Psychosocial correlates of dating violence victimization among Latino youth.

Howard, Donna E. ; Beck, Kenneth ; Kerr, Melissa Hallmark 等

A growing literature attests to the fact that dating violence is an important public health problem (Howard & Wang, 2003a,b; Silverman, Raj, Mucci, & Hathaway, 2001; U.S. Department of Health and Human Services, 2000a,b; Centers for Disease Control, 2000). Data from the most recent national Youth Risk Behavior Survey of high school students indicate that approximately 10% had been hit, slapped or hurt on purpose by their boyfriend or girlfriend over the previous year (Centers for Disease Control, 2002).

Available national data also suggest a clustering of problem behaviors and other risk indicators among adolescents who experience dating violence; that is, adolescents who report sad/hopeless or depressed feelings, poorer self-esteem, substance use, multiple sex partners, and unprotected sex are more likely to report being a victim of dating violence (Ackard, Neumark-Satainer, & Hannah, 2003; Howard & Wang, 2003a,b; Silverman, Raj, Mucci, & Hathaway, 2001). Elsewhere, among largely urban minority youth, Howard et al. found religious service attendance and perceptions of high parental monitoring to be associated with fewer reports of dating violence (Howard, Yue, & Boekeloo, 2003).

When national data are examined by ethnicity, Hispanic girls appear more likely to report dating violence victimization than their peers (Howard & Wang, 2003; Centers for Disease Control, 2002). Despite this, there is little information on the experience of dating violence victimization among Latino youth. Clearly, more needs to be learned about the correlates of dating violence among various ethnic groups in order to support the development of culturally sensitive prevention and intervention efforts.

There is also a great deal to learn about the correlates of dating violence among male and female Latino youth. In addition to the correlates they share in common, there may be important gender differences in the risk profiles associated with dating violence. Among U.S. girls, dating violence has been associated with binge drinking and cocaine or inhalant use, whereas among boys, attempted suicide and fighting is linked to dating violence (Howard & Wang, 2003a,b).

There were several primary aims of the present study. First, we examined whether there was a clustering of problem behaviors among Latino youth who reported dating violence. It was hypothesized that Latino youth who reported engagement in a host of risk behaviors would be more likely to report being a victim of physical dating violence. Second, the study assessed whether certain personal and familial factors were associated with decreased likelihood of dating violence. It was hypothesized that youth who had a good sense of self, were engaged in religious or community activities, and perceived strong parental monitoring or family connectedness would be less likely to report dating violence. Finally, the study examined whether there were gender differences in the risk profiles of Latino youth who reported dating violence. While most research and intervention efforts to date have focused on girls as victims (Silverman, Raj, Mucci, & Hathaway, 2001; Harned, 2001; Bennett & Fineran, 1998; Molidor & Tolman, 1998; Lane & Gwartney-Gibbs, 1985; Gelles, 1981), the experience of physical dating violence among boys may be a more serious problem than has previously been recognized (Howard & Wang, 2003; Hyman, 1999). If indeed, dating during adolescence is preparation for adult relationships and the patterns learned early become habituated, then such investigations must begin now (Hyman, 1999; O'Leary, Barling, Arias, Rosenbaum, Malone, & Tyree, 1989; Torrey & Lee, 1987). Further, as argued by Foshee (1996), the traditional approach to dating violence prevention, which focuses on males as perpetrators and females as victims may be not only inappropriate but also lacking in conceptual clarity. Thus, the stratified analyses were expected to provide useful information for tailoring preventive interventions.

METHOD

Study Design and Sample Selection

The study was a cross-sectional, anonymous, self-administered survey of Latino adolescents (n = 446) residing in a suburban area outside of Washington, DC. After receiving IRB approval from the University of Maryland, trained Latino interviewers recruited Latino youth through direct invitation using a central location intercept strategy. There were no restrictions on eligibility based on gender, sexual orientation, socioeconomic status, school enrollment status, or English speaking and reading proficiency.

Recruitment sites included school areas (off school property), athletic and social events, and malls. Respondents were reimbursed for their time with a movie ticket or a gift certificate to McDonald's. In addition, youth were provided with resources about Identity, Inc, a Latino youth-serving community-based organization, local health service agencies, and relevant hotlines. The survey was administered in either Spanish or English depending on the preference of the respondent.

Adolescent informed consent was utilized. Given the nature of the recruitment methodology, the difficulty in contacting parents, and the anonymity of this survey, parental consent was not required. There were no privacy concerns reported by respondents in the obtained sample. Further details on recruitment and sampling methods can be found elsewhere (Kerr, Beck, Shattuck, Kattar, & Uriburu, 2003).

A total of 476 surveys were collected; however, only 446 were usable due to missing data and other inaccuracies that rendered them invalid. While it was not possible to precisely determine the refusal rate, estimates across interviewers ranged from as low as 5% to as high as 25%.

Survey and Measures

The survey used in this study was the Identity Positive Youth Development Survey for Latino Youth. It is a comprehensive, 2-part, 10-page questionnaire that takes approximately 30 minutes to complete. The survey was constructed after a rigorous development process that included an extensive literature review, feedback by a team of experts, cognitive testing (a formal process of review and feedback by members of the target population), and pilot testing with 110 male and female Latino adolescents (Kerr, Beck, Shattuck, Kattar, & Uriburu, 203). Part I of the survey included questions regarding a variety of social indicators of youth well-being, such as prosocial behavior, family connectedness, and academic support and encouragement. Part II of the survey concentrated on a developmentally appropriate risk assessment, including use of a variety of licit and illicit substances, violence-related behaviors, sexual practices, and emotional states such as depression and suicide ideation. The survey also included questions pertaining to the sociodemographic characteristics of respondents and their parents/guardians, such as age, gender, country of origin, length of U.S. residence, and parent/guardian education level.

Table 1 provides a description of all study variables. The dependent variable was physical dating violence. Five sub-domains of psychosocial factors were examined in relation to dating violence: other violence engagement, substance use, emotional well-being, prosocial behaviors, and parent and other family factors. In addition, demographic variables (grade and gender) were included.

Data Analysis

All statistical analyses were performed using the statistical software SPSS 11.5 for Windows (Shad, Barnwell, & Bieler, 1997). Initially, frequency distributions were examined for each item to determine coding of variables. Due to the small number of victims (n = 39), dating violence was collapsed to an "ever" versus "never" binary variable. Based on the frequencies in response categories and the appropriateness for statistical analysis, most independent variables were also recoded as dichotomous variables. In such cases, a coding of "1" indicated "ever" use while "0" indicated "never" use.

A previously developed algorithm was utilized to distinguish the most frequently monitored adolescents from those less frequently monitored (Beck, Boyle, & Boekeloo, 2004; Howard, Yue, & Boekeloo, 2003). Adolescents who reported that their parent/guardian engaged in each of the six monitoring behaviors "most" or "all of the time" were considered the frequently monitored group (n = 91, 20.5%), while youth who reported more infrequent monitoring were considered the less frequently monitored group.

The data were first analyzed using univariate logistic models between the dependent variable (physical dating violence) and each domain of the independent variable (violence, substance use, emotional state, protective behaviors, parental/familial factors and demographics) to examine their relationship. Analyses were performed on the entire sample and separately by gender. The unadjusted odds ratios (OR) and 95% confidence intervals (CI) as well as [chi square] tests were examined. To identify the most significant variables in relation to physical dating violence, multivariate logistic regression was used to include all significant independent variables from the univariate analyses in the models. Adjusted OR and 95% CI were examined to assess the significance of the relationships.

RESULTS

Sample Characteristics

The age range of respondents was 14-19 years, with a mean age of 16.1 years. The sample was comprised of slightly more males (51.6%) than females (48.2%). The majority of youth reported living in a two-parent household (60.3%). More than half the sample was born outside the U.S. (56.3%); the majority were from El Salvador (19.1%), Mexico (7.8%), and other Central American countries (11.7%).

Prevalence of Dating Violence Victimization

Approximately 9% of Latino adolescents reported experiencing physical dating violence in the previous year. There were nonsignificant differences in dating violence by gender; that is, roughly 8.9% of the girls and 8.8% of the boys reported being a victim of dating violence.

Bivariate Relationships between Physical Dating Violence and Risk Factors

Table 2 shows the unadjusted odds ratios for relationships between psychosocial factors and physical dating violence. For the overall sample, dating violence victimization was positively associated with engagement in a host of risk behaviors and inversely related to sense of self and family connectedness; that is, adolescents who were engaged in violence-related behaviors, such as weapon carrying, fighting, or gang involvement, or used substances (binge drinking or cocaine use) were more likely to report dating violence victimization. Depression and suicidal ideation were also positively associated with dating violence.

Neither parental monitoring nor religious involvement, two factors often seen to be protective against adolescent risk behavior, were significantly related to victimization. Similarly, volunteerism and grade in school were nonsignificant. With respect to monitoring, the odds ratio was, however, in the expected direction. Furthermore, being at a party without parental supervision was significantly related to dating violence victimization.

A similar pattern was exhibited for both adolescent females and males with several noteworthy exceptions. Girls who reported a stronger sense of self and higher family connectedness were less likely to report dating violence. This relationship was not evident for the males. Rather, boys who reported spending at least one hour each week with a mentor or caring adult other than a family member were more likely to report dating violence. For females, engagement in gang-related activities, but not gang membership, was significantly related to victimization, whereas both were highly significant for males. Among males, the odds of dating violence were lower if they were actual members of a gang rather than simply being involved in gang-related activities.

In most instances, the magnitude of the association between risk behavior and dating violence victimization was much greater for males than females. The most dramatic gender differences were seen for "being at an unsupervised party over the weekend." Compared to girls who never went to weekend unsupervised parties, those who did were almost twice as likely to have experienced victimization. Among boys, this behavior was associated with a ten-fold increase in victimization.

Multivariate Relationships between Physical Dating Violence and Risk Factors

In order to detect risk factors that were uniquely associated with physical dating violence victimization, multivariate logistic regression analyses, including all significant variables from the univariate models, were performed. Overall, youth who reported carrying a gun, involvement in physical fights, and who had considered suicide were at greater odds of also reporting being slapped or physically hit on purpose by a boyfriend or girlfriend (see Table 3).

Important differences emerged when analyses were stratified by gender. Among females, fighting was the sole risk behavior associated with dating violence victimization. At the same time, girls who reported a stronger sense of self were less likely to report dating violence. Among the males, gun carrying, but not physical fighting, and having considered suicide were uniquely associated with dating violence. Furthermore, spending time each week with a mentor was also significantly associated with dating violence.

DISCUSSION

Findings from this study substantiate what has been documented elsewhere regarding the reach of dating violence into the world of adolescents and are in accord with estimates of its prevalence (Howard & Wang, 2003a,b; Halpern et al., 2001; O'Keefe, 1997; Jezl et al., 1996; Foshee, 1996). Almost one in ten Latino youth reported physical dating violence experiences during the past year. While no systematic pattern emerged by grade, prevalence data clearly suggest that attention needs to be focused on psychosocial dynamics in dating relationships among mid-adolescents.

The risk profile of adolescents who were victims of dating violence adds further evidence that such victimization may fit the framework of Problem Behavior Theory (Resnick, Bearman, Blum, Bauman, Harris, Jones, Tabor, Beuhring, Sieving, Shew, Ireland, Bearinger, & Udry, 1997; Diclemente, Hansen, & Ponton, 1996; Basen-Engquist, Edmundson, & Parcel, 1996; Farrell, Danish, & Howard, 1992; Jessor, 1991; Jessor, 1982; Dryfoos, 1990). That is, there appears to be a subset of vulnerable Latino adolescents who are prone to multiple problem behaviors in tandem, and this syndrome may derive from personal and socioenvironmental antecedent factors (Siegel, Cousins, & Rubovits, 1993).

In this sample, dating violence clustered with other violence-related behavior. Regardless of the motive for carrying a weapon, youth who possessed a gun were seven times as likely to have also been a victim of dating violence. The odds that physical fighting would correlate with physical dating violence was of a similar magnitude.

Youth who had considered suicide were also more likely to report dating violence, though the strength of this relationship was less than that for overt, actual acts of violence. Arguably, suicide can be seen as an act of violence directed inward, rather than externalized. The relationship between suicidal thoughts and dating violence was essentially a dynamic among the males. Indeed, boys who reported having thoughts about suicide were almost six times as likely to report dating violence during the past year than did those without such thoughts. The despair these boys report experiencing appears to be linked to their dating violence experience. It is unclear, however, whether these feelings lead to increased vulnerability to being physically mistreated, or whether having experienced physicality in a dating relationship may lead to extreme psychological distress. In addition, some third unidentified factor may actually explain both of these observed relationships.

Substance use behavior did not remain significant once the relationship of all risk factors were jointly accounted for. Considered individually, such behavior may represent important risk factors; however, its relationship to dating violence victimization may have been eclipsed by the violence-related behaviors.

We did not find evidence that familial factors were associated with a decreased likelihood of dating violence. Parent monitoring and religious involvement were not found to be significantly associated with physical dating violence victimization among these youth. This runs counter to the work of Howard et al. among a population of predominantly African American youth (Howard, Yue, & Boekeloo, 2003). Measurement differences cannot explain these differences since both studies used the same parental monitoring scale, operationalized in a similar way. Since the process by which parental monitoring exerts its effect on youth behavior is not fully clear, it is possible that other aspects of this dynamic may be more pivotal for Latino youth. Perhaps it is not the youths' perception that their parents know where they are, who they are with, and what they are doing after school hours, but that factors such as honest disclosure and communication translate into protection from harm or reduced exposure to risk (Borawski, Levers-Landis, Lovegreen, & Trapl, 2003; Litt, 2003). Also, power insufficiency may have made this relationship difficult to detect.

While the prevalence of dating violence was similar for females and males, important gender differences were found among correlates. For girls, a strong sense of self seemed to decrease the odds of being physically abused in a dating relationship. Again, due to the cross-sectional nature of the data, it is not possible to determine the direction of effects. It could be argued that a strong sense of self makes it less likely that a girl would find herself in or tolerate a physical dating violence situation. It is also plausible that if a girl has been abused, her sense of self would be diminished.

An unexpected finding was that boys who spent more than one hour each week with a mentor (i.e., a caring adult outside one's family) were approximately ten times as likely as those without such contact to report physical dating violence. One would want to know whether boys who are victims of dating violence more actively seek time with a mentor for comfort and coping or whether it is some dynamic of these relationships that actually poses physical harm to the boys. The study also did not afford an opportunity to examine the extent to which boys' reports of physical dating violence reflect behavior within heterosexual or same-sex relationships. Such information would be critically important in directing intervention efforts.

Limitations

Clearly, cross-sectional studies, while allowing for determination of the prevalence of health behaviors and conditions, limit the investigatot's ability to clarify temporal relationships. Nor was the sample size sufficient to allow examination of correlates of dating violence by age. Measurement of physical dating violence by a single-item, self-report question is subject to bias, and self reports of dating experiences (as constituting intent of harm or purposeful force) are highly subjective (Wekerle & Wolfe, 1999).

Indeed, the context of dating violence victimization may differ for males and females; that is, it is not clear whether male victimization occurs at the hands of females who are acting in self defense (Malik, Sorenson, & Aneshensel, 1997; Foshee, 1996). Important background information regarding the dynamics that preceded the violence, including who initiated use of force, was lacking. Without such information we cannot disentangle perpetration from victimization. While the potential for physical harm is greater for females who are victims of dating violence (Lane & Gwartney-Gibbs, 1985; Gelles, 1981), the psychological effects of dating violence on both males and females may affect their subsequent relationships in very consequential ways.

These findings, while addressing some dimensions of the familial and parenting dynamics, do not shed light on other aspects of the home, family, and school setting that might provide important insight into the factors associated with dating violence. Finally, the data did not afford the opportunity to examine the profile of perpetrators of dating violence, an area that warrants further attention with regard to dating violence prevention and intervention efforts.

CONCLUSION

Physical dating violence appears to affect a small but significant number of Latino youth. The correlates of dating violence provide further evidence of a clustering of problem behaviors among certain vulnerable adolescents. Both the antecedents and consequences of dating violence victimization deserve further study.

Table 1
Study Variables

Variable Description

Dependent Variable

Dating Violence (b) Past year frequency of having been
 slapped or physically hurt on
 purpose by boy/girlfriend

Independent Variables

Violence Engagement (b)
 1. Gun Carrying (b) Past year gun carrying
 2. Other Weapon Carrying (b) Past year knife or club carrying
 3. Physical Fighting (b) Past year fighting
 4. Gang Membership (c) Lifetime gang membership
 5. Gang Involvement (c) Lifetime gang-related involvement

Substance Use (b)
 1. Binge Drinking Past year frequency of binge
 drinking
 2. Marijuana Past year marijuana use
 3. Cocaine Past year cocaine use
 4. Glue/Inhalants Past year glue/inhalant use
 5. Heroin Past year heroin use

Emotional Well-Being (c)
 1. Suicide Ever seriously considered
 attempting suicide
 2. Depression Ever felt depressed every day for
 at least two weeks in a row
 3. Sense of Self and Future (d) Endorsement of statements regarding
 making good decisions, liking self,
 acting honestly even in difficult
 situations, feeling good about the
 future

Prosocial Behaviors (e)
 1. Time with Mentor Average number of hours per week
 spent with caring adult other than
 family
 2. Volunteerism Average number of hours per week
 spent helping others without pay
 3. Religious Involvement Average number of hours per week
 spent at church or in religious
 activities

Parental/Familial Factors
 1. Parental Monitoring (f) Perception that parent knows
 youth's whereabouts and activities
 2. Family Connectedness (d) Extent to which youth felt close
 to, spent time with, and
 communicated with family

 Number of
Variable Item ([alpha]) (a)

Dependent Variable

Dating Violence (b) 1

Independent Variables

Violence Engagement (b)
 1. Gun Carrying (b) 1
 2. Other Weapon Carrying (b) 1
 3. Physical Fighting (b) 1
 4. Gang Membership (c) 1
 5. Gang Involvement (c) 1

Substance Use (b)
 1. Binge Drinking 1
 2. Marijuana 1
 3. Cocaine 1
 4. Glue/Inhalants 1
 5. Heroin 1

Emotional Well-Being (c)
 1. Suicide 1
 2. Depression 1

 3. Sense of Self and Future (d) 10 (0.83)

Prosocial Behaviors (e)
 1. Time with Mentor 1

 2. Volunteerism 1

 3. Religious Involvement 1

Parental/Familial Factors
 1. Parental Monitoring (f) 6 (0.88)

 2. Family Connectedness (d) 8 (0.86)

(a) Cronbach's alpha was used to assess internal consistency in
those cases where variables were represented by a summative scale.

(b) Response categories included "almost daily," "a couple of times
a week," "a couple of times a month, "less than once a month" and
"never."

(c) Response categories were "yes" or "no."

(d) Response categories included "strongly agree," "agree,"
"disagree" and "strongly disagree."

(e) Response categories included "8 hour or more," "6-7 hours,"
"4-5 hours." "2-3 hours," "1 hour or less" and "0 hours."

(f) Response categories included "all of the time," "most of
the time," "sometimes" and "never."

Table 2
Unadjusted Odds Ratios for Relationships Between Dating Violence
Victimization and Psychosocial Risk Factors Among Latino
Adolescents (a)

Risk Total
Factor Odds Ratio 95% Cl (b)

Grade (c) 0.99 0.80-1.24
Gun Carrying
 Ever 17.68 7.96-39.26 ***
 Never 1.00
Other Weapon Carrying
 Ever 6.34 3.20-12.59 ***
 Never 1.00
Physical Fighting
 Ever 15.69 5.47-45.03 ***
 Never 1.00
Gang Membership
 Ever 4.58 2.14-9.82 ***
 Never 1.00
Gang Involvement
 Ever 7.23 3.63-14.41 ***
 Never 1.00
Binge drinking
 Ever 4.58 2.24-9.37 ***
 Never 1.00
Cocaine Use
 Ever 8.98 4.34-18.62 ***
 Never 1.00
Considered Suicide
 Ever 6.15 3.03-12.48 ***
 Never 1.00
Depression
 Ever 3.08 1.57-6.02 **
 Never 1.00
Religious Involvement
 1+ hours/week 2.02 0.98-4.18
 0 hours 1.00
Night/Weekend Unsupervised Party
 Ever 3.74 1.73-8.07 **
 Never 1.00
After-School Unsupervised Party
 Ever 4.38 2.08-9.23 ***
 Never 1.00
Sense of Self 0.86 0.79-0.93 ***
Family
Connectedness 0.87 0.81-0.94 **
Volunteered
 1+ hours/week 1.35 0.70-2.61
 0 hours 1.00
Parental Monitoring
 High 0.42 0.14-1.20
 Low 1.00
Spend Time with Mentor
 1+ hours/week 1.86 0.96-3.62
 0 hours 1.00

Risk Female
Factor Odds Ratio 95% Cl (b)

Grade (c) 1.21 0.89-1.65
Gun Carrying
 Ever 11.19 3.03-41.27 ***
 Never 1.00
Other Weapon Carrying
 Ever 7.83 2.85-21.55 ***
 Never 1.00
Physical Fighting
 Ever 17.66 4.92-63.35 ***
 Never 1.00
Gang Membership
 Ever 2.17 0.44-10.69
 Never 1.00
Gang Involvement
 Ever 5.69 2.07-15.66 **
 Never 1.00
Binge drinking
 Ever 4.12 1.54-11.00 **
 Never 1.00
Cocaine Use
 Ever 8.26 2.38-28.61 **
 Never 1.00
Considered Suicide
 Ever 3.80 1.41-10.21 **
 Never 1.00
Depression
 Ever 2.67 1.02-6.95 *
 Never 1.00
Religious Involvement
 1+ hours/week 1.51 0.55-4.14
 0 hours 1.00
Night/Weekend Unsupervised Party
 Ever 1.86 0.70-4.93
 Never 1.00
After-School Unsupervised Party
 Ever 2.97 1.12-7.89 *
 Never 1.00
Sense of Self 0.72 0.62-0.84 ***
Family
Connectedness 0.80 0.71-0.90 ***
Volunteered
 1+ hours/week 1.06 0.41-2.73
 0 hours 1.00
Parental Monitoring
 High 0.56 0.18-1.76
 Low 1.00
Spend Time with Mentor
 1+ hours/week 0.78 0.30-2.08
 0 hours 1.00

Risk Male
Factor Odds Ratio 95% Cl (b)

Grade (c) 0.81 0.58-1.14
Gun Carrying
 Ever 26.59 9.02-78.40 ***
 Never 1.00
Other Weapon Carrying
 Ever 6.41 2.35-17.50 **
 Never 1.00
Physical Fighting
 Ever 20.00 2.62-151.82 **
 Never 1.00
Gang Membership
 Ever 7.33 2.73-19.66 ***
 Never 1.00
Gang Involvement
 Ever 10.91 3.76-31.67 ***
 Never 1.00
Binge drinking
 Ever 5.17 1.79-14.94 **
 Never 1.00
Cocaine Use
 Ever 11.31 4.20-30.47 ***
 Never 1.00
Considered Suicide
 Ever 10.63 3.78-29.93 ***
 Never 1.00
Depression
 Ever 3.71 1.44-9.54 **
 Never 1.00
Religious Involvement
 1+ hours/week 2.62 0.92-7.47
 0 hours 1.00
Night/Weekend Unsupervised Party
 Ever 9.84 2.22-43.49 **
 Never 1.00
After-School Unsupervised Party
 Ever 7.18 2.04-25.26 **
 Never 1.00
Sense of Self 0.93 0.84-1.03
Family
Connectedness 0.93 0.84-1.03
Volunteered
 1+ hours/week 1.69 0.66-4.30
 0 hours 1.00
Parental Monitoring
 High 0.88 N/A (d)
 Low 1.00
Spend Time with Mentor
 1+ hours/week 4.61 1.61-13.19 **
 0 hours 1.00

(a) The last category was used as the reference. (b) Cl = confidence
intervals. (c) Grade consisted of the following question: "What grade
will you be in this fall?" (response categories included "8th" through
"college"). (d) 0 in cell.

* p < .05, ** p < .01, *** p < .0

Table 3
Adjusted Odds Ratios for Relationships Between Dating Violence
Victimization and Psychosocial Risk Factors Among Latino
Adolescents (a)

Risk Total
Factor Odds Ratio 95% Cl (b)

Gun Carrying
 Ever 7.67 2.09-28.21 **
 Never 1.00
Physical Fighting
 Ever 7.24 2.18-24.08 **
 Never 1.00
Considered Suicide
 Ever 3.95 1.33-11.74 *

 Never 1.00
Sense of Self NS
Spend Time with Mentor
 1+ hours N/A (c)
 0 hours

Risk Female
Factor Odds Ratio 95% Cl (b)

Gun Carrying
 Ever NS
 Never
Physical Fighting
 Ever 12.86 2.37-70.0 **
 Never 1.00
Considered Suicide
 Ever NS
 Never
Sense of Self 0.80 0.66-0.97 *
Spend Time with Mentor
 1+ hours N/A (c)
 0 hours

Risk Male
Factor Odds Ratio 95% Cl (b)

Gun Carrying
 Ever 12.45 2.26-68.58 **
 Never 1.00
Physical Fighting
 Ever NS
 Never
Considered Suicide
 Ever 5.85 1.25-27.37 *
 Never 1.00
Sense of Self N/A (c)
Spend Time with Mentor
 1+ hours 9.83 1.70-56.79 *
 0 hours

(a) The last category was used as the reference.

(b) Cl = confidence intervals.

The authors would like to recognize the invaluable contribution of Candice Kattar and Diego Unburu of Identity, Inc. to this project.

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Kenneth Beck, Ph.D., Department of Public and Community Health, University of Maryland, College Park.

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Reprint requests to Donna E. Howard, DrPH, Associate Professor, University of Maryland, Department of Public and Community Health, College Park, MD 20742. Email: dhowardI@umail.end.edu