Young Mothers Curriculum: Developed for use at Stepping Stones International in the setting of Botswana

This curriculum for the “Young Mothers Program” was designed specifically for use in Botswana by the NGO Stepping Stones International (SSI), an organization based in Mochudi, Botswana. The resources were designed using evidence-based materials and key informant interviews with stakeholders in Botswana and were crafted specifically to meet the needs of young women in Botswana. A need exists for programs targeted at young mothers in Botswana to support them, allow them to support each other, aid in the development of parenting skills, build their self-esteem, and prevent subsequent pregnancies among teens. The program meets those needs through an educational and support group curriculum for mothers who are both in and out of school. Covered topics include goal setting, self-esteem, sexual and reproductive health, maternal and child health, breastfeeding, gender-based violence, mental health, and leadership skills.Master of Public Healt

Minor Sex Trafficking and Violence Victimization: Experiences of Interpersonal Violence among Minors Who Have Experienced Sex Trafficking in the United States

Minors in the United States who exchange sex for something of commercial value are considered victims of domestic minor sex trafficking (DMST) and commercial sexual exploitation of children (CSEC) regardless of the circumstances surrounding the exchange due to inherent age-related vulnerability. Childhood violence and abuse are commonly proposed as risk factors for DMST, though many studies rely on small, non-population-based samples and tend to focus on cisgender females. Less is known about how adolescent interpersonal violence victimizations connect to DMST experiences. Additionally, little is known about how DMST may lead to experiences of violence victimization in adulthood. This dissertation used data from The National Longitudinal Study of Adolescent to Adult Health (Add Health), a population-based sample of adolescents in the United States, to examine correlates of DMST among minor respondents. The Add Health measure for DMST was drawn from questions about minors exchanging sex for money or drugs. This dissertation examined: 1) the associations between DMST and interpersonal violence victimizations (intimate partner violence (IPV), non-partner violence) during adolescence, and 2) the associations between interpersonal violence victimizations in young adulthood and victimizations in adolescence/childhood (DMST, interpersonal violence, maltreatment). In adolescence, minors who experienced non-partner violence had significantly greater odds of having exchanged sex, while IPV was not significantly associated with minors’ experiences of sex exchange. Looking beyond adolescence, minor sex exchange was significantly associated with non-partner violence in young adulthood in partially-adjusted regression models but not fully-adjusted models, and sex exchange as a minor was not significantly associated with young adulthood IPV victimization. However, adolescent interpersonal violence victimizations were significantly associated with young adulthood victimizations. Maltreatment in childhood was also significantly associated with young adulthood violence victimization.Prevention and intervention efforts targeting adolescents who are potentially at risk for or survivors of DMST should consider how non-partner violence victimizations impact these adolescent populations. Programming and/or messaging should be adjusted to account for these poly-violence victimizations. In considering the links between adolescent and young adulthood violence, prevention and screening efforts should consider how violence victimizations across the life course—from childhood to young adulthood—impact the experiences and needs of violence survivors.Doctor of Public Healt

Toward a contextually sensitive understanding of polyvictimization:A latent class analysis of violence, risks, and protections among South African adolescents from highly deprived settings

South African adolescents experience a high prevalence of violence victimization alongside the health and economic burdens of HIV/AIDS and poverty. Polyvictimization is a useful theory and framework that allows for a nuanced understanding of lived adolescent experience patterns. Polyvictimization examinations are further enriched by person-centered analytical approaches. This study used latent class analysis to differentiate a sample of South African adolescents from highly deprived communities by their polyvictimization profiles and contextual violence risk and protective factors. Adolescents were sampled twice (2010/2011; 2011/2012), and data reflected their lifetime (sexual abuse) or recent (all other forms of assessed abuse/violence) violence victimizations, as well as individual, household, and community characteristics. Model fit indices supported a seven-class model with adolescents in high, moderate, and low polyvictimization classes. Adolescents in the high polyvictimization classes experienced a heavy burden of poverty and multiple forms of violence across contexts and were distinguished by HIV/AIDS and disability. Adolescents in the low polyvictimization class experienced relatively little violence, despite living in violent communities, and low household and individual burdens of HIV/AIDS and disability. Findings emphasize the importance of considering adolescent violence through a contextually sensitive polyvictimization lens to understand the complex web of violence that adolescents experience. This work supports previous research in low-resource South African settings highlighting the interconnected nature of violence, poverty, disability, and HIV/AIDS. Future research should explore these complex violence patterns and their effects, while program and policy actions must target and prevent adolescent violence especially for those impacted by poverty, disability, and HIV/AIDS.</p

A scoping review of vicarious trauma interventions for service providers working with people who have experienced traumatic events

Health and human service providers who aid traumatized individuals frequently experience vicarious trauma (VT). Although VT plays a critical role in service providers’ mental health and well-being, as well as in the quality of their service provision, little information is available concerning the development and implementation of VT interventions for service providers. To advance the development of evidence in this area, we undertook a scoping review in which we reviewed existing interventions intended to address VT among service providers working with traumatized clients. Searches of electronic databases were conducted to identify studies published in peer-reviewed journals, with no date restrictions. Over 1,315 citations were reviewed, and a total of 27 studies were included in the final review. The findings show that VT interventions in the literature can be divided broadly into four categories: psychoeducation, mindfulness intervention, art and recreational programs, and alternative medicine therapy. The VT interventions reviewed generally showed promise in their key outcomes, including reductions in secondary trauma stress, compassion fatigue, burnout, and other mental health outcomes. However, the current body of research is lacking both in rigor and in specificity regarding the definition of VT. Furthermore, existing VT interventions are generally self-care based and tend to focus on general stress management rather than addressing the specific effects of VT. Therefore, we call for an increase in efforts to tailor VT interventions to different service settings and participant characteristics, as well as greater attention to developing primary VT interventions at the organizational level

Contextually sensitive polyvictimization profiles and physical and mental health outcomes among South African adolescents from low-resource communities: an extended latent class analysis

Adolescents in South Africa may experience violence victimizations in many forms (abuse, bullying, assault) and across many contexts (home, school, community). Polyvictimization is a valuable framework to examine the diversity of violence in adolescents’ lives, particularly when employed alongside person-centered methods such as latent class analysis. This study builds on previous work examining contextually sensitive patterns of polyvictimization among South African adolescents and uses longitudinal Young Carers data (n = 3401) from highly-deprived, low-resource settings to investigate the associations between latent class polyvictimization profiles and physical and mental health outcomes using the Bolck–Croon–Hagenaars (BCH) method. Key results found that adolescents who experienced high polyvictimization alongside contextual factors (poverty, disability, etc.) had greater odds of suicidality and higher scores for depression and anxiety measures than their peers who experienced moderate or low polyvictimization. These outcomes were often worse within the high polyvictimization classes for those participants experiencing burdens of HIV/AIDS and disability. Results were mixed for the physical health outcomes (chronic health condition; recent poor health) and when distinguishing between the moderate and low polyvictimization classes, as some classes characterized by decreased polyvictimization had worse health outcomes. These findings highlight the need to consider polyvictimization as a relevant health risk and contextual factor when addressing the health and well-being needs of South African adolescents. Health programming and policy efforts should seek to screen for and address the causes of and distress from polyvictimization when targeting adolescents and provide a cohesive response to the adolescent violence and health burdens in low-resource communities