Few empirical studies have documented the life trajectories of gang-affiliated adolescent females and the long- term health consequences of adolescent drug use and partner violence victimization. The purpose of this study is to identify and determine how distinct drug use and intimate partner violence victimization trajectories that emerge in adolescence through young adulthood contribute to physical and mental health outcomes among Mexican American women within the context of a highly disadvantaged community. This group of women are particularly vulnerable given they have low rates of access and utilization of health care, are the most likely age group to be uninsured, and represent a nexus of risk, vulnerability and potentially high costs to communities given their reproductive and sexual health stage of life. This application proposes a 15 year follow up of a cohort of Mexican American adolescent females previously identified in a CDC funded study who were affiliated with male gang members during their adolescence and involved in high rates of drug use and victims of intimate partner violence. Building upon the research teams previous studies and using analytical tools from the theory of gender and power and social bonding theory, this application will implement a concurrent mixed methods nested design approach to provide a comprehensive understanding of the long-term consequences of drug use and IPV. The sample will consist of 300 young adult Mexican-American females.
The specific aims for this study are: 1) determine the prevalence of physical (cardiovascular and metabolic risk markers and STI infection) and mental (depression, PTSD, anxiety/stress) health outcomes; 2) identify and characterize distinct drug use and IPV trajectories from adolescence through young adulthood; 3) determine whether sexual relationship power and family social bonds during distinct age-graded stages alter drug use and IPV trajectories and health outcomes; and 4) characterize qualitatively the culture and community context and their influence on drug use and IPV trajectories over the life course. This research will have an important positive impact by identifying women who are at the highest risk for developing harmful drug and IPV trajectories as they transition into young adulthood. In doing this, we will lay the foundation for identifying critical points of behavioral intervention during key age-graded periods as well as culturally and contextually appropriate values and strategies that will reduce health disparities among similar high-risk female populations that have gone underrepresented in existing research.

Public Health Relevance

This application seek a comprehensive understanding of the long term health consequences of drug use and intimate partner violence victimization physical and mental health outcomes among a vulnerable cohort of Mexican-American females recruited over 15 years ago who were affiliated with male gang members during their adolescence. The study will provide a unique opportunity to investigate detrimental life trajectories contributing t the prevalence of cardiovascular and metabolic risk markers, infection, depression, PTSD, anxiety and stress within a marginalized and underserved community context. Findings will contribute to policy discourse that can lead to the development of innovative public health programs and campaigns that will reduce health disparities among minority women. PHS 398/2590 (Rev. 11/07) Page Continuation Format Page

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA039269-03
Application #
9276638
Study Section
Community Influences on Health Behavior (CIHB)
Program Officer
Schulden, Jeffrey D
Project Start
2015-07-01
Project End
2020-05-31
Budget Start
2017-06-01
Budget End
2018-05-31
Support Year
3
Fiscal Year
2017
Total Cost
$680,144
Indirect Cost
$214,990
Name
University of Southern California
Department
Type
Schools of Social Work
DUNS #
072933393
City
Los Angeles
State
CA
Country
United States
Zip Code
90033