Describing associations between child maltreatment frequency and the frequency and timing of subsequent delinquent or criminal behaviors across development: variation by sex, sexual orientation, and race.

BACKGROUND: Child maltreatment has been linked to lower health, education, and income later in life, and is associated with increased engagement in delinquent or criminal behaviors. This paper explores trajectories of these behaviors from adolescence into early adulthood and tests maltreatment as a predictor, and whether observed patterns are consistent across different demographic groups. METHODS: Using data from the National Longitudinal Study of Adolescent to Adult Health, a longitudinal study of a nationally representative sample of U.S. adolescents (in grades 7-12 in the 1994-95 school year), we ran linear mixed effects models to estimate growth curves of two dependent variables: violent and nonviolent offending behavior. We tested if maltreatment altered the intercept or slope of the curves and how the curves of these behaviors and the associations between them and maltreatment varied by sex, race/ethnicity, and sexual orientation. RESULTS: The sample (n = 10,613) had equal proportions males and females, approximately one third identified as a race/ethnicity other than white, and over 10% were non-heterosexual. Experiences of maltreatment were highest for Native Americans and lowest for whites. Models indicated that males were more likely than females to engage in both violent and nonviolent offending and respondents who identified as non-heterosexual were more likely than their heterosexual peers to engage in nonviolent offending behavior. When maltreatment was included in models as a predictor, adolescents who experienced maltreatment had a more rapid increase in their non-violent offending behavior. For violent offending behavior, adolescents who experienced maltreatment had higher levels of offending and the levels progressively increased as maltreatment frequency did. Sex was a moderator; the relationship between maltreatment and predicted nonviolent offending was stronger for males than it was for females. Race/ethnicity and sexual orientation did not moderate the associations between maltreatment and offending behavior. CONCLUSIONS: This study provides insights from a nationally representative sample into the pattern of both delinquent and criminal behaviors in adolescence and young adulthood, describing not only how the pattern varies over time, but also by sociodemographics and offending type. Additionally, it highlights how the association between maltreatment and these behaviors varies by both offending type and sex.

Disrupting the link between maltreatment and delinquency: how school, family, and community factors can be protective.

BACKGROUND: Past experiences of childhood maltreatment are common for youth involved in the juvenile justice system. This paper explores potential protective factors at the peer, family, school, and neighborhood levels that disrupt the relationship between maltreatment and later non-violent and violent offending behavior and how these protective effects vary by a number of different sociodemographics. METHODS: We used data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative longitudinal study of adolescents who were in grades 7-12 in the 1994-95 school year. Pulling data from Add Health respondents from ages 13 to 30, we used linear mixed effects modeling to create growth curves of predicted violent and non-violent offending frequency from adolescence into young adulthood, with maltreatment frequency as a predictor. Next, we tested whether potential protective factors including time with friends, a high-quality relationship with a parent figure, school connection, or neighborhood collective efficacy moderated the intercept or slope of the growth curves. Finally, we tested if sex, race/ethnicity, or sexual orientation moderated these protective effects. RESULTS: For violent offending, school connection, high-quality relationships with mother or father figures, and neighborhood collective efficacy were all generally protective, meaning they were associated with lower levels and shallower slopes of predicted violent offending, but they were not more or less protective for those who experienced maltreatment. For non-violent offending, the same was true of school connection, high-quality relationships with a mother figure, and neighborhood collective efficacy, which were all generally protective. We found no evidence of a protective effect for time spent with friends, though this is likely due to measurement constraints, as simply measuring time spent with friends may have heterogeneous effects on delinquent behaviors. We found no evidence that any of these protective effects varied by sociodemographics. CONCLUSIONS: This paper identifies factors that teachers, juvenile corrections officers, policymakers and others can intervene on to prevent engagement (or re-engagement) in delinquency and offending among youth and young adults who experienced maltreatment. As they are also protective for youth who have not experienced maltreatment they also inform general delinquency prevention efforts.

Parent-Teen Communication about Sexual and Reproductive Health: Cohort Differences by Race/Ethnicity and Nativity.

Parent-teen discussions about sexual and reproductive health (SRH) are associated with delayed sex and higher contraceptive use among teens. Using the National Survey of Family Growth, we conducted bivariate and multivariate analyses of different types of parent-teen SRH discussions among two cohorts of teens. We describe differences in patterns for males and females by race/ethnicity and nativity, and test for racial/ethnic interactions within each cohort. Analyses found that the prevalence of parent-teen discussions about SRH increased across cohorts. For males and females, there were increases in parent-teen discussions about condoms, and for males only, there were increases in any SRH discussions and discussions about contraception and STIs. Based on interactions, parent-teen discussions and STI discussions increased most for Hispanic females, and among Hispanics, increased most for the foreign-born. These data indicate increases in different types of parent-teen SRH discussions, particularly for males and foreign-born teens overall, and for Hispanic teen females regarding condom use. Future research should examine what factors are driving these changes, including changes in the structure of U.S. Hispanic communities and expansion of evidence-based teen pregnancy prevention programs.

Obesity and contraceptive use among women 20-44years of age in the United States: results from the 2011-15 National Survey of Family Growth (NSFG).

OBJECTIVE: Obesity has increased dramatically in the United States in recent decades. Our objective was to explore associations of contraceptive choices of US women, aged 20-44years, with body mass index (BMI) and relevant covariates. STUDY DESIGN: Data are based on interviews with a national sample of 11,300 women in the 2011-2015 National Survey of Family Growth. We analyzed women ages 20-44 at risk of unintended pregnancy. The primary dependent variable was BMI category. Covariates analyzed included age, parity, race/ethnicity, marital status, self-reported health and education. Data were analyzed via cross-tabulation and logistic regression. We determined unadjusted and adjusted odds ratios for three categories of contraceptive method: female sterilization, intrauterine device (IUD) and hormonal contraception. RESULTS: Obese women have higher odds of female sterilization (BMI 30.0-34.9 kg/m2: adjusted odds ratio (aOR)=1.96, 95% confidence interval (CI) 1.45-2.66; BMI 35.0 kg/m2 and higher: aOR=1.56, 95% CI 1.13-2.14) compared to women with normal BMI. Odds of IUD use are significantly higher among women with BMI >35 kg/m2 (aOR=1.64, 95% CI 1.20-2.25). Odds of hormonal contraceptive use are correspondingly reduced (aOR=0.78, 95% CI 0.62-0.98) for women in the highest BMI category. CONCLUSIONS: Contraceptive use varies by BMI category even after adjusting for usual correlates of use. Differences in contraceptive use by BMI category have implications for contraceptive counseling and provision. IMPLICATIONS: Findings that obese women are more likely to rely on female sterilization raise questions about how weight concerns and obesity affect contraceptive decision making. Future research could explore associations between obesity and contraceptive use in adolescent women.

Fertility Desires and Intentions Among U.S. Women by Disability Status: Findings from the 2011-2013 National Survey of Family Growth.

Objectives We compared fertility desires and intentions among women with disabilities and women without disabilities in the United States, using a new evidence-based measure of disability. Methods We analyzed data from a sample of 5601 US women 15-44 years of age in the 2011-2013 National Survey of Family Growth. The data were analyzed via cross-tabulation and logistic regression. We classified women into those with a disability and those without a disability. Results Women with disabilities were about as likely to want a baby (61%) as women without disabilities (60%). But only 43% of women with disabilities intended to have a baby in the future, compared with 50% of women without disabilities. Thus, the difference between the percent who want a baby and the percent who intend to have one was larger for disabled women. Women with disabilities were also less certain of their fertility intentions. Multivariate analysis shows that having a disability lowers the odds of intending another birth, after controlling for several other determinants of fertility intentions. Conclusions for Practice All women, regardless of disability status, desired more children than they actually planned to have, but the gap was larger for most groups of women with disabilities than for non-disabled women. Given the sample sizes available in this analysis, future research should use more detailed classifications of disability, however, we have shown that women living with disabilities constitute large populations with unexplored family planning needs.

Trends and determinants of IUD use in the USA, 2002-2012.

STUDY QUESTION: What factors and subgroups have propelled the recent increase in intrauterine device (IUD) use in the USA? SUMMARY ANSWER: The increase in IUD use, from 1.8 to 9.5% in the USA between 2002 and 2012, was driven primarily by a marked uptake among parous women who intended to have more children. WHAT IS KNOWN ALREADY: Recent data suggest an unprecedented increase in IUD use among women in the USA, yet less is known about how this increase has affected the overall proportion of women, at risk of unintended pregnancy, who are using contraception and which social and economic groups are involved. STUDY DESIGN, SIZE, DURATION: Data are drawn from the 2002 and 2011-2013 National Surveys of Family Growth. The surveys were based on cross-sectional, national samples of women of 15-44 years of age in the USA. Women responded to in-person interviews, which lasted an average of 80 min. The response rate was 80% in 2002 and 73% in 2011-2013. The sample included 7643 completed interviews in 2002 and 5601 interviews in 2011-2013. PARTICIPANTS/MATERIALS, SETTING, METHODS: This study was limited to women at risk of unintended pregnancy, i.e. women who were sexually active in the previous 3 months (using contraception or not); it excludes women who were sterile, currently pregnant or trying to conceive. Altogether, 5181 women were at risk in the 2002 sample and 3681 were at risk in the 2012 sample. We used descriptive statistics to investigate trends in contraceptive use patterns by women's sociodemographic characteristics between 2002 and 2012 and used logistic regression to identify current predictors of IUD use in 2012. MAIN RESULTS AND THE ROLE OF CHANCE: IUD use increased from 1.8% in 2002 to 9.5% in 2012 (P < 0.001). The surge was especially marked among parous women who intended to have more children (4.2% in 2002 to 19.3% in 2012; P < 0.001); it occurred to a lesser extent among parous women who did not intend to have more children (2.0-9.7% P < 0.001), suggesting that IUDs are more often used for spacing than for ending childbearing in the USA. The most important predictors of IUD use in 2012 were age, parity and intent to have children. Dissatisfaction with a previous method was also associated with IUD use (adjusted odds ratio = 1.89, P < 0.001). LIMITATIONS, REASONS FOR CAUTION: As with all cross-sectional studies, causal inference is limited. Data are self-reported, but the survey had a high response rate and rigorous quality controls. WIDER IMPLICATION OF THE FINDINGS: This study shows promising trends in the use of highly effective contraceptive methods in the USA, which may help to explain recently reported declines in unintended pregnancy in the USA. STUDY FUNDING/COMPETING INTERESTS: Caroline Moreau was supported by the William Robertson endowment funds. The work of Hannah Lantos and William Mosher on this analysis was supported by the Department of Population Family and Reproductive Health, The Johns Hopkins Bloomberg School of Public Health. The authors declare that no conflict of interest exists.

Determinants and Correlates of Preventive Behaviors at First Sex With a First Partner and Second Partner: Analysis of the FECOND Study.

PURPOSE: This study explores transitions in contraceptive use in early sexual life in France and has three objectives: describe predictors of contraceptive use at first sex with first and second partners, describe contraceptive trajectories in these partnerships, and test associations between use at first sex and switching in first partnership on use with second partner. METHODS: Our analyses include 1,823 participants, aged 15-29 years, of the 2010 French national sexual health survey who reported at least two lifetime sexual partners and a subset of 1,593 people who report contraceptive use throughout their first partnership. We use logistic regression and generalized estimating equation models to investigate the three objectives. RESULTS: Our results reveal a decline in contraceptive use between first and second partner, driven primarily by decreases in condom use, from 87.9% to 79.5% between first and second partner. This is partially offset by an increase in use of effective methods (from 7.8% to 38.1%), particularly by women. Any method use and discontinuation with first partner were predictors of patterns with second partner. CONCLUSIONS: Analysis of early transitions in contraceptive use of adolescents in early sexual life reveals shifts from sexually transmitted infection to pregnancy prevention and an increase in unprotected sex.

Who Adolescents Trust May Impact Their Health: Findings from Baltimore.

This study is one of the first to explore the relevance of trust to the health of adolescents living in a disadvantaged urban setting. The primary objectives were to determine the differences in the sociodemographic characteristics between adolescents who do and do not trust and to examine the associations between trust and health. Data were drawn from the Well-Being of Adolescents in Vulnerable Environments (WAVE) study, which is a cross-sectional global study of adolescents in very low-income urban settings conducted in 2011-2013. This paper focused on 446 adolescents in Baltimore as it was the primary site where trust was explicitly measured. For the main analyses, six health outcomes were examined: (1) self-rated health; (2) violence victimization; (3) binge drinking; (4) marijuana use; (5) post-traumatic stress disorder (PTSD); and (6) condom use at last sex. Independent variables included sociodemographic variables (age, gender, current school enrolment, perceived relative wealth, and family structure) and two dimensions of trust: community trust (trust in individuals/groups within neighborhood) and institutional trust (trust in authorities). The results show that more than half the sample had no trust in police, and a high proportion had no trust in other types of authority. Among girls, those with higher levels of community trust were less likely to be victimized and involved in binge drinking. Meanwhile, girls with higher levels of institutional trust were more likely to use a condom and less likely to have used marijuana. Among boys, those with higher levels of community trust were more likely to use a condom, while those with higher levels of institutional trust were less likely to use marijuana, but more likely binge drink. Overall, this study highlights the importance of trust for adolescent health. Most surprising were the differences in the associations between boys and girls with regard to the type of trust and specific health outcome that was significant.

A global study on the influence of neighborhood contextual factors on adolescent health.

PURPOSE: This study uses data collected as part of the Well-Being of Adolescents in Vulnerable Environments study to (1) compare the perceptions of neighborhood-level factors among adolescents across five different urban sites; (2) examine the associations between factors within the physical and social environments; and (3) examine the influence of neighborhood-level factors on two different health outcomes-violence victimization in the past 12 months and ever smoked. METHODS: Across five urban sites (Baltimore, New Delhi, Johannesburg, Ibadan, and Shanghai), 2,320 adolescents aged 15-19 years completed a survey using audio computer-assisted self-interview technology. To recruit adolescents, each site used a respondent-driven sampling method, which consisted of selecting adolescents as "seeds" to serve as the initial contacts for recruiting the entire adolescent sample. All analyses were conducted with Stata 13.1 statistical software, using complex survey design procedures. To examine associations between neighborhood-level factors and among our two outcomes, violence victimization and ever smoked, bivariate and multivariate analyses were conducted. RESULTS: Across sites, there was great variability in how adolescents perceived their neighborhoods. Overall, adolescents from Ibadan and Shanghai held the most positive perceptions about their neighborhoods, whereas adolescents from Baltimore and Johannesburg held the poorest. In New Delhi, despite females having positive perceptions about their safety and sense of social cohesion, they had the highest sense of fear and the poorest perceptions about their physical environment. The study also found that one of the most consistent neighborhood-level factors across sites and outcomes was witnessing community violence, which was significantly associated with smoking among adolescents in New Delhi and Johannesburg and with violence victimization across nearly every site except Baltimore. No other neighborhood-level factor exerted greater influence. CONCLUSIONS: This study confirms the important associations between perceptions of a neighborhood and adolescent health. At the same time, it demonstrates that not all neighborhood-level factors are associated with adolescent health outcomes in the same way across different urban contexts. Further longitudinal research is needed to examine the direction of causation between adolescent health neighborhood contexts and health outcomes and the reasons for why different urban contexts may exert varying levels of influence on the health of adolescents.

How adolescents perceive their communities: a qualitative study that explores the relationship between health and the physical environment.

BACKGROUND: The Well-Being of Adolescents in Vulnerable Environments (WAVE) study was conducted among adolescents aged 15-19 years in Baltimore, Ibadan, Johannesburg, New Delhi, and Shanghai to examine perceived factors related to their health. A preliminary analysis of the data, unexpectedly, revealed that the influence of the physical environment on adolescent health was a dominant theme across every site examined. To explore this further, this paper analyzed the specific components of the physical environment that were perceived to influence health, and how they contributed to various health outcomes across sites. METHODS: Researchers in each site conducted in-depth interviews among adolescents; community mapping and focus groups among adolescents; a Photovoice methodology, in which adolescents were trained in photography and took photos of the meaning of 'health' in their communities; and key informant interviews among adults who work with young people. A total 529 participants from across the sites were included in the analysis. RESULTS: Findings showed that while there was surprising uniformity in how adolescents characterized their physical environment, perceived health outcomes related to the physical environment varied by site and gender. In Baltimore and Johannesburg, vacant homes and the lack of recreation facilities were perceived to impact on sexual and reproductive health problems for girls, while among boys they contributed to drugs and violence. In Shanghai, New Delhi, and Ibadan, garbage and trash observed in their communities were perceived to have a higher impact on infectious and chronic diseases. CONCLUSIONS: As the world continues to urbanize, our study points to a strong need to examine how the physical aspects of a living environment contribute to the health of adolescents. Specific aspects, such as housing, safety, garbage, and recreational spaces must all be examined as possible pathways for making improvements to health of adolescents, particularly among those living in poor urban environments.