Barnett, T. E., Rowley, S., Zimmerman, M. A., Vansadia, P., & Caldwell, C. (2011). A longitudinal study of household change on African American adolescents. Journal of Community Psychology, 39(3), 303-315.
Project: Flint Adolescent Study

Bauermeister, J. A., Zimmerman, M. A., & Caldwell, C. H. (2011). Neighborhood Disadvantage and Changes in Condom Use among African American Adolescents. Journal of Urban Health, 88(1), 66-83.
Link to Pubmed | abstract| Neighborhood context may influence youth sexual decision-making. We examined the association between neighborhood characteristics and condom use in a sample of African American youth followed across the high school years (N = 681; 51% female). Using a three-level hierarchical linear model, we modeled inconsistent condom use over time and then examined its association with youth's sexual risk trajectories (sexual intercourse frequency, number of partners, and pregnancy concerns) and individual-level characteristics (sex, age, SES, and household composition), and neighborhood disadvantage. While sexual intercourse frequency was associated with inconsistent condom use over time, youth reporting greater pregnancy concerns and number of partners reported more consistent condom use over time. Females were more likely to report more inconsistent condom use over time. Neighborhood disadvantage characteristics were associated with less baseline condom use, but did not have an association with changes in youth's condom use over the high school years. We discuss the implications for community-based HIV/AIDS prevention for youth.
[PMCID: PMC3042087]
Project: Flint Adolescent Study

Bauermeister, J. A., Johns, M. M., Pingel, E., Eisenberg, A., Santana, M. L., & Zimmerman, M. (2011). Measuring Love: Sexual Minority Male Youths' Ideal Romantic Characteristics. J LGBT Issues Couns, 5(2), 102-121.

Brenner, A. B., Bauermeister, J. A., & Zimmerman, M. A. (2011). Neighborhood variation in adolescent alcohol use: examination of socioecological and social disorganization theories. J Stud Alcohol Drugs, 72(4), 651-659.
Project: Flint Adolescent Study

Butler-Barnes, S. T., Chavous, T. M., & Zimmerman, M. A. (2011). Exposure to Violence and Achievement Motivation Beliefs: Moderating Roles of Cultural-Ecological Factors. Race and Social Problems, 3(2), 17.
Project: Flint Adolescent Study

Caldwell, C.H., Bell, L., Brooks, C.L., Ward, J.D., & Jennings, C. (2011). Engaging Nonresident African American fathers in intervention research: What practitioners should know about parental monitoring in nonresident families. Journal of Research on Social Work Practice, 21, 298-307.
Project: Fathers and Sons

Caldwell, C.H., De Loney, E. H., Mincy, R., Klempin, S., Brooks, C.L., & Rafferty, J. (2011).  Strengthening bonds between nonresident African American fathers and sons as a way to reduce or prevent youth risky behaviors. In Craig Haen (Ed.), Creative approaches for engaging boys in treatment. Routledge Book Series on Counseling and Psychotherapy with Boys and Men. New York: Routledge Publishers, pp.265-291.
Project: Fathers and Sons

Caldwell, C., Antonakos, C., Kruger, D. J., & de Loney, E. H. (under review). Pathways to prevention: Improving the parenting attitudes and behaviors of nonresident African American fathers as a way to reduce aggressive behavior in boys.
Project: Fathers and Sons

Caldwell, C., Ward, J., Reischl, T., & De Loney, E. H. (2011). Effective parenting intervention strategies for preventing youth risky behvaiors among African American boys: Is there a role for fathers? In N. E. Hill, T. L. Mann & H. E. Fitzgerald (Eds.), African American children and mental health (pp. 151-181). Santa Barbara, CA: Praeger.
Project: Fathers and Sons

Carty, D. C., Kruger, D. J., Turner, T. M., Campbell, B., DeLoney, E. H., & Lewis, E. Y. (2011). Racism, health status, and birth outcomes: results of a participatory community-based intervention and health survey. J Urban Health, 88(1), 84-97.
Project: REACH U.S.

Clark, S. J., Cowan, A. E., & Freed, G. L. (2011). Private-sector vaccine purchase costs and insurer payments: A disincentive for using combination vaccines? Hum Vaccin, 7(4), 426-428.
Project: Variation in Immunization (SIP)

Freed, G. L., Clark, S. J., Cowan, A. E., & Coleman, M. S. (2011). Primary care physician perspectives on providing adult vaccines. Vaccine, 29(9), 1850-1854.
Project: Variation in Immunization (SIP)

Griffith, D. M., Gunter, K., & Allen, J. O. (2011). Male Gender Role Strain as a Barrier to African American Men's Physical Activity. Health Educ Behav.
Project: Men 4 Health

Hammond, W. P., Caldwell, C. H., Brooks, C. L., & Bell, L. (2011). Being there in spirit, fire, and mind: Expressive roles among nonresidential African American fathers. Journal of Research on Social Work Practice, 21(3), 308-318.
Project: Fathers and Sons

Hurd, N., Zimmerman, M. A., & Reischl, T. M. (2011). Role Model Behavior and Youth Violence: A Study of Positive and Negative Effects. Journal of Early Adolescence, 31(2), 323-354.
Project: Flint Adolescent Study

Kruger, D.J. (2011) Evolutionary theory in public health and the public health of evolutionary theory. Futures, 43 (8), 762-770.

Kruger, D.J., Munsell, M.A., & French-Turner, T.M. (in press). Using a life history framework to understand the relationhip between neighborhood structural deteriation and adverse birth outcomes. Journal of Social, Evolutionary and Cultural Psychology.

Livingood, W. C., Allegrante, J. P., Airhihenbuwa, C. O., Clark, N. M., Windsor, R. C., Zimmerman, M. A., et al. (2011). Applied social and behavioral science to address complex health problems. Am J Prev Med, 41(5), 525-531.

Ranney, M. L., Whiteside, L., Walton, M. A., Chermack, S. T., Zimmerman, M. A., & Cunningham, R. M. (2011). Sex differences in characteristics of adolescents presenting to the emergency department with acute assault-related injury. Acad Emerg Med, 18(10), 1027-1035

Skolarus, L. E., Zimmerman, M. A., Murphy, J., Brown, D. L., Kerber, K. A., Bailey, S., et al. (2011). Community-Based Participatory Research: A New Approach to Engaging Community Members to Rapidly Call 911 for Stroke. Stroke.
Focus/Project: Community Based Participatory Research/PIR

Stoddard, S. A., & Zimmerman, M. A. (2011). Association of interpersonal violence with self-reported history of head injury. Pediatrics, 127(6), 1074-1079.
Project: Flint Adolescent Study

Stoddard, S. A., & Garcia, C. M. (2011). Hopefulness among non-U.S.-Born Latino youth and young adults. J Child Adolesc Psychiatr Nurs, 24(4), 216-222.

Stoddard, S. A., McMorris, B. J., & Sieving, R. E. (2011). Do social connections and hope matter in predicting early adolescent violence? Am J Community Psychol, 48(3-4), 247-256.

Stoddard, S. A., Zimmerman, M. A., & Bauermeister, J. A. (2011). Thinking about the future as a way to succeed in the present: a longitudinal study of future orientation and violent behaviors among African American youth. Am J Community Psychol, 48(3-4), 238-246.

Stoddard, S. A., Zimmerman, M. A., & Bauermeister, J. A. (In Press). A Longitudinal Analysis of Cumulative Risks, Cumulative Promotive Factors, and Adolescent Violent Behavior. Journal of Research on Adolescence.

Walton, M. A., Resko, S., Whiteside, L., Chermack, S. T., Zimmerman, M., & Cunningham, R. M. (2011). Sexual risk behaviors among teens at an urban emergency department: relationship with violent behaviors and substance use. J Adolesc Health, 48(3), 303-305.
Project: SafER Teens

Xue, Y., Zimmerman, M., & Barnett, T. (In press). Parental support and the longitudinal relationships between exposure to community violence and violent behavior among African American adolescents. Journal of Research on Adolescence.

Zimmerman, M. A., Stewart, S. E., Morrel-Samuels, S., Franzen, S., & Reischl, T. M. (2011). Youth Empowerment Solutions for Peaceful Communities: Combining theory and practice in a community-level violence prevention curriculum. Health Promotion Practice, 12(3), 425-439.
Link to PubMed | View Abstract| This article describes the development and evaluation of an after-school curriculum designed to prepare adolescents to prevent violence through community change. This curriculum, part of the Youth Empowerment Solutions for Peaceful Communities (YES) program, is guided by empowerment and ecological theories within a positive youth development context. YES is designed to enhance the capacity of adolescents and adults to work together to plan and implement community change projects. The youth curriculum is organized around six themed units: (a) Youth as Leaders, (b) Learning about Our Community, (c) Improving Our Community, (d) Building Intergenerational Partnerships, (e) Planning for Change, and (f) Action and Reflection. The curriculum was developed through an iterative process. Initially, program staff members documented their activities with youth. These outlines were formalized as curriculum sessions. Each session was reviewed by the program and research staff and revised based on underlying theory and practical application. The curriculum process evaluation includes staff and youth feedback. This theoretically based, field-tested curriculum is designed to be easily adapted and implemented in a diverse range of communities.
Project: Youth Empowerment Solutions

Alaimo, K., Reischl, T.M., Allen, J.O. (2010).  Community gardening, neighborhood meetings, and social capital.  Journal of Community Psychology, 38, 1-18.
Project: Community Garden Storytelling Project

Caldwell, C.H., Rafferty, J., Reischl, T.M., De Loney, E.H., & Brooks, C.L. (2010). Enhancing Parenting Skills among Nonresident African American Fathers as a Strategy for Preventing Youth Risky Behaviors. American Journal of Community Psychology. 45(1-2): 17-35. {Epub Jan 16 2010} PMID: 20082239
View in PubMed | View Abstract This study evaluated the effectiveness of a theoretically based, culturally specific family intervention designed to prevent youth risky behaviors by influencing the parenting attitudes and behaviors of nonresident African American fathers and the parent–child interactions, intentions to avoid violence, and aggressive behaviors of their preadolescent sons. A sample of 158 intervention and 129 comparison group families participated. ANCOVA results indicated that the intervention was promising for enhancing parental monitoring, communication about sex, intentions to communicate, race-related socialization practices, and parenting skills satisfaction among fathers. The intervention was also beneficial for sons who reported more monitoring by their fathers, improved communication about sex, and increased intentions to avoid violence. The intervention was not effective in reducing aggressive behaviors among sons. Findings are discussed from a family support perspective, including the need to involve nonresident African American fathers in youth risky behavior prevention efforts. |
Project: Fathers and Sons

Clark, N. (2010). Key Informants Perspectives on Managing Epilepsy Report. Ann Arbor: Center for Managing Chronic Disease, University of Michigan.
Project: Managing Epilepsy Well

Clark, N. M., S. Stoll, et al. (2010). Fostering epilepsy self management: the perspectives of professionals. Epilepsy and Behavior, 19(3): 255-63.
Link to PubMed | View Abstract Epilepsy clinical, academic, and human service professionals (N = 101) were surveyed regarding the challenges people with epilepsy face managing their condition. 30% of the respondents had personal experience with epilepsy. Interviews were transcribed and coded into themes. Response differences by profession and personal experience were examined using chi-squared tests. The two greatest challenges reported most frequently for people with epilepsy were finding high quality health care and managing psychological and emotional effects. The two most important epilepsy outcomes were seizure control and quality of life. The two greatest challenges facing clinicians were too little time with patients and limited clinical focus. The two main weaknesses in the field were insufficient research and narrow approaches to addressing epilepsy. Significant differences in responses across professions were evident as were differences according to personal experience with epilepsy. Few clinicians cited quality of care as a major challenge (p<0.0001) compared to other professions. Few respondents with personal experience with epilepsy cited stigma as a challenge (p = 0.006).
Project: Managing Epilepsy Well

DiIorio, C. K., Y. A. Bamps, et al. (2010). The Prevention Research Centers' Managing Epilepsy Well Network. Epilepsy & Behavior 19(3): 218-224.
Project: Managing Epilepsy Well

Elkington, K.S., Bauermeister, J.A. & Zimmerman, M.A. (2010). Psychological distress, substance use, and HIV/STI risk behaviors among youth. Journal of Youth and Adolescence, 39(5): 514-527. | Abstract| Psychological distress has been inconsistently associated with sexual risk behavior in youth, suggesting additional factors, such as substance use, may explain this relationship. The mediating or moderating role of substance use on the relationship between psychological distress and sexual risk behaviors was prospectively examined over the four high school years in a sample of urban youth (N = 850; 80% African American; 50% female). Growth curve modeling was used to estimate changes in sexual risk across adolescence and to test its association to psychological distress symptoms and frequency of substance use. Substance use was associated with psychological distress. Greater psychological distress was associated with increased sexual intercourse frequency, decreased condom use, and increased number of partners. Substance use fully mediated the relationship between psychological distress and intercourse frequency and condom use, and partially mediated the relationship between psychological distress and number of partners. We found no differences in mediation by sex or race/ethnicity and no evidence to support moderation of psychological distress and substance use on sexual risk. Findings suggest that psychological distress is associated with sexual risk because youth with greater psychological distress are also more likely to use substances. Practical implications for adolescent HIV/STI prevention are discussed.
Project: Flint Adolescent Study

Elkington, K. S., J. A. Bauermeister, et al. (2010). Do parents and peers matter? A prospective socio-ecological examination of substance use and sexual risk among African American youth. Journal of Adolescence. Epub ahead of print.
View in PubMed | View Abstract We examined the direct contribution of parent and peer risk and promotive factors on youth condom use trajectories, in addition to the indirect influence of these factors via youth's substance use over four years in a sample of urban, African American youth (N=679; 51% female; M=14.86 years; SD=0.65). Growth curve modeling was used to estimate changes in substance use and sexual risk across adolescence and test their association with parent and peer factors. Parent and peer risk factors were strongly associated with increasing substance use as youth aged. Substance use and condom use were interrelated. Parent and peer risk factors were indirectly associated with youth condom use; parent and peer promotive factors were directly associated with condom use, after accounting for substance use. Findings suggest the value of considering multiple influences on youth risk behavior.
Project: Flint Adolescent Study

Griffith, D.M., Campbell, B., Allen, J.O., Robinson, K. J., Kretman, S. (2010). YOUR Blessed Health: An HIV Prevention Program Bridging Faith and Public Health Communities. Public Health Reports, 125 (1, Suppl), 4-11.
Link to article|View AbstractAfrican American faith-based institutions are not necessarily equipped to balance their moral and spiritual missions and interpretation of religious doctrine with complex health issues such as human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). YOUR Blessed Health (YBH) is a faith-based, six-month pilot project designed to increase the capacity of faith-based institutions and faith leaders to address HIV/AIDS and sexually transmitted infections (STIs) in 11- to 19-year-old African Americans. In addition to increasing the knowledge and skills of young people, the intervention seeks to change churches’ norms to provide more open settings where young people can talk with faith leaders about sex, relationships, STIs, and HIV/AIDS. YBH expands the roles of adult faith leaders, particularly pastors’ spouses, to include health education as they implement the intervention in their congregations and communities. The intervention includes a flexible menu of activities for faith leaders to select from according to their institutional beliefs, doctrines, and culture. |
Project: YOUR Blessed Health

Griffith, D.M., Pichon, L. C., Campbell, B., Allen, J.O. (2010). YOUR Blessed Health: A faith-based, CBPR approach to addressing HIV/AIDS among African Americans. AIDS Education and Prevention, 22 (3): 203-217.
Project: YOUR Blessed Health

Griffith D.M., Allen J.O., Deloney E.H., Robinson K., Lewis E.Y., Campbell B., Morrel-Samuels S., Sparks A, Zimmerman, M.A. & Reischl, T. (2010). Community-based organizational capacity building as a strategy to reduce racial health disparities. Journal of Primary Prevention. 31(1-2):31-39.
Project: Community Capacity Building

Hindman A, Skibbe L, Miller A, Zimmerman M. (2010) Ecological contexts and early learning: Contributions of child, family, and classroom factors during head start, to literacy and mathematics growth through first grade. Early Childhood Research Quarterly. 25(2):235-250.
Project: Other

Hurd, N. and M. A. Zimmerman (2010). Natural Mentors, Mental Health and Risk Behaviors: A longitudinal analysis of African American Adolescents Transitioning into Adulthood. American Journal of Community Psychology 46(1-2): 36-48.
Project: Flint Adolescent Study

Hurd, N. M. and M. A. Zimmerman (2010). Natural mentoring relationships among adolescent mothers: A study of resilience. Journal of Research on Adolescence 20(3): 789-809.
View in PubMed | View Abstract This study focused on natural mentoring relationships between nonparental adults and African American adolescent mothers. Data were collected from 93 adolescent mothers over 5 time points, starting in the adolescent mothers’ senior year of high school and ending 5 years after high school. We found that having a natural mentor was related to fewer depressive symptoms and fewer anxiety symptoms over time. Natural mentor presence also modified the relationship between stress and mental health problems over time. Facilitating these natural mentoring relationships between adolescent mothers and nonparental adults may be a useful strategy for promoting healthy development within this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)
Project: Flint Adolescent Study

Johns, M. M., J. A. Bauermeister, Zimmerman M.A. (2010). Individual and Neighborhood Correlates of HIV Testing among African American Youth Transitioning from Adolescence into Young Adulthood. AIDS Educ Prev 22(6): 509-22.
View in PubMed | View Abstract Disparities in HIV testing rates exist among socially disadvantaged communities. Using a longitudinal sample of urban African American youth followed from adolescence into young adulthood (n = 396; 51% female), we examined whether HIV testing was associated with individual (e.g., gender, socioeconomic status [SES], education, and history of sexually transmitted infections [STIs]) and area (i.e., neighborhood disadvantage and HIV prevalence) characteristics. In our multilevel regressions, we found females were more likely to have tested for HIV, with the magnitude of this association increasing if they lived in areas of greater disadvantage yet decreasing in higher HIV prevalence areas. Those without a high school degree, with a lower SES, or with a history of STIs in adolescence were less likely to test if they lived in greater disadvantage and HIV prevalence areas. We discuss the implications of these findings from an ecological perspective and propose recommendations for increasing testing among African American youth.

Kruger, D. J., Y. Lewis, et al. (2010). Mapping a message for faith leaders: Encouraging community health promotion with local health data. Health Promotion Practice 11(6): 837-844.
View in PubMed | View Abstract This study reports the use of a community-based health survey to share local health information with faith leaders. Geographical information systems software identified survey respondents within 2 km (1.25 miles) of places of worship. Results were tabulated for the community surrounding each place of worship and were compared with city- and county-level data. Faith leaders were presented with community-specific reports describing the health attributes of residents who lived in the surrounding area, in order to assist with the identification issues of concern and opportunities to develop health ministries to address these issues. Faith leaders were encouraged to share this information with members of their faith community and develop means of obtaining additional information on the people of interest. We believe that engaging faith leaders with neighborhood-specific health information will be critical in providing an understanding of the importance of their voice in improving health outcomes of their faith community, the surrounding neighborhood, and the community at large. Our goal is to empower faith leaders to understand personal and community health issues and to act as a conduit for health-related information and health promotion at a local level. Church health teams developed an HIV and sexually transmitted infection prevention program for African American adolescents and young adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)

Kruger, D.J., Hamacher, L., Strugar-Fritsch, D., Shirey, L., Renda, E., & Zimmerman, M.A. (2010). Facilitating the development of a county health coverage plan with data from a community based health survey. Journal of Public Health Policy 31, 199–211.
Project: Speak to Your Health! Community Survey

Morrel-Samuels, P., & Zimmerman, M. (2010). Research Methodology: An Innovative Approach to a Venerable Course. Clinical and Translational Science, 3(6), 309-311. View Abstract This paper outlines a number of innovations that we have recently implemented in the Research Methodology Course at the University of Michigan’s School of Public Health. Consistent with the goals of evidence-based medicine, evidence-based public health, intrinsic motivation, and phase 4 (T4) translational research, we have placed the emphasis on enhancing the students’ desire to learn—and more specifically on their desire to learn rigorous methods for conducting useful research that delivers practical benefits in a straightforward manner. A dozen innovations, along with some preliminary outcomes, are outlined in detail.

Resko, S. M., M. A. Walton, et al. (2010). Alcohol availability and violence among inner-city adolescents: A multi-level analysis of the role of alcohol outlet density. Am J Community Psychol 46(3-4): 253-62.
View in PubMed | View AbstractResearchers recognize that the connection between alcohol and peer violence may relate to community level ecological factors, such as the location of businesses that sell alcohol. Building on previous research among adults, this study examines the relationship between alcohol outlet density and violent behaviors among adolescents, taking into account demographic characteristics, individual alcohol use, and neighborhood level socioeconomic indicators. Data drawn from a diverse Emergency Department based sample of 1,050 urban adolescents, combined with tract level data from the state liquor control commission and U.S. Census, were analyzed. Results of multivariate multi-level regression analysis indicate that alcohol outlet density is significantly related to adolescents' violent behaviors, controlling for demographic characteristics and individual alcohol use. Census tract level socioeconomic indicators were not significantly associated with youth violence. Findings suggest that alcohol outlet density regulation should be considered as part of broader violence prevention strategies for urban adolescents.

Robinson, K., Campbell, B. & Campbell, T. (2010). YOUR Blessed Health: A Faith-Based, Community-Based Participatory Research Project to Reduce the Incidence of HIV/AIDS and Sexually Transmitted Infections. In: Kerson, T. & McCoyd, J. (Eds.), Social Work in Health Settings: Practice in Context, 3rd ed. Milton Park, Abingdon, UK: Routledge.
Project: YOUR Blessed Health

Stoddard, S. A., M. A. Zimmerman, et al. (2010). Thinking About the Future as a Way to Succeed in the Present: A Longitudinal Study of Future Orientation and Violent Behaviors Among African American Youth. American Journal of Community Psychology Epub ahead of print.
View in PubMed | View Abstract Previous research has linked higher levels of hopelessness about one's future to violent behavior during adolescence; however, little is known about this relationship over time for adolescents. Using growth curve modeling, we tested the association between future orientation and violent behavior across the high school years of adolescence in a sample of African American youth (n = 681). Variation based on demographic characteristics (i.e., sex, SES, previous violence) was explored. At baseline, differences in violent behavior varied by demographic characteristics. Overall, violent behavior decreased with age. Higher levels of future orientation were associated with greater decreases in violent behavior over time. Demographic characteristics were not associated with change in violent behavior overtime. Our findings suggest that future orientation can act as a promotive factor for at risk African American youth. Interventions that help support the development of future goals and aspirations could play a vital role in violence prevention efforts.



Project: Flint Adolescent Study

Walton, M. A., S. T. Chermack, et al. (2010). Effects of a Brief Intervention for Reducing Violence and Alcohol Misuse Among Adolescents: A Randomized Controlled Trial. JAMA 304(5): 527-535.
View in PubMed | View Abstract Context Emergency department (ED) visits present an opportunity to deliver brief interventions to reduce violence and alcohol misuse among urban adolescents at risk of future injury. Objective To determine the efficacy of brief interventions addressing violence and alcohol use among adolescents presenting to an urban ED. Design, Setting, and Participants Between September 2006 and September 2009, 3338 patients aged 14 to 18 years presenting to a level I ED in Flint, Michigan, between 12 PM and 11 PM 7 days a week completed a computerized survey (43.5% male; 55.9% African American). Adolescents reporting past-year alcohol use and aggression were enrolled in a randomized controlled trial (SafERteens). Intervention All patients underwent a computerized baseline assessment and were randomized to a control group that received a brochure (n = 235) or a 35-minute brief intervention delivered by either a computer (n = 237) or therapist (n = 254) in the ED, with follow-up assessments at 3 and 6 months. Combining motivational interviewing with skills training, the brief intervention for violence and alcohol included review of goals, tailored feedback, decisional balance exercise, role plays, and referrals. Main Outcome Measures Self-report measures included peer aggression and violence, violence consequences, alcohol use, binge drinking, and alcohol consequences. Results About 25% (n = 829) of screened patients had positive results for both alcohol and violence; 726 were randomized. Compared with controls, participants in the therapist intervention showed self-reported reductions in the occurrence of peer aggression (therapist, -34.3%; control, -16.4%; relative risk [RR], 0.74; 95% confidence interval [CI], 0.61-0.90), experience of peer violence (therapist, -10.4%; control, +4.7%; RR, 0.70; 95% CI, 0.52-0.95), and violence consequences (therapist, -30.4%; control, -13.0%; RR, 0.76; 95% CI, 0.64-0.90) at 3 months. At 6 months, participants in the therapist intervention showed self-reported reductions in alcohol consequences (therapist, -32.2%; control, -17.7%; odds ratio, 0.56; 95% CI, 0.34-0.91) compared with controls; participants in the computer intervention also showed self-reported reductions in alcohol consequences (computer, -29.1%; control, -17.7%; odds ratio, 0.57; 95% CI, 0.34-0.95). Conclusion Among adolescents identified in the ED with self-reported alcohol use and aggression, a brief intervention resulted in a decrease in the prevalence of self-reported aggression and alcohol consequences. Trial Registration clinicaltrials.gov Identifier: NCT00251212

Wong, N. T., M. A. Zimmerman, et al. (2010). A typology of youth participation and empowerment for child and adolescent health promotion. American Journal of Community Psychology 46(1-2): 100-114.
View in PubMed | View Abstract Research suggests that increasing egalitarian relations between young people and adults is optimal for healthy development; however, the empirical assessment of shared control in youth–adult partnerships is emerging, and the field still requires careful observation, identification, categorization and labeling. Thus, our objective is to offer a conceptual typology that identifies degrees of youth–adult participation while considering the development potential within each type. We use an empowerment framework, rooted in evidence-based findings, to identify five types of youth participation: (1) Vessel, (2) Symbolic, (3) Pluralistic, (4) Independent and (5) Autonomous. The typology is constructed as a heuristic device to provide researchers, practitioners and policy-makers with a common language for articulating degrees of youth participation for optimal child and adolescent health promotion. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)

Zimmerman, M.A., Brenner, A. (2010). Resilience in adolescence: Overcoming neighborhood disadvantage. In Reich, J.W., Zautra, A.J., Hall, J.S. (Ed.) Handbook of Adult Resilience. (283-308). New York: Guilford Press.

Bauermeister, J. A., Zimmerman, M., Xue, Y., Gee, G. C., & Caldwell, C. H. (2009). Working, sex partner age differences, and sexual behavior among African American youth. Archives of Sexual Behavior, 38(5), 802-813. PMID: 18574686 (Epub 2008 Jun 24)
View in PubMed | AbstractParticipation in the workplace has been proposed as a potential structural-level HIV/STI prevention strategy for youth. Only a few cross-sectional studies have explored the effect of work during adolescence and young adulthood on sexual behavior and their results have been mixed. This study builds on this literature by exploring whether work influences youths' sexual behavior in a cohort of African American youth (N = 562; 45% males; M = 14.5 years, SD = 0.6) followed from adolescence to young adulthood (ages 13-25 years). Using growth curve modeling, we tested whether working was associated with older sex partners. Then, we explored the association between sex partner age differences and sexual behaviors (i.e., number of sex partners, condom use, and frequency of sexual intercourse). Finally, we tested whether the relationship between sex partner age differences and sexual behaviors was confounded by working. Working greater number of hours was not significantly associated with having older sex partners. Sex partner age differences was associated with number of partners, condom use, and higher sex frequency. These associations were larger for females. Working was associated with higher sex frequency, after accounting for age differences. We discuss the implications of these findings for future research and program planning, particularly in the context of youth development programs.|
Project: Flint Adolescent Study

Bauermeister, J.A., Zimmerman, M., Caldwell, C, Xue, Y., & Gee, G.  (2009). What predicts sex partner age differences among African American youth? A longitudinal study from adolescence to young adulthood.  Journal of Sex Research, 10:1-15. PMID: 19517294
View in PubMed |Abstract Partner age is associated with youth's sex risk behaviors and sexually transmitted infections. At present, however, it is not known whether the co-occurrence of other risk behaviors is associated with having older sex partners during adolescence and young adulthood. Using growth curve modeling, this study first describes the shape of the age difference between participants and their sex partners across adolescence and young adulthood in a sample of African American youth. Second, whether this model varied systematically by sex, mother's education, and high school dropout was tested. Third, whether age differences were associated with youth's self-acceptance, alcohol use, and employment trajectories over these two developmental periods was assessed. Finally, whether these associations had non-proportional effects over both periods was tested. This study modeled sex partners' age differences nonlinearly, with females being more likely to date older partners at baseline and over time. High school dropouts also reported older partners at baseline. Self-acceptance and the number of hours worked were associated with sex partners' age differences over time, with the effect decreasing over young adulthood years. Alcohol use frequency was also associated with having older partners over time. This study discusses the findings from a health perspective on youth's sexual development. |
Project: Flint Adolescent Study

Bauermeister, J.A.., Zimmerman, M.A., Gee, G.C., Caldwell, C. & Xue, Y. (2009). Work and Sexual Trajectories Among African American Youth. Journal of Sex Research, 46(1): 1-11. PMID: 19137477
View in PubMed |Abstract The beneficial or deleterious effects of employment on youth and well-being have been highly contested. This study explores whether work influences youths' sexual risk correlates in a sample of African Americans (N = 562; 55% females; M = 14.5 years, SD = 0.6 years) followed longitudinally from adolescence to early adulthood. The study used growth curve modeling to test the association between number of hours worked and condom use, sex partners' age differences, and number of partners over time. Working a greater number of hours was associated with less condom use, with the effect varying by youths' grade point average. Working a greater number of hours was associated with older sex partners among female youth. No association was found between work and number of partners. The findings suggest that working during adolescence and early adulthood increased participants' sexual activity, thus lending some support for the work consequences perspective. The implications for future research and youth development programs are discussed. |
Project: Flint Adolescent Study

Clark SJ, Cowan AE, Wortley PM. (2009) Influenza vaccination attitudes and practices among US registered nurses. American Journal of Infection Control. 37(7), 551-6. PMID: 19556035
View in PubMed |Abstract The influenza vaccination rate among US health care personnel (HCP) remains low and may vary by occupational categories. The objective of this study was to explore knowledge, attitudes, and beliefs associated with influenza vaccination in a broad population of registered nurses. METHODS: The study used a cross-sectional mail survey, administered January-March 2006, of 2000 registered nurses in 4 US states. RESULTS: Of the 2000 surveys sent, 1310 (72%) were returned, and 1017 (67%) were eligible for analysis. The majority of respondents (59%) reported receiving influenza vaccine during the 2005-2006 influenza season. The most common reason for being vaccinated was protecting oneself from illness (95%), and the most common reason for not being vaccinated was concern about adverse reactions (39%). Respondents who reported their patient population as high risk related to influenza were more likely to be vaccinated and to agree with statements regarding influenza disease and influenza vaccination of HCP. CONCLUSION: Concerns about adverse reactions and vaccine effectiveness continue to be barriers to influenza vaccination among registered nurses. Those most knowledgeable about influenza vaccination of HCP have higher vaccination rates. Future efforts to improve vaccination rates should include data on vaccine effectiveness and adverse effects, as well as descriptions of high-risk populations. |
Project: Variations in Immunization Practices

Clark SJ, Cowan AE, Wortley PM. (2009). Worksite policies related to influenza vaccination: a cross-sectional survey of US registered nurses. Hum Vaccine. 5(8), 545-50. PMID: 19458489
View in PubMed |Abstract The influenza vaccination rate among US health care personnel (HCP) remains low and may vary by occupational categories. The objective of this study was to explore knowledge, attitudes, and beliefs associated with influenza vaccination in a broad population of registered nurses. METHODS: The study used a cross-sectional mail survey, administered January-March 2006, of 2000 registered nurses in 4 US states. RESULTS: Of the 2000 surveys sent, 1310 (72%) were returned, and 1017 (67%) were eligible for analysis. The majority of respondents (59%) reported receiving influenza vaccine during the 2005-2006 influenza season. The most common reason for being vaccinated was protecting oneself from illness (95%), and the most common reason for not being vaccinated was concern about adverse reactions (39%). Respondents who reported their patient population as high risk related to influenza were more likely to be vaccinated and to agree with statements regarding influenza disease and influenza vaccination of HCP. CONCLUSION: Concerns about adverse reactions and vaccine effectiveness continue to be barriers to influenza vaccination among registered nurses. Those most knowledgeable about influenza vaccination of HCP have higher vaccination rates. Future efforts to improve vaccination rates should include data on vaccine effectiveness and adverse effects, as well as descriptions of high-risk populations. |
Project: Variations in Immunization Practices

Dempsey AF, Cowan AE, Broder KR, Kretsinger K, Stokley S, Clark SJ. (2009). Diagnosis and testing practices for adolescent pertussis among a national sample of primary care physicians. Preventive Medicine, 48, 500-4. PMID: 19264095
View in PubMed |Abstract Adolescents are a primary reservoir for propagating pertussis infection. This study aimed to describe diagnosis and testing practices for adolescent pertussis among a national sample of primary care physicians. METHODS: From January to March, 2007 we administered a written survey to a United States sample of American Medical Association physicians that included 725 family practitioners (FPs) and 725 general pediatricians (PDs). RESULTS: Response rate was 60% (n=702). Overall, 16% of respondents indicated that they did not test adolescents for pertussis as part of their clinical practice. A similar proportion did not recognize the clinical manifestations of pertussis in a standardized adolescent case patient. FPs were less likely than PDs to test for pertussis in general and to diagnose the case patient with pertussis. Barriers to testing adolescents for pertussis included delay in obtaining test results (52%), inconvenience of sample collection (29%), lack of testing supplies (29%), lack of familiarity with testing protocols (28%) and cost (22%). CONCLUSION: Our results suggest that a substantial number of primary care physicians do not utilize pertussis testing and may not be able to recognize the clinical symptoms of this infection in adolescents. Interventions to improve physician knowledge about this important public health issue may be warranted. |
Project: Variations in Immunization Practices

Dempsey AF, Cowan AE, Broder KR, Kretsinger K, Stokley S, Clark SJ. (2009). Adolescent TDAP vaccine utilization among primary care physicians. Journal of Adolescent Health 44, 387-93.
Project: Variations in Immunization Practices

Franzen, S., Morrel-Samuels, S., Reischl, T., & Zimmerman, M. (2009). Using Process Evaluation to Strengthen Intergenerational Partnerships in the Youth Empowerment Solutions Program. Journal of Intervention and Prevention in the Community. 37(4), 289-301. PMID: 19830624
View in PubMed |Abstract This study illustrates the utility of process evaluation methods for improving a new violence prevention program, Youth Empowerment Solutions for Peaceful Communities (YES). The YES program empowered young adolescents to plan and complete community improvement projects with neighborhood adult advocates. The process evaluation methods included questionnaires and focus groups with students and interviews with neighborhood advocates. Process evaluation results guided program improvements for the second year. The process evaluation results after the second program year suggested that the program improvements were associated with higher student ratings of program staff and neighborhood advocates. The students and neighborhood advocates reported increased positive experiences after the second program year, but continued to note the challenges of working inter-generationally on community improvement projects. |
Project: Youth Empowerment Solutions

Holden, D.J., Zimmerman, M.A. (Eds.) (2009). A Practical Guide to Program Evaluation Planning. Thousand Oaks, CA: Sage.
Project: Other

Hurd, NM, Zimmerman, MA, & Xue, Y. (2009). Negative adult influences and the protective effects of role models: A study with urban adolescents. Journal of Youth and Adolescence, 38(6), 777-789. PMID: 19636780 [ View Abstract]
Project: Flint Adolescent Study

Kretman, S., Zimmerman, M., Morrel-Samuels, S., & Hudson, D. (2009). Adolescent violence: Risk, resilience, and prevention. Adolescent health: Understanding and preventing risk behaviors (pp. 213-232). San Francisco, CA US: Jossey-Bass. [E-book]
Project: Youth Empowerment Solutions

Kruger, D.J., & De Loney, E. H. (2009). The association of incarceration with community health and racial health disparities. Progress in Community Health Partnerships: Research, Education, and Action, 3(2):113-121.
Link to article | Abstract Background: Bureau of Justice Statistics data indicate that the United States has the highest incarceration rate in the world, and substantial disparities exist between incarceration rates for Whites and minorities. Research on the impact of incarceration usually focuses on the sentenced individual and occasionally on the children of incarcerated parents. The health consequences of incarceration may also extend to other family members and friends left behind in the community, exacerbating racial disparities in physical and mental health. Objectives: We used a community-based public health survey to assess how incarceration of a friend or family member was associated with physical and mental health status. Methods: Participants provided information on physical and mental health status in a county- wide telephone health interview. Results: Controlling for demographics and health-related behaviors, individuals knowing someone who was recently incarcerated reported worse mental and physical health. Blacks were more likely to report knowing someone who was incarcerated and also felt closer to the incarcerated individuals. The degree of felt closeness with someone incarcerated was positively correlated with worse physical health (Pearson r = 0.14; P < .01) and mental health (Pearson r = 0.09; P < .05). Conclusions: Our results indicate that the incarceration of close others influences mental and physical health and the health disparities between Blacks and Whites. More attention should be given to the potential effects of incarceration on the people closest to those incarcerated.|
Project: Speak to Your Health! Community Survey

Kruger, D.J., Lewis, Y., & Schlemmer, E.R. (2009). Mapping a message for faith leaders: Encouraging community health promotion with local health data. Health Promotion Practice. Epub ahead of print.
View in PubMed |Abstract This study reports the use of a community-based health survey to share local health information with faith leaders. Geographical information systems software identified survey respondents within 2 km (1.25 miles) of places of worship. Results were tabulated for the community surrounding each place of worship and were compared with city- and county-level data. Faith leaders were presented with community-specific reports describing the health attributes of residents who lived in the surrounding area, in order to assist with the identification issues of concern and opportunities to develop health ministries to address these issues. Faith leaders were encouraged to share this information with members of their faith community and develop means of obtaining additional information on the people of interest. We believe that engaging faith leaders with neighborhood-specific health information will be critical in providing an understanding of the importance of their voice in improving health outcomes of their faith community, the surrounding neighborhood, and the community at large. Our goal is to empower faith leaders to understand personal and community health issues and to act as a conduit for health-related information and health promotion at a local level. Church health teams developed an HIV and sexually transmitted infection prevention program for African American adolescents and young adults. PMID: 1916889 |
Project: Speak to Your Health! Community Survey

Kruger, D.J., Morrel-Samuels, S., Davis-Satterla, L., Harris-Ellis, B. J., & Slonim, A. (2009). Developing a cross-site evaluation tool for diverse health interventions. Health Promotion Practice. E-pub ahead of print.
View in PubMed |Abstract The Prevention Research Center of Michigan provided technical assistance for the evaluation of 10 projects funded by the Michigan Department of Community Health's (MDCH) Health Disparities Reduction Program. These projects varied considerably in focus, methodology, geographical coverage, and populations served. The authors developed a cross-site evaluation tool to complement the internal evaluations of the projects. The tool contains four sections based on priorities identified by MDCH: evidence-based practice, research-based learning/evaluation (including process, impact, and outcomes indicators), cultural competence, and sustainability. Recognizing the diversity of programmatic efforts and organizational evaluation capacity, the authors sought to enable each project to create the best evaluation possible given the resources and data available. Each section contains a range of components from basic questions to more advanced evaluation techniques. The instrument attempts to use the highest quality of information available for each project. This evaluation tool can be used by programs with diverse goals and methodology. |
Project: Cross Site Evaluation of MDCH Health Disparity Reduction Program

Kruger, D. J., Shirey, L. A., Morrel-Samuels, S., Skorcz, S., & Brady, J. S. (2009). Using a community-based health survey as a tool for informing local health policy. Journal of Public Health Management and Policy, 47(1): 47-53.
View in PubMed |Abstract BACKGROUND: The Speak to Your Health! community survey is a biennial community-based survey designed and implemented by the Prevention Research Center of Michigan whose central mission is to strengthen the capacity of the community to improve health. METHOD: The survey was developed collaboratively by the university and community partners that comprise the Prevention Research Center of Michigan and focuses on health and social issues at the heart of the community of Genesee County, Michigan. FINDINGS: The results of this survey have been used to shape policy changes and strategic planning at the county health department and in local health intervention programs. CONCLUSIONS: This project has demonstrated that useful quantitative data for addressing local public health policy and planning can be collected using the principles of community-based research. |
Project: Speak to Your Health! Community Survey

Walton, M., Cunningham, R., Goldstein, A., Chermack, S., Zimmerman, M., Bingham, C., et al. (2009). Rates and correlates of violent behaviors among adolescents treated in an urban emergency department. Journal of Adolescent Health, 45(1), 77-83.
Project: Other

Xue Y, Zimmerman MA, & Cunningham, R. (2009).  Relationship between alcohol use and violent behavior among urban African-American youths from adolescence to emerging adulthood: A Longitudinal Study. American Journal of Public Health. 99(11), 2041-8. PMID: 19762672
View in PubMed |Abstract We examined developmental trajectories of alcohol use and violent behavior among urban African American youths and the longitudinal relationship between these behaviors from adolescence to emerging adulthood. METHODS: Our sample included 649 African American youths (49% male) followed for 8 years. We assessed violent behavior and alcohol use by asking participants how often they had engaged in each behavior in the preceding 12 months. Growth curve analyses were conducted to identify the developmental trajectories of the 2 behaviors and to explore the longitudinal relationship between them. RESULTS: Violent behavior peaked in middle to late adolescence and declined thereafter, whereas the frequency of alcohol use increased steadily over time. These developmental trajectories varied according to gender. Among both male and female participants, early violent behavior predicted later alcohol use, and early alcohol use predicted later violent behavior. Moreover, changes in one behavior were associated with changes in the other. CONCLUSIONS: Our results support a bidirectional relationship between alcohol use and violent behavior. Efforts to reduce one problem can be expected to reduce the other. Programs and policies aimed at reducing violence or alcohol use among adolescents should take into account this relationship. |
Project: Flint Adolescent Study

Alaimo, K., Packnett, E., Miles, R. A., & Kruger, D. J. (2008). Fruit and vegetable intake among urban community gardeners. Journal of Nutrition Education and Behavior, 40(2), 94-101.
View in PubMed |Abstract OBJECTIVE: To determine the association between household participation in a community garden and fruit and vegetable consumption among urban adults. DESIGN: Data were analyzed from a cross-sectional random phone survey conducted in 2003. A quota sampling strategy was used to ensure that all census tracts within the city were represented. SETTING: Flint, Michigan. PARTICIPANTS: 766 adults. VARIABLES MEASURED: Fruit and vegetable intake was measured using questionnaire items from the Behavioral Risk Factor Surveillance System. Household participation in a community garden was assessed by asking the respondent if he or she, or any member of the household, had participated in a community garden project in the last year. ANALYSIS: Generalized linear models and logistic regression models assessed the association between household participation in a community garden and fruit and vegetable intake, controlling for demographic, neighborhood participation, and health variables. RESULTS: Adults with a household member who participated in a community garden consumed fruits and vegetables 1.4 more times per day than those who did not participate, and they were 3.5 times more likely to consume fruits and vegetables at least 5 times daily. CONCLUSIONS AND IMPLICATIONS: Household participation in a community garden may improve fruit and vegetable intake among urban adults. |
Project: The Community Garden Storytelling Project of Flint

Allen, J.O., Alaimo, K., Elam, D., & Perry, E. (2008). Growing vegetables and values: Benefits of neighborhood-based community gardens for youth development and nutrition. Journal of Hunger and Environmental Nutrition, 3(4), 418-439.
Link to Journal | Abstract Community gardens are one way that residents have mobilized to beautify urban neighborhoods, improve access to fresh produce, and engage youth. Qualitative case studies were conducted of two neighborhood-based community gardens with youth programs. Data collection included participant observation and in-depth interviews with adult gardeners and neighbors, youth, and community police officers. Results suggest that the garden programs provided opportunities for constructive activities, contributions to the community, relationship and interpersonal skill development, informal social control, exploring cognitive and behavioral competence, and improved nutrition. Community gardens promoted developmental assets for involved youth while improving their access to and consumption of healthy foods. |
Project: The Community Garden Storytelling Project of Flint

Dempsey AF, Cowan AE, Stokley S, Messonier M, Clark SJ, Davis MM. (2008) The role of economic information in decision-making by the Advisory Committee on Immunization Practices. Vaccine, 26, 5389-92. PMID: 18708111
View in PubMed |Abstract With cost of vaccines steadily increasing, recommendations of the Advisory Committee on Immunization Practices (ACIP) have growing economic implications for the public. We used semi-structured telephone interviews to assess the knowledge, attitudes, and practices of the 15 voting members of the 2006-2007 ACIP regarding the use of economic information by the committee in their deliberations about new vaccine recommendations. These interviews demonstrated the importance of economic information in ACIP deliberations, but also revealed that many members felt economic information should not be outweighed by the more important issues of vaccine efficacy, disease burden, and safety. In addition, though members had variable levels of expertise in analyzing economic data, there was a general concern that assumptions inherent in the development of cost-effectiveness models made interpretation of the data resulting from these models difficult. To counteract this concern, several ACIP members suggested standardizing the process of how economic data are presented to the committee so that a more uniform consideration of consequential information might be undertaken by the ACIP in their deliberations. |
Project: Variations in Immunization Practices

Freed GL, Cowan AE, Clark SJ. (2008) Variation in provider vaccine purchase prices and payer reimbursement. Pediatrics, 122, 1325-31.PMID: 19047253
View in PubMed |Abstract The purpose of this work was to collect data regarding vaccine prices and reimbursements in private practices. Amid reports of physicians losing money on vaccines, there are limited supporting data to show how much private practices are paying for vaccines and how much they are being reimbursed by third-party payers. METHODS: We conducted a cross-sectional survey of a convenience sample of private practices in 5 states (California, Georgia, Michigan, New York, and Texas) that purchase vaccines for administration to privately insured children/adolescents. Main outcome measures included prices paid to purchase vaccines recommended for children and adolescents and reimbursement from the 3 most common, non-Medicaid payers for vaccine purchase and administration. RESULTS: Detailed price and reimbursement data were provided by 76 practices. There was a considerable difference between the maximum and minimum prices paid by practices, ranging from $4 to more than $30 for specific vaccines. There was also significant variation in insurance reimbursement for vaccine purchase, with maximum and minimum reimbursements for a single vaccine differing from $8 to more than $80. Mean net yield per dose (reimbursement for vaccine purchase minus price paid per dose) varied across vaccines from a low of approximately $3 to more than $24. Reimbursement for the first dose of vaccine administered ranged from $0 to more than $26, with a mean of $16.62. CONCLUSIONS: There is a wide range of prices paid by practices for the same vaccine product and in the reimbursement for vaccines and administration fees by payers. This variation highlights the need for individual practices to understand their own costs and reimbursements and to seek opportunities to reduce costs and increase reimbursements. |
Project: Variations in Immunization Practices

Freed GL, Cowan AE, Gregory S, Clark SJ. (2008) Primary care physician perspectives on reimbursement for childhood immunizations. Pediatrics,122, 1319-24. PMID: 19047252
View in PubMed |Abstract The purpose of this research was to explore physicians' attitudes and behaviors related to vaccine financing issues within their practice. Amid the increasing number of vaccine doses recommended for children and adolescents, anecdotal reports suggest that physicians are facing increasing financial pressures from vaccine purchase and administration and may stop providing vaccines altogether to privately insured children. Whether these sentiments are widely held among immunization providers is unknown. METHODS: We conducted a cross-sectional mail survey from July to September 2007 of a random sample of 1280 US pediatricians and family physicians engaged in direct patient care. Main outcome measures included delay in the purchase of specific vaccines for financial reasons; reported decrease in profit margin from immunizations; and practice consideration of whether to stop providing all vaccines to privately insured children. RESULTS: The response rate was 70% for pediatricians and 60% for family physicians. Approximately half of the respondents reported that their practice had delayed the purchase of specific vaccines for financial reasons (49%) and experienced decreased profit margin from immunizations (53%) in the previous 3 years. Twenty-one percent of respondents strongly disagreed that "reimbursement for vaccine purchase is adequate," and 17% strongly disagreed that "reimbursement for vaccine administration is adequate." Eleven percent of respondents said their practice had seriously considered whether to stop providing all vaccines to privately insured children in the previous year. CONCLUSIONS: Physicians who provide vaccines to children and adolescents report dissatisfaction with reimbursement levels and increasing financial strain from immunizations. Although large-scale withdrawal of immunization providers does not seem to be imminent, efforts to address root causes of financial pressures should be undertaken. |
Project: Variations in Immunization Practices

Griffith, D. M., Allen, J. O., Zimmerman, M. A., Morrel-Samuels, S., Reischl, T. M., Cohen, S. E., et al. (2008). Organizational empowerment in community mobilization to address youth violence. American Journal of Preventive Medicine, 34(3 Suppl), S89-99.
View in PubMed |Abstract Community mobilization efforts to address youth violence are often disconnected, uncoordinated, and lacking adequate resources. An organizational empowerment theory for community partnerships provides a useful framework for organizing and evaluating a coalition's community mobilization efforts and benefits for individual organizations, partnerships, and communities. Based on a qualitative analysis of steering committee interviews and other primary data, the results of a case study suggest that the intraorganizational infrastructure; interorganizational membership practices and networking; and extraorganizational research, training, and organizing activities facilitate the community mobilization efforts of the Youth Violence Prevention Center in Flint, Michigan. The organizational empowerment framework, and its focus on organizational structures and processes, illustrates the importance of recognizing and incorporating the organizational systems and structures that provide the foundation on which a community mobilization effort may build. This framework also highlights how organizational structures and processes are central components of multilevel strategies for organizing and mobilizing community efforts to address youth violence. |
Project: Youth Violence Prevention Center

Griffith, D. M., & Griffith, P. A. (2008). Commentary on "perspective on race and ethnicity in alzheimer's disease research". Alzheimer's & Dementia 4(4), 239-241. doi:10.1016/j.jalz.2007.10.014 (Epub 2007 Dec 21)
View in PubMed |Abstract There are persistent disparities in Alzheimer's disease by race and ethnicity that are not well understood. The emphasis given to seeking a genetic basis for racial differences might be a distraction from the more relevant issue of identifying preventable causes of Alzheimer's disease. The majority of Alzheimer's disease cases are diagnosed as the late onset type and are unlikely to be inherited. Late onset Alzheimer's disease cases, therefore, more likely represent variations in gene expression than gene frequency. Although conceptual and methodologic problems have limited our understanding of this relationship, race-based studies provide important opportunities to understand the environmental factors associated with gene expression. Improving our understanding of the factors associated with race and ethnicity might help to clarify the epidemiology and course of Alzheimer's disease. |
Project: Other

Kannan, S., Webster, D., Sparks, A., Acker, C. M., Greene-Moton, E., Tropiano, E., et al. (2008). Using a cultural framework to assess the nutrition influences in relation to birth outcomes among African American women of childbearing age: Application of the PEN-3 theoretical model. Health Promotion Practice.
View in PubMed |Abstract The purpose is to present the process and results of focus groups conducted to access information for the design of a healthy eating curriculum to reduce maternal nutritional risks and enhance protective factors among African American women in relation to birth outcomes. Sixteen younger (19 to 25 years) and 20 older African American women (45 to 60 years), respectively, participated. The PEN-3 model, (Airhihenbuwa, 1995, 1999) guided the focus groups. Most women stated that culture and family relationships impacted their food choices. Younger women expressed creativity with recipes and presented a desire to be more involved with preparing foods. Older women expressed eagerness to teach family-centered culinary skill-building classes. Both groups of women acknowledged time and budget barriers, identified the prevalence of lactose intolerance, and recognized that large grocery stores that offered food variety were not located in their community. Health professionals are encouraged to consider these findings while designing interventions targeting young African American women's nutrition in relation to birth outcomes. |
Project: REACH 2010 Enhanced Evaluation

Kruger, D.J., Brady, J.S., & Shirey, L.A. (2008). Using GIS to facilitate community-based public health planning of diabetes intervention efforts. Health Promotion Practice, 9(1), 76-81. PMID: 17494946
View in PubMed |Abstract Data from a community survey were analyzed geographically to help facilitate local diabetes prevention efforts. Data were available from the Speak to Your Health! Community Survey, designed and implemented by The Prevention Research Center of Michigan (PRC/MI), whose central mission is to strengthen community capacity to improve health. This survey was developed collaboratively by the university and community partners that comprise the PRC/MI and focuses on health and social issues at the heart of the community of Genesee County, Michigan. Survey data were used to calculate and geographically map diabetes-risk scores and mapped diabetes-screening rates. These maps indicated that those areas where the estimated risk of diabetes was the highest had only moderate rates of diabetes screening relative to other areas. It is hoped that these results will reach those involved in local diabetes-intervention programs with the intent that the data will be used in planning local prevention and intervention efforts. |
Project: Speak to Your Health! Community Survey

Kruger, D.J., Reischl, T.M., & Zimmerman, M.A. (2008). Time perspective as a mechanism for functional developmental adaptation. Journal of Social, Evolutionary and Cultural Psychology, 2, 1-22.
>>View Article
Project: Speak to Your Health! Community Survey

Kruger, D.J. (2008). Human life history variation and sex differences in mortality rates. Special Issue: Proceedings of the 2nd Annual Meeting of the NorthEastern Evolutionary Psychology Society. Journal of Social, Evolutionary, and Cultural Psychology, 2(4), 281-288.
>>View article
Project: Other

Reischl, T., & Franzen, S. (2008) " Call and Response: Developing a Collaborative Evaluation Plan for a New Community-Based Program" in D. Holden, & M. Zimmerman (2008). Program Evaluation Planning: From Start to Design.  New York, Sage Publications.
Project: Other

Reischl, T.M., Sarigiannis, A. N., & Tilden, J.Jr. (2008). Assessing emergency response training needs of local environmental health professionals. Journal of Environmental Health, 71(2), 14-19. PMID: 18807819
View in PubMed |Abstract The Michigan Center for Public Health Preparedness collaborated with environmental health (EH) professionals at the local, state, and national levels to develop and conduct a state-wide study to identify the preparedness-training needs of local EH professionals in Michigan. The specific aims of the study were first, to determine the self-rated level of confidence among Michigan's EH professionals regarding relevant emergency planning and response competencies; second, to determine the specific preparedness training topic preferences of Michigan's EH professionals; and third, to establish baseline needs assessment data to be used to track progress toward higher levels of readiness after implementation of planning, training, and other preparedness activities. The study recruited 400 EH professionals to complete the survey (61% of all EH professionals in 45 local health departments in Michigan). The top training topic preferences were "environmental health role in emergencies" followed by "water security" and "food security." The EH professionals rated their confidence in demonstrating relevant emergency planning and response competencies. Most of the average ratings (on a 5-point scale) were close to the scale's middle point (rating = 3), suggesting that EH professionals rate themselves as "somewhat confident" in performing important tasks in preparedness and response. Variations in specific ratings helped identify training needs. The discussion of these results focused on the implications of this study for the development of emergency response training for environmental health professionals. |
Project: Other

Salem, D.A., Reischl, T. M., & Randall, K. W. (2008). The effect of professional partnership on the development of a mutual-help organization. American Journal of Community Psychology, 42(1-2), 179-191.
View in PubMed |Abstract The effects of partnership between Schizophrenics Anonymous (SA, a mutual-help organization) and the Mental Health Association in Michigan (MHAM, a professionally staffed advocacy organization) on SA's growth and development were explored. Following the initiation of a formal partnership, SA groups were more available throughout the state, more likely to be associated with formal mental health settings, and less likely to have leaders who had been participants in other SA groups. Groups with consumer leaders had significantly greater longevity than groups with professional leaders. Changes in the organizational structure and process of SA were also identified. SA leaders reported that SA moved from a collective to a more bureaucratic structure. As a result, there was greater consistency, administrative capacity, and response capacity. This enhanced capacity came with costs reported by SA leaders. The leadership role of SA members became less defined. SA members expressed concerns about the more hierarchical structure of SA's organization, decreased consumer control, increased professional involvement in SA, and an excessive focus on group development as opposed to group maintenance. Mental Health Association in Michigan staff reported that MHAM was also impacted by the partnership, both with regard to internal functioning and external perception. Implications for effective partnerships between mutual-help and professional organizations are discussed. |
Project: Other

Shirey, L.A., Griffith, D. M., Brady, J. S., Kruger, D. J., Morrel-Samuels, S., & Greene-Moton, E. (2008). Challenges and lessons learned in developing a community-based health survey. Progress in Community Health Partnerships, 2(2), 99-104.
View article| Abstract Background: Collecting community-level data to inform health interventions and monitor health status is critical to improving community health and eliminating health disparities. Ideally, the process for designing and utilizing these data collection tools will include representation from community, service, and academic institutions. The process for incorporating these entities' diverse needs and perspectives, however, can be challenging. Objectives: This paper describes how a community-academic partnership designed a survey in 2003 and 2005 to examine factors influencing the health of residents in an urban city and surrounding county area. Methods: The partnership used community-based public health research principles to guide the development of the telephone surveys. Lessons Learned: Through these two survey development processes, we learned three key lessons: To regularly examine our partnership and process; to communicate directly with and obtain the support of each individual partner; and to focus on building the capacity of the partners and partnership. |
Project: Speak to Your Health! Community Survey

Walton, M., Cunningham, R., Xue, Y., Trowbridge, M., Zimmerman, M., & Maio, R. F. (2008). Internet referrals for adolescent violence prevention: An innovative mechanism for inner-city emergency departments. Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine, 43(3), 309-312. doi:10.1016/j.jadohealth.2008.01.016
View in PubMed |Abstract Internet referrals provide a potential solution to limited staff time in emergency departments for health education. One hundred fifteen adolescents were surveyed and referred to a violence prevention website; 22% logged on the website. Although this study bears replication, Internet referral may be a low-intensity intervention that could compliment other violence prevention strategies among adolescents. |
Project: Youth Violence Prevention Center

Woolley, M.E., Grogan-Kaylor, A., Gilster, M. E., Karb, R., Gant, L. M., Reischl, T. M., et al. (2008). Neighborhood social capital, poor physical conditions and school achievement. Children & Schools, 30(3), 133-145.
Abstract Success in school is a vital developmental outcome for children. In recent decades, it has been shown that school outcomes are influenced by a variety of environments and social processes in the lives of children, both within and across the central microsystems of family, school, and neighborhood. The current study used a multilevel analytic strategy and three data sources - a community survey, the 2000 census, and citywide school achievement data - to examine the association between neighborhood social capital and physical conditions with academic achievement. The sample comprised predominantly African American children in first through eighth grades in a midsized Midwest industrial city. Results revealed that increased levels of neighborhood bonding social capital and lower levels of poor physical conditions were predictive of higher student scores on achievement tests in math and reading. In addition, as children progressed from the first through the eight grades, the magnitude of the effect of bonding social capital and poor neighborhood physical conditions on school achievement increased. |
Project: Speak to Your Health! Community Survey

Davis MM, Cowan AE, Marin M, Guris D, Clark SJ. (2007). Physician attitudes regarding breakthrough varicella disease and a potential second dose of varicella vaccine. Pediatrics, 119, 258-64. PMID: 17272614
View in PubMed |Abstract We assessed physicians' attitudes about the 1-dose varicella vaccination program and whether physicians think a 2-dose recommendation is needed to reduce the risk of breakthrough disease. METHODS: We conducted a national mail survey of a random sample of 550 pediatricians and 550 family physicians from April to June 2005. Physicians who provide outpatient primary care to children < or = 6 years of age were eligible for analysis. RESULTS: Surveys were returned by 727 respondents, for a response rate of 69%; 610 physicians were eligible. Most respondents (94%) recommend routine 1-dose varicella vaccination, and 79% have seen breakthrough disease in the past 5 years (95% of pediatricians and 58% of family physicians). The majority (68%) agreed or strongly agreed that the current burden of breakthrough disease is acceptable. Only 38% (46% of pediatricians and 28% of family physicians) agreed or strongly agreed that a second dose of varicella vaccine is needed to address the burden of breakthrough disease, whereas 40% were neutral. However, if the Advisory Committee on Immunization Practices were to recommend a second dose of varicella vaccine, then 65% of pediatricians and 39% of family physicians would likely follow the recommendation. Most respondents (78%) would be more willing to recommend a second dose if a combination measles-mumps-rubella-varicella vaccine was available. CONCLUSIONS: Pediatricians and family physicians support the 1-dose varicella vaccination program. A new Advisory Committee on Immunization Practices recommendation for a second dose of varicella vaccine for children was issued after the survey (in June 2006). Two of 3 pediatricians and 2 of 5 family physicians stated that they would adopt a 2-dose recommendation in practice; rates of adoption may be bolstered with current availability of measles-mumps-rubella-varicella vaccine and harmonization of the varicella vaccination schedule with that of measles-mumps-rubella vaccine.|
Project: Variation in Immunization Practices

Fergus, S., Zimmerman, M. A., & Caldwell, C. H. (2007). Growth trajectories of sexual risk behavior in adolescence and young adulthood. American Journal of Public Health, 97(6), 1096-1101.
View in PubMed |Abstract OBJECTIVES: Adolescence and young adulthood (ages 18-25 years) are periods of development and change, which include experimentation with and adoption of new roles and behaviors. We investigated longitudinal trajectories of sexual risk behaviors across these time periods and how these trajectories may be different for varying demographic groups. METHODS: We developed multilevel growth models of sexual risk behavior for a predominantly African American sample (n=847) that was followed for 8 years, from adolescence to young adulthood. We investigated differences in growth parameters by race/ethnicity and gender and their interactions. RESULTS: The final model included linear and quadratic terms for both adolescence and young adulthood, indicating acceleration of sexual risk behaviors during adolescence and a peak and deceleration during young adulthood. African American males exhibited the highest rate of sexual risk behavior in ninth grade, yet had the slowest rate of growth. Compared with their White peers, African American males and females exhibited less sexual risk behavior during young adulthood. CONCLUSIONS: Our results suggest that youths of different races/ethnicities and genders exhibit varying sexual risk behavior trajectories. |
Project: Flint Adolescent Study

Griffith, D.M., Childs, E.L., Eng, E., & Jeffries, V. (2007). Racism in organizations: The case of a county health department. Journal of Community Psychology, 35(3), 287-302.
View in PubMed |Abstract Racism is part of the foundation of U.S. society and institutions, yet few studies in community psychology or organizational studies have examined how racism affects organizations. This paper proposes a conceptual framework of institutional racism, which describes how, in spite of professional standards and ethics, racism functions within organizations to adversely affect the quality of services, the organizational climate, and staff job satisfaction and morale. Grounded in systems theory and organizational empowerment, the framework is based on data that describe how racism was made manifest in a county public health department. The findings highlight the importance of understanding how organizations are influenced by external forces and can negatively affect clients, communities, and their own staff members. |
Project: Other

Griffith, D.M., Mason, M., Yonas, M., Eng, E., Jeffries, V., Plihcik, S., et al. (2007). Dismantling institutional racism: Theory and action. American Journal of Community Psychology, 39(3-4), 381-392.
View in PubMed |Abstract Despite a strong commitment to promoting social change and liberation, there are few community psychology models for creating systems change to address oppression. Given how embedded racism is in institutions such as healthcare, a significant shift in the system's policies, practices, and procedures is required to address institutional racism and create organizational and institutional change. This paper describes a systemic intervention to address racial inequities in healthcare quality called dismantling racism. The dismantling racism approach assumes healthcare disparities are the result of the intersection of a complex system (healthcare) and a complex problem (racism). Thus, dismantling racism is a systemic and systematic intervention designed to illuminate where and how to intervene in a given healthcare system to address proximal and distal factors associated with healthcare disparities. This paper describes the theory behind dismantling racism, the elements of the intervention strategy, and the strengths and limitations of this systems change approach. |
Project: Other

Griffith, D. M., Mason, M. A., Rodela, M., Matthews, D. D., Tran, A., Royster, M., et al. (2007). A structural approach to examining prostate cancer risk for rural southern African American men. Journal of Health Care for the Poor and Underserved, 18(4 Suppl), 73-101.
View in PubMed |Abstract Physical, cultural, and social factors influence health risk and behavior, but few have explored how the environmental context affects African American men's prostate cancer screening and treatment. This paper describes a structural analysis of data from eight focus groups of rural, southern African American men (n=66). A structural approach highlights the interrelationships between individuals, the health service system, and community factors that directly and indirectly affect screening and treatment for prostate cancer. The availability of accurate and timely health information and health services, social norms regarding health and professional help-seeking, and the sociopolitical context shaped men's screening and treatment behaviors. These proximal and distal health factors affected men's prostate cancer knowledge, perceived risk, willingness to seek care and trust in the health service system. The findings suggest that prostate cancer screening and treatment occurs in a larger structural context that has important implications for help-seeking and health promotion. |
Project: Other

Kruger, D. J., Hutchinson, P., Monroe, M. G., Reischl, T. M., & Morrel-Samuels, S. (2007). Assault injury rates, social capital, and fear of neighborhood crime. Journal of Community Psychology, 35(4), 483-498. Link to Journal|AbstractThis study develops an explanatory framework for fear of neighborhood crime based on respondents' social context and local rates of assault injuries. Rates of assault injuries within zip codes are based on hospital discharge records. We find that only four variables have a significant unique contribution to fear of crime: respondent's sex, perceptions of neighborhood social capital, and the rates of struck by/against assault injuries for the 10-24 and 50+ age groups. We also find that the perception of neighborhood social capital moderates the impact of assault injury rates on fear of crime; those who perceive a high level of neighborhood social capital exhibit less sensitivity to assault injury rates. We include a map of assault injury rates and fear of crime by ZIP Code and describe the community context related to our results. |
Project: Youth Violence Prevention Center

Kruger, D. J., Reischl, T. M., & Gee, G. C. (2007). Neighborhood social conditions mediate the association between physical deterioration and mental health. American Journal of Community Psychology, 40(3-4), 261-271.
View in PubMed |Abstract This study investigates how neighborhood deterioration is associated with stress and depressive symptoms and the mediating effects of perceived neighborhood social conditions. Data come from a community survey of 801 respondents geocoded and linked to a systematic on-site assessment of the physical characteristics of nearly all residential and commercial structures around respondents' homes. Structural equation models controlling for demographic effects indicate that the association between neighborhood deterioration and well-being appear to be mediated through social contact, social capital, and perceptions of crime, but not through neighborhood satisfaction. Specifically, residential deterioration was mediated by social contact, then, social capital and fear of crime. Commercial deterioration, on the other hand, was mediated only through fear of crime. Additionally, data indicate that the functional definition of a "neighborhood" depends on the characteristics measured. These findings suggest that upstream interventions designed to improve neighborhood conditions as well as proximal interventions focused on social relationships, may promote well-being. |
Project: Speak to Your Health! Community Survey

Xue, Y., Zimmerman, M. A., & Caldwell, C. H. (2007). Neighborhood residence and cigarette smoking among urban youths: The protective role of prosocial activities. American Journal of Public Health, 97(10), 1865-1872. doi:10.2105/AJPH.2005.081307
View in PubMed |Abstract OBJECTIVES: We examined the association between neighborhood characteristics and cigarette use among adolescents and explored the protective effects of participation in prosocial activities to better understand strengths in adolescents' lives and help identify protective factors for the prevention of adolescent smoking. METHODS: We interviewed ninth graders who had grade point averages of 3.0 or lower and who were not developmentally disabled. Participants' addresses were geocoded so that interview data could be linked to 1990 US census data on neighborhood characteristics. RESULTS: Neighborhood disadvantage and the percentage of Black residents in a neighborhood had different effects on cigarette smoking among Black and White adolescents. Living in a neighborhood with a high percentage of Black residents had favorable effects for Blacks but not for Whites. For both groups, a low percentage of Black residents was a risk factor for cigarette use, and risk effects were higher in the more disadvantaged neighborhoods. Involvement in prosocial activities moderated neighborhood risks. CONCLUSIONS: Neighborhood effects on adolescent cigarette use were contingent upon both contextual and individual characteristics. Participation in prosocial activities had a protective effect among adolescents in high-risk neighborhoods. Engaging adolescents in such activities may help offset the adverse effects of living in a disadvantaged neighborhood. |
Project: Flint Adolescent Study

Clark SJ, Cowan AE, Stokley S, Bilukha O, Davis MM.(2006) Physician perspectives to inform a new recommendation for meningococcal conjugate vaccine (MCV4). Journal of Adolescent Health, 39,850-5. PMID: 17116515
View in PubMed |Abstract In January 2005, the U.S. Food and Drug Administration licensed a new tetravalent meningococcal conjugate vaccine (MCV4). Before any policy decisions by the U.S. Advisory Committee on Immunization Practices (ACIP) related to MCV4, the Centers for Disease Control and Prevention requested a study to explore the perspective of primary care physicians regarding different recommendation scenarios for use of MCV4. METHODS: Cross-sectional mail survey of a national random sample of pediatricians (PDs) and family physicians (FPs), conducted January 2005. Respondents chose from four MCV4 recommendation scenarios in terms of ability to implement, perceived patient/parent preferences, scientific evidence, and overall best fit. RESULTS: Response rate to the single-mailing survey was 57%. In terms of ability to implement, respondents generally preferred an MCV4 recommendation targeted to middle-school entry (11-12 years old) or with the Td booster at any age, but on the basis of scientific evidence they favored MCV4 at high school completion. For "overall best fit," relatively equal proportions of respondents favored a recommendation at middle school entry and one linked to Td booster administration (whenever it occurred); there were no significant differences between PDs and FPs. Major influences on willingness to recommend MCV4 were vaccine safety/side effects and insurance coverage/reimbursement. CONCLUSIONS: Support for an MCV4 recommendation at middle school entry is common but not universal among primary care providers. Data suggest that respondents appreciate the potential discrepancy between practical aspects of vaccine delivery and the need to protect those adolescents at greatest risk of disease. Respondents' preferences for the overall best fit appear to prioritize ease of implementation over epidemiologic patterns. |
Project: Variation in Immunization Practices

Clark SJ, Adolphe S, Davis MM, Cowan AE, Kretsinger K. (2006). Attitudes of US obstetricians toward a combined tetanus-diphtheria-acellular pertussis vaccine for adults. Infectious Disease in Obstetrics and Gynecology 87040, 1-5. PMID: 17485814
View in PubMed |Abstract To describe obstetricians' perspectives related to tetanus-diphtheria-acellular pertussis (Tdap) vaccination of mothers and other adults in close contact with infants. METHODS: Mail survey of national random sample of 400 obstetricians. RESULTS: Response rate was 54%. Most respondents would likely recommend Tdap for women during the postpartum hospital stay (78%) or during pregnancy (69%) if a national recommendation was issued. Expected barriers were knowing the date of patients' most recent Td booster (74%) and patient resistance (46%). Most felt that obstetricians have a role in promoting and administering Tdap vaccine to adults other than mothers likely to come in close contact with infants. CONCLUSION: Obstetricians are likely to agree with the recent provisional US recommendation to administer Tdap to postpartum mothers and other adults expected to come in close contact with infants. Obstetricians would also be likely to support a potential recommendation to administer Tdap during pregnancy. Barriers to adoption of new Tdap vaccine recommendations should be monitored. |
Project: Variation in Immunization Practices

Davis MM, Broder K, Cowan AE, Mijalski C, Kretsinger K, Stokley S, Clark SJ. (2006) Physician attitudes and preferences about combined Tdap vaccines for adolescents. American Journal of Preventive Medicine, 3, 176-80. PMID: 16913066 View in PubMed |Abstract Combined tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) boosters for adolescents are a new strategy to prevent pertussis. We examined the current practices of pediatricians and family physicians regarding adolescent tetanus and diphtheria toxoids (Td) vaccine immunizations and providers' potential adherence to new Tdap recommendations for adolescents. METHODS: Using a brief survey instrument sent to a random sample of pediatricians and family physicians in January 2005, we assessed providers' patterns of administration of Td boosters, barriers to Td boosters, and agreement that pertussis vaccination of adolescents is warranted. Results of analyses in February 2005 were presented to the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC) to inform its deliberations regarding adolescent Tdap vaccination. RESULTS: The overall response rate was 56% (57% pediatricians, 55% family physicians). Among 297 respondents (154 pediatricians, 143 family physicians) eligible for analysis because they provide care to adolescents, pediatricians (77%) were significantly more likely than family physicians (51%, p < 0.0001) to report that they routinely administer Td at preventive care visits for adolescents aged 11 to 12 years, but otherwise the specialties were similar in their Td practices. Forty-four percent of respondents cited infrequency of adolescent visits as a barrier to Td immunization. Slightly more than half the sample (57%) agreed or strongly agreed that pertussis is serious enough to warrant replacing Td with Tdap for adolescents; pediatricians (70%) were significantly more likely than family physicians (42%, p < 0.0001) to endorse this statement. CONCLUSIONS: This national survey indicates moderate willingness, stronger among pediatricians than among family physicians, to support recommendations for Tdap among adolescents. In February 2006, CDC released recommendations that adolescents aged 11 to 18 (preferred age 11 to 12) receive a single dose of Tdap in place of Td if they have not already received the latter. Near-term efforts regarding Tdap recommendations must address providers' concerns about infrequent routine visits for adolescents and convince more physicians of the importance of pertussis booster immunization during adolescence. |
Project: Variation in Immunization Practices

Nesse, R. M., & Kruger, D. J. (2006, January 30). The vulnerable sex. The House Magazine, 4-5. [View Magazine]
Project: Other

Griffith, D. M., Moy, E., Reischl, T. M., & Dayton, E. (2006). National data for monitoring and evaluating racial and ethnic health inequities: Where do we go from here? Health Education and Behavior, 33(4), 470-487.
View in PubMed |Abstract The elimination of racial and ethnic health inequities has become a central focus of health education and the national health agenda. The documentation of an increasing gap in life expectancy and other health outcomes suggests the need for more effective strategies to eliminate health inequities, which can be informed by better monitoring and evaluation data. Although the sophistication and volume of health data available have increased dramatically in recent years, this article examines the quality of the current data collected to achieve the goal of eliminating racial and ethnic health inequities. This article explores several key aspects of data to inform addressing inequities including terminology, the role of data, and explanations of the problem. The authors conclude with recommendations for refining data collection to facilitate the elimination of racial and ethnic health inequities and suggest how the Society for Public Health Education can become a more central figure in our national efforts. |
Project: Other

Hudson, D., Zimmerman, M. A., & Morrel-Samuels, S. (2006). Youth violence prevention: Theory and practice. In A. C. Gielen, D. A. Sleet & R. J. DiClemente (Eds.), Injury and Violence Prevention : Behavioral science theories, methods, and applications (pp. 368-392). San Francisco: Jossey-Bass.
Project: Youth Violence Prevention Center

Kruger, D. J., & Nesse, R. M. (2006). An evolutionary life-history framework for understanding differences in human mortality rates. Human Nature, 17(1), 74-97. [View Journal]
Project: Other

Ostaszewski, K., & Zimmerman, M. (2006). The effects of cumulative risks and promotive factors on Urban adolescent alcohol and other drug use: A longitudinal study of resiliency. American Journal of Community Psychology, 38(3-4), 237-249. doi:10.1007/s10464-006-9076-x.

Selig, S., Tropiano, E., & Greene-Moton, E. (2006). Teaching cultural competence to reduce health disparities. Health Promotion Practice, 7(3 Suppl), 247S-55S.
View in PubMed |Abstract As part of the Genesee County, Michigan, REACH 2010 initiative, a new course, Cultural Competence in Health Care, was developed at the University of Michigan-Flint. The objective of this course is to improve the cultural competence of future health and human service providers and to reduce persistent racial and ethnic health disparities. This article describes the course and the important role that REACH 2010 partners played in its development and implementation. Course materials, methods, and student feedback are summarized, along with lessons learned. |
Project: REACH 2010 Enhanced Evaluation

Alaimo, K., Reischl, T. M., Hutchison, P. M., & Atkinson, A. E. (2005). "We don't only grow vegetables, we grow values": Neighborhood benefits of community gardens in Flint, Michigan. In: D. Brugge, & H. P. Hynes (Eds.), Community Research in Environmental Health: Studies in Science, Advocacy, and Ethics (pp. 123-142). Burlington, VT: Ashgate.
Project: Community Garden Storytelling Project of Flint

Eng, E., Moore, K. S., Rhodes, S. D., Griffith, D. M., Allison, L. L., Shirah, K., et al. (2005). Insiders and outsiders assess who is "the community": Participant observation, key informant interview, focus group interivew and community forum. In B. A. Israel, E. Eng, A. J. Schulz & E. A. Parker (Eds.), Methods in Community-Based Participatory Research for Health (pp. 77-100). San Francisco, CA: Jossey-Bass.
Project: Other

Fergus, S., & Zimmerman, M. A. (2005). Adolescent resilience: A framework for understanding healthy development in the face of risk. Annual Review of Public Health, 26, 399-399-419.
View in PubMed |Abstract Adolescent resilience research differs from risk research by focusing on the assets and resources that enable some adolescents to overcome the negative effects of risk exposure. We discuss three models of resilience-the compensatory, protective, and challenge models-and describe how resilience differs from related concepts. We describe issues and limitations related to resilience and provide an overview of recent resilience research related to adolescent substance use, violent behavior, and sexual risk behavior. We then discuss implications that resilience research has for intervention and describe some resilience-based interventions. |
Project: Flint Adolescent Study

Fergus, S.,Zimmerman, M. A., & Caldwell, C. H. (2005). Psychosocial correlates of smoking trajectories among urban African American adolescents. Journal of Adolescent Research, 20(4), 423-452. [View Journal]
Project: Flint Adolescent Study

Morrel-Samuels, S., & Sincox, A. K. (2005). Changing the health of Michigan's communities through research. The Michigan Nurse, 78(5), 11. PMID: 16101000 [View Journal]
Project: Other

Njai, R., Zimmerman, M. A., Letcher, A., & Bell, L. (2005, Fall). Know Y.A. R.O.O.T.S: A youth empowerment program for violence prevention. Community Youth Development Journal. [View Journal]
Project: Youth Violence Prevention Center

Caldwell, C. H., Kohn-Wood, L. P., Schmeelk-Cone, K. H., Chavous, T. M., & Zimmerman, M. A. (2004). Racial discrimination and racial identity as risk or protective factors for violent behaviors in African American young adults. American Journal of Community Psychology, 33(1-2), 91-105.
View in PubMed |Abstract This study examined the influences of racial discrimination and different racial identity attitudes on engaging in violent behavior among 325 African American young adults. The contributions of racial discrimination and racial identity attitudes in explaining violent behavior during the transition into young adulthood while controlling for the influences of prior risk behaviors at ninth grade were examined separately for males and females. In addition, the buffering effects of racial identity attitudes on the relationship between racial discrimination and violent behavior were tested. Results indicated that experience with racial discrimination was a strong predictor of violent behavior, regardless of gender. The centrality of race for males and the meaning others attribute to being Black for both males and females were moderators of the influence of racial discrimination on violent behavior. |
Project: Flint Adolescent Study

Caldwell, C. H., Sellers, R. M., Bernat, D. H., & Zimmerman, M. A. (2004). Racial identity, parental support and alcohol use in a sample of academically at-risk african american high school students. American Journal of Community Psychology, 34(1-2), 71-82. PMID: 15495795 View in PubMed |Abstract This study examined racial identity and parental support as predictors of alcohol use in a sample of 488 African American adolescents. Two dimensions of racial identity were investigated: (1) racial centrality (i.e., the significance that one places on race in defining oneself) and (2) private regard (i.e., the extent to which one feels positively about Black people). In addition, perceived support from mothers and fathers was examined. Multivariate results showed that private regard and father support were associated with less self-reported alcohol use after partialling out the effects of age and gender. An interaction between the two racial identity dimensions was also found such that private regard was associated with less alcohol use for adolescents who reported that race was a more central part of their identity. |
Project: Flint Adolescent Study

Caldwell, C. H., Wright, J. C., Zimmerman, M. A., Walsemann, K. M., Williams, D., & Isichei, P. A. (2004). Enhancing adolescent health behaviors through strengthening non-resident father-son relationships: A model for intervention with African-American families. Health Education Research, 19(6), 644-656.
View in PubMed |Abstract This paper provides a description of and rationale for components of a theoretically based conceptual model that guided the development and implementation of the Fathers and Sons Intervention Program. Using a community-based participatory research process, this intervention was designed to prevent risky health behaviors through strengthening father-son relationships among non-resident African-American fathers and their pre-adolescent sons. The implications of the conceptual model for future interventions with African-American fathers and sons are discussed. |
Project: Fathers and Sons

Fisher, M. L., Kruger, D.J., Platek, S. M., & Salmon, C. (2004). Reflections from the next generation: These are the voyages of students in evolutionary psychology. Evolutionary Psychology, 2, 160-173. Abstract There appears to be a common belief among evolutionary psychologists that academic positions may be difficult to obtain. Similar to many contemporary students involved in Evolutionary Psychology (EP), we were concerned as to our academic job prospects. This worry seems to be frequently shared by academic supervisors, as a training in EP may make a student undesirable for future academic positions. As recent students in EP who now possess academic positions, we have reflected upon our experiences to provide advice as to what students and their supervisors can do to improve their employment prospects. We begin by individually discussing our backgrounds, including the details of our current positions, and then come together in the discussion section to offer some suggestions to students and supervisors. |
Project: Other

Kruger, D. J., & Nesse, R. M. (2004). Sexual selection and the male:Female mortality ratio. Evolutionary Psychology, 2, 66-85. Abstract |This paper extends the evolutionary understanding of sex differences in mortality rates by quantifying and graphically examining the overall Male to Female Mortality Ratio (M:F MR) for 11 specific leading causes of death across age groups in the USA, over the course of the lifespan in 20 different countries, and across the past 70 years in 5 countries. The resulting quantitative descriptions of rates, trends, and the relative contributions of various proximate causes of death to the M:F MR provide an initial exploration of the risks associated with being male. This analysis also illustrates how sex differences shaped by sexual selection interact in complex ways with multiple aspects of culture and environment to yield a pattern that has some consistency across decades and societies, but also has variations arising from differences among cohorts and cultures. The results confirmed our expectations of higher mortality rates for men than for women, especially in early adulthood, where three men died for every woman who died. For external causes the ratios were even higher. Historical mortality data reflect an epidemiological transition in which discrepancies between male and female mortality rates increase as general mortality rates fall. Cross-national variation in the modern M:F MR further suggests a universal pattern that is influenced by cultural and environmental context. Being male is now the single largest demographic risk factor for early mortality in developed countries. |
Project: Other

Meliker, J.R., Maio, R.F., Zimmerman, M.A., Kim, H. M., Smith, S. C., & Wilson, M. L. (2004). Spatial analysis of alcohol-related motor vehicle crash injuries in Southeastern Michigan. Accident Analysis & Prevention, 36(6), 1129-1135.
View in PubMed |Abstract Temporal, behavioral and social risk factors that affect injuries resulting from alcohol-related motor vehicle crashes have been characterized in previous research. Much less is known about spatial patterns and environmental associations of alcohol-related motor vehicle crashes. The aim of this study was to evaluate geographic patterns of alcohol-related motor vehicle crashes and to determine if locations of alcohol outlets are associated with those crashes. In addition, we sought to demonstrate the value of integrating spatial and traditional statistical techniques in the analysis of this preventable public health risk. The study design was a cross-sectional analysis of individual-level blood alcohol content, traffic report information, census block group data, and alcohol distribution outlets. Besag and Newell's spatial analysis and traditional logistic regression both indicated that areas of low population density had more alcohol-related motor vehicle crashes than expected (P < 0.05). There was no significant association between alcohol outlets and alcohol-related motor vehicle crashes using distance analyses, logistic regression, and Chi-square. Differences in environmental or behavioral factors characteristic of areas of low population density may be responsible for the higher proportion of alcohol-related crashes occurring in these areas. |
Project: Other

Peterson, N. A., & Zimmerman, M.A. (2004). Beyond the individual: Toward a nomological network of organizational empowerment. American Journal of Community Psychology, 34(1), 129-145. PMID: 15495799 View in PubMed |Abstract Empowerment research has generally been limited to the individual level of analysis. Efforts to study empowerment beyond the individual require conceptual frameworks suggesting attributes that define the construct and guide its measurement. This paper presents an initial attempt to describe the nomological network of empowerment at the organizational level of analysis--organizational empowerment (OE). Intraorganizational, interorganizational, and extraorganizational components of OE are described. Implications for empowerment theory and practice are discussed. |
Project: Other

Repetto, P. B., Caldwell, C. H., & Zimmerman, M. A. (2004). Trajectories of depressive symptoms among high risk African-American adolescents. Journal of Adolescent Health, 35(6), 468-477.View in PubMed |Abstract PURPOSE: To examine the trajectories of depressive symptoms among African-American youth and the psychosocial factors associated with these trajectories. METHODS: The sample included 579 African-American adolescents who were at risk of dropping out of school, interviewed annually starting from ninth grade for 4 years. The measures included depressive symptoms, anxiety symptoms, self-esteem, stress, and active coping; all self-reported. We used cluster analysis to develop longitudinal trajectories of depression in our sample. RESULTS: Four different trajectories of depressive symptoms were found that represented the changes in depressive symptoms among the participants. These trajectories are: consistently high (15.9%), consistently low (21.1%), decreasing (41.8%), and increasing (21.2%) depressive symptoms. The results from the comparisons of the trajectories indicated that adolescents who presented consistently high levels of depressive symptoms were more likely to be female, reported more anxiety symptoms, lower self-esteem, higher stress, and lower grade point average (GPA) compared with adolescent members of the other trajectories. DISCUSSION: Depressive symptoms may be manifested in different ways according to the patterns of change. Different correlates are associated with these trajectories of depressive symptoms and provide insights about the antecedents and consequences of the patterns of change in depressive symptoms. |
Project: Flint Adolescent Study

Repetto, P. B., Zimmerman, M. A., & Caldwell, C. H. (2004). A longitudinal study of the relationship between depressive symptoms and alcohol use in a sample of inner-city black youth. Journal of Studies on Alcohol, 65(2), 169-178.
View in PubMed |Abstract OBJECTIVE: The purpose of this study was to examine longitudinally the relationship between depressive symptoms and alcohol use in a sample of black youth. METHOD: Participants were 458 black males and females interviewed annually during the high school years and then for 3 years during the transition to adulthood. The relationship was examined using growth curves with Hierarchical Linear Modeling. RESULTS: The results suggest that depressive symptoms decrease over time, whereas the use of alcohol increases. The findings also suggest that youths use alcohol as a way to cope with depressive symptoms and that males are more likely to use alcohol as self-medication. The results also indicate that changes in alcohol use do not predict depressive symptoms, but that life changes associated with the transition to adulthood, such as attending college, predict changes in depressive symptoms and alcohol use. CONCLUSIONS: Findings highlight the role of depressive symptoms for predicting alcohol use among black youth and the role of significant life transitions in altering the pattern of alcohol use presented previously by these youths. |
Project: Flint Adolescent Study

Rog, D.; Boback, N.; Barton-Villagrana, H.; Marrone-Bennett, P.; Cardwell, J.; Hawdon, J.; Diaz, J.; Jenkins, P.; Kridler, J.; Reischl,T.M. (2004). Sustaining collaboratives: A cross-site analysis of the national funding collaborative on violence prevention. Evaluation and Program Planning, 27, 249-261.
Project: National Violence Prevention Collaborative Cross-Site Evaluation

Steinman, K. J., & Zimmerman, M. A. (2004). Religious activity and risk behavior among African American adolescents: Concurrent and developmental effects. American Journal of Community Psychology, 33(3-4), 151-161.
View in PubMed |Abstract This study examines how religious activity is associated with risk behaviors, concurrently and developmentally among urban African American adolescents. Seven hundred and five African American youths were interviewed annually during high school. Retention rates for the study exceeded 90%. Frequency of religious activity, sexual intercourse, and alcohol, cigarette, and marijuana use were assessed at each wave. Growth curve analyses found negative concurrent associations between religious activity and each of the four risk behaviors. The developmental effects of religious activity varied by gender. Higher levels of religious activity in 9th grade predicted smaller increases in marijuana use among males and cigarette use among females. In addition, larger decreases in religious activity during high school were associated with greater increases in alcohol use among males and sexual intercourse among females. During high school, religious activity limits the development of certain types of risk behavior among African American youth, even after controlling for reciprocal effects. |
Project: Flint Adolescent Study

Viswanathan, M., Ammerman, A., Eng, E., Gartlehner, G., Lohr, K. N., Griffith, D. M., et al. (2004). Community-based participatory research: Assessing the evidence. Rockville, MD: Agency for Healthcare Research and Quality.
Project: Other

Wang, C. C., Morrel-Samuels, S., Hutchison, P. M., Bell, L., & Pestronk, R. M. (2004). Flint photovoice: Community building among youths, adults, and policymakers. American Journal of Public Health, 94(6), 911-913.
View in PubMed |Abstract Flint Photovoice represents the work of 41 youths and adults recruited to use a participatory-action research approach to photographically document community assets and concerns, critically discuss the resulting images, and communicate with policymakers.At the suggestion of grassroots community leaders, we included policymakers among those asked to take photographs. In accordance with previously established photovoice methodology, we also recruited at the project's outset another group of policymakers and community leaders to provide political will and support for implementing photovoice participants' policy and program recommendations.Flint Photovoice enabled youths to express their concerns about neighborhood violence to policymakers and was instrumental in acquiring funding for local violence prevention. We note salutary outcomes produced by the inclusion of policymakers among adults who took photographs. |
Project: Flint Photovoice

Zimmerman, M. A., Morrel-Samuels, S., Wong, N., Tarver, D., Rabiah, D., & White, S. (2004). Guns, gangs, and gossip: An analysis of student essays on youth violence. Journal of Early Adolescence, 24(4), 385-411. Abstract Youth violence is an important public health problem, but few researchers have studied violence from youth's perspectives. Middle school students' essays about the causes of youth violence were analyzed using qualitative and quantitative methods. The causes of violence identified by students were categorized into individual, peer, family, and societal factors. Seven to 11 subcategories were identified within each factor. Variations in the frequency of quotes among factors, the independent effects of factor and sex, and their interaction were examined. Peer factors were identified most often and family factors least often as causes of violence. Females were more likely than males to report peer factors as a cause. The most frequently mentioned subcategories within each factor were lack of anger management, need for acceptance, harassment/lack of respect, violence in the media, and parenting practices. The discussion examines youth's theories about the causation of violence and their implications for interventions. |
Project: Youth Violence Prevention Center

Bryant, A., & Zimmerman, M. A. (2003). Role models and psychosocial outcomes among African American adolescents. Journal of Adolescent Research, 18(1), 36-67. PMID: 8556888 View in PubMed |Abstract Substance use and delinquency, psychological well-being, and social support were compared across 5 family constellations among 254 urban African-American adolescent males. Single-mother, stepparent, both parents, mother with extended family, and extended family only households were studied. The only differences found were that youth living in single-mother households reported more parental support than other youth. Relationships with father and male role models were also studied and related to several psychosocial outcomes. The results challenge the assumptions that single African-American mothers are alone in providing support to their sons and that fathers' absence results in no significant relationship. |
Project: Flint Adolescent Study

Caldwell, C. H., Chavous, T. M., Barnett, T. E., Kohn-Wood, L. P., & Zimmerman, M. A. (2003). Social determinants of experiences with violence among adolescents: Unpacking the role of race in violence. Phylon, 50, 87-113.
Project: Flint Adolescent Study

Chavous, T. M., Bernat, D. H., Schmeelk-Cone, K. H., Caldwell, C. H., Kohn-Wood, L. P., & Zimmerman, M. A. (2003). Racial identity and academic attainment among African American adolescents. Child Development, 74(4), 1076-1090.
View in PubMed |Abstract In this study, the relationships between racial identity and academic outcomes for African American adolescents were explored. In examining race beliefs, the study differentiated among (a) importance of race (centrality), (b) group affect (private regard), and (c) perceptions of societal beliefs (public regard) among 606 African American 17-year-old adolescents. Using cluster analysis, profiles of racial identity variables were created, and these profile groups were related to educational beliefs, performance, and later attainment (high school completion and college attendance). Results indicated cluster differences across study outcomes. Also, the relationships between academic attitudes and academic attainment differed across groups. Finally, the paper includes a discussion on the need to consider variation in how minority youth think about group membership in better understanding their academic development. |
Project: Flint Adolescent Study

Schmeelk-Cone, K. H., Zimmerman, M. A., & Abelson, J. L. (2003). The buffering effects of active coping on the relationship between SES and cortisol among African American young adults. Behavioral Medicine, 29(2), 85-94. PMID: 15147107
View in PubMed |Abstract Cortisol levels have consistently been related to socioeconomic status (SES). Possible moderators for this relationship are coping styles that are known to moderate relationships between cardiovascular factors and SES. The authors examined whether coping style moderated a relationship between resting cortisol levels and various measures of SES in a sample of urban, African American young adults. Those scoring low on coping style had high cortisol levels if they were currently students or unemployed. This effect, however, differed for men and women. The authors suggest that coping style may play an adaptive role regarding salivary cortisol measures in young adults when they are students or unemployed. Active coping may help protect against stress among young African American adults. |
Project: Flint Adolescent Study

Sellers, R. M., Caldwell, C. H., Schmeelk-Cone, K. H., & Zimmerman, M. A. (2003). Racial identity, racial discrimination, perceived stress, and psychological distress among African American young adults. Journal of Health & Social Behavior, 44(3), 302-317.PMID: 14582310
View in PubMed |Abstract This study examines the direct and indirect relationships among racial identity, racial discrimination, perceived stress, and psychological distress in a sample of 555 African American young adults. A prospective study design was used to assess the influence of two dimensions of racial identity attitudes (i.e., centrality and public regard) on other study variables to investigate the relationship between racial identity attitudes and psychological distress. The results show some evidence of a direct relationship between racial centrality and psychological distress, as well as evidence of indirect relationships for both centrality and public regard through the impact of racial discrimination and perceived stress. In addition, racial centrality was both a risk factor for experiencing discrimination and a protective factor in buffering the negative impact of discrimination on psychological distress. Results are discussed within the context of identifying multiple pathways to psychological well-being for African American young adults within the context of racial discrimination. |
Project: Flint Adolescent Study

Steinman, K. J., & Zimmerman, M. A. (2003). Episodic and persistent gun-carrying among urban African-American adolescents. Journal of Adolescent Health, 32(5), 356-364. PMID: 12729985
View in PubMed |Abstract To examine whether similar risk factors influenced episodic and persistent gun-carrying among urban African-American adolescents. METHODS: The sample consisted of 705 African-American youths (48.9% male; mean age at baseline = 14.56 years) who were interviewed annually throughout high school as part of a larger study on students who leave school before graduation. Episodic gun-carrying was defined as carrying a gun during one or two waves of the study. Persistent gun-carrying involved carrying a gun during three or four waves. Data were analyzed using multinomial logistic regression to test how risk factors assessed at ninth grade influenced the persistence of gun-carrying. RESULTS: Fifteen percent of students reported carrying a gun episodically, and 5% persistently. "Male gender" (OR = 3.61, 95% CI = 2.16-6.04), "adult weapon-carrying" (OR = 1.58, 95% CI = 1.20-2.09), "marijuana use" (OR = 1.03, 95% CI = 1.01-1.06), "selling drugs" (OR = 3.24, 95% CI = 1.52-6.92), and "fighting" (OR = 1.57, 95% CI = 1.14-2.15) distinguished noncarriers from episodic carriers. Frequency of fighting (OR = 1.60, 95% CI = 1.00-2.57) and selling drugs (OR = 3.29, 95% CI = 1.16-9.35) distinguished episodic gun-carriers from persistent gun-carriers. Variables associated with victimization did not uniquely differentiate among the patterns of gun-carrying. These results were similar for males and females. CONCLUSIONS: Similar risk factors characterize episodic and persistent gun-carrying. Specifically, selling drugs and fighting had a strong dose-response relationship with the persistence of gun-carrying. In this population, episodic gun-carrying should be viewed as very risky and not merely as youthful experimentation or a defensive behavior. |
Project: Flint Adolescent Study

Wallace, J. M., Forman, T. A., Caldwell, C. H., & Willis, D. S. (2003). Religion and U.S. secondary school students: Current patterns, recent trends, and sociodemographic correlates. Youth & Society, 35(1), 98-125. [View Journal]
Project: Other

Zimmerman, M. A., & Schmeelk-Cone, K. H. (2003). A longitudinal analysis of adolescent substance use and school motivation among African American youth. Journal of Research on Adolescence, 13(2), 185-210. [View Journal]
Project: Flint Adolescent Study

Caldwell, C. H., Zimmerman, M. A., Bernat, D. H., Sellers, R. M., & Notaro, P. C. (2002). Racial identity, maternal support, and psychological distress among African American adolescents. Child Development, 73(4), 1322-1336. PMID: 12146750
View in PubMed |Abstract This study investigated the role of racial identity and maternal support in reducing psychological distress among African American adolescents. Both direct and indirect influences of multiple dimensions of racial identity (i.e., centrality, private regard) and maternal support on perceived stress, depressive symptoms, and anxiety were examined among 521 African American twelfth graders. Findings indicated that maternal support was positively related to both centrality and private regard. Results provided little support for a direct association between racial identity or maternal support and depressive symptoms and anxiety within a multivariate context. Rather, the influences of racial identity attitudes and maternal support on these mental health outcomes were mediated by perceived stress. Further, the two racial identity attitudes were associated with perceived stress in different ways. Study findings suggest that the significance and meaning that African American adolescents attribute to being Black may be critical to their psychological well-being, and that maternal support and perceived stress are important considerations. |
Project: Flint Adolescent Study

Miller, A. L., Notaro, P. C., & Zimmerman, M. A. (2002). Stability and change in internal working models of friendship: Associations with multiple domains of urban adolescent functioning. Journal of Social and Personal Relationships, 19(2), 233-259. [View Journal]
Project: Flint Adolescent Study

Zimmerman, M. A., Bingenheimer, J. B., & Notaro, P. C. (2002). Natural mentors and adolescent resiliency: A study with urban youth. American Journal of Community Psychology, 30(2), 221-243. PMID: 12002244 View in PubMed |Abstract Natural mentors may play an important role in the lives of adolescents. We interviewed 770 adolescents from a large Midwestern city. Fifty-two percent reported having a natural mentor. Those with natural mentors were less likely to smoke marijuana or be involved in nonviolent delinquency, and had more positive attitudes toward school. Natural mentors had no apparent effect on anxiety or depression. Using the resiliency theory framework, natural mentors were found to have compensatory but not protective effects on problem behaviors, and both compensatory and protective effects on school attitudes. Direct and indirect (mediated) effects of natural mentors are explored for problem behaviors and school attitudes. The potential importance of natural mentors is supported, and implications for future research are considered. |
Project: Flint Adolescent Study

Caldwell, C. H., Zimmerman, M. A., & Isichei, P. A. (2001). Forging collaborative partnerships to enhance family health: An assessment of strengths and challenges in conducting community-based research. Journal of Public Health Management & Practice, 7(2), 1-9. PMID: 12174395
View in PubMed |Abstract Community-based research has emerged as a vital strategy for developing effective, culturally relevant health interventions. This article describes the strengths and challenges of building a collaborative research partnership based on equality between academic researchers, public health practitioners, and representatives from community-based organizations. The model of collaboration adopted for the Fathers and Sons Project is described and examples of model applications are discussed. Lessons learned in the form of strengths/benefits and potential pitfalls in developing a community-based intervention designed to enhance the health behaviors of African American nonresidential fathers and their sons are provided. |
Project: Fathers and Sons

Notaro, P. C., Gelman, S. A., & Zimmerman, M. A. (2001). Children's understanding of psychogenic bodily reactions. Child Development, 72(2), 444-459. PMID: 11333077
View in PubMed |Abstract One hundred twenty-eight children in preschool through fifth grade (range = 4,3-11,4) and 76 adults serving as a comparison group participated in two studies that examined how children reason about psychogenic bodily reactions, that is, ailments or nonconscious physiological responses with origins in the mind (e.g., stress-induced headache). Psychogenic bodily reactions provide an opportunity to study how children integrate knowledge between the domains of bodily response and psychology. In Study 1, participants were asked whether various familiar psychogenic bodily reactions were possible (e.g., can someone get a tummyache from worrying?). In Study 2, participants were presented with a novel domain (hypothetical "aliens" from outer space) and were asked whether various unfamiliar bodily conditions (e.g., toes swelling) could arise from various physical or psychological causes. As predicted, adults typically reported that psychogenic bodily reactions were possible, and that unfamiliar bodily conditions could result from either psychological or physical causes. In contrast, young children typically denied that psychogenic bodily reactions could occur and predicted that unfamiliar bodily conditions resulted from physical causes only. The results support a developmental path: younger children view psychogenic bodily responses as wholly physical, but with age, view them as both physical and psychological phenomena. |
Project: Flint Adolescent Study

Zimmerman, M. A., Tuttle, L., Kieffer, E. C., Parker, E. A., Caldwell, C. H., & Maton, K. I. (2001). Psychosocial outcomes of urban African American adolescents born to teenage mothers. American Journal of Community Psychology, 29(5), 779-805. PMID: 11594699
View in PubMed |Abstract This is a study of psychosocial outcomes of adolescents born to teenage mothers. Adolescents'problem behaviors, psychological well-being, social support, school variables, and sexual behaviors are compared across three groups- those born to mothers 17 or younger, mothers 18-19 years old, and mothers 20 or older. Analyses from two samples of African American adolescents from Maryland (n = 205) and Michigan (n = 570) are reported. The results from both samples indicate that mother's age at birth is unrelated to adolescents' psychosocial outcomes. These two studies add to the limited number of analyses that examine adolescent outcomes for children of teen mothers. The results suggest that efforts to understand social structural determinants of healthy and problematic adolescent development may be more informative than examining the effects of mother's age. They also suggest that teen pregnancy prevention programs may be more effective if they are part of a larger prevention strategy that incorporates social structural change efforts and not only a focus on individual level change. |
Project: Flint Adolescent Study

Newman, P. A., & Zimmerman, M. A. (2000). Gender differences in HIV-related sexual risk behavior among urban African American youth: A multivariate approach. AIDS Education & Prevention, 12(4), 308-325. PMID: 10982121
View in PubMed |Abstract Alcohol and other drug (AOD) use during sexual encounters, sexual partner's age, perceived HIV risk and perceived condom effectiveness were studied among 388 sexually active African American youth. Cluster analysis of condom use, number of partners, and frequency of sexual intercourse identified four groups: low risk, monogamy strategy, condom strategy, and high risk. Low-risk youth used condoms consistently and had few partners. High-risk youth used condoms inconsistently with many partners. Monogamy strategy youth used condoms inconsistently but had few partners. Condom strategy youth used condoms consistently with a moderate number of partners. The high-risk group included more males and the monogamy group included more females. High-risk males reported more AOD use during sexual activity than all females, and low-risk or condom strategy males. Females had older partners, rated condoms as less effective and perceived lower HIV/AIDS risk than males. Results suggest differential HIV risk mechanisms by gender. Implications for gender-specific HIV prevention are discussed. |
Project: Flint Adolescent Study

Zimmerman, M. A. (2000). Empowerment theory: Psychological, organizational and community levels of analysis. In J. Rappaport, & E. Seidman (Eds.), Handbook of Community Psychology (pp. 43-63). New York, NY: Plenum Press.
Project: Other

Zimmerman, M. A., Salem, D. A., & Notaro, P. C. (2000). Make room for daddyII: The positive effects of fathers' role in adolescent development. In M. C. Wang, & R. D. Taylor (Eds.), Resilience Across Contexts : Family, Work, Culture, and Community (pp. 233-253). Mahwah, NJ: Lawrence Erlbaun.
Project: Other

Watts, R. J., Griffith, D. M., & Abdul-Adil, J. (1999). Sociopolitical development as an antidote for oppression. American Journal of Community Psychology, 27(2), 255-271. [View Journal]
Project: Other

Zimmerman, M. A., Ramirez-Valles, J., & Maton, K. I. (1999). Resilience among urban African American male adolescents: A study of the protective effects of sociopolitical control on their mental health. American Journal of Community Psychology, 27(6), 733-751. PMID: 10723533
View in PubMed |Abstract Resilience refers to the notion that some people succeed in the face of adversity. In a risk-protective model of resilience, a protective factor interacts with a risk factor to mitigate the occurrence of a negative outcome. This study tested longitudinally the protective effects of sociopolitical control on the link between helplessness and mental health. The study included 172 urban, male, African American adolescents, who were interviewed twice, 6 months apart. Sociopolitical control was defined as the beliefs about one's capabilities and efficacy in social and political systems. Two mental health outcomes were examined--psychological symptoms and self-esteem. Regression analysis to predict psychological symptoms and self-esteem over time were conducted. High levels of sociopolitical control were found to limit the negative consequences of helplessness on mental health. The results suggest that sociopolitical control may help to protect youths from the negative consequences of feelings of helplessness. Implications for prevention strategies are discussed. |
Project: Flint Adolescent Study

Caldwell, C. H., Antonucci, T. C., & Jackson, J. S. (1998). Supportive/conflictual family relations and depressive symptomatology: Teenage mother and grandmother perspectives. Family Relations, 47(4), 395. [View Journal]
Project: Other

Doljanac, R. F., & Zimmerman, M. A. (1998). Psychosocial factors and high-risk sexual behavior: Race differences among urban adolescents. Journal of Behavioral Medicine, 21(5), 451-467. PMID: 9836131
View in PubMed |Abstract Adolescence is a period of sexual experimentation. We examined psychosocial predictors of high-risk sexual behavior and condom use. The sample included 824 ninth-graders, most of whom are African American. We conducted separate analyses for whites and African Americans. Predictors included alcohol and substance use, delinquency, prosocial behaviors, and family and peer influences. We found that problem behaviors predicted high-risk sexual behavior, but the effects were stronger for white youth. We also found that friends' behaviors were more predictive than family influences, except for family conflict. In general, the models explained more variance for white youths than for African-American youths. The results suggest that problem behavior theory and social interactions theory may be most relevant for white youth and that other models may be necessary to explain high-risk sexual behavior among African-American youths. |
Project: Flint Adolescent Study

Ramirez-Valles, J., Zimmerman, M. A., & Newcomb, M. D. (1998). Sexual risk behavior among youth: Modeling the influence of prosocial activities and socioeconomic factors. Journal of Health & Social Behavior, 39(3), 237-253. PMID: 9785696
View in PubMed |Abstract Sexual activity among high-school-aged youths has steadily increased since the 1970s, emerging as a significant public health concern. Yet, patterns of youth sexual risk behavior are shaped by social class, race, and gender. Based on sociological theories of financial deprivation and collective socialization, we develop and test a model of the relationships among neighborhood poverty; family structure and social class position; parental involvement; prosocial activities; race; and gender as they predict youth sexual risk behavior. We employ structural equation modeling to test this model on a cross-sectional sample of 370 sexually active high-school students from a midwestern city; 57 percent (n = 209) are males and 86 percent are African American. We find that family structure indirectly predicts sexual risk behavior through neighborhood poverty, parental involvement, and prosocial activities. In addition, family class position indirectly predicts sexual risk behavior through neighborhood poverty and prosocial activities. We address implications for theory and health promotion. PIP: Sexual activity among high school-aged youths has increased steadily since the 1970s, with more than half of high school students in 1990 being sexually active, and only about half of those individuals reporting that they or their sex partners used condoms during their most recent sexual intercourse. Patterns of youth sexual risk behavior and their consequences are, however, partly defined by social class, race, and gender. Based upon sociological theories of financial deprivation and collective socialization, the authors develop and test a model of the relationships among neighborhood poverty; family structure and social class position; parental involvement; prosocial activities; race; and gender as they predict youth sexual risk behavior. Structural equation modeling is used to test the model upon a cross-sectional sample of 209 male and 161 female sexually active high school students from Michigan. The students are 86% Black and of mean age 14.63 years. Family structure was found to indirectly predict sexual risk behavior through neighborhood poverty, parental involvement, and prosocial activities, while family class position indirectly predicts sexual risk behavior through neighborhood poverty and prosocial activities. Implications for theory and health promotion are considered. |
Project: Flint Adolescent Study

Salem, D. A., Zimmerman, M. A., & Notaro, P. C. (1998). Effects of family structure, family process, and father involvement on psychosocial outcomes among African American adolescents. Family Relations, 47(4), 331-341. [View Journal]
Project: Flint Adolescent Study

Stevenson, W., Maton, K. I., & Teti, D. M. (1998). School importance and dropout among pregnant adolescents. Journal of Adolescent Health, 22, 376-382. PMID: 9589338
View in PubMed |Abstract This study examined the relationship of psychological well-being, social support, and demographic variables to school importance and school dropout among pregnant teens. METHOD: Fifty-one Caucasians and 68 African-Americans (mean age = 16.7 years, mean weeks pregnant = 23) were recruited from two Baltimore area prenatal teen clinics. The adolescents completed questionnaires measuring depression, self-esteem, mastery, parental and friend support, demographic characteristics (i.e., age, marital status, ethnicity, socioeconomic status), school importance, and status. RESULTS: Most adolescents were enrolled in school or had graduated (69.7%), were receiving at least passing grades (78.7%), and perceived finishing high school as very important (76.7%). Blacks were more likely to say school was important (p < 0.001), were less likely to drop out (p < 0.01), and received higher grades (p < 0.01) than whites. Dropouts had lower family incomes than current school attenders and graduates (p < 0.05). One measure of psychological well-being (mastery, p < 0.01) was positively correlated with school importance. Social support did not correlate with school importance or dropout. CONCLUSIONS: These findings suggest that dropping out of school among pregnant teens may be more strongly related to sociocultural factors than to individual characteristics such as emotional support and psychological well-being. Overall, this study reveals a positive picture of educational continuation and performance during pregnancy, with most adolescents recognizing the importance of education and remaining in school. |
Project: Flint Adolescent Study

Zimmerman, M. A., Steinman, K. J., & Rowe, K. (1998). Violence among urban African American adolescents: The protective effects of parent support. In X. B. Arriaga, & S. Oskamp (Eds.), Addressing community problems : Psychological Research and Interventions (pp. 78-103). Newbury Park, Calif. : Sage Publications.
Project: Flint Adolescent Study