Precipitating Circumstances Associated With Intimate Partner Problem-Related Suicides.

INTRODUCTION: In 2020, suicide was the 12th leading cause of death among adults in the U.S. Previous research has shown that one common precipitating circumstance among adult suicide decedents is experiencing intimate partner problems (IPPs), such as divorce, separation, romantic break-ups, arguments, conflicts, and intimate partner violence. This study examines how precipitating factors differ between IPP- and non-IPP-related suicides. METHODS: In 2022, this study analyzed National Violent Death Reporting System data from adult suicide decedents in 48 states and 2 territories between 2003 and 2020. Multivariable logistic regression models were used to compare precipitating circumstances between IPP- and non-IPP-related suicides, controlling for sociodemographic characteristics. RESULTS: Of the 402,391 suicides, 20% (n=80,717) were known to be IPP-related. Circumstances that significantly increased the odds of IPP-related suicides included a history of suicidal thoughts and attempts and mental health problems (depressed mood, alcohol problem, mental health diagnosis), life stressors (interpersonal violence perpetration and victimization, arguments, financial problems, job problems, family problems), and recent legal problems. Non-IPP-related suicides were more likely to occur among older individuals and to be precipitated by a physical health problem or crime. CONCLUSIONS: The findings can inform prevention strategies that build resiliency and problem-solving skills, strengthen economic support, and identify and assist people at risk for IPP-related suicides. The Centers for Disease Control and Prevention's Suicide Resource for Action and Intimate Partner Violence Prevention resource packages highlight the best available evidence for policies, programs, and practices related to preventing suicides and IPP.

Promoting Survivor Safety in Immigrant Communities: Online Simulation Training for Korean American Faith Leaders.

This study examined the efficacy of a short virtual case simulation for Korean American (KA) faith leaders, "Religious Leaders for Healthy Families." The goal of the program is to increase knowledge about intimate partner violence (IPV) and healthy intimate partner relationships, enhance self-efficacy in IPV prevention and intervention, strengthen attitudes that support their roles on IPV prevention and intervention, increase positive outcome expectations of their actions, and increase behavioral intentions and behaviors on IPV prevention and intervention. KA faith leaders from two large metropolitan areas with a high concentration of KA immigrants were invited to participate in the study (N=102). Participants completed three online assessments: baseline, a 3-month, and a 6-month follow-up. After the baseline assessment, participants were randomized to either intervention (n = 53) or control (n = 49). The intervention consisted of four online simulation modules, each taking approximately 15-20 min to complete. At the 6-month follow-up, faith leaders in the intervention group significantly increased their knowledge and self-efficacy in IPV prevention and intervention compared to the control group. Mean scores for attitudes against IPV and prevention behaviors increased from baseline to the 6-month follow-up for the intervention group more than the control group, but the differences were not statistically significant. "Religious Leaders for Healthy Families" has the potential to reduce disparities in accessing resources and services for immigrant survivors of IPV. With its ease of use, this short, free online intervention has a high potential for uptake among faith leaders. Results are promising, but the COVID-19 pandemic negatively affected the study, with participants having scarce opportunities to practice the skills learned from the intervention. A larger follow-up study that combines "Religious Leaders for Healthy Families" with a community-wide intervention that targets all community members is warranted to reach more faith leaders and community members.

Prevalence and Predictors of Perpetration of Cyberviolence Against a Dating Partner: A Cross-Cultural Study with Moroccan and Spanish Youth.

The rise in the levels of cyberviolence in adolescent couples has become a social, educational, and public health problem of enormous magnitude. This study analyzed the nature and dimensions of cyberviolence among adolescents and its association with other forms of offline violence by country of origin (Morocco or Spain) and gender. The objective of the study was to identify the predictors of the perpetration of cyberviolence against a dating partner. The predictor variables were five types of dating victimization (cyber, physical, sexual, emotional with a social impact, and emotional with an individual impact), history of violence, and parental monitoring knowledge. The sample consisted of Spanish (n = 802) and Moroccan students (n = 241) who had dated and attended secondary schools in southeastern Spain. Over half of the participants had perpetrated cyberviolence against their partners; the prevalence was higher among girls and Moroccan youth. Boys reported more physical victimization than girls. For all groups, the strongest predictor of cyberviolence perpetration was cyberviolence victimization. The influence of other forms of victimization, history of offline violence, and parental monitoring differed by the youth's country of origin and gender. The study reinforces the need for intersectional and cross-cultural analyses of online behaviors.

Design, implementation, and evaluation of community health worker training programs in Latinx communities: A scoping review.

This review examines the current reporting trends of program design, implementation, and evaluation of training programs for Latinx community health workers. Five scholarly databases were searched using a scoping review methodology to identify articles describing training programs for Latinx community health workers. The timeframe was 2009 to 2021. We identified 273 articles, with 59 meeting inclusion criteria. Researchers thematically coded the articles to identify reporting strategies related to program design, implementation, and evaluation. Findings suggest a lack of consensus in reporting elements critical to program resources, instructor qualifications, frequency and length of training implementation, theoretical background, and pedagogical tools associated with the training program. We offer detailed reporting recommendations of community health worker training programs to support the consistent dissemination of promising practices and facilitate the initiation of new programs for Latinx community health workers.

Prevention of partner violence: virtual case simulation for religious leaders of Korean American immigrant communities.

The project 'Religious Leaders for Healthy Families' aims to prevent intimate partner violence (IPV) and increase access to resources for immigrant victims by enhancing the capacity of religious leaders. Due to cultural and psychosocial barriers, immigrant women prefer to exhaust informal resources, including religious leaders, before seeking help from professional service providers. This study reports the development of a virtual case simulation in which Korean American (KA) religious leaders living in the USA practice how to prevent and address IPV in their congregation. Intervention mapping (IM) guided the development of the simulation. This process was informed by theory, research and expertise in prevention and virtual case simulation. We partnered with victim service organizations and received feedback from religious leaders. The simulation was pilot tested with nine KA religious leaders and three community leaders with IPV expertise in the KA community. The resulting intervention consists of 4 behavioral outcomes and 24 performance objectives. We identified the knowledge, attitudes, outcome expectations and self-efficacy needed to accomplish each objective. The most creative phase was the development of four modules, as interactive virtual case simulations, that address all performance objectives. IM and social cognitive theory provided a useful framework for developing this virtual case simulation. With culturally responsive modifications, the intervention has the potential to be adapted for religious leaders from other immigrant communities.

Religion can play a pivotal role in helping immigrant women. Religious institutions help immigrants maintain their ethnic identity and language and support their integration into the new culture. This study explains the development of an online intervention for Korean American religious leaders to prevent partner violence. Religious leaders in immigrant communities can play a significant role in perpetuating cultural norms that contribute to partner violence or, conversely, create norms that promote equity between partners and value seeking help. Partner violence is high in cultures that adhere to traditional gender roles, with male-dominated interactions, and perceive seeking help as a failure that would bring shame to the whole family. The intervention consists of four modules that depict interactions between a religious leader and female parishioners: (i) a deacon worried about a parishioner who might be a victim, (ii) an immigrant woman married to an abusive husband, (iii) a woman in the hospital because of multiple bruises and a broken arm and (iv) a graduate student concerned about her fiancé's behavior. Experts in various fields, community leaders in the prevention of partner violence, and religious leaders provided their feedback and expertise for program development.

Promotoras Voice Their Challenges in Fulfilling Their Role as Community Health Workers.

Promotoras de salud (Spanish for female community health workers) are integral to efforts to enhance the health and well-being of Latinx individuals, families, and communities. The purpose of this study was to describe the challenges that promotoras face and the proposed solutions from the perspective of the promotoras themselves. Five promotoras who worked for a year as volunteers in a community-based participatory research study, Lazos Hispanos, participated in two group interviews. Eight challenges emerged-balancing their new work with their family commitments, handling their perceived imbalance of power with men, managing the emotional impact of hearing participants' problems, facing and handling the barriers imposed by having limited English language skills, feeling discouraged by the perception of ethnocentric beliefs and discrimination from some providers, feeling disheartened by the cultural beliefs of some Latinx participants, handling the lack of transportation for themselves and for the participants, and managing the burden of data collection for the research aspect of the program. The explanation of these challenges and the practical solutions they proposed are embedded in their intersecting identities. The solutions are a valuable addition to the practice of health promotion and community-based participatory research, particularly within Latinx communities.

Bullying and Attitudes Toward Masculinity in Croatian Schools: Behavioral and Emotional Characteristics of Students Who Bully Others.

Prevention of bullying is paramount to creating a positive and welcoming school environment. This study compared the following characteristics reported by students who had perpetrated bullying in Croatian schools and those who did not: gender, type of school, family wealth, negative emotionality, behaviors that may compromise health, and endorsement of traditional masculinity. Within the framework of the "Croatian Adolescent Masculinity Study," second and third grade students of secondary schools (equivalent to tenth and eleventh grade in the United States) in the city of Zagreb (N = 4,072) completed a cross-sectional, paper-and-pencil survey. Descriptive and logistic regression analyses were conducted separately for males and females to identify constructs associated with bullying perpetration. More males (12.7%) than females (5.8%) perpetrated bullying. Compared to students who did not report bullying others, significantly more students, who perpetrated bullying reported feeling sad or hopeless, having suicidal ideation, carrying a weapon, missing school because of feeling unsafe, drinking alcohol, getting inebriated, being victims of bullying, and endorsing traditional masculinity norms. The proportion of males reporting bullying others did not vary by type of school; females were more likely to perpetrate bullying in predominantly male and mixed-gender vocational schools. Bullying prevention interventions should address the complexity of problems associated with bullying others. Students who reported bullying others were more likely to participate in other harmful behaviors and have emotional problems. Endorsement of traditional masculinity norms should be further researched in other cultures and included in investigations of bullying perpetration, given its association with increased bullying among male and female students.

Lazos Hispanos: Promising Strategies and Lessons Learned in the Development of a Multisystem, Community-Based Promotoras Program.

U.S. Latinos face multiple inter-related barriers to access health and social services. Researchers and practitioners have called upon community-based participatory research (CBPR) to address such challenges and health disparities, with the community health worker-or promotoras-model evidencing positive outcomes. What is less clear, however, are the promising strategies to support the development of a multisystem, community-based promotoras program. In response, the current study applied a CBPR conceptual model as an organizing framework to develop a promotora program. Lazos Hispanos (Hispanic Links) was developed to enhance the health and well-being of Latinx residing in low-income communities in the Southeastern United States. This study highlights 16 lessons learned, anchored in the first two dimensions of the CBPR conceptual model: community context and partnership development. First, the community assessment and activities leading to Lazos Hispanos took nearly 2 years but were crucial to develop a strong basis for the program. Second, the development of a multicultural and interdisciplinary research team enriched every aspect of the program and enhanced culturally responsive community engagement. Selection, training, and ongoing support of the promotoras were fundamental to program success. Particularly important were the following: receiving mentorship from a successful promotora organization; delineating mutually agreed upon roles and responsibilities; following national training standards for community health workers; and, holding monthly meetings for training, support, and data collection. The engagement of community service providers as partners was facilitated by building upon existing community relationships, signing a memorandum of understanding that specified roles and responsibilities, conducting tours of provider facilities with the promotoras, and keeping providers abreast of the program via bi-annual community gatherings. The development process showed fidelity to the conceptual model. Lazos Hispanos has proven an asset to participants, the promotoras, and service providers as the program continues to develop a community-based, health supportive infrastructure.

A multistakeholder evaluation of Lazos Hispanos: An application of a community-based participatory research conceptual model.

The goal of Lazos Hispanos is to enhance the health and well-being of the Latinx community through promotoras, who connect community members with service providers for multiple health and social needs. A community-based participatory research conceptual model framed the multimethod evaluation of promotoras, service providers, and community participants at baseline and at the 1-year follow up. The promotoras increased their self-efficacy and knowledge, felt a strong sense of commitment to the community, viewed themselves as a bridge between participants and providers, and felt empowered by their new role. Service providers valued the promotoras as their ambassadors in the community and Lazos Hispanos as central to connecting service providers, promotoras, and community members; they noted that this collaboration increased their accountability with the Latinx community. This multistakeholder evaluation highlights the depth of positive changes achieved during the first year and the challenges of a community-embedded project and the benefits and possibilities of calling upon theoretically informed evaluation models.

Overcoming Barriers: Practical Strategies to Assess Latinos Living in Low-Income Communities.

The value of community assessments depends on the researchers' ability to reach a diverse and representative sample of participants. This process is particularly challenging when assessing the health and well-being of vulnerable populations that are reticent to participate in research because of demographic and sociopolitical factors. One such group is Latinxs (the gender-neutral version of Latinos or Latinas) of mixed immigration status who live in low-income, socially and geographically isolated enclaves in the Southeast. Framed by community-based participatory research and social marketing theories, this study describes practical strategies for health researchers, practitioners, and advocates seeking to engage and build trusting relationship within U.S. Latinx communities. First, identify and leverage points of entry to different segments of the communities of interest by engaging meaningful gatekeepers from different sections of the population and searching for places where potential participants gather. Second, reduce the burden of assessments by using incentives and creating intentional reciprocity. Third, establish critical, long-lasting trust with community members, leaders, and allies by adapting data collection procedures, ensuring confidentiality, engaging bilingual facilitators, and most important, being present with and for the community. Finally, presenting the findings back to the community can increase the ownership of the process.

Victimized for Being Different: Young Adults With Disabilities and Peer Victimization in Middle and High School.

Children who are victims of peer aggression can suffer negative emotional, academic and physical consequences that can last into adulthood. Previous research indicates children with disabilities are victimized up to 4 times as often as children without disabilities. However, their unique needs are often not considered in the design and implementation of prevention interventions. The current study examined the perceived effects of family, peer, and school support among children with disabilities to protect them from or help them cope with peer victimization. In this retrospective study, college students registered with a university Disability Resource Center (n = 161) completed an electronic survey about their recollections of peer victimization and of factors that protected them during middle and high school. Three subscales of the Social and Emotional Health Survey measured perception of family, peer, and school support. In open-ended questions, students described instances of peer victimization and of protection. Results indicated that two thirds of participants experienced peer victimization. The most frequently reported type of aggression was relational, followed by verbal. Frequency of victimization did not differ by gender. Most participants experienced victimization related to their disabilities or related to a combination of disability with another personal characteristic. Participants who reported higher levels of family and peer support experienced significantly less peer victimization. Coping with victimization took many forms such as withdrawing from peers, listening to music, and mental health treatment. Unexpectedly, some participants reported disability-related victimization from school staff. Findings highlight the high frequency of victimization and the value of educating parents, school personnel, and other students on strategies to support students with disabilities. These strategies could be incorporated into prevention programs.

Goals and Strategies to Solve Peer Conflict: Comparison by Aggression Trajectories / Metas y estrategias para resolver conflictos entre pares: una comparación de trayectorias de agresión / Metas e estratégias para resolver conflitos entre pares: uma comparação de trajetórias de agressão

Abstract Objective. Prior research identified three trajectories of adolescent aggressive behavior from Grades 6 to 12: Low, Medium Desisting, and High Desisting Aggression. This study examined whether youth in these trajectories differed in their goals and strategies to solve conflict. Method. The sample consisted of 620 randomly selected students (n=620) participating in the Healthy Teens Longitudinal Study. Participants attended schools in Northeast Georgia, USA. Mean scores were plotted for the seven years, and analysis of variance was used to examine whether student endorsement of goals and strategies differed by aggression trajectories. Results. Self-reported student goals and strategies were stable over time. At Grade 6 and 12, significantly more students in the Low Aggression trajectory endorsed positive goals and strategies to resolve peer conflict, and significantly more students in the two more aggressive trajectories endorsed aggressive goals and strategies. Youth in the two more aggressive trajectories did not differ in goals or strategies. Seeking help from a teacher did not vary by aggression trajectory or grade level. Conclusion. Given the stability of goals and strategies, school should implement programs early to enhance social-cognitive factors affecting students' behavior in peer conflict situations, and thus prevent violence and enhance a positive school climate.

Resumen Objetivo. Estudios anteriores han identificado tres trayectorias en los comportamientos agresivos de adolescentes que cursan entre los grados 6° y 12°: agresión baja, desistimiento medio y alto desistimiento. Este estudio explora si jóvenes, en estas trayectorias, difieren en sus metas y estrategias para resolver conflictos entre pares. Método. La muestra la conformaron 620 estudiantes, seleccionados al azar, participando en el estudio longitudinal Healthy Teens. Todos los participantes asistían a colegios en el noreste de Georgia, E.E.U.U.. Se calcularon puntajes medios para los siete grados escolares analizados y se realizaron análisis de varianza para examinar diferencias entre las tres trayectorias. Resultados. El autoreporte de metas y estrategias fue estable en el tiempo. En todos los grados, significativamente más estudiantes en la trayectoria de baja agresividad aprobaron metas y estrategias positivas para resolver conflictos, y más estudiantes en las trayectorias más agresivas aprobaron metas y estrategias agresivas. Los dos grupos de estudiantes en las trayectorias más agresivas no mostraron diferencias en sus metas y estrategias. La búsqueda de ayuda de un profesor no varió por trayectoria o grado escolar. Conclusión. Dada la estabilidad de las metas y estrategias, las escuelas deben implementar temprano programas de prevención para mejorar factores sociocognitivos que ayudan a estudiantes a resolver conflictos con sus pares, y así prevenir la violencia entre estudiantes y promover un clima escolar positivo.

Resumo Escopo . Estudos anteriores têm identificado três trajetórias nos comportamentos agressivos de adolescentes que cursam entre os grados 6º e 12º: agressão baixa, retirada média e alta retirada. Este estudo explora a possibilidade de que os jovens, nestas trajetórias, se diferenciam nas suas metas e estratégias para resolver conflitos entre pares. Metodologia . A amostra foi conformada por 620 estudantes, selecionados por sorteio, participando no estudo longitudinal Healthy Teens. Todos os participantes assistiam a escolas no Nordeste de Geórgia, EUA. Foram calculadas as pontuações médias para os sete grados escolares analisados e foi feita uma análise de variação para examinar as diferenças entre as três trajetórias. Resultados . O auto reporte de metas e estratégias foi estável no tempo. Em todos os grados, significativamente mais estudantes na trajetória de baixa agressividade aprovaram metas e estratégias positivas para resolver conflitos, e mais estudantes nas trajetórias mais agressivas aprovaram metas e estratégias agressivas. Os dois grupos de estudantes nas trajetórias mais agressivas não mostraram diferenças nas suas metas e estratégias. A procura de ajuda de um professor não variou por trajetória ou grado escolar. Conclusão . Levando em conta a estabilidade das metas e estratégias, as escolas devem implementar cedo programas de prevenção para melhorar fatores sócio cognitivos que ajudem a estudantes a resolver conflitos com seus pares, e assim prevenir a violência entre estudantes e promover um clima escolar positivo.

Social Misfit or Normal Development? Students Who Do Not Date.

OBJECTIVE: Prior research identified 4 distinct dating trajectories from 6th to 12th grade: Low, Increasing, High Middle School, and Frequent. The purpose of this study was to examine whether 10th graders in the Low dating group differed on emotional, interpersonal, and adaptive skills from youth in the other trajectories. METHODS: The sample consisted of 594 10th graders. We compared the 4 dating groups using teacher ratings (social skills, leadership, depression) and student self-reports (positive relationships with friends, at home, and at school; depression, suicidal ideation). To compare scores by dating trajectory, we used chi-square test and analysis of variance. RESULTS: Students in the Low dating group had significantly higher teacher ratings of social skills and leadership, and lower ratings of depression compared to the other groups. Self-reports of positive relationships did not differ by dating groups. Self-reported depression was significantly lower in the Low dating group, but suicidal ideations did not differ. CONCLUSION: Adolescents who were not in a romantic relationship had good social skills and low depression, and fared better or equal to peers who dated. These results refute the notion that non-daters are maladjusted. Health promotion interventions in schools should include non-dating as one option of healthy development.

Korean clergy for healthy families: online intervention for preventing intimate partner violence.

BACKGROUND: Intimate partner violence (IPV) among immigrant women is a serious public health problem. Churches and clergy play a fundamental role in their lives, as a form of social organization and alternative to community services. PURPOSE: To describe the implementation and evaluation of an intervention for Korean American faith leaders designed to increase knowledge about IPV and about resources to handle IPV, strengthen attitudes that do not support IPV, enhance self-efficacy to handle IPV, and increase prevention and intervention behaviors about IPV. METHODS: Korean American faith leaders in a Southeastern state of the USA were invited to participate in the study (n = 55). Participants completed two online assessments: baseline and a 3-month follow-up. After the baseline assessment, participants were randomized to either the intervention (n = 27) or the control (n = 28) group. The intervention consisted of three online modules, each taking approximately 30-45 min to complete. Modules were developed based on the researchers' work with Korean American faith leaders. Assessments and interventions were available in Korean and English. RESULTS: Compared to the control group, the intervention group significantly improved their knowledge of resources and enhanced attitudes against IPV. The intervention group increased their self-efficacy and behaviors to prevent IPV more than the control group, but these changes were not statistically significant. CONCLUSIONS: The online training provided a safe and convenient environment for the Korean American clergy, for whom anonymity and convenient access were important. Results are promising, but highlight the need to include more specific training of skills, which could be incorporated into the online modules in the form of an avatar. This online training could serve as a template to be adapted for other immigrant groups.

Planning Ahead: Using the Theory of Planned Behavior to Predict Older Adults' Intentions to Use Hospice if Faced With Terminal Illness.

Hospice is underutilized in the United States, and many patients enroll for short periods of times. The purpose of this cross-sectional study was to identify significant predictors of intentions to use hospice in community-dwelling older adults. The Theory of Planned Behavior informed the selection of predictors. Data were collected from 146 White older adults ( M age = 69.5; 69% females). Multiple linear regression analyses showed that higher hospice knowledge, normative beliefs that support hospice utilization, higher perceived control to use hospice, and preferences for end-of-life care that favor comfort and quality of life over living as long as possible were significant predictors of intentions to use hospice. In spite of being a sample of mostly highly educated older adults, almost half did not know about funding for hospice. These results provide better understanding of where to focus interventions to educate older adults about hospice, ideally in advance of a crisis.

Longitudinal Examination of Aggression and Study Skills From Middle to High School: Implications for Dropout Prevention.

BACKGROUND: High school completion provides health and economic benefits. The purpose of this study is to describe dropout rates based on longitudinal trajectories of aggression and study skills using teacher ratings. METHODS: The sample consisted of 620 randomly selected sixth graders. Every year from Grade 6 to 12, a teacher completed a nationally normed behavioral rating scale. We used latent class mixture modeling to identify the trajectories. RESULTS: Participants followed 3 trajectories of aggression (Low, Medium Desisting, and High Desisting) and 5 trajectories of study skills (Low, Average-Low, Decreasing, Increasing, and High). Over three-quarters of the sample were in stable trajectories of study skills over time. Most students in the High Desisting Aggression group were in the Low Study Skills group, and all students in the High Study Skills group were in the Low Aggression group. The overall dropout rate was 17%, but varied dramatically across combined aggression and study skills groups, ranging from 2% to 50%. CONCLUSIONS: The results highlight the importance of early prevention that combines academic enhancement and behavioral management for reducing school dropout.

Implementing and evaluating an interprofessional minority health conference for social work and healthcare professionals.

Interprofessional education (IPE) is one strategy for addressing health inequities; however, little attention has been paid to continuing IPE for practicing social work and healthcare professionals. This article offers guidance to faculty in social work and health-related academic units on offering continuing IPE on the topic of minority health. An interprofessional group of faculty offered a day-long conference on minority health, ethics, and social justice. The conference goal was to promote interprofessional communication in a co-learning environment and promote dialogue on social determinants of health and health equity in the state. Data were obtained from surveys and analysis of work plans developed during the conference. Workshop participants were majority White (62%), social workers (79%), and practiced for 14 years on average. The most useful topics were dementia and polypharmacy. Takeaway strategies included interprofessional work, being mindful of access to resources, and engagement in continuing education. Lessons learned include plan in advance for all professions; recruit faculty and students from multiple departments to increase interprofessional diversity; offer strategies and incentives to increase student participation; be strategic about conference location and format; and identify a strategic format and theme. IPE is a means of preparing learners for working together in their future careers to provide high-quality patient-centred care and reduce health disparities. Professional development can provide an opportunity to enhance skills to address health disparities, and learning can be significantly enhanced when participants connect with colleagues from different professions, discuss diverse opinions, and share successful practices.

Low and Increasing Trajectories of Perpetration of Physical Dating Violence: 7-Year Associations with Suicidal Ideation, Weapons, and Substance Use.

Understanding the interrelation among problem behaviors and their change over time is fundamental for prevention research. The Healthy Teens Longitudinal Study followed a cohort of adolescents from Grades 6-12. Prior research identified two distinct trajectories of perpetration of physical dating violence: Low and Increasing. The purpose of this study was to examine whether adolescents in these two trajectories differed longitudinally on other problem behaviors: (1) suicidal ideation and attempts, (2) weapon-carrying and threats with a weapon, and (3) substance use, particularly alcohol and marijuana. The sample consisted of 588 randomly-selected students (52% males; 49% White, 36% Black, 12% Latino). Students completed a self-reported, computer-based survey each spring from Grades 6-12. To examine significant differences by perpetration of physical dating violence trajectory, we used Chi-square test and generalized estimating equations modeling. Across most grades, significantly more students in Increasing than in the Low trajectory reported suicidal ideation and attempts, carried a weapon, and threatened someone with a weapon. Adolescents in the Increasing trajectory also had higher trajectories of alcohol use, being drunk, and marijuana use than those in the Low trajectory. All differences were already significant in Grade 6. The difference in the rate of change between groups was not significant. This longitudinal study highlights that problem behaviors-physical dating violence, suicidal ideation and attempts, weapon carrying and threats, marijuana and alcohol use-cluster together as early as sixth grade and the clustering persists over time. The combination of these behaviors poses a great public health concern and highlight the need for early interventions.

School Climate Associated with School Dropout Among Tenth Graders / Ambiente escolar asociado con la deserción de los alumnos de décimo grado / Clima escolar associado à deserção escolar entre alunos de primeiro ano de ensino médio

Objective. This study evaluated the association between high school dropout and six dimensions of school climate. Method. The sample consisted of 638 tenth graders who participated in the Healthy Teens Longitudinal Study. Participants attended school in Northeast Georgia, United States of America; they were surveyed even if they dropped out of school. Information about dropout was obtained through twelfth grade. Logistic regression was used to identify predictors of dropout. Results. More boys (22.1%) than girls (14.4%) dropped out of school. Compared to students who remained in school, students who dropped out of school reported significantly higher overt and relational peer victimization and lower positive relationships with peers, school connectedness, caring adults at school, and meaningful participation in school. In the logistic regression model, male gender (AOR = 1.68) and relational victimization (AOR = 1.51) increased the odds of dropping out, and school connectedness (AOR = 0.78) and the presence of a caring adult at school (AOR = 0.73) decreased odds of dropping out. Conclusion. The dimensions of school climate in tenth grade were associated with the decision to abandon or persist in school. Its multiple dimensions can guide educators to develop programs and practices to reduce high school dropout.

Objetivo. El estudio evaluó la asociación entre los desertores de bachillerato y seis dimensiones de ambiente escolar. Método. La muestra consistía en 638 estudiantes de décimo grado quienes participaron en el Estudio Longitudinal de Adolescentes Saludables. Los estudiantes iban al colegio al Noreste de Georgia, Estados Unidos; eran encuestados aún si desertaban del colegio. La información relacionada con la deserción se obtiene en grado doce. Se utilizó la regresión logística para identificar indicadores de deserción. Resultados. Más niños (22.1%) que niñas (14.4%) desertaron del colegio. Comparado con los estudiantes que permanecieron en el colegio, los que desertaron mostraron un alto nivel de muestra de victimización relacional con sus pares y menos relaciones positivas con estos, poca conexión con el colegio, menos relación con un adulto protector dentro del mismo y menos participación significativa. En el modelo de logística regresiva, el género masculino (AOR = 1.68) y victimización relacional (AOR = 1.51) aumentaron las probabilidades de desertar, mientras que la conexión con el colegio (AOR = 0.78) y la presencia de una adulto protector (AOR = 0.73) disminuyen las posibilidades de la deserción. Conclusión. Las dimensiones del ambiente escolar en décimo grado fueron asociadas con la decisión de abandonar o persistir en el colegio. Sus múltiples dimensiones pueden llevar a los educadores a desarrollar programas y prácticas para reducir la deserción en bachillerato.

Escopo. Este estudo avalia a associação entre deserção escolar em ensino médio e seis dimensões do clima escolar. Metodologia. A amostra consistiu em 638 estudantes de primeiro ano de ensino médio que participaram no Estudo Longitudinal de Adolescentes Saudáveis. Os participantes eram estudantes de uma escola no nordeste de Georgia, Estados Unidos; eles formaram parte da pesquisa ainda que eles tivessem deixado a escola. A informação sobre deserção escolar foi obtida a través do terceiro ano de ensino médio. A regressão logística foi usada para identificar preditores de deserção. Resultados. Mais homens (22.1%) que mulheres (14.4%) deixaram a escola. Comparando com estudantes que ficaram na escola, os estudantes que a deixaram reportaram uma significativamente maior evidente e relacional vitimização dos pares, e menores relações positivas com pares, conexão com a escola, atenção dos adultos na escola e participação significativa na escola. No modelo de regressão logística, o gênero masculino (AOR = 1.68) e vitimização relacional (AOR = 1.51) acrescentaram a probabilidade de deserção escolar, e a conexão com a escola (AOR = 0.78) e a presença se adultos que prestavam assistência aos alunos na escola (AOR = 0.73) reduziram a probabilidade de deserção escolar. Conclusão. As dimensões do clima escolar em alunos do primeiro ano de ensino médio foram associados à decisão de abandonar ou ficar na escola. Estas dimensões múltiplas podem guiar aos educadores a desenvolver programas e práticas para reduzir a deserção escolar no ensino médio.

Cigarette Smoking Trajectories From Sixth to Twelfth Grade: Associated Substance Use and High School Dropout.

INTRODUCTION: The purpose of this longitudinal study was to identify distinct trajectories of cigarette smoking from sixth to twelfth grade and to characterize these trajectories by use of other drugs and high school dropout. METHODS: The diverse sample for this analysis consisted of a cohort of 611 students from Northeast Georgia who participated in the Healthy Teens Longitudinal Study (2003-2009). Students completed seven yearly assessments from sixth through twelfth grade. We used semi-parametric, group-based modeling to identify groups of students whose smoking behavior followed a similar progression over time. RESULTS: Current smoking (past 30 day) increased from 6.9% among sixth graders to 28.8% among twelfth graders. Four developmental trajectories of cigarette smoking were identified: Abstainers/Sporadic Users (71.5% of the sample), Late Starters (11.3%), Experimenters (9.0%), and Continuous Users (8.2%). The Abstainer/Sporadic User trajectory was composed of two distinct groups: those who never reported any tobacco use (True Abstainers) and those who reported sporadic, low-level use (Sporadic Users). The True Abstainers reported significantly less use of alcohol and other drugs and lower dropout rates than students in all other trajectories, and Sporadic Users had worse outcomes than True Abstainers. Experimenters and Continuous Users reported the highest drug use. Over one-third of Late Starters (35.8%) and almost half of Continuous Users (44.4%) dropped out of high school. CONCLUSIONS: Cigarette smoking was associated with behavioral and academic problems. Results support early and continuous interventions to reduce use of tobacco and other drugs and prevent high school dropout.