Gene A. Shelley

Latino Teens Talk About Help Seeking and Help Giving in Relation to Dating Violence

The authors examine attitudes about help seeking and help giving related to dating violence among Latino ninth graders, including survey and focus group data. Latino teens are more likely to seek help for a dating violence situation from informal sources of support (e.g., friends) than from formal sources (e.g., health professionals). Students are most likely to turn to other teens for help and do not confide or trust the adults in their social network. Teens are reluctant to intervene in dating violence situations. The quality of help offered by teens related to dating violence is perceived as being limited.

Child maltreatment prevention priorities at the Centers for Disease Control and Prevention

The Division of Violence Prevention at Centers for Disease Control and Prevention’s (CDC) National Center for Injury Prevention and Control has had a long-standing interest in the prevention of child maltreatment. The nation’s public health agency, CDC, seeks to focus the public health perspective on the problem of child maltreatment and to promote science-based practice in the field. Since 1999, CDC has developed research priorities to address the prevention of child maltreatment. Described here is a brief rationale for applying a public health approach to child maltreatment and a discussion of the priority-setting process, priorities in each of four areas of the public health model, and some of CDC’s current child maltreatment prevention activities.

Latinos’ Perspectives and Experiences With Intimate Partner Violence

This qualitative study, utilizing focus group interviews with community members and in-depth interviews with victims and perpetrators, explored Latinos’ beliefs and perceptions of IPV in Oklahoma City, Oklahoma, as a basis for developing culturally appropriate intimate partner violence (IPV) services for this population. The findings from these interviews suggest that this community recognizes IPV as a problem and is aware of the multiple dimensions, potential causes, and negative consequences of IPV. In general, participants perceived family and neighbors as preferring to not get involved in situations of IPV. However, family was also expected to, and often did, provide tangible support to victims. Directions for developing prevention programs for this population and future research are suggested.

Challenges in the Evaluation and Implementation of School-Based Prevention and Intervention Programs on Sensitive Topics:

The current emphasis on best practices for school-based health and mental health programs brings with it the demand for evaluation efforts in schools. This article describes the challenges of launching a successful school program and evaluation, with lessons learned from three projects that focus on intimate partner violence. The authors discuss issues related to constraints on the research design in schools, the recruitment of schools and participants within schools, program and evaluation implementation issues, the iterative implementation-evaluation cycle, and the dissemination of programs and study findings. The authors emphasize the need for flexibility and cultural awareness during all stages of the process.

Exploring the Links Between Components of Coordinated Community Responses and Their Impact on Contact With Intimate Partner Violence Services

In the 1990s, concerns with response fragmentation for intimate partner violence (IPV) led to the promotion of coordinated community responses (CCRs) to prevent and control IPV. Evaluation of CCRs has been limited. A previous evaluation of 10 CCRs funded by the Centers for Disease Control and Prevention showed no overall impact on rates of IPV when compared to matched communities. However, there was great variability in the quality and quantity of CCR efforts between sites and thus potentially different levels of impact. This article establishes the impact of each of the 10 CCRs on womens past-year exposure to IPV and contact with IPV services and explores the associations between specific CCR components and contact with IPV services.

An Examination of Whether Coordinated Community Responses Affect Intimate Partner Violence

This study tests the impact of coordinated community response (CCR) on reducing intimate partner violence (IPV) and on modifying knowledge and attitudes. The authors conduct hierarchical linear modeling of data from a stratified random-digit dial telephone survey (n = 12,039) in 10 test and 10 control sites, which include 23 counties from different regions in the United States, to establish the impact of a CCR on community members’ attitudes toward IPV, knowledge and use of available IPV services, and prevalence of IPV. Findings indicate that CCRs do not affect knowledge, beliefs, or attitudes of IPV, knowledge and use of available IPV services, nor risk of exposure to IPV after controlling for age, gender, ethnicity, income, and education. Women in communities with 6-year CCRs (as opposed to 3-year CCRs) are less likely to report any aggression against them in the past year. These results are discussed within the context of evaluation challenges of CCRs (e.g., IPV activities in comparison communities, variability across interventions, time lag for expected impact, and appropriateness of outcome indicators) and in light of the evidence of the impact of other community-based collaborations.

Provision of HIV Counseling and Testing Services at Five Community-Based Organizations Among Young Men of Color Who Have Sex with Men

In the context of monitoring and improving CDC-funded HIV prevention programs, we describe HIV tests and infections, provision of results, previous HIV tests, and risk behaviors for young (aged 13–29) men of color who have sex with men who received HIV tests at five community-based organizations. Of 1,723 tests provided, 2.1% were positive and 75.7% of positives were previously unaware of their infection. The highest positivity rate was among men aged 25–29 (4.7%). Thirty-four percent of tests were provided to men who were tested for the first time. Over half the tests (53.2%) were provided to men who reported sex with a person of unknown HIV status, and 34% to men who reported sex with an anonymous partner. Continued and more focused prevention efforts are needed to reach and test young men of color who have sex with men and to identify previously undiagnosed HIV infections among this target population.

An Evaluation of Mpowerment on Individual-Level HIV Risk Behavior, Testing, and Psychosocial Factors Among Young MSM of Color: The Monitoring and Evaluation of MP (MEM) Project

Young men who have sex with men (MSM) of color are at increased risk for HIV infection. Mpowerment (MP) is an intervention designed to reduce risky sexual behavior and increase HIV testing among young MSM ages 18-29. From 2009 to 2012, three community-based organizations with support from the U.S. Centers for Disease Control and Prevention evaluated MP among N = 298 participants. Following a repeated measures design, data from 3- and 6-month follow-ups were compared to baseline. HIV testing and self-efficacy for safer sex increased at both follow-up time points; self-acceptance as an MSM was higher at follow-up 2. Condomless anal/vaginal sex was lower at follow-up 1 only. Frequency of exchange of safer sex messages among gay/bisexual/transgender friends was lower at follow-up 1, but similar to baseline at follow-up 2. Exposure to MP was associated with improved perceived positive social norms about safer sex and safer sex messages among gay/bisexual/transgender friends.

The Changing Landscape of Hiv Prevention in the United States: Health Department Experiences and Local Adaptations in Response to the National Hiv/aids Strategy and High-impact Prevention Approach

Objective: HIV prevention has changed substantially in recent years due to changes in national priorities, biomedical advances, and health care reform. Starting in 2010, motivated by the National HIV/AIDS Strategy (NHAS) and the Centers for Disease Control and Preventions (CDCs) High-Impact Prevention (HIP), health departments realigned resources so that cost-effective, evidence-based interventions were targeted to groups at risk in areas most affected by HIV. This analysis describes how health departments in diverse settings were affected by NHAS and HIP. Methods: We conducted interviews and a consultation with health departments from 16 jurisdictions and interviewed CDC project officers who monitored programs in 5 of the jurisdictions. Participants were asked to describe changes since NHAS and HIP and how they adapted. We used inductive qualitative analysis to identify themes of change. Results: Health departments improved their HIV prevention practices in different ways. They aligned jurisdictional plans with NHAS and HIP goals, increased local data use to monitor program performance, streamlined services, and strengthened partnerships to increase service delivery to persons at highest risk for infection/transmission. They shifted efforts to focus more on the needs of people with diagnosed HIV infection, increased HIV testing and routine HIV screening in clinical settings, raised provider and community awareness about preexposure prophylaxis, and used nontraditional strategies to successfully engage out-of-care people with diagnosed HIV infection. However, staff-, provider-, and data-related barriers that could slow scale-up of priority programs were consistently reported by participants, potentially impeding the ability to meet national goals. Conclusion: Findings suggest progress toward NHAS and HIP goals has been made in some jurisdictions but highlight the need to monitor prevention programs in different contexts to identify areas for improvement and increase the likelihood of national success. Health departments and federal funders alike can benefit from the routine sharing of successes and challenges associated with local policy implementation, considering effects on the overall portfolio of programs.