School partner perspectives on the implementation of the Your Voice Your View sexual assault prevention program for high school students.

Despite the high risk for sexual assault among adolescents, few sexual assault prevention programs designed for implementation in high schools have sustained rigorous evaluation. The present study sought to better understand the factors that influenced the implementation of Your Voice Your View (YVYV), a four-session sexual assault prevention program for 10th grade students, which includes a teacher "Lunch and Learn" training as well as a 4-week school-specific social norms poster campaign. Following program implementation, eight school partners (i.e., health teachers, guidance counselors, teachers, and principals) participated in an interview to provide feedback on the process of program implementation. The Consolidated Framework for Implementation Research was utilized to examine site-specific determinants of program implementation. Participants discussed the importance of the design quality and packaging of the program, as well as the relative advantage of offering students a violence prevention program led by an outside team, as opposed to teachers in the school. School partners highlighted the importance of intensive preplanning before implementation, clear communication between staff, the utility of engaging a specific champion to coordinate programming, and the utility of offering incentives for participation. Having resources to support implementation, a desire to address sexual violence in the school, and a positive classroom climate in which to administer the small-group sessions were seen as school-specific facilitators of program implementation. These findings can help to support the subsequent implementation of the YVYV program, as well as other sexual assault prevention programs in high schools.

Design of a community-based, Hybrid Type II effectiveness-implementation asthma intervention study: The Rhode Island Asthma Integrated Response (RI-AIR) program.

BACKGROUND: Pediatric asthma is among the most common health conditions and disproportionately impacts Black and Latino children. Gaps in asthma care exist and may contribute to racial and ethnic inequities. The Rhode Island Asthma Integrated Response (RI-AIR) program was developed to address current limitations in care. The aims of the RI-AIR Hybrid Type II effectiveness-implementation trial were to: a) simultaneously evaluate the effectiveness of RI-AIR on individual-level and community-level outcomes; b) evaluate implementation strategies used to increase uptake of RI-AIR. In this manuscript, we outline the design and methods used to implement RI-AIR. METHODS: School-based areas (polygons) with the highest asthma-related urgent healthcare utilization in Greater Providence, R.I., were identified using geospatial mapping. Families with eligible children (2-12 years) living in one of the polygons received evidence-based school- and/or home-based asthma management interventions, based on asthma control level. School-based interventions included child and caregiver education programs and school staff trainings. Home-based interventions included individualized asthma education, home-environmental assessments, and strategies and supplies for trigger remediation. Implementation strategies included engaging school nurse teachers as champions, tailoring interventions to school preferences, and engaging families for input. RESULTS: A total of 6420 children were screened throughout the study period, 811 were identified as eligible, and 433 children were enrolled between November 2018 and December 2021. CONCLUSIONS: Effective implementation of pediatric asthma interventions is essential to decrease health inequities and improve asthma management. The RI-AIR study serves as an example of a multi-level intervention to improve outcomes and reduce disparities in pediatric chronic disease. CLINICAL TRIALS REGISTRATION NUMBER: NCT03583814.

Preventing sexual violence among high school students through norms correction and bystander intervention: A school-based cluster trial of Your Voice Your View.

Risk for sexual violence begins early in the lifespan; thus, interventions are needed to decrease the risk for sexual violence among high school youth. The current study evaluates the Your Voice Your View (YVYV) sexual violence prevention program using a school-based cluster trial among 26 high schools in the Northeastern United States. YVYV, includes: 1) a series of four classroom workshops designed to engage students as allies in violence prevention through bystander intervention skills training, address risks for sexual aggression, and reduce risk for victimization; 2) a Lunch and Learn teacher training workshop; and 3) a 4-week social norms poster campaign based on normative data from the school. Schools were matched based on size and demographics and randomly assigned to the intervention group or a wait-list control group. A sample of 2685 10th grade students enrolled in the research and completed assessments at baseline, 2-month and 6-month follow-up periods. The magnitude of the difference in sexual aggression did not vary by condition at either follow-up period. The magnitude of 6-month differences in experiencing unwanted sexual intercourse varied significantly by condition (IRR = 0.33 [0.14-0.76]), demonstrating a small protective effect favoring intervention schools (Cohen's f2 = 0.012). These findings highlight the promise of multicomponent interventions grounded in bystander intervention skills training, risk reduction, and social norms theory as a promising, comprehensive approach for sexual violence prevention among youth.

The Impact of Police Response on Intimate Partner Violence Victims' Social, Emotional, and Physical Well-Being: Results From the National Crime Victimization Survey.

This study examined whether police involvement in intimate partner violence (IPV) incidents is associated with victims' socio-emotional problems, and emotional and physical toll symptoms for 1 month or longer post-victimization. Data from the 2010-2019 National Crime Victimization Survey suggest that police investigational effort, later contact with the police, suffering severe injury during victimization, and repeated victimization were positively associated with experiencing socio-emotional problems. Later contact with police and severe injury were positively associated with both emotional and physical toll symptoms, while the female sex was positively associated with emotional toll symptoms. The arrest of the abuser was negatively associated with physical toll symptoms. Findings highlight the need for policies and practices in response to IPV that consider the diverse needs of survivors of partner abuse to help reduce IPV-related trauma.

Interpersonal Violence Victimization Experiences of Middle School Youth: An Exploration by Gender and Sexual/Romantic Attraction.

Sexual minority youth (SMY) are at increased risk for interpersonal violence victimization compared to heterosexual youth. The current study examined how self-reported victimization (i.e., bullying, sexual harassment and dating violence) among middle school youth varied as a function of sexual/romantic attraction as well as gender identity. Cross-sectional data were gathered from students at seven middle schools in New England (n = 2245). Mean comparisons with post-hoc Tukey tests determined differences in rates of past 6-month and lifetime interpersonal violence victimization by sexual/romantic attraction and the intersection of gender and attraction. As hypothesized, interpersonal violence victimization among middle school youth differed as a function of sexual/romantic attraction as well as gender. To date, most research has focused on older samples, particularly high-school youth and young adults. These data are consistent with these prior studies documenting increased risk for interpersonal violence victimization among youth who indicate same-gender attraction but add to the literature in demonstrating the expansive forms of peer victimization that same-gender-attracted youth already experience by early adolescence. Given that victimization is associated acutely and longitudinally with many deleterious outcomes, including poorer mental health and increased risk for subsequent victimization, greater structural supports are needed for early adolescent SMY.

Implementing school-wide sexual assault prevention in middle schools: A qualitative analysis of school stakeholder perspectives.

Sexual assault and harassment are significant problems that begin early in the lifespan. The current study sought to understand the contextual factors that influence the implementation of school-wide sexual assault prevention programs in middle schools that focus on fostering community norms change. The Consolidated Framework for Implementation Research (CFIR) is a menu of constructs arranged across 5 domains that assists stakeholders in assessing and identifying site-specific determinants of successful intervention implementation. In the present study, researchers conducted a series of 10 interviews with middle school stakeholders (i.e., principals, guidance counselors, teachers) to document characteristics inside and outside of the school environment (i.e., cultural norms, relative priority, prior interventions, implementation climate) relevant to the implementation of prevention programming, using the CFIR as a guiding framework for analysis. Whereas schools recognized the importance of implementing violence prevention programming, stakeholders reported several other competing demands (i.e., time, resources) that make it difficult to implement rigorous programming without support from an outside agency/team. Community agencies and research teams hoping to implement violence prevention in middle schools can benefit from using stakeholder interviews grounded in the CFIR model to gain a better awareness of the school- and community-specific factors that are likely to influence successful implementation of violence prevention programs in middle schools.

The Confluence Model of Sexual Aggression: An Application With Adolescent Males.

The Confluence Model of Sexual Aggression is a well-established framework for understanding factors that contribute to men's perpetration of sexual aggression against women, highlighting the roles of hostile masculinity, impersonal sex orientation, and exposure to pornography. To date, only one study has applied aspects of the Confluence Model to examine predictors of sexual aggression in adolescent males, and the study did not include pornography exposure as a predictor. The current study evaluates the Confluence Model as a framework for understanding the perpetration of both contact and noncontact sexual aggression in a sample of 935 heterosexual 10th-grade adolescent boys. Composite scores for hostile masculinity and impersonal sex orientation were generated. Nearly all the variables included in the hostile masculinity and impersonal sex constructs were associated with perpetration. Zero-inflated Poisson regression models revealed distinct combinations of salient predictors when the dependent variable was identified as boys' frequency of perpetration, compared with when the dependent variable was defined as any perpetration of sexual aggression. Impersonal sex orientation and violent pornography exposure were associated with perpetrating noncontact sexual aggression in the last 6 months, while violent pornography exposure and the interaction of hostile masculinity and impersonal sex orientation increased the frequency of recent contact sexual aggression. Results suggest that hostile masculinity, impersonal sex orientation, and violent pornography exposure are important factors to address within sexual assault prevention approaches for adolescent boys.

Predictors of Sexual Intimate Partner Violence Perpetration Among Men: A Prospective Analysis.

Research demonstrates that both peer socialization and underage drinking play a significant role in teen dating violence. However, less is known about the lasting effects of these risk factors on boys' ability to form healthy romantic relationships as they get older. The present study examined whether boys who perceived their peers would respect them more for having sex and those who engaged in past year heavy alcohol use would be more likely to perpetrate sexual intimate partner violence (IPV) in young adulthood compared to boys who did not endorse perceived peer approval for sex or report past year heavy drinking. Analyses were conducted using a sample of boys (n = 1,189) from Waves I and III of the National Longitudinal Study of Adolescent to Adult Health (Add Health). A logistic regression was conducted to assess the relationship between perceived peer approval to have sex and heavy alcohol use at Wave I and sexual IPV at Wave III, after adjusting for demographic factors and other correlates of sexual IPV at Wave I, including age, race/ethnicity, sexual initiation in adolescence, parental attachment, annual family income, and neighborhood poverty. Boys who believed they would gain peer respect by having sex and boys who reported getting drunk in the last 12 months, regardless of how often, were significantly more likely to report sexual IPV in young adulthood compared to boys who did not endorse either of these factors. Targeting boys' perceived peer norms regarding sexual activity and heavy alcohol use may therefore be especially important for preventing sexual IPV later in life.

Inequities Laid Bare: The Mental Health of Young Adults in Rhode Island During the COVID-19 Pandemic.

This study documents disparities in the mental health burden of young adults in Rhode Island during the COVID-19 pandemic as it pertains to essential worker status, sexual orientation, gender identity, and childhood trauma. A cross-sectional web-based survey of young adults aged 18 to 25 years conducted between May and October of 2020 assessed anxiety symptoms, depressive symptoms, and thoughts of suicide. In fully adjusted regression models, (n =528 young adults) being an essential worker, a sexual minority, having lower relative SES, and having more adverse childhood experiences were significantly associated with negative mental health outcomes. In models adjusted for individual ACEs, exposure to mental illness in the household, physical violence between adults in the household, emotional abuse, and sexual abuse were independently associated with all three outcomes. Young adults most vulnerable and stigmatized in the community are also those who are most severely affected in terms of mental health.

Changes in cigar sales following implementation of a local policy restricting sales of flavoured non-cigarette tobacco products.

INTRODUCTION: On 3 January, 2013, the city of Providence, Rhode Island, began enforcing a restriction on the retail sale of all non-cigarette tobacco products with a characterising flavour other than tobacco, menthol, mint or wintergreen. We assessed the policy impact on cigar sales-which comprise 95% of flavoured non-cigarette tobacco products sold through conventional tobacco retail outlets (eg, convenience stores, supermarkets) in Providence-over time and in comparison to the rest of the state (ROS). METHODS: Weekly retail scanner sales data were obtained for January 2012 to December 2016. Cigar sales were categorised into products labelled with explicit-flavour (eg, Cherry) or concept-flavour (eg, Jazz) names. Regression models assessed changes in prepolicy and postpolicy sales in Providence and ROS. RESULTS: Average weekly unit sales of flavoured cigars decreased prepolicy to postpolicy by 51% in Providence, while sales increased by 10% in ROS (both p<0.01). The Providence results are due to a 93% reduction in sales of cigars labelled with explicit-flavour names (p<0.01), which did not change significantly in ROS. Sales of cigars labelled with concept-flavour names increased by 74% in Providence and 119% in ROS (both p<0.01). Sales of all cigars-flavoured and otherwise-decreased by 31% in Providence (p<0.01). We detected some evidence of product substitution and cross-border purchasing. CONCLUSIONS: The Providence policy had a city-specific impact on retail sales of flavoured cigars, which was attenuated by an increase in sales of concept flavour-named cigars. Products with concept-flavour names may avoid enforcement agency detection, and their continued sale undermines the intent of the policy.

Alcohol Use and Intimate Partner Violence Among Community College Women: An Exploration of Protective Factors.

Little is known regarding the association between alcohol use and violence among community college women. Accordingly, this study investigated daily-level associations between alcohol use and intimate partner victimization (IPV) in a sample of young women (ages 18-24) in a community college setting, and the potentially protective role of education aspirations and living with family. Using a calendar-based assessment, women enrolled in a large community college (N = 212) completed past-month surveys of IPV and alcohol use. Unadjusted Generalized Estimating Equations showed nonsignificant positive associations between alcohol consumption (any alcohol use and number of drinks) and IPV at the daily level. Adjusted models showed a slight (but nonsignificant) increase in the odds of experiencing IPV on a drinking day. Those reporting a family income above $20,000 were at increased risk of experiencing violence. Living with family and wanting to attain a master's or doctoral degree reduced the risk of experiencing IPV on drinking days. Although the literature suggests that drinking among 4-year college women elevates the odds of experiencing IPV, our findings suggest the importance of examining contextual variables when understanding risk among community college women. Particularly, the role of family and educational aspirations may serve as protective factors in the association between alcohol use and IPV on a daily basis. As this is the first day-level study of IPV and alcohol use among community college women, further research is warranted to better explicate these findings.

Advancing Tobacco Control Through Point of Sale Policies, Providence, Rhode Island.

Local point of sale (POS) policies are key strategies for preventing and decreasing tobacco use among youth. In January 2013, Providence, Rhode Island implemented a comprehensive POS tobacco policy restricting the sale of flavored tobacco products and discounts of tobacco product prices. Lack of sustained funding for enforcement has been challenging. Our research focuses on the policy evaluation after enforcement began. We observed a decrease in availability of flavored tobacco products as citations for violations increased. However, we observed little change in the availability of flavored tobacco products with ambiguous descriptors that connote a flavor. Current use (within 30 days before survey) of tobacco products among high school students declined after the policy was enforced. Collectively, these findings demonstrate that POS tobacco policies are effective. The tobacco industry's marketing of products that do not explicitly reference flavors might undermine enforcement of POS tobacco restrictions in Providence and elsewhere in the United States.

Relationship between breastfeeding and asthma prevalence in young children exposed to adverse childhood experiences.

OBJECTIVE: To investigate if duration of supplemental breastfeeding is associated with a lower asthma risk and whether adverse childhood experiences (ACEs) early in life influence this relationship in children ages 3 to 5 years. METHODS: Data were from the 2011-2012 National Survey of Children's Health, a nationally representative cross-sectional survey. Modified Poisson regression models were used to estimate incident risk ratios (IRR) for lifetime and current asthma in young children aged 3 to 5 years (n = 15,642). We tested for effect measure modification using stratified analyses. RESULTS: Exclusive breastfeeding for at least 6 months or supplemental breastfeeding for children ≥12 months significantly reduced the risk of lifetime asthma prevalence compared to never breastfed children (IRR 0.64; 95% CI: 0.46-0.88, p = 0.007; and IRR 0.68; 95% CI: 0.47-0.99, p = 0.044, respectively), adjusted for covariates. In stratified analyses, breastfeeding reduced the risk of lifetime asthma for children who experienced 1 ACE but not for children who experienced 2 or more ACEs. CONCLUSION: Exclusive breastfeeding for at least 6 months, with and without supplementation, appears to prevent asthma or delay its onset. The protective effect of breastfeeding was attenuated among children who experienced more than 2 ACEs. The known harmful effects that ACEs have on children's health may outweigh the benefits of breastfeeding in reducing the risk of a child developing asthma. Understanding how specific time periods in a child's life may be most affected by exposure to early life adversities, along with the protective effect of breastfeeding against asthma, are important areas of further study.

Psychosocial Determinants of Teens' Online Engagement in Drug Prevention Social Media Campaigns: Implications for Public Health Organizations.

Social networking sites (SNSs) now serve as a primary form of communication among adolescents. Consequently, drug prevention campaigns delivered through SNSs have the potential to reach a wide network of adolescents if teens are willing to engage in the message diffusion process by commenting on, "liking," following, creating, or sharing prevention messages with their networked peers. However, little is known about the psychosocial factors that influence adolescents' willingness to participate in drug prevention social media campaigns. We use qualitative methods to explore reasons why adolescents may or may not want to engage in the message diffusion process. We conducted four semi-structured focus groups with a total of 33 high school students from various school- and community-based youth programs in Rhode Island. Focus groups were followed by a brief self-administered questionnaire collecting information about participants' social media use to augment qualitative findings. Overall, findings reveal that engaging teens in the message diffusion process can be advantageous but difficult to accomplish due to multiple factors. Most notably, asking adolescents to participate in drug prevention campaigns delivered through SNSs means also asking youth to violate online norms that promote drug use, which could in turn subject them to peer reprisal. We conclude that future studies should begin to investigate strategies addressing the various challenges we identified. Meanwhile, prevention specialists should consider alternative or supplemental evidence-based approaches to drug prevention rather than invest resources into activities that may offer little return on investment.

The Relationship Between Sexual History, Bullying Victimization, and Poor Mental Health Outcomes Among Heterosexual and Sexual Minority High School Students: A Feminist Perspective.

This study uses a feminist theoretical framework to extend the literature on the relationship between sexual history, bullying victimization, and poor mental health outcomes. First, we examined whether an association between the sexual double standard and bullying victimization would apply to sexual minority youth the same way it applies to heterosexual youth. A second aim was to assess whether sexual minority boys, typically stereotyped as effeminate, would report the highest odds of bullying victimization. A third and final aim of our study was to look at the joint effect of sex and sexual intercourse on depression and suicidal ideation. Our analytic sample ( N = 9,300) was from the 2009, 2011, and 2013 Rhode Island Youth Risk Behavior Surveys. Findings demonstrated that heterosexual girls who engaged in sexual intercourse had significantly higher adjusted odds of bullying victimization than heterosexual boys who engaged in the same behavior. Similar results were not found for sexual minority adolescents, suggesting the sexual double standard may not apply to sexual minority adolescents in the same way it applies to heterosexual adolescents. Consistent with our second hypothesis, sexual minority boys reported the highest odds of being recently bullied compared with heterosexual boys. Among students who were recently bullied, sexual minority girls displayed the highest adjusted odds of recent depression and suicidal ideation. Our study demonstrated that using a feminist theoretical framework broadens our understanding of why girls and sexual minority boys are particularly vulnerable to bullying victimization and the sequel of depression and suicidal ideation.