Community-wide resilience mitigates adverse childhood experiences on adult and youth health, school/work, and problem behaviors.

This study developed community-wide measures for 118 Washington State communities of levels of adverse childhood experiences (ACEs) and resilience, and found significant mitigating effects of resilience on community-wide levels of mental health, physical health, problem behaviors, and school/work outcomes, independent of community-wide levels of ACEs, low income, and race/ethnic composition. The data set was constructed by calculating aggregated community-level variables from measures obtained from survey responses to the Behavioral Risk Factor Surveillance System for adults and the Healthy Youth Survey for youth and combining them with state archival data. Principal component factor scores were calculated for community-wide levels of individual and contextual resilience. Individual resilience included prevalence of social-emotional support, life satisfaction, and optimism. Contextual resilience included social capital factors, social cohesion and collective efficacy for adults and protective supports for youth in four domains-family/adult, peer, school, and neighborhood/community. Both contextual and individual resilience levels mitigated outcomes for adults-only contextual resilience for youth. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

How to increase community-wide resilience and decrease inequalities due to adverse childhood experiences (ACEs): Strategies from Walla Walla, Washington.

Adverse childhood experiences (ACEs) negatively impact community-level social problems, education, work, mental, and physical health beyond the effects of economic and political inequality. This paper summarizes the evidence that community-wide resilience moderates such impacts and examines how resilience can be increased by strategic interventions focused on community capacity building; Trauma-Informed Practices (TIPs) by staff in community organizations; and cultural change. Findings from three formative research evaluations in Walla Walla, Washington, show how community capacity was increased, trauma-informed practices were implemented across local organizations, and a school's culture was transformed. Common elements of change were shifts in: mindsets, collaborative relationships, and organizational values/structures. These changes enabled the adoption of scaffolded, equity-based, innovative interventions that can potentially decrease economic and racial/ethnic disparities by preventing the progression of ACEs into adult adversities, poverty, and discrimination.

The Effects of Household Assets Inequality and Conflict on Population Health in Sudan

We explored the effects on health of both household asset inequality and political armed conflict in Sudan. Using the 2010 Sudan household survey; we evaluated the role of both household asset distribution (measured by the Gini coefficient) and armed conflict status at the state level. We measured associations with six health-related outcomes: life expectancy; infant mortality; height-for-age (stunting); adequacy of food consumption; teenage birth rates and vaccination coverage for young children. For each of six measures of health in Sudan; outcomes were significantly worse in the states with more unequal asset distribution; with correlation coefficients ranging between -0.56 (stunting) and -0.80 (life expectancy). Conflict status predicted worse outcomes. Wealth redistribution in the more unequal states; as well as a political resolution of conflict; may improve population health

"Sisters, Mothers, Daughters and Aunties": HIV vaccine acceptability among African, Caribbean and other Black women in Toronto.

OBJECTIVES: Black women in Canada are at disproportionately high risk for HIV. We assessed HIV vaccine acceptability and correlates of acceptability among Black women from African and Caribbean communities in Toronto. METHODS: "Sisters, Daughters, Mothers, and Aunties" was a community-based research project. Black women of African and Caribbean descent were recruited using venue-based sampling across diverse community organizations in Toronto. We used a structured questionnaire to collect data on socio-demographic characteristics and acceptability of 8 future HIV vaccines, each defined by a set of 7 dichotomous attributes. Conjoint analysis was used to quantify the relative impact of vaccine attributes on acceptability, with multiple regression to adjust for socio-demographic characteristics associated with overall acceptability. RESULTS: Mean vaccine acceptability was 58.8 (SD=17.2) on the 100-point scale. Efficacy had the greatest impact on acceptability, followed by side effects, cost, duration of protection, and number of doses. Acceptability of a high (99%) efficacy vaccine (70.1/100) was significantly greater than for a 50% efficacy vaccine (47.6/100). Vaccine acceptability was significantly higher among women of Caribbean versus African descent, ever married versus single women, and women with full-time versus part-time employment. CONCLUSIONS: Black women in Toronto indicated a modest level of acceptability for future HIV vaccines. Educational interventions that address the benefits of partially efficacious vaccines and clearly explain potential side effects, as well as vaccine cost subsidies may promote HIV vaccine uptake. Differences in acceptability within Black communities suggest that tailored multi-level interventions may mitigate barriers to uptake.

HIV prevalence and related behaviors among sex workers in Jamaica.

BACKGROUND: The aims of the study were to estimate HIV prevalence among sex workers (SWs) in Jamaica and to identify risk factors associated with HIV infection. METHOD: Face to face interviews and HIV testing of 450 SWs across Jamaica were conducted in 2005. Participants were identified by key informants. RESULTS: About 9% of SWs were HIV-positive. HIV-positive SWs tended to be older, less educated, have a history of crack/cocaine use, and were less likely to be aware of the Ministry of Health's prevention programme. More than 90% of SWs reported having easy access to condoms and using condoms at last sex with local and tourist clients. However, 30% of SWs used condoms with nonpaying partners. Knowledge of HIV prevention methods was high but only 38.6% of SWs appropriately rejected myths about HIV transmission by mosquito bites and meal sharing. CONCLUSION: Prevention programmes targeting SWs must emphasize the risk associated with both paying and nonpaying sexual partners while providing knowledge about HIV prevention. Increased access to prevention programmes is likely to reduce HIV prevalence among this population.

HIV prevention for Black women: structural barriers and opportunities.

Black women bear a disproportionate burden of HIV/AIDS in North America. The purpose of this investigation was to explore Black Canadian women's perspectives on HIV risk and prevention. Four 90-minute focus groups (n=26) and six key informant interviews were conducted in Toronto with Black women of African and Caribbean descent and low socioeconomic status. Data analysis revealed a number of potent barriers to existing HIV preventive interventions: stigma, cultural disconnections, lack of engagement of Black religious institutions, and multiple intersecting forms of discrimination. Recommended HIV prevention opportunities included the Black church, mainstreaming, health care providers, and ethno-specific agencies. HIV prevention strategies for North American Black women, rather than focusing on HIV and individual risk behaviors, may benefit from a primary focus on social and structural factors (e.g., promoting gender equality, economic opportunity, women-controlled prevention technologies and combating racism in health care) thereby integrating HIV prevention into the larger context of community health and survival.