Abstinence beliefs in early adolescence and sexual risk behavior two years later.

INTRODUCTION: The United States has the highest teen pregnancy rate and sexually transmitted infection rates among developed countries. One common approach that has been implemented to reduce these rates is abstinence-only-until-marriage programs that advocate for delaying sexual intercourse until marriage. These programs focus on changing adolescents' beliefs toward abstinence until marriage; however, it is unclear whether adolescents' beliefs about abstinence predict their sexual behavior, including sexual risk behavior (SRB). An alternative approach may be encouraging youth to delay their sexual debut until they reach the age of maturity, but not necessarily until marriage. METHODS: To address this question, we compare the longitudinal association between abstinence beliefs (i.e., abstaining completely until marriage) and beliefs about delayed sexual debut with subsequent SRB 24 months later. The harmonized data set included 4620 (58.2% female, Mage = 13.0, SDage = 0.93) participants from three randomized controlled trials attending 44 schools in the southern United States. Negative binomial regressions were employed to examine the association of abstinence until marriage beliefs and beliefs regarding delaying sex with SRB. RESULTS: We identified that beliefs supporting delaying sex until an age of maturity were associated with lower odds of engaging in SRB, such as having multiple sex partners and frequency of condomless sex, for both sexes. However, stronger abstinence beliefs had no significant associations with all SRB outcomes. CONCLUSIONS: Findings suggest prevention programming that focuses on encouraging youth to delay sex until an appropriate age of maturity may be more effective at preventing SRB and consequent negative sexual health outcomes.

Community-Level Factors As Positive and Negative Correlates of Sexual Aggression Perpetration Among Adolescent Boys.

Often, perpetrators of sexual violence first aggress in their teens. Presently, very little is known about environmental factors that may influence adolescents' engagement in sexual aggression. Drawing upon data collected at 27 high schools in the Northeast United States, this study is the first to test the association between community-level factors and male adolescents' sexual aggression. A series of backward linear regressions determined that 10 of 19 community variables were associated with males' sexual aggression, which were then used to generate a ratio of positive to negative correlates of sexual aggression for each high school. In multilevel analyzes, as hypothesized, the ratio of positive to negative correlates was positively associated with schools' sexual aggression perpetration rates. We discuss the study's implications for future sexual assault research and prevention interventions.

Sexual violence in early adolescence is associated with subsequent teen pregnancy and parenthood.

Being a victim of sexual violence (SV) is associated with risk for teen pregnancy in cross-sectional research. However, longitudinal data are necessary to determine if SV victimization plays a causal role in early pregnancy. To address this gap in research, we test whether experiencing SV victimization in early adolescence is associated with pregnancy and having children by mid-adolescence. The current sample comprised 4594 youth (58% female; 51% Hispanic; 39% Black) attending 44 schools in the southern United States. Self-reported data were collected via audio computer-assisted self-interview (ACASI) when students were in 7th or 8th grade and again approximately 24 months later. Approximately 2.9% of boys and 8.2% of girls reported SV victimization at baseline. At follow-up, 3.4% of boys and 4.0% of girls reported being involved with one or more pregnancies; 1.1% of boys and girls reported having one or more children. Being a victim of SV at baseline was associated with pregnancy and having a child at follow-up for girls. SV was not related to outcomes among boys. The present findings indicate that girls victimized by SV are at risk of becoming pregnant and becoming teen parents. The combined sequelae of SV and teen pregnancy impair health, economic, and social functioning across the lifespan and carry forward into future generations. Future research should explore mechanisms through which victimization confers risk for pregnancy to inform prevention strategies.

Bullying and suicide risk among sexual minority youth in the United States.

Bullying is associated with increased suicide risk and maladaptive development for sexual minority youth (SMY). The purpose of this study is to determine whether multiple forms of bullying mediate the relationship between biological sex and suicide risk among SMY and to determine whether sexual identity moderates these relationships (i.e., moderated mediation). Data from the 2015-2019 National Youth Risk Behavior Surveillance Survey was analyzed using multiple group structural equation modeling with the 5967 youth that self-identified as Lesbian/Gay, Bisexual, or Not sure of their sexual identity. All forms of bullying were associated with suicide risk. After controlling for bullying, Male SMY reported less suicide risk in comparison to female SMY. Female SMY were more likely to be cyberbullied while male SMY were more likely to be threatened or injured with a weapon. Sexual identity did not moderate these relationships. These finding align with the minority stress theory which posits the victimization experiences are linked to negative mental health outcomes among minority youth. Although sexual identity did not moderate these relationships, this study reveals new mechanistic pathways influencing sex-based suicide risk disparities among SMY. Findings can inform future research and the development of suicide prevention interventions that address the unique needs of SMY occurring at the intersection of sex and sexual identity.

Community-level risk & protective correlates of violent crimes.

Despite declining rates over the past several decades, violence continues to be a pervasive public health problem. To date, we have very little knowledge about the factors at the outer layers of the social ecology that may serve to protect or exacerbate violence. The purpose of the present research is to identify community-level risk and protective correlates of multiple forms of violent crime. Official crime data were collected from 36 of the municipalities (92%) across the state of Rhode Island. Additionally, the research team identified 23 types of community establishments and identified the number of each for each of the 36 municipalities. Semi-partial correlations were computed between the 23 community variables and each of nine types of violent crimes. While there were a number of significant results, only a few meaningful patterns were found. The number of transit stations was associated with all forms of sexual violence, sex trafficking, and general physical assault. Gun dealers were associated with domestic assault, child abuse, kidnapping, and assault with a weapon, but inversely related to sex trafficking. Boys and Girls Clubs were negatively associated with the number of assaults, assaults with a weapon, sexual assaults, sexual assaults on a child, sex trafficking, and kidnappings. Contrary to prior findings, the number of alcohol outlets was generally unrelated to violent crime. These findings must be interpreted with great caution given nature of the research design. However, this study provides an initial step to advance the research on community-level risk and protective factors for violence.

Adaptation and implementation of a parenting curriculum in a refugee/immigrant community using a task-shifting approach: a study protocol.

BACKGROUND: Delivering evidence-based interventions to refugee and immigrant families is difficult for several reasons, including language and cultural issues, and access and trust issues that can lead to an unwillingness to engage with the typical intervention delivery systems. Adapting both the intervention and the delivery system for evidence-based interventions can make those interventions more appropriate and palatable for the targeted population, increasing uptake and effectiveness. This study focuses on the adaptation of the SafeCare© parenting model, and its delivery through either standard implementation methods via community-based organizations (CBO) and a task-shifted implementation in which members of the Afghans, Burmese, Congolese community will be trained to deliver SafeCare. METHOD: An adaptation team consisting of community members, members of CBO, and SafeCare experts will engage a structured process to adapt the SafeCare curriculum for each targeted community. Adaptations will focus on both the model and the delivery of it. Data collection of the adaptation process will focus on documenting adaptations and team member's engagement and satisfaction with the process. SafeCare will be implemented in each community in two ways: standard implementation and task-shifted implementation. Standard implementation will be delivered by CBOs (n = 120), and task-shifted implementation will be delivered by community members (n = 120). All interventionists will be trained in a standard format, and will receive post-training support. Both implementation metrics and family outcomes will be assessed. Implementation metrics will include ongoing adaptations, delivery of services, fidelity, skill uptake by families, engagement/completion, and satisfaction with services. Family outcomes will include assessments at three time points (pre, post, and 6 months) of positive parenting, parent-child relationship, parenting stress, and child behavioral health. DISCUSSION: The need for adapting of evidence-based programs and delivery methods for specific populations continues to be an important research question in implementation science. The goal of this study is to better understand an adaptation process and delivery method for three unique populations. We hope the study will inform other efforts to deliver health intervention to refugee communities and ultimately improve refugee health.

The impact of the Great Recession on California domestic violence events, and related hospitalizations and emergency service visits.

OBJECTIVE: Explore the impact of the Great Recession on domestic violence (DV) related hospitalizations and emergency department (ED) visits in California. METHODS: Hospital and ED data were drawn from California's Office of Statewide Health Planning and Development (OSHPD). DV-related hospitalizations and ED visits in California were analyzed between January 2000 and September 2015 (53,596), along with total medical costs. Time series were divided into pre-recession (Jan 2000-Nov 2007) and recession/post-recession (Dec 2007-Sept 2015) periods. RESULTS: The medical cost of DV-related hospitalizations alone was estimated as $1,136,165,861. A dramatic increase in DV episodes was found potentially associated with the Great Recession. The number of ED visits per month tripled from pre- to post-recession (104.9 vs. 290.6), along with an increased number of hospitalizations (77.1 vs. 95.6); African Americans and Native Americans were disproportionally impacted. In addition, psychiatric comorbidities, severe DV episodes, in-hospital mortality and charge per hospitalization escalated. The rise in DV hospitalizations and ED visits beginning in December 2007 was mainly attributable to physical abuse episodes in adults; minors had no change in DV trends. DISCUSSION: Recessions are frequent in modern economies and are repeated cyclically. Our study provides critical information on the effects of the 2007 financial crisis on DV-related healthcare service utilization in California. Given the current financial crisis associated with COVID-19, which expert predict could extend for years, the results from this study shine a spotlight on the importance of DV-related screening, prevention and response.

Effect of the SafeCare© intervention on parenting outcomes among parents in child welfare systems: A cluster randomized trial.

Child maltreatment has long-lasting negative impacts, and interventions are needed to improve caregiver's parenting skills to prevent maltreatment. This paper reports on a randomized trial comparing the SafeCare© model to services as usual (SAU) for child-welfare referred caregivers. SafeCare is an 18-session behavioral parenting program that teaches skills in positive parent-child interactions, home safety, and child health. SAU is generally unstructured and includes support, crisis management, referrals for need, and parenting education. Teams of providers at nine sites were randomized to implement SafeCare (19 teams; 119 providers) or continue SAU (17 teams; 118 providers). Two-hundred eighty eight caregivers (193 SafeCare; 95 SAU) with children aged 0-5 who were receiving services agreed to complete a baseline and 6-month assessment. Assessments measured positive parenting behaviors, parenting stress, protective factors, and neglectful behaviors using validated scales. Participants were primarily white (74.6%), female (87.0%), and low-income (68.6%), and had a mean age of 29. Latent change score models (LCSM) using a sandwich estimator consistent with the trial design were used to examine changes in 13 outcomes. Results indicated that SafeCare had small to medium effects for improving several parenting outcomes including supporting positive child behaviors (d = 0.46), proactive parenting (d = 0.25), and two aspects of parenting stress (d = 0.28 and .30). No differential change between groups was found for other indicators, including all indicators of neglect. Parenting programs such as SafeCare offer a promising mode of intervention for child welfare systems. Scale-up of parenting programs can improve parenting, improve child outcomes, and potentially reduce maltreatment. CLINICALTRIAL.GOV REGISTRATION NUMBER: NCT02549287.

Preventing intimate partner violence through paid parental leave policies.

Paid parental leave policies have the potential to strengthen economic supports, reduce family discord, and provide opportunities to empower women (Basile et al., 2016; Niolon et al., 2017). In this article, we present a theory of change and evidence to suggest how paid parental leave may impact intimate partner violence (IPV). In doing so, we present three mechanisms of change (i.e., reduction in financial stress, increase in egalitarian parenting practices, and promotion of child/parent bonding) through which paid parental leave could reduce rates of IPV. We also describe limitations of the current state of knowledge in this area, as well as opportunities for future research. Ultimately, our goal is to facilitate the identification and implementation of approaches that have the potential to reduce violence at the population level. Paid parental leave embodies the potential of policies to change societal-level factors and serve as an important prevention strategy for IPV.

Feminine Discrepancy Stress and Psychosocial Maladjustment Among Adolescent Girls.

Discrepancy stress, stress about being perceived to not conform to one's gender role (i.e., gender role discrepancy), has demonstrated effects on risky sexual and violent behaviors. However, evidence of these effects has been limited to men and boys, neglecting the impact gender role discrepancy and discrepancy stress may have on girls. In addition, no study to date, has assessed the mental health correlates of gender role discrepancy and discrepancy stress. In the current study, we sought to elucidate the relationship between perceived feminine discrepancy and feminine discrepancy stress and psychosocial maladjustment while controlling for trauma symptoms stemming from the potential repercussions of feminine discrepancy. Maladjustment was measured by creating a second-order latent factor derived from four first-order latent constructs: sexual behavior, substance use, mood disorder symptoms, and hopelessness. Data are drawn from a cross-sectional sample of female students in middle and high school (N = 643) who completed self-report questionnaires. Using structural equation modeling, we found girls reporting feminine discrepancy (i.e., less feminine than the average girl) were more likely to report feminine discrepancy stress and trauma symptomatology. Controlling for feminine discrepancy and trauma symptoms, the relationship between discrepancy stress and maladjustment was positive and significant. Additionally, girls reporting feminine discrepancy scored higher on trauma symptomatology, and trauma demonstrated a strong direct effect on psychosocial maladjustment. These data suggest that developing trauma focused prevention strategies that incorporate social norms around gender socialization may have an impact on multiple behavioral and mental health problems.

Masculine Discrepancy Stress and Psychosocial Maladjustment: Implications for Behavioral and Mental Health of Adolescent Boys.

Gender role discrepancy (GRD), or nonconformity to socially prescribed gender roles, has been linked to a multitude of adverse mental and behavioral health outcomes. Masculine discrepancy stress (MDS), stress about being perceived not to conform to one's gender role, may explain the relationship between GRD and deleterious health outcomes. However, research on MDS has primarily been restricted to adult males. This leaves a critical gap pertaining to the potential effect of MDS on adolescent boys, who may be more malleable and susceptible to the influence and pressures of gender socialization. In the current study, data are drawn from a sample of adolescent male students (N = 592) who completed self-report questionnaires. We employed structural equation modeling to test the effects of GRD and MDS on psychosocial maladjustment measured via sexual behavior, substance use, violence, mood disorder symptoms, and hopelessness. In addition, we controlled for critical risk factors including sociodemographic characteristics, adverse childhood experiences, trauma symptoms, and neighborhood disorganization. Findings indicate significant potentiating effects of MDS on maladjustment while there were direct protective effects of GRD. These data suggest that developing prevention strategies that incorporate social norms pertaining to gender socialization may have an impact on multiple behavioral and mental health problems.

Boys are victims too? Sexual dating violence and injury among high-risk youth.

OBJECTIVE: Prior research with youth exposed to violence suggests that, in this high-risk population, boys may be victims of sexual teen dating violence (TDV) and injury as frequently as girls. We sought to replicate these findings with a demographically similar sample and to determine whether the findings could be attributed the high-risk nature of the sample by assessing the impact of violence exposure on sex differences. METHODS: A cross-sectional sample of 2577 youth (ages 11-18, M=15.4, SD=1.9, 52% female, 25% Caucasian) collected in 2004 from a high-risk community reported on history of dating and exposure to multiple forms of violence. We conducted moderation analyses to test whether polyvictimization (PV) and age moderated the potential sex differences in perpetration and victimization of sexual TDV and injury. RESULTS: No significant sex differences in victimization were observed regardless of degree of PV. Boys reported more frequent sexual TDV and injury perpetration relative to girls, but only for youth reporting high degree of PV. There were no sex differences in perpetration among low PV youth. CONCLUSIONS: These findings suggest boys from high-risk communities may disproportionately perpetrate severe acts of TDV but at this early age they are equally likely to be victimized. To interrupt the cycle of violence victimization and perpetration, comprehensive violence prevention interventions targeting high-risk youth should be implemented at schools, in homes, and in the community; and they should recognize the potential for girls and boys to be victims of even the most severe forms of TDV.

Evaluation of the expect respect support group program: A violence prevention strategy for youth exposed to violence.

In the present study, we assess the effects of the Expect Respect Support Groups (ERSG) on frequency of teen dating violence (TDV) and general youth violence. ERSG is a school-based violence prevention program for youth who have been exposed to violence in their home, school, or community. Boys and girls (N=1,678, Mage=14.3, S.D.=1.7, Range=11-17) from 36 schools in Texas participated in this accelerated longitudinal (7-year trajectory) study beginning in 2011. Latent growth curve analyses were conducted using three waves of data from three cross-sectional cohorts of adolescents. Among boys, the number of ERSG sessions attended related to incremental declines in psychological TDV perpetration and victimization, physical TDV victimization, sexual TDV perpetration and victimization, reactive aggression, and proactive aggression. Girls attending ERSG demonstrated reductions in reactive and proactive aggression. The present findings suggest ERSG may be an effective cross-cutting strategy to reduce TDV and other forms of violence among high-risk boys and possibly girls. This information provides valuable understanding of TDV and youth violence in high-risk populations and may be useful in tailoring future prevention efforts to different groups of teens.

In Search of Modifiable Risk and Protective Factors for Teen Dating Violence.

The present research explores the additive and interactive effects of anger or hostility (A/H), acceptance of violence (AoV), and constructive conflict resolution strategies (CRS) on the perpetration of physical and sexual teen dating violence (TDV). Adolescents completed surveys assessing physical and sexual TDV perpetration, A/H, AoV, and positive CRS. While the findings require replication with longitudinal data, the results suggest that developing interventions to modify AoV and A/H may have the potential to prevent instances of TDV perpetration among both boys and girls. The results for CRS were mixed and necessitate further exploration. These cross-sectional data provide insight into potentially fruitful areas of exploration for the development and tailoring of prevention strategies for teens at risk for physical and sexual TDV perpetration.

The Development of Severe and Chronic Violence Among Youth: The Role of Psychopathic Traits and Reward Processing.

Psychopathic traits are a manifestation of a personality pathology that comprises a core affective-interpersonal dysfunction (callous-unemotional traits) and an impulsive-antisocial behavioral component. Of particular importance, psychopathic traits are associated with the perpetration of some of the most severe acts of violence, and they appear to indicate a subset of youth at risk for earlier onset, greater frequency, and persistence of violent offending. Although these youth represent a minority of the population, they commit a significant proportion of the violence in the general community. In our review, we highlight evidence of a unique neurobiological predisposition that underlies the core affective deficits and describe contemporary accounts for the developmental processes leading to the antisocial behavior associated with psychopathy. Current evidence suggests that, for this subset of youth, the structure and function of neural circuitry supporting emotion processing, reward learning, decision making, and the development of emotion related to empathy may be crucial to understanding why they are at risk for violence. In particular, a reward dominant pattern of neurobehavioral conditioning may explain how these youth progress to some of the most severe and persistent forms of violence. However, this pattern of conditioning may also be essential to the primary prevention of such deleterious behavior. We suspect that effective strategies to prevent such violence may ultimately be informed by understanding these affective and motivational mechanisms.

Gender Role Discrepancy Stress, High-Risk Sexual Behavior, and Sexually Transmitted Disease.

Nearly 20 million new sexually transmitted infections occur every year in the United States. Traditionally, men have demonstrated much greater risk for contraction of and mortality from STDs perhaps because they tend to engage in a number of risky sexual activities. Research on masculinity suggests that gender roles influence males' sexual health by encouraging risk-taking behavior, discouraging access to health services, and narrowly defining their roles as partners. However, despite the propensity of highly masculine men to engage in high-risk sexual behavior, there is reason to suspect that men at the other end of the continuum may still be driven to engage in similar high-risk behaviors as a consequence of gender socialization. Discrepancy stress is a form of gender role stress that occurs when men fail to live up to the ideal manhood derived from societal prescriptions (i.e., Gender Role Discrepancy). In the present study, we surveyed a national sample of 600 men via Amazon Mechanical Turk to assess perceived gender role discrepancy, experience of discrepancy stress, and the associations with risky sexual behavior and potential contraction of STDs. Results indicated that men who believe they are less masculine than the typical man (i.e., gender role discrepancy) and experience distress stemming from this discrepancy (i.e., discrepancy stress) engage in high-risk sexual behavior and are subsequently diagnosed with more STDs. Findings are discussed in relation to implications for primary prevention strategies.

Masculine discrepancy stress, substance use, assault and injury in a survey of US men.

To understand and ultimately prevent injury and behavioural health outcomes associated with masculinity, we assessed the influence of masculine discrepancy stress (stress that occurs when men perceive themselves as falling short of the traditional gender norms) on the propensity to engage in stereotypically masculine behaviours (eg, substance use, risk taking and violence) as a means of demonstrating masculinity. Six-hundred men from the USA were recruited via Amazon's Mechanical Turk (MTurk) online data collection site to complete surveys assessing self-perceptions of gender role discrepancy and consequent discrepancy stress, substance use/abuse, driving while intoxicated (DWI) and violent assaults. Negative binomial regression analyses indicated significant interactive effects wherein men high on gender role discrepancy and attendant discrepancy stress reported significantly more assaults with a weapon (B=1.01; SE=0.63; IRR=2.74; p=0.05) and assaults causing injury (B=1.01; SE=0.51; IRR=2.74; p<0.05). There was no association of discrepancy stress to substance abuse, but there was a protective effect of gender role discrepancy for DWI among men low on discrepancy stress (B=-1.19, SE=0.48; IRR=0.30; p=0.01). These findings suggest that gender role discrepancy and associated discrepancy stress, in particular, represent important injury risk factors and that prevention of discrepancy stress may prevent acts of violence with the greatest consequences and costs to the victim, offender and society.

Adolescent stalking and risk of violence.

Stalking perpetration and the associated risk for violence among adolescents has generally been neglected. In the present study, 1236 youth completed surveys assessing empirically established stalking indicators, threats and aggression toward stalking victims, dating violence, and violent delinquency. Latent Profile Analysis identified 3 latent classes of boys: non-perpetrators (NP), hyper-intimate pursuit (HIP), and comprehensive stalking perpetrators (CSP) and, and 2 classes for girls: NP and HIP. Boys in the CSP class were the most violent youth on nearly all indices with boys in the HIP class demonstrating an intermediate level of violence compared to NP boys. Girls in the HIP class were more violent than NP girls on all indices. These findings suggest stalking in adolescence merits attention by violence prevention experts. In particular, juvenile stalking may signify youth at risk for multiple forms of violence perpetrated against multiple types of victims, not just the object of their infatuation.

Gender Role Attitudes and Male Adolescent Dating Violence Perpetration: Normative Beliefs as Moderators.

Commonly used dating violence prevention programs assume that promotion of more egalitarian gender role attitudes will prevent dating violence perpetration. Empirical research examining this assumption, however, is limited and inconsistent. The current study examined the longitudinal association between gender role attitudes and physical dating violence perpetration among adolescent boys (n = 577; 14 % Black, 5 % other race/ethnicity) and examined whether injunctive (i.e., acceptance of dating violence) and descriptive (i.e., beliefs about dating violence prevalence) normative beliefs moderated the association. As expected, the findings suggest that traditional gender role attitudes at T1 were associated with increased risk for dating violence perpetration 18 months later (T2) among boys who reported high, but not low, acceptance of dating violence (injunctive normative beliefs) at T1. Descriptive norms did not moderate the effect of gender role attitudes on dating violence perpetration. The results suggest that injunctive norms and gender role attitudes work synergistically to increase risk for dating violence perpetration among boys; as such, simultaneously targeting both of these constructs may be an effective prevention approach.