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Choi J, Gabay EK, Cuccaro PM. School Teachers' Perceptions of Adolescent Human Papillomavirus (HPV) Vaccination: A Systematic Review. Vaccines (Basel) 2024; 12:361. [PMID: 38675743 PMCID: PMC11053788 DOI: 10.3390/vaccines12040361] [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: 02/10/2024] [Revised: 03/13/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
School nurses are uniquely positioned to educate students about immunizations, including human papillomavirus (HPV) vaccination, but schools are often without a nurse for different reasons. In lieu of nurses, teachers who closely interact with students and are traditionally well-trusted by parents may be able to communicate about HPV vaccination, alleviating parental vaccine hesitancy. This systematic review explores school teachers' perspectives on adolescent HPV vaccination and factors influencing their willingness to make vaccine recommendations. We searched three databases with appropriate medical subject headings and keywords to identify relevant studies. We reviewed fifteen studies and provided an extensive summary and a comparison of the results across the studies. Teachers had low to moderate levels of HPV knowledge with low self-efficacy to counsel parents about the HPV vaccine and expressed concerns about the vaccine condoning adolescent sexual activity, vaccine side effects, and parental disapproval. Nonetheless, some teachers showed interest in learning about vaccine effectiveness in preventing HPV-associated cancers and wanted guidance on vaccine communication with parents, viewing schools as adequate venues to promote and deliver HPV vaccines. Schools should consider educating teachers on HPV and HPV vaccination, with a focus on effective vaccine communication practices to increase adolescent HPV vaccine uptake.
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Affiliation(s)
- Jihye Choi
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA;
- Center for Health Promotion and Preventive Research, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA;
| | - Efrat K. Gabay
- Center for Health Promotion and Preventive Research, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA;
| | - Paula M. Cuccaro
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA;
- Center for Health Promotion and Preventive Research, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA;
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Cuccaro PM, Choi J, Gabay EK, Wilkerson JM, Santa Maria D, Misra SM, Aguilar McBride M, Vernon SW. Lessons Learned from All for Them: Best Practices for a Cross-Collaboration Approach to HPV Vaccination in Public Schools. Vaccines (Basel) 2023; 11:vaccines11050946. [PMID: 37243050 DOI: 10.3390/vaccines11050946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/05/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
The Community Preventive Services Task Force endorses vaccination programs in schools to increase access to vaccinations. However, implementing a school-based approach requires substantial coordination, planning, and resources. All for Them (AFT) is a multilevel, multicomponent approach to increase HPV vaccination among adolescents attending public schools in medically underserved areas in Texas. AFT comprised a social marketing campaign, school-based vaccination clinics, and school nurse continuing education. Process evaluation metrics and key informant interviews to understand experiences with AFT program implementation informed lessons learned. Lessons emerged in six domains: strong champion, school-level support, tailored and cost-effective marketing approaches, mobile provider collaboration, community presence, and crisis management. Strong support at district and school levels is vital for gaining principal and school nurse buy-in. Social marketing strategies are integral to program implementation and should be adjusted to maximize their effectiveness in motivating parents to vaccinate children against HPV, which also can be achieved through increased community presence of the project team. Preparing contingency plans and flexibility within the program can facilitate appropriate responses to provider restrictions in mobile clinics or in the event of unforeseen crises. These important lessons can offer useful guidelines for the development of prospective school-based vaccination programs.
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Affiliation(s)
- Paula M Cuccaro
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA
- Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA
| | - Jihye Choi
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA
| | - Efrat K Gabay
- Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA
| | - J Michael Wilkerson
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA
- Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA
| | - Diane Santa Maria
- Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA
- Cizik School of Nursing, The University of Texas Health Science Center at Houston, 6901 Bertner Ave., Houston, TX 77030, USA
| | | | - Mayra Aguilar McBride
- Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA
| | - Sally W Vernon
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, USA
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Leos RA, Cuccaro PM, Herbold JR, Hernandez BF. School Parent Attitudes and Perceptions Relating to Animals, Animal-Assisted Interventions, and the Support of Children’s Mental Health. Healthcare (Basel) 2023; 11:healthcare11070963. [PMID: 37046890 PMCID: PMC10094665 DOI: 10.3390/healthcare11070963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/15/2023] [Accepted: 03/26/2023] [Indexed: 03/30/2023] Open
Abstract
Growing awareness of the negative effects of trauma has led San Antonio, TX, school districts to expand efforts that can help mitigate these effects and support mental health. Given the literature around the psychological benefits of human–animal interactions, the concept of incorporating animals in treatments or interventions is not a new one. While schools have begun considering or utilizing animal-assisted interventions (AAIs), there have been limited efforts to understand existing perceptions relating to animals and AAIs among school parents in this Hispanic community. To address this gap, a cross-sectional study consisting of a 34-item survey was conducted to explore attitudes, knowledge, and perceptions relating to animals (i.e., pets), AAIs, and the need for supporting young children’s mental health among parents. A total of 187 surveys from two school districts were completed and utilized for analysis. The study’s findings demonstrate that parents acknowledged the importance of addressing mental health issues early on and were aware of the health benefits human–animal interactions can provide. Furthermore, parents had positive attitudes toward pets and positive perceptions toward AAIs in schools. Some implementation concerns were expressed relating to safety and well-being. Overall, these findings suggest there is existing parent support in using AAIs as a trauma-informed strategy and school innovation.
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Thomas RD, Davis JW, Cuccaro PM, Gemeinhardt GL. Assessing associations between insecure income and US workers’ health: An IPUMS-MEPS analysis. Soc Sci Med 2022; 309:115240. [DOI: 10.1016/j.socscimed.2022.115240] [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] [Received: 04/02/2022] [Revised: 07/01/2022] [Accepted: 07/23/2022] [Indexed: 10/15/2022]
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Leos RA, Cuccaro PM, Herbold JR, Hernandez BF. Exploring School Staff Perceptions Relating to Animals and Their Involvement in Interventions to Support Mental Health. Int J Environ Res Public Health 2022; 19:ijerph19127126. [PMID: 35742375 PMCID: PMC9223198 DOI: 10.3390/ijerph19127126] [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] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 02/05/2023]
Abstract
Given the growing awareness of the health benefits of human–animal interactions, the use of animal-assisted interventions (AAIs) in educational settings has increased over the years. While many school districts are now considering or utilizing AAIs, the literature investigating AAI-related perceptions among school stakeholders is limited with previous studies focusing on evaluating specific programs. To address this gap, a qualitative exploratory study was conducted using semi-structured interviews with school staff in the San Antonio, TX community. A total of 11 interviews were completed with staff serving preschool and elementary school age children. Data collected from interviews were analyzed using thematic analysis. Findings demonstrated that participating staff had some knowledge of the potential benefits of human–animal interactions and perceived the involvement of animals in interventions to be beneficial to children’s emotions and social-emotional skills. While perceptions of AAIs were generally positive, concerns around children’s safety and well-being were expressed as potential barriers in the adoption of AAIs in schools. These findings are preliminary and provide a segue to future research that can help expand our understanding of how school staff perceive AAIs, their impact on children’s mental health, their compatibility with school values, and their advantage relative to other interventions.
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Walker TJ, Szeszulski J, Robertson MC, Cuccaro PM, Fernandez ME. Understanding implementation strategies to support classroom-based physical activity approaches in elementary schools: A qualitative study. Eval Program Plann 2022; 92:102051. [PMID: 35240403 PMCID: PMC9177707 DOI: 10.1016/j.evalprogplan.2022.102051] [Citation(s) in RCA: 6] [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] [Received: 05/28/2020] [Revised: 10/15/2021] [Accepted: 02/11/2022] [Indexed: 06/03/2023]
Abstract
BACKGROUND Classroom-based physical activity approaches can improve children's physical activity levels during school. However, the implementation of these approaches remains a challenge. The purpose of this study was to examine implementation strategies to support the delivery of classroom-based physical activity approaches from the perspectives of elementary school staff. METHODS We conducted individual interviews with elementary school staff from a mid-sized school district in Texas. Interviews lasted approximately 60 min and were audio recorded and transcribed for analyses. We used directed content analysis and an iterative categorization approach to identify emerging themes related to implementation strategies. RESULTS We interviewed 15 participants (4 classroom teachers, 4 physical education teachers, 3 assistant principals, and 4 principals) about implementation strategies supporting classroom-based physical activity approaches. Four prominent themes related to implementation strategies emerged: 1) the role of program champions, 2) the use and function of staff training, 3) the importance of strategic planning, and 4) the use of positive reinforcements to support implementation. CONCLUSIONS Results highlight the need for multiple implementation strategies to support the delivery of classroom-based physical activity approaches. Results also highlight potential mechanisms through which the implementation strategies operate. This information is valuable to future planning efforts for classroom-based physical activity approaches.
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Affiliation(s)
- Timothy J Walker
- University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research, 7000 Fannin St., Houston, TX 77030, USA.
| | - Jacob Szeszulski
- University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research, 7000 Fannin St., Houston, TX 77030, USA.
| | - Michael C Robertson
- University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research, 7000 Fannin St., Houston, TX 77030, USA; MD Anderson Cancer Center, Center for Energy Balance, Department of Behavioral Science, Houston, TX 77030, USA.
| | - Paula M Cuccaro
- University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research, 7000 Fannin St., Houston, TX 77030, USA.
| | - Maria E Fernandez
- University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion & Behavioral Sciences, Center for Health Promotion and Prevention Research, 7000 Fannin St., Houston, TX 77030, USA.
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Peskin MF, Coyle KK, Anderson PM, Laris BA, Glassman JR, Franks HM, Thiel MA, Potter SC, Unti T, Edwards S, Johnson-Baker K, Cuccaro PM, Diamond P, Markham CM, Shegog R, Baumler ER, Gabay EK, Emery ST. Replication of It's Your Game…Keep It Real! in Southeast Texas. J Prim Prev 2020; 40:297-323. [PMID: 31028508 DOI: 10.1007/s10935-019-00549-0] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Despite the recent efforts of the Office of Adolescent Health to replicate programs with demonstrated efficacy, there are still few evidence-based HIV, sexually transmitted infection (STI), and teen pregnancy prevention programs that have been replicated in "real-world" settings. To test the effectiveness of It's Your Game…Keep It Real! (IYG), an evidence-based STI and pregnancy prevention program for middle schools, the curriculum was implemented by teachers in urban and suburban middle schools in Southeast Texas from 2012 to 2015. IYG was evaluated using a group-randomized wait-list controlled effectiveness trial design in which 20 middle schools in nine urban and suburban school districts in Southeast Texas were randomized equally, using a multi-attribute randomization protocol, to either the intervention condition (received IYG) (n = 10 schools comprising 1936 eligible seventh graders) or the comparison condition (received usual care) (n = 10 schools comprising 1825 eligible seventh graders). All students were blinded to condition prior to administering the baseline survey. The analytic sample comprised 1543 students (n = 804, intervention; n = 739, comparison) who were followed from baseline (seventh grade) to the 24-month follow-up (ninth grade). Multilevel regression analyses were conducted to assess behavioral and psychosocial outcomes at follow-up. There were no significant differences in initiation of vaginal or oral sex between study conditions at follow-up. However, at 12-month follow-up, compared with students in the comparison condition, students in the intervention condition reported increased knowledge, self-efficacy, and perceived favorable norms related to HIV/STIs, condoms, and/or abstinence; decreased intentions to have sex; and increased intentions to use birth control. Knowledge outcomes were statistically significant at 24-month follow-up. This IYG effectiveness trial did not replicate the behavioral effects of the original IYG efficacy trials. However, it adds to the growing literature on the replication of evidence-based programs, and underscores the need to better understand how variations in implementation, setting, and measurement affect the behavioral impact of such programs.Clinical trial registration clinicaltrials.gov (NCT03533192).
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Affiliation(s)
- Melissa F Peskin
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA.
| | | | | | | | | | | | | | | | | | | | - Kimberly Johnson-Baker
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Paula M Cuccaro
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Pamela Diamond
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Christine M Markham
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Ross Shegog
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Elizabeth R Baumler
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Efrat K Gabay
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
| | - Susan Tortolero Emery
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, 77030, USA
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Ibekwe LN, Cuccaro PM, Savas LS, Valerio MA, Foxhall LE, Fernandez ME. Abstract C112: Implementing a colorectal cancer screening intervention in Texas FQHCs: A qualitative evaluation of provider perceptions. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp19-c112] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background: Federally qualified health centers (FQHCs) are well positioned to increase colorectal cancer screening (CRCS) in underserved populations who most often have low screening rates, including racial/ethnic minorities, the uninsured, and low SES individuals. To optimize effectiveness and promote sustainability of CRCS programs in FQHCs, we assessed provider/staff perceptions of the facilitators and barriers to implementing the Alliance for Colorectal Cancer Testing (ACT) program in Texas FQHCs, funded by the Cancer Prevention & Research Institute of Texas (CPRIT). Methods: UTHealth School of Public Health research staff conducted in-depth, face-to-face, semi-structured interviews in English with providers/staff at ACT FQHCs. Interviews lasted 30-45 minutes and elicited perceptions about facilitators and barriers to implementation of ACT. They were audio recorded, transcribed, and coded by hand deductively, using thematic content analysis to identify key themes. Results: We interviewed 20 individuals across 5 ACT FQHCs. Most were non-Hispanic white (38%) and female (88%). Years worked at clinic ranged from 11 months to 11 years (mean 6.2 years) and hours worked per week ranged from 12-60 hours (mean 42.2). Participants’ positions ranged from clinic CEO to provider to clerical staff. Seven themes emerged as facilitators to implementation: 1) external support (e.g., large cancer center facilitated implementation); 2) external funding (e.g., covered screening and diagnostic services); 3) patient tracking and monitoring (e.g., patient list review, FIT distribution/follow-up); 4) clinic leadership and staff support (e.g., clinic level prioritization of CRCS, understanding/acceptance of roles, active leadership support); 5) staff training; 6) same day FIT return (e.g., completing FIT at clinic or at home and returning same day); and 7) community outreach (e.g., newsletters, FIT distribution at community events). Four themes emerged as barriers: 1) CRCS completion and return process/structure (e.g., USPS refusal to pickup/deliver samples, patient inability to return FIT, FIT completion errors, lab delays); capacity (e.g., perception that patients and providers lack time); education (e.g., perception of patient lack of understanding of risk); and clinic resources (e.g., need for simple, bilingual educational materials). Conclusion: In addition to maintaining program facilitators, increased CRCS patient education/awareness, simple and bilingual educational materials, processes to support FIT return, a contact person coordinating CRCS tasks, ongoing staff training, and a clinic manual describing all roles/responsibilities are important for improved implementation and sustainability of ACT. Findings from this evaluation will help inform development of strategies to facilitate FQHCs’ implementation of ACT and other intervention strategies to increase CRCS by reducing two key factors, financial and structural barriers.
Citation Format: Lynn N Ibekwe, Paula M Cuccaro, Lara S Savas, Melissa A Valerio, Lewis E Foxhall, Maria E Fernandez. Implementing a colorectal cancer screening intervention in Texas FQHCs: A qualitative evaluation of provider perceptions [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C112.
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Affiliation(s)
- Lynn N Ibekwe
- 1The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion & Prevention Research, Houston, TX, USA,
| | - Paula M Cuccaro
- 1The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion & Prevention Research, Houston, TX, USA,
| | - Lara S Savas
- 1The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion & Prevention Research, Houston, TX, USA,
| | - Melissa A Valerio
- 1The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion & Prevention Research, Houston, TX, USA,
| | - Lewis E Foxhall
- 2The University of Texas MD Anderson Cancer Center, Office of Health Policy, Houston, TX, USA
| | - Maria E Fernandez
- 1The University of Texas Health Science Center at Houston School of Public Health, Center for Health Promotion & Prevention Research, Houston, TX, USA,
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Peskin MF, Markham CM, Shegog R, Baumler ER, Addy RC, Temple JR, Hernandez B, Cuccaro PM, Thiel MA, Gabay EK, Tortolero Emery SR. Adolescent Dating Violence Prevention Program for Early Adolescents: The Me & You Randomized Controlled Trial, 2014-2015. Am J Public Health 2019; 109:1419-1428. [PMID: 31415194 PMCID: PMC6727296 DOI: 10.2105/ajph.2019.305218] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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] [Accepted: 06/04/2019] [Indexed: 11/04/2022]
Abstract
Objectives. To test the efficacy of Me & You, a multilevel technology-enhanced adolescent dating violence (DV) intervention, in reducing DV perpetration and victimization among ethnic-minority early adolescent youths. We assessed secondary impact for specific DV types and psychosocial outcomes.Methods. We conducted a group-randomized controlled trial of 10 middle schools from a large urban school district in Southeast Texas in 2014 to 2015. We used multilevel regression modeling; the final analytic sample comprised 709 sixth-grade students followed for 1 year.Results. Among the total sample, odds of DV perpetration were lower among intervention students than among control students (adjusted odds ratio = 0.46; 95% confidence interval = 0.28, 0.74). Odds of DV victimization were not significantly different. There were significant effects on some specific DV types.Conclusions. Me & You is effective in reducing DV perpetration and decreasing some forms of DV victimization in early middle-school ethnic-minority students.
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Affiliation(s)
- Melissa F Peskin
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Christine M Markham
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Ross Shegog
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Elizabeth R Baumler
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Robert C Addy
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Jeff R Temple
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Belinda Hernandez
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Paula M Cuccaro
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Melanie A Thiel
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Efrat K Gabay
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
| | - Susan R Tortolero Emery
- At the time of the study, Melissa F. Peskin, Christine M. Markham, Ross Shegog, Elizabeth R. Baumler, Robert C. Addy, Belinda Hernandez, Paula M. Cuccaro, Melanie A. Thiel, Efrat K. Gabay, and Susan R. Tortolero Emery were with the Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston. Jeff R. Temple is with the University of Texas Medical Branch, Galveston
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Jetelina KK, Reingle Gonzalez JM, Cuccaro PM, Peskin MF, Pompeii L, Atem F, Elliott MN, Earnshaw VA, Davies SL, Schuster MA. Mechanisms and Frequency of Violent Injuries Among Victims and Perpetrators of Bullying. J Adolesc Health 2019; 64:664-670. [PMID: 30612808 DOI: 10.1016/j.jadohealth.2018.10.295] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 07/10/2018] [Revised: 10/02/2018] [Accepted: 10/26/2018] [Indexed: 01/17/2023]
Abstract
PURPOSE This article aims to (1) evaluate whether bullying typology predicts violent injury; (2) longitudinally examine whether violent injury trajectories differ across bullying typology as children age; and (3) longitudinally determine whether children who consistently reported perpetration or victimization (i.e., reported bullying at fifth, seventh, and 10th grade) were different from children who inconsistently reported perpetration or victimization. METHODS Longitudinal data were obtained from 4,297 children at three waves (fifth, seventh, and 10th grade) in three United States communities. Children were categorized into four mutually exclusive bullying typologies: neither victim nor perpetrator; victim only; perpetrator only; victim-perpetrator. Children self-reported mechanisms of violent injuries that needed medical attention in the past year. Regression models were used to evaluate the relationship between bullying group and the likelihood of violent injury over time. RESULTS Seventeen percent (n=857) of children in fifth grade reported a violent injury. Prevalence of overall violent injuries, and specifically firearm and knife injuries, increased over time. Children who reported perpetration in the absence of victimization were at increased odds for violent injury (adjusted odds ratio = 1.41, 95% confidence interval: 1.24, 1.60) compared with children who reported neither victimization nor perpetration, while children who reported victimization in the absence of perpetration were at decreased odds (adjusted odds ratio=.84, 95% confidence interval: .73, .97). A significant linear dose-response relationship was observed between duration of bullying perpetration and violent injury. CONCLUSIONS The relationship between bullying perpetration and violent injury over time was strong. Future research should investigate potential mediating behaviors, such as weapon access, which might explain the observed relationship.
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Affiliation(s)
- Katelyn K Jetelina
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, Texas.
| | | | - Paula M Cuccaro
- University of Texas Health Science Center, School of Public Health, Houston, Texas
| | - Melissa F Peskin
- University of Texas Health Science Center, School of Public Health, Houston, Texas
| | - Lisa Pompeii
- University of Texas Health Science Center, School of Public Health, Houston, Texas
| | - Folefac Atem
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, Texas
| | | | | | - Susan L Davies
- Department of Health Behavior, UAB Center for the Study of Community Health, Birmingham, Alabama
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11
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Jetelina KK, Reingle Gonzalez JM, Cuccaro PM, Peskin MF, Pompeii L, Atem F, Elliott MN, Earnshaw VA, Davies SL, Schuster MA. Self-reporting discrepancies of bullying victimization and perpetration measures. Ann Epidemiol 2019; 32:58-63. [DOI: 10.1016/j.annepidem.2019.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/11/2018] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
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12
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Wallander JL, Fradkin C, Elliott MN, Cuccaro PM, Tortolero Emery S, Schuster MA. Racial/ethnic disparities in health-related quality of life and health status across pre-, early-, and mid-adolescence: a prospective cohort study. Qual Life Res 2019; 28:1761-1771. [PMID: 30927145 DOI: 10.1007/s11136-019-02157-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine (1) racial/ethnic disparities in health-related quality of life (HRQOL) and overall health status among Black, Latino, and White youth during adolescence; (2) whether socioeconomic status (SES) and family contextual variables influence disparities; and (3) whether disparities are consistent from pre- to early- to mid-adolescence. METHODS A population sample of 4823 Black (1755), Latino (1812), and White (1256) youth in three US metropolitan areas was prospectively assessed in a longitudinal survey conducted on three occasions, in 5th, 7th, and 10th grades, when youth reported their HRQOL using the PedsQL™ short-form Total, Physical and Psychosocial scales and youth and parents separately reported on youth's overall health status. Parents reported their education and household income to index SES, family structure, and use of English at home. RESULTS Based on analysis conducted separately at each grade, marked racial/ethnic disparities were observed across all measures of HRQOL and health status, favoring White and disfavoring Black, and especially Latino youth. More strongly present in 5th and 7th grade, HRQOL disparities decreased by 10th grade. Most disparities between White and Black youth disappeared when adjusting for SES. However, even after adjusting for SES, family structure, and English use, overall health status disparities disfavoring Latino youth remained across all three assessments. CONCLUSIONS Racial/ethnic disparities in adolescent HRQOL and health are substantial. These disparities appear consistent from pre- to early-adolescence but diminish for HRQOL by mid-adolescence. As disparities appear influenced by SES and other family contextual variables differently in different racial/ethnic groups, efforts to reduce health disparities in youth should address culturally specific conditions impinging on health.
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Affiliation(s)
- Jan L Wallander
- Psychological Sciences and Health Sciences Research Institute, SSHA, University of California, 5200 N. Lake Rd, Merced, CA, 95343, USA.
| | - Chris Fradkin
- Psychological Sciences and Health Sciences Research Institute, SSHA, University of California, 5200 N. Lake Rd, Merced, CA, 95343, USA.,Departamento de Psicologia, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Paula M Cuccaro
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, USA
| | - Susan Tortolero Emery
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, USA
| | - Mark A Schuster
- Kaiser Permanente School of Medicine, Pasadena, CA, USA.,Division of General Pediatrics, Boston Children's Hospital, Boston, USA.,Department of Pediatrics, Harvard Medical School, Boston, USA
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13
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Correnti CM, Klein DJ, Elliott MN, Veledar E, Saraiya M, Chien AT, Schwebel DC, Mrug S, Tortolero SR, Cuccaro PM, Schuster MA, Chen SC. Racial disparities in fifth-grade sun protection: Evidence from the Healthy Passages study. Pediatr Dermatol 2018; 35:588-596. [PMID: 29962040 PMCID: PMC6168341 DOI: 10.1111/pde.13550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Despite rising skin cancer rates in children, multiple studies reveal inadequate youth sun-protective behavior (eg, sunscreen use). Using Healthy Passages data for fifth-graders, we set out to determine sunscreen adherence in these children and investigated factors related to sunscreen performance. METHODS Survey data were collected from 5119 fifth-graders and their primary caregivers. Logistic regression was used to assess associations between sunscreen adherence and performance of other preventive health behaviors (eg, flossing, helmet use) and examine predictors of sunscreen adherence. Analyses were repeated in non-Hispanic black, Hispanic, and non-Hispanic white subgroups. RESULTS Five thousand one hundred nineteen (23.4%) children almost always used sunscreen, 5.9% of non-Hispanic blacks (n = 1748), 23.7% of Hispanics (n = 1802), and 44.8% of non-Hispanic whites (n = 1249). Performing other preventive health behaviors was associated with higher odds of sunscreen adherence (all P < .001), with the greatest association with flossing teeth (odds ratio = 2.41, 95% confidence interval = 1.86-3.13, P < .001). Factors for lower odds of sunscreen adherence included being male and non-Hispanic black or Hispanic and having lower socioeconomic status. School-based sun-safety education and involvement in team sports were not significant factors. CONCLUSION Our data confirm low use of sun protection among fifth-graders. Future research should explore how public health success in increasing prevalence of other preventive health behaviors may be applied to enhance sun protection messages. Identifying risk factors for poor adherence enables providers to target patients who need more education. Improving educational policies and content in schools may be an effective way to address sun safety.
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Affiliation(s)
- Christina M. Correnti
- Department of Dermatology, University of Maryland School of Medicine,
Baltimore, Maryland
- Department of Dermatology, Emory University School of Medicine, Atlanta,
Georgia
| | - David J. Klein
- Division of General Pediatrics, Boston Children’s Hospital, Boston,
Massachusetts
- RAND Corporation, Santa Monica, California
| | | | - Emir Veledar
- Department of Dermatology, Emory University School of Medicine, Atlanta,
Georgia
| | - Mona Saraiya
- Division of Cancer Prevention and Control’s Epidemiology and Applied
Research Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alyna T. Chien
- Division of General Pediatrics, Boston Children’s Hospital, Boston,
Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston,
Massachusetts
| | - David C. Schwebel
- Department of Psychology, University of Alabama at Birmingham, Alabama
| | - Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, Alabama
| | - Susan R. Tortolero
- Center for Health Promotion and Prevention Research, University of Texas
Health Science Center School of Public Health, Houston, Texas
| | - Paula M. Cuccaro
- Center for Health Promotion and Prevention Research, University of Texas
Health Science Center School of Public Health, Houston, Texas
| | - Mark A. Schuster
- Division of General Pediatrics, Boston Children’s Hospital, Boston,
Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston,
Massachusetts
- Kaiser Permanente School of Medicine, Pasadena, California
| | - Suephy C. Chen
- Department of Dermatology, Emory University School of Medicine, Atlanta,
Georgia
- Division of Dermatology, Atlanta Veterans Affairs Medical Center, Atlanta,
Georgia
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14
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Fenton AT, Elliott MN, Schwebel DC, Berkowitz Z, Liddon NC, Tortolero SR, Cuccaro PM, Davies SL, Schuster MA. Unequal interactions: Examining the role of patient-centered care in reducing inequitable diffusion of a medical innovation, the human papillomavirus (HPV) vaccine. Soc Sci Med 2017; 200:238-248. [PMID: 29157686 DOI: 10.1016/j.socscimed.2017.09.030] [Citation(s) in RCA: 14] [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] [Received: 02/16/2017] [Revised: 09/07/2017] [Accepted: 09/14/2017] [Indexed: 11/19/2022]
Abstract
RATIONALE Studies of inequities in diffusion of medical innovations rarely consider the role of patient-centered care. OBJECTIVE We used uptake of the human papillomavirus (HPV) vaccine shortly after its licensing to explore the role of patient-centered care. METHODS Using a longitudinal multi-site survey of US parents and adolescents, we assessed whether patient-centered care ratings might shape racial/ethnic and socioeconomic gaps at two decision points in the HPV vaccination process: (1) Whether a medical provider recommends the vaccine and (2) whether a parent decides to vaccinate. RESULTS We did not find evidence that the association of patient-centeredness with vaccination varies by parent education. In contrast, parent ratings of providers' patient-centeredness were significantly associated with racial/ethnic disparities in parents' reports of receiving a HPV vaccine recommendation from a provider: Among parents who rate patient-centered care as low, white parents' odds of receiving such a recommendation are 2.6 times higher than black parents' odds, but the racial/ethnic gap nearly disappears when parents report high patient-centeredness. Moderated mediation analyses suggest that patient-centeredness is a major contributor underlying vaccination uptake disparities: Among parents who report low patient-centeredness, white parents' odds of vaccinating their child are 8.1 times higher than black parents' odds, while both groups are equally likely to vaccinate when patient-centeredness is high. CONCLUSION The results indicate that patient-centered care, which has been a relatively understudied factor in the unequal diffusion of medical innovations, deserves more attention. Efforts to raise HPV vaccination rates should explore why certain patient groups may be less likely to receive recommendations and should support providers to consistently inform all patient groups about vaccination.
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Affiliation(s)
- Anny T Fenton
- Department of Sociology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, USA.
| | - Marc N Elliott
- 1776 Main Street, RAND Corporation, Santa Monica, CA 90401, USA.
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Campbell Hall 415, 1530 3rd Avenue South, Birmingham, AL 35294, USA.
| | - Zahava Berkowitz
- Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, CDC, 1600 Clifton Road Atlanta, GA 30329, USA.
| | - Nicole C Liddon
- Division of Adolescent and School Health, CDC, 1600 Clifton Road Atlanta, GA 30329, USA.
| | - Susan R Tortolero
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA.
| | - Paula M Cuccaro
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA.
| | - Suzy L Davies
- Department of Health Behavior, UAB Center for the Study of Community Health, 1665 University Boulevard, Birmingham, AL 35294, USA.
| | - Mark A Schuster
- Division of General Pediatrics, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Enders, 300 Longwood Avenue, Boston, MA 02115, USA; Kaiser Permanente School of Medicine, 100 South Los Robles Avenue, Pasadena, CA 91106, USA.
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15
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Hernandez BF, Peskin MF, Shegog R, Gabay EK, Cuccaro PM, Addy RC, Ratliff E, Emery ST, Markham CM. iCHAMPSS: Usability and Psychosocial Impact for Increasing Implementation of Sexual Health Education. Health Promot Pract 2016; 18:366-380. [PMID: 28420265 DOI: 10.1177/1524839916682004] [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] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Diffusion of sexual health evidence-based programs (EBPs) in schools is a complex and challenging process. iCHAMPSS ( CHoosing And Maintaining effective Programs for Sex education in Schools) is an innovative theory- and Web-based decision support system that may help facilitate this process. The purpose of this study was to pilot-test iCHAMPSS for usability and short-term psychosocial impact. METHOD School district stakeholders from across Texas were recruited ( N = 16) and given access to iCHAMPSS for 3 weeks in fall 2014. Pre- and posttests were administered to measure usability parameters and short-term psychosocial outcomes. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. RESULTS Most participants reported that iCHAMPSS was easy to use, credible, helpful, and of sufficient motivational appeal. iCHAMPSS significantly increased participants' self-efficacy to obtain approval from their board of trustees to implement a sexual health EBP. Positive, though nonsignificant, trends included increased knowledge to locate EBPs, skills to prioritize sexual health education at the district level, and ability to choose an EBP that best meets district needs. CONCLUSIONS iCHAMPSS is an innovative decision support system that could accelerate uptake of EBPs by facilitating diffusion and advance the field of dissemination and implementation science for the promotion of sexual health EBPs.
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Affiliation(s)
- Belinda F Hernandez
- 1 The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Melissa F Peskin
- 1 The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Ross Shegog
- 1 The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Efrat K Gabay
- 1 The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Paula M Cuccaro
- 1 The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Robert C Addy
- 1 The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Eric Ratliff
- 1 The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Susan T Emery
- 1 The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Christine M Markham
- 1 The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
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16
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Jetelina KK, Reingle Gonzalez JM, Cuccaro PM, Peskin MF, Elliott MN, Coker TR, Mrug S, Davies SL, Schuster MA. The Association Between Familial Homelessness, Aggression, and Victimization Among Children. J Adolesc Health 2016; 59:688-695. [PMID: 27646498 DOI: 10.1016/j.jadohealth.2016.07.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 03/17/2016] [Revised: 06/13/2016] [Accepted: 07/10/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the relationship between the number of periods children were exposed to familial homelessness and childhood aggression and victimization. METHODS Survey data were obtained from 4,297 fifth-grade children and their caregivers in three U.S. cities. Children and primary caregivers were surveyed longitudinally in 7th and 10th grades. Family homelessness, measured at each wave as unstable housing, was self-reported by the caregiver. Children were categorized into four mutually exclusive groups: victim only, aggressor only, victim-aggressor, and neither victim nor aggressor at each time point using validated measures. Multinomial, multilevel mixed models were used to evaluate the relationship among periods of homelessness and longitudinal victimization, aggression, and victim aggression compared to children who were nonvictims and nonaggressors. RESULTS Results suggest that children who experienced family homelessness were more likely than domiciled children to report aggression and victim aggression but not victimization only. Multivariate analyses suggested that even brief periods of homelessness were positively associated with aggression and victim aggression (relative to neither) compared to children who were never homeless. Furthermore, childhood victimization and victim aggression significantly decreased from 5th grade to 10th grade while aggression significantly increased in 10th grade. CONCLUSIONS Children who experienced family homelessness for brief periods of time were significantly more likely to be a victim-aggressor or aggressor compared to those who were never homeless. Prevention efforts should target housing security and other important factors that may reduce children's likelihood of aggression and associated victimization.
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Affiliation(s)
- Katelyn K Jetelina
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas Regional Campus, Dallas, Texas.
| | - Jennifer M Reingle Gonzalez
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas Regional Campus, Dallas, Texas
| | - Paula M Cuccaro
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, Texas
| | - Melissa F Peskin
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, Texas
| | | | - Tumaini R Coker
- Department of Pediatrics, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Sylvie Mrug
- Department of Psychology, University of Alabama Birmingham, Birmingham, Alabama
| | - Susan L Davies
- Department of Health Behavior, UAB Center for the Study of Community Health, Birmingham, Alabama
| | - Mark A Schuster
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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17
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Ladapo JA, Elliott MN, Kanouse DE, Schwebel DC, Toomey SL, Mrug S, Cuccaro PM, Tortolero SR, Schuster MA. Firearm Ownership and Acquisition Among Parents With Risk Factors for Self-Harm or Other Violence. Acad Pediatr 2016; 16:742-749. [PMID: 27426038 PMCID: PMC5077672 DOI: 10.1016/j.acap.2016.05.145] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 05/12/2016] [Accepted: 05/20/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Recent policy initiatives aiming to reduce firearm morbidity focus on mental health and illness. However, few studies have simultaneously examined mental health and behavioral predictors within families, or their longitudinal association with newly acquiring a firearm. METHODS Population-based, longitudinal survey of 4251 parents of fifth-grade students in 3 US metropolitan areas; 2004 to 2011. Multivariate logistic models were used to assess associations between owning or acquiring a firearm and parent mental illness and substance use. RESULTS Ninety-three percent of parents interviewed were women. Overall, 19.6% of families reported keeping a firearm in the home. After adjustment for confounders, history of depression (adjusted odds ratio [aOR], 1.36; 95% confidence interval [CI], 1.04-1.77), binge drinking (aOR 1.75; 95% CI, 1.14-2.68), and illicit drug use (aOR 1.75; 95% CI, 1.12-2.76) were associated with a higher likelihood of keeping a firearm in the home. After a mean of 3.1 years, 6.1% of parents who did not keep a firearm in the home at baseline acquired one by follow-up and kept it in the home (average annual likelihood = 2.1%). No risk factors for self-harm or other violence were associated with newly acquiring a gun in the home. CONCLUSIONS Families with risk factors for self-harm or other violence have a modestly greater probability of having a firearm in the home compared with families without risk factors, and similar probability of newly acquiring a firearm. Treatment interventions for many of these risk factors might reduce firearm-related morbidity.
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Affiliation(s)
- Joseph A. Ladapo
- Departments of Medicine and Population Health, New York University School of Medicine, New York, NY
| | | | | | | | - Sara L. Toomey
- Division of General Pediatrics, Boston Children’s Hospital, Boston, MA,Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Sylvie Mrug
- Department of Psychology, University of Alabama, Birmingham, AL
| | | | | | - Mark A. Schuster
- Division of General Pediatrics, Boston Children’s Hospital, Boston, MA,Department of Pediatrics, Harvard Medical School, Boston, MA
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18
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Ladapo JA, Elliott MN, Kanouse DE, Tortolero SR, Windle M, Cuccaro PM, Davies SL, Schuster MA. Tobacco use and smoking intentions among U.S. fifth-grade students. J Adolesc Health 2014; 55:445-51. [PMID: 24794053 PMCID: PMC4143448 DOI: 10.1016/j.jadohealth.2014.03.008] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 03/20/2014] [Accepted: 03/20/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE To identify the risk and protective factors for cigarette smoking and future intentions among racially/ethnically diverse preadolescent children. METHODS We analyzed data from 5,119 fifth-grade children and their parents living in three U.S. metropolitan areas. Using the multivariate logistic regression models, we examined how cigarette smoking and intentions to smoke within 1 year are associated with (1) number of friends who smoke, (2) parental disapproval of smoking, (3) parental communication about not smoking, (4) performance in school, and (5) educational aspirations. RESULTS Twenty-nine percent of the children were black, 44% were Hispanic, 22% were white, and 5% were of another race/ethnicity. Mean age was 11.1 years. The prevalence of ever smoking a cigarette among black, Hispanic, and white children was 9.8%, 5.6%, and 4.9%, respectively. In adjusted analyses, children were more likely to have smoked a cigarette if their friends smoked (adjusted odds ratio [aOR] 5.1, 95% confidence interval [CI] 3.8-6.9), they frequently had trouble with schoolwork (aOR 2.1, 95% CI 1.5-3.1), or their parents were not college graduates (aOR 2.0, 95% CI 1.2-3.5 for high school graduate). They were less likely to have smoked cigarettes if their parents disapproved of smoking (aOR .3, 95% CI .1-.6). Parental communication (aOR .1, 95% CI .0-.6) and disapproval (aOR .2, 95% CI .1-.7) had protective associations for future intentions among children who had ever and had never smoked, respectively. CONCLUSIONS Fifth-graders share many of the same risk factors for smoking identified in older adolescents, some of which are modifiable. Antismoking policies and programs should be designed for preadolescents as well as adolescents, and campaigns targeting parents should place greater emphasis on communication and expressed disapproval of smoking.
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Affiliation(s)
- Joseph A. Ladapo
- Department of Population Health, New York University School of Medicine, New York, NY
| | | | | | | | - Michael Windle
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA
| | | | - Susan L. Davies
- Department of Health Behavior, University of Alabama-Birmingham School of Public Health, Birmingham, AL
| | - Mark A. Schuster
- Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Boston, MA,Department of Pediatrics, Harvard Medical School, Boston, MA
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Tortolero SR, Peskin MF, Baumler ER, Cuccaro PM, Elliott MN, Davies SL, Lewis TH, Banspach SW, Kanouse DE, Schuster MA. Daily violent video game playing and depression in preadolescent youth. Cyberpsychol Behav Soc Netw 2014; 17:609-15. [PMID: 25007237 PMCID: PMC4227415 DOI: 10.1089/cyber.2014.0091] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Most studies on the impact of playing violent video games on mental health have focused on aggression. Relatively few studies have examined the relationship between playing violent video games and depression, especially among preadolescent youth. In this study, we investigated whether daily violent video game playing over the past year is associated with a greater number of depressive symptoms among preadolescent youth, after controlling for several well-known correlates of depression among youth. We analyzed cross-sectional data collected from 5,147 fifth-grade students and their primary caregivers who participated in Wave I (2004-2006) of Healthy Passages, a community-based longitudinal study conducted in three U.S. cities. Linear regression was conducted to determine the association between violent video game exposure and number of depressive symptoms, while controlling for gender, race/ethnicity, peer victimization, witnessing violence, being threatened with violence, aggression, family structure, and household income level. We found that students who reported playing high-violence video games for ≥2 hours per day had significantly more depressive symptoms than those who reported playing low-violence video games for <2 hours per day (p<0.001). The magnitude of this association was small (Cohen's d=0.16), but this association was consistent across all racial/ethnic subgroups and among boys (Cohen's d values ranged from 0.12 to 0.25). Our findings indicate that there is an association between daily exposure to violent video games and number of depressive symptoms among preadolescent youth. More research is needed to examine this association and, if confirmed, to investigate its causality, persistence over time, underlying mechanisms, and clinical implications.
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Affiliation(s)
- Susan R. Tortolero
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas
| | - Melissa F. Peskin
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas
| | - Elizabeth R. Baumler
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas
| | - Paula M. Cuccaro
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas
| | | | - Susan L. Davies
- Department of Health Behavior, School of Public Health, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Terri H. Lewis
- Department of Health Behavior, School of Public Health, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Stephen W. Banspach
- Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Mark A. Schuster
- RAND Corporation, Santa Monica, California
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Schwebel DC, Lewis T, Simon TR, Elliott MN, Toomey SL, Tortolero SR, Cuccaro PM, Schuster MA. Prevalence and Correlates of Firearm Ownership in the Homes of Fifth Graders: Birmingham, AL, Houston, TX, and Los Angeles, CA. Health Educ Behav 2014; 41:299-306. [PMID: 24419969 DOI: 10.1177/1090198113512126] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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
Firearms in the home are associated with increased injury risk, especially when loaded and unlocked. In this study, 5,010 fifth-graders and their caregivers in three U.S. metropolitan areas participated in the 2004-2006 Healthy Passages study on adolescent health. Firearm ownership and storage patterns were examined by four self-reported sociodemographic characteristics (child's race/ethnicity, child's gender, family socioeconomic status, and study site) and reasons for ownership. Eighteen percent (n = 880) of the families reported firearms in the home. Families with African American and Hispanic children had lower odds of owning firearms than families with non-Hispanic White children. The most common reasons for ownership were protection from crime and hunting. Six percent (n = 56) of the families with firearms stored at least one firearm unlocked, assembled, without a trigger lock, and with unlocked ammunition. Compared with families with non-Hispanic White children, families with African American children engaged in safer storage practices. Results can inform childhood firearm injury prevention activities.
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Affiliation(s)
| | - Terri Lewis
- University of Alabama at Birmingham, AL, USA
| | - Thomas R Simon
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Sara L Toomey
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
| | | | - Paula M Cuccaro
- The University of Texas Health Science Center at Houston, TX, USA
| | - Mark A Schuster
- RAND Corporation, Santa Monica, CA, USA Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
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Bogart LM, Elliott MN, Kanouse DE, Klein DJ, Davies SL, Cuccaro PM, Banspach SW, Peskin MF, Schuster MA. Bogart et al. respond. Am J Public Health 2013; 103:e1-2. [PMID: 24028223 DOI: 10.2105/ajph.2013.301570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Laura M Bogart
- Laura M. Bogart and Mark A. Schuster are with the Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA, and the Department of Pediatrics, Harvard Medical School, Boston. Marc N. Elliott and David E. Kanouse are with RAND Corporation, Santa Monica, CA. David J. Klein is with the Division of General Pediatrics, Department of Medicine, Boston Children's Hospital. Susan L. Davies is with the Department of Health Behavior, School of Public Health, University of Alabama, Birmingham. Paula M. Cuccaro and Melissa F. Peskin are with the Center for Health Promotion and Prevention Research, University of Texas Health Science Center, Houston. Stephen W. Banspach is with the National Center for Chronic Disease Prevention and Health Promotion, Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
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Bogart LM, Elliott MN, Kanouse DE, Klein DJ, Davies SL, Cuccaro PM, Banspach SW, Peskin MF, Schuster MA. Association between perceived discrimination and racial/ethnic disparities in problem behaviors among preadolescent youths. Am J Public Health 2013; 103:1074-81. [PMID: 23597387 DOI: 10.2105/ajph.2012.301073] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the contribution of perceived racial/ethnic discrimination to disparities in problem behaviors among preadolescent Black, Latino, and White youths. METHODS We used cross-sectional data from Healthy Passages, a 3-community study of 5119 fifth graders and their parents from August 2004 through September 2006 in Birmingham, Alabama; Los Angeles County, California; and Houston, Texas. We used multivariate regressions to examine the relationships of perceived racial/ethnic discrimination and race/ethnicity to problem behaviors. We used values from these regressions to calculate the percentage of disparities in problem behaviors associated with the discrimination effect. RESULTS In multivariate models, perceived discrimination was associated with greater problem behaviors among Black and Latino youths. Compared with Whites, Blacks were significantly more likely to report problem behaviors, whereas Latinos were significantly less likely (a "reverse disparity"). When we set Blacks' and Latinos' discrimination experiences to zero, the adjusted disparity between Blacks and Whites was reduced by an estimated one third to two thirds; the reverse adjusted disparity favoring Latinos widened by about one fifth to one half. CONCLUSIONS Eliminating discrimination could considerably reduce mental health issues, including problem behaviors, among Black and Latino youths.
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Affiliation(s)
- Laura M Bogart
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA 02115, USA
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Schuster MA, Elliott MN, Kanouse DE, Wallander JL, Tortolero SR, Ratner JA, Klein DJ, Cuccaro PM, Davies SL, Banspach SW. Racial and ethnic health disparities among fifth-graders in three cities. N Engl J Med 2012; 367:735-45. [PMID: 22913683 DOI: 10.1056/nejmsa1114353] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [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] [Indexed: 11/19/2022]
Abstract
BACKGROUND For many health-related behaviors and outcomes, racial and ethnic disparities among adolescents are well documented, but less is known about health-related disparities during preadolescence. METHODS We studied 5119 randomly selected public-school fifth-graders and their parents in three metropolitan areas in the United States. We examined differences among black, Latino, and white children on 16 measures, including witnessing of violence, peer victimization, perpetration of aggression, seat-belt use, bike-helmet use, substance use, discrimination, terrorism worries, vigorous exercise, obesity, and self-rated health status and psychological and physical quality of life. We tested potential mediators of racial and ethnic disparities (i.e., sociodemographic characteristics and the child's school) using partially adjusted models. RESULTS There were significant differences between black children and white children for all 16 measures and between Latino children and white children for 12 of 16 measures, although adjusted analyses reduced many of these disparities. For example, in unadjusted analysis, the rate of witnessing a threat or injury with a gun was higher among blacks (20%) and Latinos (11%) than among whites (5%), and the number of days per week on which the student performed vigorous exercise was lower among blacks (3.56 days) and Latinos (3.77 days) than among whites (4.33 days) (P<0.001 for all comparisons). After statistical adjustment, these differences were reduced by about half between blacks and whites and were eliminated between Latinos and whites. Household income, household highest education level, and the child's school were the most substantial mediators of racial and ethnic disparities. CONCLUSIONS We found that harmful health behaviors, experiences, and outcomes were more common among black children and Latino children than among white children. Adjustment for socioeconomic status and the child's school substantially reduced most of these differences. Interventions that address potentially detrimental consequences of low socioeconomic status and adverse school environments may help reduce racial and ethnic differences in child health. (Funded by the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Mark A Schuster
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA 02115, USA.
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