Issues and Solutions for Collecting Biological Specimen in Longitudinal Studies: Experience from the Community Child Health Network Research Network.

The inclusion of biomarkers in studies of stress and health outcomes is of growing interest, including for community-based participatory research (CBPR) studies. Yet the perspectives of participants and communities have been infrequently consulted to inform the biomarker collection process. The objective of this paper is to describe the process and outcomes of using CBPR in framing biomarker collection in a study of allostatic load in a maternal and child health population. Through analysis of focus group data, we identify aspects of CBPR that facilitate increased community trust and endorsement related to collecting biological samples, and also provide a community perspective that is often overlooked in the literature. We found that a CBPR approach facilitated greater understanding among community members about the importance of biomarkers, while simultaneously informing the design of a biomarker data collection protocol that was responsive to the desired scope and data collection procedures that reflected community priorities.

Where Did She Go? The Transformation of Self-Esteem, Self-Identity, and Mental Well-Being among Women Who Have Experienced Intimate Partner Violence.

BACKGROUND: Discussions on intimate partner violence (IPV) often focus on physical abuse, ignoring psychological and sexual abuse and controlling behaviors. The damage of varied forms of IPV on mental well-being in its broader form have been far less explored, especially among low-income women. Our aim was to improve our understanding of self-perceptions of mental well-being among low-income women who have experienced IPV by considering a broader definition of mental well-being that includes self-esteem and self-identity as core components. METHODS: Using qualitative methods, we present findings from in-depth interviews with 41 low-income women currently or recently experiencing abuse and housing instability. RESULTS: Women experienced varied types of violence (physical, sexual, emotional, psychological, social isolation, and controlling behaviors). Injuries resulting from physical abuse were viewed differently from those arising from emotional and psychological control. Physical injuries healed faster, whereas damage to self-esteem and identity lingered. The journey through and out of IPV is often marked by an initial erosion of sense of self (identity deconstruction) followed by the identity reconstruction through an extended process of change aimed at rebuilding self-esteem, mental well-being, self-efficacy, and ultimately self-identity. CONCLUSIONS: IPV-related training for physicians and allied health professionals should emphasize the varied nature of IPV and its impact on identity, self-esteem, and self-efficacy. Treatment should be holistic to address comorbid needs, including physical injury, mental health, and addiction problems. Consider supportive programs that integrate those living with or leaving IPV with women with past lived experience who can help women to understand the process of change and support this change in a nurturing setting.

Linking childhood and adult criminality: using a life course framework to examine childhood abuse and neglect, substance use and adult partner violence.

Child abuse and neglect, considered criminal acts under the Criminal Code of Canada, play an important role in substance use, violence, and other criminal behaviour in adulthood. We adopted the life course perspective to identify modifiable contextual influences and co-occurring individual, social, and familial determinants associated with adult criminality. Using in-depth interview data, a sub-sample of 13 women who had recently experienced intimate partner violence, recounted their experiences of childhood abuse, their own substance use or criminality, as well as implications of these factors on their children's life trajectories. For the purposes of this paper criminality was defined as child abuse and neglect, domestic violence, illegal substance use and underage alcohol use. Our objective was to explore, in our data: (1) patterns and trajectories of criminality from childhood to adulthood among women who were victims of violence, and (2) cumulative effects of early life exposures on experiences of criminality; with the aim of describing the life course perspective as a useful framework to understand criminality along the life trajectory. The analysis was not designed to demonstrate causal connections between early childhood and adulthood experiences of criminality. Rather we generated qualitative and quantitative hypotheses to guide future research in the field. Implications for research and interventions are discussed.

Oral health, oral pain, and visits to the dentist: neighborhood influences among a large diverse urban sample of adults.

The objective of this study was to assess the association between oral health and individual-level characteristics as well as both socioeconomic position (SEP) and service provision characteristics at the neighborhood level. Multilevel logistic analysis was undertaken of data from the Neighbourhood Effects on Health and Well-being Study in Toronto comprising 2,412 participants living in 47 neighborhoods and 87 census tracts. Three oral health outcomes were investigated: last dental visit, self-rated oral health, and self-rated oral pain. Results indicated that SEP was significantly associated with no dental visits in the last year, poor self-rated oral health, and experiencing oral pain after adjusting for age, gender, and immigrant status. Lack of dental insurance was associated with no visits to the dentist in the last year and poor self-rated oral health; however, no association was observed with oral pain. In adjusted regression models, few neighborhood level variables were significantly associated with dental visits and self-rated oral health and no neighborhood variables were associated with oral pain. Based on these results, SEP appears to be important in evaluating oral health outcomes. While insignificant in this study, neighborhood factors are important when considering the impact of service provision on oral health.