Hoping to address a critical health gap among the youth of the United States, Julie Cederbaum, assistant professor at the USC School of Social Work, is participating in two new studies on the disproportionate effect of HIV/AIDS and substance use on young African-American men and adolescents.

A recently awarded federal grant will enable her team to investigate the effectiveness of a media intervention designed to increase HIV testing among African-American youth, while a second project will evaluate mother–son communication strategies as a deterrent to tobacco, alcohol and substance use in a similar population.

The first study—led by Professor John Jemmott of the University of Pennsylvania—will examine the impact of a series of dramatic film shorts that will be aired on public buses in Los Angeles beginning this fall. The 3-minute episodes will follow the intertwining lives of a handful of characters as they deal with issues related to HIV/AIDS, sexually transmitted infections and HIV testing.

"African Americans have some of the highest rates of new HIV infections in the country, as well as some of the lowest HIV testing rates," Cederbaum said. "We want to find out if seeing these episodes triggers people to think about whether they should be tested or gets them thinking about the behaviors they are engaging in."

Research has revealed that young African-American men are at a higher risk for HIV or other sexually transmitted infections than many other populations. In 2008, the Centers for Disease Control (CDC) found that infection rates among African-American youth in the United States rivaled those in sub-Saharan African countries.

Social factors at play include poverty, poor access to preventive medical care and homophobia; according to the research team, the latter often prompts young African-American men who have sex with men hide these activities and avoid testing.

Cederbaum said a significant HIV stigma remains in the African-American community. "I think that's a big deterrent to testing," she said. "What are people going to think of me if I have to be tested?"

Researchers will focus on African-American youth between the ages of 14 and 24 who ride Los Angeles Metro buses in designated areas of the city—specifically, social work students trained in data collection will use handheld mobile devices to conduct anonymous surveys with 800 riders at bus stops in South Los Angeles and Inglewood, areas with a high population of African- American residents.

The serial drama, titled "Reality Check," features 27 episodes; each will be shown once an hour for one week, then made available online. After each episode airs, a list of free HIV testing sites will be displayed on the screens. Surveys of riders will take place before and immediately after the 27 episodes air, as well as three and six months after the broadcast.

The research team will also collect data from HIV-testing locations to determine changes in HIV testing rates among African-American youth. Surveys of young African-American bus riders and testing sites in Richmond, Calif., an area with similar sociodemographic features, will serve as a control group.

"The goal is to see if this type of media outreach or public health campaign can increase HIV testing among African-American youth," Cederbaum said. "It's media, but it's very different from a flat, two-dimensional poster. It's unique in that this is the first video media campaign that will run on buses."

Cederbaum's clinical expertise and connection to trained data collectors, as well as her knowledge of qualitative methods, will fill several niches in the research team.

The $700,000 grant, of which roughly $200,000 is earmarked to USC, runs through May 2013.

The second study, a two-year, $100,000 project led by Cederbaum and Professor M. Katherine Hutchinson of New York University, will utilize data from a previous study to explore the influence of urban African-American mothers on the use of tobacco, alcohol and other substances by their sons. The original research, headed by Loretta Jemmott of the University of Pennsylvania, involved providing training to mothers in either HIV-risk reduction or health promotion.

While the original study examined the HIV intervention using the health intervention as a control, Cederbaum and her colleague proposed flipping the comparison—exploring the effectiveness of the health-related training on tobacco, alcohol and substance use among young African-American male adolescents in urban settings.

"This is really targeting a group that has been very understudied," she said.

A considerable amount of research has focused on communication between mothers and daughters, aggression in young men or sexual risk reduction, Cederbaum explained, but few studies have explored the impact of mother–son communication on tobacco, alcohol and substance abuse issues.

Finding a deterrent to substance use behaviors among African-American youth is critical, given that studies by the CDC have shown that African-American male high school students are significantly more likely than their white peers to drink alcohol or try marijuana before age 13.

Substance use in early adolescence has significant health and social consequences, according to the researchers. Cigarette smoking can lead to cancer or heart and lung disease, while alcohol and drug use have been linked to aggression and delinquent behavior. Other negative consequences include injury, suicide, violence, teen pregnancy and HIV infection.

The dataset features information from the original randomized study of 575 African-American mothers with sons between the ages of 11 and 15 in 42 public housing communities in Philadelphia.

Cederbaum said the new study will lead to insights about the influence of African-American mothers on their adolescent sons, leading to the development and refinement of family-based strategies to reduce the use of tobacco, alcohol and other illicit substances among urban African- American youth.

The National Institutes of Health provided funding for both studies. The first study, titled "'Reality Check' in Transit: Evaluation of a Serial Drama for Black Youth," received funding from the National Institute of Mental Health, while funding for the second project, "Maternal Influences of Substance Use among Urban Black Male Adolescents," is being provided by the National Institute of Drug Abuse.