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Objective: A Haddon Matrix analysis was used to systematically review literature evaluating college campus sexual assault prevention programs to identify research gaps and intervention opportunities. Methods: Articles included were published from January 1, 2001 to December 31, 2017; indexed in PubMed, PsycInfo, or Scopus; involving English-speaking undergraduate students in the US; with experimental or quasi-experimental design. Results: All 31 eligible studies evaluated educational programing; all relied on self-report measures; and three-quarters had follow-up periods [less than or equal to] 6 months. Significant positive effects were reported by 6 of 10 studies that measured bystander behavior, 6 of 10 that educated potential victims and assessed victimization, and one of four that educated potential perpetrators and measured perpetration. Conclusion: The Haddon Matrix analysis identified the need for interventions that address perpetrators and the post-assault period, as well as studies of the impact of enforcing existing policies and new environmental and situational approaches to sexual assault prevention.

Objectives Toddlers are vulnerable to unintentional injuries. A safety intervention targeting low-income families of toddlers, was effective at improving home safety. The current study examined whether the effect varies by initial home safety problems. Methods 277 mother-toddler dyads recruited in the Mid-Atlantic region of the United States during 2007-2010 were randomized into safety promotion (n = 91) or attention-control groups (n = 186). Observers rated participants' homes with a 9-item safety problem checklist at baseline, and at 6- and 12-months follow-up. Initial home safety problems were categorized as multiple ([greater than or equal to] 4 problems) and none/few (< 4). Linear mixed models assessed the moderating effect with a three-way interaction (time, intervention, and initial safety problems). Results At 12 months, the intervention effect was stronger among families with multiple initial problems than no/few initial problems, with a reduction of 1.55 more problems among the families with multiple problems, compared to the families with no/few problems (b = - 1.55, SE = 0.62, p = 0.013). Conclusions Interventions targeting families with multiple safety problems may be more effective than universal programming., Author(s): Yan Wang [sup.1] [sup.2] , Andrea C. Gielen [sup.3] , Laurence S. Magder [sup.2] , Erin R. Hager [sup.1] [sup.2] , Maureen M. Black [sup.1] [sup.2] [sup.4] Author Affiliations: [...]

Adolescent academic achievement is closely linked to numerous health outcomes. Studies have demonstrated a positive relationship between parental academic monitoring and adolescent academic achievement. Less is known about factors associated with parental academic monitoring, and research is particularly lacking with low-income, African American young adolescents who are at high risk for school disengagement and underachievement. Data were collected from a sample of incoming urban sixth graders using a computer-assisted questionnaire. Data were analyzed as cross-sectional using the responses of 111 African American adolescents, ages 10-14 years. The median responses of adolescents about perceptions of parental academic monitoring were used to classify adolescents into two groups, lower and higher perceived academic monitoring. Logistic regression and stratified analyses determined factors related to higher parental academic monitoring. Adolescents' perceived parental general support (OR: 2.08, CI: 1.29-3.36) and friends' pro-social behavior (OR: 1.54, CI: 1.03-2.30), were significant factors in the multivariate model. Also, adolescents living with one biological parent and with other adults were more likely to report higher parental academic monitoring, compared to adolescents living with one biological parent and no other adults (OR: 3.58, CI: 1.00-12.83). Perceptions of general parental support and peer groups offer insight into why parental academic monitoring allows only some African American urban youth to succeed academically. Parental support provides a context that influences youths' perceptions of their parents' academic monitoring and should be considered in future research. Results identify factors in a high-risk population that may help explain why some urban youth succeed academically while others do not. (Contains 3 tables and 2 figures.)

Little is known about parents' perceptions and prevention strategies regarding childhood falls. In this qualitative study using semi-structured interviews, we sought to describe parental reports of child fall experiences, concerns, and prevention strategies in the home. Sixteen parents with at least one child younger than 18 months were asked about their awareness of fall risks, falls experienced by the child, fall concerns, prevention strategies, and where in the home the child spends time throughout the day. Seven themes emerged: (1) "falls are unexpected," (2) "role of the physical environment," (3) "children's temperament and developmental stage," (4) "physical barriers and baby products," (5) "addressing walking surfaces," (6) "modifying the height of a fall," and (7) "supervision." Parents are aware of in-home fall hazards and actively use strategies to lessen fall risk. Anticipatory guidance should promote evidence-based and evidence-informed prevention strategies and augment effective strategies some parents use to lower fall risk. [ABSTRACT FROM AUTHOR]

Motor vehicle safety and tobacco control are among the greatest public health achievements of the 20th century, according to the Centers for Disease Control and Prevention. As the number of miles traveled in the United States multiplied 10 times from the 1920s to the 1990s, the annual motor vehicle crash death rate per vehicle mile traveled decreased by 90%. Similarly, tobacco-related deaths from heart disease, stroke, and cancer were rapidly mounting over the first two thirds of the 20th century. Then, in the last third of the century, tobacco consumption decreased by more than 50%, and rates of heart disease and stroke deaths, and later cancer deaths, declined similarly. This analysis addresses the central question of what lessons can be learned from these success stories that will help public health professionals successfully tackle new and emerging health behavior problems of today and tomorrow? Surveillance, research, multilevel interventions, environmental modifications, and strong policies were key to reducing motor vehicle- and tobacco-related health problems. Generating public support and advocacy, and changing social norms also played critical roles in promoting the safer and smoke-free behaviors. Lessons learned include the need for evidence-based practices and interventions that are ecologically comprehensive with an emphasis on changing environmental determinants and capitalizing on the concept of reciprocal determinism. The analysis concludes with a description of how the PRECEDE-PROCEED planning framework can be used to apply the lessons from motor vehicle safety and tobacco control to other public health threats.

Background: Prior to the COVID‐19 pandemic, nearly 60% of children under 5 years of age were cared for in out‐of‐home child care arrangements in the United States. Thus, child care provides an opportunity to identify and address potential child maltreatment. However, during the pandemic, rates of reporting child maltreatment decreased—likely because children spent less time in the presence of mandated reporters. As children return to child care, states must have regulations in place to help child care providers prevent, recognize and report child maltreatment. However, little is known about the extent to which state regulations address child maltreatment. Therefore, the purpose of this cross‐sectional study was to assess state regulations related to child maltreatment and compare them to national standards. Method: We reviewed state regulations for all 50 states and the District of Columbia for child care centres ('centres') and family child care homes ('homes') through 31 July 2021 and compared these regulations to eight national health and safety standards on child maltreatment. We coded regulations as either not meeting, partially meeting or fully meeting each standard. Results: Three states (Colorado, Utah and Washington) had regulations for centres, and one state (Washington) had regulations for homes that at least partially met all eight national standards. Nearly all states had regulations consistent with the standards requiring that caregivers and teachers are mandated reporters of child maltreatment and requiring that they be trained in preventing, recognizing and reporting child maltreatment. One state (Hawaii) did not have regulations consistent with any of the national standards for either centres or homes. Conclusions: Generally, states lacked regulations related to the prevention, recognition and reporting of child maltreatment for both centres and homes. Encouraging states to adopt regulations that meet national standards and further exploring their impact on child welfare are important next steps. [ABSTRACT FROM AUTHOR]

We evaluated a synergistic epidemic (syndemic) of substance use, mental illness, and familial conflict non-negotiation among HIV-positive injection drug users (IDU). Baseline BEACON study data was utilized. Latent class analyses identified syndemic classes. These classes were regressed on sex, viral suppression, and acute care non-utilization. Females were hypothesized to have higher syndemic burden, and worse health outcomes than males. Nine percent of participants had high substance use/mental illness prevalence (Class 4); 23 % had moderate levels of all factors (Class 3); 25 % had high mental illness (Class 2); 43 % had moderate substance use/mental illness (Class 1; N = 331). Compared to Classes 1-3, Class 4 was mostly female (p < .05), less likely to achieve viral suppression, and more likely to utilize acute care (p < .05). Interventions should target African-American IDU females to improve their risk of negative medical outcomes. Findings support comprehensive syndemic approaches to HIV interventions, rather than singular treatment methods., Author(s): Allysha C. Robinson[sup.1] , Amy R. Knowlton[sup.2] , Andrea C. Gielen[sup.2] , Joseph J. Gallo[sup.3] Author Affiliations: (1) Department of Surgery, Brigham and Women's Hospital, Harvard Schools of Medicine [...]

Background: Numerous studies have demonstrated an association between characteristics of the school environment and the likelihood of school violence. However, little is known about the relative importance of various characteristics of the school environment or their differential impact on multiple violence outcomes. Methods: Primarily African-American students (n = 27) from Baltimore City high schools participated in concept mapping sessions, which produced interpretable maps of the school environment's contribution to school violence. Participants generated statements about their school environment's influence on school violence and, with the assistance of quantitative methods, grouped these statements according to their similarity. Participants provided information about the importance of each of these statements for the initiation, cessation, and severity of the violence that occurs at school. Results: More than half of the 132 statements generated by students were rated as school environment characteristics highly important for the initiation, cessation, and/or severity of school violence. Participants identified students' own actions, expectations for disruptive behavior, and the environment outside the school as the characteristics most important for the initiation and increased severity of violence that occurs in school. Participants had a more difficult time identifying school environment characteristics important for the cessation of school violence. Conclusion: This study provides support from students for the role of the school environment in school violence prevention, particularly in preventing the initiation and reducing the severity of school violence. Schools can utilize the information presented in this article to begin discussions with students and staff about prioritizing school environment changes to reduce school violence. (Contains 2 figures and 3 tables.)

The No Child Left Behind Act requires state boards of education to identify schools that are unsafe. Schools that are identified by measures such as suspension and expulsion rates are subsequently labeled "persistently dangerous." To our knowledge there is no published research that attempts to characterize fighting behavior among youths who may attend schools designated as persistently dangerous. Two hundred thirteen sixth-grade African American boys and girls attending two urban middle schools on probation for persistently dangerous status were examined to investigate differences in demographic characteristics of gender and age and predictor factors of nonparental adult mentorship (NPAM), parental acceptance of fighting behavior, and peer fighting. These analyses suggest a relationship between being more likely to fight and number of peers who fight, youths who believed their parents endorse fighting, and youths without nonparental adult mentorship. This study also indicates that regardless of school status there are modifiable predictors associated with early adolescent fighting. (Contains 3 tables.)

Youth violence is a significant public health problem. Although the relationship between neighborhood-level factors and urban youth violence is recognized, the specific mechanisms of this relationship are often unclear. Prominent neighborhood individuals were identified within four select low-income urban neighborhoods in Baltimore City. In-depth interviews were conducted to explore these individuals' perceptions of the relationship between social and structural neighborhood-level factors and urban youth violence. Employment opportunities, local businesses, trash management, vacant housing, and street lighting were perceived as important neighborhood factors influencing young people's experiences. The relationship between these neighborhood characteristics and the local illicit drug market and youth violence is highlighted. Results provide an enhanced understanding of the importance of using a participatory-based research approach and the mechanisms of the relationship between neighborhood-level factors and youth violence. Both are critical components in designing and implementing multilevel youth violence prevention efforts.