Human Development and Social Justice Active Projects

Current Research from the Director

“Who should be treated? The ethical challenges of administering opioid agonist treatment (OAT) for people who inject drugs during COVID-19."
Roberto Abadie, PhD, University Nevada, Lincoln (HIV and Drug Abuse Prevention Research Ethics Training Institute Alum)
Celia B. Fisher, PhD, Fordham University
Funded by the Greenwall Foundation

There have been a number of highly influential public health ethics theoretical frameworks, a recently revised American Public Health Association (APHA) Public Health Ethics Code, and ethical guidance for public health emergencies developed for the Center for Disease Control and Prevention. All provide broad guidance for ethical decision-making regarding access to medical care during the COVID pandemic, but due to the novelty of the current pandemic and the crises in Opioid Agonist Treatment it has created, little is known regarding it’s applicability to the challenges facing patients and clinicians providing addiction care in economically marginalized regions of the U.S. This study will provide a critical analysis of the extent to which the core values articulated in current models for public health ethics reflect the moral values of PWID and ethical decision-making challenges faced by OAT staff in Puerto Rico. Drawing on the perspectives of key stakeholders this project will also contribute to the development of tailored, contextually-based ethics guidelines for OAT and other forms of addiction treatment for current and future infectious disease crises.

Current Research from the Lab

Influence of LGBT Adolescent Identity Processes on the Association Between Offline and Social Media Discrimination and Mental Health and Substance Use
Celia B. Fisher, PhD, Fordham University
Xiangyu Tao, MA, Fordham University (HDSJ Lab Doctoral Student)

Purpose. Anti-transgender and anti-gay legislation have increased social acceptability of discriminatory actions against LGBTQ+ populations exposing youth to heterosexist and transphobic social media messaging. Drawing on the minority stress and identity development models, this study examined the influence of LGBT identity exploration and commitment on the association between exposure to these forms of discrimination and mental health and SUD. Methods. An online survey was completed by 471 racially/ethnically diverse LGBT 14-18 year-olds. Multiple regression assessed the moderating influences of identity processes on the association between online and social media discrimination and depression (PHQ-9), anxiety (GAD-7), and SUD (CRAFFT). Demographic variables and offline and online identity disclosure and social support served as covariates. Results. Overall, 63.5% of youth met criteria for moderate levels of depression, 52.7% for anxiety and 39.8% were at risk for SUD. Identity commitment and exploration were associated with increases in social media and offline discrimination. Although commitment was negatively related to depression and anxiety, it did not buffer the detrimental impact of discrimination on these symptoms. Rather, paradoxically at higher levels of offline discrimination, it increased the association for depression and anxiety. Identity exploration was associated with increased SUD, but did not moderate the association between discrimination and SUD. Discussion. This is the first study to examine relationships among LGBT adolescent identity processes, offline and social media discrimination, and mental health and substance use. By investigating these relationships, the study furthers understanding of developmental processes that influence risk and resilience among LGBT youth in response to discrimination.

"COVID-19 Vaccine Hesitancy Among Economically Marginalized Hispanic Parents of Children Under Five Years in the United States"
Celia B. Fisher, PhD, Fordham University
Purnima Madhivanan MBBS, MPH, Ph.D. (HIV and Drug Abuse Prevention Research Ethics Training Institute Alum)
Anna Park, MA, MS, PhD, Fordham University (HDSJ Lab Postdoctoral Fellow)
Elise Bragard, MA, PhD, Fordham University (HDSJ Lab Doctoral Student)

Hispanic children have high rates of COVID-19 related hospitalizations and related deaths. Following FDA emergency approval of COVID-19 vaccination for children under five, vaccination rates have been alarmingly low, especially in border states with significant Hispanic populations. The aim of the current study was to identify demographic, health belief, structural and cultural factors associated with COVID-19 vaccine hesitancy among economically marginalized Hispanic parents of children under five living in US border states. In July, 2022, 309 Hispanic female guardians in Texas, Arizona and New Mexico responded to an online survey assessing parental intent to vaccinate their child, demographic parent and child characteristics, COVID-19 health and vaccine beliefs, trust in traditional sources of health information, physician and community support, and acculturation to Anglo American norms. Data indicated 45.6% of parents did not intend to vaccinate their child (resistant parents), 22.0% were unsure, and 32.4% intended to vaccinate their child (accepting parents). Bivariate correlations followed by multinomial logistic regression indicated vaccine acceptance was positively associated with perceived child COVID-19 susceptibility, trust in traditional health resources, a doctor’s recommendation for vaccination, community support, child’s age, higher parental income and education, and if the child had private compared to government or no health insurance. Vaccine acceptance was negatively associated with vaccine misconceptions, belief vaccination was unnecessary, general vaccine mistrust, nativity, time living in the US, and preference for English language. This study demonstrates how misinformation and distrust regarding vaccine safety, lack of community and other structural supports, and acculturation to perceived Anglo American norms are risk factors for vaccine hesitancy among economically marginalized Hispanic families. The research highlights the importance of public health strategies that draw on Hispanic community partnerships and on early and enhanced pediatrician-parent communication about routine and COVID-specific vaccinations are important public health strategies.

Social Media: A Double-Edged Sword for LGBT Youth
Celia B. Fisher, PhD, Fordham University
Xiangyu Tao, MA, Fordham University (HDSJ Lab Doctoral Student)
Madeline Ford, Fordham University (Undergraduate Research Assistant)

As LGBT youth navigate a heteronormative and cisnormative society where they face the pressures of minority stress, social networking sites (SNS) play an increasingly critical role in their journey towards connection and acceptance. Through SNS platforms, youth can find a sense of community, but are also exposed to heterosexist and transphobic SNS messaging. These experiences can have a positive or negative impact on mental health. The current study examined how LGBT youth’s online experience as reflected in their qualitative narratives can illuminate relationships between quantitative measures of exposure to social media discrimination, social support, mental health, and substance use. An online survey completed by 398 racially/ethnically diverse LGBT youth (14 – 18 years) administered quantitative measures of exposure to SNS discrimination, social support, loneliness, mental health, and substance use and an open-ended question on youth’s experiences and feelings related to social belonging or isolation on SNS.  Between 40% - 63% of youth met criteria for moderate levels of depression, anxiety and substance use disorder and these were associated with moderate to high levels of SNS discrimination. SNS social support and loneliness positively correlated with social media discrimination, but not with mental health indices. Content analysis of narratives yielded 3 over-arching themes of SNS characterized as (1) a supportive environment, where youth felt a sense of belonging, made friends, and cultivated a positive identity; (2) a hostile environment where they experienced personal attacks, observed attacks against other LGBT persons, felt isolated and remained closeted, and (3) a both supportive and hostile environment where they experienced support and hostility and where LGBT SNS communities served as a refuge against discrimination.  For all youth SNS discrimination was associated with mental health and SUD symptoms. However, compared to youth who characterized social media as hostile, at the highest levels of discrimination those experiencing SNS as supportive or both supportive and hostile, were at greater mental health risk and SUD.  One reason may be that those holding positive or mixed expectations for their online experience, are not prepared for exposure to the more extreme levels of hostility they may encounter. This study also underscores the value of mixed-method approaches in understanding the benefits and risks of social media for LGBT youth.

Associations between Sexting Motivations and Consequences among Adolescent Men who have Sex with Men (AMSM)
Elise Bragard, MA, PhD, Fordham University (HDSJ Lab Doctoral Student)
Celia B. Fisher, PhD, Fordham University
Diana Paradise, Fordham University (Undergraduate Research Assistant)

Sexting is defined as the sending/receiving of sexual messages, photos, or videos via online communication (including via text message, email, social media platform, or dating/hook-up app). Research indicates that LGBTQ youth, and specifically AMSM, sext more frequently than their heterosexual peers. However, there is a dearth of research that provides a comprehensive descriptive analysis of sexting motivations and consequences specific to the AMSM population. Additionally, there has been no research to date that examines the associations between reported motivations and actual consequences of sexting. This online quantitative project will survey 400 AMSM (14-17 years) who have prior sexting experience from diverse backgrounds to examine the associations between their reported motivations for setting and the consequences they experienced as a direct result of sexting.

Risks and Benefits of Online Social Media Advocacy Work for LGBT Youth
Xiangyu Tao, MA (HDSJ Lab Doctoral Student)
Celia B. Fisher, PhD, Fordham University

Research indicates that LGBTQ youth are more likely to experience cyberbullying than their peers, especially among those who engaged in advocacy work against anti-LGBTQ attitudes. Qualitative work also shows that social media networks can serve as an important support resource for them. It is unclear whether the negative mental health impact of sexual and gender social media discrimination can be buffered by such supportive networks for LGBTQ youth living in different social-political environments. This online mix-method project will survey 450 LGTBQ youth from diverse backgrounds to examine the associations among their online advocacy work for promoting LGBTQ equality, exposure to social media sexual/gender discrimination, perceived and seeking of social support on social media, and mental health and substance use. 

Current Master's Theses and Doctoral Dissertations

Exposure to Gendered Racism, Friendships, and Mental Health among Young Women of Color
Xiangyu Tao, MA (HDSJ Lab Doctoral Student)
Katherine Brown (Fordham University Undergraduate Research Assistant)
Dissertation

Intersectionality theory posits that young women of color experience gendered racism, a fusion of sexism and racism rooted in oppressive power systems. Recent research has underscored the profound mental health implications of such experiences. The role of friendships in this context may be dual-faceted: they can serve as protective buffers or magnify the stressors of gendered racism. For instance, gendered racial/ethnic socialization can empower, but also present challenges for young women of color. Excessive discussions, or co-ruminating on gendered racism topics can heighten mental health. Social media may further complicate these dynamics. Thus, the current study aims to understand friendships’ roles in offline and online gendered racism exposure and associated mental health and substance use risk among Asian, Black, and Hispanic/Latina women. Preliminary analyses highlight that these women predominantly report strong bonds, support, and often engage in discussions around empowerment and oppression with their same race/ethnicity and gender close friend. However, Asian women reported fewer instances of discrimination, both offline and online, compared to Black women. Positive friendships were associated with lower mental health and substance use risk. Furthermore, higher intimacy and support between friends buffered the negative effects of co-rumination against racism on substance use. SEM analyses reveal that co-rumination about gendered racism with friends serves as a pathway linking offline and online gendered racism exposure to heightened anxiety and substance use. These results underscore the need for interpersonal interventions addressing gendered racism to support the well-being of young women of color.

Recently Completed Master's Theses and Doctoral Dissertations

Social Media Use, Social Media Racial/Ethnic Discrimination, and Mental Health Among BIPOC Adolescents During the COVID-19 Pandemic
Xiangyu Tao, MA
Master's Thesis

Parental Messaging And Attitudes Toward Sex And Sexuality Among Ethnically Diverse Adolescent Girls
Elise Bragard, MA. PhD
Dissertation

The Role of Sexual Subjectivity and Peer Influences on Sexting Consequences Among Adolescent Girls
Elise Bragard, MA, PhD
Master's Thesis

Social Determinants of HPV Vaccination Intentions among Black Mothers with Young Daughters
Aaliyah Gray, MA, PhD
Dissertation

Predictors of Sexual Health in Lesbian and Bisexual Black Women who Have Sex with Men
Aaliyah Gray, MA, PhD
Master's Thesis

Psychosocial developmental trajectory profiles and psychiatric hospitalization among transition-age youth receiving mental health services
Deborah Layman, MA, PhD
Dissertation

Developmental strengths and vulnerabilities and mental health among young adults with a history of adolescent inpatient psychiatric hospitalization
Deborah Layman, MA, PhD
Master's Thesis