Josephine D. Korchmaros

Lower level mediation in multilevel models

Multilevel models are increasingly used to estimate models for hierarchical and repeated measures data. The authors discuss a model in which there is mediation at the lower level and the mediational links vary randomly across upper level units. One repeated measures example is a case in which a persons daily stressors affect his or her coping efforts, which affect his or her mood, and both links vary randomly across persons. Where there is mediation at the lower level and the mediational links vary randomly across upper level units, the formulas for the indirect effect and its standard error must be modified to include the covariance between the random effects. Because no standard method can estimate such a model, the authors developed an ad hoc method that is illustrated with real and simulated data. Limitations of this method and characteristics of an ideal method are discussed.

Emotional Closeness as a Mediator of the Effect of Genetic Relatedness on Altruism

Inclusive fitness theory has been used to explain the overall pattern of altruistic behavior. However, this theory does not address the proximal causes of altruism. The purpose of the present study was to increase the understanding of altruism by testing a model that includes both ultimate and proximate causes. In particular, emotional closeness was tested as a mediator of the effect of genetic relatedness on altruistic behavior. This was accomplished by having college students choose which of their family members they would most likely provide with life-saving assistance. As expected, results showed that emotional closeness is an important proximal cause of altruism that partially mediates the effect of genetic relatedness on willingness to act altruistically.

National Trends in Exposure to and Experiences of Violence on the Internet Among Children

OBJECTIVE: To examine rates of technology-based violent experiences (eg, bullying, harassment, unwanted sexual experiences [USEs] perpetration, and victimization) and exposures (eg, hate sites) from 2006 to 2008 among US children. PATIENTS AND METHODS: One thousand five-hundred eighty-eight youth aged 10 to 15 years were surveyed nationally online in 2006, 2007 (76% follow-up rate), and 2008 (73% follow-up rate). RESULTS: All other things equal, rates of Internet-based violent exposures and experiences were stable. Of exception, harassment perpetration and exposure to violent cartoon sites reduced by 26% and 36% over the 2 year period (P < 0.05), respectively. In contrast, several rates of violent experiences via text messaging increased over time, specifically: harassment victimization (aOR = 1.6, p = 0.001) and perpetration (aOR = 1.4, p = 0.03), and USE victimization (aOR = 1.9, p = 0.02). Increases in bullying victimization were suggested (aOR = 1.5, p = 0.06). Text messaging USE perpetration did not significantly change, however. General technology use (i.e., intensity and frequency of Internet and text messaging) was consistently influential in explaining the odds of almost all violent experiences and exposures both online and via text messaging; as was age for many exposures and experiences online. CONCLUSIONS: Ongoing surveillance of text-messaging–based experiences is needed to understand trends as population usage rates begin to stabilize. General technology use is a predictive factor for almost all technology-based violent experiences and exposures. Age is also influential in explaining involvement in Internet-based experiences and exposures. Prevention programs should focus on reducing risk as youth age into later adolescence and to help heavy technology users manage their risk for violence involvement.

Sexual harassment among adolescents of different sexual orientations and gender identities

This article examines (a) variation in rates of sexual harassment across mode (e.g., in-person, online) and type of harassment, (b) the impact of sexual harassment (i.e., distressing vs. non-distressing), and (c) how sexual harassment is similarly and differently experienced across sexual orientation and gender identity groups. Data were collected as part of the Teen Health and Technology online survey of 5,907 13 to 18 year-old Internet users in the United States. Past year sexual harassment was reported by 23-72% of youth, depending upon sexual orientation, with the highest rates reported by lesbian/queer girls (72%), bisexual girls (66%), and gay/queer boys (66%). When examined by gender identity, transgender youth reported the highest rates of sexual harassment - 81%. Overall, the most common modes for sexual harassment were in-person followed by online. Distress in the form of interference with school, family, and/or friends; creating a hostile environment; or being very/extremely upset was reported by about half of the sexually harassed bisexual girls and lesbian/queer girls, 65% of the gender non-conforming/other gender youth, and 63% of the transgender youth. Youth with high social support and self-esteem were less likely to report sexual harassment. Findings point to the great importance of sexual harassment prevention for all adolescents, with particular emphasis on the unique needs and experiences of youth of different sexual orientations and gender identities. Socio-emotional programs that emphasize self-esteem building could be particularly beneficial for reducing the likelihood of victimization and lessen the impact when it occurs.

An evolutionary and close-relationship model of helping

Our research examined whether relationship factors account for the positive association between genetic relatedness and willingness to help. College students’ (31 male and 46 female) willingness to help family members was measured using hypothetical dilemmas involving life-or-death and everyday-favor situations. Relationship factors were measured using a questionnaire. As expected, emotional closeness and obligation mediated the association between genetic relatedness and willingness to help. Furthermore, as expected, propinquity, similarity, and frequency and amount of interaction mediated the association between genetic relatedness and emotional closeness. Type of situation moderated the association between genetic relatedness and willingness to help, although not entirely as expected. This research suggests that relationship factors account for a substantial proportion of the association between genetic relatedness and helping.

Accessing sexual health information online: use, motivations and consequences for youth with different sexual orientations

We examine reasons why youth of different sexual orientations look for sexual health information online, and what, if anything, they do with it. The Teen Health and Technology study involved online surveys of 5542 Internet users, ages 13 through 18 in the United States. Searching for sexual health information online was reported frequently and varied significantly by sexual orientation: from 19% of heterosexual youth to 78% of gay/lesbian/queer youth. The most common reasons youth look for sexual health information is for privacy and curiosity. Sexual minority youth are more likely than heterosexual youth to report that they looked for information online because they did not have anyone to ask. Once youth have the information, no differences by sexual orientation were noted as to what they did with it. Instead, seeking out the information for privacy-related reasons and having no one to ask were related to taking some action on the information received. Findings indicate that online information is most valuable to those youth who lack alternatives. Care needs to be taken to help ensure that the sexual health information online is accurate and includes topics specific to sexual minority youth.

A Text Messaging-Based Smoking Cessation Program for Adult Smokers: Randomized Controlled Trial

Background Despite promising data in Western countries, there is a dearth of research into the efficacy of text messaging-based smoking cessation programs in other settings, including the Middle East, where smoking prevalence rates are higher. Objective This paper reports cessation rates observed in SMS Turkey, a text messaging-based smoking cessation program for adult smokers in Ankara, Turkey. Methods This study was a small-scale, parallel-group randomized controlled trial (RCT) conducted in Ankara, Turkey. Participants were adult daily smokers who were seriously thinking about quitting in the next 15 days and living in Ankara, Turkey. The text messaging intervention, SMS Turkey, provided 6 weeks of daily messages aimed at giving participants skills to help them quit smoking. Messages were sent in an automated fashion, except 2 days and 7 days after the initial quit day. On days 2 and 7, the research assistant manually assigned participants to content “paths” based on whether they were still not smoking or had relapsed. The control arm received a brochure that provided similar information about smoking cessation. The main outcome measure was self-reported 3-month sustained abstinence, verified by carbon monoxide (CO) readings. Neither participants nor researchers were blinded to arm assignment. Results The 151 participants were randomly assigned to 1 of 2 groups: 76 to the SMS Turkey intervention group and 75 to the brochure control group. Using intention to treat, all 151 participants were included in analyses. Three-month cessation trends were not significantly higher in the intervention group: 11% intervention vs 5% control had quit (χ2 1=1.4, P=.24; R2=2.0, 95% CI 0.62-6.3). When the sample was stratified by sex, female intervention participants (14%, n=5) were significantly more likely to have quit at 3 months than female control participants (0%, n=0; χ2 1=3.7, P=.05). Among light smokers (ie, those smoking less than 20 cigarettes per day), intervention participants (17%, n=5) also were significantly more likely to have quit compared to control participants (0%, n=0; χ2 1=5.3, P=.02). We noted no difference in cessation rates for males or heavy smokers. Participants experienced significant technology problems during the study. Some participants received duplicate text messages at least once during the trial; others failed to receive some program messages. Neither receiving duplicate messages (χ2 1=0.12, P=.73), or missing 5 or more program messages (χ2 1=0.75, P=.39) negatively affected quitting rates. Conclusions Although the study was not powered to detect statistically significant differences, as the primary aim was to provide estimates of effect size that could be used to better inform a power analysis for a larger trial, findings provide optimism that SMS Turkey may be able to affect quitting rates in environments with high smoking prevalence, such as Ankara, Turkey. The SMS Turkey software program did not work as well as it did 2 years previous. The system will need to be updated to maintain software compatibility with ongoing technology evolution. Trial Registration Clinicaltrials.gov NCT00912795 http://clinicaltrials.gov/ct2/show/NCT00912795 (Archived by WebCite at http://www.webcitation.org/6Ch1cIA8l).

Chasing Sexual Orientation: A Comparison of Commonly Used Single-Indicator Measures of Sexual Orientation

This research investigated the utility of single-indicator measures of sexual orientation in examining group differences. Adolescents and young adults reported their sexual orientations, preferences, and partners. Results indicate that, (a) depending on the measure of sexual orientation, 10% to 22% cannot be categorized into a sexual orientation group using a single-indicator measure; (b) self-identified sexual orientation is often incongruent with preference and behavior; (c) incongruity differs by gender and self-identified sexual orientation; and (d) detected differences in gay/lesbian, bisexual, and straight individuals vary by measure of sexual orientation. These results indicate that classification of sexual orientation by single-indicator measures can lead to inconsistent conclusions across studies.

Perpetration of teen dating violence in a networked society

Teen dating violence (TDV) is a serious form of youth violence that youth fairly commonly experience. Although youth extensively use computer-mediated communication (CMC), the epidemiology of CMC-based TDV is largely unknown. This study examined how perpetration of psychological TDV using CMC compares and relates to perpetration using longer-standing modes of communication (LSMC; e.g., face-to-face). Data from the national Growing up with Media study involving adolescents aged 14-19 collected from October 2010 to February 2011 and analyzed May 2012 are reported. Analyses focused on adolescents with a history of dating (n=615). Forty-six percent of youth daters had perpetrated psychological TDV. Of those who perpetrated in the past 12 months, 58% used only LSMC, 17% used only CMC, and 24% used both. Use of both CMC and LSMC was more likely among perpetrators who used CMC than among perpetrators who used LSMC. In addition, communication mode and type of psychological TDV behavior were separately related to frequency of perpetration. Finally, history of sexual intercourse was the only characteristic that discriminated between youth who perpetrated using different communication modes. Results suggest that perpetration of psychological TDV using CMC is prevalent and is an extension of perpetration using LSMC. Prevention should focus on preventing perpetration of LSMC-based TDV as doing so would prevent LSMC as well as CMC-based TDV.

Prevalence rates of sexual coercion victimization and perpetration among Uganda adolescents

Abstract Coercion is consistently reported as a risk factor for HIV in sub-Saharan Africa (SSA). Because of the gendered nature of previous research, however, little is known about male victims or female perpetrators. To address this gap, we report survey data from 354 sexually experienced secondary school students in Mbarara, Uganda. Findings suggest that females are more likely to report involvement in coercive sex compared to males (66% vs. 56%, respectively). Of those involved, females are most likely to report being a victim-only (40%) and males, perpetrator-victims (32%). Although involvement in violent and coercive sex is gendered, 47% of males report victim experiences and 25% of females report perpetration behavior. Furthermore, about one in ten female and male perpetrators reported using physical force or threats to compel sex. When all potentially influential factors were considered simultaneously, several characteristics seem to differentiate youth by their coercive sex (in) experience. For example, victims are more likely to have lower levels of social support from their families and feel that they have an above average or very strong chance of getting HIV compared to otherwise similar youth with no experience with coercive sex. Perpetrators are more likely to have had an HIV test but use condoms less than half the time or never compared to their otherwise similar, yet uninvolved peers. They also are significantly more likely to report dating violence perpetration. Perpetrator-victims share some similarities with other involved youth, as well as some differences. Findings underscore both the importance of asking all youth, irrespective of biological sex, perpetrator and victimization questions; and also the need for more work to be done to help youth plan for a healthy and wanted first sexual experience.