Intergenerational Continuity of Childhood Adversity and Its Underlying Mechanisms Among Teen Mothers and Their Offspring.

The present study investigates how parenting stress mediates the intergenerational continuity of childhood adversity in teenage mothers. Childhood adversity experiences of caregivers significantly affect their offspring's exposure to childhood adversity. However, little is known about the mechanisms linking childhood adversity across generations. The study measures how parental distress and parent-child dysfunctional interaction mediate the association between teen mothers' childhood adversity and their offspring's adversity, measuring when the offspring reached 11.5 years of age. The results revealed that parental distress, but not parent-child dysfunctional interaction, mediated the association between teen mothers' child abuse and their offspring's household dysfunction. This suggests that parental distress may be a crucial intervention target to prevent the intergenerational continuity of childhood adversity. The findings imply that efforts to prevent the intergenerational continuity of childhood adversity may be more successful if the public and professionals have a broader understanding of the associations between early adversity and parenting contexts. In conclusion, the study shed light on the potential mechanisms underlying the intergenerational continuity of childhood adversity and highlights the importance of targeting parenting stress, specifically parental distress, as an intervention strategy to prevent the perpetuation of childhood adversity across generations.

Maternal childhood adversity and adolescent marijuana use at age 17 years: The role of parental mental health and parenting behaviors.

INTRODUCTION: Children's risk for marijuana use may be linked to their parents' history of childhood adversity, yet little is known about the mechanisms underlying this link. This study examined whether maternal parenting behavior and mental health serve as mechanisms linking maternal childhood adversity to their children's marijuana use at age 17 years, by gender. METHODS: Data were from the Young Women and Child Development Study (59% male), a longitudinal panel study, which began in 1988 and followed mother-child dyads for 17 years (n = 240). Participants were recruited from health and social services agencies located in a metropolitan region of Washington State. Hypotheses were tested using Structural Equation Modeling in Mplus. Multiple-group analysis was conducted to evaluate potential gender differences. RESULTS: Results showed that maternal childhood adversity was associated with their mental health outcomes (ß = .32, p < .001), which in turn was predictive of mothers' harsh parenting (ß = .27, p < .01). Maternal harsh parenting behavior was then associated with their children's marijuana use at age 17 years (ß = .34, p < .001). Multiple group analyses revealed that the path from harsh parenting to adolescent marijuana use differed across genders being only significant for boys (ß = .42, p < .001). CONCLUSIONS: The intergenerational impact of childhood adversity highlights the need for interventions that target both parents and children. This would support teen mothers with a history of childhood adversity to acquire skills and knowledge to help mitigate its impact on their parenting behaviors and offset risks for their children.

Adults with a child maltreatment history: Narratives describing individual strengths that promote positive wellbeing.

BACKGROUND: Child maltreatment often has negative impacts, but some individuals have strengths that lead to better outcomes. OBJECTIVE: Describe the narratives of adults who experienced childhood maltreatment, all of whom had positive psychosocial wellbeing at average age 18 years. PARTICIPANTS AND SETTING: A purposive sample of 21 adults (mean age 27.8 years SD = 1.0) who were part of a longitudinal study on the effects of childhood maltreatment. The sample was self-described as 85.7 % female, 14.3 % male, 42.9 % Black, 33.3 % Latinx, 19.0 % White, and 4.8 % multiracial. METHODS: This descriptive qualitative study, which is part of a sequential mixed method study, used semi-structured interviews and a narrative analysis approach. Four coders completed: (1) initial reading of sample interviews (2) generating codes independently and discussion, (3) creating a codebook, (4) reviewing 10-11 transcripts each (5) reconvening to discuss/resolve differences in coding, (6) identifying themes. RESULTS: There were four themes. The first theme was seeing oneself in a good light, highlighting self-worth and helper roles. The second theme, moving forward, included letting go of their past and a future orientation. Coping with life, the third theme, included boundaries for people around them, routines, and self-sufficiency. Meaning making, the fourth theme, included insights on the effect of their maltreatment and foster care, and reflections on appreciating life and adapting to changing circumstances. CONCLUSIONS: Findings describe varied strengths that promote positive functioning after childhood maltreatment. Study themes highlight how these strengths allow adults to make meaning of their experiences and move forward successfully in life.

La Linterna: Clinical model for trauma-exposed, migrant children.

OBJECTIVE: Exposure to childhood adversity is increasingly recognized as an important topic in pediatric medicine and a powerful driver of adult disease burden. While significant evidence exists that early intervention is critical for children exposed to adversities, few models have been established for addressing the complex medical, psychological, and social needs of these patients in a holistic manner. METHOD: La Linterna is an interdisciplinary clinical initiative providing trauma-informed primary care, mental health treatment, immigration legal counsel, and comprehensive case management to children (and their families) exposed to adversities throughout the migration process. Started in 2019, the clinic serves immigrant families throughout the city of Los Angeles. Described as the process of implementing an interdisciplinary, trauma-informed practice to meet the medical, mental health, social care needs of this uniquely vulnerable patient population. RESULTS: Strong evidence exists in the medical literature arguing for the implementation of a holistic, trauma-informed model of patient care. We describe "principles" and "lessons learned" during implementation, as well as detail an approach to improving services to immigrant families who have experienced adversities via an interactive, patient-centered process. CONCLUSIONS: Trauma-informed care is critical for meeting the needs of vulnerable children and their families. La Linterna represents an innovative and effective way to enhance care for one of the most vulnerable United States populations, immigrant and refugee families. Implementation of all or some of the program's components is possible throughout the United States and would mark an improvement over current practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Developmental inflection point for the effect of maternal childhood adversity on children's mental health from childhood to adolescence: Time-varying effect of gender differences.

Childhood adversities have a well-established dose-response relationship with later mental health. However, less attention has been given to intergenerational influences. Further, it is unknown how intergenerational influences intersect with children's developmental stages and gender. The current study examined whether a developmental inflection point exists when the intergenerational influences of childhood adversities gain salience and explored differences by children's gender. Data were from the Young Women and Child Development Study (n = 361). Time-varying effect models (TVEMs) and moderation TVEMs by child's gender were evaluated. Our findings reveal that ages 5-8, the period of transition into primary schools, may represent a developmental inflection point when the intergenerational influences of maternal childhood adversity start emerging substantially. The results from gender interaction TVEMs reveal that maternal childhood adversity was a statistically significant predictor of internalizing problems until age 11, regardless of child's gender, and remained statistically significant for girls' internalizing problems until age 16.7. For externalizing problems, maternal childhood adversity was a statistically significant predictor until age 13, regardless of gender.

Pre- and Perinatal Risk Factors for Child Maltreatment in Military Families Across the First Two Years of Life.

Military families are exposed to a unique constellation of risk factors, which may impact maltreatment outcomes. The present study examined prospective relationships between demographic, health, birth-related, and military-specific risk factors identified prior to a child's birth on their risk for maltreatment in the first two years of life. Data from the Millennium Cohort Study, Department of Defense (DoD) operational records and Family Advocacy Program data on met-criteria maltreatment, and Birth and Infant Health Research program data on suspected maltreatment were linked for 9076 service member parents. Discrete time survival analysis showed that preterm birth increased risk of maltreatment while parents' older age, physical health, and service in the Navy or Air Force decreased risk. Building on DoD's New Parent Support Program, findings suggest the need for universal and targeted prevention efforts, beginning during pregnancy, which limit or eliminate risk factors for maltreatment in military families.

Maternal and adolescent depressive symptoms and family conflict: An autoregressive cross-lagged examination of competing models in multi-stressed mothers and adolescents.

Maternal and adolescent depression are challenges that often co-occur. Many studies have drawn bivariate associations between maternal depressive symptoms, adolescent depressive symptoms, and family conflict, but few have examined reciprocal effects. Even among extant studies, there is a lack of clarity related to directionality of influence. Three competing theoretical models may explain the relationship between maternal depressive symptoms, adolescent depressive symptoms, and family conflict, and these processes may differ by adolescents' sex. Using three time points of data from 187 diverse mother-adolescent dyads, we fit a taxonomy of autoregressive cross-lagged structural equation models to simultaneously evaluate the competing theoretical models and also examine differences by sex using multiple-group analyses. Results indicate a symptom-driven model whereby adolescent depressive symptoms predicted increases in family conflict. Sex differences were also found. For males, but not females, greater adolescent depressive symptoms predicted subsequent increases in maternal depressive symptoms, which then predicted lower family conflict-possibly indicating maternal disengagement/withdrawal. Our findings suggest addressing adolescent depressive symptoms in order to prevent family conflict and that distinctive targets for the prevention/intervention of family conflict should account for differences by adolescents' sex.

The Experiences of Caretaking and Financial Stress among Social Workers during the COVID-19 Pandemic.

Social workers have engaged in promotive, preventive, and intervention work throughout the COVID-19 pandemic. Given that social workers are disproportionately women, and the essential nature of practice during the pandemic, how social workers experience caretaking and financial stressors warrants examination. Data are drawn from a larger cross-sectional survey of U.S.-based social workers (N = 3,118) conducted from June to August 2020. A convergent mixed-methods design included thematic content analysis and univariate, ordinal, and linear regression models. The sample was 90 percent female; average age was 46.4 years. Although 44 percent indicated moderate or significant caretaking stress, results varied by race/ethnicity, workplace setting, and age. Social workers of color were more likely to report caretaking (p < .001) and financial stress (p < .001) compared with White counterparts. Social workers in children/family services were more likely to report increased financial stress (p < .004). Older age was protective for both caretaking (p < .001) and financial stress (p < .001). Three distinct subthemes were found in caretaking stress (work/life balance, safety concerns, and positionality) and two in financial stress (uncertainty and absence of workplace recognition). Understanding workforce stressors may help organizations and policymakers better support an essential workforce integral to the United States' COVID-19 response and recovery.

Comparing the prevalence of sexual behaviors and victimization among adolescents based on child welfare system involvement.

OBJECTIVE: Sexual behavior presents risks, particularly among vulnerable groups such as adolescents with child welfare system involvement. This study compares the prevalence of sexual behaviors and victimization among adolescents in Los Angeles County with and without child welfare system involvement. It examines associations between online and offline sexual behaviors and victimization. METHODS: The sample included middle and high school students (N = 2365) and high school students only (N = 1068) participating in the 2015 Los Angeles Youth Risk Behavior Survey (YRBS). Measures included child welfare system involvement with or without foster care placement, demographics (race, ethnicity, gender, age), in-person sexual behaviors (e.g., unsafe sex), online sexual behaviors (e.g., sent/received sext), and sexual victimization (forced sex, dating physical violence, dating sexual assault). Logistic regressions examined variability in sexual behaviors and victimization based on child welfare involvement, net of demographics. Path analyses associated online sexual behaviors with victimization and offline risk. RESULTS: Greater reported sexual behavior and victimization among foster care youths was found, relative to youths without child welfare system involvement (maximum OR = 9.8). Youth with child welfare system involvement but not placed in foster care reported more unsafe sex, sexting because of pressure, finding a sex partner online, having sex with a partner met online, and forced sex (maximum OR = 10.4). Sexting was associated with forced sex and dating sexual assault, finding a sexual partner online, and physical violence. CONCLUSIONS: Targeted prevention is needed for online and offline sexual risks and victimization among youth with child welfare system involvement.

"We are on the frontlines too": A qualitative content analysis of US social workers' experiences during the COVID-19 pandemic.

Social work has been a part of the essential workforce historically and throughout the COVID-19 pandemic, yet lack recognition. This work explores the experiences and invisibility of social workers within the pandemic response. Data are drawn from a large cross-sectional survey of US-based social worker from June to August of 2020. A summative content analysis of responses to the question 'What do you wish people knew about social work during the COVID-19 pandemic' was undertaken. Participants (n = 515) were majority white (72.1%) and female (90.8%). Seven coding categories were subsequently collapsed into three domains: (1) meeting basic needs, (2) well-being (emotional distress and dual role) and (3) professional invisibility (workplace equals, physical safety, professional invisibility and organisational invisibility). Meeting social needs requires broad-based policies that strengthen the health and social safety net. Social workers have and will continue to play a critical role in the response, and recovery from COVID-19. Organisational and governmental policies must expand to increase the visibility and responsiveness to the needs of social care providers.

Longitudinal determinants of anal intercourse among women with, and without HIV in the United States.

BACKGROUND: Anal intercourse (AI) is not uncommon among U.S. women and, when condomless, confers a far greater likelihood of HIV transmission than condomless vaginal intercourse. We aim to identify determinants preceding AI, among women with, and women without HIV. METHODS: 3708 women living with (73%), and without HIV (27%) participating in the Women's Interagency HIV Study provided sexual behavior and other data at 6-monthly visits over a median of 9 years (1994-2014). We used generalized estimating equation models to examine sociodemographic, structural and behavioral determinants reported in the visit preceding (1) AI, and (2) condomless AI. RESULTS: AI was reported at least once over follow-up by 31% of women without, and 21% with HIV. AI was commonly condomless; reported at 76% and 51% of visits among women living without HIV, and with HIV, respectively. Women reporting AI were more likely to be younger (continuous variable, adjusted odds ratio (aOR) = 0.97, 95% confidence interval (CI):0.96-0.98), Hispanic (aOR = 1.88, CI:1.47-2.41) or White (aOR = 1.62, CI:1.15-2.30) compared to Black, and have at least high school education (aOR = 1.33, CI:1.08-1.65). AI was more likely following the reporting of either (aOR = 1.35, CI:1.10-1.62), or both (aOR = 1.77, CI:1.13-2.82) physical and sexual violence, excessive drinking (aOR = 1.27, CI:1.05-1.66) or any drug use (aOR = 1.34, CI:1.09-1.66), multiple male partners (aOR = 2.64, CI:2.23-3.11), exchange sex (aOR = 3.45, CI:2.53-4.71), one or more female sex partners (aOR = 1.32, CI:1.01-1.75), condomless vaginal intercourse (aOR = 1.80, CI:1.53-2.09), and high depressive symptoms (aOR = 1.23, CI:1.08-1.39). CONCLUSION: AI disproportionally follows periods of violence victimization, substance use, multiple sex partners and depression. Better prevention messaging and biomedical interventions that reduce acquisition or transmission risk are needed, but when AI occurs in the context of violence against women, as our findings indicate, focusing on gender-based violence reduction and immediate treatment to reduce HIV transmission risk is important.

AIM for Teen Moms: Social Support's Role in Contraception Use Among Young Mothers.

PURPOSE: Rapid repeat pregnancy is associated with negative outcomes for teen mothers and their offspring. Contraceptive use can reduce this risk. We explored the impact of AIM for Teen Moms, a future-oriented behavioral intervention, on emotional and tangible support and the influence of this support on the attitudes, intentions, and past 3-month contraceptive use behaviors. METHOD: Participants were 295 first-time moms (ages 15-19) in Los Angeles County who participated in a randomized control trial intervention to reduce rapid repeat pregnancies. Participants completed surveys at baseline and 36-months. Hypotheses were tested using multivariate and interaction analysis. RESULTS: Teen mothers in treatment group reported more emotional (ß =.13, p < .05) and tangible support (ß =.13, p < .05). Higher tangible support was positively associated with birth control attitudes (ß =.13, p < .05), which, in turn, predicted intention to use birth control (ß =.31, p < .001). Intention to use birth control also predicted higher past 3-month birth control use (ß =.18, p < .01); there was also a direct path from attitude to 3-month birth control use (ß =.35, p < .001). There was no association between emotional support and birth control attitudes, intentions, or behaviors. CONCLUSION: AIM for Teen Mom's effects on contraception use at 36 months was mediated by social support, specifically tangible support, which, in turn, affected birth control attitudes, intentions, and reported birth control use. Interventionists must consider how intervention content can specifically address the building of target support to meet the needs of teen mothers.

Cumulative Violence Exposure and Alcohol Use Among College Students: Adverse Childhood Experiences and Dating Violence.

Multiple types of childhood adversities are risk factors for dating violence among college-age youth and in turn, dating violence is associated with alcohol use. This work quantitatively examines associations of childhood adversity and dating violence with alcohol use among college students using a cumulative stress approach. Multi-campus surveys were collected from March to December 2016 in four universities across the United States and Canada (n = 3,710). Latent class analysis identified patterns of childhood adversity and dating violence. Regression analyses investigated the associations of latent class patterns with past year number of drinks, alcohol use frequency, and problematic drinking. Latent class analysis produced seven classes: "low violence exposure" (18.5%), "predominantly peer violence" (28.9%), "peer violence and psychological child abuse" (10.8%), "peer and parental domestic violence" (9.9%), "peer and psychological dating violence" (17%), "peer and dating violence" (6.6%), and "childhood adversity and psychological dating violence" (8.3%). Compared to the "low violence exposure" group, "peer and psychological dating violence" (B = .114, p < .05), "peer and dating violence" (B = .143, p < .05), and "childhood adversity and psychological dating violence" (B = .183, p < .001) groups were significantly associated with problematic drinking. Results highlight how childhood adversity and dating violence contribute to problematic alcohol use, suggesting interventions that address both childhood adversity and dating violence may be most effective at reducing alcohol misuse among college students.

Acculturation discrepancy and mental health associations among Hispanic childhood cancer survivors and their parents.

OBJECTIVE: Acculturation discrepancy occurs when the rate of host culture acquisition and/or heritage culture retention between non-native parents and their children diverges. The resulting conflict may exacerbate mental health conditions in already vulnerable populations. The present study examined discrepancies between Hispanic and Anglo-American acculturation, as two separate constructs, and mental health symptomology in Hispanic childhood cancer survivors (HCCS) and their parents. METHODS: Participants were 68 matched parent-child dyads (HCCS (Mage  = 19.4 (2.77) years., 50.0% female); and parent (Mage  = 46.3 (6.07) years., 89.7% female)). Study variables were HCCS posttraumatic-growth (PTG) and quality-of-life (PedsQL); parent posttraumatic stress (PTSD); and parent/HCCS depressive symptoms (CESD) and acculturation orientations. Discrepancy was calculated as the dyadic difference between like acculturation measures. RESULTS: After controlling for covariates, Hispanic acculturation discrepancy and HCCS psychosocial health (a subset of PedsQL) was negatively correlated (r = -0.26, p < 0.5); while Anglo-American acculturation discrepancy was positively associated with HCCS PTG (r = 0.34, p < 0.01) and overall PedsQL (r = 0.24, p < 0.05), and moderated the relationship between parent CESD and HCCS PedsQL. CONCLUSION: The findings suggest that the two acculturation discrepancy constructs have opposite effects. HCCS losing their heritage culture while their parents simultaneously retain it appears to be a deleterious process; whereas, HCCS learning the US culture more rapidly than parents may have protective benefits. This study has important implications for mental health interventions among HCCS. Findings should be used to inform the survivorship clinical community of the value of acculturation timing and parent/child discrepancy.

Strategies for implementation of virtual home visitation in the United States.

Utilising telepractice videoconferencing technology to offer home visitation services has the potential to provide access and parenting support through a high-tech and high-touch service delivery option. Families can receive evidence-based, family support intervention from their home via videoconferencing technology, removing the need for the provider to be physically in the home. While the expansion of telehealth and telepractice services for families is essential for meeting the needs of both parents and their children, well-documented engagement barriers to digital health/computer-mediated interventions exist across treatment modalities and technology platforms. Semi-structured interviews with 15 providers were conducted and analysed to identify engagement strategies utilised to sustain families in a home visitation model offered through live videoconferencing technology on a telehealth platform. Analysis revealed four themes that were deemed essential for successfully attracting and maintaining families in a telepractice-based home visitation programme: (a) engagement strategies to encourage families to participate; (b) clinical skills used within sessions; (c) articulation of benefits to the family; and (d) exploration of rationale for ending services. This study was able to identify strategies for engagement and sustained involvement of families in telehealth-based home visitation. Findings include evidence that providers should be able to move between telehealth and on-ground service provision with relative ease.

Bearing a Disproportionate Burden: Racial/Ethnic Disparities in Experiences of U.S.-Based Social Workers during the COVID-19 Pandemic.

While social workers have served as frontline workers responding to the needs of vulnerable populations during COVID-19 pandemic, little is known about how social work professionals themselves have been impacted. This article explored the impact of COVID-19 on social work professionals' mental health, physical health, and access to personal protective equipment (PPE). This was a cross-sectional web-based survey of social workers practicing in the United States (N = 3,118); data on demographic and workplace characteristics, physical and mental health, and safety concerns were collected between June and August of 2020. Univariate statistics were used to characterize the sample. Ordinal logistic and multinomial regression were used to achieve the research aims. The majority of participants reported either moderate or severe concerns related to mental (55 percent) and physical (55 percent) health; 36 percent of respondents indicated concerns about PPE access. Respondents' concerns differed by demographic (e.g., race, age) and workplace characteristics (e.g., setting, role, region). Social workers of color are experiencing COVID-19-related concerns of significantly greater severity relative to their White counterparts. Findings highlight an immediate need to deepen understanding of the factors that contribute to these trends and identify mechanisms to support the frontline social work workforce most impacted.

Using the Theory of Reasoned Action to examine grandparent and maternal substance use on the cannabis use of children of teen mothers.

BACKGROUND: Parental cannabis use is associated with increased risks of cannabis use among offspring, yet few studies have explored the mechanisms influencing intergenerational continuity in cannabis use. To understand the mechanism by which intergenerational cannabis use is influenced, this work explores cannabis use across three generations using a family expansion of the Theory of Reasoned Action (TRA). METHODS: Data come from the Young Women and Child Development Study which began when teen mothers were pregnant and followed mother-child dyads for 17 years (N = 240). Constructs include cannabis use of grandparents, mothers, and teens, and TRA constructs of behavioral and normative beliefs, intention, and behavior. Hypotheses were tested using Structural Equation Modeling. RESULTS: Grandfather's cannabis use was significantly linked to mother's normative beliefs (ß = .22, p = .006), but not attitudes (ß = .12, p = .182). Teen mothers' attitude was associated with intention (ß = .79, p < .001); intention predicted cannabis behavior (ß = .61, p < .001). Teen mothers' cannabis use was predictive of adolescent's attitude (ß = .21, p = .002); attitude predicted intention (ß = .73, p < .001) and intention predicted behavior (ß = .60, p < .001). DISCUSSION: Parents play an influential role in the cannabis use behaviors of adolescents. Future work should consider interventions that target both parent and adolescents, increasing knowledge and skills related to parent-child communication, parental monitoring, and positive parental role modeling to reduce intergenerational continuity of cannabis use.

Adverse childhood experiences and the substance use behaviors of Latinx youth.

PURPOSE: Adverse childhood experiences (ACEs) are associated with substance use, how cultural factors influence this association for Latinx youth is unknown. This study uses longitudinal data to examine associations of cultural factors, ACEs and substance use among Latinx young adults. METHODS: Latinx youth (N = 1179) completed surveys from a longitudinal study at seven assessment points from 2005 to 2016; ACEs was assessed when participants were on average 21.6 and substance use 23.9 years. ACEs measured psychological, physical, and sexual abuse, parental violence, divorce, substance use, mental illness, and incarceration. A three-stage hierarchical ordinary least squares (alcohol use) and negative binomial regression models (problematic alcohol, marijuana and tobacco use) were estimated to evaluate the role of cultural factors (acculturation, enculturation and ethnic identity) and ACEs in shaping substance use behaviors. RESULTS: Controlling for cultural variables, ACEs sum (B = 0.03, p = .01), maltreatment (B = 0.16, p < .01), and household (B = 0.12, p = .03) subdomains predicted alcohol use. One additional increase in maltreatment (IRR=1.23, 95 % CI: 1.00, 1.53) predicted 23 % higher count of problematic alcohol use. Maltreatment (IRR=1.50, 95 % CI: 1.05, 2.13) and household (IRR=1.66, 95 % CI: 1.18, 2.32) subdomains predicted increased counts of marijuana use. Four or more ACEs predicted increased counts of tobacco use (IRR=1.49, 95 % CI: 1.08, 2.06) among Latinx young adults. CONCLUSIONS: Results suggest a predictive relationship between ACEs, and alcohol, marijuana and tobacco use, after accounting for cultural factors. Beyond acculturation, enculturation and ethnic identity, findings identify ACEs as a salient predictor of substance use among Latinx young adults.

"Trying My Best": Sexual Minority Adolescents' Self-Care During the COVID-19 Pandemic.

PURPOSE: The COVID-19 pandemic has resulted in major life disruptions for sexual minority adolescents (SMAs), who already face and cope with pervasive and disproportionate rates of social, behavioral, and mental health challenges. Current research suggests that SMAs are struggling with COVID-19-related shelter in place orders navigating family proximity and dynamics and experiencing isolation from SMA-specific supports. Given identified challenges that may exacerbate known mental health disparities in SMAs, this work explores self-care practices among SMAs during the COVID-19 pandemic. METHODS: The present study uses data from open-ended questions to understand SMA experiences of self-care within a nationwide sample of SMAs (N = 770; M = 17.48 years, SD = 1.00) who are part of an ongoing prospective study. Data were collected via online questionnaire between May 13 and 31, 2020. Thematic analysis guided data exploration. RESULTS: Thematic analysis revealed five self-care practices among SMAs: (1) relationships, (2) routines, (3) body and mind, (4) rest and reset, and (5) tuning out. SMAs engaged in many positive coping strategies (i.e., exercise, establishing routine) and often linked these activities to positive well-being. Other SMAs engaged in activities to distract or disengage from stressors (i.e., excessive TV and alcohol and drug use). CONCLUSIONS: These findings highlight the resiliency of SMAs during the current pandemic, opportunities for providers to emphasize adaptive coping skills with youths, and the need for more research on adolescent self-care practices.

Effect of a church-based intervention on abstinence communication among African-American caregiver-child dyads: the role of gender of caregiver and child.

Parent-child sexual-health communication is critical. Religious involvement is important in many African-American families, but can be a barrier to sexual-health communication. We tested a theory-based, culturally tailored intervention to increase sexual-abstinence communication among church-attending African-American parent-child dyads. In a randomized controlled trial, 613 parent-child dyads were randomly assigned to one of three 3-session interventions: (i) faith-based abstinence-only; (ii) non-faith-based abstinence-only; or (iii) attention-matched health-promotion control. Data were collected pre- and post-intervention, and 3-, 6-, 12- and 18-months post-intervention. Generalized-estimating-equations Poisson-regression models revealed no differences in communication by intervention arm. However, three-way condition � sex-of-child � sex-of-parent interactions on children's reports of parent-child communication about puberty [IRR=0.065, 95% CI: (0.010, 0.414)], menstruation or wet dreams [IRR=0.103, 95% CI: (0.013, 0.825)] and dating [IRR=0.102, 95% CI: (0.016, 0.668)] indicated that the non-faith-based abstinence intervention's effect on increasing communication was greater with daughters than with sons, when the parent was the father. This study highlights the importance of considering parent and child gender in the efficacy of parent-child interventions and the need to tailor interventions to increase fathers' comfort with communication.