No abstract

Studies consistently demonstrate that African American youth experience disproportionate levels of community violence, which is associated with negative health and well-being outcomes among these youth. The frequency and severity of community violence exposure is a unique challenge for these youth and requires tailored approaches to promote resilience after community violence exposure. However, limited research exists that operationalizes resilience after community violence based on the unique context and lived experience of African American youth. Developing a more contextually relevant understanding of resilience is critical to reducing health inequities experienced by African American youth and promoting their well-being. Five focus groups were conducted with 39 African American adolescents (ages 13-18) exposed to community violence. Participants also completed a brief survey that included questions on demographics, adverse childhood experiences, social capital, and resilience. Focus-group transcripts were independently coded by two members of the research team and analyzed using an inductive approach. Youth highlighted key indicators of resilience including the ability to persevere, self-regulate, and change to adapt/ improve. Youth also described family, peer, and cultural contexts that impact how resilience is produced and manifested, highlighting trust, perceived burdensomeness, self-determination, connectedness, and mental health stigma as key factors within these contexts. Results of this qualitative study support the development of health promotion programs for African American youth exposed to community violence that address unique risks and build on existing protective factors within family, peer, and cultural contexts.

Objective: African American adolescents experience disproportionate rates of adverse childhood experiences (ACEs), which heightens their risk for negative social, behavioral, and health outcomes. Schools may be a source of support for adolescents exposed to ACEs; however, for many African American adolescents, schools are a source of additional stress due to experiences of racial/ethnic microaggressions. The current study examined the relationship between ACEs, school-based racial/ethnic microaggressions, and resilience after violence exposure in African American adolescents. Method: Participants included 189 African American adolescents with an average age of 15.15 (SD = 1.27, range = 13-18). Fifty-one percent identified as female. Participants reported an average ACE score of 5.81 (SD = 3.63). Moderation analyses were conducted using the three subscales of the School-based Racial and Ethnic Microaggression Scale (academic inferiority, expectations of aggression, and stereotypical misrepresentations; Keels et al., 2017). Results: ACEs were negatively related to resilience after violence exposure in all three microaggression models. The microaggressions subscales academic inferiority (b = À.05, t(183) = À2.05, p = .04) and stereotypical misrepresentations (b = À.08, t(183) = À2.04, p = .04) significantly moderated the relationship between ACEs and resilience after violence exposure, such that the inverse relationship between these two variables was stronger at higher levels of endorsed microaggressive experiences measured with these two subscales. The moderation model was not significant for the expectations of aggression subscale. Conclusions: Findings suggest that school-based racial/ethnic microaggressions negatively impact resilience after violence exposure among African American adolescents exposed to multiple ACEs. Clinical Impact StatementOur study indicates adverse childhood experiences are negatively related to resilience after violence exposure among African American adolescents and at high levels of school-based racial/ethnic microaggressions this relationship is even stronger. It is important to address the interactive effects of school-based racial microaggressions, violence exposure, and ACEs among African American adolescents to improve trauma-informed program and policies within schools to promote health equity.

ObjectiveTo determine whether patients presenting to the emergency department (ED) with injury were more likely to report risky health behaviours than pts without injury.MethodsAdult (age>18) patients with non-life-threatening injury or illness presenting to the ED were screened for following: alcohol consumption, smoking, exercise, seatbelt and helmet use.Results16 299 patients were screened; 5327 (33.5%) with injuries; 6868 (43.2%) male. Injured pts were significantly more likely to be male (36.4% vs 31.4%; p=0.000), younger (43.7 vs 46.1; 95% CI 1.85 to 3.10), drink alcohol (39% vs 36%; p=0.003); exercise regularly (57.9% vs 50.7%; p=0.000); and significantly less likely to wear a seatbelt regularly (33.6% vs 66.4%; p=0.000). There was no difference in reported cigarette smoking between injured and non-injured patients (66.9% vs 67.7%, p=0.331). There were no significant differences in drinking patterns (# of days of drinking per week, usual # of drinks per occasion, maximum # of drinks per occasion) between injured and non-injured patients.ConclusionsWhile there were differences in some health behaviours (alcohol consumption, exercise and seatbelt use) between injured and non-injured pts presenting to the ED, there were no differences in drinking patterns between injured and non-injured patients who reported any alcohol consumption. This supports the need to continue to screen for alcohol problems and provide interventions for all ED patients.

Community violence continues to be a major national public health issue that disproportionately impacts African American youth. Community Based Participatory Research (CBPR) approaches have been recommended to address youth violence and provide an opportunity to partner in research with those most impacted to develop new strategies. In this brief report we describe specific capacity building efforts in our CBPR project, Building Bonds, Healing Youth, which aims to develop and test a community-level intervention to promote resilience among African American youth exposed to community violence. We specifically describe our capacity building efforts that centered around developing youth critical consciousness and highlight specific methods that we employed. Reflections from our youth partners highlight the potential impact of incorporating youth critical consciousness development into capacity building efforts with youth partners. This brief report supports incorporating critical consciousness in CBPR with youth to promote mutual benefit as youth contribute their lived experiences, expertise, and commitment to improving research addressing youth health and well-being. introduction Community violence is a major public health issue that disproportionately impacts African American (AA) youth. AA youth are more likely to be exposed to ongoing community violence than White youth (Centers for Disease Control and Prevention, 2009; Morgan & Truman, 2019) and experience a myriad of related health and well-being issues (e.g., sleep disruption, sexual risks, depression, isolation, and academic failure) (Busby et al., 2013; Kliewer et al., 2019; Voisin et al., 2016). Few interventions specifically target community violence exposure (Voisin & Berringer, 2015), particularly among AA youth. New strategies are necessary to address the needs of AA youth burdened with the consequences of community violence. Community-Based Participatory Research (CBPR) emphasizes communitydeveloped research agendas, shared decision making, co-learning, and local capacity building to understand and intervene in problems from a socioecological perspective (Frerichs et al., 2016; Israel et al., 1998; Wallerstein & Duran, 2006). Increasingly, CBPR approaches are recommended to address youth violence (David-Ferdon & Simon, 2014) and provide an opportunity to partner with those most impacted to address public health gaps and build community capacity in the process (Collins et al., 2018). In this brief report, we describe capacity-building efforts in our CBPR project (Building Bonds,