Drug Addiction Within African American Community Annotated

Drug Addiction Within African American Community Annotated ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Drug Addiction Within African American Community Annotated I need an annotated bibliography for these seven sources. The topic I have chosen to explore for the paper is “drug addiction within the African-American community in the United States” Drug Addiction Within African American Community Annotated I have attached links or downloads of the seven sources (including 3 scholarly articles). Make sure it is in APA format and no plagiarism. Each annotation should summarize and assess the source. Each annotation should cover the main points of the source, the methods used in the source, and the source’s potential importance or usefulness for the research. https://americanaddictioncenters.org/rehab-guide/a… https://www.drugabuse.gov/publications/research-re… https://sunrisehouse.com/addiction-demographics/af… acculturation_and_drug_use_stigma_among_latinos.pdf a_qualitative_study_of_black_women.pdf until_i_get_off_parole.pdf opioid_crisis_african_amer J Immigrant Minority Health (2015) 17:1607–1614 DOI 10.1007/s10903-015-0161-9 ORIGINAL PAPER Acculturation and Drug Use Stigma Among Latinos and African Americans: An Examination of a Church-Based Sample Karen R. Flo?rez • Kathryn Pitkin Derose • Joshua Breslau Beth Ann Griffin • Ann C. Haas • David E. Kanouse • Brian D. Stucky • Malcolm V. Williams • Published online: 23 January 2015 Ó Springer Science+Business Media New York 2015 Abstract Substance use patterns among Latinos likely reflect changes in attitudes resulting from acculturation, but little is known about Latinos’ attitudes regarding drug addiction. We surveyed a church-based sample of Latinos and African Americans (N = 1,235) about attitudes toward drug addiction and socio-demographics. Linear regression models compared Latino subgroups with African-Americans. In adjusted models, Latinos had significantly higher drug addiction stigma scores compared to African Americans across all subgroups (US-born Latinos, b = 0.22, p .05; foreign-born Latinos with high English proficiency, b = 0.30, p .05; and foreign-born Latinos with low English proficiency, b = 0.49, p .001). Additionally, Latinos with low English proficiency had significantly higher mean levels of drug use stigma compared Latinos with high proficiency (both foreign-born and US-born). In this church-affiliated sample, Latinos’ drug addiction stigma decreases with acculturation, but remains higher among the most acculturated Latinos compared to AfricanAmericans. These attitudes may pose a barrier to treatment for Latino drug users. Keywords Drug addiction stigma Acculturation Church-based sample Latinos African Americans K. R. Flo?rez (&) K. P. Derose D. E. Kanouse B. D. Stucky M. V. Williams Health Program, RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA e-mail: [email protected] J. Breslau A. C. Haas RAND Corporation, Pittsburgh, PA, USA B. A. Griffin RAND Corporation, Arlington, VA, USA Introduction Migration to the United States appears to have a significant influence on the substance use patterns of Latino immigrants. Longer residence in the United States (US) is consistently associated with higher risk for substance use and substance use disorders across Latino samples encompassing different ages and countries of origin (e.g., Mexicans) [1–5]. Indeed, migration appears to be such a powerful predictor of substance use and abuse that it continues to shape migrants’ substance use behavior even after they return to their country of origin, and even among persons who never migrated but have family members that did. For example, several studies using large representative samples of Mexicans living in Mexico demonstrated higher lifetime prevalence of alcohol and other drugs use (e.g., marijuana, cocaine) among return migrants and relatives of migrants compared to those with no migration history, [6–8] even after controlling for sociodemographic differences associated with migration and drug use (e.g., age, gender, marital status, educational attainment).Drug Addiction Within African American Community Annotated Greater availability of drugs in the US relative to Mexico also seems to account for some, but not all, of the increase in drug use that occurs across generations in the US [6]. Changes in patterns of drug use related to migration may reflect broader changes in attitudes to or moral valuations of drug use, which occur as part of acculturation to American culture and society. Specifically, acculturation involves changes in attitudes, values, and behaviors that result from social and psychological exchanges between groups from different cultures [9]. Numerous studies using language-based measures of acculturation demonstrate greater drug use and abuse among the most acculturated Latinos [2, 10–23], suggesting Latino migrants have more opportunities for use and may develop more liberal norms 123 1608 of substance use in the US than were prevalent in their country of origin [8]. However, there are few studies on drug use norms or beliefs specifically, including the extent to which Latino immigrants in the US are averse to drug use and to drug users in general. An important index of cultural change with respect to substance use that has powerful public health implication is the extent of stigma towards substance users, i.e. the extent to which drug users are devalued and viewed within a community as tainted [24]. Stigma in the community has public health implications since it marginalizes people with the stigmatizing attribute, creating incentives for them to conceal their stigma-related behavior or condition rather than seeking help for it [25]. Stigma might be particularly important for migrant communities because it may exacerbate existing fears of authority and lead to avoiding treatment and more adverse consequences for users. Further, drug abuse stigma has been shown to influence HIV-related attitudes among adults [26, 27], such that stigmatization toward people living with HIV/AIDS (PLWHA) is associated with stigmatization toward vulnerable groups to HIV transmission, including drug users [28]. Greater drug abuse stigma has also been shown to be associated with lower levels of drug use among youth [29]. Yet we know of no study that has examined drug abuse stigma among Latinos. Part and parcel of the problem is a lack of instruments that assess this construct, with most studies on substance use stigma solely concentrating on alcohol or on drug abuse-related stigma held by health providers working with at-risk populations [30–32]. Only two instruments, both of which assessed attitudes toward alcoholics, have been translated into Spanish and validated in Spanish-speaking samples [33, 34]. The aim of this paper is to report on a general drug addiction stigma scale and examine the extent to which proxies for acculturation (e.g., nativity) are associated with drug addiction stigma in a community sample of Latino and African Americans. Specifically, this study uses baseline data from a pilot intervention study addressing HIV-related attitudes and behaviors conducted in collaboration with African American and Latino churches in a high HIV prevalence area of Long Beach in Los Angeles County. Focusing on this church-based sample in Long Beach is important for several reasons. First, the prevalence of illegal drug use during 2010–2012 among persons aged 12 or older is higher in Long Beach (12.05 %) compared to LA County (10.17 %) and nationwide (8.90 %) [35]. Second, religion has been identified as having a protective effect against substance use across the lifecourse continuum, given that some religions explicitly prohibit substance use [36] or prescribe behavioral norms that may discourage substance use [37]. Drug Addiction Within African American Community Annotated Third, Latinos and African Americans have high rates of membership in religious congregations [38, 39], therefore churchgoers represent an important segment of these two communities. 123 J Immigrant Minority Health (2015) 17:1607–1614 Lastly, focusing on African Americans and Latinos provides important evidence on whether drug addiction stigma may have a distinct moral valence (i.e., intrinsically aversive) in immigrant versus US-born groups. Most importantly, the comparison group is people who live in the same community, rather than a group with which Latinos have little direct contact. An issue with research that postulates distinct culturally-based beliefs and norms among different ethnic groups is the comparison group used in the study. Specifically, there is a major assumption in this field—that immigrants are acculturating to white middle class values, norms and behaviors [40, 41] despite the fact that immigrants tend to settle in large, ethnically-diverse, urban cities [42]. These features of the settlement context are crucial to our understanding of who migrants see as their relevant peers or models for life in the new culture. Methods Survey Participants completed a survey as part of a study evaluating a new pilot intervention, the Facilitating Awareness to Increase Testing for HIV (FAITH) Project, which is a multifaceted, congregation-based intervention to reduce HIVrelated stigma [29]. All of the participating churches were located in and near Long Beach, a city within Los Angeles County. We selected churches purposively to represent diversity in size and denomination: two African American Baptist churches, two Latino Pentecostal churches, and one large Latino Roman Catholic church. Church coordinators and other congregational leaders at 5 churches (3 Latino and 2 African American) helped to promote the survey within each congregation, and English and Spanish language group survey sessions managed by survey administrators were conducted at church sites during regularly scheduled ministry meetings and/or after religious services. Overall participation rate across the 5 churches were 73 % at baseline and 79 % at follow-up, each calculated as a proportion of regular church attendees at the time of the survey. Participants received a $20 gift card and a meal for completing each survey. The research protocol was approved by the RAND Human Subjects Protection Committee. Further, all study participants were adults (i.e., 18 years and older) and provided informed consent prior to the survey. Measures Drug Addiction Stigma We modified Ronzani’s alcoholism stigma scale to assess drug addiction stigma [30]. Our adapted version is J Immigrant Minority Health (2015) 17:1607–1614 composed of 5 items and explores stereotypes regarding people who use drugs and moral issues popularly associated with addiction (e.g., weakness in character). A 5-point Likert scale was used by participants to indicate level of agreement with each statement. Scoring ranged from 1 to 5, with higher scores signaling greater stigmatizing attitudes towards drug addiction. The adapted scale exhibited good internal consistency among Latinos (Cronbach’s a = 0.88) and African Americans (Cronbach’s a = 0.91). Drug Addiction Within African American Community Annotated Race-Ethnicity/Nativity/Language (Study Groups) Given that race-ethnicity, nativity, and English language fluency influence acculturation, we used these variables to create 4 study groups: (1) African Americans (reference group); (2) US-born Latinos who reported speaking English ‘‘well’’ or ‘‘very well;’’ (3) foreign-born Latinos who reported speaking English ‘‘well or ‘‘very well;’’ and (4) foreign-born Latinos who reported speaking English ‘‘not well’’ or ‘‘not at all.’’ Other sociodemographic variables were defined as gender (male, female), marital status (single/never married, married/living with partner, divorced/separated/widowed), age (18–20, 31–50, 51?), income ($9,999 or less, $10,000– $29,999, $30,000–$49,999, $50,000–$69,999, $70,000?), education (less than high school, high school, more than high school), and number of household members. Knowing someone with HIV has been shown to be associated with lower HIV-related stigma [43–45] and may be associated with stigma towards drug addiction. To explore this, we asked respondents whether they know anyone (friends, family, co-workers, others) who ‘‘has HIV or AIDS or has died of HIV’’ (Yes/No). Data Analysis Factor Analyses To ensure that the adapted 5-item drug addiction stigma scale measures a single dimension, we conducted a multigroup one-factor confirmatory factor analysis (CFA) using Mplus mean and variance adjusted weighted least squares algorithm (WLSMV) that is appropriate for categorical response items [46]. Model fit, that is, the degree to which the model accurately reflects the data, was evaluated with commonly used model fit indices (RMSEA B .08, TLI C .95, CFI C .95) [47]. Models are described as closely fitting the data when these criteria are satisfied. Item loadings and thresholds were constrained to equality across the four groups: (1) African Americans (n = 419), (2) US born Latinos with high English proficiency (n = 205), (3) foreign born Latinos with high English proficiency (n = 194), and (4) foreign born Latinos with low English 1609 proficiency (n = 393). The four groups were modeled as predictors of the drug use stigma latent variable with African American’s coded as the reference group. Imputation Procedures Rates of missing data for our study variables were relatively low, ranging from 1 to 5 % per item. Before conducting multivariate analyses, IVEware 0.2 was utilized to impute missing data by sequential regression multivariate imputation [38]. Five imputed datasets were created for the baseline survey and all analyses adjust appropriately using standard rules for aggregating results across multiply imputed data sets [39]. Multivariate Analyses Multivariate linear regression models were fit to examine the independent associations between study group and drug addiction stigma, while controlling for other socio-demographic characteristics and knowing someone with HIV. A p value of .05 was considered statistically significant for all analyses. Results Table 1 provides an overview of participant characteristics for the entire sample (n = 1,235) and by study group. There were a number of socio-demographic differences among the groups, most notably: the younger age of USborn Latinos; the higher income and education among African Americans; the much higher proportion of married/ living with partner among both foreign-born Latino subgroups; and the larger household size of all Latino subgroups. Further, while almost half of African Americans knew someone who was HIV positive (49.4 %), the large majority of Latinos (72.3–81.7 %) did not know someone who was HIV positive irrespective of place of birth or English proficiency. Drug Addiction Within African American Community Annotated Finally, the mean drug use stigma score varied across groups, with a range of 2.7–3.7 such that African Americans had the lowest mean levels of drug use stigma and Foreign-born Latinos with low English proficiency had the highest mean. Factor Analysis All factor loadings for the multi-group 1-factor CFA were [0.80 (see Table 2). Model fit indices suggest that the modified items comprise a unidimensional measure of drug use stigma (v2 = 91, df = 17, CFI = .994, TLI = .992, RMSEA = 0.061). Among the subgroups, on average, foreign born Latinos with low English proficiency held 123 1610 J Immigrant Minority Health (2015) 17:1607–1614 Table 1 Participant characteristics All (N = 1,235) African Americans (n = 425) Latino; US-born (n = 206) Latino; Foreign-born and high English proficiency (n = 199) Latino; Foreign-born and low English proficiency (n = 405) 18–30 29.2 26.0 74.9 23.0 11.8 31–50 51? 45.6 25.2 41.7 32.3 20.1 5.0 60.6 15.4 55.2 32.9 Female 63.2 64.9 64.1 52.4 66.1 Male 36.8 35.1 35.9 47.6 33.9 Age (%) Gender (%) Race/ethnicity; nativity/English language proficiency (%) African American 34.4 – – – – Latino; US-born 16.8 – – – – Latino; Foreign-born and high English proficiency 16.0 – – – – Latino; Foreign-born and low English proficiency 32.9 – – – – 22.0 18.1 26.7 16.0 26.8 Income (%) $9,000 or less $10–$29,000 32.3 20.6 34.9 29.2 44.7 $30,000–$49,000 22.0 19.3 21.1 30.9 20.9 $50,000–$69,000 10.6 17.4 6.7 13.3 4.2 $70,000 or more Education (%) 13.1 24.6 10.7 10.5 3.4 High school 32.0 6.8 12.7 33.6 67.5 High school 28.3 24.6 42.6 31.8 23.0 [High school 39.7 68.6 44.7 34.6 9.5 Marital status (%) Single, never married 31.1 39.9 64.9 19.1 10.3 Married/living with partner 53.4 37.3 28.3 69.5 73.3 Divorced/separated/widowed 15.5 22.8 6.8 11.5 14.3 4.4 (3.2) 3.3 (2.2) 5.0 (2.5) 5.2 (5.4) 4.9 (2.8) No 68.4 50.6 72.3 75.4 81.7 Yes 31.6 49.4 27.7 24.6 18.3 3.2 (1.3) 2.7 (1.2) 3.3 (1.1) 3.4 (1.2) 3.7 (1.2) Household size mean (SD) Number of family members Knows someone who is HIV? (%) Drug abuse stigma score mean (SD) more stigmatizing attitudes towards people who use drugs than African Americans with nearly one standard deviation difference. They also held more stigmatizing attitudes towards people who use drugs than their US born counterparts, as well as foreign-born Latinos with high English proficiency. Multivariate Regression Analysis After adjusting for age, gender, income, household size, education, marital status, and knowing someone with HIV, Latinos still had significantly higher drug addiction stigma scores compared to African Americans across all subgroups (US-born Latinos, b = 0.22, p .05; foreign-born 123 Latinos with high English proficiency, b = 0.30, p .05; and foreign-born Latinos with low English proficiency, b = 0.49, p .001) (see Table 3). Further, we tested for significant differences between the Latino groups in our model and found that foreign-born Latinos with low English proficiency had significantly higher mean levels of drug use stigma compared to their foreign-born and US born high English proficiency counterparts (p 0.05 and 0.01, respectively). Older adults (i.e., 51?) and men had higher drug use stigma scores, as did those with less education (less than high school, b = 0.21, p .001 and high school graduates, b = 0.15, p .001, compared to those with more than high school). Single/never married and divorced, separated, J Immigrant Minority Health (2015) 17:1607–1614 Table 2. Drug Addiction Within African American Community Annotated Drug abuse stigma factor loadings and mean differences across groups 1611 Factor loadingsa Item Drug addicts are morally weak people a African Americans were the reference group; group mean differences are in units of standard deviations from the African American group Group mean (SE) 0.93 Drug addicts are people with no will-power 0.90 Drug addiction is a sign of weakness in character 0.83 Drug addicts do not care about their problems 0.83 Drug addicts do not want to quit using drugs 0.82 Group US born Latinos with high English proficiency 0.57 (0.10) Foreign born Latinos with high English proficiency 0.61 (0.10) Foreign born Latinos with low English proficiency 0.99 (0.08) or widowed respondents had higher drug use stigma scores compared to those married or living with a partner (b = 0.18, p .001 and b = 0.16, p .001, respectively). Finally, those with annual household incomes of $70,000 or more had significantly lower stigma scores (b = – 0.23, p .001) compared to those with $9,000 or less, and higher numbers of family members in the household was associated with lower stigma scores (b = – 0.02, p .001). Discussion Our findings demonstrate that, overall, church-affiliated Latinos have significantly higher rates of stigmatizing attitudes towards drug addiction compared to churchaffiliated African Americans. Further, we found that the size of the differences were largest among foreign-born Latinos with low English proficiency, who are less acculturated than their US and foreign born high English proficiency counterparts. Because both African Americans and Latinos were sampled in religious settings, the differences we observed cannot be attributed simply to differences in religious commitment or practice. Religious views about drug use are also likely salient for both groups. Therefore, we interpret the higher stigmatizing attitudes towards drug addiction among Latinos compared to African Americans as evidence that Latinos may hold a distinct set of cultural norms regarding drug addiction. We also interpret the higher stigmatizing attitudes towards drug addiction among immigrant Latinos with low English proficiency compared to their US-born and foreign-born counterparts to suggest that such cultural norms are likely influenced by one’s social and cultural context and can change when the cultural context changes. For example, drug use in the US has been described as a function of more permissive social norms and attitudes in regard to this behavior [48], and drug use amo … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10