Ethnic Identity, Empowerment, Social Support and Sexual Risk Behaviors Among Black Adolescent Girls: Examining Drug Use as a Mediator

Opara, Ijeoma; Rodas, Elizabeth I. Rivera; Garcia‐Reid, Pauline; Reid, Robert J.

doi:10.1007/s10560-020-00706-z

Cited by 18 publications

(5 citation statements)

References 96 publications

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“…Our video game intervention specifically addresses the intersectional identities of Black adolescent girls by incorporating the lived experiences of focus group participants into game story lines. In addition, the video game fosters a sense of social support by allowing Black adolescent girls to interact with each other, which is an important protective factor for sexual health [ 38 ]. It is among the first targeted interventions that is sex positive and harnesses the power of peer interactions through multiplayer gameplay to deliver HIV and STI prevention material.…”

Section: Discussionmentioning

confidence: 99%

“…We will investigate participant perceptions of research procedures and game content to analyze suggestions for the improvement of both. We will also explore whether connection to one’s ethnic identity may be a protective factor against sexual risk behavior [ 38 ]. Because the exploratory aim concerns implementation procedures and the adaptation and expansion of the game, there are no a priori hypotheses.…”

Section: Introductionmentioning

confidence: 99%

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Pilot-testing a Multiplayer HIV and Sexually Transmitted Infection Prevention Video Game Intervention for Black Adolescent Girls: Protocol for a Randomized Controlled Trial

Weser¹,

Opara²,

Budge³

et al. 2023

JMIR Res Protoc

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Background Black adolescent girls aged between 14 and 19 years are more likely than White girls to be diagnosed with a sexually transmitted infection (STI). As STI diagnosis is associated with an increase in the risk for HIV acquisition, an early intervention specifically tailored to Black adolescent girls is warranted. A web-based video game intervention has the potential to reach this demographic. Because studies of social and behavioral determinants of disease demonstrate the protective role of peer group structures on individual outcomes, a multiplayer game can facilitate opportunities to exchange and evaluate information, learn social norms, develop behavioral skills, and allow peers to influence attitudes and behavior. No prior research has examined the feasibility of a web-based multiplayer game intervention for this population. Objective This study describes the protocol for a randomized controlled trial (RCT) pilot-testing the feasibility, acceptability, and limited efficacy of a multiplayer game–based intervention for increasing HIV and STI testing and condom use in Black adolescent girls. Methods We enrolled 79 Black adolescent girls aged 14 to 19 years residing in the United States into a 2-arm parallel RCT. The intervention is a theory-based, community-informed, multiplayer game that can be played with peers on the web using videoconferencing software. The goal of the game is to empower Black adolescent girls to make healthy decisions regarding dating, relationships, and sex, thus reducing HIV and STI infection. Control condition participants received a list of resources after playing a time and attention control game. All study procedures were conducted via the internet. We conveniently sampled Black adolescent girls using web-based advertisements. Study assessments occurred at enrollment, 1 week, 1 month, and 4 months after enrollment. The primary outcome of this study is increased HIV and STI testing by Black adolescent girls. Secondary outcomes include increased condom use, self-efficacy to use condoms, positive attitudes toward condom use, intentions, harm perceptions, HIV and STI and pre-exposure prophylaxis knowledge, positive sexual norms, sexual communication with partners, and reduced incidence of sexual risk behaviors associated with HIV and STI transmission. Secondary outcomes also included assessment of intervention feasibility and acceptability. Results From February to April 2022, a total of 79 Black adolescent girls were enrolled, with 40 (51%) having been randomized into the intervention condition and 39 (49%) into the control condition. At baseline, participant ages ranged from 14 to 19 (mean 16.4, SD 1.23) years. Conclusions Web-accessible game interventions overcome common impediments of face-to-face interventions presenting a unique opportunity to reach Black adolescent girls and improve their sexual health and self-efficacy. Trial data will provide information about the limited efficacy of the intervention and inform future web-based studies and a larger RCT aimed at improving the sexual health of Black adolescent girls. Trial Registration ClinicalTrials.gov NCT04108988; https://clinicaltrials.gov/ct2/show/NCT04108988 International Registered Report Identifier (IRRID) DERR1-10.2196/43666

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pilot-testing a Multiplayer HIV and Sexually Transmitted Infection Prevention Video Game Intervention for Black Adolescent Girls: Protocol for a Randomized Controlled Trial

Weser¹,

Opara²,

Budge³

et al. 2023

JMIR Res Protoc

Self Cite

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“…Empowerment research has shown the importance of nurturing intrapersonal psychological empowerment (sociopolitical control) among adolescents. Studies have shown the importance of the association between sociopolitical control on risky behaviors among youth such as drug use (Opara et al, 2020) and sexual risk behaviors among youth of color (Hamme Peterson et al, 2010) and specifically, Black girls (Opara et al, 2021b(Opara et al, , 2022a. Sociopolitical control has also been found to be a significant mediator between cultural protective factors such as ethnic identity on health outcomes such as substance use (Opara et al, 2021b) and developmental outcomes such as school importance, substance use, and psychological symptoms (Christens, 2012).…”

Section: Measuring Empowermentmentioning

confidence: 99%

“…The concept of intersectionality allows for the examination of multiple dimensions of identities and various social locations, highlighting the manner in which they intersect (Crenshaw, 1989) and can be beneficial in understanding how to improve health outcomes (Bowleg, 2012). Without acknowledging intersecting identities of Black girls in prevention programs, the absence of such can lead to multiple forms of oppression, which can create barriers to forming healthy relationships, produce unbalanced power dynamics in romantic partnerships, and consequently lead to poor sexual health outcomes and substance use (Opara et al, 2020; Brooks et al, 2010). Within substance use and sexual health research, class differences tend to be ignored and overshadowed by race and gender-specific disparities that impact Black girls with regard to safe sex practices (Caldwell & Mathews, 2015).…”

Section: Intersectionality Theorymentioning

confidence: 99%

Addressing Gendered Racism Against Black Girls Using a Strengths-Based Empowerment-Intersectional Framework for Sexual Health and Substance Use Prevention Programming

Opara

Martín²,

Hill

et al. 2023

Health Promotion Practice

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Although Black girls use substances at lower rates than boys and girls from various other racial groups, they tend to have worse health outcomes associated with substance use that can also impact their sexual health. The association between substance use and sexual risk behaviors is usually attributed to lack of access to quality health care and lack of culturally specific prevention programming and treatment options tailored to this group. Accordingly, the theoretical frameworks for health promotion for Black girls often focus on addressing deficits, ignoring the powerful and intersecting social forces that can impact identity, agency, and behavioral options. Key among these forces is gendered racism. We propose a strengths-based conceptual framework to address and challenge gendered racism as a critical foundation for promoting health and wellbeing for Black girls. Our approach integrates Intersectionality Theory and Empowerment Theory, with psychological and intrapersonal empowerment identified as critical mediators of behavior and health outcomes, supported by protective factors of positive racial identity and gendered racial socialization. This framework has been developed with and for Black girls but can be adapted for health promotion efforts with other minoritized groups.

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“…To help all children feel safe, happy, and connected is a huge step in the direction of being culturally sensitive and responsive. These bonds may help children feel valued and supported, thus increasing confidence in their self-worth (Opara et al, 2020). Not only might these relationships help children feel more positively about their race and ethnicity, but research shows that more positive racial-ethnic affirmation is important to children choosing adaptive instead of maladaptive coping strategies.…”

Section: Implications For Practitionersmentioning

confidence: 99%

After-School Connectedness, Racial–Ethnic Identity, Affirmation, and Problem Behaviors

Augustine¹,

Smith

Witherspoon

2022

JYD

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After-school programs are potential contexts that may promote positive youth development (PYD) and reduce problem behaviors among African American children. One way after-school programs may be associated with reduced problem behaviors is by fostering an affirming sense of identity. Prior research on racial–ethnic identity among African American children and adolescents has shown that a positive and affirming sense of identity is related to less maladaptive coping, yet little is known about how after-school programs may foster an affirming sense of identity and lead to reduced problem behaviors. The current study adds to this discourse by investigating how children’s connection to staff and peers in after-school settings is associated with racial–ethnic identity (as measured by racial–ethnic affirmation) and reduced problem behaviors. Participants were 186 African American children ages 7–11 (M = 8.44; SD = 1.10) who completed surveys in the LEGACY Together Afterschool research project. Data were collected at 55 community-based after-school programs. Results indicated that positive racial–ethnic affirmation mediated the association between after-school connectedness and problem behaviors, such that child-report of connectedness—that is feeling safe and happy in the after-school programs—was directly related to positive racial–ethnic identity and indirectly to reduced problem behaviors. These findings underscore the importance of supportive after-school programs that encourage meaningful interactions among staff and children that are nurturing and affirming to children’s identities.

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Ethnic Identity, Empowerment, Social Support and Sexual Risk Behaviors Among Black Adolescent Girls: Examining Drug Use as a Mediator

Cited by 18 publications

References 96 publications

Pilot-testing a Multiplayer HIV and Sexually Transmitted Infection Prevention Video Game Intervention for Black Adolescent Girls: Protocol for a Randomized Controlled Trial

Pilot-testing a Multiplayer HIV and Sexually Transmitted Infection Prevention Video Game Intervention for Black Adolescent Girls: Protocol for a Randomized Controlled Trial

Addressing Gendered Racism Against Black Girls Using a Strengths-Based Empowerment-Intersectional Framework for Sexual Health and Substance Use Prevention Programming

After-School Connectedness, Racial–Ethnic Identity, Affirmation, and Problem Behaviors

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