Intimate partner violence victimization and perpetration as precursors to suicide.

It remains unclear how often and under what circumstances intimate partner violence (IPV) precedes suicide. Available research on IPV and suicide focuses largely on homicide-suicide, which is a rare event (<2% of suicides). We focus instead on single suicides (i.e., suicides unconnected to other violent deaths), which are the most common type of fatal violence in the US. Unfortunately, information about IPV circumstances is often unavailable for suicides. To address this gap, we sought to identify the proportion of single suicides that were preceded by IPV in North Carolina (NC), to describe the prevalence of IPV victimization and perpetration as precursors to suicide, and to explore how IPV-related suicides differ from other suicides. We used data from the NC Violent Death Reporting System (2010-2017, n = 9682 single suicides) and hand-reviewed textual data for a subset of cases (n = 2440) to document IPV circumstances. We had robust inter-rater reliability (Kappa: 0.73) and identified n = 439 IPV-related suicides. Most were males who had perpetrated nonfatal IPV (n = 319, 72.7%) prior to dying by suicide. Our findings suggest that IPV was a precursor for at least 4.5% of single suicides. Next, we conducted logistic regression analyses by sex comparing IPV-related suicides to other suicides. For both men and women, IPV was more common when the person who died by suicide had recently disclosed suicidal intent, was younger, used a firearm, and was involved with the criminal legal system, even after controlling for covariates. We also found sex-specific correlates for IPV circumstances in suicide. Combined with homicide-suicide data (reported elsewhere), IPV is likely associated with 6.1% or more of suicides overall. Results suggest clear missed opportunities to intervene for this unique subpopulation, such as suicide screening and referral in IPV settings (e.g., batterer intervention programs, Family Justice Centers) that is tailored by sex.

On Mining Words: The Utility of Topic Models in Health Education Research and Practice.

Written language is the primary means by which scientific research findings are disseminated. Yet in the era of information overload, dissemination of a field of research may require additional efforts given the sheer volume of material available on any specific topic. Topic models are unsupervised natural language processing methods that analyze nonnumeric data (i.e., text data) in abundance. These tools aggregate, and make sense of, those data making them interpretable to interested audiences. In this perspective piece, we briefly describe topic models, including their purpose, function, and applicability for health education researchers and practitioners. We note how topic models can be applied in several contexts, including social media-based analyses, and mapping trends in scientific literature over time. As a tool for studying words, and patterns of words, topic models stand to improve our understanding of events prior and those occurring in the moment and help us look ahead into the future.

Evaluations of Prevention Programs for Sexual, Dating, and Intimate Partner Violence for Boys and Men: A Systematic Review.

Among violence prevention educators and researchers, there is growing interest in sexual, dating, and intimate partner violence (SV/DV/IPV) prevention programs for males because of evidence showing that boys and men are more likely than girls and women to perpetrate SV as well as more severe forms of DV/IPV. To date, comprehensive guidance on the content, structure, delivery, and effectiveness of such programs is limited. We reviewed randomized controlled studies that evaluated SV/DV/IPV perpetration prevention programs for boys and men. Searches yielded 5,249 potential documents for review of which 10 met inclusion criteria-representing 9 unique studies of 7 distinct programs. Two reviewers independently reviewed and abstracted data from these studies regarding program setting and target audience; type of violence addressed; number and length of program sessions; program duration, topics, activities, and delivery mode; and implementer details. Study characteristics were also examined (sample size, participant characteristics, recruitment, randomization, comparison/control condition, data collection protocols, attrition, measures of violence perpetration, and perpetration findings). The Cochrane Risk of Bias Tool was used to assess study design quality. Results show considerable heterogeneity among program content and delivery strategies, study designs, and outcome measurement. Study sample size ranged widely, and most used cluster-randomized designs, recruited undergraduate college students, and evaluated a multisession program delivered via group sessions. Only one program reduced men's self-reported SV perpetration. Accordingly, critical gaps exist around "what works" for SV/DV/IPV perpetration prevention programs for boys and men.

Fatalities related to intimate partner violence: towards a comprehensive perspective.

BACKGROUND: In 2015, 1350 people in the US were killed by their current or former intimate partner. Intimate partner violence (IPV) can also fatally injure family members or friends, and IPV may be a risk factor for suicide. Without accounting for all these outcomes, policymakers, funders, researchers and public health practitioners may underestimate the role that IPV plays in violent death. OBJECTIVE: We sought to enumerate the total contribution of IPV to violent death. Currently, no data holistically report on this problem. METHODS: We used Violent Death Reporting System (VDRS) data to identify all IPV-related violent deaths in North Carolina, 2010-2017. These included intimate partner homicides, corollary deaths, homicide-suicides, single suicides and legal intervention deaths. We used the existing IPV variable in VDRS, linked deaths from the same incident and manually reviewed 2440 suicide narratives where intimate partner problems or stalking were a factor in the death. RESULTS: IPV contributes to more than 1 in 10 violent deaths (10.3%). This represents an age-adjusted rate of 1.97 per 100 000 persons. Of the IPV-related violent deaths we identified, 39.3% were victims of intimate partner homicide, 17.4% corollary victims, 11.4% suicides in a homicide-suicide event, 29.8% suicides in a suicide-only event and 2.0% legal intervention deaths. IMPLICATIONS: If researchers only include intimate partner homicides, they may miss over 60% of IPV-related deaths. Our novel study shows the importance of taking a comprehensive approach to prevent IPV and decrease violent deaths. IPV is a risk factor for suicide as well as homicide.

Community-University Partnership Characteristics for Translation: Evidence From CDC's Prevention Research Centers.

Background: The Centers for Disease Control and Prevention's Prevention Research Centers (PRC) Program supports community engagement and partnerships to translate health evidence into practice. Translation is dependent on the quality of partnerships. However, questions remain about the necessary characteristics to develop and maintain translation partnerships. Aim: To identify the characteristics that influence community-university partnerships and examine alignment with the Knowledge to Action (K2A) Framework. Methods: Final Progress Reports (N = 37) from PRCs funded from September 2009 to September 2014 were reviewed in 2016-2017 to determine eligibility. Eligible PRCs included those that translated an innovation following the applied research phase (2009-2014) of the PRC award (n = 12). The PRCs and the adopters (i.e., community organizations) were recruited and participated in qualitative interviews in 2017. Results: Ten PRCs (83.3% response rate) and four adopters participated. Twelve codes (i.e., elements) were found that impacted partnerships along the translation continuum (e.g., adequate communication, technical assistance). Each element aligned with the K2A Framework at multiple steps within the translation phase. The intersection between the element and step in the translation phase is termed a "characteristic." Using interview data, fifty-two unique partnership characteristics for translation were found. Discussion and Conclusion: The results suggest multiple characteristics that impact translation partnerships. The inclusion of these partnership characteristics in policies and practices that seek to move practice-based or research-based evidence into widespread use may impact the receptivity by partners and evidence uptake by communities. Using the K2A Framework to assess translation partnerships was helpful and could be considered in process evaluations to inform translation partnership improvement.

A Systematic Review of U.S.-Based Colorectal Cancer Screening Uptake Intervention Systematic Reviews: Available Evidence and Lessons Learned for Research and Practice.

Background: We examined colorectal cancer screening (CRCS) intervention effectiveness, through the effect sizes associated with: (1) screening modality, (2) intervention level (e.g., client-directed), and (3) intervention component (e.g. client reminders) within published CRCS intervention systematic reviews (SRs). Methods: A search of peer-reviewed CRCS SRs that were written in English was employed utilizing five databases: CINAHL, Cochrane Library, rTIPS, PubMed, and PsycINFO EBSCOHOST. SRs that included CRCS interventions with a randomized controlled trial, quasi-experimental, or single arm design were eligible. Data on effect sizes by screening modality, intervention level, and intervention component were extracted and synthesized. Results: There were 16 eligible CRCS intervention SRs that included 116 studies published between 1986 and 2013. Reviews organized data by CRCS screening modality, or intervention component. Effect size reporting varied by format (i.e., ranges, medians of multiple studies, or effect size per study), and groupings of modalities and components. Overall, the largest effect sizes were for studies that utilized a combination of colonoscopy, fecal occult blood test (FOBT), and sigmoidoscopy as screening options (16-45 percentage point difference). Conclusions: Evidence suggests that CRCS interventions which include a combination of screening modalities may be most effective. This is the first SR to examine effect sizes of published CRCS SRs. However, because some SRs did not report effect sizes and there were tremendous variability reporting formats among those that did, a standard reporting format is warranted. Synthesizing findings can contribute to improved knowledge of evidence-based best-practices, direct translation of findings into policy and practice, and guide further research in CRCS.

Association of socioeconomic status with financial burden of disease among elderly patients with cardiovascular disease: evidence from the China Health and Retirement Longitudinal Survey.

OBJECTIVES: The prevalence of cardiovascular diseases (CVD) within low-income and middle-income countries has reached epidemic proportions. However, the association between out-of-pocket (OOP) payment and socioeconomic status (SES) of patients with CVD is not well studied. We aimed to understand the financial burden among Chinese middle-aged and older patients with CVD, and whether there was an association with SES. SETTINGS: A nationally representative survey-The China Health and Retirement Longitudinal Survey (CHARLS)-was conducted in 28 provinces of mainland China in 2011 and 2013. PARTICIPANTS: Of the over 18 000 CHARLS respondents, eligible participants were those aged 45 years and over who had been previously diagnosed with CVD. OUTCOME MEASURES: Financial burden was measured by individual OOP payment and household catastrophic health expenditure (CHE) occurrence (ie, the annual household health expenditure was 40% or more of the total non-food household expenditure). Multilevel regression models were used to explore the association between financial burden and SES. RESULTS: Among CHARLS respondents, CVD prevalence increased from 14.7% in 2011 to 16.6% in 2013. Average annual CVD OOP payment increased from 5000 RMB (770 USD) to 6120 RMB (970 USD). Furthermore, CHE occurrence increased from 44.2% to 48.1%. Patients spent almost twice on outpatient as on inpatient services. Two of the three SES indicators (total household expenditure, occupation type) were found to be associated with CVD OOP payment amount, and the likelihood of CHE. Unemployed patients had a higher likelihood of CHE compared with agricultural workers. Rural-urban difference was associated with the likelihood of CHE in 2011 alone. CONCLUSION: The Chinese health system should use this health expenditure pattern among patients with CVD to create more equitable health insurance schemes that financially balance between outpatient and inpatient care, and provide better financial risk protection to patients with low SES.

Sexual Coercion Practices Among Undergraduate Male Recreational Athletes, Intercollegiate Athletes, and Non-Athletes.

Prior research shows that male intercollegiate athletes are at risk for perpetrating sexual violence. Whether this risk extends to male recreational athletes has not been explored. This study assessed associations between attitudes toward women, rape myth acceptance, and prevalence of sexual coercion among 379 male, undergraduate recreational and intercollegiate athletes and non-athletes. Our analyses showed significant differences between the responses of athletes and non-athletes for all dependent variables, and intercollegiate and recreational athletes on attitudes toward women and the prevalence of sexual coercion. Controlling for rape myth acceptance and traditional gender role attitudes eliminated differences between athletes and non-athletes in prevalence of sexual coercion.

Community-University Partnerships for Research and Practice: Application of an Interactive and Contextual Model of Collaboration.

Community-university partnerships are frequently used to enhance translational research efforts while benefiting the community. However, challenges remain in evaluating such efforts. This article discusses the utility of applying the contextual and interactive model of community-university collaboration to a translational research education program, the Institute for Translational Research in Adolescent Behavioral Health, to guide programmatic efforts and future evaluations. Institute stakeholders from academia and the community completed in-depth interviews querying their expectations and experiences in this collaboration. Key quotes and themes were extracted and analyzed based on the constructs within the 3 phases of the model. The findings note specific themes for future evaluations. Overall, the contextual and interactive model of community-university collaboration proved a useful framework to guide the process evaluation of the Institute. Findings suggest possible strategies for the successful development, evaluation, and sustainability of community-university partnerships.

Challenges and Benefits in Designing and Implementing a Team-Based Research Mentorship Experience in Translational Research.

BACKGROUND: Translational research seeks to build bridges between research and practice to address public health issues efficiently and effectively. The purpose of this paper was to evaluate a newly formed Institute that provided graduate students and adolescent behavioral health community professionals with a translational research service-learning opportunity through the creation of a community-university mentoring partnership. Goals of the team-based research mentorship approach included: 1) providing students the skills for implementing translational research; 2) providing research opportunities for community agencies to enhance operations and to encourage ongoing research involvement; and 3) developing relationships between university faculty and community agency professionals for further research collaborations. METHODS: The Institute used the National Institute on Drug Abuse's Mentoring Mosaic to select a diverse group of Community and Academic Mentors. The research mentorship experience of the initial cohort was evaluated based upon the Research Mentorship Conceptual Framework and Self-Assessment Tool. RESULTS: As a direct result of the research mentorship, outcomes for the Academic and Community Mentors and Scholars (i.e., those seeking a graduate certificate) included improved working relationships/networking and research experience. Through experiential learning, Scholars also discovered career trajectory clarity, the need for community collaboration in research, opportunities for continuing professional development, a greater understanding of public health competencies and how they align with community-based research, and skill development in best practices for translational research. CONCLUSION: The team mentoring approach is a form of pedagogy that holds promise to enhance translational research and community-based research efforts while developing public health competencies.