Kathryn A. Brookmeyer

Schools, Parents, and Youth Violence: A Multilevel, Ecological Analysis

Using data from the National Longitudinal Study of Adolescent Health (Add Health), this study utilized an ecological approach to investigate the joint contribution of parents and schools on changes in violent behavior over time among a sample of 6,397 students (54% female) from 125 schools. This study examined the main and interactive effects of parent and school connectedness as buffers of violent behavior within a hierarchical linear model, focusing on both students and schools as the unit of analysis. Results show that students who feel more connected to their schools demonstrate reductions in violent behavior over time. On the school level, our findings suggest that school climate serves as a protective factor for student violent behavior. Finally, parent and school connectedness appear to work together to buffer adolescents from the effects of violence exposure on subsequent violent behavior.

A Systematic Qualitative Review of Risk and Protective Factors for Sexual Violence Perpetration

The current review summarized results of 191 published empirical studies that examined the risk and protective factors for sexual violence perpetration. Studies in the review examined factors for perpetration by and against adolescents and adults, by male and female perpetrators, and by those who offended against individuals of the same sex or opposite sex. Factors associated with child sexual abuse (CSA) perpetration were not included. In all, 2 societal and community factors, 23 relationship factors, and 42 individual-level factors were identified. Of these 67 factors, consistent significant support for their association with SV was found for 35, nonsignificant effects were found for 10, 7 factors had limited or sample-specific evidence that they were associated with SV but were in need of further study, and 15 demonstrated mixed results. The factors identified in the review underscore the need for comprehensive prevention programs that target multiple risk and protective factors as well as factors that occur across the social ecology. Moreover, we identified two domains of factors—the presence and acceptance of violence and unhealthy sexual behaviors, experiences, or attitudes—that had consistent significant associations with SV but are not typically addressed in prevention programs. Therefore, SV prevention may also benefit from learning from effective strategies in other areas of public health, namely sexual health and youth violence prevention.

An Assessment of the GYT: Get Yourself Tested Campaignc An Integrated Approach to Sexually Transmitted Disease Prevention Communication

Background Youth in the United States bear a disproportionate burden of sexually transmitted diseases (STDs). Stigma, misconceptions, and access challenges keep many from getting tested or treated. The GYT: Get Yourself Tested campaign was launched in 2009 to reduce stigma and promote STD communication and testing. This evaluation sought to assess the first 2 years of campaign engagement and associations with STD testing among youth. Methods Campaign engagement with select GYT on-the-ground events, social media sites, and STD testing locator tools was measured through process/media tracking metrics. Sexually transmitted disease testing patterns were assessed using data from Planned Parenthood affiliates (2008–2010) and national trend data from clinics participating in national infertility prevention activities (2003–2010). Results On-the-ground events reached an estimated 20,000 youth in 2009 and 52,000 youth in 2010. Across 2009 to 2010, GYT’s Facebook page gained 4477 fans, Twitter feed gained 1994 followers, and more than 140,000 referrals were made to the STD testing locator. From April 2008 to 2010, there was a 71% increase in STD testing and a 41% increase in chlamydia testing at reporting Planned Parenthood affiliates (representing ∼118 health centers). Chlamydia case positivity rates during this period were stable at 6.6% (2008) and 7.3% (2010). Trend data indicate that testing was higher in spring 2009 and 2010 compared with other periods during those years; this pattern is commensurate with STD Awareness Month/GYT activities. Conclusions Data quality is limited in a manner similar to many STD prevention efforts. Within these limitations, evidence suggests that GYT reaches youth and is associated with increased STD testing.

Israeli Adolescents Exposed to Community and Terror Violence: The Protective Role of Social Support

This study investigates how social support may protect Israeli early adolescents who have witnessed community violence from engaging in violent behavior when they have also witnessed terror violence. The study examines how support from parents, school, and friends could serve as protective, despite the interactive risk effects of witnessing community and terror violence. In general, results indicate that support from parents operated as a protective factor, whereas support from friends acted as a risk by increasing the likelihood of violent behavior. Support from school has both a protective and risk effect, depending on the type of violence exposure witnessed. The extent to which these facets of social support operated as risk or protective factors is conditional on whether youth had also witnessed terror violence, and terror violence appear to moderate each of the three facets of support differently. The implications of these findings and intervention initiatives for Israeli youth are discussed.

Gender Role Discrepancy Stress, High-Risk Sexual Behavior, and Sexually Transmitted Disease

Nearly 20 million new sexually transmitted infections occur every year in the United States. Traditionally, men have demonstrated much greater risk for contraction of and mortality from STDs perhaps because they tend to engage in a number of risky sexual activities. Research on masculinity suggests that gender roles influence males’ sexual health by encouraging risk-taking behavior, discouraging access to health services, and narrowly defining their roles as partners. However, despite the propensity of highly masculine men to engage in high-risk sexual behavior, there is reason to suspect that men at the other end of the continuum may still be driven to engage in similar high-risk behaviors as a consequence of gender socialization. Discrepancy stress is a form of gender role stress that occurs when men fail to live up to the ideal manhood derived from societal prescriptions (i.e., Gender Role Discrepancy). In the present study, we surveyed a national sample of 600 men via Amazon Mechanical Turk to assess perceived gender role discrepancy, experience of discrepancy stress, and the associations with risky sexual behavior and potential contraction of STDs. Results indicated that men who believe they are less masculine than the typical man (i.e., gender role discrepancy) and experience distress stemming from this discrepancy (i.e., discrepancy stress) engage in high-risk sexual behavior and are subsequently diagnosed with more STDs. Findings are discussed in relation to implications for primary prevention strategies.

Aggressive Behavior and Quality of Friendships: Linear and Curvilinear Associations

The current study investigates linear and curvilinear associations between overt aggressive behavior and the adolescents’ reports of the quality of their friendships over time. Moderation by gender was also investigated. The sample consisted of 246 boys and 253 girls from the sixth and seventh grades of a large public middle school. Findings suggested a curvilinear association between aggression and friendship quality for boys such that nonaggressive and highly aggressive boys tended to perceive their relationships with friends more positively than did boys who exhibited moderate levels of overt aggression. In contrast, a negative linear association was found between aggression and friendship quality for girls. These findings provide evidence that the association between friendship quality and overt aggression is a complex phenomenon and point to the importance of examining gender differences and the curvilinear association between aggression and friendship quality.

GYT: Get Yourself Tested Campaign Awareness: Associations With Sexually Transmitted Disease/HIV Testing and Communication Behaviors Among Youth.

Background The GYT: Get Yourself Tested campaign promotes sexually transmitted disease (STD) and HIV testing and communication with partners and providers among youth. We evaluated these behaviors in relation to campaign awareness among youth through a national survey. Methods We collected data from 4017 respondents aged 15 to 25 years through an online panel survey designed to be representative of the US population. The GYT campaign targeted 4 key behaviors: STD testing, HIV testing, talking to partners about testing, and talking to providers about testing. Results Respondents who were aware of the GYT campaign (24.4%) were more likely to report engaging in each of the 4 target behaviors. Associations remained significant when stratified by race and sex and when taking into account sexuality, sexual activity, age, insurance status, and use of campaign partner-provided services. Conclusions Awareness of the GYT campaign is related to the 4 target behaviors promoted by the campaign, suggesting that health promotions campaigns oriented toward youth can be successful in increasing STD-related, health-seeking behavior, including among populations disproportionately affected by STD.

Reaching Youth With Sexually Transmitted Disease Testing Building on Successes, Challenges, and Lessons Learned From Local Get Yourself Tested Campaigns

Nine programs were funded across eight states in the United States to customize, implement, and evaluate local campaigns in support of the national Get Yourself Tested (GYT) campaign. Each program promoted chlamydia screening and treatment/referral to sexually active young women (aged 15–25 years) and their partners through accessible, free, or low-cost services. This article documents the strategies and outcomes of these local GYT campaigns, highlighting the diversity in which a national sexual health campaign is implemented at the local level and identifying challenges and successes. Nearly all (n = 7) programs involved target audience members in campaign development/implementation. Youth were linked to free or low-cost sexually transmitted disease testing through community centers, high schools and colleges, community and clinic events; online or text-based ordering of test kits; and community pickup locations. Sites used a combination of traditional and new media, on-the-ground activities, promotional products, and educational and social events to promote testing. With the exception of one site, all sites reported increases in the number of persons tested for chlamydia during campaign implementation, compared to baseline. Increases ranged from 0.5% to 128%. Successes included development of local partnerships, infrastructure, and capacity; use of peer leaders and involvement; and opportunities to explore new innovations. Challenges included use of social media/new technologies, timing constraints, limited organizational and evaluation capacity, and unforeseen delays/setbacks. Each of these issues is explored, along with lessons learned, with intent to inform future sexual health promotion efforts.

Perpetrators and context of child sexual abuse in Kenya

Child sexual abuse (CSA) interventions draw from a better understanding of the context of CSA. A survey on violence before age 18 was conducted among respondents aged 13-17 and 18-24 years. Among females (13-17), the key perpetrators of unwanted sexual touching (UST) were friends/classmates (27.0%) and among males, intimate partners (IP) (35.9%). The first incident of UST among females occurred while traveling on foot (33.0%) and among males, in the respondents home (29.1%). Among females (13-17), the key perpetrators of unwanted attempted sex (UAS) were relatives (28.9%) and among males, friends/classmates (31.0%). Among females, UAS occurred mainly while traveling on foot (42.2%) and among males, in school (40.8%). Among females and males (18-24 years), the main perpetrators of UST were IP (32.1% and 43.9%) and the first incident occurred mainly in school (24.9% and 26.0%), respectively. The main perpetrators of UAS among females and males (18-24 years) were IP (33.3% and 40.6%, respectively). Among females, UAS occurred while traveling on foot (32.7%), and among males, in the respondents home (38.8%); UAS occurred mostly in the evening (females 60.7%; males 41.4%) or afternoon (females 27.8%; males 37.9%). Among females (18-24 years), the main perpetrators of pressured/forced sex were IP and the first incidents occurred in the perpetrators home. Prevention interventions need to consider perpetrators and context of CSA to increase their effectiveness. In Kenya, effective CSA prevention interventions that target intimate relationships among young people, the home and school settings are needed.

Symptoms of Depression in Israeli Adolescents Following a Suicide Bombing: The Role of Gender.

This report investigated the potential role of gender in moderating the effects of terror attack exposure on depression symptoms in middle school students from Dimona, Israel (N = 90). Specifically, the effects of three aspects of terror attacks were investigated: physical exposure, relational exposure, and media exposure. Ninety early adolescents were assessed for terror exposure and depression before and after a suicide bombing in a town market. Results indicate that the effects of relational exposure to the suicide bombing—knowing others directly affected by a suicide bombing—on depression symptoms differed by gender. Adolescent girls who knew people affected by the suicide bombing reacted with higher levels of depressive symptoms while similarly exposed adolescent boys did not. It may be that girls, as compared to boys, express greater sympathy for victims, and are hence more vulnerable to disruptions of their social network, resulting in a heightened depressive vulnerability.