Pior ainda para as meninas negras: racismo, cor ou raça e uso de álcool e tabaco entre estudantes
Data
2023-12-18
Autores
Menezes, Alessandra Aparecida da Silva 
Orientadores
Escudeiro, Richard Miskolci
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Avaliar, interseccionalmente com sexo/gênero, o papel (mediador e preditor) do bullying racial e os efeitos de um programa de prevenção na relação entre cor ou raça e uso de substâncias entre escolares do Ensino Fundamental. Métodos: Foram conduzidos três estudos embasados em teorias estatístico-socioepidemiológicas. O primeiro, estudo transversal com dados da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015, abrangeu 102.072 adolescentes, representantes dos estudantes dos nonos anos do Brasil. O estudo avaliou a relação entre ser alvo recente de bullying racial e o uso recente de álcool, tabaco e substâncias ilícitas (Artigo 1). O segundo, estudo prospectivo de coorte, utilizou dados de dois ensaios controlados randomizados por conglomerados (ECRCs), realizados em 2019 com estudantes dos quintos (linha de base: 1.727; segmento: 1.334) e sétimos (linha de base: 2.303; seguimento: 1.739) anos de escolas públicas estaduais da cidade de São Paulo. Este estudo investigou se ser alvo de bullying racial na linha de base poderia prever o início do uso de álcool e tabaco entre os estudantes em nove meses de seguimento (Artigo 2). O terceiro estudo avaliou variação racial no efeito preventivo de um programa de prevenção, avaliado pelos ECRCs descritos no segundo estudo (Artigo 3). As análises foram conduzidas no programa R, empregando principalmente modelos lineares generalizados de Poisson. Resultados: Entre os estudantes dos nonos anos, observou-se que as meninas apresentaram prevalência mais alta de uso recente de álcool em comparação aos meninos, e essa prevalência foi ainda maior entre as pretas. Consistentemente, o bullying racial explicou o uso recente de álcool e tabaco entre os estudantes negros (pardos e pretos) (Artigo 1). Entre os participantes da avaliação do programa de prevenção, na linha de base, as meninas dos sétimos nos também apresentaram maior prevalência de uso de álcool em comparação aos meninos. Em nove meses de seguimento, o bullying racial previu o início do uso de álcool e tabaco neste ano escolar, com variações entre os estratos da intersecção cor ou raça e sexo/gênero, destacando a maior vulnerabilidade das meninas negras (Artigo 2). O programa não foi eficaz na prevenção do uso de álcool e tabaco, independentemente da cor ou raça dos estudantes, tanto nos quintos quanto nos sétimos anos (Artigo 3). Conclusões: O bullying racial prediz e explica parcialmente o uso de substâncias por estudantes negros. Além disso, o gênero exerce influência no consumo de álcool, com as meninas apresentando maior consumo do que os meninos, e com as negras com o consumo mais elevado entre as meninas. Programas escolares, embasados em evidências científicas, devem incorporar explicitamente metas antirracistas em suas estratégias de prevenção do uso de substâncias. Ações envolvendo a polícia, os serviços de saúde e a escola são discutidas.
Objective: To evaluate, in an intersectional way with sex/gender, the role (mediator and predictor) of racial bullying and the effects of a prevention program on the relationship between race/skin color and substance use among elementary and middle school students. Methods: Three studies based on statistical-socioepidemiological theories were conducted. The first was a cross-sectional study using data from the 2015 National Student Health Survey (PeNSE), involving 102,072 adolescents representing nineth grade students in Brazil. This study assessed the relationship between recent racial bullying and recent use of alcohol, tobacco, and illicit substances (Article 1). The second, a prospective cohort study, utilized data from two cluster-randomized controlled trials (cRCT) conducted in 2019 with fifth- (baseline: 1,727; follow-up: 1,334) and seventh- (baseline: 2,303; follow-up: 1,739) grade students in public state schools in the city of São Paulo. It investigated whether being a target of racial bullying at baseline could predict the initiation of alcohol and tobacco use among students over nine months of follow-up (Article 2). The third study assessed racial variation in the preventive effect of a prevention program, evaluated through the cRCT described in the second study (Article 3). The analyses were conducted using the R program, employing primarily generalized linear Poisson models. Results: Among nineth grade students, it was observed that girls had a higher prevalence of recent alcohol use compared to boys, with this prevalence even higher among Black students. Consistently, racial bullying explained recent alcohol and tobacco use among mixed-race and Black students (Article 1). Among participants in the prevention program evaluation, at baseline, seventh-grade girls also had a higher prevalence of alcohol use compared to boys. After nine months of follow-up, racial bullying predicted the initiation of alcohol and tobacco use in this grade, with variations across the race/skin color and sex/gender intersection strata, highlighting the greater vulnerability of mixed-race and Black girls (Article 2). The prevention program was not effective in preventing alcohol and tobacco use, regardless of students’ race/skin color, in both the fifth and seventh grades (Article 3). Conclusions: Racial bullying predicts and partially explains substance use among mixed-race and Black students. Besides that, gender influences alcohol consumption, with girls having higher consumption than boys, and mixed-race and Black girls having the highest consumption among girls. School programs, based on scientific evidence, must explicitly incorporate anti-racist goals into their substance use prevention strategies. Actions involving the police, health services and schools are discussed.
Objective: To evaluate, in an intersectional way with sex/gender, the role (mediator and predictor) of racial bullying and the effects of a prevention program on the relationship between race/skin color and substance use among elementary and middle school students. Methods: Three studies based on statistical-socioepidemiological theories were conducted. The first was a cross-sectional study using data from the 2015 National Student Health Survey (PeNSE), involving 102,072 adolescents representing nineth grade students in Brazil. This study assessed the relationship between recent racial bullying and recent use of alcohol, tobacco, and illicit substances (Article 1). The second, a prospective cohort study, utilized data from two cluster-randomized controlled trials (cRCT) conducted in 2019 with fifth- (baseline: 1,727; follow-up: 1,334) and seventh- (baseline: 2,303; follow-up: 1,739) grade students in public state schools in the city of São Paulo. It investigated whether being a target of racial bullying at baseline could predict the initiation of alcohol and tobacco use among students over nine months of follow-up (Article 2). The third study assessed racial variation in the preventive effect of a prevention program, evaluated through the cRCT described in the second study (Article 3). The analyses were conducted using the R program, employing primarily generalized linear Poisson models. Results: Among nineth grade students, it was observed that girls had a higher prevalence of recent alcohol use compared to boys, with this prevalence even higher among Black students. Consistently, racial bullying explained recent alcohol and tobacco use among mixed-race and Black students (Article 1). Among participants in the prevention program evaluation, at baseline, seventh-grade girls also had a higher prevalence of alcohol use compared to boys. After nine months of follow-up, racial bullying predicted the initiation of alcohol and tobacco use in this grade, with variations across the race/skin color and sex/gender intersection strata, highlighting the greater vulnerability of mixed-race and Black girls (Article 2). The prevention program was not effective in preventing alcohol and tobacco use, regardless of students’ race/skin color, in both the fifth and seventh grades (Article 3). Conclusions: Racial bullying predicts and partially explains substance use among mixed-race and Black students. Besides that, gender influences alcohol consumption, with girls having higher consumption than boys, and mixed-race and Black girls having the highest consumption among girls. School programs, based on scientific evidence, must explicitly incorporate anti-racist goals into their substance use prevention strategies. Actions involving the police, health services and schools are discussed.
Descrição
Citação
MENEZES, Alessandra Aparecida da Silva. Pior ainda para as meninas negras: racismo, cor ou raça e uso de álcool e tabaco entre estudantes. 2023. 204 f. Tese (Doutorado em Saúde Coletiva) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2023.