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Rhoden-Neita MA, Huang H, Fava NM. The Effects of Childhood Adversity and Self-Regulation on the Well-Being of Adults with Delinquency Histories: A Mediation Model. J Evid Based Soc Work (2019) 2024; 21:117-139. [PMID: 37847740 DOI: 10.1080/26408066.2023.2265923] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
PURPOSE Most youth with delinquency histories experience childhood adversity leaving them vulnerable to poor adult well-being. Previous research indicates that self-regulation difficulties could explain how childhood adversity affects adult well-being. Yet, very few studies target adult self-regulation intervention. Therefore, this study examined the intervening effects of emerging adult self-regulation on the association between childhood adversity and adult well-being. METHOD Using data from the first four waves of the Add Health Study, the researchers conducted structural equation modeling for mediation with bootstrapping. The researchers tested the mediation effects of emerging adult self-regulation on the association between childhood adversity (child maltreatment and violent victimization) and later adult well-being (mental health problems, alcohol and drug use, criminal behaviors) among people with delinquency histories and/or arrest prior to age 18 (N = 1,792). RESULTS Several significant direct effects and one partial mediation effect were found. For example, child maltreatment significantly predicted adult mental health problems and criminal behaviors. Self-regulation (via the dissatisfaction with life and self subscale) mediated the association between child maltreatment and adult mental health problems. DISCUSSION Findings highlight the need for social workers to focus on prevention services and trauma-informed treatment for people with delinquency histories. In addition, evidence-based practice requires self-regulation interventions for adults with histories of childhood adversity and delinquency to focus on their emotional and cognitive functioning as well as self-esteem. CONCLUSION Implementing self-regulation interventions during emerging adulthood can be useful to mitigate later adult mental health problems among people with histories of childhood adversity and delinquency.
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Affiliation(s)
| | - Hui Huang
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Nicole M Fava
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
- Center for Children and Families, Florida International University, Miami, Florida, USA
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2
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Fava NM, Coxe SJ, Fortenberry JD, Bay-Cheng LY. Sexual Self-Concept After Child Maltreatment: The Role of Resilient Coping and Sexual Experience Among U.S. Young Adults. Arch Sex Behav 2024; 53:359-373. [PMID: 37847345 DOI: 10.1007/s10508-023-02706-3] [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] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 10/18/2023]
Abstract
Evidence supports sexual experience as normative and health-promoting for many, but this picture is less clear for people with histories of adversity. Amazon Mechanical Turk (MTurk) was used to garner data from a sample of 362 young adults (aged 18-25) wherein 44.5% (n = 161) identified as women. We assessed longitudinal associations between child maltreatment and sexual self-concept, as mediated by sexual behaviors and sexual partners, and whether resilient coping moderated these associations using structural equation modeling. Although both child maltreatment and resilient coping were directly associated with aspects of sexual experience, only resilient coping was directly associated with sexual self-concept. In addition, we found support for sexual experience as a mediator between child maltreatment/resilient coping and sexual self-concept. Specifically, cumulative maltreatment was associated with more sexual partners, which was associated with higher sexual self-monitoring. Resilient coping was associated with more sexual partners and more sexual behaviors, which was associated with higher sexual self-monitoring and higher sexual self-consciousness, sexual assertiveness, sexual self-esteem, and sexual motivation, respectively. Thus, sexual behaviors and sexual partners operated independently. Findings contrast messaging that sexual experience is universally risky regardless of maltreatment history. Rather, sexual experience may foster positive sexual self-concept for some. Sexual health advocates must attend to differences between sexual behaviors and sexual partners in relation to sexual well-being, and support resilience in the sexual domain.
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Affiliation(s)
- Nicole M Fava
- School of Social Work, Robert Stempel College of Public Health & Social Work, Center for Children and Families, Florida International University, AHC-5, Room 587, 11200 SW 8th Street, Miami, FL, 33199, USA.
| | - Stefany J Coxe
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA
| | | | - Laina Y Bay-Cheng
- Psychology Department, LaMarsh Centre for Child & Youth Research, York University, Toronto, ON, Canada
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Fava NM, Meldrum RC, Villar MG, Zucker RA, Trucco EM. Adverse childhood experiences, sleep problems, low self-control, and adolescent delinquency: A longitudinal serial mediation analysis. Dev Psychopathol 2023; 35:1868-1877. [PMID: 35678388 PMCID: PMC9732146 DOI: 10.1017/s0954579422000530] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/13/2022]
Abstract
Several studies link adverse childhood experiences (ACEs) to delinquency. Yet, developmental sequalae accounting for this association remain unclear, with previous research limited by cross-sectional research designs and investigations of singular mediating processes. To redress these shortcomings, this study examines the longitudinal association between ACEs and delinquency as mediated by both sleep problems and low self-control, two factors which past research implicates as potentially important for understanding how ACEs contribute to antisocial behavior. Data collected from 480 adolescents (71.3% boys; 86.3% White) and their parents participating in the Michigan Longitudinal Study was used to conduct a serial mediation analysis. The association between ACEs (prior to age 11) and delinquency in late adolescence was found to operate indirectly via sleep problems in early adolescence and low self-control in middle adolescence. Nonetheless, a direct association between ACEs and later delinquency remained. Pathways through which ACEs contribute to later delinquency are complex and multiply determined. Findings indicate that early behavioral interventions, including improving sleep and self-control, could reduce later delinquency. Still, more research is needed to identify additional avenues through which the ACEs-delinquency association unfolds across development.
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Affiliation(s)
- Nicole M Fava
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Ryan C Meldrum
- Criminology and Criminal Justice, Florida International University, Miami, FL, USA
| | - Michelle G Villar
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Robert A Zucker
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Elisa M Trucco
- Center for Children and Families, Florida International University, Miami, FL, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Department of Psychology, Florida International University, Miami, FL, USA
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Trucco EM, Fava NM, Villar MG, Kumar M, Sutherland MT. Social Isolation During the COVID-19 Pandemic Impacts the Link between Child Abuse and Adolescent Internalizing Problems. J Youth Adolesc 2023; 52:1313-1324. [PMID: 37067640 PMCID: PMC10108819 DOI: 10.1007/s10964-023-01775-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/03/2023] [Indexed: 04/18/2023]
Abstract
Collective traumas have a notable impact on adolescent well-being. While some youth face increased risk for mental health problems (e.g., those with maltreatment histories), many demonstrate resilience following traumatic events. One contributing factor to well-being following trauma is the degree to which one isolates from others. Accordingly, we examined the association between maltreatment and internalizing problems during the COVID-19 pandemic as moderated by social isolation. Among adolescents reporting pre-pandemic emotional abuse, those experiencing less isolation reported the lowest levels of anxiety symptoms. Among adolescents reporting pre-pandemic physical abuse, those experiencing less isolation reported the greatest levels of anxiety and depressive symptoms. The findings highlight a public health-oriented approach to youth well-being during collective trauma that extends beyond mitigating disease transmission.
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Affiliation(s)
- Elisa M Trucco
- Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
- Center for Children and Families, Florida International University, 11200 SW 8th Street, AHC-1 Rm. 140, Miami, FL, USA.
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA.
| | - Nicole M Fava
- Center for Children and Families, Florida International University, 11200 SW 8th Street, AHC-1 Rm. 140, Miami, FL, USA
- Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Michelle G Villar
- Center for Children and Families, Florida International University, 11200 SW 8th Street, AHC-1 Rm. 140, Miami, FL, USA
| | - Mari Kumar
- Center for Children and Families, Florida International University, 11200 SW 8th Street, AHC-1 Rm. 140, Miami, FL, USA
| | - Matthew T Sutherland
- Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
- Center for Children and Families, Florida International University, 11200 SW 8th Street, AHC-1 Rm. 140, Miami, FL, USA
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5
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Abtahi Z, Zahedi L, Eizadyar Z, Fava NM. #BlueGirl: A study of collective trauma on Twitter. J Trauma Stress 2022; 35:1631-1641. [PMID: 35916169 DOI: 10.1002/jts.22865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 02/09/2022] [Revised: 05/24/2022] [Accepted: 05/31/2022] [Indexed: 12/24/2022]
Abstract
Collective trauma is the outcome of traumatic incidents that necessitate collective self-reflection and create a need for public discourse. Access to social media allows individuals to shape event coverage beyond what is put forth by mainstream media through hashtag-based communities. The death of Sahar Khodayari, or "Blue Girl," an Iranian woman who committed suicide after being sentenced to prison for appearing in a sports stadium dressed as a man, is one such event that became a collective trauma. The current study sought to examine the collective trauma reaction among Farsi-speaking Twitter users in response to Khodayari's death as represented in public tweets. The overall pool of data consisted of 8,653 tweets containing at least one of four hashtags (i.e., #BlueGirl, #Blue_Girl,, # #), posted September 9-24, 2019, as well as 603 tweets posted on the anniversary of the event 1 year later. Using thematic analysis, we identified three main themes within these public tweets representing different responses to Khodayari's death: social justice, awareness, and process. In undemocratic countries, like Iran, where there are limited free physical spaces for public gatherings, social media provides a platform for people to come together after tragic events to express emotions and discuss thoughts and actions. The present findings demonstrate that Twitter allowed Farsi-speaking users to demand social justice, share awareness about #BlueGirl, and process their emotions and thoughts accordingly. Therefore, social media may provide a window into the collective trauma experience, and it may also serve as a new mode of studying trauma on new platforms.
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Affiliation(s)
- Zahra Abtahi
- School of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Leila Zahedi
- School of Computing and Information Sciences, Florida International University, Miami, Florida, USA
| | | | - Nicole M Fava
- School of Public Health and Social Work, Florida International University, Miami, Florida, USA.,Center for Children and Families, Florida International University, Miami, Florida, USA
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6
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Fava NM, Panisch LS, Burke SL, Li T, Spadola CE, O'Driscoll J, Leviyah X. The Mediating Effect of Maternal Wellbeing on the Association between Neighborhood Perception and Child Wellbeing: A Longitudinal Investigation. Matern Child Health J 2022; 26:2070-2078. [PMID: 35934723 PMCID: PMC10319474 DOI: 10.1007/s10995-022-03490-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/19/2022] [Accepted: 07/20/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Negative perceptions of one's neighborhood are linked to poor mental and physical health. However, it is unclear how caregiver's neighborhood perception affects health outcomes in children. This study assessed the mediating effect of maternal wellbeing on the association between neighborhood perception and child wellbeing at different time points and overall. METHOD A structural equation model (SEM) was used to evaluate whether maternal wellbeing mediates the influence of neighborhood perception on child wellbeing at different ages. The Fragile Families and Child Wellbeing Study data from years 3, 5, and 9 was analyzed. The delta method evaluated the mediation effect of maternal wellbeing, controlling for mothers' age. Direct and indirect effects of neighborhood perception at year 3 on child wellbeing at year 9 via maternal wellbeing at year 5 were analyzed via a longitudinal mediation with a two time points lag. RESULTS Maternal wellbeing partially mediated the effect of neighborhood perception on child wellbeing at different ages. Longitudinal mediation analyses revealed that better neighborhood perception at year 3 improved maternal wellbeing at year 5 and child wellbeing at year 9; maternal wellbeing at year 5 partially mediated the effect of neighborhood perception at year 3 on child wellbeing at year 5. CONCLUSIONS FOR PRACTICE Our findings suggest that it may be beneficial for mental health practitioners to discuss relationships between neighborhood environment and wellbeing with caregivers, with a focus on reframing negative self-perceptions. Future research should evaluate longitudinal relationships between changes in neighborhood infrastructure and corresponding wellbeing in caregivers and children.
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Affiliation(s)
- Nicole M Fava
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Westchester, Florida, U.S.,Center for Children and Families, Florida International University, Westchester, Florida, U.S
| | - Lisa S Panisch
- School of Social Work, Wayne State University, 5447 Woodward Avenue, 48202, Detroit, MI, USA.
| | - Shanna L Burke
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Westchester, Florida, U.S
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Westchester, Florida, U.S
| | - Christine E Spadola
- School of Social Work, The University of Texas at Arlington, 211 S. Cooper Street, Box 19129, Arlington, Texas, 76019, United States
| | - Janice O'Driscoll
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Westchester, Florida, U.S
| | - Xeniah Leviyah
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Westchester, Florida, U.S.,Center for Children and Families, Florida International University, Westchester, Florida, U.S
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7
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Fava NM, Fortenberry JD. Trauma-Informed Sex Positive Approaches to Sexual Pleasure. Int J Sex Health 2021; 33:537-549. [PMID: 38595781 PMCID: PMC10903666 DOI: 10.1080/19317611.2021.1961965] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 07/16/2021] [Accepted: 07/16/2021] [Indexed: 04/11/2024]
Abstract
This paper develops a trauma-informed sex-positive framework as a public health, clinical, and research approach to sexual experience over the life course. The framework centers trauma-informed sex positivity as the linkage for sexual pleasure (along with sexual wellbeing and sexual health) to the social, cultural, and legal concepts of sexual justice. By providing a conceptual distinction of sexual pleasure from sexual wellbeing and sexual health, the framework improves clarity about how these constructs are related as well as provides possibilities for detailed operationalization in public health surveillance and in the new research.
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Affiliation(s)
- Nicole M. Fava
- Center for Children and Families, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
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8
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Ladis B, Trucco EM, Huang H, Thomlison B, Fava NM. Longitudinal Effects of Peer, School, and Parenting Contexts on Substance Use Initiation in Middle Adolescence. J Evid Based Soc Work (2019) 2021; 18:566-584. [PMID: 34096482 PMCID: PMC8649054 DOI: 10.1080/26408066.2021.1932660] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Purpose: Preventing substance use initiation (SUI) can reduce negative consequences associated with adult substance use disorder. The role of involvement with deviant peers, school connectedness, and parenting quality on SUI was investigated among a community sample (N = 387).Method: PROCESS tested whether three parenting quality factors (Parental Knowledge and Affective Relationships, Parental Control, and Parental Communication and Involvement) served as moderators of two different mediation pathways (involvement with deviant peers and school connectedness) on three SUI outcomes (alcohol, cigarettes, and marijuana).Results: Involvement with deviant peers mediated the relation between school connectedness and substance use. Low school connectedness predicted high deviant peer affiliation, which, in turn, predicted high SUI. School connectedness did not mediate involvement with deviant peers and substance use. Parenting quality factors were not significant moderators.Conclusion: Supporting adolescents who lack strong school connections may help prevent involvement with deviant peers, which, in turn, may prevent SUI.
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Affiliation(s)
- Barry Ladis
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, United States
| | - Elisa M Trucco
- Department of Psychology, Florida International University, Miami, United States
- Center for Children and Families, Florida International University, Miami, United States
- Department of Psychiatry, University of Michigan, United States
| | - Hui Huang
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, United States
| | - Barbara Thomlison
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, United States
| | - Nicole M Fava
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, United States
- Center for Children and Families, Florida International University, Miami, United States
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9
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Mendel WE, Sperlich M, Fava NM. "Is there anything else you would like me to know?": Applying a trauma-informed approach to the administration of the adverse childhood experiences questionnaire. J Community Psychol 2021; 49:1079-1099. [PMID: 33792050 PMCID: PMC8222088 DOI: 10.1002/jcop.22562] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/08/2021] [Accepted: 03/01/2021] [Indexed: 05/28/2023]
Abstract
Nearly ubiquitous agreement exists regarding the potentially negative impact of adverse childhood experiences (ACEs) on health and well-being across the lifespan. This has propelled a movement across the nation for consistent screening of ACEs. Despite agreement regarding the consequences of ACEs, little research related specifically to the administration of the ACE questionnaire exists. Using data from a mixed-methods study of first-time mothers as means of illustration, this paper examines shortcomings of the ACE questionnaire. Participant responses revealed ambiguity with item structure, limited breadth of included events, and failure to capture the gravity of the experience. These shortcomings underscore inadequacies of the measure in accurately understanding individuals' lived experiences and call for the application of trauma-informed (TI) values, both in its content and administration. We apply the main tenets of a TI framework to the ACE questionnaire and make recommendations for its administration, translating theoretical underpinnings of a TI approach into action.
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Affiliation(s)
- Whitney E Mendel
- Master of Public Health Program, Daemen College, Amherst, New York, USA
| | - Mickey Sperlich
- School of Social Work, University at Buffalo, Buffalo, New York, USA
| | - Nicole M Fava
- Center for Children and Families, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
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Clarke RD, Morris SL, Wagner EF, Spadola CE, Bursac Z, Fava NM, Hospital M. Feasibility, acceptability and preliminary impact of mindfulness-based yoga among Hispanic/Latinx adolescents. Explore (NY) 2021; 18:299-305. [PMID: 33741254 DOI: 10.1016/j.explore.2021.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/16/2020] [Revised: 03/01/2021] [Accepted: 03/07/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND The Hispanic/Latinx population constitutes the fastest growing ethnic/racial minority group in the United States (U.S.). Compared to their non-Hispanic/Latinx White counterparts, Hispanic/Latinx youth experience more depression and anxiety, and have more unmet mental health needs (88% vs 76%). Emerging research supports the psychological and physical benefits of mind-body awareness training to enhance well-being and mental health, but almost no studies have recruited ethnic/racial minority samples. PURPOSE The current study examined the feasibility, acceptability and preliminary impact of a mindfulness-based yoga program among Hispanic/Latinx public high school students. PROCEDURES Participants (N = 187) were recruited from a local public high school in a large multi-ethnic urban school district in the Southeast U.S. and participated in 6 weekly hour-long sessions of mindfulness-based yoga. Participants completed assessments at pretest and one month after program completion. MAIN FINDINGS The sample was predominantly Hispanic/Latinx (95%) and female (64%), on average 15.2 years old (SD = 1.3), and 51% were born outside the U.S. Participants reported on average a 14.2% reduction in depressive symptoms (pretest mean = 5.51, posttest mean = 4.73, p = .032, Cohen's d = 0.2), a 14.9% reduction in anxiety symptoms (pretest mean = 9.90, posttest mean = 8.42, p = .005, Cohen's d = 0.2), and a 21.9% reduction in stress (pretest mean = 9.66, posttest mean = 7.54, p < .001, Cohen's d = 0.5). CONCLUSION These findings provide support for the effectiveness of a mindfulness-based yoga program for Hispanic/Latinx adolescents, a medically underrepresented group experiencing significant mental health disparities.
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Affiliation(s)
- Rachel D Clarke
- Community-Based Research Institute, Florida International University, Miami, FL, USA; Florida International University Research Center in a Minority Institution, Miami, FL, USA.
| | - Staci Leon Morris
- Community-Based Research Institute, Florida International University, Miami, FL, USA; Florida International University Research Center in a Minority Institution, Miami, FL, USA
| | - Eric F Wagner
- Community-Based Research Institute, Florida International University, Miami, FL, USA; Florida International University Research Center in a Minority Institution, Miami, FL, USA
| | - Christine E Spadola
- Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University, Boca Raton, FL, USA
| | - Zoran Bursac
- Department of Biostatistics, Florida International University, Miami, FL, USA
| | - Nicole M Fava
- School of Social Work, Florida International University, Miami, FL, USA
| | - Michelle Hospital
- Community-Based Research Institute, Florida International University, Miami, FL, USA; Florida International University Research Center in a Minority Institution, Miami, FL, USA
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Bay-Cheng LY, Ginn HG, Fava NM, Maguin EM, Bascug EW. At risk and in love: A mixed methodexamination of the link between childhood maltreatment and youth relationships. J Adolesc 2021; 87:28-37. [PMID: 33450465 DOI: 10.1016/j.adolescence.2020.12.007] [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] [Received: 04/01/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Research indicates that sexual and romantic relationships play an important role in youth well-being and development. This strengths-based perspective sits in tension with the documented risks that youth with histories of maltreatment face in sexual/romantic relationships. We conducted a U.S.-based mixed-method study to examine the connection between childhood maltreatment and youth relationships. METHOD We collected retrospective ratings of relationship quality and open-ended comments about those relationships using an online sexual life history calendar. Quantitative analyses drew on data from 98 participants (51 cisgender women, 47 cisgender men) between the ages of 18-25 (Mage = 22.51). Qualitative analyses compared demographically matched subsamples of 19 participants who reported multiple forms of child maltreatment and 20 who reported none. RESULTS Quantitative analyses indicated that ratings of relationship stability, intimacy, and pleasure were unrelated to prior abuse or neglect. Qualitative analyses showed the relationships of those with multiple maltreatment histories, compared to those without any maltreatment, to be more often intertwined with and complicated by other hardships (e.g., homelessness). CONCLUSIONS Quantitatively, childhood maltreatment appeared unrelated to youth sexual/romantic relationship quality, though we regard those findings with due caution. Complementing this was qualitative evidence of differences between participants based on trauma histories, with those who had experienced childhood maltreatment referring more often to surrounding circumstances and hardships in descriptions of their youth sexual/romantic relationships. These mixed method findings reinforce the importance of youth sexuality research, policy, and practice that takes the broader conditions of young people's lives into consideration.
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12
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Fava NM, Sanchez M, Wuyke G, Diez S, Vazquez V, Ravelo GJ, Villalba K, Rojas P. Associations Between Sexual Trauma and Sexual Relationship Power Among Latina Immigrant Farmworkers: The Moderating Role of Gender Norms. J Trauma Stress 2020; 33:1093-1101. [PMID: 32667079 PMCID: PMC7725861 DOI: 10.1002/jts.22561] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Received: 04/02/2019] [Revised: 02/02/2020] [Accepted: 06/03/2020] [Indexed: 11/05/2022]
Abstract
Sexual trauma is a national public health concern due to the alarming rates at which it occurs and decades of research supporting its long-term deleterious effects on health outcomes. We assessed the impact of gender norms and sexual trauma on power within sexual relationships among Latina immigrant farmworkers. At baseline, participants (N = 175) completed a survey examining demographic information, sexual trauma history, and gender norms; a follow-up was administered 6 months later. Past sexual trauma was associated with less power in sexual relationships, r = -.25, p < .001, as was endorsement of traditional Latina gender norms (i.e., marianismo): sexual relationship control, r = -.38, p < .001; sexual decision-making dominance, r = -.21, p = .005. In contrast, egalitarian gender norm endorsement was associated with higher levels of sexual relationship control, r = .37, p < .001, and sexual decision-making dominance, r = .17, p = .023. Gender norms moderated the association between sexual trauma and sexual relationship power. Specifically, women who subscribed more to marianismo and reported sexual trauma had less decision-making dominance in sexual relationships, whereas those with lower ratings of marianismo reported higher levels of decision-making dominance despite sexual trauma, R2 = .03, p = .022. Sexual trauma history coupled with higher ratings of egalitarian gender norms was associated with higher levels of sexual relationship control, DR2 = .02, p = .023. These results highlight the importance of culturally informed research to increase the sexual and overall health of vulnerable populations (e.g., Latina immigrant farmworkers).
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Affiliation(s)
- Nicole M. Fava
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mariana Sanchez
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA,Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Gabriella Wuyke
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Stephanie Diez
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA,Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Vicky Vazquez
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Gira J. Ravelo
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Karina Villalba
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Patria Rojas
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA,Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
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Panisch LS, Faulkner M, Fernandez SB, Fava NM. Exploring How Trauma Is Addressed in Sexual Education Interventions for Youth: A Scoping Review. Health Educ Behav 2020; 47:880-893. [PMID: 32900237 DOI: 10.1177/1090198120954398] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Traumatic experiences are common among adolescents and can negatively affect learning and increase the risk of early pregnancy, parenthood, and sexually transmitted infections. Little is known about how current sexual health interventions address trauma. A scoping review was conducted to gain insight into how trauma is addressed in adolescent sexual health interventions. Peer-reviewed studies from the United States published between 2008 and 2018 describing a sexual health intervention for youth were considered. Studies were analyzed to determine if and how trauma was addressed in the interventions. Out of 169 articles initially screened, 29 met inclusion criteria and 23% (n = 6) addressed trauma. Four interventions addressed trauma in the intervention content, while two studies evaluated trauma in outcome measures. Educators can broaden this reach by developing trauma-informed content that is compatible with existing curricula. Ongoing study is recommended to evaluate the impact of trauma-informed content on the sexual knowledge, attitudes, and behaviors of youth.
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Ladis B, Trucco EM, Huang H, Thomlison B, Fava NM. Psychometric Properties of a Comprehensive Parenting Practice Measure for Parents of Adolescents. Child Adolesc Social Work J 2020; 37:49-72. [PMID: 31929679 PMCID: PMC6953731 DOI: 10.1007/s10560-019-00627-6] [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] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Many measures exist that assess parenting skills and practices. Few comprehensive measures for parents of adolescents (13-17 years) exist. The aim of the current study was to develop a comprehensive assessment measure of parenting practices based on items from existing measures. Research and clinical settings can benefit from the advancement of a valid and more inclusive measure of parenting to assess youth behavior and functioning. This study utilized a sample that included 387 caregivers and youth (mean age of youth = 13.6, SD = .59) from a longitudinal study examining contextual influences on youths'substance use initiation. Exploratory factor analysis (EFA) was conducted on 12 parent-report measures of parenting. Confirmatory factor analysis (CFA) was conducted on a second sample, which included peers (N = 362, mean age of peers = 13.6, SD = 1.09) and peers' caregivers of the youth included in the original sample. The EFA results indicated a three-factor solution (i.e., parental knowledge and affective relationships, parental control, parental communication and involvement), which was supported in the CFA. The final measure demonstrated strong internal consistency and satisfactory convergent and discriminant validity. This study supported the sound psychometrical features of the Parenting Practice Measure (PPM), a comprehensive measure of parenting quality for adolescent samples. The PPM can serve as a tool for clinicians to design more targeted treatment plans and evaluate the effectiveness of treatments when working with parents with children in the early teenage years.
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Affiliation(s)
- Barry Ladis
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Elisa M Trucco
- Department of Psychology & Center for Children and Families, Florida International University, 11200 SW 8th Street, AHC1 237, Miami, FL 33199, USA
| | - Hui Huang
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Barbara Thomlison
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Nicole M Fava
- Robert Stempel College of Public Health and Social Work & Center for Children and Families, Florida International University, Miami, FL, USA
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Burke SL, Hu T, Naseh M, Fava NM, O’Driscoll J, Alvarez D, Cottler LB, Duara R. Factors influencing attrition in 35 Alzheimer's Disease Centers across the USA: a longitudinal examination of the National Alzheimer's Coordinating Center's Uniform Data Set. Aging Clin Exp Res 2019; 31:1283-1297. [PMID: 30535620 PMCID: PMC6557707 DOI: 10.1007/s40520-018-1087-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 10/30/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE A lack of understanding of the causes of attrition in longitudinal studies of older adults may lead to higher attrition rates and bias longitudinal study results. In longitudinal epidemiological studies of Alzheimer's disease and related dementias, high rates of attrition may cause a systematic underestimation of dementia prevalence and skew the characterization of the disease. This can compromise the generalizability of the study results and any inferences based on the surviving sample may grossly misrepresent the importance of the risk factors for dementia. The National Institute on Aging outlined a National Strategy for Recruitment and Participation in Alzheimer's Disease Clinical Research to address this problem, providing evidence of the magnitude of this problem. METHOD To explore predictors of attrition, this study examined the National Alzheimer's Coordinating Center (NACC) Uniform Data Set, a repository of observations of older adults spanning 11 years, using survival analysis. Four samples were examined: the full sample (n = 30,433), the alive subsample excluding those who died (n = 24,231), the MRI sample [participants with complete MRI data (n = 1104)], and the alive MRI subsample [participants with MRI data excluding those who died (n = 947)]. RESULTS Worsening cognitive impairment, neuropsychiatric symptoms, and difficulty with functional activities predicted attrition, as did lower hippocampal volume in the MRI subsample. Questionable co-participant reliability and an informant other than a spouse also increased risk of attrition. DISCUSSION Special considerations exist in recruiting and retaining older adults in longitudinal studies, and results of baseline psychological, functional, and cognitive functioning should be used to identify targeted retention strategies.
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Affiliation(s)
- Shanna L. Burke
- Florida International University, Robert Stempel College of Public Health and Social Work, School of Social Work, 11200 S.W. 8th Street, AHC5 585, Miami, Florida 33199, 305-348-7462,
| | - Tianyan Hu
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Health Policy and Management, 11200 S.W. 8th Street, AHC5-452, Miami, Florida 33199, 3053488416,
| | - Mitra Naseh
- Florida International University, Robert Stempel College of Public Health and Social Work, School of Social Work, Miami, FL 33199,
| | - Nicole M. Fava
- Florida International University, Robert Stempel College of Public Health and Social Work, School of Social Work, 11200 S.W. 8th Street, AHC5- 566, Miami, FL 33199, 305-348-4568,
| | - Janice O’Driscoll
- Florida International University, Robert Stempel College of Public Health and Social Work, School of Social Work, 11200 S.W. 8th Street, AHC5, Miami, Florida 33199, 305-721-4142,
| | - Daniel Alvarez
- Florida International University, Robert Stempel College of Public Health and Social Work, School of Social Work, 11200 S.W. 8th Street, Miami, Florida 33199,
| | - Linda B. Cottler
- College of Public Health and Health Professions, Dean's Professor and Chair-Department of Epidemiology, College of Public Health and Health Professions and, College of Medicine, University of Florida, 2004 Mowry Drive, PO Box 100231, Gainesville, FL 32611, 352-273-5468,
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach FL 33140, Departments of Neurology, University of Florida College of Medicine, Gainesville, FL and Herbert Wertheim, College of Medicine, Florida International University, Miami,
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Sanchez M, Diez S, Fava NM, Cyrus E, Ravelo G, Rojas P, Li T, Cano MA, De La Rosa M. Immigration Stress among Recent Latino Immigrants: The Protective Role of Social Support and Religious Social Capital. Soc Work Public Health 2019; 34:279-292. [PMID: 31033427 PMCID: PMC9872174 DOI: 10.1080/19371918.2019.1606749] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Religious institutions can be a source of support for recent Latino immigrants struggling to adjust to a new culture. For undocumented immigrants, who are often marginalized from other formal institutions, they may symbolize a place of refuge and hope through supportive social networks that mitigate common challenges such as social isolation and other forms of immigration stress. This cross-sectional study examined the impact of religious social capital and social support on immigration stress among documented and undocumented recent Latino immigrants (N = 408). Religious social capital was associated with higher levels of social support, while social support was protective against immigration stress. Social support mediated associations between religious social capital and immigration stress, but only among undocumented immigrants. Findings suggest religious social capital may be a particularly useful resource for undocumented immigrants, aiding in the provision of social support and in decreasing levels of immigration stress. Future research directions and implications for culturally tailored service delivery are presented.
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Affiliation(s)
- Mariana Sanchez
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel, College of Public Health and Social Work, Florida International University, Miami, Florida, USA
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public, Health and Social Work, Florida International University, Miami, Florida, USA
| | - Stephanie Diez
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel, College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Nicole M. Fava
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Elena Cyrus
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Gira Ravelo
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel, College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Patria Rojas
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel, College of Public Health and Social Work, Florida International University, Miami, Florida, USA
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public, Health and Social Work, Florida International University, Miami, Florida, USA
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Miguel Angel Cano
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel, College of Public Health and Social Work, Florida International University, Miami, Florida, USA
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel, College of Public Health and Social Work, Florida International University, Miami, Florida, USA
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Burke SL, Hu T, Fava NM, Li T, Rodriguez MJ, Schuldiner KL, Burgess A, Laird A. Sex differences in the development of mild cognitive impairment and probable Alzheimer's disease as predicted by hippocampal volume or white matter hyperintensities. J Women Aging 2019; 31:140-164. [PMID: 29319430 PMCID: PMC6039284 DOI: 10.1080/08952841.2018.1419476] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 01/25/2023]
Abstract
This study examined biological sex differences in the development of mild cognitive impairment (MCI) and probable Alzheimer's disease (AD) development as predicted by changes in the hippocampus or white matter hyperintensities. A secondary data analysis of the National Alzheimer's Coordinating Center Uniform Data Set was conducted. We selected samples of participants with normal cognition at baseline who progressed to MCI (n = 483) and those who progressed to probable AD (n = 211) to determine if hippocampal volume or white matter hyperintensities (WMH) at baseline predicted progression to probable AD or MCI and whether the rate of progression differed between men and women. The survival analyses indicated that changes in hippocampal volumes affected the progression to probable AD (HR = 0.535, 95% CI [0.300-0.953]) only among women. White men had an increased rate of progression to AD (HR = 4.396, CI [1.012-19.08]; HR = 4.665, 95% CI [1.072-20.29]) compared to men in other race and ethnic groups. Among women, increases in hippocampal volume ratio led to decreased rates of progressing to MCI (HR = 0.386, 95% CI [0.166-0.901]). Increased WMH among men led to faster progression to MCI (HR = 1.048. 95% CI [1.011-1.086]). Women and men who were older at baseline were more likely to progress to MCI. In addition, results from longitudinal analyses showed that women with a higher CDR global score, older age at baseline, or more disinhibition symptoms experienced higher odds of MCI development. Changes in hippocampal volumes affect the progression to or odds of probable AD (and MCI) more so among women than men, while changes in WMH affected the progression to MCI only among men.
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Affiliation(s)
- Shanna L. Burke
- Robert Stempel College of Public Health & Social Work, School of Social Work, Florida International University, Miami, Florida, USA
| | - Tianyan Hu
- Department of Health Policy and Management, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Nicole M. Fava
- Robert Stempel College of Public Health & Social Work, School of Social Work, Florida International University, Miami, Florida, USA
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Miriam J. Rodriguez
- Psychology Doctoral Program, Albizu University-Miami Campus, Miami, Florida, USA
| | - Katie L. Schuldiner
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Aaron Burgess
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Angela Laird
- Department of Physics, Center for Imaging Science, Florida International University, Miami, Florida, USA
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18
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Burke SL, Hu T, Fava NM, Duara R, O’Driscoll J, Alvarez D. FACTORS INFLUENCING ATTRITION IN 35 ALZHEIMER’S DISEASE CENTERS ACROSS THE UNITED STATES: A LONGITUDINAL EXAMINATION OF THE NATIONAL ALZHEIMER’S COORDINATING CENTER’S UNIFORM DATA SET. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2035] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S L Burke
- Florida International University, Miami, Florida, United States
| | - T Hu
- Florida International University Robert Stempel College of Public Health and Social Work Department of Health Policy and Management, Miami
| | - N M Fava
- Florida International University, Miami, FL, USA
| | - R Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Miami Beach FL, USA
| | - J O’Driscoll
- Florida International University Robert Stempel College of Public Health and Social Work School of Social Work, Miami, Florida
| | - D Alvarez
- Florida International University, Miami, FL, USA
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Abstract
There is a wealth of knowledge regarding negative sexual outcomes experienced by youth with childhood maltreatment (CM) histories, yet a dearth of research examines healthy sexual development among these youth. This gap exists despite evidence of resilience highlighting alternative and healthy physical, social, and psychological futures for youth who were abused. This study tested whether trajectories of resilience identified in studies of psychological functioning were applicable to sexual health. Using data from the first four waves of the National Longitudinal Study of Adolescent to Adult Health, latent class growth analysis was conducted among individuals with histories of CM (N = 1,437). On average, participants were 15, 16, 21, and 28 years old, respectively, by waves of data collection. About half of the sample was female (55%), the majority were White (66%), and a sizeable portion had experienced multiple forms of CM prior to Wave I (38%). Controlling for CM severity, three distinct sexual health trajectory classes were identified: resilient, survival, and improving, which were differentiated by age and biological sex. Older participants' sexual health was more likely to diminish over time, girls were more likely to show gains in sexual health over time, and significant differences in levels of sexual behaviors between the classes were only present during adolescence. Findings support the need for increased attention on the potential for sexual health despite experiences of CM, and highlight the applicability of resilience theory to youth sexuality.
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Affiliation(s)
- Nicole M Fava
- a Robert Stempel College of Public Health & Social Work , Florida International University , Miami , FL , USA.,e Center for Children and Families , Florida International University , Miami , FL , USA
| | - Laina Y Bay-Cheng
- b School of Social Work , University at Buffalo , Buffalo , NY , USA
| | | | - Julie C Bowker
- c Department of Psychology , University at Buffalo , Buffalo , NY , USA
| | - Timothy Hayes
- d Department of Psychology , Florida International University , Miami , FL , USA.,e Center for Children and Families , Florida International University , Miami , FL , USA
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Munro-Kramer ML, Fava NM, Banerjee T, Darling-Fisher CS, Pardee M, Villarruel AM, Martyn KK. The Effect of a Youth-Centered Sexual Risk Event History Calendar (SREHC) Assessment on Sexual Risk Attitudes, Intentions, and Behavior. J Pediatr Health Care 2017; 31:302-313. [PMID: 27773349 PMCID: PMC5398950 DOI: 10.1016/j.pedhc.2016.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/09/2016] [Accepted: 09/11/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The purpose of this study was to examine the effect of a youth-centered assessment, the Sexual Risk Event History Calendar (SREHC), compared with the Guidelines for Adolescent Preventive Services (GAPS) assessment, on sexual risk attitudes, intentions, and behaviors. METHODS The Interaction Model of Client Health Behavior guided this participatory research-based randomized control trial. Youth participants recruited from university and community clinics in the Midwestern United States were randomized to a health care provider visit using either the SREHC or GAPS and completed surveys at baseline, postintervention, and 3, 6, and 12 months. RESULTS Participants included 181 youth (15-25 years old) and nine providers. Findings showed that youth in the SREHC group reported stronger intentions to use condoms compared with those in the GAPS group. Age and race were also significant predictors of sexual experience. DISCUSSION This study highlights the importance of using a youth-centered, systematic approach in the assessment of sexual risk behaviors.
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21
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Fava NM, Munro-Kramer ML, Felicetti IL, Darling-Fisher CS, Pardee M, Helman A, Trucco EM, Martyn KK. Patient-Centered Participatory Research in Three Health Clinics: Benefits, Challenges, and Lessons Learned. West J Nurs Res 2016; 38:1509-1530. [PMID: 27338752 PMCID: PMC5182169 DOI: 10.1177/0193945916654665] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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] [Indexed: 11/16/2022]
Abstract
Research informed by individuals' lived experiences is a critical component of participatory research and nursing interventions for health promotion. Yet, few examples of participatory research in primary care settings with adolescents and young adults exist, especially with respect to their sexual health and health-risk behaviors. Therefore, we implemented a validated patient-centered clinical assessment tool to improve the quality of communication between youth patients and providers, sexual risk assessment, and youths' health-risk perception to promote sexual health and reduce health-risk behaviors among adolescents and young adults in three community health clinic settings, consistent with national recommendations as best practices in adolescent health care. We describe guiding principles, benefits, challenges, and lessons learned from our experience. Improving clinical translation of participatory research requires consideration of the needs and desires of key stakeholders (e.g., providers, patients, and researchers) while retaining flexibility to successfully navigate imperfect, real-world conditions.
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Munro-Kramer ML, Fava NM, Saftner MA, Darling-Fisher CS, Tate NH, Stoddard SA, Martyn KK. What are we missing? Risk behaviors among Arab-American adolescents and emerging adults. J Am Assoc Nurse Pract 2016; 28:493-502. [PMID: 26990394 PMCID: PMC5010467 DOI: 10.1002/2327-6924.12352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 07/22/2015] [Accepted: 01/16/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Research on Arab-Americans as a distinct ethnic group is limited, especially when considering the health of Arab-American youth. This study describes health risk (substance use, violence); health promotive behaviors (hope, spirituality); and sexual activity (oral, vaginal, anal sex) of Arab-American adolescents and emerging adults (aged 15-23) within their life context, as well as the association between these behaviors. METHODS A secondary analysis of data on a subset of Arab-American participants obtained from a randomized-control trial was utilized to conduct mixed methods analyses. Qualitative analyses completed on the open-ended questions used the constant comparative method for a subsample (n = 24) of participants. Descriptive quantitative analyses of survey data utilized bivariate analyses and stepwise logistic regression to explore the relation between risk behaviors and sexual activity among the full sample (n = 57). CONCLUSIONS Qualitative analyses revealed two groups of participants: (a) multiple risk behaviors and negative life-events, and (b) minimal risk behaviors and positive life-events. Quantitative analyses indicated older youth, smokers, and those with higher hope pathways were more likely to report vaginal sex. IMPLICATIONS FOR PRACTICE The unique cultural and social contexts of Arab-American youth provide a framework for recommendations for the prevention of risk behaviors.
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Affiliation(s)
| | - Nicole M. Fava
- Florida International Institute Robert Stempel College of Public Health & Social Work, 11200 SW 8 Street, AHC5 505, Miami, FL 33199, Telephone: 305-348-4903,
| | - Melissa A. Saftner
- University of Minnesota School of Nursing, 6-165 Weaver-Densford Hall, Minneapolis, MN 55455-0213, Telephone: 218-726-8934,
| | - Cynthia S. Darling-Fisher
- University of Michigan School of Nursing, 400 N. Ingalls, Room 3176, Ann Arbor, MI 48109-5482, Telephone: 734-647-0328,
| | - Nutrena H. Tate
- Wayne State University College of Nursing, 5557 Cass, 140 Cohn, Detroit, MI 48202, Telephone: 313-557-1754,
| | - Sarah A. Stoddard
- University of Michigan School of Nursing, 400 N. Ingalls, Room 3344, Ann Arbor, MI 48109-5482, Telephone: 734-647-0327,
| | - Kristy K. Martyn
- Director of the Doctor of Nursing Practice Program, Independence Chair in Nursing, Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, NE, Rm 336, Atlanta, GA 30322, Telephone: 404-727-6913,
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Fava NM, Simon VA, Smith E, Khan M, Kovacevic M, Rosenblum KL, Menke R, Muzik M. Perceptions of general and parenting-specific posttraumatic change among postpartum mothers with histories of childhood maltreatment. Child Abuse Negl 2016; 56:20-9. [PMID: 27131270 PMCID: PMC4884472 DOI: 10.1016/j.chiabu.2016.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 04/05/2016] [Accepted: 04/14/2016] [Indexed: 05/23/2023]
Abstract
Although adaptive meanings of childhood maltreatment (CM) are critical to posttraumatic adaptation, little is known about perceptions of posttraumatic change (PTC) during the vulnerable postpartum period. PTC may be positive or negative as well as global or situational. This study examined general and parenting-specific PTC among 100 postpartum women with CM histories (Mage=29.5 years). All reported general and 83% reported parenting PTC. General PTC were more likely to include negative and positive changes; parenting PTC were more likely to be exclusively positive. Indicators of more severe CM (parent perpetrator, more CM experiences) were related to parenting but not general PTC. Concurrent demographic risk moderated associations between number of CM experiences and positive parenting PTC such that among mothers with more CM experiences, demographic risk was associated with stronger positive parenting PTC. Results highlight the significance of valence and specificity of PTC for understanding meanings made of CM experiences.
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Affiliation(s)
- Nicole M Fava
- Merrill Palmer Skillman Institute & Department of Psychology, Wayne State University, United States
| | - Valerie A Simon
- Merrill Palmer Skillman Institute & Department of Psychology, Wayne State University, United States
| | - Erin Smith
- Merrill Palmer Skillman Institute & Department of Psychology, Wayne State University, United States
| | - Maria Khan
- Merrill Palmer Skillman Institute & Department of Psychology, Wayne State University, United States
| | - Merdijana Kovacevic
- Merrill Palmer Skillman Institute & Department of Psychology, Wayne State University, United States
| | - Katherine L Rosenblum
- Department of Psychiatry & Center for Human Growth and Development, University of Michigan, United States
| | - Rena Menke
- Department of Psychiatry, University of Michigan, United States
| | - Maria Muzik
- Department of Psychiatry & Center for Human Growth and Development, University of Michigan, United States.
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Martyn KK, Munro ML, Darling-Fisher CS, Ronis DL, Villarruel AM, Pardee M, Faleer HE, Fava NM. Patient-centered communication and health assessment with youth. Nurs Res 2014; 62:383-93. [PMID: 24165214 DOI: 10.1097/nnr.0000000000000005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Patient-centered communication is fundamental to individualizing healthcare, but there has been limited evaluation of provider communication with youth. OBJECTIVES The aim was to compare communication outcomes after use of an event history calendar (EHC) and Guidelines for Adolescent Preventive Services (GAPS) to structure interactions during a clinic visit. Patient and provider descriptions of EHC and GAPS communication experiences were also obtained. METHODS This is a secondary analysis of data obtained during a randomized controlled trial. A sequential explanatory mixed-methods approach was used. A split-plot design with one between factor (EHC, GAPS) and one within factor (pretest, posttest) was used for the quantitative portion. Qualitative data were collected from open-ended questions, audiotaped visits, and exit interviews. Providers (n = 9) at three clinics were assigned at random and trained to implement either the EHC or GAPS protocol. Male and female youth (n = 186) were randomly assigned to the EHC or GAPS intervention. Before their clinic visit, youth completed assessments of past communication experiences with healthcare providers (pretest); communication during the current visit was assessed immediately after the visit (posttest). RESULTS Communication outcomes from pretest to posttest improved for youth in both the EHC and GAPS groups. Post hoc subgroup analysis suggested that men and Arab Americans derived more benefit from the EHC intervention in some aspects of communication. Qualitatively, the EHC group identified improved outcomes in validating patient perspective, being viewed in context, reaching a shared understanding of needs and preferences, and being helped to share power in the healthcare interaction. DISCUSSION EHC and GAPS provided effective frameworks for structuring communication during a clinic visit. Compared with GAPS, the integrated time-linked assessment captured by the EHC enhanced patient-centered communication in select groups.
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Affiliation(s)
- Kristy K Martyn
- Kristy K. Martyn, PhD, RN, CPNP-PC, FNP-BC, is Acting Professor and Assistant Dean of Clinical Advancement, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA. Michelle L. Munro, MS, RN, CNM, FNP-BC, is Research Fellow, Cynthia S. Darling-Fisher, PhD, RN, FNP-BC, is Clinical Assistant Professor; David L. Ronis, PhD, is Research Scientist; Antonia M. Villarruel, PhD, RN, FAAN, is Professor, Nola J. Pender Collegiate Chair; and Michelle Pardee, DNP, RN, FNP-BC, is Clinical Assistant Professor, School of Nursing, University of Michigan, Ann Arbor. Hannah E. Faleer, BS, is Doctoral Student, Department of Psychology, Northern Illinois University, DeKalb. Nicole M. Fava, PhD, MSW, is Postdoctoral Fellow, Wayne State University, Detroit, MI
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Munro ML, Martyn KK, Fava NM, Helman A. Inter-Rater Reliability of the Measure of Patient-Centered Communication in Health Promotion Clinic Visits with Youth. Int J Commun Health 2014; 3:34-42. [PMID: 25705720 PMCID: PMC4332588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Patient-centered communication during clinic visits is critical for a patient and provider to establish a relationship that explores the patient's needs and desires and tailors health care accordingly. However, there are currently limitations to measuring patient-centered communication within the clinic visit. This study will examine the inter-rater reliability of a modified version of the Measure of Patient-Centered Communication (MPCC) for use with youth in health promotion clinic visits. Transcripts from actual patient-provider interactions (n=11) with 17-23 year old participants and providers (n=6; NPs and MDs) were analyzed for inter-rater reliability of a modified version of the MPCC. The MPCC demonstrated satisfactory inter-rater reliability among the five components of patient-centered communication (kappa=0.78) and good mean inter-rater reliability among the five provider responses (percent agreement=87.5%). Measuring patient-centered communication presents challenges. This study demonstrated that the MPCC could be a potential tool in this endeavor; however, adjustments are needed for it to be a reliable measure of patient-centered communication during clinic visits with youth. In order to provide patient-centered communication and care we must be able to accurately measure the communication and techniques being implemented in all patient visits.
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Affiliation(s)
- Michelle L. Munro
- University of Michigan, School of Nursing, 400 North Ingalls Building, Room 3188, Ann Arbor, MI 48109-5482, Telephone: 734-647-0154, Fax: 734-647-0351
| | | | - Nicole M. Fava
- Wayne State University, Merrill Palmer Skillman Institute
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Fava NM, Bay-Cheng LY. Young women's adolescent experiences of oral sex: relation of age of initiation to sexual motivation, sexual coercion, and psychological functioning. J Adolesc 2012; 35:1191-201. [PMID: 22546273 DOI: 10.1016/j.adolescence.2012.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2010] [Revised: 12/21/2011] [Accepted: 03/22/2012] [Indexed: 10/28/2022]
Abstract
Research examining oral sex during adolescence tends to investigate only potential negative consequences without considering its place in sexual development or distinctions between cunnilingus and fellatio. Using retrospective reports from 418 undergraduate women, we examined the relations among young women's ages of initiation of both cunnilingus and fellatio and sexual motives, experiences of sexual coercion, and indicators of psychological functioning. Age at cunnilingus initiation was unrelated to sexual coercion or psychological functioning; however it was related to engaging in sex for personal stimulation and gratification (personal drive motive) and to feel agentic, assertive, and skillful (power motive). Age at fellatio initiation was related to feelings of inferiority compared to others and a devaluing of the self (interpersonal sensitivity). Findings challenge the unilateral assumption that all adolescent sexual activity is negative and indicate the need for future research distinguishing between cunnilingus and fellatio.
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Affiliation(s)
- Nicole M Fava
- School of Social Work, University at Buffalo, 685 Baldy Hall, Buffalo, NY 14260-1050, USA.
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Abstract
Recent studies indicate that cunnilingus may be as prevalent as fellatio among American adolescents. Despite this approximate equivalence in rates, there is an imbalance in the amount and type of attention paid to fellatio and cunnilingus. Furthermore, there has been little empirical examination of young women's experiences and perceptions of cunnilingus during adolescence. Two studies in response to this gap in knowledge were conducted. In Study 1, regression analyses indicated that a young woman's sexual assertiveness was linked to having more lifetime cunnilingus partners, as well as more cunnilingus experiences in the past three months. Study 2 explored young women's perceptions of cunnilingus and their speculations about their male partners' perceptions thereof. Linear mixed modeling revealed that participants had highly favorable impressions of cunnilingus, which they believed their male partners shared. These findings are considered in terms of positive adolescent sexual development and cultural norms regarding female sexuality.
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Affiliation(s)
- Laina Y Bay-Cheng
- School of Social Work, University at Buffalo, Buffalo, NY 14260-1050, USA
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Bay-Cheng LY, Livingston JA, Fava NM. Adolescent Girls' Assessment and Management of Sexual Risks: Insights from Focus Group Research. Youth Soc 2011; 43:1167-1193. [PMID: 21860537 PMCID: PMC3158581 DOI: 10.1177/0044118x10384475] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We conducted focus groups with girls ages 14 to 17 (N = 43) in order to study how the dominant discourse of sexual risk shapes young women's understanding of the sexual domain and their management of these presumably pervasive threats. Through inductive analysis, we developed a coding scheme focused on three themes: (a) types of sexual risk; (b) factors that moderate sexual risk; and (c) strategies for managing sexual risk. Collectively, participants identified many risks but distanced themselves from these by claiming that girls' susceptibility is largely a function of personal factors and therefore avoidable given the right traits, values, and skills. We consider this reliance on other-blaming and self-exemption, as well as instances in which individual participants diverged from this group discourse, in the context of neoliberalism.
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Affiliation(s)
- Laina Y. Bay-Cheng
- 685 Baldy Hall, School of Social Work, University at Buffalo, Buffalo, NY 14260-1050; 716/645-1225 (phone); 716/645-3456 (fax);
| | - Jennifer A. Livingston
- Research Institute on Addictions, 1021 Main Street, Buffalo, NY 14203; 716/887-2380 (phone); 716/887-2215 (fax);
| | - Nicole M. Fava
- 685 Baldy Hall, School of Social Work, University at Buffalo, Buffalo, NY 14260-1050; 716/645-1225 (phone); 716/645-3456 (fax);
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