RESUMEN
This study investigates variation in adolescent attitudes regarding dating violence under different conditions, the association of these conditional attitudes with subsequent adolescent relationship abuse (ARA), and youth and parent-reported characteristics associated with youth attitudes. The sample consists of 607 youth, as a subset from those who responded to a nationally representative longitudinal survey of dating violence. A latent class analysis identified three profiles of attitudinal patterns: No Tolerance for Hitting Partners (NT), Some Tolerance for Hitting Partners (ST), and High Tolerance for Hitting Partners (HT). The HT profile predicted subsequent physical (compared to the NT profile), sexual ARA perpetration (compared to both the NT and the ST profiles), and physical ARA victimization (compared to the NT profile). The ST profile predicted subsequent psychological ARA perpetration and victimization (compare to the NT profile). Results inform youth dating violence prevention programs to reduce ARA and intimate partner violence by changing youth attitudes toward dating violence.
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Conducta del Adolescente , Acoso Escolar , Víctimas de Crimen , Violencia de Pareja , Humanos , Adolescente , Conducta del Adolescente/psicología , Conducta Sexual , Víctimas de Crimen/psicologíaRESUMEN
Adolescent relationship abuse (ARA) (i.e. physical, sexual, psychological, or economic abuse in the context of romantic relationships) is associated with adverse health outcomes, including anxiety, depression, suicidality, unintended pregnancy, and substance misuse. A related phenomenon, reproductive coercion involves interference with the reproductive decision making of a partner with the intention of promoting pregnancy or controlling outcomes of a pregnancy. Reproductive coercion is associated with unintended pregnancy, partner violence, and sexually transmitted infections. Little is known about the intersection between economic ARA, sexual exploitation, and reproductive coercion. This paper explores the intersections between reproductive coercion, transactional sex, and economic abuse victimization in adolescent dating relationships. In an online survey, 1,752 adolescents (ages 13-17) were asked about economic adolescent relationship abuse (educational, employment and financial interference), transactional sex, reproductive coercion, and contraceptive access within their relationships. We assessed associations with chi-square tests and logistic regression analysis. Youth who experienced economic ARA (70%, 1,232) reported financial dependence on their partner, contraceptive access, and reproductive coercion (74-83%; p-values<0.001) more often than their counterparts without economic ARA. Adolescents experiencing economic abuse were more likely to report transactional sex (aOR = 2.76, CI [2.12, 3.60], p < .001), depending on a partner to pay for contraception or birth control (aOR = 2.20, CI [1.71, 2.84], p < .001), and reproductive coercion (aOR = 3.20, CI [2.37, 4.32], p < .001). Youth-serving providers and agencies should be aware of intersections between economic ARA, transactional sex, financial dependence, and reproductive coercion, particularly for adolescents with health-related social needs.
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Víctimas de Crimen , Violencia de Pareja , Embarazo , Femenino , Adolescente , Humanos , Estudios Transversales , Conducta Sexual , Violencia , Coerción , Violencia de Pareja/psicologíaRESUMEN
This study aims to identify homogeneous groups of individuals based on self-reported victimization and perpetration of three subtypes of adolescent relationship abuse (ARA; physical, psychological, and sexual) and sexual harassment (SH). Study sample consists of 645 current or past-year daters aged 12-21, drawn from the National Survey on Teen Relationships and Intimate Violence (STRiV). Latent class analysis was used to classify individuals, and a three-class model was selected (Low ARA-Low SH, High ARA-High SH, and Psychological ARA-Medium SH). Results provide evidence for three latent classes with varying patterns of ARA and SH. A number of exogenous variables were significantly associated with these patterns, e.g., youth who were previously exposed to any general violence were three times as likely to be in the High ARA-High SH class as those not previously exposed to violence. Adolescent relationship abuse prevention efforts should include activities to address sexual harassment, and vice versa. Results call for universal preventive intervention programs targeting adolescent relationship abuse and sexual harassment to start as early as adolescence, and the existence of the High ARA-High SH group supports the need for more targeted effort to interrupt such patterns.
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Conducta del Adolescente/psicología , Violencia de Pareja/prevención & control , Acoso Sexual/prevención & control , Adolescente , Acoso Escolar , Niño , Víctimas de Crimen/psicología , Femenino , Humanos , Análisis de Clases Latentes , Masculino , Evaluación de Programas y Proyectos de Salud , Encuestas y Cuestionarios , Adulto JovenRESUMEN
INTRODUCTION: Sexual minority youth (SMY) are at significantly greater risk for experiencing adolescent relationship abuse (ARA) than exclusively heterosexual youth, yet little is known about the factors that elevate their risks for such abuse. Peer victimization (i.e., bullying, sexual harassment) has been associated with ARA among heterosexual youth. SMY experience higher rates of peer victimization than heterosexual youth, suggesting that it may be a risk factor for ARA among these youth. Using longitudinal data from a community sample of adolescents recruited from the northeastern US, we examined whether sexual identity was associated prospectively with ARA, and whether that relationship would be indirect, and mediated via bullying and sexual harassment at a 12-month follow-up. We expected to find higher rates of peer victimization and ARA among SMY than heterosexual youth, and we expected that sexual harassment and bullying would predict subsequent relationship abuse. METHODS: Adolescents (N = 800; 58% female; 81% European-American; 19% SMY) between 13 and 15 years (M = 14.45, SD = 0.85) completed a web survey at baseline, 6-months and 12-months. RESULTS: Consistent with prior studies, SMY reported higher rates of bullying, sexual harassment, and relationship abuse than heterosexual youth. SMY who reported sexual harassment at baseline were more likely to report relationship abuse over time. Contrary to our expectations, however, bully victimization did not predict subsequent relationship abuse. CONCLUSIONS: Sexual harassment can be particularly harmful for SMY because it targets gender and sexual identity at a formative developmental period and puts youth at risk for relationship abuse.
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Acoso Escolar/estadística & datos numéricos , Víctimas de Crimen/estadística & datos numéricos , Violencia de Pareja/estadística & datos numéricos , Acoso Sexual/estadística & datos numéricos , Adolescente , Conducta del Adolescente/psicología , Femenino , Heterosexualidad/estadística & datos numéricos , Humanos , Estudios Longitudinales , Masculino , Minorías Sexuales y de Género/estadística & datos numéricos , Encuestas y CuestionariosRESUMEN
The purpose of the current study was to examine the impact of exposure to Bringing in the Bystander-High School Curriculum (BITB-HSC) on school personnel, which included a seven session classroom curriculum for ninth through twelfth graders (student curriculum), a bystander training workshop for school personnel (school personnel workshop), and reading materials (handout). We examined how exposure to these various BITB-HSC intervention components was associated with school personnel's knowledge and bystander efficacy, intentions, and barriers specific to student relationship abuse (RA) and sexual assault (SA). Participants were 488 school personnel from 12 high schools in upper New England who completed the 4-month follow-up survey that assessed for intervention exposure (284 participants completed both the baseline and follow-up survey). Whereas 53% of participants were exposed to no intervention components, the other half of the sample were exposed to a combination of intervention components. Higher baseline knowledge and reactive bystander intentions were associated with subsequent exposure to both the student curriculum and the handout, and fewer barriers to bystander action predicted exposure to the school personnel workshop. Exposure to the school personnel workshop, student curriculum, and handout was associated with subsequent greater knowledge, exposure to the student curriculum predicted reactive bystander intentions, and exposure to the handout predicted higher reactive bystander intentions and bystander efficacy. Findings suggest that despite challenges with engagement, exposure to the BITB-HSC components may be a useful tool in improving school personnel's responses to RA and SA among high school students.
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Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/métodos , Maestros/psicología , Delitos Sexuales/prevención & control , Estudiantes/psicología , Adolescente , Adulto , Anciano , Víctimas de Crimen/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , New England , Instituciones Académicas , Delitos Sexuales/psicología , Adulto JovenRESUMEN
This study evaluated the effectiveness of a seven-session, bystander-focused, classroom-delivered curriculum (i.e., Bringing in the Bystander-High School Curriculum [BITB-HSC]) in reducing rates of interpersonal violence among high school students. High schools (N = 26) were randomly assigned to the treatment or control condition. In classrooms in treatment schools, students (n = 1081) completed a baseline survey, participated in the BITB-HSC, and completed an immediate post-test, a short-term post-test (approx. 2 months after intervention), and a long-term post-test (approx. 1 year after intervention). Youth in control schools (n = 1322) completed surveys at similar time points but did not participate in the BITB-HSC. Participants were 15.8 years old on average and largely White (85.1%) and heterosexual (84.5%). Students exposed to the BITB-HSC demonstrated significant short-term changes in victim empathy and bystander barriers/facilitators, and long-term changes in rape myths, media literacy, bystander readiness, and knowledge relative to youth in the control condition. Although the BITB-HSC had little long-term impact on actual bystander behavior, there were reductions in some forms of violence among students in the BITB-HSC condition relative to the control condition. Future research is needed to determine if, for whom, why, and in what contexts (e.g., classroom-based versus school-wide initiatives) bystander-focused violence prevention initiatives reduce violence.
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Delitos Sexuales/prevención & control , Violencia/prevención & control , Adolescente , Análisis por Conglomerados , Femenino , Humanos , Masculino , New England , Encuestas y CuestionariosRESUMEN
Little is known about the association between school climate and adolescent relationship abuse (ARA). We used 2011-2012 data from surveys of California public school students (in the United States of America) who were in a dating relationship in the last year (nâ¯=â¯112â¯378) to quantify the association between different school climate constructs and physical ARA. Fifty-two percent of students were female, and all students were in 9th or 11th grade (approximately ages 14-17). Over 11% of students reported experiencing physical ARA in the last year. Increased school connectedness, meaningful opportunities for participation, perceived safety, and caring relationships with adults at school were each significantly associated with lower odds of physical ARA. Increased violence victimization and school-level bullying victimization were associated with higher odds of physical ARA. These school climate-ARA associations were significantly moderated by student sex, school socioeconomic status, and school-level bullying victimization. School climate interventions may have spillover benefits for ARA prevention.
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Acoso Escolar/estadística & datos numéricos , Violencia de Pareja/estadística & datos numéricos , Clase Social , Estudiantes/estadística & datos numéricos , Adolescente , Conducta del Adolescente/psicología , California , Femenino , Humanos , Masculino , Percepción , Instituciones Académicas/clasificación , Distribución por Sexo , Encuestas y Cuestionarios , Estados UnidosRESUMEN
Witnessing inter-parental intimate partner violence has been found to be associated with adolescents' own relationship abuse. This study investigates the relationship between patterns of inter-parental intimate partner verbal and physical violence victimization reported by parents and their children's reports of dating abuse experiences and behavior. Latent class analysis was performed on a sample of 610 parents (42% male and 67% white) and their dating adolescent children (ages 12-21 years; 52% male). Parents reported five types of victimization by their partners in the past year, while youth concurrently reported their own victimization and perpetration within their dating relationships. Three profiles of parents' intimate partner victimization were related to youth relationship abuse experiences and behaviors. Children of parents who experienced verbal abuse were more likely to experience similar patterns in their own relationships, whereas children of parents who report physical and verbal abuse were more likely to report psychological, physical and sexual abusive encounters in their partnerships. Findings indicate that parents' relationship quality and abusive behaviors may have a long lasting effect on their children as they enter mid and late adolescence. Parents should pay attention to their own relationship quality and behavior even as their teen-age children gain independence.
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Conducta del Adolescente , Víctimas de Crimen/psicología , Violencia de Pareja/psicología , Padres/psicología , Psicología del Adolescente , Adolescente , Adulto , Agresión/psicología , Acoso Escolar , Niño , Femenino , Humanos , Relaciones Interpersonales , Estudios Longitudinales , Masculino , Adulto JovenRESUMEN
Research on adult intimate partner violence has demonstrated that economic considerations and financial decision-making are associated with the use of violence in marital and cohabiting relationships. Yet limited work has examined whether financial behaviors influence the use of violence in adolescent dating relationships. We use data from the National Survey on Teen Relationships and Intimate Violence (STRiV) (n = 728), a comprehensive national household survey dedicated specifically to the topic of adolescent relationship abuse, to examine associations between requests for money lending, economic control/influence, financial socialization and adolescent relationship abuse among a large, diverse sample of male and female adolescents [48 % female; 30 % non-White, including Black (10 %), Hispanic (2 %), and other (18 %)]. Findings suggest that requests for money lending are associated with heightened risk of moderate and serious threats/physical violence perpetration and victimization, net of traditional predictors. We discuss the implications of our findings for intervention and prevention efforts.
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Cortejo/psicología , Toma de Decisiones , Economía , Violencia de Pareja/psicología , Adolescente , Víctimas de Crimen , Femenino , Humanos , Masculino , Factores de Riesgo , Socialización , Estadística como Asunto , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Parenting behaviors such as monitoring and communications are known correlates of abusive outcomes in adolescent dating relationships. This longitudinal study draws on separate parent (58 % female; 61 % White non-Hispanic, 12 % Black non-Hispanic, 7 % other non-Hispanic, and 20 % Hispanic) and youth (ages 12-18 years; 48 % female) surveys from the nationally representative Survey of Teen Relationships and Intimate Violence. Latent class analyses were applied to investigate whether there are distinguishable parenting profiles based on six measures of parent-youth relationship and interactions, with youth's attitudes about abusive dating behavior and both perpetration and victimization examined in a follow-up survey as distal outcomes (n = 1117 parent-youth dyads). A three-class model-a "Positive Parenting" class, a "Strict/Harsh Parenting" class, and a "Disengaged/Harsh Parenting" class-was selected to best represent the data. The selected latent class model was conditioned on parents' (anger trait, relationship quality, attitudes about domestic violence) and youth's (prior victimization and perpetration) covariates, controlling for parent's gender, race/ethnicity, income, marital status, and youth's age and gender. Youth in the "Positive Parenting" class were significantly less likely 1 year later to be tolerant of violence against boyfriends under any conditions as well as less likely to perpetrate adolescent relationship abuse or to be a victim of adolescent relationship abuse. Parents' anger and relationship quality and youth's prior perpetration of adolescent relationship abuse as well as gender, age, and race/ethnicity predicted class membership, informing universal prevention program and message design, as well as indicated efforts to target communications and services for parents as well as for youth.
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Conducta del Adolescente , Relaciones Interpersonales , Violencia de Pareja/estadística & datos numéricos , Relaciones Padres-Hijo , Responsabilidad Parental , Conducta Sexual/estadística & datos numéricos , Adolescente , Actitud , Niño , Víctimas de Crimen , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Padres , Encuestas y CuestionariosRESUMEN
Incarcerated women are disproportionately affected by HIV and sexually transmitted infections (STIs) due to risk factors before, during, and after imprisonment. This study assessed the behavioral, social, and contextual conditions that contribute to continuing sexual risk behaviors among incarcerated women to inform the adaptation of an evidenced-based behavioral intervention for this population. Individual, in-depth interviews were conducted with 25 current and 28 former women prisoners to assess HIV/STI knowledge, perceptions of risk, intimate relationships, and life circumstances. Interviews were independently coded using an iterative process and analyzed using established qualitative analytic methods. Major themes identified in the interviews involved three focal points: individual risk (substance abuse, emotional need, self-worth, perceptions of risk, and safer sex practices); interpersonal risk (partner pressure, betrayal, and violence); and risk environment (economic self-sufficiency and preparation for reentry). These findings highlight the critical components of HIV/STI prevention interventions for incarcerated women.
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Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Prisioneros/psicología , Asunción de Riesgos , Conducta Sexual/psicología , Enfermedades de Transmisión Sexual/epidemiología , Adolescente , Adulto , Femenino , Infecciones por VIH/epidemiología , Vivienda , Humanos , Relaciones Interpersonales , Entrevistas como Asunto , Persona de Mediana Edad , North Carolina/epidemiología , Percepción , Prisioneros/estadística & datos numéricos , Prisiones , Investigación Cualitativa , Factores de Riesgo , Parejas Sexuales , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/prevención & control , Estigma Social , Apoyo Social , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Violencia , Adulto JovenRESUMEN
Economic adolescent relationship abuse (ARA) includes coercive behaviors leading to interference with education, employment, and finances. To date, no study has examined help seeking among adolescents and young adults if they were to experience economic ARA. The goals of this article include examining: (a) help-seeking intentions of adolescents regarding economic ARA; (b) help-seeking sources and reasons for not seeking help; and (c) differences in help-seeking intentions based on age, race/ethnicity, gender identity, and experiences of economic ARA. We conducted a cross-sectional survey of adolescents ages 13-19 focused on economic ARA experiences and help seeking. We performed descriptive statistics of help-seeking intentions, sources, and barriers. We utilized logistic regression, adjusted for age, race/ethnicity, and gender identity, to explore associations between economic ARA victimization and help-seeking intentions. Of 2,852 participants, 56% said they would seek help for economic ARA. Adolescents with positive help-seeking intentions shared that they would seek help from their parents (43%) or friends (35%). Those less likely to seek help were concerned about others finding out (32%), not being believed (31%), or authority figures being notified (31%). Help-seeking intentions were lower among Black/African American adolescents (aOR = 0.55, CI [0.43, 0.70]) and Multiracial adolescents (aOR = 0.26, CI [0.16, 0.42]) compared to White adolescents. Help-seeking intentions were higher among gender diverse adolescents (aOR = 5.78, CI [2.98, 11.22]) and those ages 15-17 years (aOR = 1.84, CI [1.36, 2.47]) compared to those identifying as female and ages 18-19 years. Help-seeking intentions were lower among adolescents who experienced economic ARA (aOR = 0.61, CI [0.51, 0.72]). While the majority of adolescents reported that they would seek help if they experienced economic ARA, those who had experienced economic ARA were less likely to report intentions to seek help. Supportive interventions for adolescents experiencing economic ARA are needed.
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Víctimas de Crimen , Intención , Adulto Joven , Humanos , Masculino , Femenino , Adolescente , Estudios Transversales , Identidad de Género , AmigosRESUMEN
Purpose: The goal of this study was to examine plurisexual identity, intimate partner violence (IPV), reproductive coercion, and parental monitoring among pregnant 13-21-year-olds. Methods: We conducted a cross-sectional analysis of data collected from a cohort of pregnant adolescents and young adults between October 2019 and May 2023 (n = 398). Logistic regression was completed to assess IPV and reproductive coercion as a function of plurisexual identity. Next, we assessed potential interactions between parental monitoring and plurisexual identity and examined IPV and reproductive coercion as a function of parental monitoring for the full sample and stratified by plurisexuality. Results: Plurisexual identity was associated with IPV (adjusted odds ratio [aOR] = 2.3; confidence interval [CI]: 1.4-4.0). IPV was inversely related to parental monitoring among plurisexual participants (aOR: 0.51; CI: 0.32-0.82), but this association was not significant for heterosexual participants (aOR: 1.1; CI: 0.75-1.6). Conclusions: This work demonstrates the importance of parental monitoring in supporting young plurisexual pregnant people.
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PURPOSE: Sexual and gender diverse youth (SGDY) are at greater risk for adolescent relationship abuse (ARA) than cisgender heterosexual youth, but there are not enough evidence-based interventions for reducing ARA among SGDY. We piloted online human-centered design (HCD) methodology to engage SGDY in generating ARA intervention ideas. This study evaluated the acceptability, appropriateness, and feasibility of the online methods and identified SGDY-derived intervention ideas for reducing ARA. METHODS: From August 2020 through March 2021, we conducted a longitudinal online HCD study with 46 SGDY (aged 14-18 years) recruited via social media from across the United States. SGDY completed HCD activities using MURAL (collaborative digital whiteboard) in four group-based sessions (1.5 hours each) and a follow-up survey with validated measures of acceptability, appropriateness, and feasibility (a priori success benchmarks: means > 3.75 on each five-point scale). RESULTS: SGDY in the sample were 41% racial/ethnic minorities. SGDY rated the online HCD methods as highly acceptable, appropriate, and feasible (means ≥ 4.29). SGDY co-created a breadth of ARA intervention concepts across all social-ecological levels, including commonplace ideas (e.g., curriculum for schools) and novel ideas, such as social media-based interventions to foster healthy relationships, incentivization interventions for performing social justice work, and school plays with SGDY storylines. DISCUSSION: Online HCD methods are acceptable, appropriate, and feasible for designing ARA intervention ideas. The intervention ideas generated in this study can help catalyze ARA intervention research for SGDY. Our method can be transported to other populations and health topics to help advance adolescent health and equity.
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The coronavirus disease 2019 pandemic was a public health emergency that impacted adolescents across the United States and disproportionately affected youth experiencing marginalization due to less access to resources and supports. This study reviews the increases in intimate partner and youth violence during the pandemic, mechanisms contributing to these increases, and the overarching health impacts on adolescents. Pediatric health professionals have a vital role to play in implementing healing-centered practices and prevention efforts that mitigate impacts of trauma and violence and that support youth and families in pathways to healing and recovery.
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COVID-19 , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Adolescente , Estados Unidos/epidemiología , Violencia/prevención & control , SARS-CoV-2 , Violencia de Pareja/prevención & control , Pandemias/prevención & controlRESUMEN
OBJECTIVE: Adolescent relationship abuse (ARA) is associated with myriad negative health outcomes. Pediatric primary care presents an opportunity to engage adolescents and parents, who can be protective against ARA, in ARA prevention; however, no family-focused, health care-based ARA interventions exist. The purpose of this study is to explore the perspectives of adolescents, parents, and health care providers (HCPs) on incorporating ARA prevention into primary care, including 1) current discussions around ARA, 2) how to best include ARA prevention education, and 3) how to address implementation barriers. METHODS: We conducted individual, semi-structured interviews with HCPs, adolescents ages 11 to 15, and parents recruited through convenience sampling. Transcripts were individually coded by 4 study team members (with every third transcript co-coded to assess discrepancies) and analyzed via thematic analysis. RESULTS: Participants identified a need for pediatric HCPs to involve younger adolescents and parents in universal, inclusive ARA prevention and noted that HCPs require training, techniques, and resources around ARA. Participants acknowledged multilevel barriers to implementing primary care-based ARA prevention. They suggested that ARA education be intentionally integrated into HCP and clinic workflows and recommended strategies to garner adolescent and parent buy-in to facilitate ARA-focused conversations. CONCLUSIONS: Pediatric primary care is a promising environment to involve parents and adolescents in universal ARA-prevention. Future research should contextualize these results with larger samples across multiple practice settings and integrate relevant partners in the development and evaluation of evidenced-based ARA prevention for pediatric primary care.
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Violencia , Humanos , Masculino , Femenino , Adolescente , Atención Primaria de Salud , Violencia/prevención & control , Padres , Personal de SaludRESUMEN
Stemming intimate partner violence among adults demands earlier education and skill-building supportive of healthy youth and young adult dating relationships. The current U.S.-based study examines a spectrum of youth and young adult relationship dynamics (RDs), inclusive of abusive interactions. In a nationally representative cohort of youth aged 10-18 at baseline and one parent or caregiver, survey responses regarding RDs from 618 participants ages 15-23 at wave 5 follow-up were analyzed. Latent class analysis of four positive dynamics, six problematic dynamics, and three scales of adolescent relationship abuse (ARA) were estimated, yielding four latent profiles of dating RDs. Relationships characterized by Unhealthy and Intense RDs both exhibited high probability of ARA but differed from each other in terms of other positive and problematic dynamics. Relationships characterized by Disengaged RDs had lower probability of ARA but elevated probability of awkward communications, negative feelings, social liability, and other challenging dynamics. Several baseline covariates were significantly associated with profiles of dating RDs approximately 5 years later. Younger participants were more likely to subsequently fall in an Intense or Disengaged RDs profile, as were participants with baseline emotional health problems. Further, classification in the Unhealthy RDs profile was less likely for participants reporting a better baseline relationship with their parents and more likely for those exposed to violence in childhood. These findings suggest that in addition to developmental maturity, youth and young adults would benefit from closer investigation and processing of past emotional and relational issues and traumas to foster healthier dating relationships.
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Conducta del Adolescente , Víctimas de Crimen , Violencia de Pareja , Humanos , Adulto Joven , Adolescente , Niño , Víctimas de Crimen/psicología , Estudios Longitudinales , Violencia de Pareja/psicología , Violencia , Padres/psicología , Conducta del Adolescente/psicología , Relaciones InterpersonalesRESUMEN
Adolescent relationship abuse (ARA) is highly prevalent across all sociodemographic groups with negative outcomes in multiple domains of health. Using a healing-centered engagement approach, health care providers can support healthy adolescent relationships and connect ARA survivors to resources and supports to ensure health and well-being. Essential components of health care support for adolescents experiencing ARA include validation of disclosure, assessing safety, a warm hand-off to advocacy resources, addressing immediate and long-term health needs, and connection to a trusted adult. Informing adolescents about limits of confidentiality and use of shared decision-making after ARA disclosure recognizes adolescents' lived experiences and emerging autonomy.
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Conducta del Adolescente , Atención a la Salud , Adulto , Humanos , AdolescenteRESUMEN
PURPOSE: Supporting adolescents in developing healthy relationships and promoting sexual and reproductive health (SRH) is an important responsibility of pediatric primary care providers. Less is known about evidence-based interventions in pediatric settings focused on healthy relationships and SRH. METHODS: We conducted a systematic review to describe SRH and healthy relationship/adolescent relationship abuse (ARA) interventions for pediatric primary care over the past 20 years. Eligible articles were original research on an SRH-focused or ARA-focused intervention, conducted in-person within pediatric primary care or school-based health centers specifically for middle or high school-aged adolescents. Data abstracted from included articles included intervention description, content, delivery, evaluation design, and effectiveness of primary outcomes. Heterogeneous outcomes and evidence levels made conducting a meta-analysis infeasible. RESULTS: Nineteen studies described 17 interventions targeting a variety of SRH and ARA topics (e.g., sexually transmitted infections, contraception, ARA). Interventions largely focused on screening/counseling adolescents (89%). Interventions generally were reported as being effective in changing adolescent health or practice-level outcomes. DISCUSSION: This review provides preliminary evidence that SRH and ARA interventions in pediatric primary care settings can be effective in promoting adolescent health. Future work should consider ARA-specific prevention interventions, including parents in interventions, and strategies for implementation, dissemination, and scaling.
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Salud Sexual , Enfermedades de Transmisión Sexual , Adolescente , Niño , Humanos , Anticoncepción , Atención Primaria de Salud , Salud Reproductiva , Conducta Sexual , Enfermedades de Transmisión Sexual/prevención & controlRESUMEN
Youth violence victimization continues to be pervasive and a significant cause of adolescent mortality. Since their 2014 "Connecting the Dots" report, the Centers for Disease Control and Prevention have encouraged researchers to identify shared protective factors that prevent multiple forms of youth violence. Parental monitoring, a bidirectional construct encompassing parental knowledge and regulation of their child's activities with children's concurrent perception of their parent's awareness of such activities, could be such a cross-cutting protective factor. In this study, we examined associations between parental monitoring and multiple types of violence victimization among a school-based sample of adolescents. We conducted a cross-sectional analysis of an anonymous survey of health risk and protective behaviors completed by students across Pittsburgh Public Schools (N = 2,426). In separate analyses, we used logistic regression to examine associations between youth-reported parental monitoring and multiple experiences of youth violence victimization, ranging from school- and electronic-based bullying to different forms of sexual and physical violence. We found that many experiences of youth violence victimization were consistent with nationally representative data. In addition, we determined that higher parental monitoring was significantly and inversely associated with all violence victimization outcomes examined (school-based bullying, electronic-based bullying, threatening someone with a weapon, adolescent relationship abuse, sexual assault, and exchange sex) at the p < .05 threshold. Overall, this study is one of the first that examines how parental monitoring relates to multiple forms of youth violence victimization, including exchange sex, which is a critical but less-studied violence experience. This work adds to the growing literature on how parental monitoring may serve as a shared protective factor for multiple forms of violence victimization.