A Comparison of Strategies to Increase Household Survey Response Rates in a Predominantly Indigenous Community Population.

The present study describes 4 strategies for increasing response rates to a community-based survey on youth violence in an ethnically diverse population in Hawai'i. A total of 350 households were mailed a Safe Community Survey using 4 different randomly assigned incentive strategies. The strategies varied by length of survey and timing of incentive for completion (given before completion, after completion, or both). In univariate analyses, there were no significant differences across survey strategies on participant demographics, community perceptions of violence-related behaviors, or percent of missing items. However, in multivariate regressions, respondents' sex and percent of missing items on the surveys were consistently significant predictors across multiple outcomes. Although the use of strategies to increase response rates in community-based surveys might be desirable, resulting data need to be examined for the potential that strategies might recruit different populations, which may have an impact on the data obtained. This study offers lessons and recommendations for surveying Native and Indigenous communities.

Understanding the Role of School Connectedness and Its Association With Violent Attitudes and Behaviors Among an Ethnically Diverse Sample of Youth.

Interpersonal youth violence is a growing public health concern in the United States. Having a high sense of school connectedness has been found to be a protective factor for youth violence. A high school course that aims to enhance school connectedness was developed and evaluated to investigate the students' sense of school connectedness and its association with violent attitudes and behaviors. Survey data from 598 students from a predominately Asian and Pacific Islander student body were analyzed to assess their level of school connectedness and violent attitudes and behaviors. Analysis of Variance was used to identify differences in the school connectedness and violence scores related to students' demographic characteristics. The role of school connectedness in the relationship between student demographic characteristics and violent attitudes and behaviors was examined with structural equation modeling. Overall, students reported a moderately high sense of school connectedness. School connectedness was found to be negatively associated with violent attitudes but not self-reported violent behaviors. Multiple-group analyses were conducted across the ethnic groups, which found differential associations between the school connectedness and violence variables. These results highlight the value of disaggregating the Asian and Pacific Islander category and the need for future research to further contextualize and clarify the relationship between school connectedness and interpersonal youth violence. This will help inform the development of evidence-based strategies and prevention programming that focus on school connectedness to address disparities in interpersonal youth violence outcomes.

Interpersonal youth violence perpetration and victimization in a diverse Asian American and Pacific Islander adolescent sample.

This study was the first to examine ethnic, sex, and ethnicity-by-sex differences for under-researched, Asian American and Pacific Islander, adolescent groups on youth violence outcomes other than cyberbullying. This effort included the less researched, emotional violence, and included socioeconomic status (SES) measures as covariates. The sample size from 2 high schools in spring 2007 was 881, using an epidemiologic survey design. The pattern of results was higher rates of violence victimization for ethnic groups, with lower representation in the 2 schools' population, and ethnic groups that more recently moved or immigrated to Hawai'i. For emotional victimization, girls of European American and "other", ethnicities self-reported higher rates than boys. Several implications (e.g., need for ethnically and gender-based approaches) and further research (e.g., ethnocultural identity) are discussed.

Developing a comprehensive school connectedness scale for program evaluation.

BACKGROUND: Evidence show that school connectedness is important to youth wellness. However, considerable inconsistency in the concepts and measures of school connectedness exists across studies. In addition, many measures do not capture the multifaceted dimensions of the school connectedness construct. This study examined the psychometric properties of a school connectedness scale that aimed to measure comprehensively the key constructs of school connectedness. METHODS: The scale was developed with teachers and tested with an ethnically diverse sample of 717 high school students enrolled in a school connectedness course using confirmatory factor analysis. RESULTS: Confirmatory factor analyses demonstrated the association of the 15 items with the 5 factors identified in the literature-school involvement, academic motivation, school attachment, teacher support, and peer relations (χ(2) = 439.99, df = 83, p < .0001, Comparative Fit Index = 0.991, Tucker-Lewis index = 0.988, root mean square error of approximation = 0.077). Cronbach coefficient alphas for the factors ranged from 0.73 to 0.93. CONCLUSIONS: Although further tests need to be conducted to assess its validity and reliability, this newly developed scale may provide researchers a tool to measure comprehensively school connectedness for program evaluation.

Longitudinal Dynamic Analyses of Depression and Academic Achievement in the Hawaiian High Schools Health Survey using Contemporary Latent Variable Change Models.

The scientific literature consistently supports a negative relationship between adolescent depression and educational achievement, but we are certainly less sure on the causal determinants for this robust association. In this paper we present multivariate data from a longitudinal cohort-sequential study of high school students in Hawai'i (following McArdle, 2009; McArdle, Johnson, Hishinuma, Miyamoto, & Andrade, 2001). We first describe the full set of data on academic achievements and self-reported depression. We then carry out and present a progression of analyses in an effort to determine the accuracy, size, and direction of the dynamic relationships among depression and academic achievement, including gender and ethnic group differences. We apply three recently available forms of longitudinal data analysis: (1) Dealing with Incomplete Data -- We apply these methods to cohort-sequential data with relatively large blocks of data which are incomplete for a variety of reasons (Little & Rubin, 1987; McArdle & Hamagami, 1992). (2) Ordinal Measurement Models (Muthén & Muthén, 2006) -- We use a variety of statistical and psychometric measurement models, including ordinal measurement models to help clarify the strongest patterns of influence. (3) Dynamic Structural Equation Models (DSEMs; McArdle, 2009). We found the DSEM approach taken here was viable for a large amount of data, the assumption of an invariant metric over time was reasonable for ordinal estimates, and there were very few group differences in dynamic systems. We conclude that our dynamic evidence suggests that depression affects academic achievement, and not the other way around. We further discuss the methodological implications of the study.

Ethnic differences in risk factors for suicide among American high school students, 2009: the vulnerability of multiracial and Pacific Islander adolescents.

This study compared self-reported risk factors for suicide among American high school students in the last decade. Data from the 1999-2009 Youth Risk Behavior Surveys was analyzed by 8 self-reported ethnicity groups across 6 suicide-related items: depression, suicide ideation, suicide planning, suicide attempts, and suicide attempts requiring medical attention). Native Hawaiian/Pacific Islander adolescents had the higher prevalence of risk factors for suicide. Multiracial adolescents were also at high risk for suicide-related behaviors, with a risk comparable to American Indian/Alaska Native adolescents. Overall, Native Hawaiian/Pacific Islander, multiracial, and American Indian/Alaska Native adolescents reported a significantly higher risk for suicide-related behaviors compared to their Asian, Black, Hispanic, and White peers. The ethnic disparities in risk factors for suicide dictate a need to understand the vulnerability of the Pacific Islander, American Indian, and growing multiracial adolescent populations, in an effort to develop and implement suicide prevention strategies.

Epidemiology of mixed martial arts and youth violence in an ethnically diverse sample.

Mixed martial arts' (MMAs) growing international popularity has rekindled the discussion on the advantages (e.g., exercise) and disadvantages (e.g., possible injury) of contact sports. This study was the first of its kind to examine the psychosocial aspects of MMA and youth violence using an epidemiologic approach with an Asian American and Pacific Islander (AAPI) adolescent sample (N = 881). The results were consistent with the increased popularity of MMA with 52% (adolescent males = 73%, adolescent females = 39%) enjoying watching MMA and 24% (adolescent males = 39%, adolescent females = 13%) practicing professional fight moves with friends. Although statistically significant ethnic differences were found for the two MMA items on a bivariate level, these findings were not statistically significant when considering other variables in the model. The bivariate results revealed a cluster of risk-protective factors. Regarding the multiple regression findings, although enjoying watching MMA remained associated with positive attitudes toward violence and practicing fight moves remained associated with negative out-group orientation, the MMA items were not associated with unique variances of youth violence perpetration and victimization. Implications included the need for further research that includes other diverse samples, more comprehensive and objective MMA and violence measures, and observational and intervention longitudinal studies.

Monitoring the multi-faceted problem of youth violence: the Asian/Pacific Islander Youth Violence Prevention Center's surveillance system.

Youth violence (YV) is a complex public health issue that spans geographic, ethnic, and socioeconomic lines. The Asian/Pacific Islander Youth Violence Prevention Center conducts qualitative and quantitative research on YV in Hawai'i. A critical element in YV prevention involves measuring YV and its risk-protective factors to determine the scope of the problem and to monitor changes across time. Under the Asian/Pacific Islander Youth Violence Prevention Center's (APIYVPC's) surveillance umbrella, a variety of methodologies are utilized. The major forms of active surveillance are a School-Wide Survey for youth, and a Safe Community Household Survey for adults. A variety of secondary data sources are accessed, such as the Centers for Disease Control and Prevention (Youth Risk Behavior Surveillance System), the Hawai'i State Department of the Attorney General, the Hawai'i State Department of Education, and the Hawai'i State Department of Health. State data are especially important for the Center, because most of these sources disaggregate ethnicity data for Asian Americans/Pacific Islanders. This paper details the surveillance methodologies utilized by the APIYVPC to monitor YV in one specific community and in Hawai'i, in comparison to the rest of the State and nation. Empirical results demonstrate the utility of each methodology and how they complement one another. Individually, each data source lends valuable information to the field of YV prevention; however, collectively, the APIYVPC's surveillance methods help to paint a more complete picture regarding violence rates and the relationship between YV and its risk-protective factors, particularly for minority communities.

Potential causal relationship between depressive symptoms and academic achievement in the Hawaiian high schools health survey using contemporary longitudinal latent variable change models.

There is a relatively consistent negative relationship between adolescent depressive symptoms and educational achievement (e.g., grade point average [GPA]). However, the causal direction for this association is less certain due to the lack of longitudinal data with both indicators measured across at least 2 time periods and due to the lack of application of more sophisticated contemporary statistical techniques. We present multivariate results from a large longitudinal cohort-sequential study of high school students (N = 7,317) with measures of self-reported depressive symptoms and self-reported GPAs across multiple time points (following McArdle, 2009, and McArdle, Johnson, Hishinuma, Miyamoto, & Andrade, 2001) using an ethnically diverse sample from Hawai'i. Contemporary statistical techniques included bivariate dynamic structural equation modeling (DSEM), multigroup ethnic and gender DSEMs, ordinal scale measurement of key outcomes, and imputation for incomplete longitudinal data. The findings suggest that depressive symptoms affect subsequent academic achievement and not the other way around, especially for Native Hawaiians compared with female non-Hawaiians. We further discuss the scientific, applied, and methodological-statistical implications of the results, including the need for further theorizing and research on mediating variables. We also discuss the need for increased prevention, early intervention, screening, identification, and treatment of depressive symptoms and disorders. Finally, we argue for utilization of more contemporary methodological-statistical techniques, especially when violating parametric test assumptions.

Social ecological determinants of youth violence among ethnically diverse Asian and Pacific Islander students.

This study assesses the relative fit of risk/protective and social ecological models of youth violence among predominantly Asian and Pacific Islander students. Data from a 2007 survey of two multi-ethnic high schools in Hawai'i were used. The survey assessed interpersonal youth violence, suicidality and risk and protective factors. Two models of youth violence (risk/protective and social ecological) were tested using structural equation modeling. We found good fits for the risk/protective model (χ(2) = 369.42, df = 77, P < .0001; CFI = .580; RMSEA = .066) and the ecological model (χ(2) = 1763.65, df = 292, P < .0001; CFI = .636; RMSEA = .076). The risk/protective model showed the importance of coping skills. However, the ecological model allowed examination of the interconnectivity among factors. Peer exposure to violence had no direct influence on individuals and peer influence was fully mediated by school climate. Furthermore, family factors directly contributed to peer exposure, community, and individual risk/protection. These findings have significant implications for intervention and prevention efforts and for the promotion of positive, competent, and healthy youth development. While few family and school-based programs have been developed and evaluated for adolescents, they have the greatest potential for success.

Community perceptions of safety in relation to perceived youth violence-delinquency in a primarily native Hawaiian and Asian American community in Hawai'i.

Perception of safety is an important component to the well-being of community members in their own neighborhood. The present study was the first of its kind to model community perception of safety utilizing a primarily Native Hawaiian and Asian American community sample (N = 101) and with perceived youth violence and delinquency as prominent potential influences. The study found that the majority of participants felt that several types of youth violence and delinquency were problems in the community. The overall social-ecological model evidenced a strong fit and indicated that community perception of safety was adversely impacted by perceived youth violence and delinquency and increased through positive relations with neighbors. The implications included the need for a more comprehensive approach to positive youth development and community capacity-building, including incorporation of cultural components, and to determine whether the model is applicable to other minority communities.

The impact of cyberbullying on substance use and mental health in a multiethnic sample.

The objective of this study was to examine the relationship between cyberbullying and mental health problems among a multiethnic sample of high school students in Hawai'i. A University-Community partnership was established to direct the research. Using a mixed-methods approach, we explored violence among Asian and Pacific Islander youth. In the first phase, focus groups were conducted to identify areas of youth concern and develop survey questions. Responses from 677 high school students on interpersonal youth violence and risk and protective factors were utilized in this study. More than 1 in 2 youth (56.1%) had been victims of cyberbullying in the last year. Filipino and Samoan youth were more likely to report feeling badly about themselves as a result of cyberbullying. While cyberbullying and mental health problems varied by sex and ethnicity, we found that cyberbullying is widespread with serious potential consequences among Asian and Pacific Islander youth. A multifaceted approach is needed to reduce and prevent cyberbullying. School, family and community programs that strengthen positive relationships and promote safe use of technology provide promise for reducing cyberbullying.

Low cultural identification, low parental involvement and adverse peer influences as risk factors for delinquent behaviour among Filipino youth in Hawai'i.

BACKGROUND: Among Filipino youth in Hawai'i, low Filipino cultural identification and low family support may be important risk factors for delinquency. AIMS: To examine, in a sample of Filipino youth in Hawai'i, correlations between delinquent behaviour and the aforementioned - as well as other, potentially mediating - variables. METHODS: A youth risk survey and Filipino Culture Scale were administered to Filipino students (N = 150) in Hawai'i. A parent risk survey was administered to available and consenting parents. RESULTS: Delinquent behaviour correlated positively with acculturative stress, low cultural identification and adverse peer influences; and negatively with total Filipino Culture Scale score. Structural equation modelling suggested that absent/ineffective adults and adverse peer influences might be more important variables compared to low self-esteem and less religiosity, linking low cultural identification to delinquent behaviour. CONCLUSIONS: Although further studies are warranted, to be effective, efforts to prevent delinquency by enhancing Filipino youths' cultural connectedness may also need to enhance family connectedness and address adverse peer influences.

The relationship among exposure to stressful life events, drug use, and violence perpetration in a sample of native Hawaiian, Samoan, and Filipino adolescents.

This study examined the relationship between stressful life events, drug use, and self-reported violence perpetration among 293 Native Hawaiian, Samoan, and Filipino adolescents. Data were collected using semistructured interviews with students in three high schools in Hawai'i. Stressful life events were delineated into three categories: transitions, discrete events, and victimization. Samoans reported more stressful life events than Native Hawaiians and/or Filipinos, depending on the subscale, but there were no sex differences in the stressful life events total scale or subscales. There were sex differences on several stressful life events items, including boys reporting more physical victimization and more life threatening illnesses and injuries than girls. Stressful life events were related to higher rates of violence perpetration for all groups, though specific types of events were significant for some groups but not others. Drug use moderated the influence of transitions on violent behaviors for boys and Samoan adolescents and also of discrete events on violence perpetration for Samoan adolescents. Additional research is needed to examine other risk factors, as well as types of protective factors that may moderate the relationship between life stressors and engaging in violent behaviors.

Prevalence of victims of violence among ethnically diverse Asian/Pacific Islanders.

The present research project is the first large-scale study (N = 5,051) that investigated the prevalence of victims of violence for an ethnically diverse Asian/Pacific Islander sample. The rate for the adolescent respondents of "was a victim of violence (was physically harmed by someone)" within the past 6 months was 3.33%. Over twice that rate was found for family members (6.97%) and over three times the adolescent-respondent rate was obtained for close friends (10.75%). Only partial support was found for the hypothesis that Asian groups would have the lowest rates, and Polynesian, African American, Hispanic, and Native American Indian/Alaska Native groups would have the highest rates. Higher rates were found for Whites (adolescent respondents, close friends) and the Portuguese (family members, close friends), suggesting a "minority" effect. There is a need to disaggregate ethnicity, engage in further research that considers risk and protective factors, and investigate culturally appropriate interventions.

A confirmatory model for depression among Japanese American and part-Japanese American adolescents.

A confirmatory model integrating Japanese ethnicity, cultural identity, and depression was developed (N = 140). The model incorporated the Center for Epidemiologic Studies-Depression Scale (CES-D), Major Life Events Scale, and Japanese Cultural Scale. Japanese American adolescents scored higher on the Japanese Cultural Scale and reported fewer depressive symptoms on the CES-D total and on 2 of the 3 CES-D factors than part-Japanese American adolescents. Predictors for depression were being Japanese American vs. part-Japanese American, female gender, and culturally intensified events. A significant interaction of behavior by self-identification was noted. The model had good overall fit and suggested that the formation of cultural identity may contribute to depressive symptoms experienced by adolescents, particularly adolescents of mixed heritage.

Demographic and social variables associated with psychiatric and school-related indicators for Asian/Pacific-Islander adolescents.

BACKGROUND: Factors associated with Asian/Pacific-Islander adolescent adjustment is a greatly neglected research area. AIMS: The purpose of the present study was to investigate the relation between demographic, social and adjustment measures based on a large-scale investigation of Asian/Pacific-Islander youths. METHOD: A total of 2577 adolescents were surveyed across 4 public schools in Hawai'i during the 1992--1993 school year. RESULTS: Three social variables (number of relatives frequently seen, family support and friends' support) exhibited statistically significant but low correlations. Family support had the highest negative association with the four psychiatric symptoms (depression, anxiety, aggression, substance use). Friends' support was inconsistently associated with the adjustment measures, and the number of relatives frequently seen resulted in negligible effects. In contrast, demographic variables, especially ethnicity, played a much greater role in the association with the four school-related measures (grade-point average, absences, suspensions, conduct infractions). DISCUSSION: For Asian/Pacific-Islander youths, the quality of the social supports, including family relations, may be particularly important in the adolescents' adjustment. When examining school-related outcomes, demographic variables, with particular emphases on ethnicity and culture, must be considered. When developing and implementing prevention and intervention services and programs, consideration of family and ethnic-cultural influences should be taken into account, with further research needed in several related domains: other SES influences, life stressors, migration-generational effects, ethnic identity, self-concept indicators and socio-political aspects.