Elevating Black fathers' experiences in the National Fatherhood Initiative: Strengths and areas for improvement of 24/7 Dad® curriculum and case management services.

The Healthy Marriage and Responsible Fatherhood grant program is one of the most robust mechanisms supporting fatherhood programming in the United States, with the gold standard of care including fatherhood curriculum (e.g., 24/7 Dad®) and case management services. Despite the fact that fatherhood in the United States is not a monolith and Black fathers make up over 40% of those served through Responsible Fatherhood (RF) program, little research explicitly centers the lived experiences of low-income Black fathers. The current study used focus groups with fathers (n = 23) and staff (n = 8) enrolled in a RF grantee program. Thematic analysis was used to determine programmatic mechanisms supporting these fathers' success and areas for improvement. Our findings highlight that the creation of a "safe space" by facilitators and the power of the group dynamic were essential elements for fathers' success overall. We also identified numerous programmatic mechanisms supporting Black fathers' success specific to fathering, healthy relationships, and economic stability. Finally, we highlighted important limitations that may impede the success of low-income, Black fathers related to the 24/7 Dad® curriculum, engagement efforts, and economic stability, and discuss related practice, policy, and research recommendations.

Randomized controlled trials evaluating adolescent dating violence prevention programs with an outcome of reduced perpetration and/or victimization: A meta-analysis.

INTRODUCTION: Adolescent dating violence (ADV), including psychological, physical, threatening, and/or sexual abuse between adolescent romantic partners, is an epidemic in the United States, with youth report rates ranging from 15 to 77% for perpetration and 14-73% for victimization. ADV victimization is associated with multiple adverse outcomes in both adolescence and adulthood (e.g., suicidal ideation, substance use, bullying), as is ADV perpetration (e.g., sexually transmitted infections, intimate partner violence in adulthood). Given the high prevalence and profound impact of ADV on youth in the US, many prevention efforts have emerged in the past 20 years. Previous reviews of these efforts have focused primarily on school-based interventions or have broadly reviewed programs including all research design types and outcomes. This review is the first to provide a comprehensive, quantitative synthesis of all existing ADV prevention programs tested using randomized controlled trial designs with a control group, specifically measuring ADV perpetration and/or victimization as outcomes. METHODS: Employing a systematic literature search and screening protocol, nine studies were identified for meta-analysis. RESULTS: Results indicate that ADV prevention programs may decrease the risk of emotional, physical, and sexual perpetration, as well as emotional and physical victimization. CONCLUSIONS: This is the first review to uncover significant intervention effects on the actual occurrence of ADV, with previous reviews only finding effects on outcomes such as ADV knowledge and attitude. Findings suggest that ADV prevention programs are promising and may warrant implementation more broadly with youth, and this review provides methodological suggestions for future research evaluating new ADV prevention programs.

Feasibility of Mild Traumatic Brain Injury Assessment Based on Cardiovascular Response to Postural Change.

OBJECTIVE: To determine the feasibility of short-term cardiovascular responses to postural change as a screening tool for mild traumatic brain injury (mTBI), using heart rate metrics that can be measured with a wearable electrocardiogram sensor. SETTING: Military TBI clinic. DESIGN: Data collected from active-duty service members who had sustained a medically diagnosed mTBI within the prior 72 hours and from age- and sex-matched controls. Cardiac data collected while participants performed a sequence of postural changes. MAIN MEASURES: Model classification compared with clinical mTBI diagnosis. RESULTS: Cardiac biomarkers of mTBI were identified and logistic regression classifiers for mTBI were developed from different subsets of biomarkers. The best model achieved 90% sensitivity and 69% specificity using data from 2 different postural changes. CONCLUSION: Noninvasive measurement of cardiovascular response to postural change is a promising approach for field-deployable post-mTBI screening.

Efficacy of a Resourcefulness Intervention to Enhance the Physical and Mental Health of Parents Caring for Technology-dependent Children at Home: A Randomized Controlled Trial.

INTRODUCTION: Parent caregivers of children who require lifesaving medical technology (e.g., mechanical ventilation, feeding tubes) must constantly maintain vigilance. Poor physical and psychological health can negatively impact their ability to do so. METHOD: A two-arm randomized controlled trial was conducted with 197 parent caregivers of technology-dependent children (aged < 18 years) to test the efficacy of Resourcefulness Training1, a cognitive-behavioral intervention that teaches social (help-seeking) and personal (self-help) resourcefulness skills, in improving key outcomes including mental health-related quality of life (HRQOL), depressive cognitions and symptoms, perceived and physiological chronic stress, burden, and physical HRQOL at five-time points. RESULTS: Mixed-effects models using the intent-to-treat principle indicated statistically significant improvement with intervention participants at six and/or nine months postintervention for depressive cognitions, perceived stress, and physical HRQOL, controlling for covariates. DISCUSSION: Study findings support the efficacy of Resourcefulness Training to significantly decrease perceived stress and improve psychological/physical outcomes with these vulnerable caregivers.

Using grounded theory to develop a theory of change for a violence intervention program.

Hospital-based violence intervention programs (HVIP) are critical to interrupting the cycle of violence. These interventions are considered "complex" in that they have many mechanisms of change and related outcomes. Few HVIPs clearly identify the underlying mechanisms of intervention and explicitly link those with key outcomes however, limiting the field's ability to know what works best and for whom. To develop a program theory of change for these "complex interventions," a non-linear, robust methodology that is grounded in the lived experience of those delivering and receiving services is needed. To aid researchers, evaluators, students, and program developers, we describe the use of Grounded Theory as a methodology to enhance the development of complex interventions, illuminating a non-linear approach that engages key stakeholders. To illustrate application, we describe a case example of The Antifragility Initiative, a HVIP in Cleveland, Ohio. The development of the program theory of change was conducted in four phases: (1) review of existing program documents, (2) semi-structured interviews with program developers (n = 6), (3) a focus group with program stakeholders (n = 8), and (4) interviews with caregivers and youth (n = 8). Each phase informed the next and culminated in a theoretical narrative and visual model of the Antifragility Initiative. Together, the theoretical narrative and visual model identify the underlying mechanisms that can promote change by the program.

A phenomenological study identifying facilitators and barriers to Black and Latinx youth's engagement in hospital-based violence intervention programs.

Black and Latinx youth are disproportionately affected by violence in the United States. Hospital-based violence intervention programs (HVIPs) have emerged as an effective response to this epidemic; however, participation rates remain low. This study aimed to identify facilitators and barriers to recruitment and engagement amongst black and Latinx youth from the perspective of HVIP staff. Employing a phenomenological approach, a purposive sample of key informants was recruited. Focus groups and semi-structured interviews lasting approximately 90 min were conducted with representatives (N = 12) from five HVIPs in U.S. cities across the Midwest and Northeast, making up 15% of all HVIPs in the United States. Each interview was recorded and transcribed verbatim. The research team employed rigorous content analysis of the data. Three themes and subsequent categories resulted from the analysis: (1) Interpersonal/Relational Facilitators (building rapport; connecting with youth; enhancing the teachable moment; building relational health); (2) Structural/Systemic Barriers (lack of reinforcement; difficulties connecting after discharge from the hospital; hospital workflow; institutional challenges); (3) Structural/Systemic Facilitators (embedding the HVIP; trauma-informed practices and policies). Given the limited research on black and Latinx youth and the disproportionate rate of violent injuries amongst these groups, an evidence-based systematic approach to engage youth is essential to promote health equity. The findings from this study suggest that there are several steps that HVIPs and hospitals can take to enhance their recruitment and engagement of youth and their families.

Understanding How Relational Health Effects Intimate Partner Violence Perpetration among Low-Income, Black, Indigenous, Men of Color Exposed to Adverse Childhood Experiences: An Exploratory Study.

Relational health has emerged as a consistent factor that can mitigate the effects of trauma among children; however, less is known about relational health with adults, particularly related to intimate partner violence (IPV) perpetration among racially and socioeconomically marginalized men. The Exploratory Sequential Design, Taxonomy Development Model was used. Semi-structured interviews (N = 11) and narrative analysis were conducted in Phase I. In Phase II, variables approximating the key themes that emerged in Phase I were selected from an existing dataset (N = 67), and relationships were examined using bivariate associations. The sample consisted of low-income Black, Indigenous, men of color (BIMOC) in a batterer intervention program (BIP). Adverse life experiences shaped participants' world view via mistrust in others, stifling emotions and vulnerability, and a sense of personal guilt and shame. These orientations were then carried into adult relationships where men coped using social isolation to manage challenges, negatively affecting intimate relationships. For some men, mental health exacerbated these circumstances. Significant bivariate and multivariate associations supported this narrative. This study lays the foundation for future research to examine the potential effects of social support on IPV perpetration. BIPs should consider augmenting programming to enhance men's social networks to support their use of nonviolence after program completion.

An Investigation of the Accuracy of Reaction Time Measurements on ANAM4 TBI-MIL Across Three Computer Platforms.

STUDY DESIGN: Using two observational methods and a within-subjects, counterbalanced design, this study aimed to determine if a computer's hardware and software settings significantly affected reaction time (RT) on the Automated Neuropsychological Assessment Metrics (Version 4) Traumatic Brain Injury Military (ANAM4 TBI-MIL). METHODS: Three computer platforms were investigated: Platform 1-older computers recommended for ANAM4 TBI-MIL administration, Platform 2-newer computers with settings downgraded to run like the older computers, and Platform 3-newer computers with default settings. Two observational methods were used to compare measured RT to observed RT on all three platforms: 1, a high-speed video analysis to compare the timing of stimulus onset and response to the measured RT and 2, comparing a preset RT delivered by a robotic key actuator activated by optic detector to the measured RT. Additionally, healthy active duty service members (n = 169) were administered a brief version of the ANAM4 TBI-MIL battery on each of the three platforms. RESULTS: RT differences were observed with both the high-speed video and robotic arm analyses across all three computer platforms, with the smallest discrepancies between observed and measured RT on Platform 1, followed by Platform 2, then Platform 3. When simple reaction time (SRT) raw and standardized scores obtained from the participants were compared across platforms, statistically significant and clinically meaningful differences were seen, especially between Platforms 1 and 3. CONCLUSIONS: A computer's configurations have a meaningful impact on ANAM SRT scores. The difference in an individual's performance across platforms could be misinterpreted as clinically meaningful change.