Kelly M. King

Setting policy priorities to address eating disorders and weight stigma: views from the field of eating disorders and the US general public

BackgroundThe prevalence and health consequences of eating disorders and weight stigmatization have prompted increasing discussion of potential policy actions to address these public health issues. The present study aimed to assess support for policy strategies to address eating disorders and weight stigmatization among the general public and relevant health professionals.MethodsAn Internet survey was fielded to a national sample of 944 US adults and 1,420 members of professional organizations specializing in eating disorders to examine their support for 23 potential policy strategies to address eating disorders and weight stigma. Participants also rated policy actions according to their potential for positive impact and feasible implementation.ResultsSupport for the majority of health and social policies was high in both samples. For example, strategies to 1) improve school-based health curriculum to include content aimed at preventing eating disorders, 2) require training for educators and health providers on the prevention and early identification of eating disorders, and 3) implement school-based anti-bullying policies that that protect students from being bullied about their weight, were supported by over two-thirds of participants.ConclusionsOur findings suggest that both health and social policy actions will be important in broader policy initiatives to address eating disorders and weight stigma.

Correlates of gang involvement and health-related factors among African American females with a detention history☆

Background Prior studies have assessed relationships between gang membership and health-related factors. However, the existing literature has largely failed to consider how individual and broader social contextual factors might be related to such gang involvement among African American females. Thus, the aim of the present study was to identify empirically driven correlates of gang involvement and then better understand the relationship between gang membership and health-related behaviors for African American females, after controlling for covariates of gang involvement. Methods Data were collected from a convenience sample of detained African American adolescents females, between the ages of 13-17, currently incarcerated in a short-term detention facility in Atlanta, Georgia (n= 188). After obtaining written informed assent and parental permission, participants answered survey questions using A-CASI procedures that assessed socio-contextual factors and health-related behaviors. Results Multiple logistic regression models controlling for age and SES documented that low self-esteem, emotional dysregulation, trauma history, deviant peers, low parental monitoring, infrequent parental communication, housing instability and poor neighborhood quality were correlates of gang involvement. In addition, multiple linear and logistic regression models, controlling for these constructs, revealed that gang involvement was independently associated with lower STD prevention knowledge, a higher likelihood of having a gang-involved boyfriend, a greater risk of having current casual sexual partnerships, higher rates of substance abuse, higher incidences of condom misuse and a lower likelihood of ever having been tested for HIV. Conclusions These results provide information that can help service providers target certain profiles of African American females who may be at risk for joining gangs and address the health risk behaviors that may be associated with such memberships.

Sexual Sensation Seeking, Drug Use and Risky Sex among Detained Youth.

Sexual sensation seeking has been correlated with drug use and risky sex in a number of populations. However, these relationships have had limited examination among adolescents, and to date, have not been explored among detained youth, a group with some of the highest rates of illicit drug use and STIs. To better understand these relationships we utilized A-CASI to collect data on sociodemographics, sexual sensation seeking, drug use and risky sexual behaviors among a sample of 550 detained youth. A series of multivariable regression models controlling for age, gender, race/ethnicity, socioeconomic status and risky peer networks indicated that sexual sensation seeking was associated with alcohol and ecstasy use. Additionally, sexual sensation seeking was associated with having sex while high on drugs; having sex with a partner who was high on drugs; exchanging sex for drugs; exchanging sex for money; having more sexual partners in the last two months; having engaged in unprotected vaginal sex; and a less condom use during oral sex. These data have important implications for STI/drug use prevention interventions among detained adolescents.

Gang Norms and Risky Sex Among Adolescents With a History of Detention

ABSTRACT Prior studies have examined whether or not belonging to a gang was associated with risky sexual behaviors. However, the literature has yet to explore whether it is not just gang membership but gang norms that are associated with risky sex, which was the primary aim of this study. Audio computer-assisted self-interviewing technology was used to collect data from a convenience sample of 136 adolescent detainees who reported gang involvement. Demographics, gang norms, and risky sexual behaviors occurring in the 2 months prior to being detained were assessed. Multiple logistic regression models controlling for demographics documented that adolescents who reported high-risk gang norms were significantly more likely to: have sex while high on drugs, have sex with a partner who was high on drugs, have group sex, and report condom breakage or leakage during a sexual encounter, compared with those with low-risk gang norms. Results suggest that the norms present within gangs infer added sexual risks. Future research should assess how risk norms differ across various gangs. Sexually transmitted infection prevention approaches should target youth who belong to gangs that promote risky norms given that conventions exist on a continuum.

Public attitudes about different types of anti- bullying laws: Results from a national survey

State anti-bullying laws have been enacted across the United States to address bullying both by and of youths. Although these statutes can provide critical protection to youth, there is debate about whether such laws should enumerate protected classes of youth. Weight-based bullying is an increasingly prevalent form of harassment and it has been overlooked in policy initiatives. Enumeration in existing laws might help protect overweight victims. As no research has examined this issue, we conducted a national survey of American adults (N=1155) to assess public opinion about enactment of anti-bullying laws that vary according to whether or not they enumerate distinguishing characteristics. Our results demonstrated substantial public agreement (ranging from 2/3 to 3/4 of participants) with enactment of state and federal anti-bullying laws that enumerate distinguishing characteristics, including physical appearance and weight, which are currently absent in most statutes. Our evidence can inform policy and legal approaches to protect youth effectively from bullying.

Recently released Black men’s perceptions of the impact of incarceration on sexual partnering

Abstract Evidence suggests that men with recent histories of incarceration are more likely to engage in high-risk sexual activity, however there is limited research exploring how having been recently released from prison might impact men’s sexual risk behaviours or sexual partnering. This qualitative study explores the ways in which exposure to incarceration impacts the dynamics of sexual partnering among recently released Black men in Baltimore, USA. In-depth interviews were conducted with 19 recently released Black men between 21–45 years of age living in the city. Data were analysed using a combination of inductive and deductive approaches. Participants reported that women living in the neighbourhoods to which they returned found recently released men to be highly desirable sexual partners because they offered increased potential for sexual gratification, were perceived as healthier than other sexual partners in their communities and represented opportunities for attaining financial stability and the potential for establishing romantic partnerships. As a result, men reported they had more opportunities for sex and more power to negotiate sex with women. Recently released Black men’s perceptions of their own sexual desirability among women raise important implications regarding power in the sexual relationships of recently released men that may increase HIV- and sexually transmitted infection-related risk for recently released men and their sexual partners.

Enduring Consequences From the War on Drugs: How Policing Practices Impact HIV Risk Among People Who Inject Drugs in Baltimore City

ABSTRACT Background: Neighborhood-level characteristics, including police activity, are associated with HIV and Hepatitis C injection risk-behaviors among people who inject drugs (PWID). However, the pathways through which these neighborhood perceptions shape individual-level HIV risk behaviors are unclear. This study helps to explain perceived behaviors between perceived neighborhood police activity and HIV injection risk behavior (i.e., injection syringe/tool sharing in the previous 6 months). Methods: A sample of (n = 366) PWIDs who self-reported recent use were recruited using community-based outreach methods in Baltimore, Maryland. Neighborhood police perceptions were assessed by asking participants whether they would (1) be more likely to ask others to share injection tools in the context of heightened police activity and (2) be less likely to carry syringes with them due to fear of arrest. Poisson regression with robust variance was used to identify statistical relationships. Recent police encounters, frequency of heroin injection, and sociodemographic characteristics were controlled for in the model. Results: Neighborhood police perceptions shaped injection-risk behavior. Half of the sample (49%) reported an aversion of carrying personal syringes, due to fear of arrest. Those who agreed they would be more likely to ask others to share injection equipment in the context of heightened police activity were more likely to share syringes (21% vs. 3%, p <.01). Adjusted models showed that syringe sharing was independently associated with asking to borrow equipment in neighborhoods with perceived heightened police activity (aPR: 2.22, 95% confidence interval (CI): 1.7, 3.0). Conclusion: This study sheds light on how police perceptions may influence injection risk behavior. While these relationships require further elucidation, this study suggests that public health interventions aiming to reduce HIV risk would benefit from improving community-police relationships.

Combating Weight-Based Bullying in Schools: Is There Public Support for the Use of Litigation?.

BACKGROUND Bullying litigation is an emerging area of law that has increased in response to serious cases of bullying at school. Weight-based bullying is prevalent at school, but no research has examined the use of litigation to address this problem. We assessed public support for litigation approaches to address weight-based bullying at school, and whether support for litigation varies according to the reason why a student is bullied. METHODS A national sample of 994 adults (49% parents) completed an online questionnaire assessing their support for litigation approaches in response to hypothetical incidents of youth bullying. RESULTS As many as two thirds of participants supported litigation against schools for failing to intervene and protect students from weight-based bullying. Litigation remedies received slightly higher support in response to bullying due to race or sexual orientation compared to body weight. Participants favored litigation approaches that target schools for inadequate intervention or a bullys parents on behalf of their childs actions. CONCLUSIONS Our study offers novel findings about public and parental views of litigation as a potential approach to address weight-based (and other forms of) bullying, and introduces considerations about the potential role of litigation as part of broader remedies to address youth bullying.