Understanding Adverse Childhood Experiences and Juvenile Court Outcomes: The Moderating Role of Race and Ethnicity

Youth involved in the juvenile justice system have enhanced traumatic exposure including abuse, neglect, and household dysfunction compared to their non-involved counterparts. While prior research has conceptualized the role of trauma in predicting juvenile recidivism, the interrelated role of adverse childhood experiences (ACEs) and race/ethnicity in informing juvenile court processing and outcomes is unaddressed. As such, we examine the moderating role of race/ethnicity with ACEs across court outcomes (e.g., dismissal, diversion, probation, residential placement) among juveniles after their first ever arrest (37.2% Black, 18.3% Hispanic). Higher ACEs were associated with (1) decreased adjudication likelihood, (2) case dismissal for Black and Hispanic youth, (3) deeper dispositions versus diversion for Hispanic youth, (4) residential placement versus diversion for White youth, and (5) residential placement versus probation, with no racial or ethnic differences. Policy implications and future research surrounding the treatment of justice-involved youth with childhood traumatic exposure across race/ethnicity are discussed.

Family-Based Obesity Prevention Interventions among Hispanic Children and Families: A Scoping Review

This scoping review examined intervention and sample characteristics of family-based obesity prevention interventions among Hispanic youth. This review also examined the degree to which existing interventions were culturally-adapted, acknowledged social determinants of health (SDoH), and collaborated with community stakeholders. A comprehensive search across Medline Ovid, Embase, Scopus, PsycInfo, and Pubmed was used to identify 13 studies primarily based in the U.S. (92.3%). Data was extracted by two independent reviewers. Most used a randomized control trial design (69.2%), a behavior change theory (84.6%), and reported moderate to high (≥70%) retention (69.2%). Studies targeted improvements in physical activity (69.2%) and fruit and vegetable intake (92.3%) through nutrition education, cooking demonstrations, and tastings. Younger children from low socioeconomic backgrounds (61.5%) were well represented. Most interventions were culturally-adapted (69.2%), all studies reported collaboration with stakeholders, yet only half used strategies that acknowledged SDoH (46.2%). To increase our understanding of the underlying mechanisms by which family-based approaches can reach and engage Hispanic youth and families, future studies should rigorously evaluate theoretical constructs, family processes, and SDoH that influence program participation and health behaviors. This information will guide the design and development of future interventions aimed at reducing obesity disparities among Hispanic youth.

Impact of Sugar Reduction and PNPLA3 Genotype on Liver Fat, Liver Fibrosis, and Body Composition in Hispanic Youth With Obesity: A Randomized Controlled Trial

Objectives Pediatric Non-Alcoholic Fatty Liver Disease is prevalent among Hispanics, which may partially result from a higher frequency of the C > G polymorphism in the patatin-like phospholipase 3 (PNPLA3) gene. Our prior work showed an interaction between the GG genotype and high dietary sugar, resulting in higher liver fat. Additionally, studies show that extreme sugar depletion improves liver fat in children with obesity. This trial aimed to test whether a clinical intervention for sugar reduction versus standard diet advice in Hispanic youth differentially impacts liver fat, liver fibrosis, body weight and composition, and whether effects differed by PNPLA3 genotype. Methods Hispanic youth with obesity (n = 105; 72% GG) were randomized to a healthy eating control group or a sugar reduction group (goal, <10% of calories from free sugar) for 12 weeks. Participants continued their typical exercise regimens and incorporated their interventions into their ad libitum diet. Liver fat and fibrosis were measured by magnetic resonance imaging and elastography, and body composition by dual energy x-ray absorptiometry before and after the intervention. Results Both treatment and control groups reduced free sugar intake, with a greater reduction in the treatment group (−4.8 ± 6.5% vs. −3.0 ± 8.5%, P = 0.02). At follow-up, free sugar intake in the intervention group was 8.8 ± 5.4% of calories. In modified intent to treat analyses, there were no differential intervention effects on liver fat, liver fibrosis, body weight, body fat or fat distribution (P > 0.05). No treatment by PNPLA3 genotype interaction was observed for any endpoint (P > 0.05). While there was no significant change in fat mass in either study arm, secondary analyses revealed that participants who reduced fat mass, significantly reduced liver fat compared to those without fat mass reduction [−1.8% (−6.2, −3.4) vs. 0.3% (−1.0, 1.1), P < 0.001]. Conclusions In Hispanic Youth with obesity, a clinic-based intervention focused on sugar reduction did not affect liver fat, liver fibrosis, body weight or composition, regardless of PNPLA3 genotype. However, the reduction in sugar intake observed might not have been sufficient to shift liver fat. Further, our results suggest that reducing fat mass is essential to reducing liver fat. Funding Sources The National Institute on Minority Health and Health Disparities (MD-010358).

Abstract P151: Acculturation Predicts Activity-specific Parenting Practices In Hispanic/Latino Youth

Background: Hispanic youth are less physically active and more sedentary than non-Hispanic youth, contributing to relatively high rates of obesity among the nation’s largest ethnic minority group. Though parents can influence children’s behavior, it is unclear whether parenting practices related to the child’s physical activity are associated with activity in Hispanic/Latino youth, and whether cultural and environmental contexts predict the use of these parenting practices. Objective: We assessed 1) whether activity-specific parenting practices (ASPPs) are associated with moderate-to-vigorous physical activity (MVPA) and sedentary activity among Hispanic/Latino youth, and 2) if higher parental acculturation and greater perceived neighborhood-level socioeconomic challenges are associated with the use of less effective ASPP patterns. Methods: Youth from the Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth; n=976) were examined. Activity was assessed using 7-day accelerometer data. ASPPs were identified from the Parenting strategies for Eating and Activity Scale (PEAS) using exploratory and confirmatory factor analysis of the ten items on activity. We used survey-weighted linear regression models to assess whether derived ASPPs predicted mean daily MVPA and sedentary time. K-means cluster analysis was used to group individuals based on ASPP use. Finally, we used survey-weighted multinomial logistic regression models to examine the association of parent acculturation-related measures and perceived neighborhood socioeconomic status and barriers to activity with ASPP cluster membership. Results: Factor analysis of the activity-specific PEAS items identified three ASPPs: Limit Setting, Discipline, and Monitoring/Reinforcement. Discipline predicted higher MVPA in females only (β 1.89 [95% CI 0.11-3.67]), and Monitoring/Reinforcement predicted higher MVPA in males only (β 4.71 [95% CI 0.68-8.74]). There was no association between Limit Setting and MVPA or any ASPPs and sedentary activity. K-cluster analysis revealed three ASPP patterns: Restrictive (high scores for Limit Setting and Discipline), Supportive (high scores for Limit Setting and Monitoring/Reinforcement) and Permissive (low score across ASPPs). Higher Anglo-orientation on the Brief ARSMA-II acculturation measure predicted membership in the Supportive compared to Permissive cluster (p= 0.03), while perceived neighborhood characteristics did not predict ASPP cluster membership. Conclusions: ASPPs are associated with MVPA in sex-specific ways but have no association with sedentary activity in Hispanic/Latino youth. Among acculturation and neighborhood characteristics, only Anglo-orientation predicted ASPPs patterns. More research is needed to understand how acculturation is influencing ASPPs and if ASPPs can be leveraged to change children’s activity.

The Effect of Cardiorespiratory Fitness and Insulin Resistance on Bone Health in Hispanic Children

Obesity appears to have a negative impact on pediatric bone health, and insulin resistance may mediate this relationship. It is unclear if cardiorespiratory fitness (CRF) has a protective effect on bone in obese children. We tested the hypothesis that CRF attenuates the negative effect of obesity and insulin resistance on skeletal health in a large cohort of Hispanic youth. We studied 413 (193 males and 220 females) children and adolescents from the Viva la Familia Study. They were all pubertal; mean age (SD) 13.4 ± 2.3 years; 27% were normal weight (NW), 19% overweight (OW) and 54% obese (OB). They underwent measurement of body composition, total body bone mineral content (BMC) and density (BMD) by DXA scan; VO2peak using the ramp protocol on a treadmill for CRF; fasting glucose and insulin. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. BMC increased from NW to OW to OB (mean 1.35 ± 0.4, 1.41 ± 0.4, and 1.49 ± 0.4 kg, respectively, p=.005). Peak VO2 decreased from NW to OW to OB (41.3 ± 9.7, 35.5 ± 7.7, 28.9. ± 5.5 mL/kg per min, respectively, p <.001). After adjusting for sex, age and lean body mass, BMC was inversely related to fat mass (r = -0.34, p <.001) and HOMA-IR (r = -0.29, p <.001). Similar relationships were found for BMD. In a regression model with BMC as the dependent variable, lean body mass (standardized coefficient (β)=0.95, p <.001) was positively and fat mass (β=-0.18, p <0.001) negatively associated with BMC (model R2=0.88, p<.001). HOMA-IR (β=-0.07, p =0.001) and VO2peak (β=0.09, p =0.003) had significant and opposite associations with BMC (model p<.001) but fat mass was no longer a significant contributor. With BMD as the dependent variable, lean body mass (β=0.82, p <.001), HOMA-IR (β=-0.06, p =0.04) and peak VO2 (β=0.17, p <.001), but not fat mass, contributed to the variance in BMD (R2=0.79, p<.001). In conclusion, lean body mass is the major determinant of BMC and BMD in Hispanic youth. Adiposity associated insulin resistance has a negative effect on BMC and BMD. CRF contributes positively to the variance in BMC and BMD. This suggests that CRF and higher lean mass attenuate the adverse effects of insulin resistance on bone health in children.

National-Level Disparities in Internet Access Among Low-Income and Black and Hispanic Youth: Challenges in Reaching At Risk Groups (Preprint)

BACKGROUND Internet access is increasingly critical for adolescents with regard to obtaining health information and resources, participating in online health promotion and communicating with health practitioners. Yet, past work demonstrates that access is not uniform across U.S. youth, with lower access found among groups with higher health related needs. Population level data yield important insights about access and internet use in the U.S. OBJECTIVE To examine internet access and mode of access by social class and race/ethnicity among youth (14-17 years) in the U.S. METHODS Using the Current Population Survey (CPS), we examined internet access, cell/smartphone access and modes of connecting to the internet for adolescents for 2015 (unweighted N= 6950; expanded weights N = 17,103,547) and 2017 (unweighted n = 6761; expanded weights N = 17,379,728). RESULTS Internet access increased from 2015 to 2017, but SES and racial/ethnic disparities remain. In 2017, the greatest disparities were found for youth in low-income households (no home access (HA) = 23%), and for Blacks (no HA = 18%) and Hispanics (no HA = 14%). Low-income Black and Hispanic youth were the most likely to lack home internet access (no HA, Low-SES Black = 29%; Low-SES Hispanic = 21%). Mode of access (e.g., from home, smartphone) and smartphone only analyses also revealed disparities. CONCLUSIONS Without internet access, online dissemination of information, health promotion, and health care will not reach a significant segment of youth. Currently, SES and racial/ethnic disparities in access prolong health inequalities.