Besides reducing overall smoking prevalence, do anti-tobacco policies to raise prices and restrict locations for smoking also reduce educational disparities? Theories emphasizing proximate disincentives answers yes, suggesting that the policy changes create stronger disincentives for smoking among low education groups. A social resource or fundamental cause theory suggests in contrast that flexible and broad resource advantages of high education groups maintain inequalities in health behavior despite policy changes. Using 24 National Health Interview Surveys, this study tests these claims by describing smoking prevalence by education level from 1976 to 2006 in the United States and giving special attention to the last ten years when tax and clean-air policies have expanded. Logistic regression models that allow trends in smoking to vary by education, race, ethnicity, and nativity find a small decline in educational disparities in smoking. However, this decline stemmed from trends among Hispanic and foreign-born respondents; in contrast, smoking disparities among white, African American, and native-born respondents show no evidence of narrowing. Likely due to the greater resources of high education groups for health behavior, changes in prices and restrictions thus far have done little to reduce educational disparities.

Pedersen SL; McCarthy DM. An examination of subjective response to alcohol in African Americans. Journal of Studies on Alcohol and Drugs 70(2): 288-295, 2009. (38 refs.)

Objective: Alcohol response is a widely studied risk factor for heavy drinking behavior and alcohol-use disorders. This study examined acute subjective response to alcohol as a predictor of drinking behavior, alcohol-related problems, and family history of alcoholism in African Americans. The convergent validity of self-reported response to alcohol (Self-Rating of the Effects of Alcohol scale [SRE]) in an African-American sample was also examined. Method: One hundred and three African-American young adults participated in an alcohol-challenge study, receiving a moderate dose of alcohol (0.72 g/kg alcohol for men, 0.65 g/kg for women). Breath alcohol concentration and subjective response to alcohol were assessed before beverage consumption, in 15-minute intervals for the first hour following consumption, and in 30-minute intervals thereafter. Results: Latent variable growth models indicated that experiencing increased acute stimulation from alcohol was related to past-month drinking behavior and alcohol-related problems. Regression analyses indicated that the SRE was related to drinking behavior, alcohol-related problems, having an alcohol-use disorder, and a family history of alcoholism. The SRE was not related to either sedation or stimulation following alcohol administration. Conclusions: Results support alcohol response as a marker of risk for increased drinking behavior and alcohol-related problems in African Americans. Further research is required to directly compare African-American and white response to alcohol within an alcohol-challenge paradigm.

Perron BE; Mowbray OP; Glass JE; Delva J; Vaughn MG; Howard MO. Differences in service utilization and barriers among Blacks, Hispanics, and Whites with drug use disorders. Substance Abuse Treatment, Prevention and Policy 4: e-article 3, 2009. (38 refs.)

Background: Treatment for drug use disorders (DUD) can be effective, but only a small proportion of people with DUD seek or receive treatment. Research on racial and ethnic treatment differences and disparities remains unclear. Understanding racial and ethnic differences and disparities in drug treatment is necessary in order to develop a more effective referral system and to improve the accessibility of treatment. The purpose of the current study was to explore the role of race and ethnicity in service utilization. Methods: Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), this study examined racial and ethnic differences in use of 14 types of treatment services for DUD and 27 different treatment barriers among persons who met lifetime criteria for a DUD. Multivariate logistic regression analyses were used to examine service utilization and barriers among the racial and ethnic groups, while adjusting for other sociodemographic and clinical variables. Results and discussion: Among Blacks, Hispanics and Whites in the overall NESARC sample, approximately 10.5% met criteria for at least one lifetime drug use disorder. Approximately 16.2% of persons with a lifetime DUD received at least one type of service. Overall, this study indicated that Whites were less likely to report receiving help for drug-related problems than Blacks, Blacks used a greater number of different types of services, and no racial and ethnic differences were observed with respect to perceived barriers to drug treatment. However, by examining types of services separately, a complex picture of racial and ethnic differences emerges. Most notably, Whites were most likely to use professional services, whereas Blacks were most likely to use 12-step and clergy. The service use pattern of Hispanics most resembled that of Whites. Conclusion: While structural barriers to accessing treatment were observed, broad-based educational programs and interventions that are appropriately targeted to racial and ethnic groups remains an important area for prevention and treatment.

Raj A; Reed E; Santana MC; Walley AY; Welles SL; Horsburgh CR et al. The associations of binge alcohol use with HIV/STI risk and diagnosis among heterosexual African American men. Drug and Alcohol Dependence 101(1/2): 101-106, 2009. (41 refs.)

Background: Studies on the mechanisms of the association between illicit drug use and HIV/STI provide important insight into why there are disproportionate rates of HIV/STI among heterosexual African American men; far less work has been conducted to examine the associations between binge alcohol use and HIV/STI risks in this Population. Objective: To assess whether binge alcohol use is associated with risky sexual behaviors and recent HIV/STI diagnosis among heterosexual African American men reporting multiple sex partners in the past year. Methods: Participants (n=672) were heterosexually active African American men age 18-65 years recruited from urban health centers and clinics ill Boston, MA, and who participated in a health sur vey. Logistic regression analyses were used to assess associations between past 30 day binge drinking and the following outcome variables: unprotected sex, six or more sex partners in the past year, sex trade involvement, and past 6 month HIV/STI diagnosis. Analyses were adjusted to control demographics, incarceration history, illicit drug use, and injection drug use. Results: Significant associations were observed between binge alcohol use and unprotected vaginal sex with non-main female partners (AOR = 1.7, 95% CI = 1.2-2.3), unprotected anal sex with non main female partners (AOR = 2.3, 95% CI = 1.4-4.0), sex trade involvement (AOR = 2.1. 95% CI = 1.3-3.5), and recent HIV/STI diagnosis (AOR = 1.9; 95% CI = 1.05-3.6). Conclusion: Heterosexual African American men engaging in binge alcohol use may be at increased risk for HIV/STI; findings support the need for integrating alcohol risk reduction into HIV prevention programs targeting this population.

Risser JMH; Padgett P; Wolverton M; Risser WL. Relationship between heterosexual anal sex, injection drug use and HIV infection among black men and women. International Journal of STD & AIDS 20(5): 310-314, 2009. (33 refs.)

US blacks carry a disproportionate risk of heterosexually transmitted HIV. This study aimed to evaluate the association between self-reported heterosexual anal intercourse and HIV. Using respondent-driven sampling (RDS), we recruited and interviewed 909 blacks from areas of high poverty and HIV prevalence in Houston, Texas, and who reported heterosexual sex in the last year. All individuals were tested for HIV. Weighted prevalence values were calculated to account for non-random recruitment associated with RDS. The weighted population prevalence of HIV infection was 2.4% and 2.5% among men and women, respectively. Education, employment status, income and crack cocaine use were not associated with HIV infection. Lifetime injection drug use (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.31-8.33%) and heterosexual anal intercourse (OR 2.41, 95% Cl 1.02-5.73%) were, associated with HIV infection. Individuals who reported both injection drug use and heterosexual anal intercourse had 6.21 increased odds of HIV (95% Cl 2.47-15.61%). Our results suggest that heterosexual anal sex may be a vector for HIV transmission, especially in the context of injection drug use. Prevention strategies directed at curbing the HIV epidemic among black heterosexuals require that we correctly identify the risks so that appropriate interventions can be developed.

Stanton CA; Lloyd-Richardson EE; Papandonatos GD; de Dios MA; Niaura R. Mediators of the relationship between nicotine replacement therapy and smoking abstinence among people living with HIV/AIDS. AIDS Education and Prevention 21(3, Supplement A): 65-80, 2009. (48 refs.)

Cigarette smoking is highly prevalent among people living with HIV/AIDS and poses unique health risks. Smoking cessation programs tailored to this population have documented improved smoking outcomes with nicotine replacement therapy (NRT). The current study examined 6-month abstinence rates from a randomized clinical trial targeting 412 HIV-positive adult current smokers (51% European American, 19% African American, and 17% Hispanic American) and tested whether psychosocial variables, such as self-efficacy and decisional balance, mediated the relationship between NRT and long-term abstinence. Meeting criteria for complete mediation, 6-month smoking abstinence rates improved significantly with increases in these mediators, and the association of NRT and smoking abstinence was no longer significant once changes in self-efficacy and decisional balance were taken into account. Failure to translate gains in self-efficacy among African Americans into improved abstinence rates accounted for racial/ethnic differences among participants. Specific psychosocial factors, such as self-efficacy, may be particularly amenable to change in cessation interventions and should be addressed with greater awareness of how cultural and social contextual factors impact treatment response among people living with HIV/AIDS.

Terchek JJ; Larkin EMG; Male ML; Frank SH. Measuring cigar use in adolescents: Inclusion of a brand-specific item. Nicotine & Tobacco Research 11(7): 842-846, 2009. (15 refs.)

This study examined whether the standard measure of cigar use in adolescents could be improved by the addition of a brand-specific example. In 2002, prevalence of tobacco use was assessed in six midwestern U.S. high schools using the Youth Risk Behavior Survey. The survey was readministered to the same schools in 2004, with the brand name "Black and Milds" added to the item measuring cigar use. Changes in local prevalence rates were compared with national rates. Local rates of cigar and cigarette use in 2002 were consistent with national rates reported in 2003. In 2004, when the cigar item was modified to include a brand-specific example, the percentage of students reporting cigar use nearly doubled-from 12.9% to 20.7%. This difference was particularly notable among Black teens. During the same period, local rates of cigarette use remained constant, as did national rates of reported cigar and cigarette use. Results suggest that the current national survey item may not adequately measure cigar use. Accordingly, prevalence of cigar use among adolescents may be greatly underestimated, especially among Black youth.

Treadwell HM; Braithwaite RL; Braithwaite K; Oliver D; Holliday R. Leadership development for health researchers at historically black colleges and universities. American Journal of Public Health 99(Supplement 1): S53-S57, 2009. (32 refs.)

Historically Black colleges and universities (HBCUs) have traditionally been a magnet for Black students at all levels nationwide and have been an exemplar of mentorship models for preparing leaders in many fields. A research career development program for junior faculty scholars that leverages the unique strengths of HBCUs has the potential to promote diverse leadership in health research and advance practical understanding of how to address HIV/AIDS and related health challenges that ravage vulnerable communities. A program that creates institutional bonds between HBCUs and other academic institutions can create a ground breaking framework for more-effective community-based participatory research. We present a rationale for supporting an HBCU-led collaborative research program, one that both advances junior faculty and explores the interrelationship between HIV/AIDS, mental health, and substance abuse through research in correctional facilities.

Webb MS; Carey MP. Psychosocial factors associated with weight control expectancies in treatment-seeking African American smokers. Journal of The National Medical Association 101(8): 793-799, 2009. (55 refs.)

African Americans are disproportionately affected by tobacco smoking and obesity. As weight control expectancies can reinforce smoking maintenance, the purpose of this study was to explore psychosocial factors related to expectancies for weight control among African Americans seeking cessation treatment. African American smokers (N = 117) provided information on demographics, family medical history, personal risk factors, smoking, weight control expectoncies and concerns, perceived stress, and acculturation. Multivariate analyses examined hypotheses regarding determinants at weight control expectancies. Fifty-one percent of participants were concerned about gaining weight upon cessation. Positive expectations for weight control through smoking were associated with older age, a family history of heart disease, greater perceived stress, and a lower level of acculturation. In conclusion, many African American smokers are concerned about postcessation weight gain; expectations for weight control through smoking are most evident those with elevated perceived stress, traditional African American cultural values, and a family history of chronic illness. Needed are culturally specific smoking cessation interventions that include weight management strategies as an adjunct to smoking cessation treatments.

Webb MS; Carey MP. The early health consequences of smoking: Relationship with psychosocial factors among treatment-seeking Black smokers. Nicotine & Tobacco Research 11(5): 564-571, 2009. (50 refs.)

Introduction: Blacks suffer disproportionately from the long-term health effects of smoking. Little is known about the prevalence of the early health consequences of smoking in this population or whether psychosocial factors influence the frequency of symptoms. This study investigated the prevalence and psychosocial correlates of smoking-related physical symptoms in Black smokers. Methods: Adult smokers (N = 117, 58% female, M age = 43.0 years) who smoked at least 5 cigarettes/day completed self-administered assessments of cigarettes smoked per day, smoking duration, alcohol use, perceived stress, depressive symptoms, and smoking-related symptoms. Results: The most frequently occurring physical symptoms were shortness of breath (66%), coughing (50%), and headaches (49%). Multivariate analyses showed that smoking history, alcohol use, perceived stress, and depressive symptoms were independently related to smoking-related symptoms, even after controlling for sociodemographic variables and medical diagnoses. Discussion: The early health consequences of smoking appear to be common among Black smokers and can serve as a cue to action for cessation efforts. Alcohol use, stress, and depression appear to negatively influence the early health consequences of smoking and should be assessed routinely in treatment-seeking Black smokers.

Webb MS; Seigers D; Wood EA. Recruiting African American smokers into intervention research: Relationships between recruitment strategies and participant characteristics. Research in Nursing and Health 32(1): 86-95, 2009. (31 refs.)

The purposes of this study were to (a) to describe an 8-month recruitment campaign to enroll African American smokers (N=249) into a randomized controlled trial and (b) examine characteristics of participants recruited through proactive (face-to-face), reactive (television, radio, or newspaper ads inviting participants), and combination (both reactive and proactive) approaches. Reactive recruitment was most successful (43%), followed by proactive (31%), and combination (26%) recruitment. Compared to proactive recruitment, reactive recruitment was associated with lower nicotine dependence, and greater readiness to quit, processes of change engagement, and acculturation. Combination recruitment was associated with lower nicotine dependence and greater readiness to quit. The differences according to recruitment strategy could be used to tailor recruitment strategies for African American smokers.

Weston BW; Krishnaswami S; Gray MT; Coly G; Kotchen JM; Grim CE et al. Cocaine use in inner city African American research volunteers. Journal of Addiction Medicine 3(2): 83-88, 2009. (24 refs.)

Objectives: To determine the prevalence of cocaine use and associated risk factors in African Americans volunteering as research subjects for a hypertension study. Methods: African Americans recruited from Milwaukee's inner city received $25 for completing a blood pressure screening protocol with the potential to participate in an additional protocol for $200, contingent on a negative drug test for cocaine. This study is based on the characteristics of the participants who completed the drug screen for cocaine. The significance of differences in the frequencies of categorical variables between users and nonusers was determined by X-2 analysis or Fisher exact test. Results: Of 389 drug-tested participants, 35% tested positive for cocaine. Cocaine Positive volunteers were slightly older (P = 0.02), had a lower body mass index (P = 0.001), a smaller waist circumference (P = 0.005), and lower serum cholesterol levels (P = 0.04). Those testing positive were more likely to be tobacco smokers (P < 0.0001), unemployed (P 0.001), and alcohol users (P < 0.0001), but less likely to use prescription medications (P = 0.01). Income and education did not differ between cocaine positive and negative subjects. Individuals employed full-time were less likely to test positive than the unemployed, whereas part-time employees were intermediate (P = 0.0003). Although those testing positive were slightly less likely to have a living mother (P = 0.07), there was no association with living fathers. Cigarette smokers were almost five times more likely to test positive for cocaine than nonsmokers (OR 4.88, 95% CI 2.73-8.71). Additional predictors of positive tests were alcohol consumption (OR 1.90, 95% CI 1.18-3.19), a reported history of substance abuse (OR 1.83, 95% CI 1.05-3.19), and a family history that included one or more deceased siblings (OR 1.82, 95% CI 1.03-3.21). Conclusions: A high prevalence of substance use was detected among inner city African Americans offered financial incentives for participating in a general medical research protocol. This information may be relevant for designing future clinical trials and drug use intervention programs.

Windsor LC; Negi N. Substance abuse and dependence among low income African Americans: Using data from the National Survey on Drug Use & Health to demystify assumptions. Journal of Addictive Diseases 28(3): 258-268, 2009. (40 refs.)

The media has portrayed African Americans as drug users and criminals. The purpose of this study is to test the assumption that low-income African Americans use more alcohol, nicotine, marijuana, and illicit drugs than other racial groups using data from the 2005 National Survey on Drug Use and Health to compare drug abuse and dependence across low income racial groups (N = 20,172). Most respondents were white, female, and older than 26 years of age. The majority completed high school and reported annual family incomes between $10,000 and $19,000. Few participants reported receiving public assistance. Drug abuse and dependence rates varied across drug type and across race. Drug dependence and abuse were measured using the Nicotine Dependence Syndrome Scale and criteria from the Diagnostic and Statistical Manual of Mental Disorders. Hierarchical regression was conducted to examine the level of association between racial background and drug abuse and dependence after controlling for age and gender. Results reveal that the assumption of high drug and alcohol use and abuse rates among low-income African Americans should be, at best, reexamined. This study has significant implications for both policy and social work practice because it breaks down normalized and biased assumptions of low-income African American drug use.

Zinzow HM; Rheingold AA; Hawkins AO; Saunders BE; Kilpatrick DG. Losing a loved one to homicide: Prevalence and mental health correlates in a national sample of young adults. Journal of Traumatic Stress 22(1): 20-27, 2009. (28 refs.)

The present study examined the prevalence, demographic distribution, and mental health correlates of losing a loved one to homicide. A national sample of 1,753 young adults completed structured telephone interviews measuring violence exposure, mental health diagnoses, and loss of a family member or close friend to a drunk driving accident (vehicular homicide) or murder (criminal homicide). The prevalence of homicide survivorship was 15%. African Americans were more highly represented among criminal homicide survivors. Logistic regression analyses found that homicide survivors were at risk for past year posttraumatic stress disorder (OR = 1.88), major depressive episode (OR= 1.64), and drug abuse/dependence (OR= 1.77). These findings highlight the significant mental health needs of homicide survivors.