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Besera G, Annor FB, Swedo EA, Aslam MV, Massetti GM. Adverse Childhood Experiences Module Nonresponse: Behavioral Risk Factor Surveillance System, 2019 and 2021. Am J Prev Med 2024:S0749-3797(24)00267-8. [PMID: 39122158 DOI: 10.1016/j.amepre.2024.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024]
Abstract
INTRODUCTION Data on adverse childhood experiences are key to understanding their burden and informing prevention programs and strategies. Population-based surveys that collect adverse childhood experiences data may be affected by item nonresponse. This study examines differences in nonresponse to the optional Behavioral Risk Factor Surveillance System adverse childhood experiences module overall, by sociodemographic characteristics, by year, and by question. METHODS This study used Behavioral Risk Factor Surveillance System adverse childhood experiences module data from 21 states in 2019 and 16 states in 2021. Weighted proportions and 95% CIs of responders and nonresponders to the adverse childhood experiences module by year and sociodemographic characteristics and percentages of nonresponders for each question were calculated. Chi-square tests were used to assess statistically significant (p<0.05) differences. Analyses were conducted in 2023. RESULTS In 2019 and 2021, 1.2% (95% CI=1.1, 1.4) and 2.4% (95% CI=2.2, 2.5) of Behavioral Risk Factor Surveillance System participants were nonresponders to the adverse childhood experiences module, respectively (p<0.01). Nonresponders were more likely to be non-Hispanic Black (p=0.01) or non-Hispanic Asian (p=0.01), to be unemployed (p<0.01), to have income <$15,000 (p<0.01), or to report poor health (p<0.01) than responders. Nonresponse by question increased as the module progressed, and nonresponse was highest for sexual abuse questions. CONCLUSIONS Overall, findings demonstrate that individuals are willing to respond to the adverse childhood experiences module questions. Although low, nonresponse to the module increased from 2019 to 2021. Higher nonresponse for sexual abuse questions may be due to their sensitivity or potential survey fatigue due to placement at the end of the module. Higher nonresponse among racial/ethnic minorities and economically disadvantages groups highlights opportunities to improve existing surveillance systems.
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Affiliation(s)
- Ghenet Besera
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Violence Prevention, Injury Center, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Francis B Annor
- Division of Violence Prevention, Injury Center, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth A Swedo
- Division of Violence Prevention, Injury Center, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maria V Aslam
- Division of Injury Prevention, Injury Center, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Greta M Massetti
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Monteith LL, Holliday R, Miller CN, Schneider AL, Brenner LA, Hoffmire CA. Prevalence and Correlates of Firearm Access Among Post-9/11 US Women Veterans Using Reproductive Healthcare: a Cross-Sectional Survey. J Gen Intern Med 2022; 37:714-723. [PMID: 36042091 PMCID: PMC9481791 DOI: 10.1007/s11606-022-07587-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 04/01/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Suicide rates have increased among women Veterans, with increased use of firearms as the method. Addressing suicide risk in this population requires understanding the prevalence and correlates of firearm access in healthcare settings frequented by women Veterans. OBJECTIVES Characterize the prevalence and correlates of firearm ownership and storage practices among women Veterans using Department of Veterans Affairs (VA) reproductive healthcare (RHC) services. DESIGN Cross-sectional national survey conducted in 2018-2019 (17.9% response rate). PARTICIPANTS Post-9/11 women Veterans using RHC (n=350). MAIN MEASURES VA Military Sexual Trauma Screen, PTSD Checklist for DSM-5, Hurt/Insult/Threaten/Scream, Columbia-Suicide Severity Rating Scale screener, self-reported firearm access. KEY RESULTS 38.0% (95% confidence interval [95% CI]: 32.9, 43.3) of participants reported personally owning firearms, and 38.9% (95% CI: 33.7, 44.2) reported other household members owned firearms. Among those with firearms in or around their homes, 17.8% (95% CI: 12.3, 24.4) and 21.9% (95% CI: 15.9, 28.9) reported all were unsafely stored (loaded or unlocked, respectively). Women who experienced recent intimate partner violence were less likely to report personally owning firearms (adjusted prevalence ratio [APR]=0.75; 95% CI: 0.57, 0.996). Those who experienced military sexual harassment (APR=1.46; 95% CI=1.09, 1.96), were married (APR=1.74; 95% CI: 1.33, 2.27), or lived with other adult(s) (APR=6.26; 95% CI: 2.87, 13.63) were more likely to report having household firearms owned by someone else. Storing firearms loaded was more prevalent among women with lifetime (APR=1.47; 95% CI=1.03, 2.08) or past-month (APR=1.69; 95% CI=1.15, 2.48) suicidal ideation and less likely among those with other adult(s) in the home (unadjusted PR=0.62; 95% CI=0.43, 0.91). Those with parenting responsibilities (APR=0.61; 95% CI=0.38, 0.97) were less likely to store firearms unlocked. CONCLUSIONS Firearm access is prevalent among post-9/11 women Veterans using VA RHC. Interpersonal factors may be important determinants of firearm access in this population. Safe firearm storage initiatives are needed among women Veterans using RHC, particularly for those with suicidal ideation.
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Affiliation(s)
- Lindsey L Monteith
- VA Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VAMC, 1700 N. Wheeling Street, Aurora, CO, 80045, USA. .,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Ryan Holliday
- VA Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VAMC, 1700 N. Wheeling Street, Aurora, CO, 80045, USA.,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Christin N Miller
- VA Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VAMC, 1700 N. Wheeling Street, Aurora, CO, 80045, USA
| | - Alexandra L Schneider
- VA Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VAMC, 1700 N. Wheeling Street, Aurora, CO, 80045, USA
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VAMC, 1700 N. Wheeling Street, Aurora, CO, 80045, USA.,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Claire A Hoffmire
- VA Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VAMC, 1700 N. Wheeling Street, Aurora, CO, 80045, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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