Home-visiting programs based on the Brazelton approach: a scoping review.

This review maps and summarizes the quantitative studies on the main outcomes associated with home visiting (HV) programs using Brazelton methods aimed at supporting expectant and new parents. One hundred thirty-seven records were identified, and 19 records were selected. The design of our study was based on the methodological framework for conducting scoping reviews. Quality was assessed through the Jadad scale. Studies were coded for participant characteristics (number, mean age, and risk status), methodology (recruitment, home visit frequency, age of the child, Brazelton method, and research design), and intervention outcomes (on infants, parents, and home visitors). The studies mostly focused on the impact of Brazelton HV programs on infant development, the mother's psychological well-being, mother-infant interaction, and home visitor satisfaction. Experimental and quasi-experimental studies consistently have shown that parents receiving the intervention have greater knowledge of their children. Results are less conclusive regarding the intervention's impact on other domains of child development, mothers' psychological well-being, and mothers' sensitivity to the relationship with the child. Overall, the results suggest that the improvements associated with the intervention are mainly influenced by the risk status of families. Further research is needed to better understand the benefits of HV based on the Brazelton approach and the target population that may benefit most from this intervention. CONCLUSION:  Although the impact of the Brazelton home visiting intervention is not yet fully understood, there is promising evidence of its positive effects on child development, maternal well-being, and parental knowledge. Further research with consistent methodologies and larger sample sizes is needed to strengthen our understanding. However, existing findings in the literature underscore the importance of preventive interventions such as the Brazelton program in improving family well-being, with potential long-term benefits. WHAT IS KNOWN: • Home visiting programs based on the Brazelton approach aim to increase parents' knowledge and sensitivity to their children. • There is no clear picture in the literature of the effectiveness of these programs. WHAT IS NEW: • Existing studies consistently show the effectiveness of these programs to improve parents' knowledge of their children. • Findings on the impact of these programs on child development, mothers' psychological well-being and sensitivity to their child are inconclusive and may be influenced by the risk status.

Sexual minority youth's mental health and substance use: The roles of victimization, cybervictimization, and non-parental adult support.

Victimization is a well-established driver of sexual minority youth's (SMY) mental health and substance use risk. The current study examined and extended this research by exploring how victimization, cybervictimization, and non-parental supportive adults contribute to SMY's vulnerability to poor mental health and substance use. Using data from the first representative sample of Texas youth that measures sexual identity, we analyzed sex-stratified models of the association between sexual identity, mental health, and substance use, and the confounding effects of victimization, cybervictimization, and non-parental adult support. Victimization was more common among SMY and accounted for a greater proportion of sexual identity disparities on mental health and substance use, especially for males. Sexual minority females were more likely to report cybervictimization than heterosexual youth, and cybervictimization was associated with mental health risk. SMY reported fewer available non-parental supportive adults, which was associated with more sadness, suicidality, and polysubstance use. Our study adds to extant evidence that victimization drives SMY's increased susceptibility to mental health and substance use risk. Schools should implement inclusive policies that prohibit bullying based on sexual minority identity and offer professional development opportunities for supporting SMY.

School climate perceptions at the intersection of sex, grade, sexual, and gender identity.

School climate is an important construct in research on adolescents. Yet, no known studies have evaluated whether the measured school climate constructs are equivalent across lesbian, gay, bisexual, transgender, questioning (LGBTQ), and heterosexual students as well as sex and grade levels. This study assessed measurement equivalence of a second-order school climate construct across 1) sexual identity and sex among cisgender adolescents and 2) sexual and gender identity and grade level among cisgender and transgender adolescents. Data come from a California statewide survey of middle and high school students. Measurement equivalence was supported. This study reinforces prior findings on sexual and gender minority disparities and sheds light on an interesting pattern of school experiences across grades that deserves further investigation.

Does a Decade of School Administrator Support for Educator Training on Students' Sexual and Gender Identity Make a Difference for Students' Victimization and Perceptions of School Climate?

Professional development training for school personnel on issues related to sexual and gender identity (i.e., SOGI training) is a school strategy designed to prevent health and educational disparities for lesbian, gay, bisexual, and transgender (LGBT) youth at school. Yet we know surprisingly little about how the presence of this practice at school affects students' experience. This study explores whether students' experiences of victimization and school climate vary as a function of school administrator support for SOGI training at two time points (2004 and 2014). We combined multiple independent databases: students' reports on victimization and school climate in 2013-2015 (n = 55,158), and school (n = 152) and school district data (n = 67) on support for SOGI training in 2004 and 2014. More positive school climates were found in schools with support for SOGI training in 2004 only and both 2004 and 2014 compared to schools with SOGI training support in 2014 only. In schools with support for SOGI training in both 2004 and 2014, LGBT students reported the lowest rates of victimization. Findings from this study provide evidence that support for SOGI training by school administration is an effective way to improve school contexts for LGBT and all students. School administrators who aim to reduce victimization disparities for LGBT students and improve school climates should support the implementation of SOGI training, and sustain such training over time.

Children experiencing sadness: Coping strategies and attachment relationships.

This study aimed to explore the events which are sources of sadness for children, and their coping strategies for overcoming their sadness according to their attachment security. We expected that distinct clusters would emerge, with securely attached children more likely showing constructive and successful coping strategies than insecurely attached children. Middle-class children (N = 191) aged 7-11 years old from four private elementary schools were asked to talk about a sad event they experienced using open-ended questions from the Sadness Interview. The answers were coded into different categories of sad events and associated coping strategies. Finally, children were assessed on their security attachment using the Security Scale. Cluster analyses identified a four-cluster solution. Children in the Clusters 1 and 2 were characterized by a perceived successful constructive coping strategy while describing minor events (in the first Cluster), and very painful events (in the second). Furthermore, in the third Cluster children overcame sad events using a perceived successful disengagement coping strategy, whereas children in the fourth Cluster are characterized by perceived unresolved sadness. ANCOVA testing showed that children in the first cluster had significantly higher attachment security compared to Clusters 3 and 4, which did not significantly differ from each other. The study of sadness in children may be particularly informative for clinicians and educators for understanding and supporting children's strategies of sadness management while considering the influence of their attachment relationships on their ability to cope with sadness.

Homophobic Bullying in Positive and Negative School Climates: The Moderating Role of Gender Sexuality Alliances.

The presence of Gay-Straight Alliances (GSAs) in schools has been linked to low rates of bullying for lesbian, gay, bisexual, questioning (LGBQ), transgender, and all students. However, little is known about how the heterogeneity in GSA functioning and school climates may affect these rates. This study examines whether a well-functioning GSA would limit the effect of a negative school climate as a risk factor for homophobic victimization experiences. The sample included 38,872 students (3401 LGBQ and 453 transgender) from 58 California high schools. Several independent databases were combined. Students reported on homophobic victimization, the school climate, and demographic information. At the school level, reports from all students were aggregated for school climate; reports from GSA members were aggregated on their perceptions of GSA functioning; publicly-available data were used for school characteristics. The results suggest that greater GSA functioning may be beneficial for all students in schools that have a negative school climate, and particularly protective for transgender students.

The contribution of school safety to weight-related health behaviors for transgender youth.

INTRODUCTION: The aim of the present study is to examine gender identity disparities in different kinds of weight-related health behaviors, including physical activity, participation in physical education at school, and healthy and unhealthy eating habits, and to investigate the relationship between school safety and such behaviors in a sample of transgender and non-transgender students. METHOD: We analyzed a statewide sample of 31,609 students (Mage = 14.04, SD = 1.70; 1.1% transgender). We used multilevel regression models to examine the interactive effects of gender identity and perceptions of school safety on the 4 different outcome variables (physical activity, physical education, healthy and unhealthy eating habits). All models included student- and school-level characteristics as controls. RESULTS: Findings indicated that transgender students, when compared to non-transgender students, reported (a) feeling less safe at school; (b) more physical activity, but less participation in physical education at school; and (c) both more healthy as well as unhealthy eating behaviors. Adjusted regression models showed a significant interaction between gender identity and perceived school safety on healthy eating behaviors; simple slopes indicated that transgender students have healthier eating behaviors when the school context is perceived as safe compared to those who perceived the school as less safe. CONCLUSIONS: School interventions are needed to improve school safety for transgender youth and to reduce gender identity-related disparities in healthy eating and physical activity. Research implications and limitations are discussed.

The role of peer victimization, sexual identity, and gender on unhealthy weight control behaviors in a representative sample of Texas youth.

OBJECTIVE: The aim of the study is to examine the association between victimization and unhealthy weight control behaviors (UWCB), accounting for other key correlates of UWCB while considering the moderating role of sexual identity and gender. METHOD: This study used data from the 2017 Texas Youth Risk Behavior Survey (YRBS), a representative sample of students in grades 9-12 in the U.S. state of Texas, including 2,067 students (1,754 heterosexuals and 313 sexual minorities). We used survey-weighted logistic regression to examine the association of sexual identity, gender, and victimization (dating violence, cyberbullying, and school bullying) with UWCB, after adjusting for demographic information and indicators of weight, physical activity, and support from adults. RESULTS: Unhealthy weight control behaviors were associated with older age, being obese, lack of support from adults, low physical activity, and cyberbullying. A significant three-way interaction between gender, sexual identity and bullying showed that bullying was associated with high levels of UWCB among sexual minority males. DISCUSSION: Our study highlights the role of victimization in health behaviors for stigmatized groups, and the importance of school efforts to implement an equitable and safe learning environment for all students.

Attitudes towards same-sex parenting in Italy: the influence of traditional gender ideology.

This study aimed to examine the role of gender ideology, religiosity and political conservatism on attitudes toward same-sex parenting in Italy at a time when same-sex parent families are undergoing attacks from ideological campaigns opposing non-traditional gender roles and families. We collected data from 4,187 heterosexual respondents about attitudes towards two-father and two-mother parenting, homonegativity, attitudes toward traditional masculinity and femininity, religious involvement and political conservatism. We conducted multiple group structural equation model analyses to test whether sex moderated any of the estimated associations among variables. Results showed that traditional beliefs about femininity were directly associated with negative attitudes towards two-mother and two-father parenting, while traditional beliefs about masculinity had a significant direct effect only on two-father parenting. Homonegativity partially mediated the association between religiosity, political conservatism and traditional beliefs about masculinity and femininity on negative attitudes toward both types of same-sex parenting. Gender differences were found for the indirect effects of political conservatism and religiosity on attitudes towards same-sex parenting. The theoretical contributions and implications of the findings are discussed.

Predictors and Mental Health Benefits of Chosen Name Use among Transgender Youth.

Chosen name use among transgender youth (youth whose gender identities are different than their sex assigned at birth) can be part of the complex process of aligning gender presentation with gender identity and can promote mental health. However, little is known about the factors that predict whether or not transgender youth have a chosen name and outcomes of chosen name use, especially in specific social contexts. We examined, among a sample of 129 transgender youth from three cities in the United States, differences in sociodemographic characteristics and mental health outcomes between transgender youth with and without a chosen name and, among those with a chosen name, predictors and mental health benefits of being able to use a chosen name at home, school, and work. There were few differences between transgender youth with and without a chosen name. Among transgender youth with a chosen name, disclosure of gender identity to supportive family and teachers predicted chosen name use at home and school, respectively. Chosen name use was associated with large reductions in negative health outcomes and relatively smaller improvements in positive mental health outcomes. Our results show that chosen name use is part of the gender affirmation process for some, but not all, transgender youth and is associated with better mental health among transgender youth who adopt a chosen name.

Interpersonal and Intrapersonal Differences among Adolescent Nonsmokers, Ex-Smokers, and Smokers.

BACKGROUND: A large body of research has traced tobacco dependence among adolescents to a series of intrapersonal and interpersonal factors. However, there are remaining questions regarding the differences on these factors related to tobacco use. OBJECTIVES: We sought to investigate intrapersonal and interpersonal differences among adolescent nonsmokers, ex-smokers, and smokers. METHODS: We used data from a 3-year project designed to investigate and address tobacco dependence among 1071 students (Mage = 15.76, SD = 1.52; girls = 51.54%) who were recruited from 11 high schools. Participants, filling out a survey, provided information on tobacco use (nonsmoker, ex-smoker, and smoker), tobacco-related experiences (smoking-related risk perception, parental smoking, number of friends who smoke, resisting peer pressure to smoke), cognitive variables (metacognitive skills), and personality traits (disinhibition and impulsivity). RESULTS: Results from a discriminant function analysis showed that smokers and ex-smokers reported more disinhibition, impulsivity, number of friends who smoke and less self-control under peer pressure to smoke compared to nonsmokers. Ex-smokers reported less metacognitive processes, more smoking-related risk perception and were less likely to have parents who smoke. Conclusions/Importance: Interventions and campaigns aimed to persuade adolescents to stop smoking should work to develop adaptive metacognitive skills and an accurate risk perception of tobacco use.

Inclusive National Educational Policies as Protective Factors for LGBTI Youth Adjustment: An European Cross-National Study.

PURPOSE: To evaluate whether the presence of inclusive national educational policies is associated with more positive adjustment, better school experiences, and less harassment among lesbian, gay, bisexual, transgender, and intersex (LGBTI) youth. METHODS: A total of 66,851 LGBTI youth aged 15-24 from 30 EU countries completed the EU-LGBTI II survey in 2019. Participants reported on feelings of sadness/depression, life satisfaction, lack of safety at school, being out at school as LGBTI, experiences of bias-based school violence, and experiences of general and bias-based harassment. Individual-level data were linked to country-level data on the presence of LGBTI-inclusive school policies obtained from the International Lesbian, Gay, Bisexual, Transgender, Queer & Intersex Youth and Student Organisation report which reviewed existing European educational measures. The inclusiveness of each policy was assessed by the inclusion of the following grounds as protected: Variation in sexual characteristics, gender identity or expression, and sexual orientation. National policies were categorized into (1) antidiscrimination laws; (2) policies and action plans; (3) inclusive curricula; (4) teacher training; and (5) government support. RESULTS: LGBTI youth with more inclusive school policies in their countries had lower odds of lack of school safety, and concealment, and higher odds of life satisfaction. Inclusive teacher training and curricula were associated with less lack of safety and depression/sadness, and less school bias-based violence. Moreover, whereas teacher training was associated with more visibility and less concealment among LGBTI youth, inclusive curricula were linked to less general and bias-based harassment experiences. DISCUSSION: A multipronged national approach that includes teacher training and inclusive curricula is needed to better support LGBTI youth.

Psychophysical Impact of COVID-19 Pandemic and Same-Sex Couples' Conflict: The Mediating Effect of Internalized Sexual Stigma.

Research on the effects of the COVID-19 pandemic on same-sex relationships is limited. The present study aimed at analyzing the association between the psychophysical impact of the COVID-19 pandemic and same-sex couples' conflict, also considering the potential mediating effect of internalized sexual stigma (ISS). For this purpose, psychophysical challenges and couples' conflict during the COVID-19 pandemic, ISS, age, biological sex, sexual orientation, relationship duration, religiosity, involvement in lesbian, gay, and bisexual (LGB) associations, sexual satisfaction, and interpersonal partner violence were assessed in an Italian sample of 232 LGB people engaged in a same-sex relationship (aged 18-45 years; M age = 28.68, SD = 6.91). The results indicated that the psychophysical impact of the COVID-19 pandemic was significantly associated with couples' conflict, and ISS mediated this relationship. Among the covariates considered, only sexual satisfaction was associated with couples' conflict. The findings suggest that ISS, over and above the adverse effects of the COVID-19 pandemic on psychophysical health, triggered conflict within same-sex relationships. Studying the role of ISS in various relational and social contexts is important, as ISS may have an adverse effect on the mental health of sexual minority people. We recommend that more efforts be made to improve research on the LGB population during the public health response to the COVID-19 emergency, because the paucity of studies underlines the invisibility of this population in many domains, including the domain of romantic relationships. Implications and directions for future research are discussed.

The less you judge, the better you sleep: The benefits of mindfulness and forgiveness for insomnia and sleep problems.

Mindfulness and forgiveness can contribute to decreased rumination, which in turn has been found to play an important role in sleep problems, such as insomnia and poor sleep quality. The authors explored rumination as a potential explanatory variable underlying the association of mindfulness with insomnia and sleep quality, with a model encompassing different mindfulness facets and controlling for interpersonal dispositional forgiveness. One hundred adults (74% females, Mage = 27.62, SD = 8.11) completed measures of Mindfulness, Forgivingness, Rumination, Sleep Quality, and Insomnia. Nonjudging was the main mindfulness facet contributing to better sleep quality. Rumination completely mediated the associations of nonjudgmental attitude with insomnia and sleep quality, and partially mediated the associations of dispositional forgiveness with the outcomes. These findings suggest that a mindful nonjudgmental attitude toward the self and a forgiving interpersonal disposition may reduce rumination by helping individuals let go of thoughts, mental images, and emotions, thus promoting better sleep.

Student Intervention Against Homophobic Name-Calling: The Role of Peers, Teachers, and Inclusive Curricula.

Encouraging bystander intervention is an effective strategy to prevent episodes of bullying victimization at school. Yet there remains a paucity of evidence on this behavior in situations of homophobic name-calling, a form of peer victimization aimed at mocking individuals based on their actual or perceived sexual orientation. The existing research has focused on intentionality rather than actual student intervention behaviors, and, of note, no previous studies have taken into consideration contextual factors at the classroom and school levels. The present study examined whether students' observations of teacher and peer interventions against homophobic name-calling and perceptions of the representation of lesbian, gay, bisexual, and transgender (LGBT) issues in class are associated with student intervention behaviors against homophobic name-calling. A three-level multilevel approach was used to account for the nested nature of students' experiences in classrooms and schools. The sample included 1,296 students (43.57% girls) recruited from 84 classrooms of 22 Italian public high schools. Preliminary analyses showed that the variability in students' reports had more to do with which classrooms versus which schools students attend. Results from multilevel regressions indicated that students who observe teachers intervening during episodes of homophobic name-calling, and who perceive the representation of LGBT issues in class as positive, were more likely to intervene against homophobic name-calling and to observe other classmates intervene as well. Also, participants who observed other students intervening were more likely to intervene. These findings highlight the importance of the role of teachers in modeling classroom norms to encourage bystander interventions. Teachers can do so indirectly such as when providing a positive representation of LGBT issues in class, or directly when intervening to condemn episodes of homophobic name-calling. In addition, our results affirm the importance of peer influence in encouraging bystander interventions during episodes of homophobic name-calling.

Promoting School Safety for LGBTQ and All Students.

Schools are often unsafe for lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) students; they frequently experience negative or hostile school climates, including bullying and discrimination based on sexual orientation and gender identity at school. Negative school climates and discriminatory experiences can threaten LGBTQ students' well-being. Simultaneously, a consistent body of research identifies strategies to support LGBTQ and all students to be safe and thrive at school. First, policies that specifically identify or enumerate protected groups such as LGBTQ students create supportive contexts for all youth. Second, professional development prepares educators and other school personnel with tools to support and protect all students. Third, access to information and support related to sexual orientation and gender identity or expression (SOGIE), including curricula that is SOGIE-inclusive, provides students with resources, support, and inclusion, creating school climate. Fourth, the presence of student-led clubs or organizations such as gender-sexuality alliances (i.e., GSAs) improve students' school experiences and well-being, and contribute to positive school climate. This article reviews the research foundations of each of these strategies and concludes with recommendations for multiple audiences: policy-makers, school personnel, parents, and students.

Sexual Prejudice in Sport Scale: A New Measure.

This study describes the process of developing and validating the Sexual Prejudice in Sport Scale (SPSS), which is a multidimensional instrument developed to assess attitudes toward lesbians and gay men (LG) in sports. The authors conducted two studies: first, to establish the factor structure of the SPSS on 297 heterosexual athletes; and, second, to test the reliability and validity of the resulting 19-item scale on a sample of 311 heterosexual and 160 LG athletes. Exploratory factor analysis of an initial item pool yielded three factors: open rejection, which assesses the blatant prejudice expressed toward LG people; denial of visibility, which evaluates attitude toward the coming out of LG people; and gendering performance, which corresponds to gender stereotypes about performance/skills of LG people. A confirmatory factor analysis was conducted to assess the stability of the SPSS. The authors documented internal consistency, test-retest stability, and convergent/divergent validity. Implications and directions for future research are discussed.

Safe and supportive schools for LGBT youth: Addressing educational inequities through inclusive policies and practices.

Inclusive policies that attend to sexual orientation and gender identity (SOGI) are associated with more supportive school environments for lesbian, gay, bisexual, and transgender (LGBT) youth. We use the 2013-2015 California Healthy Kids Survey (n = 113,148) matched with principal reports of school policies from the 2014 California School Health Profiles to examine differential effects of SOGI-focused policies for LGB and transgender youth. SOGI-focused policies had a direct association with less truancy, and moderated the association between sexual orientation/gender identity and other school outcomes. SOGI-focused policies were associated with more positive experiences and perceptions of school climate for LGB youth and, to a lesser extent, transgender youth. Findings underscore the importance of inclusive policies, especially those that address the unique needs of transgender students.

Same-Sex and Different-Sex Parent Families in Italy: Is Parents' Sexual Orientation Associated with Child Health Outcomes and Parental Dimensions?

OBJECTIVE: Seventy gay fathers through surrogacy, 125 lesbian mothers through donor insemination, and 195 heterosexual parents through spontaneous conception, all with children aged 3 to 11 years and living in Italy, were compared on children's psychological adjustment and prosocial behavior, as well as parental self-efficacy, dyadic adjustment, family cohesion, and flexibility. Associations among family structures, family processes, and child health outcomes were also tested. METHODS: Participants were matched for child characteristics. Self-report questionnaires were administered through an online survey to the parent who identified as most involved with the child on a day-to-day basis. Multivariate analyses of variance and multiple linear regressions were conducted. RESULTS: Children of gay fathers and lesbian mothers were reported as showing fewer psychological problems than children of heterosexual parents. Irrespective of the family type, girls were reported as more prosocial than boys. With respect to parental dimensions, gay fathers described themselves as more competent and satisfied with their couple relationship than did heterosexual parents; they also reported higher levels of family cohesion and flexibility than did lesbian mothers and heterosexual parents. The effect of the family type was not predictive of child health outcomes once family process variables were taken into account. CONCLUSION: Findings suggested that children with same-sex parents fare well both in terms of psychological adjustment and prosocial behavior. The present study warns policy makers against making assumptions on the basis of sexual orientation about people who are more suited than others to be parents or about people who should or should not be denied access to fertility treatments.

Assessing Prejudice Toward Two-Father Parenting and Two-Mother Parenting: The Beliefs on Same-Sex Parenting Scale.

This article describes two interrelated studies that investigated beliefs and stereotypes on two-father parenting and two-mother parenting through the development and validation of the Beliefs on Same-Sex Parenting (BOSSP) scale. The BOSSP captures two beliefs: (1) prejudices toward same-sex couples' inherent inability to parent and (2) concerns about same-sex parenting that are not necessarily related to homonegativity. In Study 1 (301 heterosexual participants), exploratory factor analysis (EFA) suggested an 11-item scale for attitudes toward both two-father families and two-mother families, with two factors: parenting skills, which evaluates beliefs on same-sex couples' ability to take care of their children; and parental adjustment, which assesses beliefs on the impact of challenges related to same-sex parenting on children's well-being. Support for convergent validity between BOSSP factor scores and those of theoretically related measures were provided. In Study 2 (346 heterosexual participants surveyed in two time points), CFA indicated that the two-factor model provided the best fit. Test-retest reliability and longitudinal invariance were documented. Finally, results revealed that more negative attitudes toward same-sex parenting were held by men than by women and were associated with negative opinions on reproductive techniques. The innovative characteristics of the BOSSP and implications for future practice are discussed.