Effects of family violence and parental psychopathology on the psychological outcome of urban adolescents exposed to community violence

Previous research has documented an association between adolescents’ exposure to community violence and a range of mental health problems. However, some violence-exposed youth maintain high levels of adaptive behavior and exhibit good psychological functioning. Thus, it appears that protective and/or risk factors are involved in the community violence-psychological outcome relation, which mitigate the conditions under which community violence exposure leads to adverse adolescent outcome. According to the ecological transactional model, protective and/or risk factors may exist within the family that influence adolescent outcome in response to community violence exposure. The purpose of this study was to delineate the relations among community violence exposure and family factors, including family violence and parental psychopathology, on adolescent psychological symptomatology and personal adjustment. Participants consisted of 121 pairs of junior high or high school students and their parent/guardian. Adolescents completed the Screen for Adolescent Violence Exposure, the Trauma Symptom Checklist for Children, and the Behavior Assessment System for Children-Self Report of Personality. The parents/guardians competed a Demographic Questionnaire, the Behavior Assessment System for Children-Parent Report, the Symptom Checklist-90-R, and the Posttraumatic Stress Diagnostic Scale. Hierarchical regression analyses were conducted and results indicated that family violence exposure did not serve as a moderator variable in the association between adolescent community violence exposure and positive or negative adolescent outcome. In contrast, parental psychopathology was found to be a moderator variable in the relationship between community violence exposure and adolescent-rated PTSD and psychological distress, but not in the relationship between community violence exposure and parent-rated adolescent internalizing and externalizing problems or adolescent-rated personal adjustment. Clinical implications and limitations of this study are discussed

Exploratory Factor Analysis of the Trauma Symptom Checklist for Children: A Comparison of Two Factor Extraction Methods

INTRODUCTION: Assessment tools that demonstrate adequate construct validity are needed to identify youth at risk of developing posttraumatic stress symptoms (PTSS) so these at risk youth can be referred to appropriate resources such as counseling. Research on the construct validity of instruments designed to measure PTSS have not shown a consistent factor structure of PTSS. Furthermore, the factor structure of PTSS measured using the Trauma Symptom Checklist for Children (TSCC), a widely used instrument, have only been studied using principal component analysis (PCA), a data reduction technique, rather than exploratory factor analysis (EFA), a factor analytic technique. AIM: The present study aims to 1) evaluate the construct validity of the TSCC using EFA, and 2) demonstrate differences in factor solutions extracted using EFA and PCA. METHODS: A secondary data analysis was conducted on a sample of 121 adolescents exposed to community violence in a mid-sized southern city. Two factor analyses were conducted on the sample using EFA and PCA. RESULTS: Using EFA, PTSS measured by the TSCC demonstrated a three factor structure. The factors were named the Posttraumatic Stress factor, Fear factor, and Sexual Concerns factor. Using PCA, five less interpretable components were extracted. DISCUSSION: The factor structure of PTSS measured by the TSCC differed from currently proposed factor solutions in the PTSS literature, lending evidence that more EFA work is necessary to determine the factor structure of PTSS. As expected, there were also differences between the factor solutions produced using the two different analytic techniques. Future research is needed to confirm this factor solution in larger, more diverse samples

A Cross Sectional Study of Mostly African- American Men Examining Mental Health and Child Behavior

Background: Home visiting receives bipartisan support at both the state and federal level, because several models have demonstrated significant results in both reduction of child maltreatment as well as parenting behavior modification. Yet, parenting research and services lack further engagement and involvement as a primary component. That is, even though research has shown that fathers play an integral role in child development, there is very little research done in which fathers are the primary focus; most of this research focuses on mothers. When it comes to serving children who are victims of child abuse and neglect, this is a problem at both the programmatic and legislative level. Methods: This study took place within the context of a broader NIH funded trial to examine the efficacy of an adapted (technologically enhanced) version of an evidence-based parenting program, SafeCare, for fathers. This was a cross-sectional examination of the results from a survey in which mostly African-American, at-risk fathers (n=84), reported on – using putative measures – parenting practices, mental health, and behavior of their children. This initial assessment used linear regression to examine the association between fathers’ mental health and their child’s externalizing and internalizing problem behaviors. Results: On average, higher levels of father depression and anxiety corresponded to higher scores for child behavior problems. That is, there was a significant correlation between the fathers’ anxiety and depression and the child’s problem behaviors. Conclusions: These findings suggest a need for acknowledging the father’s role in child development as well as any potential external factors that might have a pernicious effect on the father’s mental state[s]. In addition, more attention should be given to separating data within studies that examine both mothers and fathers in order to assess individual effects by each parent

The Impact of Maternal Literacy Skills on Child Weight in Mozambique

Background: Infant mortality is a serious public health problem. One factor that is strongly associated with infant mortality is low weight in children. The percentage of underweight children under the age of five in Mozambique was 16% in 2012. In order to reduce the number of underweight children in this country, contributing caregiver characteristics of this problem should be investigated. One potentially relevant characteristic is maternal literacy, which has been under investigated. Objective: This study aims to determine whether maternal literacy affected the weight and body-mass-index (BMI) of children ages 0 to 3 years old in Mozambique. Methodology: A cross-sectional study of 6,762 children between the ages of 0 and 47 months was conducted using the 2011 Demographic and Health Survey for Mozambique. Analysis of covariance (ANCOVA) procedures with Scheffe post hoc tests were performed in order to identify differences in mean child weight and BMI Z-score in reference to maternal literacy level, controlling for several covariates (e.g., mother’s weight, education). The data were analyzed using Statistical Analysis Software Version 9.4. Results: In the study sample, 396 (6.05%) children were found to be underweight and 4467 (58.69%) of mothers were found to be illiterate. There was a statistically significant association between maternal literacy level and the weight and BMI of children between the ages of 0 and 3 years of age, after controlling for other known predictors. A trend of stronger association was observed for each one-year increase in child age. Conclusions: Maternal literacy is significantly associated with child weight and BMI. Prioritizing secondary education for women is one important approach for ameliorating the risk of underweight children. Increased literacy rates in women could lead to better understanding of child nutritional needs, and ultimately, an overall reduction in the number of underweight children

Can Social Networking Be Used to Promote Engagement in Child Maltreatment Prevention Programs? Two Pilot Studies

Introduction: Child maltreatment is one of the United States’ most significant public health problems.In efforts to prevent maltreatment experts recommend use of Behavioral Parent Training Programs(BPTs), which focus on teaching skills that will replace and prevent maltreating behavior. eScholarship provides open access, scholarly publishing services to the University of California and delivers a dynamic research platform to scholars worldwide. While there isresearch to support the effectiveness of BPTs in maltreatment prevention, the reach of such programsis still limited by several barriers, including poor retention of families in services. Recently, newtechnologies have emerged that offer innovative opportunities to improve family engagement. Thesetechnologies include smartphones and social networking; however, very little is known about thepotential of these to aid in maltreatment prevention. The primary goal of this study was to conduct 2pilot exploratory projects. Methods: The first project administered a survey to parents and providers to gather data about at-risk parents’ use of smartphones and online social networking technologies. The second project tested asocial networking-enhanced brief parenting program with 3 intervention participants and evaluatedparental responses. Results: Seventy-five percent of parents surveyed reported owning a computer that worked. Eightyninepercent of parents reported that they had reliable Internet access at home, and 67% said theyused the Internet daily. Three parents participated in the intervention with all reporting improvement in parent-child interaction skills and a positive experience participating in the social networking-enhanced SafeCare components. Conclusion: In general, findings suggest that smartphones, social networking, and Facebook, in particular, are now being used by individuals who show risk factors forma treatment. Further, themajorityof parents surveyed in this study said that they like Facebook, and all parents surveyed said that they useFacebook and have a Facebook account. As well, all saw it as a potentially beneficial supplement forfuture parents enrolling in parenting programs

Collecting Physiological Stress Measures in Research among High-Risk Parents for Child Maltreatment: A Qualitative Investigation

Background: Studies on evidence-based, behavioral training programs have shown a positive reduction in self-reported stress among parents at high risk of child maltreatment (CM). However, no known studies on these programs have examined physiological biomarkers for stress, such as impaired levels of cortisol and dehydroepiandrosterone (DHEA), and telomere length. Further, no details are known regarding the feasibility of collecting biological markers from parents. This research examined qualitative findings from a multidisciplinary neurobiology and public health study that examined physiological responses to a six week, evidence-based, behavioral parenting program, among a maternal population at risk of CM perpetration in Atlanta, Georgia. Methods: Eighteen high-risk mothers were assessed at pre-intervention and post-intervention for parental stress and behavior (i.e., self-report, observational), and non-invasive physiological markers for cortisol, DHEA, and telomere length, Hormones were measured using two salivary methods, passive drool and Salivette swabs, as well as hair samples. Telomere length was assessed using cheek swabs. Semi-structured interviews were conducted at baseline to examine the feasibility of collecting biological samples for parental stress research among a sub-sample of participants (n=13). Results: Early qualitative themes suggest interest in providing hair and cheek swab samples. Notable suggestions were made to improve saliva collection. Particularly, participants showed clear preference for swabbing methods over passive drool collection. Conclusions: These study findings add novel results to the parenting literature on parental stress and provide emerging evidence on parental willingness to engage in physiological research. Acceptance of collection methods encourages further examination of biomarker correlates using non-invasive and inexpensive methods in biobehavioral research

Child Maltreatment and Disaster Prevention: Qualitative Study of Community Agency Perspectives

Introduction: Child maltreatment (CM) is a significant public health problem that increases following natural disasters. Ecological approaches have been used to study these complex phenomena, and the current research fits within this perspective by conducting qualitative interviews with disaster response and family-serving community agencies. The purpose of the study was to identify whether or not community agencies identified CM as an issue that is relevant for disaster planning and response and their perspectives on risk and protective factors for CM risk following disaster. Methods: Agencies (n=16) from 2 geographical areas participated - one that recently experienced a natural disaster (Louisiana (LA), n=7) and one that had not (Georgia (GA), n=9). Agency representatives completed semi-structured telephone interviews (n=16) and follow up in person focus groups (n=14). Theory-driven, thematic analyses were completed. Results: Results suggested that community agencies agree that post-disaster environments increase the risk for CM and that CM prevention has a role in disaster response planning. Risk and protective factors were identified according to Bronfenbrenner’ s ecological framework. Conclusion: Study results support the need to include CM prevention efforts within disaster planning and provide guidance for future research to inform such efforts. [West J Emerg Med. 2013;14(4):402–408

Risk Factors of Sexual Assault Victimization within the U.S. Military

INTRODUCTION: Sexual assault (SA) victimization affects thousands of service members in the military each year and identifying risk factors of SA is essential to inform prevention efforts. AIM: To synthesize literature on SA within the military to determine risk factors of SA incidence. METHODS: Risk factors from 6 epidemiological studies were compared via meta-analysis using R. Odds ratios and tests of heterogeneity were calculated to illustrate the collective odds of SA given each risk factor across the studies and to show variability. Odds ratios were calculated separately for risk factors only mentioned in one study. RESULTS: Women (OR =16.37), persons reporting sexual harassment during service (OR = 14.54), persons with a SA history (OR = 3.99), enlisted rank (OR = 2.47), non-married persons (OR = 2) and persons with no college experience were at greater risk of SA (OR = 1.32). Being White was found to be a protective factor (OR = 0.76). Our descriptive analysis found that experiencing stalking (OR = 11.84), being a sexual minority (OR = 2.15) or transgender increased the risk of SA (OR = 1.91). However, transgender womxn were at lower risk of SA than transgender mxn (OR = 0.42). DISCUSSION: It may be useful to develop tailored prevention programs for those identified as at risk according to our findings. Further, more needs to be done to address the environmental and cultural factors specific to the military that perpetuate SA incidence

Marginal Cost Analysis of Two Train-the-Trainer Models for Implementing SafeCare

[West J Emerg Med. 2014;15(5):623–626.

Technology-Based Innovations in Child Maltreatment Prevention Programs: Examples from SafeCare®

Each year, hundreds of thousands of children in the U.S. are victims of child maltreatment. Experts recommend behavioral, skill-based parent training programs as a strategy for the prevention of child abuse and neglect. These programs can be enhanced using innovative technology strategies. This paper presents a brief history of the use of technology in SafeCare®, a home visiting program shown to prevent child neglect and physical abuse, and highlights current work that takes a technology-based hybrid approach to SafeCare delivery. With this unique approach, the provider brings a tablet computer to each session, and the parent interacts with the software to receive psychoeducation and modeling of target skills. The provider and parent then work together to practice the targeted skills until mastery is achieved. Initial findings from ongoing research of both of these strategies indicate that they show potential for improving engagement and use of positive parenting skills for parents and ease of implementation for providers. Future directions for technology enhancements in SafeCare are also presented