Heathe Luz McNaughton Reyes

The Social Ecology of Adolescent Alcohol Misuse.

A conceptual framework based on social ecology, social learning, and social control theories guided identification of social contexts, contextual attributes, and joint effects that contribute to development of adolescent alcohol misuse. Modeling of alcohol use, suggested by social learning theory, and indicators of the social bond, suggested by social control theory, were examined in the family, peer, school, and neighborhood contexts. Interactions between alcohol modeling and social bond indicators were tested within and between contexts. Data were from a longitudinal study of 6,544 students, 1,663 of their parents, and the U.S. Census. All contexts were uniquely implicated in development of alcohol misuse from ages 11 through 17 years, and most alcohol modeling effects were contingent on attributes of social bonds.

What Accounts for Demographic Differences in Trajectories of Adolescent Dating Violence? An Examination of Intrapersonal and Contextual Mediators

PURPOSE To identify intrapersonal and contextual factors that mediate associations between demographic variables (minority status, socioeconomic status, family structure, gender, and neighborhood disadvantage) and trajectories of moderate and severe physical dating violence perpetration from ages 13-19 years. METHODS Multi-wave data from 959 adolescents were analyzed using formal mediation analysis in a multilevel analytical framework. RESULTS Gender and neighborhood disadvantage were not associated with trajectories of dating violence, and therefore mediation was not examined for those variables. At all ages, minority adolescents reported perpetrating significantly more moderate and severe physical dating violence than non-minority adolescents. Destructive communication skills, acceptance of dating abuse, gender stereotyping, and exposure to family violence significantly mediated those associations. Parental education was significantly negatively associated with moderate physical dating violence. Acceptance of dating abuse, gender stereotyping, and exposure to family violence significantly mediated that association. At all ages, adolescents from single-parent households perpetrated significantly more severe physical dating violence than adolescents from two-parent households, but no variables mediated that association. CONCLUSIONS Each of the identified mediating variables is amenable to change through interventions targeted at high-risk subgroups of adolescents identified by these demographic characteristics.

Heavy Alcohol Use and Dating Violence Perpetration During Adolescence: Family, Peer and Neighborhood Violence as Moderators

We examined the hypothesis that family, peer and neighborhood violence would moderate relations between heavy alcohol use and adolescent dating violence perpetration such that relations would be stronger for teens in violent contexts. Random coefficients growth models were used to examine the main and interaction effects of heavy alcohol use and four measures of violence (family violence, friend dating violence, friend peer violence and neighborhood violence) on levels of physical dating violence perpetration across grades 8 through 12. The effects of heavy alcohol use on dating violence tended to diminish over time and were stronger in the spring than in the fall semesters. Consistent with hypotheses, across all grades, relations between heavy alcohol use and dating violence were stronger for teens exposed to higher levels of family violence and friend dating violence. However, neither friend peer violence nor neighborhood violence moderated relations between alcohol use and dating violence. Taken together, findings suggest that as adolescents grow older, individual and contextual moderators may play an increasingly important role in explaining individual differences in relations between alcohol use and dating violence. Implications for the design and evaluation of dating abuse prevention programs are discussed.

The Role of Heavy Alcohol Use in the Developmental Process of Desistance in Dating Aggression during Adolescence

The current study examined the role of heavy alcohol use in the developmental process of desistance in physical dating aggression during adolescence. Using longitudinal data spanning grades 8 through 12 we tested the hypotheses that (a) higher levels of early heavy alcohol use would be associated with decreased deceleration from dating aggression during late adolescence and (b) higher levels of heavy alcohol use during time-points in late adolescence would be contemporaneously associated with elevated levels of dating aggression at those same time points. Contrary to expectations, findings indicate that the effects of both early and continuing heavy alcohol use on dating aggression were strong during early adolescence but tended to diminish over time. Unexpectedly, the contemporaneous effects of alcohol use on dating aggression were stronger in the spring than in the fall semesters. Implications for prevention and for understanding developmental relations between the two behaviors are discussed.

Vijana Vijiweni II: a cluster-randomized trial to evaluate the efficacy of a microfinance and peer health leadership intervention for HIV and intimate partner violence prevention among social networks of young men in Dar es Salaam

BackgroundIntimate partner violence (IPV) and sexually transmitted infections (STIs), including HIV, remain important public health problems with devastating health effects for men and women in sub-Saharan Africa. There have been calls to engage men in prevention efforts, however, we lack effective approaches to reach and engage them. Social network approaches have demonstrated effective and sustained outcomes on changing risk behaviors in the U.S. Our team has identified and engaged naturally occurring social networks comprised mostly of young men in Dar es Salaam in an intervention designed to jointly reduce STI incidence and the perpetration of IPV. These stable networks are locally referred to as “camps.” In a pilot study we demonstrated the feasibility and acceptability of a combined microfinance and peer health leadership intervention within these camp-based peer networks.Methods designWe are implementing a cluster-randomized trial to evaluate the efficacy of an intervention combining microfinance with health leadership training in 60 camps in Dar es Salaam, Tanzania. Half of the camps have been randomized to the intervention arm, and half to a control arm. The camps in the intervention arm will receive a combined microfinance and health leadership intervention for a period of two years. The camps in the control arm will receive a delayed intervention. We have enrolled 1,258 men across the 60 study camps. Behavioral surveys will be conducted at baseline, 12-months post intervention launch and 30-month post intervention launch and biological samples will be drawn to test for Neisseria gonorrhea (NG), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV) at baseline and 30-months. The primary endpoints for assessing intervention impact are IPV perpetration and STI incidence.DiscussionThis is the first cluster-randomized trial targeting social networks of men in sub-Saharan Africa that jointly addresses HIV and IPV perpetration and has both biological and behavioral endpoints. Effective approaches to engage men in HIV and IPV prevention are needed in low resource, high prevalence settings like Tanzania. If we determine that this approach is effective, we will examine how to adapt and scale up this approach to other urban, sub-Saharan African settings.Trial registrationClinical Trials.gov: NCT01865383. Registration date: May 24, 2013.