Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels.

IMPORTANCE: Associations between adverse childhood experiences (ACEs) and risks for adult depression, poor mental health, and insufficient social and emotional support have been documented. Less is known about how positive childhood experiences (PCEs) co-occur with and may modulate the effect of ACEs on adult mental and relational health. OBJECTIVE: To evaluate associations between adult-reported PCEs and (1) adult depression and/or poor mental health (D/PMH) and (2) adult-reported social and emotional support (ARSES) across ACEs exposure levels. DESIGN, SETTING, AND PARTICIPANTS: Data were from the cross-sectional 2015 Wisconsin Behavioral Risk Factor Survey, a random digit-dial telephone survey of noninstitutionalized Wisconsin adults 18 years and older (n = 6188). Data were weighted to be representative of the entire population of Wisconsin adults in 2015. Data were analyzed between September 2016 and January 2019. MAIN OUTCOMES AND MEASURES: The definition of D/PMH includes adults with a depression diagnosis (ever) and/or 14 or more poor mental health days in the past month. The definition of PCEs includes 7 positive interpersonal experiences with family, friends, and in school/the community. Standard Behavioral Risk Factor Survey ACEs and ARSES variables were used. RESULTS: In the 2015 Wisconsin Behavioral Risk Factor Survey sample of adults (50.7% women; 84.9% white), the adjusted odds of D/PMH were 72% lower (OR, 0.28; 95% CI, 0.21-0.39) for adults reporting 6 to 7 vs 0 to 2 PCEs (12.6% vs 48.2%). Odds were 50% lower (OR, 0.50; 95% CI, 0.36-0.69) for those reporting 3 to 5 vs 0 to 2 PCEs (25.1% vs 48.2%). Associations were similar in magnitude for adults reporting 1, 2 to 3, or 4 to 8 ACEs. The adjusted odds that adults reported "always" on the ARSES variable were 3.53 times (95% CI, 2.60-4.80) greater for adults with 6 to 7 vs 0 to 2 PCEs. Associations for 3 to 5 PCEs were not significant. The PCE associations with D/PMH remained stable across each ACEs exposure level when controlling for ARSES. CONCLUSIONS AND RELEVANCE: Positive childhood experiences show dose-response associations with D/PMH and ARSES after accounting for exposure to ACEs. The proactive promotion of PCEs for children may reduce risk for adult D/PMH and promote adult relational health. Joint assessment of PCEs and ACEs may better target needs and interventions and enable a focus on building strengths to promote well-being. Findings support prioritizing possibilities to foster safe, stable nurturing relationships for children that consider the health outcomes of positive experiences.

Youth misperceptions of peer substance use norms: a hidden risk factor in state and community prevention.

Effective community prevention of substance abuse involves the integration of policies and programs to address many different risk and protective factors across the social ecology. This study sought to examine whether youth perceptions of peer substance use norms were operating as a risk factor at the same level as other known risk factors in a statewide community prevention effort. Several different analytical techniques were employed to examine the self-reported data from a sample of over 8,000 students in grades 6, 8, 10, and 12 from across Wyoming using a survey based on a risk and protective factor model. The findings of this study revealed that youth misperception of peer substance use norms operate at a level of significance similar to other known risk factors, and these misperceptions are a risk factor that should be measured in order to estimate its relationship with substance use. The measurement of this risk factor has important strategic implications for community prevention.

Methylmercury risk and awareness among American Indian women of childbearing age living on an inland northwest reservation.

American Indian women and children may be the most overrepresented among the list of disparate populations exposed to methylmercury. American Indian people fish on home reservations where a state or tribal fishing license (a source of advisory messaging) is not required. The purpose of this study was to examine fish consumption, advisory awareness, and risk communication preferences among American Indian women of childbearing age living on an inland Northwest reservation. For this cross-sectional descriptive study, participants (N=65) attending a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic were surveyed between March and June 2006. An electronic questionnaire adapted from Anderson et al. (2004) was evaluated for cultural acceptability and appropriateness by tribal consultants. Regarding fish consumption, approximately half of the women surveyed (49%) indicated eating locally caught fish with the majority signifying they consumed medium- and large-size fish (75%) that could result in exposure to methylmercury. In addition, a serendipitous discovery indicated that an unanticipated route of exposure may be fish provided from a local food bank resulting from sportsman's donations. The majority of women (80%) were unaware of tribal or state fish advisory messages; the most favorable risk communication preference was information coming from doctors or healthcare providers (78%). Since the population consumes fish and has access to locally caught potentially contaminated fish, a biomonitoring study to determine actual exposure is warranted.

Developing theoretical and environmental policy for underage drinking.

OBJECTIVE: To estimate concern/support for policy for underage drinkers and formulate policy-specific communication strategies. METHODS: An environmentally based approach to policy formulation used concepts from the transtheoretical, decision-balance, and social-norms models. Interviews were conducted with community stakeholders, and surveys were collected on community residents as part of the evaluation effort. RESULTS: The triangulated evaluation revealed specific policies for underage drinking and techniques for facilitating policy implementation. CONCLUSION: The results demonstrate techniques for using multiple models and evaluation techniques for formulating public policy in the promotion of community health.

Engaging men as social justice allies in ending violence against women: evidence for a social norms approach.

The field of sexual assault prevention is shifting attention to educational interventions that address the role of men in ending violence against women. Recent studies document the often-misperceived norms men hold about other men's endorsement of rape-supportive attitudes and behaviors. The authors provide further evidence supporting the design of population-based social norms interventions to prevent sexual assault. Data from this study suggest that men underestimate the importance that most men and women place on consent and willingness of most men to intervene against sexual violence. In addition, men's personal adherence to only consensual activity and their willingness to act as women's allies are strongly influenced by their perceptions of other men's and women's norms. These findings support the proposition that accurate normative data, which counters the misperception of rape-supportive environments, can be a critical part of comprehensive campus efforts to catalyze and support men's development as women's social justice allies in preventing sexual violence against women.