While numerous factors contributing to racial/ethnic health disparities have been identified, the clustering and interaction of these factors as a syndemic or trajectory has not been well-studied (Starfield in Soc Sci Med 64:1355-1362, 2007; Singer in Soc Sci Med 39(7):931-948, 1994). More importantly, for immigrant/refugee populations, the interaction of contributing factors is not documented adequately enough to provide a solid framework for planning, implementation and evaluation of interventions aimed at reducing disparities. In this paper, the authors draw from the literatures on health disparities and immigrant/refugee health, as well as direct program and research experience, to propose an approach for assessment of the diachronic interaction of ecological factors (a trajectory, or "diachronic ecology") contributing to health disparities among immigrant/refugee populations. It is our hope that this approach will contribute to the important effort to collect data supporting the development of interventions and policies that effectively address the dynamic processes through which health disparities are created, maintained, and changed.

BackgroundAdolescent sexual risk taking and its consequences remain a global public health concern. Empirical evidence on the impact that social media has on sexual health behaviors among youth is sparse.ObjectiveThe study aimed to examine the relationship between social media and the change in sexual risk over time and whether parental monitoring moderates this relationship.MethodsThis study comprised a sample of 555 Latino youth aged 13-19 years from Maryland, United States completing baseline and follow-up surveys. Mixed-effects linear regression was used to examine the relationship between social media and the change in sexual risk over time and whether parental monitoring moderated the relationship.ResultsSexual risk behaviors significantly increased between baseline (T1) and follow up (T2) (mean=0.432 vs mean=0.734, P<.001). Youth sending more than 100 text messages per day had significantly higher sexual risk scores (beta=1.008, P<.001) but significantly larger declines in sexual risk scores for higher levels of parental monitoring (beta=−.237, P=.009).ConclusionsAlthough adolescents exchange SMS at high rates, parental monitoring remains vital to parent-child relationships and can moderate SMS frequency and sexual risk behaviors, despite parental influence diminishing and peer pressure and social influences increasing during adolescence.

BackgroundAdolescents are substantial users of short message service (SMS) and social media. The public health community now has more opportunities to reach this population with positive youth development and health messages through these media. Latinos are a growing and youthful population with significant health risks and needs. This population may benefit from SMS and social media health interventions.ObjectiveTo examine (1) SMS and social media utilization and behavior among Latino youth, and (2) how SMS and social media can be effectively used as a component of public health interventions focused on decreasing sexual risk taking among Latino youth.MethodsA mixed-methods approach, using both quantitative survey data and qualitative interview data, was used to provide a robust understanding of SMS and social media use and behavior for public health interventions. We recruited 428 ninth and tenth grade, self-identifying Latino adolescents to participate in a quantitative survey. Additionally, we conducted five key informant interviews with staff and 15 youth.ResultsWe found that 90.8% (355/391) of respondents had access to a mobile phone either through having their own or through borrowing or sharing one. Of those who had access to a mobile phone, 94.1% (334/355) used SMS, with 41.1% (113/275) sending and receiving more than 100 text messages per day. Of 395 respondents, 384 (97.2%) had at least one social media account, and the mean number of accounts was 3.0 (range 0–8). A total of 75.8% (291/384) of adolescents logged in to their account daily. Of those with a social media account, 89.1% (342/384) had a Facebook account. Youth who took the survey in English were significantly more likely than those who took it in Spanish to have access to a mobile phone (χ2 1 = 5.3; 93.3% vs 86.3%; P = .02); to be high-volume texters (χ2 2 = 16.8; 49.4% vs 25.3%; P < .001); to use the Internet daily (χ2 1 = 5.0; 76.6% vs 66.0%; P = .03); to have a Facebook account (χ2 1 = 9.9; 90.9% vs 79.7%; P = .002); and to have a greater mean number of social media accounts (t 387 = 7.9; 3.41 vs 2.07; P < .001).ConclusionsSMS and social media are pervasive among Latino youth. Program staff and youth perceive these as credible and essential methods of communication in the context of public health programs. Public health interventions must continue to innovate and maximize new ways to reach young people to reinforce public health messages and education.

Gender-equitable attitudes are often constructed during adolescence making this a critical time to alter gender perceptions. However, there is little research on gender attitudes and gender equity in early adolescence, especially in India. This study is a cross-sectional sample of 1,691 participants 8-18 years from three Northern India states. Surveys were collected on mobile tablets and assessed gender perceptions and attitudes. Gender-equitable scores were categorized into low, medium and high. Gender-equitable attitudes and gender vary by grade (p < .001). Gender-equitable attitudes improved with grade, but boys were 46% less likely to be in the moderate category compared to the low category as grade increased (p < .01). Compared to girls, boys were 56% less likely to be in the high category compared to the low category as grade increased (p < .001). Early adolescence is a unique opportunity to address gender attitudes before they become more solidified.