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For lesbian, gay, bisexual, and questioning (LGBQ) youth of color, the intersection of identifying as both LGBQ and a person of color results in not only managing racial stereotypes, but also heterosexism and genderism. Developing a critical understanding of oppressive social conditions and ways to engage in social action is a form of resistance for these youth. Research is needed among LGBQ youth of color that examines the range of predictors and outcomes related to civic engagement, development, and empowerment. Drawing on data derived from a sample of urban youth of color (N = 383; 53.1% Female; 75% Hispanic; Age range = 14 to 18 years; 15% identify as LGBQ), this study will: (1) examine the relationship between community-based perceptions (e.g., psychological sense of community), ethnic identity, behaviors (e.g., community civic participation) and awareness of social justice concerns with dimensions of psychological empowerment; and (2) assess differences that these relationships have between LGBQ and non-LGBQ youth of color. Findings indicate that main predictors have a positive impact on intrapersonal and cognitive dimensions of psychological empowerment through social justice orientation, with noted variations between LGBQ and non-LGBQ youth of color.

Limited research has examined intrapersonal psychological empowerment (PE) among Black girls solely. This study aims to fill a gap in empowerment literature by examining the factor structure of the Sociopolitical Control Scale for Youth (SPCS-Y) among Black girls (N = 377) between the ages of 14-17 years old. We also examine the association with ethnic identity as a conceptually related variable. Structural equation modeling (SEM) was used to examine the factorial validity of the abbreviated, eight-item SPCS-Y among Black girls. Results support the two-dimensional factor structure of the abbreviated SPCS-Y among Black girls, as well as the association intrapersonal PE has with ethnic identity. Findings provide preliminary support for the empirical and theoretical relationship between intrapersonal PE and ethnic identity among Black girls.

There is an emerging interest in studying social action and civic engagement as a part of the developmental process. Studies among youth of color indicate that empowerment has been associated with well-being, a critical perspective, and in combating social oppression. These studies also show that civic involvement and awareness of social justice issues are associated with positive developmental outcomes including empowerment. The range of predictors and outcomes related to empowerment have been insufficiently explored. This study used structural equation modeling path analysis techniques to examine the association community civic participation and psychological sense of community have with intrapersonal and cognitive psychological empowerment, through both ethnic identity and social justice orientation among urban youth of color (N =383; 53.1% Female; 75% Hispanic; 50.6% were 13 and 15 years of age). Findings illustrate that greater community civic participation and psychological sense of community are associated with both intrapersonal and cognitive psychological empowerment, through both ethnic identity and a social justice orientation; however, with some noted variations. Ethnic identity and social justice orientation mediated community civic participation and psychological sense of community and both intrapersonal and cognitive psychological empowerment. Implications put forward for community youth-workers and community programming.

The purpose of this study was to examine the effect "reflective coping, suppressive coping, and reactive coping" had on stress and indicators of well-being among Hispanic undergraduate students (N = 177) from a Hispanic Serving Institution. Findings demonstrate that both reactive and suppressive coping had separate but important moderating effects on perceived stress and well-being outcomes. Perceived stress was also associated with both depressive symptoms and life satisfaction indirectly through copying styles.

Despite the broader academic gains experienced by Hispanic students, who represent the largest minority group in the United States, they remain the least educated of all major ethnic groups, and our understanding of their academic needs and strengths remains woefully inadequate. Therefore, this study examined the risk (e.g., sexual risk taking) and protective factors (e.g., family support, supportive peer networks, and ethnic identity) associated with school importance among Hispanic teens (N = 587) residing in a high-risk, resource poor urban community and the ways in which these relationships vary between adolescent males (46.5%) and adolescent females (53.5%). Schools that are able to harness the numerous assets embedded within the Hispanic community are well positioned to create learning environments that are encouraging, are culturally responsive, and can potentially reduce risk involvement that may interfere with valuing the role of school importance. Implications for school-based personnel are discussed.

We explore the experiences of youth who disconnected from their local high schools and resumed their educations in community-based education (CBE) programs offering high school equivalency instruction. Drawing on focus-group interview narratives (N = 59) where youth describe the 'second chances' offered to them, we document supportive, encouraging relationships with adults in the CBEs that stand in contrast to their experiences in school. Simultaneously, we suggest that in the face of program narratives that emphasized individual responsibility and success, any critical read of their world articulated earlier by the youth was no longer evident. In essence, they moved from one institution framed by neoliberal tenets to another but in the process, they traded the resistance they exhibited in their public high schools to accommodation in the CBEs. We problematize the discourse of 'second chances' if and when it remains uncoupled to analyses of societal and institutional inequity and injustices.

The purpose of this investigation is to examine heterogeneity and membership with subgroups of cognitive empowerment among youth of color. Within this heterogeneity, this study hopes to identify the relationship each of these subgroups of youth have with conceptually related variables including intrapersonal psychological empowerment, psychological sense of community (SOC), and ethnic identity. The participants were 383 urban youth of color in grades 9 through 12. The results showed significant variation between profile groups of youth and the association higher levels of cognitive empowerment have with intrapersonal psychological empowerment, psychological SOC, and ethnic identity; albeit, some variation was present. This study is explorative in nature and an effort to highlight the complexity of empowerment and cognitive empowerment. Findings are significant as these outcomes provide valuable insight into the intricacies of cognitive empowerment and highlight the importance of youth experiencing high levels of cognitive empowerment on domains related to civic engagement and critical awareness.

Care management (CM) is a promising team-based, patient-centered approach "designed to assist patients and their support systems in managing medical conditions more effectively." As little is known about its implementation, this article describes CM implementation and associated lessons from 12 Agency for Healthcare Research and Quality-sponsored projects. Two rounds of data collection resulted in project-specific narratives that were analyzed using an iterative approach analogous to framework analysis. Informants also participated as coauthors. Variation emerged across practices and over time regarding CM services provided, personnel delivering these services, target populations, and setting(s). Successful implementation was characterized by resource availability (both monetary and nonmonetary), identifying as well as training employees with the right technical expertise and interpersonal skills, and embedding CM within practices. Our findings facilitate future context-specific implementation of CM within medical homes. They also inform the development of medical home recognition programs that anticipate and allow for contextual variation.

A disproportionate number of urban youth attend underresourced and segregated schools. While tenets of the American Dream are inculcated in urban youth, a dearth of educational resources is available to help realize this dream. This qualitative study explored the narratives of urban youth (N = 85), many of whom sought to be the exceptions, embracing higher education as a pathway to successful futures, yet few identified resources that would make access to higher education possible. The capital accrued in their communities allowed them to navigate their social environment; however, it was an insufficient bridge for future success in higher education. Furthermore, they espoused a belief in their own self-reliance as the one resource on which they could count on. Ironically, the youth also accepted "not making it" a result of their own shortcomings. We link findings to empowerment agents who would cultivate both bridging capital and critical consciousness among/for youth.

BackgroundThe US Preventive Services Taskforce (USPSTF) recommends routine lipid screening beginning age 35 for men [1]. For women age 20 and older, as well as men age 20-34, screening is recommended if cardiovascular risk factors are present. Prior research has focused on underutilization but not overuse of lipid testing. The objective is to document over- and under-use of lipid testing in an insured population of persons at low, moderate and high cardiovascular disease (CVD) risk for persons not already on statins.MethodsThe study is a retrospective cohort study that included all adults without prior CVD who were continuously enrolled in a large integrated healthcare system from 2005 to 2010. Measures included lipid test frequency extracted from administrative data and Framingham cardiovascular risk equations applied using electronic medical record data. Five year lipid testing patterns were examined by age, sex and CVD risk. Generalized linear models were used to estimate the relative risk for over testing associated with patient characteristics.ResultsAmong males and females for whom testing is not recommended, 35.8 % and 61.5 % received at least one lipid test in the prior 5 years and 8.4 % and 24.4 % had two or more. Over-testing was associated with age, race, comorbidity, primary care use and neighborhood income. Among individuals at moderate and high-risk (not already treated with statins) and for whom screening is recommended, between 21.4 % and 25.1 % of individuals received no screening in the prior 5 years.ConclusionsBased on USPSTF lipid screening recommendations, this study documents substantial over-testing among individuals with low CVD risk and under-testing among individuals with moderate to high-risk not already on statins. Opportunity exists to better focus lipid screening efforts appropriate to CVD risk.

Hispanic urban youth experience high levels of violence, access to drugs and alcohol, and limited access to quality educational institutions, as well as a disproportionate use of substances. However, youth exposed to multiple sources of support, such as values related to family centrality (e.g., family cohesion or "familismo") and positive social networks, are less likely to use substances, and more likely to value school and participate in community activities. The present study examines substance use and empowering-protective resources among a cohort of Hispanic students (N = 538) from a northeastern United States urban community. We also assessed the moderating influence of gender using structural equation modeling (SEM) multigroup path analysis techniques. Results indicate that access to more sociocultural resources, such as cohesive families ("familismo") and social supports, increases Hispanic adolescents' community participation and school importance. Outcomes also demonstrate the positive, yet diverging, effects of gender. Implications for community prevention and policy are discussed.

BackgroundPharmacist- or nurse-led team care decreases patient blood pressure (BP) and cardiovascular disease (CVD) risk.PurposeTo evaluate whether a Web-based dietitian-led (WD) team care intervention was feasible and resulted in decreased BP, CVD risk, and weight compared to usual care (UC).MethodsElectronic health record (EHR) data identified patients aged 30-69 years with BMI >26, elevated BP, and 10%-25% 10-year Framingham CVD risk who were registered patient website users. Patients with uncontrolled BP at screening were randomized to UC or WD, which included a home BP monitor, scale, and dietitian team care. WD participants had a single in-person dietitian visit to obtain baseline information and create a plan to reduce CVD risk. Planned follow-up occurred via secure messaging to report BP, weight, and fruit and vegetable intake and receive ongoing feedback. If needed, dietitians encouraged patients and their physicians to intensify antihypertensive and lipid-lowering medications. Primary outcomes were change in systolic BP and weight loss ≥4 kg at 6 months. Feasibility outcomes included intervention utilization and satisfaction.ResultsBetween 2010 and 2011, a total of 90 of 101 participants completed 6-month follow-ups. The WD group had higher rates of secure messaging utilization and patient satisfaction. The WD group lost significantly more weight than the UC group (adjusted net difference=-3.2 kg, 95% CI=-5.0, -1.5, p

The increasing prevalence of mental illness and addiction in the United States has drawn considerable attention from grantmakers, which could catalyze the development and delivery of innovative approaches to these complex and difficult-to-treat behavioral health disorders. To assist foundations in meaningful engagement with the field of behavioral health, this article shares the responses of 17 highly experienced behavioral health grantmakers to two research questions: What are the experiences of foundations that have funded behavioral health initiatives? What issues should be considered by foundations contemplating this area of grantmaking support? [ABSTRACT FROM AUTHOR]