Community Health and Preventive Medicine Commons^™

Impact Of The Covid-19 Pandemic On Loneliness And Social Isolation: A Multi-Country Study, Roger O’Sullivan, Annette Burns, Gerard Leavey, Iracema Leroi, Vanessa Burholt, James Lubben, Julianne Holt-Lunstad, Christina Victor, Brian Lawlor, Mireya Vilar-Compte, Carla M. Perissinotto, Mark A. Tully, Mary Pat Sullivan, Michael Rosato, Joanna Mchugh Power, Elisa Tiilikainen, Thomas R. Prohaska

Department of Public Health Scholarship and Creative Works

The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during …

Prevalencia Mensual De Trastorno De Ansiedad Generalizada Durante La Pandemia Por Covid-19 En México, Pablo Gaitán-Rossi, Víctor Pérez-Hernández, Mireya Vilar-Compte, Graciela Teruel-Belismelis

Department of Public Health Scholarship and Creative Works

Objective. Estimate the prevalence of generalized anxiety disorder (GAD) from April to June 2020. Materials and methods. Repeated cross-sections design based in the Encovid-19, a series of monthly mobile surveys with represen- tative samples of Mexico (N= 833-1 674).The questionnaire includes the GAD-2 scale, and, in July, the GAD-7 scale was added; we examined its internal validity with confirmatory factor analysis and its concurrent validity with sociodemo- graphic variables. Using GAD-7 as criterion, we analyzed the predictive validity of the GAD-2.We estimated the monthly prevalence with the GAD-2. Results. The GAD-7 and the GAD-2 are reliable and valid.The GAD-2 has …

Three Decades Of Research: The Case For Comprehensive Sex Education, Eva Goldfarb, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

Purpose

School-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based programs to find evidence for the effectiveness of comprehensive sex education.

Methods

Researchers searched the ERIC, PsycINFO, and MEDLINE. The research team identified papers meeting the systematic literature review criteria. Of 8,058 relevant articles, 218 met specific review criteria. More than 80% focused solely on pregnancy and disease prevention and were excluded, leaving …

A Retrospective Analysis Of Sex Education Messages Received By Lgb Youth, Jacqueline Bible, Alejandra Kaplan, Lisa D. Lieberman, Eva Goldfarb

Department of Public Health Scholarship and Creative Works

Using focus groups, this qualitative study asked thirty-five gay, lesbian, and bisexual (LGB) young adults to reflect on messages they received about sex and sexuality around the time they first had sex. Focus groups were conducted, recorded, transcribed, and analyzed. Through thematic analysis, the authors identified two messaging sources identified by participants: (1) formal education sources (i.e., school and parents), and (2) informal education sources (e.g., internet, peers). Formal sources often included messages perpetuating heteronormative assumptions, emphasizing abstinence, pregnancy and HIV/STI prevention, or silence as a form of messaging. Informal sources consisted of LGB-specific information. These findings suggest informal sources …

Factors Associated With Binge Drinking During The Transition Into Adulthood: Exploring Associations Within Two Distinct Young Adult Age Ranges, Tamara Leech, Sarah Jacobs, Denis Watson

Department of Public Health Scholarship and Creative Works

Background:

Binge drinking among young adults aged 18-21 years has declined over the past decade, but binge drinking rates among people 22-25 years old have remained largely the same. This steady trend in later years represents a departure from the traditional course of maturing out of risky alcohol use, perhaps because young adults are delaying the transition into adulthood.

Aims:

This paper explores the relationship between binge drinking and aspects of the transition into adulthood that could inform interventions targeting these two distinct groups of young adults.

Methods:

We use survey data on 1,081 young adults aged 18-25 living in …

Costing Of Actions To Safeguard Vulnerable Mexican Households With Young Children From The Consequences Of Covid-19 Social Distancing Measures, Mireya Vilar-Compte, Víctor Pérez, Graciela Teruel, Aranzazu Alonso, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

COVID-19 has imposed unprecedented challenges to society. As the pandemic evolves, the social distancing measures that have been globally enforced, while essential, are having undesirable socioeconomic side effects particularly among vulnerable populations. In Mexico, families who depend upon informal employment face increased threats to their wellbeing, and households who in addition have young children may face long-term consequences. The Mexican government has not yet taken actions, but a coalition of non-governmental organizations is advocating in partnership with academic institutions for social protection actions such as a cash transfer and basic services subsidies for families with young children, subsisting from the …

Syndemics Of Severity And Frequency Of Elder Abuse: A Cross-Sectional Study In Mexican Older Females, Mireya Vilar-Compte, Pablo Gaitán-Rossi

Department of Public Health Scholarship and Creative Works

Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency.

Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships.

Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had …

Syndemics Of Severity And Frequency Of Elder Abuse: A Cross-Sectional Study In Mexican Older Females, Mireya Vilar-Compte, Pablo Gaitán-Rossi

Department of Public Health Scholarship and Creative Works

Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency.

Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships.

Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had …

Does First Sex Really “Just Happen?” A Retrospective Exploratory Study Of Sexual Debut Among American Adolescents, Lisa D. Lieberman, Eva S. Goldfarb, Samantha Kwiatkowski, Paul Santos

Department of Public Health Scholarship and Creative Works

First sex marks a significant transition for most adolescents, yet teens often report that it was unplanned. Seventy-four college students participated in exploratory focus groups about their first sex. Although initially asked whether their first sex was spontaneous or planned, many participants revealed evidence of forethought or anticipation, signifying a third option, anticipation. This study suggests that the development and timing of sexual health messages should build on the apparent, albeit often unacknowledged, planning and thought that accompany the transition to first sex. Specifically, during the time immediately preceding first sex, young people might be particularly open to such messages.

Perspectives On Conceptualizing Developmentally Appropriate Sexuality Education, Sara Silverio Marques, Eva Goldfarb, Julianna Deardoff, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

Despite recognition of the importance of a developmentally appropriate approach to sexuality education, there is little direct guidance on how to do this. This study employed in-depth interviews with experienced sexuality educators and developers of sexuality education materials to identify how this concept is understood and applied in the field. Developmentally appropriate sexuality education was conceptualized consistently across interviews to include (a) addressing developmentally relevant topics, (b) adapting content to cognitive development, (c) accommodating developmental diversity, and (d) facilitating the internalization of sexual health messages. However, these views fell short of incorporating the breadth of knowledge offered by adolescent development …

Perceptions Of Peer Sexual Behavior: Do Adolescents Believe In A Sexual Double Standard?, Michael Young, Susan Cardenas, Joseph Donnelly, Mark J. Kittleson

Department of Public Health Scholarship and Creative Works

BACKGROUND

The purpose of the study was to (1) examine attitudes of adolescents toward peer models having sex or choosing abstinence, and (2) determine whether a “double standard” in perception existed concerning adolescent abstinence and sexual behavior.

METHODS

Adolescents (N = 173) completed questionnaires that included 1 of 6 randomly assigned vignettes that described male and female peer models 3 ways: (1) no information about model's sexual behavior, (2) model in love but choosing abstinence, and (3) model in love and having sex. Participants read the vignette to which they had been assigned and responded to statements about the peer …

Know Your Value: Negotiation Skill Development For Junior Investigators In The Academic Environment—A Report From The American Society Of Preventive Oncology's Junior Members Interest Group, Allison B. Burton-Chase, Maria C. Swartz, Stephanie A. Navarro Silvera, Karen Basen-Engquist, Faith E. Fletcher, Peter G. Shields

Department of Public Health Scholarship and Creative Works

The American Society of Preventive Oncology (ASPO) is a professional society for multidisciplinary investigators in cancer prevention and control. One of the aims of ASPO is to enable investigators at all levels to create new opportunities and maximize their success. One strategy adopted by ASPO was to develop the Junior Members Interest Group in 1999. The Interest Group membership includes predoctoral fellows, postdoctoral fellows, and junior faculty members who are provided career development and training opportunities (1). Responsibilities of the members of the Junior Members Interest Group include serving on the ASPO Executive Committee and the Program Planning …

A Community Conversation On Adolescent Pregnancy And Parenting Services: Networks Of Support, Gatekeepers To Care, And Non-Compulsory Fathering In A Black Urban Community, Tamara Leech, Elizabeth A. Adams, Marci Littlefield

Department of Public Health Scholarship and Creative Works

This study employed Community-Based Participatory Research (CBPR) methods to document needs and capacity around adolescent pregnancy and parenting in one predominately Black, low-income urban community. Using an iterative focus group method, we engaged 60 participants in a two-day community conversation. Quantitative data from an enrollment questionnaire and qualitative transcripts of the discussions are analyzed. Our results indicate that the community’s greatest capacity lies in a network of women. Men tend to participate in parenting more holistically once formal paternity is established. Neighborhood women typically introduce adolescents to prenatal care, so delays in revealing the pregnancy to them serve as a …

Diversity In Times Of Austerity: Documenting Resistance In The Academy, Tamara Leech, David Moscowitz, Terri Jett, Terri Carney, Ann Savage

Department of Public Health Scholarship and Creative Works

What happens to feminism in the university is parallel to what happens to feminism in other venues under economic restructuring: while the impoverished nation is forced to cut social services and thereby send women back to the hierarchy of the family, the academy likewise reduces its footprint in interdisciplinary structures and contains academic feminists back to the hierarchy of departments and disciplines. When the family and the department become powerful arbiters of cultural values, women and feminist academics by and large suffer: they either accept a diminished role or are pushed to compete in a system they recognize as antithetical …

Sexuality Information Needs Of Latino And African American Ninth Graders: A Content Analysis Of Anonymous Questions, Francisca Angulo-Olaiz, Eva Goldfarb, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

This study used qualitative content analysis to examine anonymous questions about sex and sexuality submitted by Latino and African American adolescents in Los Angeles, California, classrooms. The majority of questions asked about sexuality and sexual behavior, or anatomy and physiology, with fewer questions about pregnancy and pregnancy prevention, sexually transmitted infections, and condoms. Overall, a notable mix was found of questions implying exposure to or awareness of a wide range of sexual activities, together with questions demonstrating fundamental misunderstandings or confusion about some of the most basic aspects of sex and sexuality. Gender differences emerged across topics, subtopics, and question …

Local Tobacco Control: Application Of The Essential Public Health Services Model In A County Health Department’S Efforts To Put It Out Rockland, Lisa D. Lieberman, Una Diffley, Sandy King, Shelley Chanler, Maryanne Ferrera, Oscar Alleyne, Joan Facelle

Department of Public Health Scholarship and Creative Works

In 2000, Rockland County, a small suburban county north of New York City, dedicated $1 million of its Master Settlement Agreement funds to a comprehensive tobacco control program, Put It Out Rockland. Developed and implemented by the county health department, this program used an essential public health services model and an ongoing financial investment, within the context of strong statewide tobacco control efforts, to lower adult smoking rates to 9.7% and to reduce both smoking among youths and exposure to secondhand smoke over the ensuing decade. By combining state funds and local dollars for a total of $6.75 cost per …

Short- And Long-Term Associations Between Widowhood And Mortality In The United States: Longitudinal Analyses, J. Robin Moon, M. Maria Glamour, Anusha M. Vable, Sze Yan Liu, S.V. Subramanian

Department of Public Health Scholarship and Creative Works

Background

Past research shows that spousal death results in elevated mortality risk for the surviving spouse. However, most prior studies have inadequately controlled for socioeconomic status (SES), and it is unclear whether this ‘widowhood effect’ persists over time.

Methods

Health and Retirement Study participants aged 50+ years and married in 1998 (n = 12 316) were followed through 2008 for widowhood status and mortality (2912 deaths). Discrete-time survival analysis was used to compare mortality for the widowed versus the married.

Results

Odds of mortality during the first 3 months post-widowhood were significantly higher than in the continuously married (odds ratio …

Empowerment-Based Positive Youth Development: A New Understanding Of Healthy Development For African American Youth, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

A shift occurred in research about adolescents in the general population. Research is moving away from deficits toward a resilience paradigm and understanding trajectories of positive youth development. This shift has been less consistent in research and practice with African American youth. A gap also exists in understanding whether individual youth development dimensions generate potential in other dimensions. This study presents an empowerment-based positive youth development model. It builds upon existing research to present a new vision of healthy development for African American youth that is strengths-based, developmental, culture-bound, and action-oriented. It emphasizes the relationship between person and environment, the …

Type Of High-School Credentials And Older Age Adl And Iadl Limitations: Is The Ged Credential Equivalent To A Diploma?, Sze Yan Liu, Niraj R. Chavan, M. Maria Glymour

Department of Public Health Scholarship and Creative Works

Purpose: Educational attainment is a robust predictor of disability in elderly Americans: older adults with high-school (HS) diplomas have a substantially lower disability than individuals who did not complete HS. General Educational Development (GED) diplomas now comprise almost 20% of new HS credentials issued annually in the United States but it is unknown whether the apparent health advantages of HS diplomas extend to GED credentials. This study examines whether adults older than 50 years with GEDs have higher odds of incident instrumental or basic activities of daily living (IADLs) limitations compared with HS degree holders. Methods: We compared odds of …

Risky Sexual Behavior: A Race-Specific Social Consequence Of Obesity, Tamara Leech, Janice Johnson Dias

Department of Public Health Scholarship and Creative Works

Scant attention has been given to the consequence of actual weight status for adolescents' sexual wellbeing. In this article, we investigate the race-specific connection between obesity and risky sexual behavior among adolescent girls. Propensity scores and radius matching are used to analyze a sample of 340 adolescents aged 16-17 who participated in the National Longitudinal Survey of Youth Young Adult Survey in 2000 or 2002. Nearly even numbers of these participants identified as white and black (183 and 157, respectively). We find that compared to their non-obese white peers, obese white adolescent girls exhibit higher rates of multiple sex partners …

The Community Action Framework In Practice: An Illustration Based On The Ready By 21 Coalition Of Austin/Travis County, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

The field of positive youth development has expanded focus from articulating and measuring desired manifestations of positive well-being to assembling the environmental conditions known to promote these desired outcomes. Evidence of the effectiveness of community-level efforts promoting positive youth development is still emerging, in particular theory-driven examples of community-driven youth development. This study examined the Community Action Framework, one theory-based community youth development model, through the experiences of the Ready by 21 Austin/Travis County coalition (RB21). The coalition connects youth-serving organizations and also regional coalitions, while promoting the positive development of area youth. Participant observation, interviewing, and archival strategies were …

Implications Of Lifecourse Epidemiology For Research On Determinants Of Adult Disease, Sze Yan Liu, Richard N. Jones, M. Maria Glamour

Department of Public Health Scholarship and Creative Works

Many diseases commonly associated with aging are now thought to have social and physiologic antecedents in early life. Understanding how the timing of exposure to early life risk factors influences later-life health may illuminate mechanisms driving adult health inequalities and identify possible points for effective interventions. Recognizing chronic diseases as developing across the life course also has implications for the conduct of research on adult risk factors for disease. We review alternative conceptual models that describe how the timing of risk factor exposure relates to the development of disease. We propose some expansions of lifecourse models to improve their relevance …

Developing A School Functioning Index For Middle Schools, Amanda Birnbaum, Leslie A. Lytle, Cheryl L. Perry, David Murray, Mary Story

Department of Public Health Scholarship and Creative Works

Despite widespread recognition of schools' role in the healthy development of youth, surprisingly little research has examined the relationships between schools' overall functioning and the health‐related behavior of students. School functioning could become an important predictor of students' health‐related behavior and may be amenable to intervention. This paper describes the development and testing of the School Functioning Index (SFI) as a first step in investigating this question. The index was developed for use with middle schools and conceived as a predictor of students' violent behavior, with the potential for extending research applications to additional health and social behaviors. Using social …

A Lesson On Homophobia And Teasing, Eva S. Goldfarb

Department of Public Health Scholarship and Creative Works

Homophobia and gay-related teasing are already present among young children. This lesson introduces the term “prejudice” and places the concept of homophobia within the context of bullying and teasing with which 8–11 year olds are already familiar. The lesson builds empathy as children think about and discuss how they have felt when they have been teased or called a name and how they think people in gay or lesbian families would feel. The lesson celebrates the lives of gay and lesbian people as it celebrates diversity among all people and families. Children are encouraged to think about the diversity within …

Girls' Perception Of Physical Environmental Factors And Transportation: Reliability And Association With Physical Activity And Active Transport To School, Kelly R. Evenson, Amanda Birnbaum, Ariane L. Bedimo-Rung, James Sallis, Carolyn C. Voorhees, Kimberly Ring, John P. Elder

Department of Public Health Scholarship and Creative Works

Background

Preliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school.

Methods

Test and retest surveys, administered a median of 12 days later, …

Perceived Smoking Environment And Smoking Initiation Among Multi-Ethnic Urban Girls, Tracy R. Nichols, Amanda Birnbaum, Sara Birnel, Gilbert J. Botvin

Department of Public Health Scholarship and Creative Works

Purpose

To examine associations between the perceived smoking environment and smoking initiation among urban multi-ethnic adolescent girls in New York City.

Methods

Self-report surveys completed in grades 7, 8, and 9 assessed girls’ (n = 858) smoking initiation, and perceived smoking environment (family smoking, friends’ smoking, smoking norms, and cigarette availability). Carbon monoxide breath samples were collected from girls using a variation of the bogus pipeline procedure.

Results

Differences were found in smoking prevalence with white girls reporting the highest prevalence of smoking at baseline and the greatest increase in smoking prevalence from seventh to eighth grade. Black girls reported …

Predictors Of Violent Behavior In An Early Adolescent Cohort: Similarities And Differences Across Genders, Jonathan L. Blitstein, David M. Murray, Leslie A. Lytle, Amanda Birnbaum, Cheryl L. Perry

Department of Public Health Scholarship and Creative Works

The authors assessed a cohort of 2,335 students from the Minneapolis, Minnesota, area to identify predictors of violent behavior and to determine whether the predictors varied by gender. The sample was 76% White; boys and girls were equally represented. The majority lived with two parents. A measure of violent behavior collected at the end of the eighth-grade year (2000) was entered into Poisson regression against baseline data collected at the beginning of the seventh-grade year (1998). Predictors of violent behavior influencing both boys and girls included depressive symptoms, perceived invulnerability to negative future events, paternal nonauthoritative behavior, and drinking alcohol. …

The Role Of Peer Social Network Factors And Physical Activity In Adolescent Girls, Carolyn C. Voorhees, David Murray, Greg Welk, Amanda Birnbaum, Kurt M. Ribisi, Carolyn C. Johnson, Karin Allor Pfeiffer, Brit Saksvig, Jared B. Jobe

Department of Public Health Scholarship and Creative Works

Objective: To study the relationship between peer-related physical activity (PA) social networks and the PA of adolescent girls.

Methods: Cross-sectional, convenience sample of adolescent girls. Mixed-model linear regression analyses to identify significant correlates of self-reported PA while accounting for correlation of girls in the same school.

Results: Younger girls were more active than older girls. Most activity-related peer social network items were related to PA levels. More PA with friends was significantly related to self-reported PA in multivariate analyses.

Conclusions: Frequency of PA with friends was an important correlate of PA among the peer network variables …

Longitudinal Invariance Of The Center For Epidemiologic Studies-Depression Scale Among Girls And Boys In Middle School, Robert W. Motl, Rod K. Dishman, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

This study tested the longitudinal factorial invariance of a theoretically consistent, higher-order model for Center for Epidemiologic Studies-Depression (CES-D) scores among adolescent girls and boys in middle school. Data were collected from 2,416 adolescents who completed a survey containing the CES-D in the fall of 1998, spring of 1999, and spring of 2000. The invariance analyses were conducted using LISREL 8.50 with maximum likelihood estimation and the Satorra-Bentler scaled chi-square statistic and standard errors. The higher-order model demonstrated longitudinal, as well as gender, invariance of the overall factor structure and first- and second-order structure coefficients, first-order factor variances, second-order factor …

A Theater-Based Approach To Primary Prevention Of Sexual Behavior For Early Adolescents, Jessica B. Janega, David M. Murray, Sherri P. Varnell, Jonathan L. Blitstein, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

This article compares four mixed-model analyses valid for group-randomized trials (GRTs) involving a nested cohort design with a single pretest and posttest. This study makes estimates of intraclass correlations (ICCs) available to investigators planning GRTs addressing dietary outcomes. It also provides formulae demonstrating the potential benefits to the standard error of the intervention effect (σΔ) from adjustments for both fixed and time-varying covariates and correlations over time. These estimates will allow other researchers using these variables to plan their studies by estimating a priori detectable differences and sample size requirements for any of the four analytic options. These methods are …