Elizabeth A. Mumford

Shifting Boundaries: an experimental evaluation of a dating violence prevention program in middle schools.

We randomly assigned the Shifting Boundaries interventions to 30 public middle schools in New York City, enrolling 117 sixth and seventh grade classes (over 2,500 students) to receive a classroom, a building, a combined, or neither intervention. The classroom intervention included a six-session curriculum emphasizing the laws and consequences for perpetrators of dating violence and sexual harassment (DV/H), the social construction of gender roles, and healthy relationships. The building-based intervention included the use of building-based restraining orders, higher levels of faculty/security presence in safe/unsafe “hot spots” mapped by students, and posters to increase DV/H awareness and reporting. Student surveys were implemented at baseline, immediately after the intervention, and 6-months post-intervention. As hypothesized, behaviors improved as a result of the interventions. The building-only and the combined interventions were effective in reducing sexual violence victimization involving either peers or dating partners at 6-months post-intervention. This was mirrored by reductions in sexual violence perpetration by peers in the building-only intervention. While the preponderance of results indicates that the interventions were effective, an anomalous result (increase in sexual harassment victimization reports that was contradicted by lower frequency estimates) did emerge. However, after analysis these anomalous results were deemed to be most likely spurious. The success of the building-only intervention alone is important because it can be implemented with very few extra costs to schools.

A National Descriptive Portrait of Adolescent Relationship Abuse Results From the National Survey on Teen Relationships and Intimate Violence

This article reports results from the National Survey on Teen Relationships and Intimate Violence (STRiV) for 12- to 18-year-old youth (n = 1,804). STRiV provides the first nationally representative household survey focused on adolescent relationship abuse (ARA), covering perpetration and victimization. Among respondents (37%) reporting current- or past-year dating, 69% reported lifetime ARA victimization (63% lifetime ARA perpetration). Although psychological abuse was most common for these youth (more than 60%), the rates of sexual abuse (18%) and physical abuse victimization (18%), as well as 12% reporting perpetrating physical abuse and/or sexual abuse (12%) were substantial as well. Other than differences by age and gender, ARA rates were consistent by race/ethnicity, geographic region, urbanicity, and household characteristics, highlighting the importance of universal prevention programs. Compared with youth aged 15 to 18, those 12 to 14 years old reported lower rates of psychological and sexual ARA victimization. Similarly, we found lower ARA perpetration rates for those 12 to 14. We found no gender differences for ARA victimization but found that girls perpetrated more physical ARA than boys. Girls aged 15 to 18 reported perpetrating moderate threats/physical violence at more than twice the rate of younger girls and 3 times the rate compared with boys aged 15 to 18; girls aged 15 to 18 reported perpetrating more than 4 times the rate of serious psychological abuse than boys 15 to 18. Finally, these data document the significant positive correlation between ARA victimization and perpetration. Findings suggest that when working with youth in prevention services, interventions should not be designed for monolithic groups of “victims” or “perpetrators.”

Understanding Characteristics of Families Who Buy Local Produce

OBJECTIVE To examine individual characteristics associated with local produce purchasing among North Carolina families with children. DESIGN Cross-sectional analysis using data from the 2008 North Carolina Child Health Assessment and Monitoring Program (NC CHAMP), a representative sample of adults who have land-line telephones. SETTING North Carolina. PARTICIPANTS Families with children who participated in the NC CHAMP (n = 2,932). MAIN OUTCOME MEASURE Frequency of buying local produce from local vendors in the past year. ANALYSIS Bivariate and multivariate zero-inflated negative binomial regression identified characteristics associated with not buying local produce and, among those who purchased local produce, the frequency of purchasing. RESULTS About half of families reported buying local produce on average once a month during the past year. In adjusted results, buying local produce was more likely among white families, lower income families, families living in rural areas, families with children who ate 5 or more servings of fruits and vegetables per day, and families with children in poor health. CONCLUSIONS AND IMPLICATIONS Findings suggest that it may be useful for dietitians and health promotion professionals to assess the availability of local produce in urban areas and to focus interventions to promote local produce purchases among black families.

Law Enforcement Officer Safety and Wellness

Officers in law enforcement agencies (LEAs) experience long-term health morbidity and mortality at rates exceeding other occupations and the general population. The purpose of this study was to pilot a survey of officer safety and wellness to demonstrate feasibility, assess the need for further research, and lay the groundwork for policies and additional support for officer wellbeing. A random sample of 184 officers from 11 participating LEAs responded to a survey regarding physical activity patterns, job characteristics, substance use, critical incidents, job-related stress, personal health, and health-care usage. Officers reported physical health outcomes at rates similar to the general population but screened positive for elevated rates of posttraumatic stress disorder, common mental disorders, and alcohol misuse. These data support the need for research at the regional and national levels to inform LEA policies and programs.

Is Women’s Empowerment Associated With Help-Seeking for Spousal Violence in India?

Violence against women by their husbands is a problem for women worldwide. However, the majority of women do not seek help. This article presents findings from a national survey in India on empowerment-related correlates of help-seeking behaviors for currently married women who experienced spousal violence. We examined individual-, relationship-, and state-level measures of empowerment on help-seeking from informal and formal sources. Findings indicate that help-seeking is largely not associated with typical measures of empowerment or socio-economic development, whereas state-level indicators of empowerment may influence help-seeking. Although not a target of this study, we also note that injury from violence and the severity of the violence were among the strongest factors related to seeking help. Taken together, the low prevalence of help-seeking and lack of strong individual-level correlates, apart from severe harm, suggests widespread barriers to seeking help. Interventions that affect social norms and reach women and men across social classes in society are needed in addition to any individual-level efforts to promote seeking help for spousal violence.

Growth Models of Maternal Smoking Behavior: Individual and Contextual Factors.

Background: Persistent maternal smoking during pregnancy, reduction or cessation during pregnancy, and smoking initiation or resumption postpartum impel further research to understand these behavioral patterns and opportunities for intervention. Objectives: We investigated heterogenous longitudinal patterns of smoking quantity to determine if these patterns vary across three maternal age groups, and whether the influence of individual and contextual risk factors varies by maternal age. Methods: Separate general growth mixture models were estimated for mothers ages 15–25, 26–35, and 36+, allowing different empirical patterns of an ordinal measure of smoking behavior at six time points, from preconception through child entry to kindergarten. Results: We identify five classes for mothers ages 15–25, four classes for ages 26–35, and three classes for ages 36+. Each age group presents classes of nonsmokers and persistent heavy smokers. Intermediate to these ends of the spectrum, each age group exhibited its own smoking classes characterized by the extent of pregnancy smoking reductions and postpartum behavior. In all three age groups, class membership can be distinguished by individual sociodemographic and behavioral characteristics. Co-resident smokers predicted nearly all smoking classifications across age groups, and selected neighborhood characteristics predicted classification of younger (15–25) and older (36+) mothers. Conclusions: The design, timing, and delivery of smoking prevention and cessation services, for women seeking to become pregnant and for women presenting for prenatal or pediatric care, are best guided by individual characteristics, particularly maternal age, preconception alcohol consumption, and postpartum depression, but neighborhood characteristics merit further attention for mothers at different ages.

Romantic Relationship Characteristics and Adolescent Relationship Abuse in a Probability-Based Sample of Youth

This study examines the longitudinal association between baseline adolescent romantic relationship characteristics and later adolescent relationship abuse (ARA). Data are from the first two waves of the National Survey on Teen Relationships and Intimate Violence (STRiV). Girls and boys ages 10 to 18 were recruited randomly from the children of adults participating in a larger national household probability sample panel. About three quarters of the sample identified as White, non-Hispanic. Controlling behavior by a romantic partner consistently predicted later ARA. Higher levels of controlling behavior in the relationship was associated with higher rates of sexual and/or physical ARA victimization and higher rates for similar acts of perpetration. More controlling behavior by the partner was also associated with higher rates of psychological ARA victimization (and higher rates for psychological ARA perpetration). Our results suggest that ARA prevention programs should have explicit discussions of the deleterious effects of controlling behavior with adolescents. Respondents reporting higher feelings of passionate love were also at higher risk of experiencing sexual and/or physical ARA victimization. This finding will need to be considered by clinicians and prevention specialist in their work with youth as a potential risk marker for ARA. Baseline reports of at least one form of ARA were predictive of 1-year follow-up rates of ARA in all of our models, underscoring a long line of research that past aggressive or violent behavior is one of the strongest predictors of current aggressive or violent behavior. We also observed that female respondents were twice as likely to be perpetrators of physical and/or sexual ARA as male respondents. Prevention messaging often is focused on girls as ARA victims and our results imply that messaging should also be directed toward girls as perpetrators.

Crossing a border for a low-cost, high-risk environment: smoking status and excessive drinking among young adults in Tijuana.

This study examines the drinking and smoking behavior of 2,311 college-age adults traveling from San Diego, California, to Tijuana, Mexico (December 2006 to December 2008). We describe this Border samples drinking history and smoking status and estimate multivariate models of evening drinking participation and, conditional on drinking, blood alcohol concentration. Noting limitations, we present implications for identifying young adults at high risk for alcohol and tobacco use, particularly females, and lay the foundation for further research examining young adults’ alcohol and tobacco use in reduced price scenarios.

Postpartum Domestic Violence in Homes With Young Children: The Role of Maternal and Paternal Drinking

There has been limited investigation of mothers’ drinking patterns and their experience of domestic abuse while parenting young children, especially in the context of co-resident fathers’ drinking. Using data representative of the 2001 U.S. birth cohort, the authors conducted longitudinal latent class analyses of maternal drinking over four perinatal time points as predictors of maternal victimization at 2 years postpartum due to intimate partner violence. Women classified as higher risk drinkers over the study period faced significantly increased risk of physical abuse while parenting a 2-year-old child. Among non-drinking mothers, paternal binge drinking signaled additional risk, with clinical and programmatic implications.

Validation of a new continuous geographic isolation scale: A tool for rural health disparities research

The purpose of this study was to develop and test a new continuous measure for rural health disparities research that characterizes geographic areas according to a perspective of access to resources. We call the measure Isolation and anticipate it will be useful as an alternative to commonly used rural classification schemes (e.g., the Census Bureaus measure). Following the best known standards for measuring rurality, it captures the trade-off between access to resource-rich, high-population-density areas and the cost of travel to those areas; thus even intrinsically low-resource areas may have high access to nearby resources. Validity was tested with proxies such as distance to hospitals, physician availability, and access to high quality food. The Isolation scale demonstrated good construct validity (i.e., both convergent and criterion validity). Fit statistics indicated that, compared to other commonly-used urban/rural definitions, the Isolation scale was the best overall measure when predicting several proxies for rurality, even when categorized. We also show that the measure does a substantially better job at explaining national health outcome data at the state level. This new continuous Isolation scale shows considerable promise for improving our conceptualization, theorization, and measurement of the features of rurality that are pertinent to rural health disparities research, and can also be useful to policy makers who may find value in using isolation thresholds that are most relevant to their policy planning needs.