RTI International, Research Triangle Park, Durham, NC, USA.
Julius L. Chambers Biomedical/Biotechnology Research Institute, North Carolina Central University, Durham, NC, USA.
J Racial Ethn Health Disparities. 2020 Dec;7(6):1150-1159. doi: 10.1007/s40615-020-00739-1. Epub 2020 Apr 15.
An abundance of research investigates the health of often referred to as "at risk" or "high risk" youth from underserved communities and usually racial/ethnic minorities. These ubiquitous terms relate to poverty, violence, and unsafe behaviors (e.g., sex without condoms, alcohol, and drug use).
This analysis distinguished the heterogeneity of risks among African American female adolescents recruited for an intervention study from underserved communities in North Carolina. Eligibility included: ages 16-19, considered or dropped out of school, never completed high school, and during the past 3 months had sex with a male partner and used drugs or alcohol. A variable was created to represent the continuum of risk comprised of history of homelessness, or trading sex, or current heavy alcohol and marijuana use. Participants fell into 0, 1, or 2-3 categories. Ordinal logistic regression estimated the odds of adverse poor outcomes by category. Linear regression estimated reduction in material and emotional support by category.
Of the 237 participants, 59.5%, 27.8%, and 12.7% were in 0, 1, or 2-3 categories, respectively. Relative to adolescents in 0 categories, participants in other categories were more likely to report food insecurity (OR = 3.27, 95%CI [1.8, 5.94]); past arrest (OR = 3.56 [2.08, 6.09]); run away (OR = 3.30 [1.79, 6.10]); multiple sex partners (2.97 [1.61, 5.48]); and vaginal/anal sexual abuse (OR = 3.21[1.73, 5.96]). Material and emotional support was significantly lower for participants in 2-3 risk categories.
Vague use of "at risk" fails to recognize the heterogeneity of experiences and needs of underserved African American youth.
大量研究调查了来自服务不足社区的通常被称为“处于风险中”或“高风险”的青年的健康状况，这些青年通常属于少数族裔。这些普遍存在的术语与贫困、暴力和不安全行为（例如，没有使用安全套的性行为、酗酒和吸毒）有关。
本分析区分了来自北卡罗来纳州服务不足社区的参与干预研究的非裔美国少女的风险异质性。符合条件的包括：年龄在 16-19 岁之间，被认为或辍学，从未完成高中学业，并且在过去 3 个月内与男性伴侣发生过性行为，并且使用过毒品或酒精。创建了一个变量来表示由无家可归、卖淫或当前大量饮酒和使用大麻组成的风险连续体。参与者分为 0、1 或 2-3 类。有序逻辑回归估计了按类别划分的不良不良结局的几率。线性回归按类别估计物质和情感支持的减少量。
在 237 名参与者中，分别有 59.5%、27.8%和 12.7%的人处于 0、1 或 2-3 类。与 0 类参与者相比，其他类别的参与者更有可能报告粮食不安全（OR=3.27，95%CI [1.8, 5.94]）；过去被捕（OR=3.56 [2.08, 6.09]）；离家出走（OR=3.30 [1.79, 6.10]）；多个性伴侣（2.97 [1.61, 5.48]）和阴道/肛门性虐待（OR=3.21[1.73, 5.96]）。2-3 风险类别的参与者的物质和情感支持明显较低。
“处于风险中”的模糊使用未能认识到服务不足的非裔美国青年的经历和需求的异质性。
