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Ibitoye M, Sommer M, Davidson LL, Sandfort TGM. Exploring the effect of early menarche on sexual violence among adolescent girls and young women in southeastern Ghana: a longitudinal mediation analysis. Sex Reprod Health Matters 2023; 31:2244271. [PMID: 37656485 PMCID: PMC10478596 DOI: 10.1080/26410397.2023.2244271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Research from several high-income countries links early menarche with an increased risk for sexual violence. However, the role of early menarche in adolescent girls' and young women's sexual violence risk in sub-Saharan Africa, where sexual violence rates are high, is not well understood. The current study explores the association between early menarche and sexual violence in Ghana with secondary analysis of data collected from 700 adolescent girls and young women followed over three years. Logistic regressions were used to assess the cross-sectional association between early menarche and sexual violence. Generalised estimating equations were used to assess whether the association between early menarche and sexual violence persisted over time. Inverse odds weighting was used to test potential mediators of the association between early menarche and sexual violence. Sexual violence was fairly common in the study sample, with 27% reporting having experienced sexual violence at baseline, and approximately 50% at year three. Early menarche was associated with 72% greater odds of having experienced sexual violence at baseline (95% confidence interval: 1.01-2.93). However, the odds ratio attenuated and lost significance over the three-year study period, with a lower risk of sexual violence among girls with early menarche at year three. Neither child marriage nor early sexual initiation significantly mediated the association between early menarche and sexual violence. The findings suggest that early-maturing girls may be particularly vulnerable to sexual violence in early adolescence, thus necessitating prevention interventions around the time of menarche to reduce the risk for sexual violence.
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Affiliation(s)
- Mobolaji Ibitoye
- Postdoctoral Scholar, Institute for Population Research, Ohio State University, Columbus, OH, USA
| | - Marni Sommer
- Professor of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Leslie L. Davidson
- Professor Emerita of Epidemiology and of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Theo G. M. Sandfort
- Professor of Clinical Sociomedical Sciences (in Psychiatry), Division of Gender, Sexuality and Health, New York State Psychiatric Institute and Columbia University, New York, NY, USA
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Norwitz GA, Desmond C, Gruver RS, Kvalsvig JD, Mirti AF, Kauchali S, Davidson LL. The impact of caregiver mental health on child prosocial behavior: A longitudinal analysis of children and caregivers in KwaZulu-Natal, South Africa. PLoS One 2023; 18:e0290788. [PMID: 37862320 PMCID: PMC10588861 DOI: 10.1371/journal.pone.0290788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/16/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Prosocial behavior has positive social, cognitive, and physical health effects on the individual exhibiting the behavior as well as on society as a whole, and is integral to overall mental and physical wellbeing. The development of prosocial behavior is rooted in early childhood and learned through observation. As such, those spending time with children, especially their caregiver, play a critical role in their prosocial development. The current study investigates the impact of caregiver mental health on the prosocial development of young children over time. METHODS This paper presents a secondary analysis of child prosocial development in the Asenze Study, a longitudinal, population-based cohort study based in KwaZulu-Natal, South Africa. Children were followed-up over time from an average age of five to seven years along with their caregivers. Linear GEE regression analysis was used to assess whether a change in presence of a mental health disorder in a caregiver during this 2-year interval (using the Client Diagnostic Questionnaire) impacted the development of their child's prosocial behavior (using the Strengths and Difficulties Questionnaire). RESULTS After adjusting for early child-care, child HIV status, SDQ child prosocial subscale, SDQ total difficulties score, and household order score (CHAOS), children whose caregivers acquired a mental health disorder had a significantly smaller increase in prosocial behavioral development compared to children whose caregivers never had a mental health disorder. CONCLUSIONS Identifying contextually relevant modifiable factors such as this will help stimulate the development of interventions to promote prosocial development in childhood.
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Affiliation(s)
- Gabriella A. Norwitz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Chris Desmond
- Center for Rural Health, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Rachel S. Gruver
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Jane D. Kvalsvig
- Department of Public Health, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - Amaleah F. Mirti
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Shuaib Kauchali
- Maternal, Adolescent, and Child Health Institute NPC (MatCH), Durban, South Africa
| | - Leslie L. Davidson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
- Department of Pediatrics, Columbia College of Physicians and Surgeons, New York, NY, United States of America
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3
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Azevedo Da Silva M, Alexander EC, Martins SS, Naidoo S, Gruver RS, Desmond C, Davidson LL. Association between caregiver and household alcohol use and child behavior problems in KwaZulu Natal, South Africa. Child Psychiatry Hum Dev 2023; 54:1438-1445. [PMID: 35380341 PMCID: PMC10304574 DOI: 10.1007/s10578-022-01342-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/26/2022]
Abstract
We explored the association between household alcohol use and behavior problems among South-African children, using data from the Asenze study, a population-based cohort of South African children and their caregivers. Household alcohol use and child behavior were assessed when children were 6-8 years old. To examine the association, we performed linear regressions. The sample included 1383 children with complete data under the care of 1251 adults. Children living in a household where self-reported caregiver alcohol use was scored as hazardous (4.6%) had higher levels of problem behavior (β = 1.94, 95% CI 0.06-3.82). There were no statistically significant associations between reported hazardous alcohol use by another member of the household (14.5%) and child problem behavior. Hazardous household alcohol use was associated with child problem behavior and this effect appeared to be mainly driven by primary caregiver use.
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Affiliation(s)
- Marine Azevedo Da Silva
- Institute for Health and Social Policy, McGill University, Charles, House, Room 302, 1130 Pine Avenue West, H3A 1A3, Meredith, Montreal, Quebec, Canada.
| | - Emma C Alexander
- Imperial College Healthcare NHS Trust, London, UK
- Aceso Global Health Consultants Limited, London, UK
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Saloshni Naidoo
- Department of Public Health Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Rachel S Gruver
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Chris Desmond
- Centre for Rural Health, University of KwaZulu Natal, Durban, South Africa
| | - Leslie L Davidson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Pediatrics, Columbia University, New York, NY, USA
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4
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Nina Banerjee P, McFadden K, Shannon JD, Davidson LL. Preterm Birth and Other Measures of Infant Biological Vulnerability: Associations with Maternal Sensitivity and Infant Cognitive Development. Matern Child Health J 2023; 27:698-710. [PMID: 36759432 DOI: 10.1007/s10995-023-03590-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Low birth weight (LBW), biological vulnerability that includes preterm birth (PTB) and small for gestational age (SGA), is associated with reduced maternal sensitivity ("making accurate inferences about an infant's physical and emotional needs and responding appropriately") and impaired infant cognitive development. However, research does not examine if preterm birth, SGA, or both drive these associations. This study separated these measures of biological vulnerability to examine associations of LBW, PTB, and SGA with maternal sensitivity and infant cognitive development (controlling for maternal depression, breastfeeding, and demographic covariates). METHODS The sample included 6900 9-month-old infants from the Early Childhood Longitudinal Study-Birth Cohort and used birth certificate data, maternal interviews, assessments of maternal sensitivity and infant cognitive development. Multiple linear regressions examined LBW, PTB, and SGA associations with concurrent measures of maternal sensitivity and infant cognition. RESULTS Of the biological vulnerabilities, preterm birth had the strongest negative association with maternal sensitivity (F1,6450 = 29.48 versus 15.33 and 5.51, ps < .001) and infant cognitive development (F1,6450) = 390.65 versus 248.02 and 14.43, ps < .001). In the final regression model, preterm birth and maternal sensitivity were uniquely associated with infant cognitive development (R2 = .05, p < .001), after controlling for maternal depression, breastfeeding, and demographics. CONCLUSION In this nationally representative infant sample infants, PTB had a stronger negative association with both maternal sensitivity and infant cognitive development in comparison to SGA or LBW. The LBW designation combines infants born preterm with SGA infants, potentially minimizing differences in developmental outcomes of PTB and SGA infants.
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Affiliation(s)
- P Nina Banerjee
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, NY, USA.
| | - Karen McFadden
- Department of Early Childhood Education/Art Education Department, Brooklyn College of the City University of New York, Brooklyn, NY, USA
| | - Jacqueline D Shannon
- Department of Early Childhood Education/Art Education Department, Brooklyn College of the City University of New York, Brooklyn, NY, USA
| | - Leslie L Davidson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, NY, USA
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Nazareth ML, Kvalsvig JD, Mellins CA, Desmond C, Kauchali S, Davidson LL. Adverse childhood experiences (ACEs) and child behaviour problems in KwaZulu-Natal, South Africa. Child Care Health Dev 2022; 48:494-502. [PMID: 34913192 DOI: 10.1111/cch.12950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 10/05/2021] [Accepted: 12/05/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adverse childhood events (ACEs) are associated with negative health effects in adulthood. Despite knowledge of these later impacts, little is known about the earlier effect of ACEs on later child behaviour in low- and middle-income countries (LMIC). METHODS The population-based Asenze cohort study was implemented in a peri-rural area of KwaZulu-Natal, South Africa, comprising five Zulu tribal areas. Two waves of data were examined: family information and ACEs exposure when children were on average 5 years old and child behaviour problems (Strengths and Difficulties Questionnaire [SDQ]) approximately 2 years later (average age 7 years). Logistic regression analysis was used to examine unadjusted and adjusted relationships between cumulative ACEs experienced and the SDQ total scores (dichotomized as top 10% vs. the rest) as well as selected SDQ subscales. RESULTS A significant relationship between increased ACE exposure and SDQ total score was observed. The same relationship was also seen for the SDQ emotional symptoms and conduct problem subscales, but not for hyperactivity. The results of a sensitivity analysis excluding intimate partner violence from the ACEs measure demonstrated similar results. CONCLUSIONS There is an association between exposure to ACEs and later child behaviour problems within this LMIC population demonstrating an early negative impact for ACEs. While previous research has focused on the effects of ACEs on adult health, this study provided evidence for an earlier relationship between ACEs and child behaviour problems that may be a part of the mechanism through which later health effects arise.
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Affiliation(s)
- Meaghan L Nazareth
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Jane D Kvalsvig
- School of Nursing and Public Health, University of Kwa-Zulu Natal, Durban, South Africa
| | - Claude A Mellins
- HIV Center for Clinical and Behavioral Studies at Columbia University and New York State Psychiatric Institute, New York, New York, USA
| | - Chris Desmond
- School of Nursing and Public Health, University of Kwa-Zulu Natal, Durban, South Africa
| | - Shuaib Kauchali
- Department of Pediatrics, Nelson Mandela University, Port Elizabeth, South Africa
| | - Leslie L Davidson
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA.,Department of Pediatrics, College of Physicians & Surgeons, Columbia University, New York, New York, USA
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Desmond C, Norwitz GA, Kvalsvig JD, Gruver RS, Kauchali S, Watt KG, Myeza NP, Munsami A, Davidson LL. The Asenze Cohort Study in KwaZulu-Natal, South Africa: protocol and cohort profile. Epidemiol Health 2022; 44:e2022037. [PMID: 35413165 PMCID: PMC9684003 DOI: 10.4178/epih.e2022037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/05/2022] [Indexed: 10/22/2023] Open
Abstract
The Asenze cohort is set in South Africa, a middle-income country impacted by one of the highest global rates of people living with HIV/AIDS and high levels of socioeconomic inequality. This longitudinal population-based cohort of children and their primary caregivers assesses household and caregiver functioning, child health, social well-being, and neuro-development from childhood through adolescence. Almost 1,600 children born at the peak of the human immunodeficiency virus epidemic (2003-2005) were followed (with their primary caregivers) in 3 waves, between 2008 and 2021, at average ages of 5, 7, and 16. Wave 3 is currently underway, having assessed over 1,100 of the original wave 1 children. Wave 4 begins in 2022. The study, with a dyadic structure, uses a broad range of measures, validated in South Africa or recommended for global use, that address physical, social and neuro-development in childhood and adolescence, and the social, health, and psychological status of children's primary caregivers. The Asenze study deepens our understanding of childhood physical, cognitive, and social abilities and/or disabilities, including risk-taking behaviors, and biological, environmental, and social determinants of health. We anticipate the findings will contribute to the development of community-informed interventions to promote well-being in this South African population and elsewhere.
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Affiliation(s)
- Chris Desmond
- Center for Rural Health, University of KwaZulu-Natal, Durban, South Africa
| | - Gabriella A. Norwitz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jane D. Kvalsvig
- Department of Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Rachel S. Gruver
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Shuaib Kauchali
- Maternal, Adolescent, and Child Health Institute NPC (MatCH), Durban, South Africa
| | - Kathryn G. Watt
- Center for Rural Health, University of KwaZulu-Natal, Durban, South Africa
| | | | - Adele Munsami
- Center for Rural Health, University of KwaZulu-Natal, Durban, South Africa
| | - Leslie L. Davidson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Pediatrics, Columbia College of Physicians and Surgeons, Columbia University, New York, NY, USA
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7
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Banerjee PN, McFadden KE, Shannon JD, Davidson LL. Does breastfeeding account for the association between maternal sensitivity and infant cognitive development in a large, nationally representative cohort? BMC Pediatr 2022; 22:61. [PMID: 35081932 PMCID: PMC8790903 DOI: 10.1186/s12887-022-03133-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 01/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background Previous research has established that exposure to high maternal sensitivity is positively associated with advances in infant cognitive development. However, there are many fixed and modifiable factors that influence this association. This study investigates whether the association between maternal sensitivity and infant cognitive development in the first year of life is accounted for by other factors, such as breastfeeding, maternal depressive symptoms, maternal alcohol use, infant birth weight or demographic covariates. Methods Using data from the Early Childhood Longitudinal Study-Birth (ECLS-B) Cohort, a nationally representative sample of U.S. born children, multi-variable regression analyses was used to examine whether breastfeeding, maternal depressive symptoms and alcohol use were associated with maternal sensitivity, as measured by the Nursing Child Assessment Teaching Scale (NCATS), and with infant cognitive development, as measured by the Bayley Scales of Infant Development, Short Form, Research Edition, after controlling for demographic covariates (infant sex, maternal age, education, race/ethnicity, income, parity, family structure) and infant birth weight. Results Breastfeeding, depressive symptoms and alcohol use were not associated with maternal sensitivity scores after controlling for demographic covariates and infant birth weight. However, breastfeeding (β = .079, p < .001), depressive symptoms (β = −.035, p < .05), and maternal sensitivity (β = .175, p < .001) were each significantly associated with infant cognitive development scores, even after controlling for demographic covariates and birthweight (R2 = .053, p < .001). The association between maternal sensitivity and infant cognitive development did not attenuate after adjusting for breastfeeding. Instead, both sensitivity and breastfeeding independently contributed to higher infant cognitive development scores. Conclusion Maternal sensitivity and breastfeeding are separate means to advancing infant cognitive development. This study is significant because it is the first to examine breastfeeding, maternal depressive symptoms and alcohol use together, upon the association between maternal sensitivity and infant cognitive development, after adjusting for demographic covariates and infant birthweight. Maternal sensitivity, a measurable quality, advances infants’ cognitive development. Moreover, sensitivity and breastfeeding had independent effects upon cognitive development after controlling for multiple fixed and modifiable covariates. Understanding factors impacting the association between sensitivity and infant cognitive development provide avenues for developing more effective parenting interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03133-4.
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Affiliation(s)
- P Nina Banerjee
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA.
| | - Karen E McFadden
- Department of Early Childhood Education and Art Education, Brooklyn College, CUNY, New York, USA
| | - Jacqueline D Shannon
- Department of Early Childhood Education and Art Education, Brooklyn College, CUNY, New York, USA
| | - Leslie L Davidson
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
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8
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Jokinen T, Alexander EC, Manikam L, Huq T, Patil P, Benjumea D, Das I, Davidson LL. A Systematic Review of Household and Family Alcohol Use and Adolescent Behavioural Outcomes in Low- and Middle-Income Countries. Child Psychiatry Hum Dev 2021; 52:554-570. [PMID: 32785812 PMCID: PMC8238760 DOI: 10.1007/s10578-020-01038-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Exposure to alcohol misuse is considered an adverse childhood experience impacting on neurodevelopmental and behavioural outcomes in adolescents including substance use, mental illness, problem behaviours, suicidality, and teenage pregnancy. Most research on this issue has focussed on higher income countries, whereas patterns of alcohol use and related factors may be different in low- and middle-income countries (LMICs). This systematic review therefore seeks to collate all published studies from 1990-2020 on the topic set in LMICs. 43 studies were included, totalling 70,609 participants from 18 LMICs. Outcomes assessed included: substance use; depression/anxiety; suicidal ideation; problem behaviour; emotional dysfunction; teenage pregnancy; and self-harm. Despite heterogeneity in the studies identified, this review documented some association between exposure to household alcohol misuse and adverse adolescent outcomes in LMICs, including mental health problems, problem behaviours, and suicidality. The mechanisms leading to these outcomes are likely varied, and further research in different socio-economic and cultural contexts, particularly in the form of longitudinal studies, is called for.
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Affiliation(s)
- Tahir Jokinen
- GKT School of Medical Education, King's College London, London, UK
| | - Emma C Alexander
- London North West University Healthcare NHS Trust, London, UK
- Aceso Global Health Consultants Limited, London, UK
| | - Logan Manikam
- Aceso Global Health Consultants Limited, London, UK.
- UCL Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK.
| | - Tausif Huq
- GKT School of Medical Education, King's College London, London, UK
| | - Priyanka Patil
- Aceso Global Health Consultants Limited, London, UK
- UCL Institute of Epidemiology and Health Care, University College London, London, WC1E 7HB, UK
| | - Darrin Benjumea
- Mailman School of Public Health, Columbia University, New York, USA
| | - Ishani Das
- Mailman School of Public Health, Columbia University, New York, USA
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Gruver RS, Mall S, Kvalsvig JD, Knox JR, Mellins CA, Desmond C, Kauchali S, Arpadi SM, Taylor M, Davidson LL. Cognitive and Language Development at Age 4-6 Years in Children HIV-Exposed But Uninfected Compared to Those HIV-Unexposed and to Children Living With HIV. New Dir Child Adolesc Dev 2020; 2020:39-54. [PMID: 32618410 DOI: 10.1002/cad.20351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Perinatal HIV infection is associated with delayed neurocognitive development, but less is known about children perinatally HIV-exposed but uninfected (CHEU). We compared cognitive and language outcomes in 4-6-year old CHEU versus children HIV-unexposed and uninfected (CHUU) and children living with HIV (CLHIV). We enrolled 1,581 children (77% of the child population) in five communities in KwaZulu-Natal, South Africa. Children completed: Grover-Counter Scale of cognitive development, sub-scales of the Kaufman Assessment Battery for Children, Reynell Developmental Language Scales. HIV status of children and primary caregivers was determined by repeated rapid tests or report of prior testing. We conducted a cross-sectional multivariable linear regression on 922 dyads with complete data (257 CHEU, 627 CHUU, 38 CLHIV). On all outcome measures, CHEU and CHUU groups had comparable scores; CLHIV scored significantly lower. Emerging global progress toward the elimination of vertical HIV transmission may not only reduce mortality, but also positively impact child development.
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Affiliation(s)
- Rachel S Gruver
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Sumaya Mall
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Jane D Kvalsvig
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Justin R Knox
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Claude A Mellins
- HIV Center for Clinical and Behavioral Studies at Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Chris Desmond
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Shuaib Kauchali
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Stephen M Arpadi
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.,Department of Pediatrics, College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Myra Taylor
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Leslie L Davidson
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.,Department of Pediatrics, College of Physicians & Surgeons, Columbia University, New York, NY, USA
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10
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Davidson LL, Gruver RS. Understanding the Role of Intimate Partner Violence on Child Development in LMICs. Pediatrics 2020; 145:peds.2020-0823. [PMID: 32424078 PMCID: PMC7263046 DOI: 10.1542/peds.2020-0823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Leslie L. Davidson
- Department of Epidemiology, Mailman School of Public Health and,Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
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11
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Ajayi OR, Matthews G, Taylor M, Kvalsvig JD, Davidson LL, Kauchali S, Mellins C. Association of anthropometric status and residential locality factors with cognitive scores of 4-6-year-old children in Kwazulu-Natal, South Africa. South Afr J Clin Nutr 2019; 33:133-141. [PMID: 38283260 PMCID: PMC10813652 DOI: 10.1080/16070658.2019.1578115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 01/29/2019] [Indexed: 10/26/2022]
Abstract
Background The Asenze study has the long-term goal of promoting better physical, cognitive and psychosocial functioning of children in a rural area in KwaZulu-Natal, 50 km from Durban with a view to planning interventions to promote growth and development for very young children. The specific objective in this paper was to provide information for the Child Health and Development project of the Valley Trust to assist with intervention planning. The broader goal was to assess developmental delays in communities ravaged by the HIV epidemic.The Asenze study was designed in two phases from 2008 and 2012. The current paper reports on 1581 4-6years old children in the baseline phase (2008-2010) in the five adjacent tribal areas in the study area. Method The participants included all the 4 - 6 year olds whose parents had consented to inclusion in the project and their caregivers. Data were derived from a brief questionnaire administered in the homes of participants, and subsequently from medical and psychological assessments of the children and their caregivers at the Asenze clinic. The association between child factors and other factors (geographic area, socioeconomic status (SES), parental level of education, the child's pre-school education) on the one hand and, the child's cognitive performance (as measured by the Grover Counter and subtests of the KABC-11) were analysed. Linear regression models were employed to determine which predictor variables of interest in a model were associated with the children's cognitive scores as the dependent variables. Results Based on the data, the principal factors associated with children's cognitive outcomes were height-for-age z-score (HAZ), preschool education and the area of residence, Generally children who had low cognitive scores were more often stunted (as defined by the WHO anthropometric tables), had not had pre-school education, and came from areas less favourable in terms of local infrastructure and access to employment opportunities and arable land. Conclusion The finding from this cross-sectional analysis of baseline data showed that in addition to height for age and pre-school education, which are commonly thought to impact on cognition, the local authority area where the children lived was associated with their scores on cognitive tests. This has implications for intervention planning. The functioning of local government in promoting the type of community development which will protect the rights of children should be taken into account.
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Affiliation(s)
- O R Ajayi
- Discipline of Statistics, University of KwaZulu-Natal
| | - G Matthews
- Discipline of Statistics, University of KwaZulu-Natal
| | - M Taylor
- Discipline of Public Health Medicine, University of KwaZulu-Natal
| | - J D Kvalsvig
- Discipline of Public Health Medicine, University of KwaZulu-Natal
| | - L L Davidson
- Mailman School of Public Medicine, Columbia University, New York, USA
| | - S Kauchali
- South African Department of Health, Pretoria, South Africa
| | - C Mellins
- Mailman School of Public Medicine, Columbia University, New York, USA
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Mireku MO, Davidson LL, Zoumenou R, Massougbodji A, Cot M, Bodeau-Livinec F. Consequences of prenatal geophagy for maternal prenatal health, risk of childhood geophagy and child psychomotor development. Trop Med Int Health 2018; 23:841-849. [PMID: 29876999 PMCID: PMC6103800 DOI: 10.1111/tmi.13088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate the relationship between prenatal geophagy, maternal prenatal haematological indices, malaria, helminth infections and cognitive and motor development among offspring. METHODS At least a year after delivery, 552 of 863 HIV-negative mothers with singleton births who completed a clinical trial comparing the efficacy of sulfadoxine-pyrimethamine and mefloquine during pregnancy in Allada, Benin, responded to a nutrition questionnaire including their geophagous habits during pregnancy. During the clinical trial, helminth infection, malaria, haemoglobin and ferritin concentrations were assessed at 1st and 2nd antenatal care visits (ANV) and at delivery. After the first ANV, women were administered daily iron and folic acid supplements until three what? post-delivery. Singleton children were assessed for cognitive function at age 1 year using the Mullen Scales of Early Learning. RESULTS The prevalence of geophagy during pregnancy was 31.9%. Pregnant women reporting geophagy were more likely to be anaemic (AOR = 1.9, 95% CI [1.1, 3.4]) at their first ANV if they reported geophagy at the first trimester. Overall, prenatal geophagy was not associated with maternal haematological indices, malaria or helminth infections, but geophagy during the third trimester and throughout pregnancy was associated with poor motor function (AOR = -3.8, 95% CI [-6.9, -0.6]) and increased odds of geophagous behaviour in early childhood, respectively. CONCLUSIONS Prenatal geophagy is not associated with haematological indices in the presence of micronutrient supplementation. However, it may be associated with poor child motor function and infant geophagy. Geophagy should be screened early in pregnancy.
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Affiliation(s)
- Michael O Mireku
- School of Psychology, University of Lincoln, Lincoln, UK
- Institut de Recherche pour le Développement, Mère et Enfant Face aux Infections Tropicales, Paris, France
| | - Leslie L Davidson
- Mailman School of Public Health and the College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Romeo Zoumenou
- Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Bénin
| | | | - Michel Cot
- Institut de Recherche pour le Développement, Mère et Enfant Face aux Infections Tropicales, Paris, France
- PRES Sorbonne Paris Cité, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Paris, France
| | - Florence Bodeau-Livinec
- Département Méthodes Quantitatives en Santé Publique, Ecole des Hautes Etudes en Santé Publique, Rennes, France
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
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Bodeau-Livinec F, Davidson LL, Zoumenou R, Massougbodji A, Cot M, Boivin MJ. Neurocognitive testing in West African children 3-6 years of age: Challenges and implications for data analyses. Brain Res Bull 2018; 145:129-135. [PMID: 29630997 DOI: 10.1016/j.brainresbull.2018.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/07/2018] [Accepted: 04/04/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE When testing African children with developmental and cognitive standardized tests from high-income countries (HIC), investigators are uncertain as to whether to apply the HIC norms for these tests when standardizing a child's raw-score performance on the basis of age. The present study compared the construct validity of both raw and HIC-based standardized scores for the Mullen Scales of Early Learning (MSEL) and the Kaufman Assessment Battery in Children - 2nd edition (KABC-II) for Beninese children in a rural setting from three to six years of age. METHODS Seventy-four children 3-4 yrs of age were assessed with the MSEL, and 61 eligible older children (5-6 yrs of age) were assessed with the KABC-II. Assessors spoke the instructions to the children and caregivers for the assessment items in the local language. The developmental quality of the home environment was evaluated with the Caldwell Home Observation for Measurement of the Environment (HOME) inventory, and a material possessions and housing quality checklist was used as a measure of socio-economic status (SES). Children's mothers were given the Raven's Progressive Matrices test (nonverbal cognitive ability), and the Edinburgh Postpartum Depression Scale (EPDS) (emotional wellbeing). RESULTS For the MSEL, the 4-yr old group performed significantly better than the 3-yr old group on both the raw and standardized score comparisons for all scales. These differences were attenuated when using standardized scores, although the MSEL standardized cognitive composite score was still highly significant between years of age. When comparing 5- to 6-yr olds on KABC-II subtest and global scale performance, comparisons between the raw and standardized mean score performances were much less consistent. Generally, 6-yr olds performed significantly better than 5-yr olds on the raw score comparisons on the KABC-II subtests, but not so for standardized scores. Parent-child interactions assessed through the HOME measure was associated with both raw and standardized MSEL cognitive composite score outcomes on a multiple regression analysis. SES was the only significant predictor for KABC-II raw and standardized outcomes. CONCLUSION Standardization using HIC norms was not optimal, resulting in minimal impact to account for age when using the MSEL, and lower scores for oldest children compared with youngest children when using the KABC2. This is likely due to children in Benin drifting away from HIC-based norms with each passing year of age, systematically lowering standardized performance measures. These findings support the importance of having a local comparison group of reference or control children to allow for adjusted (for age, HOME, and SES) raw score comparisons when using western-based tests for developmental and neuropsychological evaluation.
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Affiliation(s)
- Florence Bodeau-Livinec
- EHESP, F-35000 Rennes, France; Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.
| | - Leslie L Davidson
- Columbia University, Mailman School of Public Health and the College of Physicians and Surgeons, NY, USA.
| | - Roméo Zoumenou
- Institut de Recherche pour le Développement, Mère et enfant face aux infections tropicales, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France; The Centre Biomédical des Cordeliers, Université Pierre et Marie Curie, Paris, France; PRES Paris Sorbonne Cité, Université Paris Descartes, Paris, France.
| | | | - Michel Cot
- Institut de Recherche pour le Développement, Mère et enfant face aux infections tropicales, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France; The Centre Biomédical des Cordeliers, Université Pierre et Marie Curie, Paris, France; PRES Paris Sorbonne Cité, Université Paris Descartes, Paris, France.
| | - Michael J Boivin
- Departments of Psychiatry and Neurology & Ophthalmology, Michigan State University, 909 fee Road, Rm 321, West Fee Hall, East Lansing, MI, 48824, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
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Mellins CA, Xu Q, Nestadt DF, Knox J, Kauchali S, Arpadi S, Kvalsvig J, Shrout PE, Davidson LL. Screening for Mental Health Among Young South African Children: The Use of the Strengths and Difficulties Questionnaire (SDQ). Glob Soc Welf 2018; 5:29-38. [PMID: 30038880 PMCID: PMC6054470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Little is known about the prevalence of child mental health (MH) problems in sub-Saharan Africa, where poverty, HIV, and family disruption increase risk. One barrier is the lack of MH assessment tools lay staff can validly and reliably administer in settings with few MH professionals. METHODS In a South African (SA) peri-urban cohort, we examined psychometric properties of the Strengths and Difficulties Questionnaire (SDQ), a widely used measure of child emotional and behavioral functioning. Data come from a large population-based study (N=1581) of children 4-6 years old. Lay fieldworkers administered the SDQ in isiZulu to caregivers at baseline and two years later. Exploratory factor analysisexamined whether the established SDQ five-factor structure and Total Difficulties score would be replicated. The psychometric model was tailored for ordinal items, and target factor rotation was used. RESULTS Total Difficulties, Emotional symptoms and Prosocial behavior factors were supported, with partial support for Conduct problems. Peer relationships and Hyperactivity/inattentive subscale items loaded poorly. Subscale Cronbach's alphas ranged from 0.29 (Peers) to 0.62 (Emotional). Internal consistency of Total Difficulties score was acceptable (0.74); 30% scored in the abnormal range on Total Difficulties, based on UK norms. CONCLUSIONS SDQ scores in our sample suggest young children in SA are at high risk for MH problems. The SDQ, particularly the Total Difficulties score, may be a useful screening tool in SA. Yet, some subscales did not work in this language and context; if social skills and hyperactivity/inattention arebeing considered, modification or additional measures may be needed.
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Affiliation(s)
- Claude A. Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute & Columbia University, New York, NY
| | - Qi Xu
- Department of Psychology, New York University, New York, NY
| | - Danielle F. Nestadt
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute & Columbia University, New York, NY
| | - Justin Knox
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
| | - Shuaib Kauchali
- Department of Paediatrics and Child Health, Maternal and Child Health Unit, University of KwaZulu-Natal, Durban, South Africa
| | - Stephen Arpadi
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
- Department of Pediatrics, College of Physicians and Surgeons, Columbia University of Medical Center, New York, NY
| | - Jane Kvalsvig
- Department of Paediatrics and Child Health, Maternal and Child Health Unit, University of KwaZulu-Natal, Durban, South Africa
| | | | - Leslie L. Davidson
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
- Department of Pediatrics, College of Physicians and Surgeons, Columbia University of Medical Center, New York, NY
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Ajayi OR, Matthews G, Taylor M, Kvalsvig J, Davidson LL, Kauchali S, Mellins CA. Factors associated with the health and cognition of 6-year-old to 8-year-old children in KwaZulu-Natal, South Africa. Trop Med Int Health 2017; 22:631-637. [DOI: 10.1111/tmi.12866] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Oluwakemi R. Ajayi
- School of Mathematics; Statistics and Computer Science; University of Kwa Zulu Natal; Durban South Africa
| | - Glenda Matthews
- School of Mathematics; Statistics and Computer Science; University of Kwa Zulu Natal; Durban South Africa
| | - Myra Taylor
- Discipline of Public Health Medicine; University of Kwa Zulu Natal; Durban South Africa
| | - Jane Kvalsvig
- Discipline of Public Health Medicine; University of Kwa Zulu Natal; Durban South Africa
| | - Leslie L. Davidson
- Department of Epidemiology and Pediatrics; Columbia University Medical Center; New York NY USA
| | - Shuaib Kauchali
- Department of Paediatrics and Child Health; University of Kwa Zulu Natal; Durban South Africa
| | - Claude A. Mellins
- HIV Center for Clinical and Behavioral Studies; Columbia University; New York NY USA
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Chander P, Kvalsvig J, Mellins CA, Kauchali S, Arpadi SM, Taylor M, Knox JR, Davidson LL. Intimate Partner Violence and Child Behavioral Problems in South Africa. Pediatrics 2017; 139:peds.2016-1059. [PMID: 28242862 PMCID: PMC5330393 DOI: 10.1542/peds.2016-1059] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Research in high-income countries has repeatedly demonstrated that intimate partner violence (IPV) experienced by women negatively affects the health and behavior of children in their care. However, there is little research on the topic in lower- and middle-income countries. The population-based Asenze Study gathered data on children and their caregivers in KwaZulu-Natal, South Africa. This data analysis explores the association of caregiver IPV on child behavior outcomes in children <12 years old and is the first such study in Africa. METHODS This population-based study was set in 5 Zulu tribal areas characterized by poverty, food insecurity, unemployment, and a high HIV prevalence. The Asenze Study interviewed caregivers via validated measures of IPV, alcohol use, caregiver mental health difficulties, and child behavior disorders in their preschool children. RESULTS Among the 980 caregivers assessed, 37% had experienced IPV from their current partner. Experience of partner violence (any, physical, or sexual) remained strongly associated with overall child behavior problems (odds ratio range: 2.46-3.10) even after age, HIV status, cohabitation with the partner, alcohol use, and posttraumatic stress disorder were accounted for. CONCLUSIONS Childhood behavioral difficulties are associated with their caregiver's experience of IPV in this population, even after other expected causes of child behavior difficulties are adjusted for. There is a need to investigate the longer-term impact of caregiver partner violence, particularly sexual IPV, on the health and well-being of vulnerable children in lower- and middle-income countries. Studies should also investigate whether preventing IPV reduces the occurrence of childhood behavior difficulties.
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Affiliation(s)
- Pratibha Chander
- Department of Epidemiology, Mailman School of Public Health, and
| | | | - Claude A. Mellins
- Columbia University and New York State Psychiatric Institute, New York, New York
| | - Shuaib Kauchali
- Paediatrics, University of KwaZulu-Natal, Durban, South Africa; and
| | - Stephen M. Arpadi
- Department of Epidemiology, Mailman School of Public Health, and,Department of Pediatrics, Columbia University, New York, New York
| | | | - Justin R. Knox
- Department of Epidemiology, Mailman School of Public Health, and
| | - Leslie L. Davidson
- Department of Epidemiology, Mailman School of Public Health, and,Department of Pediatrics, Columbia University, New York, New York
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Peters ZJ, Hatzenbuehler ML, Davidson LL. Examining the Intersection of Bullying and Physical Relationship Violence Among New York City High School Students. J Interpers Violence 2017; 32:49-75. [PMID: 25952291 DOI: 10.1177/0886260515585532] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Research is just beginning to explore the intersection of bullying and relationship violence. The relationship between these forms of youth aggression has yet to be examined in diverse urban centers, including New York City (NYC). This study seeks to identify intersections of joint victimization from bullying and electronic bullying (e-bullying) with physical relationship violence (pRV). This study examines data from the NYC Youth Risk Behavior Survey (YRBS), a representative sample of NYC public high school students, to assess the concurrent victimization from bullying at school and e-bullying with pRV, operationalized as physical violence by a dating partner in the past 12 months. Students who reported being bullied at school and e-bullied had increased odds (bullied: OR = 2.5, 95% CI [2.1, 2.9]; e-bullied: OR = 3.0, 95% CI [2.6, 3.5]) of also being victimized by pRV compared with those who did not report being bullied or e-bullied. In logistic regression models, being bullied at school and being e-bullied remained significant predictors of students' odds of reporting pRV (bullied: AOR = 2.6, 95% CI [2.2, 3.1]; e-bullied: AOR = 3.0, 95% CI [2.5, 3.6]) while controlling for race, gender, sexual orientation, and age. This research is the first to assess the intersection of victimization from bullying and e-bullying with pRV in a large, diverse, random sample of urban high school students. In this sample, students who report being bullied or e-bullied are more likely also to report pRV than students who have not been bullied or e-bullied. This research has potential implications for educators, adolescent health and social service providers, and policy makers to tailor programs and enact policies that jointly address bullying and pRV. Future studies are needed to longitudinally assess both victimization from and perpetration of bullying and pRV.
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Mireku MO, Davidson LL, Boivin MJ, Zoumenou R, Massougbodji A, Cot M, Bodeau-Livinec F. Prenatal Iron Deficiency, Neonatal Ferritin, and Infant Cognitive Function. Pediatrics 2016; 138:peds.2016-1319. [PMID: 27940685 PMCID: PMC5127064 DOI: 10.1542/peds.2016-1319] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate the impact of prenatal maternal iron deficiency (ID) on cord blood serum ferritin (CBSF) concentration and infant cognitive and motor development. METHODS Our prospective cohort study included 636 mother-singleton child pairs from 828 eligible pregnant women who were enrolled during their first antenatal care (ANC) visit in Allada, Benin, into a clinical trial comparing the efficacy of mefloquine and sulfadoxine-pyrimethamine. Venous blood samples of women were assessed for ferritin and hemoglobin concentrations at the first and second ANC visits (occurring at least 1-month apart) and at delivery. Women were prescribed daily iron and folic acid supplements throughout pregnancy. Hematologic examinations were repeated for cord blood at birth. At age 1 year, cognitive and motor functions of children were assessed by using the Mullen Scales of Early Learning. RESULTS The prevalence of prenatal ID at first and second ANC visits, and at delivery was 30.5%, 34.0%, and 28.4%, respectively. CBSF concentrations were similar between ID and non-ID pregnant women. Neither prenatal ID nor CBSF concentration was associated with poor cognitive or gross motor function of children at age 1 year. CBSF concentrations were lower among mothers who had ID anemia (IDA) at delivery compared with non-IDA pregnant women (adjusted mean difference: -0.2 [95% confidence interval: -0.4 to -0.0]). CONCLUSIONS In a malaria-endemic region, ID in pregnancy in the context of iron supplementation is neither associated with CBSF concentration nor with infant cognitive and motor development. Prenatal IDA around the time of delivery is associated with lower CBSF concentrations.
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Affiliation(s)
- Michael O. Mireku
- Institut de Recherche pour le Développement (IRD), Mère et Enfant Face aux Infections Tropicales, Paris, France;,Université Pierre et Marie Curie, Ecole Doctorale Pierre Louis de Santé Publique, Paris, France;,Département Méthodes Quantitatives en Santé Publique, Ecole des Hautes Etudes en Santé Publique, Rennes, France
| | - Leslie L. Davidson
- Mailman School of Public Health and the College of Physicians and Surgeons, Columbia University, New York, New York
| | - Michael J. Boivin
- Departments of Psychiatry and Neurology/Ophthalmology, Michigan State University, East Lansing, Michigan
| | - Romeo Zoumenou
- Faculté des Sciences de la Santé, Université d’Abomey-Calavi, Cotonou, Bénin
| | | | - Michel Cot
- Institut de Recherche pour le Développement (IRD), Mère et Enfant Face aux Infections Tropicales, Paris, France;,PRES Sorbonne Paris Cité, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Paris, France; and
| | - Florence Bodeau-Livinec
- Département Méthodes Quantitatives en Santé Publique, Ecole des Hautes Etudes en Santé Publique, Rennes, France;,Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
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Taylor M, Knox J, Chhagan MK, Kauchali S, Kvalsvig J, Mellins CA, Arpadi SM, Craib MH, Davidson LL. Screening Caregivers of Children for Risky Drinking in KwaZulu-Natal, South Africa. Matern Child Health J 2016; 20:2392-2401. [PMID: 27491526 DOI: 10.1007/s10995-016-2066-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background and Objectives Alcohol abuse, a significant health problem in South Africa, affects the ability of adults to care for children. Little is known regarding risky alcohol use among child caregivers there. A large population-based study examined the prevalence of, and factors associated with, risky drinking among caregivers of young children in KwaZulu-Natal, South Africa comparing the use of the Alcohol Use Disorders Identification Test (AUDIT) and the AUDIT-C screens for hazardous or harmful drinking (referred to here as risky drinking). Methods 83 % of child caregivers from five tribal areas were interviewed using the 10-question AUDIT to screen for risky drinking. The AUDIT-C screen, a subset of AUDIT questions, targets alcohol consumption and binge drinking. Factors associated with risky drinking were investigated using logistic regression. Results 1434 caregivers participated, 98 % female. Sixteen percent reported ever drinking alcohol. Based on AUDIT criteria for risky drinking, 13 % of the sample scored as moderate drinkers, 2 % as hazardous users, and 1 % as harmful or dependent users (identifying 3 % as risky drinkers). Using AUDIT-C criteria to identify risky drinking significantly increased the proportion of caregivers identified as risky drinkers to 9 %. In multivariate analyses, factors associated with risky drinking were similar in both screens: partner violence, smoking, HIV-infection, caring for a child with disabilities. Conclusions for Practice Since the AUDIT-C identified risky alcohol use not otherwise detected with the full AUDIT, and since resources for screening in health care settings is limited, the AUDIT-C may be a more appropriate screen in populations where binge drinking is common.
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Affiliation(s)
- Myra Taylor
- University of KwaZulu-Natal, Durban, South Africa
| | - Justin Knox
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168 St, New York, 10032, NY, USA
| | - Meera K Chhagan
- University of KwaZulu-Natal, Durban, South Africa.,School of Public Health, Private Bag X17, Bellville, 7535, Republic of South Africa
| | | | | | - Claude Ann Mellins
- HIV Center for Clinical and Behavioral Studies, 722 W 168 St, New York, 10032, NY, USA
| | - Stephen M Arpadi
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168 St, New York, 10032, NY, USA.,Department of Pediatrics, College of Physicians and Surgeons, Columbia University, 630 W 168 St, New York, 10032, NY, USA
| | | | - Leslie L Davidson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168 St, New York, 10032, NY, USA. .,Department of Pediatrics, College of Physicians and Surgeons, Columbia University, 630 W 168 St, New York, 10032, NY, USA.
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Mellins CA, Kauchali S, Nestadt DF, Bai D, Aidala A, Myeza N, Craib MH, Kvalsvig J, Leu CS, Knox J, Arpadi S, Chhagan M, Davidson LL. Validation of the Client Diagnostic Questionnaire to Assess Mental Health in South African Caregivers of Children. Clin Psychol Psychother 2016; 24:245-254. [PMID: 26923182 DOI: 10.1002/cpp.2008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 01/26/2016] [Accepted: 01/26/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Given the high prevalence of mental health (MH) and substance abuse problems in low-to-middle income countries, the scarcity of MH professionals and the negative impact of psychiatric disorders on caregivers of young children, there is significant need for brief evidence-based screening tools for lay counselors to assist with MH assessment. This study aimed to validate a brief screening tool to assess psychiatric and substance use disorders, the Client Diagnostic Questionnaire (CDQ), in South Africa (SA). METHODS Data are from a longitudinal study of health and psychosocial needs in preschool children in SA. Participants included 322 Zulu-speaking, female caregivers. Following procedures of the US CDQ validation study, lay counselors interviewed participants using the translated Zulu CDQ. Subsequently a psychologist conducted a full psychiatric assessment guided by the CDQ questions. Analyses examined sensitivity, specificity and overall accuracy, comparing lay counselor and psychologist assessment. RESULTS Sensitivity (73%), specificity (81%) and overall accuracy (79%) were good for the variable indicating presence of 'any diagnosis.' Among those cases identified by the psychologist as having any psychiatric diagnosis, over 70% were correctly identified by lay counselors using the CDQ (i.e., positive predictive value was greater than 70%). The false positive rate was relatively low (19%). Specificity for 'any disorder' (including substance use) and 'any psychiatric disorder' were 81% and 79%. CONCLUSIONS The isiZulu CDQ is a sensitive and valid MH diagnostic screener that can be used by lay counselors with limited MH training to identify those in need of treatment and target extremely scarce MH professionals. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGES South Africa (SA), a country heavily impacted by poverty, HIV and the legacy of Apartheid, has a high prevalence of mental health (MH) and substance abuse problems. In SA and other low-and-middle-income-countries (LMIC) there is a dearth of MH professionals. This study examined use and validity of the Client Diagnostic Questionnaire (CDQ), a brief diagnostic MH screening tool designed for use by lay counselors in HIV-affected populations. Comparing lay counsellor diagnoses on the CDQ to clinician assessment, sensitivity, specificity and overall accuracy were good at the level of 'any diagnosis.' The CDQ can be used effectively in SA and other LMIC with limited MH services to enable appropriate and efficient referral of individuals in primary care settings, supporting caregivers and the children in their care.
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Affiliation(s)
- Claude A Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Shuaib Kauchali
- Department of Pediatrics and Child Health, Maternal and Child Health Unit, University of KwaZulu-Natal, Durban, South Africa
| | - Danielle F Nestadt
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Dan Bai
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Angela Aidala
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Murray H Craib
- Department of Pediatrics and Child Health, Maternal and Child Health Unit, University of KwaZulu-Natal, Durban, South Africa
| | - Jane Kvalsvig
- Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Cheng-Shiun Leu
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA.,Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Justin Knox
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Stephen Arpadi
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.,Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - Meera Chhagan
- Department of Pediatrics and Child Health, Maternal and Child Health Unit, University of KwaZulu-Natal, Durban, South Africa
| | - Leslie L Davidson
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.,Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
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Rivas C, Ramsay J, Sadowski L, Davidson LL, Dunne D, Eldridge S, Hegarty K, Taft A, Feder G. Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse. Cochrane Database Syst Rev 2015; 2015:CD005043. [PMID: 26632986 PMCID: PMC9392211 DOI: 10.1002/14651858.cd005043.pub3] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Intimate partner abuse is common worldwide, damaging the short- and long-term physical, mental, and emotional health of survivors and children. Advocacy may contribute to reducing abuse, empowering women to improve their situation by providing informal counselling and support for safety planning and increasing access to different services. Advocacy may be a stand-alone service, accepting referrals from healthcare providers, or part of a multi-component (and possibly multi-agency) intervention provided by service staff or others. OBJECTIVES To assess the effects of advocacy interventions within or outside healthcare settings in women who have experienced intimate partner abuse. SEARCH METHODS In April 2015, we searched CENTRAL, Ovid MEDLINE, EMBASE, and 10 other databases. We also searched WHO ICTRP, mRCT, and UK Clinical Research Network (UKCRN), and examined relevant websites and reference lists with forward citation tracking of included studies. For the original review we handsearched six key journals. We also contacted first authors of eligible papers and experts in the field. SELECTION CRITERIA Randomised or quasi-randomised controlled trials comparing advocacy interventions for women with experience of intimate partner abuse versus no intervention or usual care (if advocacy was minimal and fewer than 20% of women received it). DATA COLLECTION AND ANALYSIS Two review authors independently assessed risk of bias and undertook data extraction. We contacted authors for missing information needed to calculate statistics for the review and looked for adverse events. MAIN RESULTS We included 13 trials involving 2141 participants aged 15 to 65 years, frequently having low socioeconomic status.The studies were quite heterogeneous in terms of methodology, study processes and design, including with regard to the duration of follow-up (postintervention to three years), although this was not associated with differences in effect. The studies also had considerable clinical heterogeneity in relation to staff delivering advocacy; setting (community, shelter, antenatal, healthcare); advocacy intensity (from 30 minutes to 80 hours); and abuse severity. Three trials evaluated advocacy within multi-component interventions. Eleven measured some form of abuse (eight scales), six assessed quality of life (three scales), and six measured depression (three scales). Countries and ethnic groups varied (one or more minority ethnic groups in the USA or UK, and local populations in Hong Kong and Peru). Setting was associated with intensity and duration of advocacy.Risk of bias was high in five studies, moderate in five, and low in three. The quality of evidence (considering multiple factors such as risk of bias, study size, missing data) was moderate to low for brief advocacy and very low for intensive advocacy. Incidence of abuse Physical abuseModerate quality pooled data from two healthcare studies (moderate risk of bias) and one community study (low risk of bias), all with 12-month follow-up data, showed no effect on physical abuse for brief (< 12 hours) advocacy interventions (standardised mean difference (SMD) 0.00, 95% confidence interval (CI) - 0.17 to 0.16; n = 558). One antenatal study (low risk of bias) showed an association between brief advocacy and reduced minor physical abuse at one year (mean difference (MD) change - 1.00, 95% CI - 1.82 to - 0.18; n = 110). An antenatal, multi-component study showed a greater likelihood of physical abuse ending (odds ratio (OR) 0.42, 95% CI 0.23 to 0.75) immediately after advocacy (number needed to treat (NNT) = 8); we cannot exclude impact from other components.Low to very low quality evidence from two intensive advocacy trials (12 hours plus duration) showed reduced severe physical abuse in women leaving a shelter at 24 months (OR 0.39, 95% CI 0.20 to 0.77; NNT = 8), but not at 12 or 36 months. Sexual abuseMeta-analysis of two studies (n = 239) showed no effect of advocacy on sexual abuse (SMD - 0.12, 95% CI - 0.37 to 0.14), agreeing with the change score (MD - 0.07, 95% CI - 0.30 to 0.16) from a third study and the OR (0.96, 95% CI 0.44 to 2.12) from a fourth antenatal, multi-component study. Emotional abuseOne study in antenatal care, rated at low risk of bias, showed reduced emotional abuse at ≤ 12-month follow-up (MD (change score) - 4.24, 95% CI - 6.42 to - 2.06; n = 110). Psychosocial health Quality of lifeMeta-analysis of two studies (high risk of bias) showed intensive advocacy slightly improved overall quality of life of women recruited from shelters (MD 0.23, 95% CI 0.00 to 0.46; n = 343) at 12-month follow-up, with greater improvement in perceived physical quality of life from a primary care study (high risk of bias; MD 4.90, 95% CI 0.98 to 8.82) immediately postintervention. Depression Meta-analysis of two studies in healthcare settings, one at high risk of bias and one at moderate risk, showed that fewer women developed depression (OR 0.31, 95% CI 0.15 to 0.65; n = 149; NNT = 4) with brief advocacy. One study at high risk of bias reported a slight reduction in depression in pregnant women immediately after the intervention (OR 0.51, 95% CI 0.20 to 1.29; n = 103; NNT = 8).There was no evidence that intensive advocacy reduced depression at ≤ 12-month follow-up (MD - 0.14, 95% CI - 0.33 to 0.05; 3 studies; n = 446) or at two years (SMD - 0.12, 95% CI - 0.36 to 0.12; 1 study; n = 265). Adverse effectsTwo women died, one who was murdered by her partner and one who committed suicide. No evidence links either death to study participation. AUTHORS' CONCLUSIONS Results suggest some benefits from advocacy. However, most studies were underpowered. Clinical and methodological heterogeneity largely precluded pooling of trials. Therefore, there is uncertainty about the magnitude of benefit, the impact of abuse severity, and the setting.Based on the evidence reviewed, intensive advocacy may improve short-term quality of life and reduce physical abuse one to two years after the intervention for women recruited from domestic violence shelters or refuges. Brief advocacy may provide small short-term mental health benefits and reduce abuse, particularly in pregnant women and for less severe abuse.
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Affiliation(s)
- Carol Rivas
- University of SouthamptonFaculty of Health SciencesRoom 67/20209Highfield CampusSouthamptonUKS017 1BJ
| | - Jean Ramsay
- Queen Mary University of LondonCentre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry58 Turner StreetWhitechapelLondonUKE1 2AB
| | - Laura Sadowski
- Stroger Hospital of Cook CountyDepartment of Medicine1900 W. Polk Street, 16th floorChicagoMIUSA60612
| | - Leslie L Davidson
- Columbia UniversityDepartment of Epidemiology, Mailman School of Public HealthRoom 1613, 722 W 168 StNew YorkNYUSA10032
| | - Danielle Dunne
- Department for International DevelopmentEvaluation Department22 WhitehallLondonUKSW1A 2EG
| | - Sandra Eldridge
- Queen Mary University of LondonCentre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry58 Turner StreetWhitechapelLondonUKE1 2AB
| | - Kelsey Hegarty
- The University of MelbourneDepartment of General Practice200 Berkeley StreetParkvilleMelbourneVictoriaAustralia3010
| | - Angela Taft
- La Trobe UniversityThe Judith Lumley Centre215 Franklin StreetMelbourneVictoriaAustralia3000
| | - Gene Feder
- University of BristolCentre for Academic Primary Care, School of Social and Community MedicineCanynge Hall39 Whatley RoadBristolUKBS8 2PS
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Abstract
BACKGROUND Intimate partner violence (IPV) damages individuals, their children, communities, and the wider economic and social fabric of society. Some governments and professional organisations recommend screening all women for IPV rather than asking only women with symptoms (case-finding). Here, we examine the evidence for whether screening benefits women and has no deleterious effects. OBJECTIVES To assess the effectiveness of screening for IPV conducted within healthcare settings on identification, referral, re-exposure to violence, and health outcomes for women, and to determine if screening causes any harm. SEARCH METHODS On 17 February 2015, we searched CENTRAL, Ovid MEDLINE, Embase, CINAHL, six other databases, and two trial registers. We also searched the reference lists of included articles and the websites of relevant organisations. SELECTION CRITERIA Randomised or quasi-randomised controlled trials assessing the effectiveness of IPV screening where healthcare professionals either directly screened women face-to-face or were informed of the results of screening questionnaires, as compared with usual care (which could include screening that did not involve a healthcare professional). DATA COLLECTION AND ANALYSIS Two authors independently assessed the risk of bias in the trials and undertook data extraction. For binary outcomes, we calculated a standardised estimation of the odds ratio (OR). For continuous data, either a mean difference (MD) or standardised mean difference (SMD) was calculated. All are presented with a 95% confidence interval (CI). MAIN RESULTS We included 13 trials that recruited 14,959 women from diverse healthcare settings (antenatal clinics, women's health clinics, emergency departments, primary care) predominantly located in high-income countries and urban settings. The majority of studies minimised selection bias; performance bias was the greatest threat to validity. The overall quality of the body of evidence was low to moderate, mainly due to heterogeneity, risk of bias, and imprecision.We excluded five of 13 studies from the primary analysis as they either did not report identification data, or the way in which they did was not consistent with clinical identification by healthcare providers. In the remaining eight studies (n = 10,074), screening increased clinical identification of victims/survivors (OR 2.95, 95% CI 1.79 to 4.87, moderate quality evidence).Subgroup analyses suggested increases in identification in antenatal care (OR 4.53, 95% CI 1.82 to 11.27, two studies, n = 663, moderate quality evidence); maternal health services (OR 2.36, 95% CI 1.14 to 4.87, one study, n = 829, moderate quality evidence); and emergency departments (OR 2.72, 95% CI 1.03 to 7.19, three studies, n = 2608, moderate quality evidence); but not in hospital-based primary care (OR 1.53, 95% CI 0.79 to 2.94, one study, n = 293, moderate quality evidence).Only two studies (n = 1298) measured referrals to domestic violence support services following clinical identification. We detected no evidence of an effect on referrals (OR 2.24, 95% CI 0.64 to 7.86, low quality evidence).Four of 13 studies (n = 2765) investigated prevalence (excluded from main analysis as rates were not clinically recorded); detection of IPV did not differ between face-to-face screening and computer/written-based assessment (OR 1.12, 95% CI 0.53 to 2.36, moderate quality evidence).Only two studies measured women's experience of violence (three to 18 months after screening) and found no evidence that screening decreased IPV.Only one study reported on women's health with no differences observable at 18 months.Although no study reported adverse effects from screening interventions, harm outcomes were only measured immediately afterwards and only one study reported outcomes at three months.There was insufficient evidence on which to judge whether screening increases uptake of specialist services, and no studies included an economic evaluation. AUTHORS' CONCLUSIONS The evidence shows that screening increases the identification of women experiencing IPV in healthcare settings. Overall, however, rates were low relative to best estimates of prevalence of IPV in women seeking healthcare. Pregnant women in antenatal settings may be more likely to disclose IPV when screened, however, rigorous research is needed to confirm this. There was no evidence of an effect for other outcomes (referral, re-exposure to violence, health measures, lack of harm arising from screening). Thus, while screening increases identification, there is insufficient evidence to justify screening in healthcare settings. Furthermore, there remains a need for studies comparing universal screening to case-finding (with or without advocacy or therapeutic interventions) for women's long-term wellbeing in order to inform IPV identification policies in healthcare settings.
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Affiliation(s)
- Lorna O'Doherty
- Coventry UniversityCentre for Research in Psychology, Behaviour and AchievementPriory StreetCoventryUKCV1 5FB
- The University of MelbourneDepartment of General Practice200 Berkeley StreetCarltonMelbourneVictoriaAustralia3053
| | - Kelsey Hegarty
- The University of MelbourneDepartment of General Practice200 Berkeley StreetCarltonMelbourneVictoriaAustralia3053
| | - Jean Ramsay
- Queen Mary University of LondonCentre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry58 Turner StreetWhitechapelLondonUKE1 2AB
| | - Leslie L Davidson
- Columbia UniversityDepartment of Epidemiology, Mailman School of Public HealthRoom 1613, 722 W 168 StNew YorkNYUSA10032
| | - Gene Feder
- University of BristolCentre for Academic Primary Care, School of Social and Community MedicineCanynge Hall, 39 Whatley RoadBristolUKBS8 2PS
| | - Angela Taft
- La Trobe UniversityMother and Child Health Research215 Franklin StreetMelbourneVictoriaAustralia3000
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Mireku MO, Davidson LL, Koura GK, Ouédraogo S, Boivin MJ, Xiong X, Accrombessi MMK, Massougbodji A, Cot M, Bodeau-Livinec F. Prenatal Hemoglobin Levels and Early Cognitive and Motor Functions of One-Year-Old Children. Pediatrics 2015; 136:e76-83. [PMID: 26055847 PMCID: PMC9924076 DOI: 10.1542/peds.2015-0491] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To explore the relationship between prenatal hemoglobin (Hb) concentration and infant cognitive and motor functions. METHODS Our prospective cohort study included 1-year-old children born to women enrolled at their first antenatal care (ANC) visit in Allada, Benin, before 29 weeks of pregnancy, within a trial comparing the efficacy of sulfadoxine-pyrimethamine and mefloquine. Hb concentrations of pregnant women were determined from venous blood samples collected at first and second ANC visits of at least 1-month interval and at delivery. Women were prescribed oral iron, folic acid, and anthelminthics after the first ANC visit. A total of 636 children (76.8% of eligible children) were assessed by trained research nurses for cognitive and motor functions by using the Mullen Scales of Early Learning. RESULTS Prevalence of anemia (Hb < 110 g/L) decreased from 67.0% at first ANC visit (mean gestational age [SD], 22.1 [4.0] weeks) to 38.4% at delivery. Mean (SD) Hb concentrations increased from 103.7 (12.3) at first ANC visit to 112.4 (14.1) at delivery. We observed a significant negative quadratic relationship between infant gross motor (GM) function and Hb concentration at first and second ANC visits. Thus, infant GM scores increased sharply with increasing maternal Hb concentration until 90 g/L where increasing GM was mild, and began to decline after 110 g/L. CONCLUSIONS There appears to be an Hb concentration range that may be optimal for GM function of 1-year-old children. This may reflect the importance of physiologic hemodilution, which occurs after the second trimester until 34 weeks of gestation.
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Affiliation(s)
- Michael O. Mireku
- Ecole des Hautes Etudes en Santé Publique, Département Épidémiologie et Biostatistiques, Rennes, France;,Université Pierre et Marie Curie (UPMC-Paris VI), Ecole doctorale Pierre Louis de santé publique, Paris, France;,Institut de Recherche pour le Développement (IRD), Mère et Enfant Face aux Infections Tropicales, Paris, France;,Address correspondence to Michael O. Mireku, MPH, PhD, Département Épidémiologie et Biostatistiques, École des Hautes Etudes en Santé Publique (EHESP), Avenue du Prof. Léon Bernard – CS 74312, 35043 Rennes Cedex, France. E-mail:
| | - Leslie L. Davidson
- Mailman School of Public Health and the College of Physicians and Surgeons, Columbia University, New York, New York
| | - Ghislain K. Koura
- Union Internationale Contre la Tuberculose et les Maladies Respiratoires, Département Tuberculose et VIH, Paris, France
| | - Smaïla Ouédraogo
- Institut de Recherche pour le Développement (IRD), Mère et Enfant Face aux Infections Tropicales, Paris, France;,Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Michael J. Boivin
- Departments of Psychiatry and Neurology/Ophthalmology, Michigan State University, East Lansing, Michigan
| | - Xu Xiong
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Manfred M. K. Accrombessi
- Université Pierre et Marie Curie (UPMC-Paris VI), Ecole doctorale Pierre Louis de santé publique, Paris, France;,Institut de Recherche pour le Développement (IRD), Mère et Enfant Face aux Infections Tropicales, Paris, France
| | | | - Michel Cot
- Institut de Recherche pour le Développement (IRD), Mère et Enfant Face aux Infections Tropicales, Paris, France;,PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France
| | - Florence Bodeau-Livinec
- Ecole des Hautes Etudes en Santé Publique, Département Épidémiologie et Biostatistiques, Rennes, France;,Center for Epidemiology and Statistics Sorbonne Paris Cité, Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), DHU Risks in Pregnancy, Paris Descartes University, Paris, France; and,Division of Parasitology, Department of Microbiology, New York University Medical Center, New York, New York
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Mireku MO, Boivin MJ, Davidson LL, Ouédraogo S, Koura GK, Alao MJ, Massougbodji A, Cot M, Bodeau-Livinec F. Impact of helminth infection during pregnancy on cognitive and motor functions of one-year-old children. PLoS Negl Trop Dis 2015; 9:e0003463. [PMID: 25756357 PMCID: PMC4355614 DOI: 10.1371/journal.pntd.0003463] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 12/08/2014] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To determine the effect of helminth infection during pregnancy on the cognitive and motor functions of one-year-old children. METHODS Six hundred and thirty five singletons born to pregnant women enrolled before 29 weeks of gestation in a trial comparing two intermittent preventive treatments for malaria were assessed for cognitive and motor functions using the Mullen Scales of Early Learning, in the TOVI study, at twelve months of age in the district of Allada in Benin. Stool samples of pregnant women were collected at recruitment, second antenatal care (ANC) visit (at least one month after recruitment) and just before delivery, and were tested for helminths using the Kato-Katz technique. All pregnant women were administered a total of 600 mg of mebendazole (100 mg two times daily for 3 days) to be taken after the first ANC visit. The intake was not directly observed. RESULTS Prevalence of helminth infection was 11.5%, 7.5% and 3.0% at first ANC visit, second ANC visit and at delivery, respectively. Children of mothers who were infected with hookworms at the first ANC visit had 4.9 (95% CI: 1.3-8.6) lower mean gross motor scores compared to those whose mothers were not infected with hookworms at the first ANC visit, in the adjusted model. Helminth infection at least once during pregnancy was associated with infant cognitive and gross motor functions after adjusting for maternal education, gravidity, child sex, family possessions, and quality of the home stimulation. CONCLUSION Helminth infection during pregnancy is associated with poor cognitive and gross motor outcomes in infants. Measures to prevent helminth infection during pregnancy should be reinforced.
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Affiliation(s)
- Michael O. Mireku
- Université Pierre et Marie Curie (UPMC- Paris VI), Paris, France
- Ecole des Hautes Etudes en Santé Publique, Département d’Épidémiologie et des Biostatistiques, Rennes, France
- Institut de Recherche pour le Développement (IRD), Mère et Enfant face aux Infections Tropicales, Paris, France
- * E-mail:
| | - Michael J. Boivin
- Michigan State University, Departments of Psychiatry and Neurology/Ophthalmology, East Lansing, Michigan, United States of America
| | - Leslie L. Davidson
- Columbia University, Mailman School of Public Health and the College of Physicians and Surgeons, New York, New York, United States of America
| | - Smaïla Ouédraogo
- Institut de Recherche pour le Développement (IRD), Mère et Enfant face aux Infections Tropicales, Paris, France
- Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Ghislain K. Koura
- Union Internationale Contre la Tuberculose et les Maladies Respiratoires, Département Tuberculose et VIH, Paris, France
| | - Maroufou J. Alao
- Hôpital de la Mère et de l’Enfant Lagune de Cotonou, Service de Pédiatrie, Cotonou, Bénin
| | | | - Michel Cot
- Institut de Recherche pour le Développement (IRD), Mère et Enfant face aux Infections Tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France
| | - Florence Bodeau-Livinec
- Ecole des Hautes Etudes en Santé Publique, Département d’Épidémiologie et des Biostatistiques, Rennes, France
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
- New York University Medical Center, Division of Parasitology, Department of Microbiology, New York, New York, United States of America
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Chhagan MK, Mellins CA, Kauchali S, Craib MH, Taylor M, Kvalsvig JD, Davidson LL. Mental health disorders among caregivers of preschool children in the Asenze study in KwaZulu-Natal, South Africa. Matern Child Health J 2014; 18:191-199. [PMID: 23467845 DOI: 10.1007/s10995-013-1254-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Given the existing evidence linking parental depression with infant and early child development, our aim was to describe the burden of mental health disorders among caregivers of young children aged 4-6 years living in an environment of poverty and high HIV seroprevalence. We analyzed baseline data from an epidemiologic study of the health and psychosocial needs of preschool-aged children. Primary caregivers of index children recruited from a household survey were screened for common mental disorders using the Client Diagnostic Questionnaire (CDQ). Sociodemographic, HIV and general health surveys were also conducted. Many caregivers (449/1,434; 31.3 %) screened positive for at least one psychiatric disorder on the CDQ, with post-traumatic-stress-disorder being the most common. Caregivers who screened positive for any disorder were more likely to be older, to have no individual sources of income and to have less formal education. Presence of a disorder was also significantly associated with lower employment levels within the household and death of a young child within the household. Known HIV-infected caregivers were more likely to have any mood disorder than caregivers who previously tested negative. The data support the need for mental health treatment interventions in South Africa, particularly interventions directed at PTSD and depression, and that take into account the high burden of poverty, HIV and childhood mortality. Given the limited formal mental health structure in South Africa to address these highly prevalent disorders; community-based mental health supports, available through decentralized health systems many be critical to delivering accessible interventions.
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Affiliation(s)
- Meera K Chhagan
- Department of Pediatrics and Child Health, Maternal and Child Health Unit, University of KwaZulu-Natal, P/Bag 7, Congella, Durban, 4013, South Africa.
| | - Claude A Mellins
- Departments of Psychiatry and Sociomedical Sciences, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Shuaib Kauchali
- Department of Pediatrics and Child Health, Maternal and Child Health Unit, University of KwaZulu-Natal, P/Bag 7, Congella, Durban, 4013, South Africa
| | - Murray H Craib
- Department of Pediatrics and Child Health, Maternal and Child Health Unit, University of KwaZulu-Natal, P/Bag 7, Congella, Durban, 4013, South Africa
| | - Myra Taylor
- Department of Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Jane D Kvalsvig
- Department of Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Leslie L Davidson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.,Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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Messinger AM, Fry DA, Rickert VI, Catallozzi M, Davidson LL. Extending Johnson's intimate partner violence typology: lessons from an adolescent sample. Violence Against Women 2014; 20:948-71. [PMID: 25125494 DOI: 10.1177/1077801214546907] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Johnson's intimate partner violence (IPV) typology-categorizing IPV by both use and receipt of physical violence and controlling behaviors-effectively predicts IPV consequences among adults. His typology has not yet been applied to adolescents, an important population for early IPV intervention. Therefore, in analyzing IPV covariates among 493 female urban high school students, we used as key predictors both Johnson's original typology and, for enhanced clarity, a relationship-level extension. Preliminary evidence suggests that the pattern of adolescent IPV differs substantially from that of adult IPV and that a relationship-level typology provided additional clarity in categorizing this pattern.
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DuPont-Reyes MJ, Fry D, Rickert VI, Bell DL, Palmetto N, Davidson LL. Relationship Violence, Fear, and Exposure to Youth Violence Among Adolescents in New York City. J Interpers Violence 2014; 29:2325-2350. [PMID: 24457218 DOI: 10.1177/0886260513518433] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Previous research has shown that there is an overlap between experiences of youth violence and adolescent relationship violence. Yet, little research exists which investigates the sex differences in the associations between specific types of youth violence and relationship violence while controlling for potential confounders. This study addresses this gap in the literature by exploring the associations between experiences of youth violence and receiving and delivering relationship violence in an urban adolescent sample. From 2006 to 2007, 1,454 adolescents aged 13 to 21 years in New York City completed an anonymous survey that included the validated Conflict in Adolescent Relationships Inventory that estimates experiences of relationship violence in the previous year as well as the prevalence of various exposures to youth violence. Bivariate and multivariate analyses assessed the overlap between experiencing other types of youth violence and delivering and receiving physical relationship violence and sexual coercion. Compared with youth in nonviolent relationships, we found a significant association between delivering and receiving relationship physical violence and sexual coercion with participating in a fight, missing school due to fear, being threatened/injured with a weapon, gang membership, and carrying a weapon among both males and females. We also identified the sex differences between these specific associations of youth and relationship violence. Service providers working with adolescents experiencing relationship violence should be aware that they face a higher concurrent risk of experiencing or participating in other forms of youth violence. Likewise, providers working in the area of youth violence intervention and prevention should consider the possibility of concurrent relationship violence. Based on these findings, further research should explore whether interventions targeting relationship violence can also impact participation in youth violence and vice versa.
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Affiliation(s)
| | - Deborah Fry
- University of Edinburgh/NSPCC Child Protection Research Centre, Scotland
| | | | - David L Bell
- Columbia University, New York, NY, USA New York-Presbyterian Hospital, NY, USA
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O'Doherty LJ, Taft A, Hegarty K, Ramsay J, Davidson LL, Feder G. Authors' reply to Whitehouse and Fabre. BMJ 2014; 348:g3943. [PMID: 24943226 DOI: 10.1136/bmj.g3943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Lorna J O'Doherty
- Department of General Practice, University of Melbourne, Carlton, Vic, Australia
| | - Angela Taft
- Judith Lumley Centre, La Trobe University, Melbourne, Vic, Australia
| | - Kelsey Hegarty
- Department of General Practice, University of Melbourne, Carlton, Vic, Australia
| | - Jean Ramsay
- Centre for Primary Health Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary College, University of London, London, UK
| | - Leslie L Davidson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Gene Feder
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
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29
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O'Doherty LJ, Taft A, Hegarty K, Ramsay J, Davidson LL, Feder G. Screening women for intimate partner violence in healthcare settings: abridged Cochrane systematic review and meta-analysis. BMJ 2014; 348:g2913. [PMID: 24821132 PMCID: PMC4018471 DOI: 10.1136/bmj.g2913] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the effectiveness of screening for intimate partner violence conducted within healthcare settings to determine whether or not screening increases identification and referral to support agencies, improves women's wellbeing, decreases further violence, or causes harm. DESIGN Systematic review and meta-analysis of trials assessing effectiveness of screening. Study assessment, data abstraction, and quality assessment were conducted independently by two of the authors. Standardised estimations of the risk ratios and 95% confidence intervals were calculated. DATA SOURCES Nine databases searched up to July 2012 (CENTRAL, Medline, Medline(R), Embase, DARE, CINAHL, PsycINFO, Sociological Abstracts, and ASSIA), and five trials registers searched up to 2010. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised or quasi-randomised trials of screening programmes for intimate partner violence involving all women aged ≥ 16 attending a healthcare setting. We included only studies in which clinicians in the intervention arm personally conducted the screening, or were informed of the screening result at the time of the consultation, compared with usual care (or no screening). Studies of screening programmes that were followed by structured interventions such as advocacy or therapeutic intervention were excluded. RESULTS 11 eligible trials (n=13,027) were identified. In six pooled studies (n=3564), screening increased the identification of intimate partner violence (risk ratio 2.33, 95% confidence interval 1.39 to 3.89), particularly in antenatal settings (4.26, 1.76 to 10.31). Based on three studies (n=1400), we detected no evidence that screening increases referrals to domestic violence support services (2.67, 0.99 to 7.20). Only two studies measured women's experience of violence after screening (three to 18 months after screening) and found no reduction in intimate partner violence. One study reported that screening does not cause harm. CONCLUSIONS Though screening is likely to increase identification of intimate partner violence in healthcare settings, rates of identification from screening interventions were low relative to best estimates of prevalence of such violence. It is uncertain whether screening increases effective referral to supportive agencies. Screening does not seem to cause harm in the short term, but harm was measured in only one study. As the primary studies did not detect improved outcomes for women screened for intimate partner violence, there is insufficient evidence for screening in healthcare settings. Studies comparing screening versus case finding, or screening in combination with therapeutic intervention for women's long term wellbeing, are needed to inform the implementation of identification policies in healthcare settings.
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Affiliation(s)
- Lorna J O'Doherty
- Department of General Practice, University of Melbourne, Carlton, Vic 3010, Australia
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30
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Abstract
Young people tend to disclose relationship violence experiences to their peers, if they disclose at all, yet little is known about the nature and frequency of adolescent help-seeking and help-giving behaviors. Conducted within a sample of 1,312 young people from four New York City high schools, this is the first paper to ask adolescent help-givers about the various forms of help they provide and among the first to examine how ethnicity and nativity impact help-seeking behaviors. Relationship violence victims who had ever disclosed (61%) were more likely to choose their friends for informal support. Ethnicity was predictive of adolescent disclosure outlets, whereas gender and nativity were not. Latinos were significantly less likely than non-Latinos to ever disclose to only friends, as compared to disclosing to at least one adult. The likelihood of a young person giving help to their friend in a violent relationship is associated with gender, ethnicity, and nativity, with males being significantly less likely than females to give all forms of help to their friends (talking to their friends about the violence, suggesting options, and taking action). Foreign-born adolescents are less likely to talk or suggest options to friends in violent relationships. This study also found that Latinos were significantly more likely than non-Latinos to report taking action with or on behalf of a friend in a violent relationship. This research shows that adolescents often rely on each other to address relationship violence, underlining the importance of adolescents' receipt of training and education on how to support their friends, including when to seek help from more formal services. To further understand the valuable role played by adolescent peers of victims, future research should explore both which forms of help are perceived by the victim to be most helpful and which are associated with more positive outcomes.
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Affiliation(s)
- Deborah A Fry
- University of Edinburgh/NSPCC Child Protection Research Centre, Edinburgh, UK,
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Farnsworth SK, Böse K, Fajobi O, Souza PP, Peniston A, Davidson LL, Griffiths M, Hodgins S. Community engagement to enhance child survival and early development in low- and middle-income countries: an evidence review. J Health Commun 2014; 19 Suppl 1:67-88. [PMID: 25207448 PMCID: PMC4205914 DOI: 10.1080/10810730.2014.941519] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
As part of a broader evidence summit, USAID and UNICEF convened a literature review of effective means to empower communities to achieve behavioral and social changes to accelerate reductions in under-5 mortality and optimize early child development. The authors conducted a systematic review of the effectiveness of community mobilization and participation that led to behavioral change and one or more of the following: child health, survival, and development. The level and nature of community engagement was categorized using two internationally recognized models and only studies where the methods of community participation could be categorized as collaborative or shared leadership were eligible for analysis. The authors identified 34 documents from 18 countries that met the eligibility criteria. Studies with shared leadership typically used a comprehensive community action cycle, whereas studies characterized as collaborative showed clear emphasis on collective action but did not undergo an initial process of community dialogue. The review concluded that programs working collaboratively or achieving shared leadership with a community can lead to behavior change and cost-effective sustained transformation to improve critical health behaviors and reduce poor health outcomes in low- and middle-income countries. Overall, community engagement is an understudied component of improving child outcomes.
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Affiliation(s)
- S. Katherine Farnsworth
- U.S. Agency for International Development
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Washington
,
District of Columbia
,
USA
- Bureau for Global Health, U.S. Agency for International Development, 1300 Pennsylvania Avenue NW,
Washington
,
DC
,
20004
,
USA
E-mail:
| | - Kirsten Böse
- Center for Communication Programs
, Johns Hopkins University
,
Baltimore
,
Maryland
,
USA
| | - Olaoluwa Fajobi
- Center for Communication Programs
, Johns Hopkins University
,
Baltimore
,
Maryland
,
USA
| | | | - Anne Peniston
- U.S. Agency for International Development
,
Washington
,
District of Columbia
,
USA
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Yau RK, Stayton CD, Davidson LL. Indicators of Intimate Partner Violence: Identification in Emergency Departments. J Emerg Med 2013; 45:441-9. [DOI: 10.1016/j.jemermed.2013.05.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 08/30/2012] [Accepted: 05/01/2013] [Indexed: 11/25/2022]
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Palmetto N, Davidson LL, Breitbart V, Rickert VI. Predictors of physical intimate partner violence in the lives of young women: victimization, perpetration, and bidirectional violence. Violence Vict 2013; 28:103-21. [PMID: 23520835 DOI: 10.1891/0886-6708.28.1.103] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Dating violence in young people is highly prevalent, and bidirectional violence characterizes most violent relationships. However, there is limited data on predictors of bidirectional violence in young relationships. PURPOSE To examine the frequency of victimization, perpetration, and bidirectional physical violence in young women's relationships and compare individual and relationship characteristics across violence profiles. METHODS Six hundred eighteen young women visiting an urban reproductive health care clinic completed an anonymous survey using the Conflict in Adolescent Dating Relationships Inventory to measure their experience of violence with a partner in the last year. RESULTS Thirty-four percent of women reported at least one instance of physical violence (3% "victim only" 12% "perpetrator only," 19% "bidirectional"). The frequency of violence in the previous year within the bidirectional profile was significantly higher than both the victim-only and perpetrator-only profiles. In all adjusted models, younger age, childhood sexual abuse, witnessing parental intimate partner violence (IPV), and relationship length remained significant. Black race was predictive of both perpetration and bidirectional violence, but not victimization. Compared to nulliparous women or those with one previous pregnancy, those who had had two or more had twice the odds of both victimization and bidirectional, but no increase in odds of perpetration. CONCLUSIONS Bidirectional violence was the most common profile and was associated with the highest frequency of violent behaviors. Contrary to expectation, only two variables differed significantly across the three violence profiles. However, as hypothesized, bidirectional relationships were characterized by longer length, lending moderate support for social learning theory as one explanation underlying the occurrence of bidirectional violence.
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Affiliation(s)
- Niki Palmetto
- Columbia University, Mailman School of Public Health, USA.
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Messinger AM, Rickert VI, Fry DA, Lessel H, Davidson LL. Revisiting the role of communication in adolescent intimate partner violence. J Interpers Violence 2012; 27:2920-2935. [PMID: 22491220 DOI: 10.1177/0886260512438276] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A growing literature suggests that communication strategies can promote or inhibit intimate partner violence (IPV). Research on communication is still needed on a group ripe for early IPV intervention: high school-aged adolescents. This article revisits our previous analyses of young female reproductive clinic patients (Messinger, Davidson, & Rickert, 2011) by examining how the adolescent and young adult respondents differ. To explore replicability of the adolescent results across populations, they are compared to 487 adolescent female students sampled from four urban high schools. Across samples, all communication strategies were used more frequently within violent relationships. Multivariate analysis identified escalating strategies used and received as being positively associated with physical violence used and received in all three samples. Regarding verbal reasoning and temporary conflict avoidance, substantial differences appeared between the young adult and adolescent clinic samples, and results from the adolescent clinic sample were largely replicated with the adolescent school sample, suggesting that young adult samples in this literature are not adequate proxies for adolescents.
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Affiliation(s)
- Adam M Messinger
- Justice Studies Department, Northeastern Illinois University, Chicago, IL 60625, USA.
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Davidson LL, Kauchali S, Chhagan MK, Bah F, Uwemedimo OOT, Craib MH, McKeague I. PS55 The Use Of A Wealth Index Within An Impoverished Community: A Cohort Study In Kwazulu-Natal, South Africa. Br J Soc Med 2012. [DOI: 10.1136/jech-2012-201753.154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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36
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Chhagan MK, Kauchali S, Arpadi SM, Craib MH, Bah F, Stein Z, Davidson LL. Failure to test children of HIV-infected mothers in South Africa: implications for HIV testing strategies for preschool children. Trop Med Int Health 2011; 16:1490-4. [PMID: 21883725 DOI: 10.1111/j.1365-3156.2011.02872.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the uptake of HIV testing among preschool children with HIV-positive mothers in a peri-urban population-based study in KwaZulu-Natal, South Africa, an area of high HIV prevalence. METHODS All children 4-6 years old and their primary caregivers from the area were invited to participate. All participants were asked about prior HIV testing and were offered counselling and voluntary HIV testing irrespective of previous testing. Twenty-seven HIV-infected mothers were interviewed to identify barriers to testing their children. RESULTS One thousand five hundred and eighty-three children (88% of eligible children) and their caregivers participated. Of the biological mothers, 86% were previously tested for HIV (27% tested positive). Among the surviving 244 children born to an infected mother, only 41% had been tested for HIV (23% tested positive). Subsequently, 90% of previously untested children of infected mothers underwent HIV testing (9.3% were positive). Overall seroprevalence among study children was 4.9%. All infected mothers interviewed endorsed the belief that children of HIV-infected women should be tested for HIV. Women who missed opportunities for antenatal HIV testing reported no systematic testing of their children at later ages. CONCLUSIONS In this community with high HIV prevalence, HIV testing of children is infrequent despite high testing coverage among caregivers. The low proportion of children tested for HIV, particularly those of infected mothers, is of great concern as they are at high risk for morbidity and mortality associated with untreated childhood HIV infection. HIV testing programs should strengthen protocols to include children, especially for those who missed PMTCT opportunities in infancy.
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Affiliation(s)
- Meera K Chhagan
- Department of Paediatrics and Child Health, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
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Catallozzi M, Simon PJ, Davidson LL, Breitbart V, Rickert VI. Understanding control in adolescent and young adult relationships. ACTA ACUST UNITED AC 2011; 165:313-9. [PMID: 21464379 DOI: 10.1001/archpediatrics.2011.32] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To describe the receipt of controlling behaviors in young women's dating relationships and the association with physical and sexual relationship violence (RV) and to ascertain whether young women experiencing controlling from partners support RV screening and respond honestly. DESIGN Anonymous audio computer-assisted self-interview. SETTING Reproductive health center. PARTICIPANTS A total of 603 women aged 15 to 24 years seeking reproductive care. MAIN OUTCOME MEASURES Self-reported victimization (controlling behaviors and physical and sexual aggression) by a partner in the past year. RESULTS Sixty-eight percent of participants reported receiving 1 or more episodes of controlling behavior by a partner: 38.1% reported experiencing only controlling behaviors; 11.4% and 10.0% reported receiving controlling behaviors plus physical or sexual victimization, respectively; and 8.6% reported all forms of RV. Adjusted Poisson regression found that age 15 to 18 years (relative risk, 1.40), Hispanic ethnicity (1.29), childhood exposure to domestic violence (1.11), ever pregnant (1.21), older partner (1.28), recent physical (1.89) or sexual (1.93) victimization, and uncomfortable asking for condom use (1.39) were significantly associated with increased episodes of controlling behavior by a partner. Younger women and those who reported being victimized by controlling behaviors were more than twice as likely to object to screening by a health care provider, and those who reported receiving these behaviors were 2.5 times more likely to report that they might not honestly disclose RV. CONCLUSIONS Controlling behaviors are strongly associated with physical and sexual RV. Young women experiencing controlling behaviors are more reticent about screening for RV and may not feel that they can answer honestly.
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Affiliation(s)
- Marina Catallozzi
- Division of General Pediatrics, Department of Pediatrics, College of Physicians & Surgeons, Columbia University, New York, NY 10032, USA.
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Messinger AM, Davidson LL, Rickert VI. IPV among adolescent reproductive health patients: the role of relationship communication. J Interpers Violence 2011; 26:1851-1867. [PMID: 20587465 DOI: 10.1177/0886260510372933] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Population-specific data on factors that affect intimate partner violence (IPV) are needed on female adolescents and young adults, a cohort at greatest risk of IPV in the United States (Rennison, 2001). Studies have frequently overlooked the role of relationship communication as a gatekeeper to IPV (Ridley & Feldman, 2003). To address this gap, negative binomial regression was conducted with data from a 2004 survey of 618 women aged 15 to 24 seeking care at an urban reproductive health facility. Findings suggest that, within the previous year, verbal aggression by either partner was associated with physical violence by either or both partners, and verbal reasoning was negatively correlated with physical violence. Bidirectional and unidirectional IPV relationships may employ communication strategies differently.
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Richardus JH, Graafmans WC, Bergsjø P, Lloyd DJ, Bakketeig LS, Bannon EM, Borkent-Polet M, Davidson LL, Defoort P, Leitão AE, Langhoff-Roos J, Garcia AM, Papantoniou NE, Wennergren M, Amelink-Verburg MP, Verloove-Vanhorick SP, Mackenbach JP. Suboptimal care and perinatal mortality in ten European regions: methodology and evaluation of an international audit. J Matern Fetal Neonatal Med 2009; 14:267-76. [PMID: 14738174 DOI: 10.1080/jmf.14.4.267.276] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND A European concerted action (the EuroNatal study) investigated differences in perinatal mortality between countries of Europe. This report describes the methods used in the EuroNatal international audit and discusses the validity of the results. METHODS Perinatal deaths between 1993 and 1998 in regions of ten European countries were identified. The categories of death chosen for the study were singleton fetal deaths at 28 or more weeks of gestational age, all intrapartum deaths at 28 or more weeks of gestational age and neonatal deaths at 34 or more weeks of gestational age. Deaths with major congenital anomalies were excluded. An international audit panel used explicit criteria to review all cases, which were blinded for region. Subjective interpretation was used in cases of events or interventions where explicit criteria did not exist. Suboptimal factors were identified in the antenatal, intrapartum and neonatal periods, and classified as 'maternal/social', due to 'infrastructure/service organization', or due to 'professional care delivery'. The contribution of each suboptimal factor to the fatal outcome was listed and consensus was reached on a final grade using a procedure that included correspondence and plenary meetings. RESULTS In all regions combined, 90% of all known or estimated cases in the selected categories were included in the audit. In total, 1619 cases of perinatal death were audited. Consensus was reached in 1543 (95%) cases. In 75% of all cases, the grade was based on explicit criteria. In the remaining cases, consensus was reached within subpanels without reference to predefined criteria. There was reasonable to good agreement between and within subpanels, and within panel members. CONCLUSIONS The international audit procedure proved feasible and led to consistent results. The results that relate to suboptimal care will need to be studied in depth in order to reach conclusions about their implications for assessing the quality of perinatal care in the individual regions.
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Affiliation(s)
- J H Richardus
- Department of Public Health, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
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Wylie BJ, Davidson LL, Batra M, Reed SD. Method of delivery and neonatal outcome in very low-birthweight vertex-presenting fetuses. Am J Obstet Gynecol 2008; 198:640.e1-7; discussion e1-4. [PMID: 18313634 DOI: 10.1016/j.ajog.2007.12.038] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2007] [Revised: 11/10/2007] [Accepted: 12/31/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study was undertaken to compare neonatal outcome by method of delivery in very low-birthweight less than 1500 g vertex-presenting fetuses. STUDY DESIGN A retrospective cohort was conducted of 2466 very low-birthweight singleton liveborn vertex-presenting fetuses in Washington State (1994-2003). The exposure considered was cesarean delivery vs vaginal delivery. The risk of neonatal demise was estimated by logistic regression. Secondary outcomes included intraventricular hemorrhage, respiratory distress, and neonatal sepsis. Analyses were stratified by birthweight, gestational age, and growth restriction to assess subgroup differences. RESULTS Cesarean delivery offered no survival advantage to very low-birthweight infants when compared with vaginal delivery (adjusted odds ratio [95% confidence interval]: 1.08 [0.78-1.49]). Survival benefit was noted for growth-restricted infants (adjusted odds ratio [95% confidence interval]: 0.09 [0.02-0.47]) although only 12% of such infants delivered vaginally. CONCLUSION For very low-birthweight vertex-presenting fetuses at risk of preterm delivery, cesarean delivery does not improve neonatal survival. Further studies are warranted to assess the potential benefit of cesarean delivery to growth-restricted very low-birthweight infants.
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Hockley C, Quigley MA, Hughes G, Calderwood L, Joshi H, Davidson LL. Linking Millennium Cohort data to birth registration and hospital episode records. Paediatr Perinat Epidemiol 2008; 22:99-109. [PMID: 18173788 DOI: 10.1111/j.1365-3016.2007.00902.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Millennium Cohort Study of 18,818 UK babies born in 2000-02 interviewed parents when the baby was 9 months old. Time constraints on the interview limited the amount of health-related questions that could be included. The aim of this study was to augment interview data with information from birth registrations and hospital records. It also provided an opportunity to assess the accuracy of the data acquired and parents' recall of the information on pregnancy and delivery. Deterministic and probabilistic matching were used to obtain information from birth registration and hospital records. Investigation into the accuracy of the matches obtained was undertaken. The records received were checked for range, consistency and completion. Birth registration data were obtained for 99% of those who gave consent. The number of additional variables gained ranged from six in Northern Ireland to 16 in Scotland. Hospital record data were obtained for 83% of those who gave consent. The additional general and maternity-related variables gained ranged from 55 in Scotland to 76 in England. Completion of available health record variables ranged from 28% to 100% across all UK countries. Linkage to birth registration and hospital records in order to augment Millennium Cohort Study data with routinely collected data was successful. The variables gained by linkage have added considerable value to the cohort study and validated some of the mother's responses.
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Affiliation(s)
- Christine Hockley
- National Perinatal Epidemiology Unit, Oxford University, Oxford, UK.
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Quigley MA, Hockley C, Davidson LL. Agreement between hospital records and maternal recall of mode of delivery: Evidence from 12 391 deliveries in the UK Millennium Cohort Study. BJOG 2007; 114:195-200. [PMID: 17166217 DOI: 10.1111/j.1471-0528.2006.01203.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to measure the agreement between hospital records and maternal reporting of mode of delivery in a representative UK sample. DESIGN Population-based survey (Millennium Cohort Study). SETTING UK. POPULATION A total of 12,391 singleton infants born in 2000-2002. METHODS Mothers were interviewed when infants were approximately 9 months old. Information was collected by interview on many obstetric and perinatal factors including mode of delivery. Record linkage to the mother's delivery hospital records was undertaken in those who gave consent (90%). A matching record was found for 83%. Maternal report and hospital records were compared using mode of delivery classified into three (normal, assisted and caesarean) and six groups. Factors associated with disagreement between the two data sources were identified. MAIN OUTCOME MEASURE Proportion of records in which there was agreement between the two data sources. RESULTS Agreement between maternal report and hospital records was at least 94% using six mode of delivery groups and 98% using three groups. Much of the disagreement (57-63%, depending on country) was between forceps and ventouse, and between planned and emergency caesarean. Disagreement was more common in women whose babies were first born and in women not born in the UK. CONCLUSION Our study confirms that maternal reporting of mode of delivery is highly reliable. This is important for clinical staff caring for women and those conducting epidemiological studies. Additional data sources may be necessary to gather reliable data from ethnic minority women, particularly those born outside the UK, or to distinguish forceps from ventouse, or planned from emergency caesarean section.
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Affiliation(s)
- M A Quigley
- National Perinatal Epidemiology Unit, Oxford University, Oxford, UK.
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Petrou S, Cooper P, Murray L, Davidson LL. Cost-effectiveness of a preventive counseling and support package for postnatal depression. Int J Technol Assess Health Care 2006; 22:443-53. [PMID: 16984677 DOI: 10.1017/s0266462306051361] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objectives: This study reports the cost-effectiveness of a preventive intervention, consisting of counseling and specific support for the mother–infant relationship, targeted at women at high risk of developing postnatal depression.Methods: A prospective economic evaluation was conducted alongside a pragmatic randomized controlled trial in which women considered at high risk of developing postnatal depression were allocated randomly to the preventive intervention (n = 74) or to routine primary care (n = 77). The primary outcome measure was the duration of postnatal depression experienced during the first 18 months postpartum. Data on health and social care use by women and their infants up to 18 months postpartum were collected, using a combination of prospective diaries and face-to-face interviews, and then were combined with unit costs (£, year 2000 prices) to obtain a net cost per mother–infant dyad. The nonparametric bootstrap method was used to present cost-effectiveness acceptability curves and net benefit statistics at alternative willingness to pay thresholds held by decision makers for preventing 1 month of postnatal depression.Results: Women in the preventive intervention group were depressed for an average of 2.21 months (9.57 weeks) during the study period, whereas women in the routine primary care group were depressed for an average of 2.70 months (11.71 weeks). The mean health and social care costs were estimated at £2,396.9 per mother–infant dyad in the preventive intervention group and £2,277.5 per mother–infant dyad in the routine primary care group, providing a mean cost difference of £119.5 (bootstrap 95 percent confidence interval [CI], −535.4, 784.9). At a willingness to pay threshold of £1,000 per month of postnatal depression avoided, the probability that the preventive intervention is cost-effective is .71 and the mean net benefit is £383.4 (bootstrap 95 percent CI, −£863.3–£1,581.5).Conclusions: The preventive intervention is likely to be cost-effective even at relatively low willingness to pay thresholds for preventing 1 month of postnatal depression during the first 18 months postpartum. Given the negative impact of postnatal depression on later child development, further research is required that investigates the longer-term cost-effectiveness of the preventive intervention in high risk women.
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Redshaw M, Hockley C, Davidson LL. A qualitative study of the experience of treatment for infertility among women who successfully became pregnant. Hum Reprod 2006; 22:295-304. [PMID: 16959809 DOI: 10.1093/humrep/del344] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In a study in which 18,503 women who had recently given birth were interviewed, 460 women who had received treatment for infertility (2.6%) were asked to participate in a postal study. The aim was to investigate the experience of women who had undergone treatment for infertility and given birth as a consequence, focusing on perceptions of treatment and care. METHODS The study relies on responses to open-ended questions about the impact of treatment, how treatment could be improved and advice to policy makers. The text responses to these questions were analysed qualitatively. RESULTS A total of 230 women responded (50%). Emergent themes related to the treatment process, pain and distress, lack of choice and control, timing, emotional and financial costs, fairness and contrasts in care. CONCLUSIONS Women wished to be treated with respect and dignity and given appropriate information and support. They wanted their distress recognized, to feel cared for and to have confidence in health professionals in situations where outcomes are uncertain. Women acknowledged receiving care from motivated and skilled health professionals and value the children they have enormously. For many, there is now a sense of being complete, though for some this has been at great emotional and financial cost.
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Affiliation(s)
- M Redshaw
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
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Zeitler MS, Paine AD, Breitbart V, Rickert VI, Olson C, Stevens L, Rottenberg L, Davidson LL. Attitudes about intimate partner violence screening among an ethnically diverse sample of young women. J Adolesc Health 2006; 39:119.e1-8. [PMID: 16781970 DOI: 10.1016/j.jadohealth.2005.09.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2005] [Revised: 09/07/2005] [Accepted: 09/13/2005] [Indexed: 11/30/2022]
Abstract
PURPOSE This clinic-based study investigated attitudes about intimate partner violence (IPV) screening among an ethnically diverse population of adolescent and young adult women (n = 645). METHODS A cross-sectional quantitative and qualitative survey assessed experiences with and attitudes toward IPV screening. RESULTS Almost all participants supported universal IPV screening and over 90% believed that a health care provider was the most appropriate adult to ask them about interpersonal violence. Young women's concerns toward screening varied by age and violence experience; those most likely to mind being screened were younger, had a history of childhood sexual abuse, and were victims of physical violence in the last year. However, even in these groups, over 70% supported IPV screening. Qualitative analyses suggested that provider qualities and confidentiality will affect the amount of disclosure to provider-initiated screening. Women also raised important questions about how to define IPV in relationships. CONCLUSIONS Young women generally favor universal screening of interpersonal violence, but provider qualities and confidentiality issues affect responses to screening questions.
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Affiliation(s)
- Michelle S Zeitler
- Mailman School of Public Health at Columbia University, New York, New York, USA
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Palmetto NP, Davidson LL, Jones KE, Rickert VI, Breitbart V, Tanenhaus J, Aljuwani T, Forbes M, Zeitler M, Stevens L. A Randomized Trial of Screening for Intimate Partner Violence in Young Women. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s258-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kauchali S, Davidson LL. Commentary: the epidemiology of neurodevelopmental disorders in Sub-Saharan Africa--moving forward to understand the health and psychosocial needs of children, families, and communities. Int J Epidemiol 2006; 35:689-90. [PMID: 16672308 DOI: 10.1093/ije/dyl090] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Shuaib Kauchali
- Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of Natal, 719 Umbilo Road, Durban, 4001, South Africa
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Rowe RE, Garcia J, Davidson LL. Social and ethnic inequalities in the offer and uptake of prenatal screening and diagnosis in the UK: a systematic review. Public Health 2004; 118:177-89. [PMID: 15003407 DOI: 10.1016/j.puhe.2003.08.004] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2003] [Revised: 06/03/2003] [Accepted: 08/01/2003] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To review studies addressing the question of whether there are social inequalities in either the offer or the uptake of prenatal testing in the UK. METHOD Systematic review of studies assessing the offer or uptake of prenatal screening or diagnosis according to social class or ethnic origin. Electronic databases were searched using a strategy developed for a review of inequalities in access to maternity care supplemented with terms specific to prenatal testing. Further papers were identified from reference lists, citation searches and key organizations. RESULTS From over 600 identified papers, 41 were potentially relevant. Twenty met the inclusion criteria. The studies included covered screening and/or diagnosis for Down's syndrome, neural tube defects, haemoglobin disorders and HIV. Many studies were limited by small numbers or poor reporting of data and analysis. Six studies reported data on prenatal testing according to women's social class or educational level. None found any significant social inequalities in testing. Some studies suggested that women of South Asian origin might be up to 70% less likely to receive prenatal testing for haemoglobin disorders and Down's syndrome than White women. A small number of studies suggested that South Asian women might be less likely to be offered testing. CONCLUSIONS This review provides some evidence of ethnic inequalities in access to prenatal testing. Further research is required to improve our understanding of why testing may not be offered, the reasons for failure to take up testing when offered, and to identify whether there are other social inequalities in access to prenatal testing.
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Affiliation(s)
- R E Rowe
- National Perinatal Epidemiology Unit, Institute of Health Sciences, University of Oxford, Old Road, Headington, Oxford OX3 7LF, UK.
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Carolyn Olson E, Rickert VI, Davidson LL. Identifying and supporting young women experiencing dating violence: what health practitioners should be doing NOW. J Pediatr Adolesc Gynecol 2004; 17:131-6. [PMID: 15050990 DOI: 10.1016/j.jpag.2004.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- E Carolyn Olson
- Heilbrunn Department of Population and Family Health, Mailman School of Public Heath at Columbia University, New York, New York, USA
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