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Guastaferro K, Melchior MS, Heng S, Trudeau J, Holloway JL. Maximizing the reach of universal child sexual abuse prevention: Protocol for an equivalence trial. Contemp Clin Trials Commun 2024; 41:101345. [PMID: 39188413 PMCID: PMC11345503 DOI: 10.1016/j.conctc.2024.101345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/19/2024] [Accepted: 07/27/2024] [Indexed: 08/28/2024] Open
Abstract
Background Child sexual abuse (CSA) affects 1 in 5 girls and 1 in 12 boys before age 18. Universal school-based prevention programs are an effective and cost-efficient method of teaching students an array of personal safety skills. However, the programmatic reach of universal school-based programs is limited by the inherent reliance on the school infrastructure and a dearth of available alternative delivery modalities. Methods The design for this study will use a rigorous cluster randomized design (N = 180 classrooms) to determine the equivalence of two delivery modalities of Safe Touches: as usual vs. modified. The as usual workshop will be delivered by two facilitators with live puppet skits (n = 90). Whereas, the modified workshop will be delivered by one facilitator using prerecorded skit videos (n = 90). We will determine the equivalence by measuring concept learning acquisition preworkshop to immediate postworkshop (Aim 1) and retention at 3-months postworkshop (Aim 2) among students in classrooms that receive the as usual or modified workshops. To conclude equivalence, it is imperative to also examine factors that may impact future dissemination and implementation, specifically program adoption among school personnel and implementation fidelity between the two modalities (Aim 3). Conclusion Study findings will inform the ongoing development of effective CSA prevention programs and policy decisions regarding the sustainable integration of such programs within schools. Clinical trial registration NCT06195852.
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Affiliation(s)
- Kate Guastaferro
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, 708 Broadway, 6th Floor Room 636, New York, NY, 10003, USA
| | - Mia S. Melchior
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, 708 Broadway, 6th Floor Room 636, New York, NY, 10003, USA
| | - Siyu Heng
- Department of Biostatistics, School of Global Public Health, New York University, 708 Broadway, 7th Floor Room 743, New York, NY, 10003, USA
| | - Jessica Trudeau
- New York Society for the Prevention of Cruelty to Children, 520 8 Avenue Suite 1401, New York, NY, 10018, USA
| | - Jacqueline L. Holloway
- New York Society for the Prevention of Cruelty to Children, 520 8 Avenue Suite 1401, New York, NY, 10018, USA
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Guastaferro K, Abuchaibe V, McCormick KV, Bhoja A, Abourjaily E, Melchior M, Grayson C, Welikson P, Dan C, Zeleke MB. Adapting a selective parent-focused child sexual abuse prevention curriculum for a universal audience: A pilot study. PLoS One 2024; 19:e0302982. [PMID: 38753647 PMCID: PMC11098426 DOI: 10.1371/journal.pone.0302982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Parents are an obvious, but underutilized player in the prevention of child sexual abuse (CSA). A handful of universal parent-focused prevention programs have emerged, however, the evidence for these programs is mixed and the programs suffer ubiquitously from barriers to implementation (e.g., poor engagement, low participation) thereby limiting public health impact. To combat these barriers and improve evidence, researchers previously developed and tested a selective parent-focused CSA prevention program. While promising, the selective approach still leaves a gap in the prevention landscape-parents from the universal audience. However, there appear to be no standardized methods to inform this type of adaptation-interventions designed as universal or selective have primarily been delivered as such. This study sought to adapt the selective curriculum for a universal audience and examined the acceptability and feasibility of the program for evaluation in a future trial. Using mixed methods, N = 31 parents (i.e., primary caregiver for a child under 13) completed pre- and post-workshop surveys followed by a brief individual interview conducted via Zoom. Interviews, coded using content analysis methods, focused on three themes: parents as agents of prevention (e.g., prior action, confidence), curriculum (e.g., content, design), and engagement (e.g., future marketing and promotion). Overall participants' mean score on CSA-related awareness and intention to use protective behavioral strategies increased. The participants found the curriculum highly acceptable noting strengths in the content and design. All told, the results of this pilot study suggest the acceptability and feasibility of examining the efficacy of the universal parent-focused curriculum in a larger trial. Procedural challenges, such as bots in recruitment, identify areas of caution in design of the larger trial and a roadmap for others seeking to adapt selective programs for universal audiences.
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Affiliation(s)
- Kate Guastaferro
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Vanessa Abuchaibe
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Kaylee V. McCormick
- Mission Kids Child Advocacy Center, East Norriton, Pennsylvania, United States of America
| | - Arushee Bhoja
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Ella Abourjaily
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Mia Melchior
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Corinne Grayson
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Paige Welikson
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Colin Dan
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Meron B. Zeleke
- School of Global Public Health, New York University, New York, New York, United States of America
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Hornor G. Child Sexual Abuse Victimization and Parenting. J Pediatr Health Care 2024; 38:438-449. [PMID: 38697699 DOI: 10.1016/j.pedhc.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/07/2023] [Accepted: 09/21/2023] [Indexed: 05/05/2024]
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Balén Z, Pliskin E, Cook E, Manlove J, Steiner R, Cervantes M, Garrido M, Nuñez-Eddy C, Day M. Strategies to develop an LGBTQIA+-inclusive adolescent sexual health program evaluation. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1327980. [PMID: 38590517 PMCID: PMC11000634 DOI: 10.3389/frph.2024.1327980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Adolescent sexual health interventions are increasingly incorporating content that is inclusive of LGBTQIA+ youth (lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other marginalized sexualities and genders). Evaluations of such programs must also be inclusive to enhance the validity of evaluation results and avoid further marginalization. We present strategies for increasing LGBTQIA+-inclusivity based on our evaluation of SafeSpace, a sexual health curriculum. Methods To design an LGBTQIA+-inclusive program evaluation, we leveraged LGBTQIA+ research staff's insights, pursued a parental consent waiver, developed an inclusive recruitment plan, and crafted demographic and sexual behavior survey measures with input from youth and equity experts. We conducted a pilot study with 42 youth ages 14-17 to assess the feasibility and efficacy of our strategies. Results We obtained a parental consent waiver and recruited a majority LGBTQIA+ pilot study sample (62%). Using themes from cognitive interviews with youth and experts regarding inclusive framing and use of plain language, we refined demographic measures and expanded sexual behavior measures. Conclusion Findings suggest that the strategies used to enhance LGBTQIA+-inclusivity in our evaluation of SafeSpace were effective in respectfully and more accurately capturing a fuller range of experiences and identities of LGBTQIA+ and cis-straight youth. The strategies and survey measures developed for this study can be applied to increase LGBTQIA+-inclusivity in other adolescent sexual health program evaluations.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Maeve Day
- Child Trends, Rockville, MD, United States
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Huber-Krum S, Miedema SS, Shortt JW, Villaveces A, Kress H. Path Analysis of Adverse Childhood Experiences, Early Marriage, Early Pregnancy, and Exposure to Intimate Partner Violence Among Young Women in Honduras. JOURNAL OF FAMILY VIOLENCE 2024; 39:705-722. [PMID: 38655238 PMCID: PMC11034739 DOI: 10.1007/s10896-023-00520-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 04/26/2024]
Abstract
Purpose The pathways by which adverse childhood experiences (ACEs) are associated with early marriage and early pregnancy are poorly understood. Early marriage and early pregnancy may be risk factors for adulthood intimate partner violence (IPV). The aim of this study was to assess the relationships among ACEs, early marriage, early pregnancy, and IPV among women in Honduras. Method We used weighted data from 1,436 women aged 18-24 years from the nationally representative 2017 Honduras Violence Against Children and Youth Survey. We used path analysis to estimate relationships and accounted for sample design, non-response, and within-country clustering. Results We found that ACEs had differential relationships with outcomes of interest. For example, witnessing violence in the community was directly associated with increased probability of early pregnancy (10 percentage points (PP); 95% CI: 0.04, 0.15) and IPV (6 PP; 95% CI: 0.01, 0.10), while emotional violence was not directly or indirectly associated with any outcome. Early marriage and early pregnancy had no direct or indirect effect on IPV, but the total effect of early marriage on IPV was significant. Conclusions Understanding the relationship between ACEs, early marriage, early pregnancy, and IPV may help inform prevention efforts. For example, programs aiming to reduce early pregnancy may consider addressing sexual violence experienced in childhood.
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Affiliation(s)
- Sarah Huber-Krum
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA
| | - Stephanie Spaid Miedema
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA
| | - Joann Wu Shortt
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA
| | - Andrés Villaveces
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA
| | - Howard Kress
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA
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Ding W, Xu Y, Kondracki AJ, Sun Y. Childhood adversity and accelerated reproductive events: a systematic review and meta-analysis. Am J Obstet Gynecol 2024; 230:315-329.e31. [PMID: 37820985 DOI: 10.1016/j.ajog.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/18/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE Accelerated female reproductive events represent the early onset of reproductive events involving puberty, menarche, pregnancy loss, first sexual intercourse, first birth, parity, and menopause. This study aimed to explore the association between childhood adversity and accelerated female reproductive events. DATA SOURCES PubMed, Web of Science, and Embase were systematically searched from September 22, 2022 to September 23, 2022. STUDY ELIGIBILITY CRITERIA Observational cohort, cross-sectional, and case-control studies in human populations were included if they reported the time of reproductive events for female individuals with experience of childhood adversity and were published in English. METHODS Two reviewers independently screened studies, obtained data, and assessed study quality, and conflicts were resolved by a third reviewer. Dichotomous outcomes were evaluated using meta-analysis, and pooled odds ratios and 95% confidence intervals were generated using random-effects models. Moderation analysis and meta-regression were used to investigate heterogeneity. RESULTS In total, 21 cohort studies, 9 cross-sectional studies, and 3 case-control studies were identified. Overall, female individuals with childhood adversity were nearly 2 times more likely to report accelerated reproductive events than those with no adversity exposure (odds ratio, 1.91; 95% confidence interval, 1.33-2.76; I2=99.6%; P<.001). Moderation analysis indicated that effect sizes for the types of childhood adversity ranged from an odds ratio of 1.61 (95% confidence interval, 1.23-2.09) for low socioeconomic status to 2.13 (95% confidence interval, 1.14-3.99) for dysfunctional family dynamics. Among the 7 groups based on different reproductive events, including early onset of puberty, early menarche, early sexual initiation, teenage childbirth, preterm birth, pregnancy loss, and early menopause, early sexual initiation had a nonsignificant correlation with childhood adversity (odds ratio, 2.70; 95% confidence interval, 0.88-8.30; I2=99.9%; P<.001). Considerable heterogeneity (I2>75%) between estimates was observed for over half of the outcomes. Age, study type, and method of data collection could explain 35.9% of the variance. CONCLUSION The literature tentatively corroborates that female individuals who reported adverse events in childhood are more likely to experience accelerated reproductive events. This association is especially strong for exposure to abuse and dysfunctional family dynamics. However, the heterogeneity among studies was high, requiring caution in interpreting the findings and highlighting the need for further evaluation of the types and timing of childhood events that influence accelerated female reproductive events.
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Affiliation(s)
- Wenqin Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Yuxiang Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Anthony J Kondracki
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
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Ojeleye OA, Beckie TM, Oruche UM. Psychosocial Factors Associated With Perinatal Anxiety and Perinatal Depression Among Adolescents: A Rapid Review. J Psychosoc Nurs Ment Health Serv 2024; 62:13-22. [PMID: 37646603 DOI: 10.3928/02793695-20230821-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
The current review examined the influence of psychosocial factors on adolescents' perinatal anxiety (PA) and perinatal depression (PND) across geographical regions. Three databases were searched for articles published between 2017 and 2022 and 15 articles were reviewed. We categorized factors into social, cultural, and environmental domains. Social factors included adolescent caregiver trust/attachment, social support, perceived social support, trauma/poly-traumatization, and peer solidarity. Cultural factors included feelings of shame, marital satisfaction, partner's rejection of pregnancy, lack of parental involvement in care, parenting stress, childhood household dysfunction, and adverse childhood events. Environmental factors included neighborhood support, food insecurity, domestic violence, going to church, going out with friends, and sources for obtaining information. Routine assessment of psychosocial factors among perinatal teens is crucial to identify those at higher risk for PA and PND. Further research is necessary to examine the influence of cultural and environmental factors on PA, PND, and perinatal outcomes among adolescents. [Journal of Psychosocial Nursing and Mental Health Services, 62(2), 13-22.].
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Haag AC, Bonanno GA, Chen S, Herd T, Strong-Jones S, Spiva S, Noll JG. Understanding posttraumatic stress trajectories in adolescent females: A strength-based machine learning approach examining risk and protective factors including online behaviors. Dev Psychopathol 2023; 35:1794-1807. [PMID: 35635211 PMCID: PMC9708933 DOI: 10.1017/s0954579422000475] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Heterogeneity in the course of posttraumatic stress symptoms (PTSS) following a major life trauma such as childhood sexual abuse (CSA) can be attributed to numerous contextual factors, psychosocial risk, and family/peer support. The present study investigates a comprehensive set of baseline psychosocial risk and protective factors including online behaviors predicting empirically derived PTSS trajectories over time. Females aged 12-16 years (N = 440); 156 with substantiated CSA; 284 matched comparisons with various self-reported potentially traumatic events (PTEs) were assessed at baseline and then annually for 2 subsequent years. Latent growth mixture modeling (LGMM) was used to derive PTSS trajectories, and least absolute shrinkage and selection operator (LASSO) logistic regression was used to investigate psychosocial predictors including online behaviors of trajectories. LGMM revealed four PTSS trajectories: resilient (52.1%), emerging (9.3%), recovering (19.3%), and chronic (19.4%). Of the 23 predictors considered, nine were retained in the LASSO model discriminating resilient versus chronic trajectories including the absence of CSA and other PTEs, low incidences of exposure to sexual content online, minority ethnicity status, and the presence of additional psychosocial protective factors. Results provide insights into possible intervention targets to promote resilience in adolescence following PTEs.
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Affiliation(s)
- Ann-Christin Haag
- Department of Counseling and Clinical Psychology, Columbia University Teachers College, New York, NY, USA
| | - George A. Bonanno
- Department of Counseling and Clinical Psychology, Columbia University Teachers College, New York, NY, USA
| | - Shuquan Chen
- Department of Counseling and Clinical Psychology, Columbia University Teachers College, New York, NY, USA
| | - Toria Herd
- College of Health and Human Development, Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Sienna Strong-Jones
- College of Health and Human Development, Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Sunshine Spiva
- College of Health and Human Development, Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Jennie G. Noll
- College of Health and Human Development, Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
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Merrill KG, Knight L, Nakuti J, Mirembe A, Allen E, Bhatia A, Parkes J, Naker D, Devries KM. The association between violence victimization and subsequent unplanned pregnancy among adolescent girls in Uganda: Do primary schools make a difference? PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001141. [PMID: 37523344 PMCID: PMC10389730 DOI: 10.1371/journal.pgph.0001141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 06/26/2023] [Indexed: 08/02/2023]
Abstract
Violence victimization is a risk factor for adolescent pregnancy in high-income, low violence prevalence countries, but longitudinal data are lacking from settings where violence and adolescent pregnancy are common, including sub-Saharan Africa. We also know little about contextual factors which modify this association. We analyzed data from the Contexts of Violence in Adolescence Cohort (CoVAC) study in Luwero District, Uganda. Primary students in 42 schools completed surveys in 2014 (Wave 1) and 2018 (Wave 2). Our outcome was unplanned pregnancy. Our exposure was violence victimization, including any violence, type of violence (physical, emotional, sexual), perpetrator group (teacher, peer, family member), and polyvictimization. We fit mixed-effects logistic regression models and examined school factors (e.g., connectedness, absenteeism) as effect modifiers, using data from students (n = 3,431) and staff (n = 591) at the 42 schools. 1,449 girls were included in analyses (78% follow-up). At Wave 1, 88% (n = 1,281/1,449) reported any violence (mean age = 12.73, SD = 1.44 years). At Wave 2, 13.9% (n = 201/1,449) reported an unplanned pregnancy. In adjusted models, compared to no violence, significant associations (p<0.05) were observed for any violence (OR = 1.99, 95%CI = 1.03-3.85), physical violence (OR = 1.96, 95%CI = 1.02-3.79), teacher violence (OR = 1.96, 95%CI = 1.01-3.79), peer violence (OR = 2.00, 95%CI = 1.00-4.03), family violence (OR = 2.23, 95%CI = 1.07-4.65), violence from one perpetrator group (OR = 2.04, 95%CI = 1.01-4.15), and violence from three perpetrator groups (OR = 2.21, 95%CI = 0.99-4.95). Sexual and emotional violence were associated in crude but not adjusted analyses. School and peer connectedness modified the association (p<0.05); girls who experienced violence had higher odds of unplanned pregnancy in schools with lower versus higher connectedness. Violence victimization in early adolescence is strongly associated with subsequent unplanned pregnancy among adolescent girls in Uganda but attending schools with more school or peer connectedness attenuated this link. Interventions should seek to reduce violence against girls to prevent unplanned pregnancy. Interventions promoting positive connections to school may be especially important for violence victims.
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Affiliation(s)
- Katherine G Merrill
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Louise Knight
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Elizabeth Allen
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Amiya Bhatia
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jenny Parkes
- University College London-Institute of Education, London, United Kingdom
| | | | - Karen M Devries
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Guastaferro K, Shipe SL, Connell CM, Holloway JL, Pulido ML, Noll JG. Knowledge Gains from the Implementation of a Child Sexual Abuse Prevention Program and the Future of School-Based Prevention Education. JOURNAL OF CHILD SEXUAL ABUSE 2023; 32:845-859. [PMID: 37814960 PMCID: PMC10841592 DOI: 10.1080/10538712.2023.2268618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/20/2023] [Indexed: 10/11/2023]
Abstract
School-based child sexual abuse (CSA) programs effectively increase students' CSA-related knowledge. This study focuses on an implementation trial of Safe Touches, an empirically supported, school-based CSA prevention program, that was disrupted by the COVID-19 pandemic. We sought to demonstrate gains in CSA-related knowledge following Safe Touches but were limited to a pre-post design. A total of 2,210 students across five counties in a Mid-Atlantic state received the Safe Touches workshop between September 2019 and March 2020. McNemar's chi-square test was used to assess changes in the proportion of correct responses pre-workshop (Time 1) and one-week post-workshop (Time 2). Students' CSA-related knowledge increased significantly based on changes in mean CSA knowledge scores and the number of correct item-level responses assessed at Time 1 and Time 2 (p < .000). Leveraging the experience of the facilitators' who delivered these workshops prior to the disruption of implementation, we gathered facilitators' perspectives to explore the viability of offering Safe Touches virtually. In July 2020, 16 facilitators completed an electronic survey designed to understand the viability of a virtual Safe Touches workshop. Three themes emerged from facilitator feedback on virtual programming: student engagement concerns, handling disclosures, and technology access to a virtual program. The findings of this study indicate that the Safe Touches workshop significantly increased CSA-related knowledge and, overall, facilitators supported further exploration and development of a virtual Safe Touches workshop. The transition of empirically supported school-based CSA prevention programs to a virtual delivery modality is necessary to maintain an effective means of primary prevention and opportunity for disclosure.
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Affiliation(s)
- Kate Guastaferro
- Department of Human Development and Family Studies, The Pennsylvania State University
- Department of Social and Behavioral Sciences, New York University
| | - Stacey L. Shipe
- Department of Human Development and Family Studies, The Pennsylvania State University
- Department of Social Work, State University of New York, Binghamton
| | - Christian M. Connell
- Department of Human Development and Family Studies, The Pennsylvania State University
| | | | - Mary L. Pulido
- New York Society for the Prevention of Cruelty to Children
| | - Jennie G. Noll
- Department of Human Development and Family Studies, The Pennsylvania State University
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11
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Guastaferro K, Font SA, Miyamoto S, Zadzora KM, Walters KE, O'Hara K, Kemner A, Noll JG. Provider Attitudes and Self-Efficacy When Delivering a Child Sexual Abuse Prevention Module: An Exploratory Study. HEALTH EDUCATION & BEHAVIOR 2023; 50:172-180. [PMID: 33660554 PMCID: PMC8417150 DOI: 10.1177/1090198121997731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND As constant figures in children's lives, parents are key in protecting children from sexual abuse. One barrier to reaching parents is that the topic can be difficult to broach and is sensitive in nature. Such barriers can interfere with implementation and fidelity of evidence-based prevention strategies that are focused on reducing rates of childhood sexual abuse (CSA). AIMS In this exploratory study, we examine provider attitudes about delivering CSA-specific content in an evidence-based prevention module and their self-efficacy. METHOD Thirty-three providers participated in three surveys: prior to a skills-oriented training on how to deliver the CSA prevention module (pretraining), immediately posttraining, and 6 months posttraining. Changes in self-reported willingness to deliver content, beliefs about parents' role in CSA prevention, and confidence about their ability to deliver content were assessed over time. Open-ended questions were coded thematically to reinforce quantitative findings. RESULTS Prior to training, providers were worried that parents would respond negatively to CSA content and were concerned about their comfort level discussing victimization and sexual development. Findings suggest that skill-oriented training and provision scripts effectively supported providers and improved confidence in delivering CSA prevention content. DISCUSSION Provider self-efficacy is an important element of implementation fidelity. This exploratory study demonstrated that, though providers may approach CSA content with wariness and trepidation, adequate skills-oriented training can reduce negative attitudes and increase perceived efficacy in the actual delivery of CSA content that persists through implementation. CONCLUSION Skills-based training can significantly enhance fidelity in the delivery of difficult content included in parent-focused preventative interventions.
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Affiliation(s)
| | - Sarah A Font
- The Pennsylvania State University, University Park, PA, USA
| | | | | | | | - Kathryn O'Hara
- The Pennsylvania State University, University Park, PA, USA
| | | | - Jennie G Noll
- The Pennsylvania State University, University Park, PA, USA
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12
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Russotti J, Font SA, Toth SL, Noll JG. Developmental pathways from child maltreatment to adolescent pregnancy: A multiple mediational model. Dev Psychopathol 2023; 35:142-156. [PMID: 35074030 PMCID: PMC9309193 DOI: 10.1017/s0954579421001395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Adolescent pregnancy (AP) is a significant public health issue. Child maltreatment (CM) represents an established risk factor, yet little is known about the explanatory mechanisms linking the phenomena. Informed by developmental theory, this study prospectively tested seven multi-level, indirect pathways that could plausibly explain the relationship between CM and AP: (1) substance use (polysubstance use and frequency); (2) sexual risk behavior; (3) depressive symptoms; (4) posttraumatic stress disorder symptoms; (5) cognitive dysregulation; (6) pregnancy desire and difficulty expectancies; and (7) age at menarche. Data came from a prospective, longitudinal cohort study of 469 ethnically diverse, nulliparous adolescent females, designed to examine the impact of substantiated CM on reproductive outcomes such as pregnancy and childbirth (265 maltreated and 204 demographically matched comparison adolescents). A multiple-mediator structural equation model was conducted to simultaneously test multiple indirect effects while accounting for confounding variables. Maltreatment had an indirect effect on pregnancy via substance use and higher pregnancy desire/lower perceived difficulty. Findings represent a step towards elucidating pathways linking CM with AP. Recommendations are offered to prevent pregnancy by addressing the pregnancy-specific mechanisms that are part of the maltreatment sequelae.
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Affiliation(s)
- Justin Russotti
- Mt. Hope Family Center, University of Rochester, Rochester, USA
| | - Sarah A Font
- Department of Sociology and Criminology, The Pennsylvania State University, University Park, USA
| | - Sheree L Toth
- Mt. Hope Family Center, University of Rochester, Rochester, USA
| | - Jennie G Noll
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, USA
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Najman JM, Scott JG, Farrington DP, Clavarino AM, Williams GM, McGee TR, Kisely S. Does Childhood Maltreatment Lead to Low Life Success? Comparing Agency and Self-Reports. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1320-NP1342. [PMID: 35466762 DOI: 10.1177/08862605221090565] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The long-term mental and physical health consequences of childhood maltreatment have been well documented. Less known are the longer-term consequences of childhood maltreatment, specifically the extent to which childhood maltreatment predicts adult life success. OBJECTIVES To prospectively assess the extent to which childhood experiences of physical, sexual, emotional abuse and childhood neglect predict life success at 30 years of age. PARTICIPANTS AND SETTING Data are from the Mater-University of Queensland Study of Pregnancy (MUSP), a pre-birth cohort study which follows children from conception to 30 years of age. METHODS Details of childhood maltreatment are from two sources; child safety agency notifications (and substantiations) linked to the survey data with self-reports of childhood experiences of maltreatment obtained at the 30-year follow-up using the Child Trauma Questionnaire (CTQ). Life success is a 9-item composite measure (alpha = 0.76) obtained at the 30-year follow-up. We use logistic regression models (with control for covariates) to examine the association between overall as well as specific forms of childhood maltreatment on adult life success. We further test these models using different cut-offs and propensity analyses to adjust for loss to follow-up. RESULTS Childhood maltreatment whether measured by agency report or self-report predicts overall low life success; agency substantiation OR = 1.88(1.14,3.08) & self-report OR = 2.60 (2.10,3.25). Self-report physical abuse, OR = 2.37(1.72,3.28); sexual abuse, OR = 2.85(2.05,3.96); emotional abuse, OR = 2.53(1.85,3.45) and neglect, OR = 2.36(1.83,3.03) all predict higher levels of low life success. CONCLUSIONS Our findings suggest that the long-term consequences of childhood maltreatment extend to a wide range of day-to-day circumstances and extend into mid- to later life.
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Affiliation(s)
- Jake M Najman
- School of Public Health, 1974University of Queensland, Herston, Australia
| | - James G Scott
- Mental Health Research Programme, 56362QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | | | | | - Gail M Williams
- School of Public Health, 1974University of Queensland, Herston, Australia
| | - Tara R McGee
- School of Criminology and Criminal Justice, 385727Griffith University, Mount Gravatt, QLD, Australia
| | - Steve Kisely
- School of Clinical Medicine, 1974University of Queensland, Woolloongabba, Australia
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14
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Silver IA, Brookstein AJ, D'Amato C. Juvenile incarceration in an adult correctional facility as a risk factor for adolescent childrearing? J Adolesc 2023; 95:56-69. [PMID: 36199241 DOI: 10.1002/jad.12096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/29/2022] [Accepted: 09/10/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Recent trends in reproductive rights have contributed to lasting concerns about adolescent childrearing in American society. Beyond being generally unprepared when raising a child, having a child during adolescence is associated with a variety of environmental, social, and psychological consequences for both the parents and the child. It is important to understand the factors contributing to adolescent childrearing. Although research has identified many factors that contribute to adolescent childrearing, a notable gap remains when considering the role of the correctional system and, in particular, the age-specific effects of confining adolescents in adult correctional facilities. METHODS The current study examined the age-specific effects of time spent in adult correctional facilities from 13 to 34 years of age on childrearing between 14 and 35 years of age using the National Longitudinal Survey of Youth-1997 (NLSY97). The NLSY97 is a nationally representative sample of Males (51%) and Females (49%) born in the United States. Respondents of the NLSY97 were interviewed about life events beginning at age 7 and continued to participate in the study as recently as 2021. RESULTS The results of the lagged growth curve models suggest that the time spent incarcerated between 13 and 17 years of age heightens the risk of childrearing between 14 and 18 years of age, an effect that is not observed during adulthood. CONCLUSION Overall, the results suggest that the conditions adolescents are exposed to during incarceration in an adult correctional facility could contribute to a heightened likelihood of adolescent childrearing.
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Affiliation(s)
- Ian A Silver
- Division of Applied Justice Research, Center for Courts and Corrections Research, Research Triangle Institute, Research Triangle Park, North Carolina, USA
| | - Adrienne J Brookstein
- The Department of Criminal Justice, Temple University, Philadelphia, Pennsylvania, USA
| | - Christopher D'Amato
- College of Education, Criminal Justice, and Human Services, Corrections Institute, University of Cincinnati, Cincinnati, Ohio, USA
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15
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Gilmore AK, Mosley EA, Oesterle DW, Ridings LE, Umo I, Hutchins A, Gooding HC, Wallis E, Levy S, Ruggiero K, Kaysen D, Danielson CK, Self-Brown S. Teen Well Check: an e-health prevention program for substance use, sexual assault, and sexual risk behaviors for adolescents in primary care. Eur J Psychotraumatol 2023; 14:2157933. [PMID: 37052109 PMCID: PMC9848361 DOI: 10.1080/20008066.2022.2157933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/24/2022] [Indexed: 01/12/2023] Open
Abstract
Objective: Adolescents are at risk for substance use, sexual assault, and sexual risk behaviours; however, to date no integrated prevention programmes address all three risk behaviours. The goal of this study was to evaluate the usability and acceptability of Teen Well Check, an e-health prevention programme targeting substance use, sexual assault, and sexual risk among adolescents in primary care settings.Methods: The current study included content analysis of interviews with adolescents in primary care (aged 14-18; n = 25) in the intervention development process, followed by usability and acceptability testing with qualitative interviews among adolescents in primary care (aged 14-18; n = 10) and pediatric primary care providers (n = 11) in the intervention refinement process. All data were collected in the Southeastern U.S.Results: Feedback on Teen Well Check addressed content, engagement and interaction, language and tone, aesthetics, logistics, inclusivity, parent/guardian-related topics, and the application of personal stories. Overall, providers reported they would be likely to use this intervention (5.1 out of 7.0) and recommend it to adolescents (5.4 out of 7.0).Conclusions: These findings suggest preliminary usability and acceptability of Teen Well Check. A randomized clinical trial is needed to assess efficacy.
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Affiliation(s)
- Amanda K. Gilmore
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Elizabeth A. Mosley
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
- University of Pittsburgh School of Medicine, Division of General Internal Medicine, Center for Innovative Research on Gender Health Equity, Pittsburgh, PA, USA
| | - Daniel W. Oesterle
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Leigh E. Ridings
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Idara Umo
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Anna Hutchins
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Holly C. Gooding
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Elizabeth Wallis
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Sharon Levy
- Adolescent Substance Use and Addiction Program, Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Harvard University, Cambridge, MA, USA
| | - Kenneth Ruggiero
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Debra Kaysen
- Department of Psychiatry & Behavioral Sciences, Stanford University Medical Center, Stanford, CA, USA
| | - Carla Kmett Danielson
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Shannon Self-Brown
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
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16
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Shipe SL, Guastaferro K, Noll JG, Connell CM, Morgan PL, Crowley DM. Taking a School-Based Child Sexual Abuse Prevention Program to Scale: a Cost Analysis. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1394-1403. [PMID: 35867317 PMCID: PMC11318369 DOI: 10.1007/s11121-022-01401-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/30/2022]
Abstract
Cost analyses are used to determine overall costs of implementing evidence-based programming and may help decision makers determine how best to allocate finite resources. Child sexual abuse (CSA), regularly viewed as a human rights violation, is also a public health concern estimated to impact 27% of females and 5% of males by age 18. Universal, school-based CSA programs are one prevailing prevention strategy. However, there are no known cost analyses of school-based CSA prevention programming, thereby limiting potential scalability. Using the ingredients method, this cost analysis presents the findings of implementing Safe Touches, an evidence-based universal prevention program, across four sites (i.e., counties) in one mid-Atlantic state. Reaching a total of 14,235 s grade students, results indicate an average cost of $43 per student, an average classroom cost of $859, an average district cost of $10,637, and an average site cost of $154,243. There was a noted decrease in costs when more students were reached, suggesting a need to focus efforts on bolstering the reach of implementation efforts. Sensitivity analyses explored variations in implementation constraints such as personnel and facilities suggesting a range of per-student costs (lower-bound per-student cost = $34; upper-bound per-student cost = $64). Findings presented herein may be used to inform future universal CSA prevention efforts by providing detailed information about the costs of large-scale implementation of an evidence-based program among elementary-aged children.
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Affiliation(s)
- Stacey L Shipe
- Child Maltreatment Solutions Network, Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA.
| | - Kate Guastaferro
- Child Maltreatment Solutions Network, Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Jennie G Noll
- Child Maltreatment Solutions Network, Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Christian M Connell
- Child Maltreatment Solutions Network, Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Paul L Morgan
- Department of Education Policy Studies, Pennsylvania State University, University Park, PA, USA
| | - D Max Crowley
- Child Maltreatment Solutions Network, Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
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17
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Guastaferro K, Holloway JL, Trudeau J, Lipson LB, Sunshine S, Noll JG, Pulido ML. Virtual Delivery of A School-Based Child Sexual Abuse Prevention Program: A Pilot Study. JOURNAL OF CHILD SEXUAL ABUSE 2022; 31:577-592. [PMID: 35959797 PMCID: PMC9421613 DOI: 10.1080/10538712.2022.2112347] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/06/2022] [Accepted: 07/09/2022] [Indexed: 06/15/2023]
Abstract
Universal child sexual abuse (CSA) prevention is a public health priority. The prevailing prevention strategy is school-based CSA prevention programming. School closures during the COVID-19 pandemic highlighted the need for flexible modes of delivery, including virtual programs. This pilot examined the virtual delivery of an evidence-based, school-based CSA prevention program, Safe Touches, designed to teach CSA-related knowledge and concepts. Using mixed methods, the pilot sought to determine the feasibility of the virtually delivered CSA prevention program. One school district that had previously received Safe Touches in-person participated. A total of 176 second grade students participated in the virtual workshop. Post-workshop survey responses from virtual (N = 37) and in-person workshops (N = 60) were compared descriptively. Mean item scores and response patterns from students who received the virtual workshop were nominally comparable to the student scores from the in-person workshop. Following the virtual workshop, one teacher notified the research team of a disclosure of CSA. Qualitative input from the facilitator and school staff was positive, indicating high student engagement. Results suggest the viability and feasibility of virtual school-based CSA preventive programs. Investment in virtual modes of delivery would ensure all students have access to CSA prevention programming in the future.
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Affiliation(s)
- Kate Guastaferro
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | | | - Jessica Trudeau
- The New York Society for the Prevention of Cruelty to Children, New York, NY, USA
| | - Lauren B Lipson
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - S Sunshine
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Jennie G Noll
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Mary L Pulido
- The New York Society for the Prevention of Cruelty to Children, New York, NY, USA
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18
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Ierardi E, Albizzati A, Moioli M, Riva Crugnola C. Psychopathological and Psychosocial Risk Profile, Styles of Interaction and Mentalization of Adolescent and Young Mother-Infant Dyads. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4737. [PMID: 35457605 PMCID: PMC9027302 DOI: 10.3390/ijerph19084737] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 12/10/2022]
Abstract
This study examined the psychopathological and psychosocial risk profile and the quality of mother-infant interaction in 98 adolescent and young mother-infant dyads. At their infant's age of 3 months, mothers filled in a socio-demographic form and completed a test battery: EPDS for depression, STAY-I for anxiety, PSI-SF for parenting stress, MPSS for social support, AAI for maternal attachment and reflective functioning, CECA for adverse childhood experiences, Care-Index and Mind-mindedness coding system for mother-infant interaction. Results showed that motherhood in adolescence was associated with several psychosocial risk factors. Adolescent and young mothers have depression (25%), anxiety (29%) and insecure attachment (65%), with low reflective functioning, of whom 18% have disorganized attachment. A total of 54% of the mothers had at least one adverse childhood experience. Furthermore, adolescent mothers had low sensitivity and mind-mindedness and high intrusiveness, and their infant had low responsiveness and high passive behaviors. Mothers under 18 have experienced more sexual abuse, are more likely to be single and have been followed by child social services more than mothers aged 18-21. Adolescent mothers have a high-risk psychopathological and psychosocial profile that affects their ability to mentalize and build an adequate relationship with the child. It appears to be important to support the adolescent mother-child relationship.
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Affiliation(s)
- Elena Ierardi
- Department of Psychology, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy;
- Neuropsychiatric Unit 2, ASST Santi Paolo e Carlo, 20142 Milan, Italy; (A.A.); (M.M.)
| | - Alessandro Albizzati
- Neuropsychiatric Unit 2, ASST Santi Paolo e Carlo, 20142 Milan, Italy; (A.A.); (M.M.)
| | - Margherita Moioli
- Neuropsychiatric Unit 2, ASST Santi Paolo e Carlo, 20142 Milan, Italy; (A.A.); (M.M.)
| | - Cristina Riva Crugnola
- Department of Psychology, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy;
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19
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Guastaferro K, Felt JM, Font SA, Connell CM, Miyamoto S, Zadzora KM, Noll JG. Parent-Focused Sexual Abuse Prevention: Results From a Cluster Randomized Trial. CHILD MALTREATMENT 2022; 27:114-125. [PMID: 33025835 PMCID: PMC8024425 DOI: 10.1177/1077559520963870] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study tested whether a child sexual abuse (CSA) prevention program, Smart Parents-Safe and Healthy Kids (SPSHK), could be implemented as an additional module in evidence-based parent training and whether the added module might detract from the efficacy of the original program. In a cluster randomized trial, six community-based organizations were randomized to deliver Parents as Teachers (PAT) with SPSHK (PAT+SPSHK) or PAT as usual (PAT-AU). CSA-related awareness and protective behaviors, as well as general parenting behaviors taught by PAT were assessed at baseline, post-PAT, post-SPSHK, and 1-month follow-up. Multilevel analyses revealed significant group by time interactions for both awareness and behaviors (ps < .0001), indicating the PAT+SPSHK group had significantly greater awareness of CSA and used protective behaviors more often (which were maintained at follow-up) compared to the PAT-AU group. No differences were observed in general parenting behaviors taught by PAT suggesting adding SPHSK did not interfere with PAT efficacy as originally designed. Results indicate adding SPHSK to existing parent training can significantly enhance parents' awareness of and readiness to engage in protective behavioral strategies. Implementing SPHSK as a selective prevention strategy with at-risk parents receiving parent training through child welfare infrastructures is discussed.
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Affiliation(s)
| | - John M. Felt
- The Pennsylvania State University, State College, PA, USA
| | - Sarah A. Font
- The Pennsylvania State University, State College, PA, USA
| | | | | | | | - Jennie G. Noll
- The Pennsylvania State University, State College, PA, USA
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20
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An observational study of Internet behaviours for adolescent females following sexual abuse. Nat Hum Behav 2022; 6:74-87. [PMID: 34580439 PMCID: PMC9258728 DOI: 10.1038/s41562-021-01187-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/21/2021] [Indexed: 02/07/2023]
Abstract
Child sexual abuse (CSA) is associated with revictimization and sexual risk-taking behaviours. The Internet has increased the opportunities for teens to access sexually explicit imagery and has provided new avenues for victimization and exploitation. Online URL activity and offline psychosocial factors were assessed for 460 females aged 12-16 (CSA = 156; comparisons = 304) with sexual behaviours and Internet-initiated victimization assessed 2 years later. Females who experienced CSA did not use more pornography than comparisons but were at increased odds of being cyberbullied (odds ratio = 2.84, 95% confidence interval = 1.67-4.81). These females were also more likely to be represented in a high-risk latent profile characterized by heightened URL activity coupled with problematic psychosocial factors, which showed increased odds of being cyberbullied, receiving online sexual solicitations and heightened sexual activity. While Internet activity alone may not confer risk, results indicate a subset of teens who have experienced CSA for whom both online and offline factors contribute to problematic outcomes.
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21
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Vitek KN, Yeater EA. The Association Between a History of Sexual Violence and Romantic Relationship Functioning: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2021; 22:1221-1232. [PMID: 32242504 DOI: 10.1177/1524838020915615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The consequences of sexual violence are substantial and include both intra- and interpersonal problems. Notably, sexual violence has been associated with difficulties in interpersonal relationships including intimate relationships. While there have been prior reviews considering various interpersonal and dyadic consequences associated with sexual violence, there has not been a comprehensive review considering the various aspects of adult dyadic functioning including intimacy, relationship conflict, and satisfaction satisfaction among both child and adult victims of sexual violence. The databases PsycINFO and PubMed were searched for terms related to sexual victimization (e.g., sexual assault, sexual victimization, sexual abuse, rape, revictimization), terms related to relationships (e.g., romantic relationship, intimate relationship), and terms related to relationship functioning (e.g., satisfaction, relationship quality, conflict, communication, intimacy, sexual functioning). Eligible studies for this review were required to (1) be an original study, (2) be written in English, (3) identify a sample or subsample consisting of women reporting a history of sexual violence in either childhood or adulthood, and (4) measure at least one of the following relationship areas: intimacy, relationship conflict, or relationship satisfaction in heterosexual adult romantic relationships. A total of 20 articles met inclusion criteria and were included in this review. Results demonstrated mixed findings on the association between sexual violence and relationship functioning, with some studies demonstrating an association between sexual violence and relationship functioning, and others failing to find such associations. These findings are discussed within the context of gaps in the extant literature and future research directions.
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22
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McNiss C, Kalarchian M, Laurent J. Factors associated with childhood sexual abuse and adolescent pregnancy. CHILD ABUSE & NEGLECT 2021; 120:105183. [PMID: 34245975 DOI: 10.1016/j.chiabu.2021.105183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/12/2021] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND People who experience childhood sexual abuse (CSA) have a higher rate of adolescent pregnancy than people who do not experience CSA. The purpose of this integrative review was to identify risk or protective factors that are associated with this group to help understand the high rate of adolescent pregnancy in people with CSA histories. METHODS This review was conducted using strategies described by Whittemore and Knafl (2005). Five research articles met the following criteria: written in English, published in peer-reviewed journals in the past 10 years, and included the examination of predictors of adolescent pregnancy in any domain of the social ecological model of individual, relationship, community, or societal factors present among girls with CSA histories. RESULTS Studies suggest that people who are abused in childhood through adolescence and are not believed when they report abuse may be at greater risk for pregnancy in adolescence. CSA was associated with a range of sexual risk taking behavior (e.g., ineffectual contraception use, drug and alcohol use prior to sex, multiple partners) which could lead to adolescent pregnancy. Individual-level behaviors where predominantly studied. There were no reports at the community or societal level of the model. CONCLUSIONS Identifying additional risk or protective factors at the relationship, community, and societal level may prove helpful in developing strategies tailored to this population. The unique characteristics that lead to higher rates of sexual risk-taking behavior that can lead to adolescent pregnancy have not been well documented and deserve further study to guide design and prevention/intervention modalities.
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Affiliation(s)
- Cynthia McNiss
- Dartmouth-Hitchcock Medical Center, Infectious Disease, Lebanon, NH, United States of America.
| | - Melissa Kalarchian
- School of Nursing and Department of Psychology, Duquesne University, Pittsburg, PA, United States of America
| | - Jennifer Laurent
- University of Vermont, School of Nursing, Burlington, VT, United States of America
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23
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Schulte KL, Szota K, Christiansen H. Die Entwicklung von Sexualität bei Kindern und Jugendlichen mit sexuellen Gewalterfahrungen. KINDHEIT UND ENTWICKLUNG 2021. [DOI: 10.1026/0942-5403/a000345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Zu den Folgen sexueller Gewalt gehören neben somatischen und psychischen Folgen auch Veränderungen in der Entwicklung der Sexualität. Fragestellung: Ziel dieses Reviews ist es, einen systematischen Überblick über den aktuellen Forschungsstand bezüglich der Entwicklung von Sexualität bei Kindern und Jugendlichen nach sexuellen Gewalterfahrungen zu geben. Methode: Eine systematische Literaturrecherche wurde in den Datenbanken PubMed, ERIC, Cochrane und PubPsych durchgeführt. Die Folgen von sexueller Gewalt bezüglich der Sexualität wurden systematisch analysiert. Ergebnisse: Es konnten insgesamt 127 Studien zur Sexualität nach sexueller Gewalt identifiziert werden, die acht Unterkategorien zugeordnet werden konnten: Sexuelles Risikoverhalten, Teenagerschwangerschaft, jugendliche Sexualstraftäter_innen, sexuelle Verhaltensauffälligkeiten, sexuelle Überzeugungen, Prostitution, Geschlechtskrankheiten und körperliche Symptome. Diskussion und Schlussfolgerung: Insgesamt zeigt die Literaturrecherche, dass die Sexualität von Kindern und Jugendlichen mit sexuellen Gewalterfahrungen teilweise nur lückenhaft untersucht wurde.
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Russotti J, Warmingham JM, Handley ED, Rogosch FA, Cicchetti D. Child maltreatment: An intergenerational cascades model of risk processes potentiating child psychopathology. CHILD ABUSE & NEGLECT 2021; 112:104829. [PMID: 33359770 PMCID: PMC7855935 DOI: 10.1016/j.chiabu.2020.104829] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 11/16/2020] [Accepted: 11/22/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND Child maltreatment poses substantial risk for compromised mental health in children. Further, child abuse and neglect are potentiated within a cascade of intergenerational and current familial risk processes that require clarification to inform understanding of adverse outcomes and direct prevention and intervention efforts. OBJECTIVE Using a multi-informant design, the current study applied an intergenerational cascades approach to examine the interconnected pathways among several familial risk factors associated with child maltreatment and its consequences. PARTICIPANTS Participants were 378 children (aged 10-12) and their mothers from economically disadvantaged, ethnically diverse backgrounds. The sample included maltreated children recruited via CPS records and demographically comparable non-maltreated children. METHODS Structural equation modeling (SEM) was conducted to test sequential mediation pathways examining the independent and cascading effects of maternal history of childhood maltreatment, maternal adolescent childbearing, current maternal depression, and the child's lifetime history of maltreatment on the child's internalizing and externalizing symptoms. RESULTS Multigenerational developmental cascades were identified. Maternal history of maltreatment predicted chronic maltreatment for offspring, which in turn predicted greater internalizing (β = .167, p = .03) and externalizing symptoms (β = .236, p = .005) in late childhood. Similarly, children born to mothers who began childbearing in adolescence were more likely to experience chronic maltreatment during childhood and develop subsequent symptoms. Effects were found over and above a parallel cascade from maternal maltreatment to offspring psychopathology via a maternal depression pathway. CONCLUSION Findings reveal targets to prevent or ameliorate progressions of intergenerational risk pathways.
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Affiliation(s)
- Justin Russotti
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St., Rochester, NY, 14607, United States.
| | - Jennifer M Warmingham
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St., Rochester, NY, 14607, United States
| | - Elizabeth D Handley
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St., Rochester, NY, 14607, United States
| | - Fred A Rogosch
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St., Rochester, NY, 14607, United States
| | - Dante Cicchetti
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh St., Rochester, NY, 14607, United States; Institute of Child Development, University of Minnesota, United States
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25
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Noll JG. Child Sexual Abuse as a Unique Risk Factor for the Development of Psychopathology: The Compounded Convergence of Mechanisms. Annu Rev Clin Psychol 2021; 17:439-464. [PMID: 33472010 DOI: 10.1146/annurev-clinpsy-081219-112621] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Meta-analytic, population cohort, prospective, and clinical studies provide systematic evidence that child sexual abuse accounts for unique variation in several deleterious outcomes. There is strong evidence for psychiatric disorders, including posttraumatic stress disorder and mood, anxiety, and substance use disorders, and mixed evidence for personality disorders. Evaluation of sex-specific outcomes shows strong evidence for teenage childbearing, sexual revictimization, and sexual dysfunction and mixed evidence for heightened sexual behaviors and sexual offending. This review further demonstrates not only that survivors suffer the noxious impact of traumatic sexualization but that additional transdiagnostic mechanisms, including the biological embedding of stress, emotion dysregulation, avoidance, and insecure attachment, converge to compound risk for deleterious outcomes. A road map to enhance the rigor of future research is outlined, and specific recommendations for evidence-based policy making to boost prevention efforts and increase access to treatment are discussed.
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Affiliation(s)
- Jennie G Noll
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania 16803, USA;
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Russotti J, Handley ED, Rogosch FA, Toth SL, Cicchetti D. The Interactive Effects of Child Maltreatment and Adolescent Pregnancy on Late-Adolescent Depressive Symptoms. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1223-1237. [PMID: 32594294 PMCID: PMC7395875 DOI: 10.1007/s10802-020-00669-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Adolescent females are disproportionately at risk for depression, which is expected to represent the leading cause of disability in 2030 (National Institute of Mental Health [NIMH] 2019). Although prior research has suggested that both child maltreatment and adolescent pregnancy increase the risk for depressive symptoms, less is known about how these two interact to influence depression in late adolescence. The present study tested the unique and interactive effects of adolescent pregnancy and child maltreatment on late-adolescent depressive symptomatology (N = 186) with a prospective, longitudinal design that utilized documented records of maltreatment and included demographically comparable (i.e., economically disadvantaged), nonmaltreated and non-pregnant comparisons. Participants were assessed at ages 10-12 and 18-21. Structural equation modeling was used to test whether adolescent pregnancy amplified the effect of child maltreatment on late-adolescent depressive symptoms. In the context of economic disadvantage, results indicated that the effect of child maltreatment on late-adolescent depressive symptoms was significantly enhanced for those who experienced an adolescent pregnancy. This effect remained after controlling for prior depressive symptoms, peer and maternal relationship quality, and romantic relationship violence. The findings are translated to preliminary guidance for practitioners regarding precision depression screening and tailored preventive interventions..
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Affiliation(s)
- Justin Russotti
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY, 14608, USA.
| | - Elizabeth D Handley
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY, 14608, USA
| | - Fred A Rogosch
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY, 14608, USA
| | - Sheree L Toth
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY, 14608, USA
| | - Dante Cicchetti
- Mt. Hope Family Center, University of Rochester, 187 Edinburgh Street, Rochester, NY, 14608, USA
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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Vaillancourt-Morel MP, Bergeron S, Blais M, Hébert M. Longitudinal Associations Between Childhood Sexual Abuse, Silencing the Self, and Sexual Self-Efficacy in Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:2125-2135. [PMID: 31300978 DOI: 10.1007/s10508-019-01494-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 06/10/2023]
Abstract
Sexual self-efficacy-the belief in one's ability to engage in desired and to refuse unwanted, sexual activities and behaviors-is an important feature in promoting adolescent sexual health and well-being. One factor that may affect the development of sexual self-efficacy is child sexual abuse. However, little is known about the processes underlying the relation between child sexual abuse and sexual self-efficacy. Using longitudinal data from a sample of 739 adolescent girls and boys aged between 14 and 18 years, we examined the mediational role of two "silencing the self" attitudes and behaviors in romantic relationships-self-silencing, i.e., inhibiting fulfilling one's own needs, and divided self, i.e., presenting an outer compliant self-in the associations between child sexual abuse severity and two dimensions of sexual self-efficacy: the ability to set clear sexual limits and the ability to use sexual protection. Results of path analysis showed that child sexual abuse severity was associated with more self-silencing and more divided self. In turn, self-silencing was associated with lower protection use self-efficacy, whereas divided self was associated with lower limit-setting and protection use self-efficacy. Thus, self-silencing strategies in romantic relationships mediated the associations between child sexual abuse severity and lower sexual self-efficacy. The overall findings may inform the development of prevention/intervention programs that target the enhancement of an integrated sense of self in intimate relationships to promote assertive strategies in sexual situations.
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Affiliation(s)
- Marie-Pier Vaillancourt-Morel
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.
| | - Sophie Bergeron
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - Martin Blais
- Department of Sexology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Martine Hébert
- Department of Sexology, Université du Québec à Montréal, Montréal, QC, Canada
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Marraccini ME, Brick LA, Weyandt LL, Francis A, Clarkin C, Fang Y. Effects of self-injurious thoughts and behaviors and sexual risk-taking behaviors through emotional control. J Affect Disord 2019; 249:183-191. [PMID: 30772746 DOI: 10.1016/j.jad.2019.01.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/02/2019] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND College students are at increased risk for self-injurious thoughts and behaviors (SITB) and sexual risk behaviors (SRB). Although students with a history of SITB appear to be more prone to SRB, the mechanisms linking these risk behaviors remain largely unexplored. Previous research points to emotional control (EC), defined as one's awareness and adaptability of emotions, as a potential mechanism explaining the relationship between SITB and SRB.1 METHODS: Data included 722 college students attending two different universities in the northeast and southeast regions of the United States. Multiple group structural equation models were fit to estimate the direct and indirect effects of history of SITB (suicidal ideation, attempt, and nonsuicidal self-injury) and EC on SRB jointly across men and women. RESULTS Findings supported indirect relationships between SITB and SRB through dysregulated EC, with type of SITB and patterns of SRB differing between men and women. For women, history of suicidal ideation and nonsuicidal self-injury were indirectly related to increased SRB through dysregulated EC. For men, history of suicidal ideation showed an indirect relationship on SRB through EC. LIMITATIONS Although this study employed random sampling, limitations include a cross-sectional design, which does not allow for causal inference, and reliance on self-report assessment data. CONCLUSIONS College students with a history of SITB who experience dysregulated EC may be more likely to engage in risky sexual behavior. Clinicians working with college students should concomitantly consider suicide and self-injury with SRB and consider interventions to improve EC.
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Affiliation(s)
- Marisa E Marraccini
- School of Education, University of North Carolina at Chapel Hill, 105H Peabody Hall, CB# 3500, 100 E. Cameron Ave., Chapel Hill, NC 27599, USA.
| | - Leslie A Brick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Campus Box G-BH, 700 Butler Drive, Providence, RI 02906-7724, USA.
| | - Lisa L Weyandt
- Department of Psychology, Interdisciplinary Neuroscience Program, Chafee Social Science Center, URI, 142 Flagg Rd, Kingston, RI 02881, USA.
| | - Alyssa Francis
- Department of Psychology, Chafee Social Science Center, URI, 142 Flagg Rd, Kingston, RI 02881, USA.
| | - Christine Clarkin
- Graduate School, Interdisciplinary Neuroscience Program, Quinn Hall, 55 Lower College Road, University of Rhode Island, Kingston, RI 02881, USA.
| | - Yumeng Fang
- School of Education, University of North Carolina at Chapel Hill, 105H Peabody Hall, CB# 3500, 100 E. Cameron Ave., Chapel Hill, NC 27599, USA.
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Sexual behaviors, risks, and sexual health outcomes for adolescent females following bariatric surgery. Surg Obes Relat Dis 2019; 15:969-978. [PMID: 31023575 DOI: 10.1016/j.soard.2019.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Adolescents females with severe obesity are less likely to be sexually active, but those who are sexually active engage in risky sexual behaviors. OBJECTIVES To examine patterns and predictors of sexual risk behaviors, contraception practices, and sexual health outcomes in female adolescents with severe obesity who did or did not undergo bariatric surgery across 4 years. SETTING Five academic medical centers. METHODS Using a prospective observational controlled design, female adolescents undergoing bariatric surgery (n = 111; Mage = 16.95 ± 1.44 yr; body mass index: MBMI = 50.99 ± 8.42; 63.1% white) and nonsurgical comparators (n = 68; Mage = 16.18 ± 1.36 yr; MBMI = 46.47 ± 5.83; 55.9% white) completed the Sexual Activities and Attitudes Questionnaire at presurgery/baseline and 24- and 48-month follow-up, with 83 surgical females (MBMI = 39.27 ± 10.08) and 49 nonsurgical females (MBMI = 48.56 ± 9.84) participating at 48 months. RESULTS Most experienced sexual debut during the 4-year study period, with a greater increase in behaviors conferring risk for sexually transmitted infections (STIs) for surgical females (P = .03). Half (50% surgical, 44.2% nonsurgical, P = .48) reported partner condom use at last sexual intercourse. The proportion of participants who had ever contracted an STI was similar (18.7% surgical, 14.3% nonsurgical). Surgical patients were more likely to report a pregnancy (25.3% surgical, 8.2% nonsurgical, P = .02) and live birth (16 births in 15 surgical, 1 nonsurgical), with 50% of offspring in the surgical cohort born to teen mothers (age ≤19 yr). CONCLUSIONS Bariatric care guidelines and practices for adolescent females must emphasize the risks and consequences of teen or unintended pregnancies, sexual decision-making, dual protection, and STI prevention strategies to optimize health and well-being for the long term.
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