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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. [ABSTRACT FROM AUTHOR]

This paper presents a cross-sectional study examining the influence of neighborhood violence on multiple aspects of mothers' health. While the influence of neighborhood violence on health is important to understand for all populations, mothers are especially important as they play a key role in protecting their children from the consequences of violence. Three hundred and ninety-two Baltimore City mothers of children 5 years and younger completed a self-administered survey that included questions about perceptions of their safety as well as their personal experiences with neighborhood violence. Separate models were run to compare the relationship between each measurement of neighborhood violence and five diverse health-related determinants and outcomes: self-reported health status, smoking, exercise, average hours of sleep a night, and sleep interruption. Controlling for mother's age, child's age, maternal education, and marital status, mothers with high exposure to neighborhood violence were twice as likely to report poorer health, smoking, never exercising, and poor sleep habits. Maternal perception of neighborhood safety was not related to any of the assessed health-related determinants and outcomes. This study emphasizes the importance of measuring exposure to neighborhood violence rather than solely assessing perceived safety. Neighborhood violence was a common experience for mothers in this urban sample, and should be considered by health professionals in trying to understand and intervene to improve the health of mothers and their children. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the utilisation-related outcomes associated with visiting the Johns Hopkins CareS (Children are Safe) Mobile Safety Center (MSC), a 40-foot vehicle designed to deliver effective injury prevention interventions and education to low-income urban families. DESIGN AND SETTING: Utilisation-related data were collected when the MSC was accessible at a community health centre and at community events from August 2004 to July 2006 in Baltimore City. SUBJECTS: Adults bringing their child for well child care at a community health centre and MSC visitors at community events. INTERVENTIONS: Low-cost safety products and free personalized educational services are provided on the MSC, which replicates a home environment and contains interactive exhibits. MAIN OUTCOME MEASURES: Perceived benefits of visiting the MSC; products and services received. RESULTS: MSC visitors (n = 83) and non-visitors (n = 127) did not differ in sociodemographic and injury-related characteristics; 96% of visitors reported learning something new as a result of their visit and 98% would recommend the MSC. During the first 2 years of operation, the MSC made 273 appearances, serving 6086 people. Home child safety products accounted for 71% of the 559 products distributed; educational materials made up 87% of the 7982 services received. Car safety seats accounted for 23% of the products distributed; installations made up 4% of the services received. CONCLUSIONS: This approach to disseminating injury prevention interventions holds promise for enhancing the appeal of safety information and increasing the protection of children. [ABSTRACT FROM AUTHOR]

A mobile safety center (MSC) provided education and reduced-cost safety products to low-income urban families. We evaluated uptake of this service under 3 different conditions, and safety-related knowledge and behavior associated with visiting the MSC among 210 families. Utilization varied widely under the 3 different conditions. At follow-up, MSC visitors scored slightly higher on a knowledge test than nonvisitors and improved more in reported car safety seat use, but did not differ in observed safety product use. This study provides very modest evidence of a positive impact of the MSC when its services are provided at a community health center. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if disparities exist in lifetime utilization of mental health/substance abuse services among Asian, Native Hawaiian/Other Pacific Islander (NHOPI) and white mothers. The study sample was comprised of mothers assessed to be at-risk (n = 491) and not at-risk (n = 218) for child maltreatment in the Hawaii Healthy Start Program study. Multiple logistic regression models were used to test the effects of predisposing, need, and enabling factors on utilization of services. Results revealed that, among mothers with depressive symptoms, compared with whites, Asians and NHOPI were significantly less likely to have received services. There were no significant racial differences in use of mental health/substance use services by other factors. These results suggest that racial disparities exist in utilization of mental health/substance abuse services among mothers with depressive symptoms. Future research is needed to identify barriers and facilitators to accessing needed services for Asian and NHOPI women. [ABSTRACT FROM AUTHOR]

This study was a secondary analysis of the relationships among lifetime experiences of violence, depressive symptoms, substance use, safer sex behaviors use, and past-year sexually transmitted infection (STI) treatment among a sample of 445 low income, primarily African American women (257 HIV-, 188 HIV+) reporting a male intimate partner within the past year. Twenty-one percent of HIV- and 33% of HIV+ women reported past-year STI treatment. Violence victimization increased women's odds of past-year STI treatment, controlling for HIV status and age. Depressive symptoms increased, and use of safer sex behaviors decreased, women's odds of past-year STI treatment. Results suggest that positive assessment for violence and/or depression indicates need for STI screening. (c) 2007 Wiley Periodicals, Inc. Res Nurs Health 30:413-428, 2007. [ABSTRACT FROM AUTHOR]

This article reviews 35 U.S. studies on the intersection of HIV and adult intimate partner violence (IPV). Most studies describe rates of IPV among women at risk or living with HIV/AIDS and identify correlates, using multiple types of convenience samples (e.g., women in methadone treatment, women in shelters or clinics), cross-sectional designs, and self-reported risk behaviors. HIV-positive women appear to experience any IPV at rates comparable to HIV-negative women from the same underlying populations; however, their abuse seems to be more frequent and more severe. The authors found only four relevant interventions and none addressed sexually transmitted HIV and partner violence risk reduction simultaneously. There is a critical need for research on (a) causal pathways and cumulative effects of the syndemic issues of violence, HIV, and substance abuse and (b) interventions that target IPV victims at risk for HIV, as well as HIV-positive women who may be experiencing IPV. [ABSTRACT FROM AUTHOR]

Objective: To assess childhood injury risk and parents' injury interests, and the association between the two. Method: A cross-sectional computer and telephone survey was conducted as part of a randomized controlled trial. The authors enrolled parents of children being seen at an urban pediatric primary care practice and measured selected injury knowledge, beliefs and safety practices. Parents were asked to select two of four topics of interest and recommendations regarding them were included in a computer-tailored report. Results: Participants (N = 105) were assessed as being at risk for all four areas: poisoning (88%), fires (85%), falls (55%), and car crashes (18%). Parents were interested in poisoning (81%) and car crashes (49%); their interests were unrelated to child's assessed risk. Conclusion: Soliciting parents' interests prior to counseling may help to identify priority areas for counseling as well as dispel myths and unfounded fears regarding childhood injury risks. [ABSTRACT FROM AUTHOR]

Objectives: This study describes active duty military (ADM) women's beliefs and preferences concerning domestic violence (DV) policy in the military.Methods: Telephone interviews were completed with 474 ADM women from all services, 119 of whom had experienced DV during their military service.Results: A majority (57%) supported routine screening. Although 87% said the military's policy on mandatory reporting should remain the same, only 48% thought abuse should be reported to the commanding officer; abused women were significantly less likely than nonabused women to agree with this aspect of the policy. ADM women's beliefs were similar to those of women in a previously studied civilian sample, except that 73% of ADM compared to 43% of civilian women thought routine screening would increase women's risk of further abuse.Conclusions: ADM women recognized both advantages and disadvantages of current DV policies. More research is urgently needed about actual outcomes of screening and reporting policies. [ABSTRACT FROM AUTHOR]

The purpose of the study was to assess the state of fire prevention research, provide an updated synthesis of evaluated fire prevention programs, and discuss the role of fire fighters and data systems in prevention efforts. The review included all evaluations of U.S. based fire prevention interventions published between January 1998 and September 2004 and any earlier articles about U.S. fire prevention interventions not included in two prior review articles. We retrieved information from each identified study including evaluation findings, involvement of fire service personnel and use of existing data systems. We identified twelve articles: seven reported on smoke alarm interventions, three on multi-faceted programs, and two other programs. Five programs involved fire service personnel in the design, implementation, and/or evaluation, and three used existing data systems. Studies reviewed suggest that canvassing and smoke alarm installations are the most effective means of distributing alarms and increasing the functional status of distributed alarms. The functionality of smoke alarms, an issue noted in earlier reviews, remains a problem. Programs involving partnerships with fire departments have indicated success in preventing fires and deaths, improving smoke alarm ownership and functional status, and improving children's fire safety knowledge. Using existing data systems to target and to evaluate interventions was effective. In the years since prior reviews, some improvements in the rigor of evaluation designs have been made, but there is still a need for high quality evaluations that will inform fire injury prevention efforts. [ABSTRACT FROM AUTHOR]

In this article, the authors introduce concept mapping as a useful participatory research method for public health researchers interested in generating hypotheses and developing theory. The authors first provide an overview of concept mapping, which combines qualitative approaches with quantitative analytical tools to produce visual displays of the relationship between ideas. Then, they present an illustrative research application of the method to the exploration of women's perceptions of the relationship between residential neighborhood factors and intimate partner violence experiences. They give attention to the data collection and analysis procedures and to demonstrating the intricacies of using concept mapping for public health research purposes. Finally, the article concludes with a discussion of the unique contributions and challenges associated with concept mapping. [ABSTRACT FROM AUTHOR]

This article focuses on the intersection of intimate partner violence (IPV), substance use, and HIV status among a sample of low-income urban women (n = 611). Differences emerged by drug type, categorization of IPV, and HIV status. Rates of IPV did not differ between HIV-negative and HIV-positive women, but differing rates of substance use were found to be highly significant. The relationship between IPV and drug use appeared to be stronger for HIV-negative women. Descriptive data capturing temporal relationships between substance abuse and IPV support continued examination of types of IPV separately. These findings indicate the need to create comprehensive intervention strategies to address all three issues. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the application of the transtheoretical model (TM) to women's experiences of ending intimate partner violence (IPV). METHODS: Qualitative interviews were conducted with 23 abused women. RESULTS: Women use 7 traditional processes of change. Women in early stages of change use cognitive processes. Women in later stages use behavioral processes. Consciousness-raising and social liberation appear in both early and later stages. Helping relationships are critical throughout. Decisional balance and self-efficacy are also related. CONCLUSIONS: Women ending IPV do use the TM processes and constructs of change. These findings support the development and evaluation of a TM stage-based IPV intervention. [ABSTRACT FROM AUTHOR]

STUDY OBJECTIVE: To determine how likely parents would be to contribute to strategies to reduce pedestrian injury risks and how much they valued such interventions. DESIGN: A single referendum willingness to pay survey. Each parent was randomised to respond to one of five requested contributions towards each of the following activities: constructing speed bumps, volunteering as a crossing guard, attending a neighbourhood meeting, or attending a safety workshop. SETTING: Community survey. PARTICIPANTS: A sample of 723 Baltimore parents from four neighbourhoods stratified by income and child pedestrian injury risk. Eligible parents had a child enrolled in one of four elementary schools in Baltimore City in May 2001. Main results: The more parents were asked to contribute, the less likely they were to do so. Parents were more likely to contribute in neighbourhoods with higher ratings of solidarity. The median willingness to pay money for speed bumps was conservatively estimated at $6.43. The median willingness to contribute time was 2.5 hours for attending workshops, 2.8 hours in community discussion groups, and 30 hours as a volunteer crossing guard. CONCLUSIONS: Parents place a high value on physical and social interventions to improve child pedestrian safety. [ABSTRACT FROM AUTHOR]

Intimate partner violence has been demonstrated to be a significant public health problem among African American women. This study provided an opportunity to examine prevalence of intimate partner violence and health consequences among a group of primarily middle-class, employed African American women enrolled in a privately insured HMO (n =109 abused and 97 never-abused women). Significantly more abused African American women were divorced or widowed and had incomes less than $50,000 a year. Abused women had more health problems (central nervous system, gynecological, STDs, gastrointestinal), more health problems per medical visits, and more emergency room visits (p < .05) compared to never-abused women. The health consequences of abuse and its association with health disparities are discussed. [ABSTRACT FROM AUTHOR]

This study describes the risk of intimate partner violence for women in a low-income, urban setting and the impact of violence on condom use. Partner-specific data were used to link partner characteristics with the measures of both abuse and condom use. Using the Revised Conflict Tactics Scales (CTS2), we determined annual rates, chronicity, and types of intimate partner violence among 188 HIV-positive and 257 HIV-negative women. Of the total sample, 62% reported experiencing psychological, physical, and/or sexual abuse; 44% experienced frequent abuse (=13 events); and 29% suffered an injury. Rates did not differ by women's HIV status. Women who experienced frequent abuse were significantly less likely to have used condoms with their intimate partner. Partner characteristics significantly associated with experiencing frequent abuse were his HIV status and substance use. Findings can help inform the development of programs and policies that promote women's health through integrated approaches to intimate partner violence and HIV prevention. [ABSTRACT FROM AUTHOR]

The Stages of Change (SOC) model was used to implement and evaluate a condom promotion intervention for HIV-positive and at-risk women who were recruited from clinic and community settings in Baltimore and Philadelphia. Participants were assigned to receive standard reproductive health services or enhanced services (standard plus SOC peer advocate intervention). Women who had a main partner at baseline and at a 6-month follow-up were included in the analysis (70 HIV positive, 471 at risk). Compared with the standard group, HIV-positive women in the enhanced group were significantly more likely to have progressed in the SOC model or to have maintained consistent condom use, and less likely to have relapsed or stayed in the precontemplation stage. Among the at-risk women, exposure to the intervention was associated with being at a higher SOC and being less likely to relapse relative to the standard group. The SOC model has promise for use in social and public health service settings that serve women at risk or living with HIV. [ABSTRACT FROM AUTHOR]

This paper describes the relationship between psychosocial factors and health related quality of life among 287 HIV-positive women using items from the Medical Outcomes Study HIV Health Survey to measure physical functioning, mental health and overall quality of life. Multivariate models tested the relative importance of sociodemographic characteristics, HIV-related factors and psychosocial variables in explaining these quality of life outcomes. A history of child sexual abuse and adult abuse, social support and health promoting self-care behaviors were the psychosocial factors studied. Women in the sample were on average 33 years old and had known they were HIV-positive for 41 months; 39% had been hospitalized at least once due to their HIV; 83% had children; 19% had a main sex partner who was also HIV-positive. More than one-half of the women (55%) had a history of injection drug use and 63% reported having been physically or sexually assaulted at least once as an adult. A history of childhood sexual abuse. reported by 41% of the sample, was significantly related to mental health after controlling for sociodemographic and HIV-related characteristics. Women with larger social support networks reported better mental health and overall quality of life. Women who practiced more self-care behaviors (healthy diet and vitamins, adequate sleep and exercise, and stress management) reported better physical and mental health and overall quality of life. The high prevalence of physical abuse and child sexual abuse reported by this sample underscores the importance of screening for domestic violence when providing services to HIV-positive women. That such potentially modifiable factors as social support and self care behaviors are strongly associated with health-related quality of life suggests a new opportunity to improve the lives of women living with HIV. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The authors used data from a larger study to evaluate the long-term effects of a peer advocate intervention on condom and contraceptive use among HIV-infected women and women at high risk for HIV infection. METHODS: HIV-infected women in one study and women at high risk for HIV infection in a second study were selected from the Women and Infants Demonstration Project and assigned to a standard or an enhanced HIV prevention treatment group. The enhanced intervention included support groups and one-on-one contacts with peer advocates tailored to clients' needs. The authors interviewed women at baseline and at 6-, 12- and 18-months, and measured changes in consistency of condom and contraceptive use and in self-efficacy and perceived advantages and disadvantages of condom and contraceptive use. RESULTS: Of HIV-infected women, the enhanced group had improved consistency in condom use, increased perceived advantages of condom use, and increased level of self-efficacy compared with the standard group. Of women at risk, the enhanced intervention group at six months maintained consistent condom use with a main partner and perceived more benefit of condom use compared with the standard group. These differences diminished at 12 months. CONCLUSIONS: The enhanced intervention was generally effective in the HIV+ study. In the at-risk study, however, intervention effects were minimal and short-lived. Factors related to the theory, intervention design, and sample characteristics help explain these differences. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This research addresses four questions: (1) What role do health care providers play in women's disclosure to others of their HIV-positive status? (2) What are women's concerns and experiences with disclosure? (3) What violence do women living with HIV experience? (4) How is the violence related to their diagnosis and disclosures? METHODS: Participants were 310 HIV-positive women enrolled in an HIV primary care clinic in an urban teaching hospital. Women were interviewed once using both quantitative and qualitative methods. RESULTS: Women had known they were HIV-positive for an average of 5.8 years; 22% had an HIV-positive partner; 58% had disclosed their status to more than 10 people; and 68% had experienced physical abuse and 32% sexual abuse as an adult. Fifty-seven percent of the sample reported that a health care provider had told them to disclose to their sex partners. Women who were afraid of disclosure-related violence (29%) were significantly more likely than those who were not to report that a health care provider helped them with disclosure (21% vs. 10%). Although 4% reported physical abuse following a disclosure event, 45% reported experiencing emotional, physical, or sexual abuse at some time after their diagnosis. Risk factors for experiencing abuse after diagnosis were a prior history of abuse, drug use, less income, younger age, length of time since diagnosis, and having a partner whose HIV status was negative or unknown. CONCLUSIONS: Identifying women at risk for abuse after an HIV-positive diagnosis is important for those who provide HIV testing and care. Routine screening for interpersonal violence should be incorporated into HIV posttest counseling and continuing primary care services. [ABSTRACT FROM AUTHOR]

The numbers of women of childbearing age in the US with HIV and AIDS from heterosexual transmission continues to rise. Behavioral interventions remain the best means of preventing transmission of HIV. Program planners often implement interventions to promote behavioral change in a wide range of settings such as family planning or sexually transmitted disease clinics, drug treatment facilities, or medical facilities that serve high risk and HIV positive women. Women recruited in different types of settings, however, may differ with respect to their experience with, attitudes toward, and willingness to use condoms and contraception. Such differences should be considered when tailoring interventions to the populations being served. We examined the readiness to use condoms and contraception among 3784 women in four cities recruited in three different types of settings: community, facilities not targeted to HIV positive women and medical facilities for HIV positive populations. Readiness to use condoms or contraception was measured using The Transtheoretical Model of Change. Women reported being in different stages along the continuum of condom and contraceptive use in the three settings. A greater proportion of women in the HIV-facility, 45%, had used condoms consistently for the previous 6 months compared to women in the other two settings (12% and 11%). Similarly, variation across settings was seen for contemplation of consistent contraceptive use to prevent unintended pregnancies. The variability in the distribution of condom and contraceptive use across settings underscores the importance of assessing the readiness for the behavior change and designing interventions that meet the specific needs of the populations being served. [ABSTRACT FROM AUTHOR]

Women represent an increasing proportion of AIDS cases and anecdotal reports suggest some face substantial risks when others learn they are HIV-positive. The purpose of this paper is to describe women's fears and experiences regarding disclosure of their HIV status. Fifty HIV-positive women, ages 16-45 from urban teaching hospital outpatient clinics, were interviewed using an in-depth, qualitative interview. Eighty-six percent of the women were African American and 56% were current or former IVDU. At the time of the interview, 88% of the women had known their HIV status for a year or more. All but one woman had disclosed her HIV status to at least one person and 82% had disclosed to multiple people. Although two-thirds of the women had been afraid to disclose to others because of concerns about rejection, discrimination or violence, three-quarters of the sample reported only supportive and understanding responses to their disclosure. One-quarter of the sample reported negative consequences of disclosure, including rejection, abandonment, verbal abuse and physical assault. Disclosure-related violence was discussed by nine women (18%): two who feared violence were relieved to find a supportive response; four chose not to disclose their status because they feared violence; and three women were verbally or physically assaulted. Fear of mistreatment figured prominently in decisions about disclosure among this sample. That many women found supportive and understanding responses is encouraging. However, there were sufficient examples of negative consequences, including violence, to suggest individualized approaches to post-test counseling, enhanced support services for HIV-positive women, and public education to destigmatize HIV-disease. [ABSTRACT FROM AUTHOR]

Heterosexual transmission of the human immunodeficiency virus (HIV) has become a significant health issue for women. The present study describes the extent to which a sample of women from an urban area report making efforts to protect themselves from becoming infected with HIV through several protective sexual behaviors. Secondly, we assess the extent to which adoption of these protective behaviors can be explained by health beliefs and previous HIV testing. Forty-nine percent of the sample reported having used a condom in the past year because of fear of AIDS and 48% reported having carried condoms. Women in this sample perceived themselves to be moderately susceptible to AIDS and they were well aware of the severity of the disease. Women tended to think that protecting themselves from AIDS would not be overly burdensome and that the recommended sexual protective behaviors were highly effective for preventing AIDS. Messages about the severity of AIDS and the effectiveness of protective sexual behaviors seem to be reaching women. Beliefs about personal susceptibility were consistently associated with the adoption of multiple protective behaviors, suggesting that messages emphasizing the ubiquity of risk, especially in demographically high-risk populations, may be particularly appropriate and effective. [ABSTRACT FROM AUTHOR]

The infant feeding preferences of significant others have been shown to influence a pregnant woman's breastfeeding decision. Many researchers and policy makers are calling for the inclusion of a woman's significant other in the counseling and education of pregnant women regarding breastfeeding. This study reports on the impact of the significant other's infant feeding preferences and beliefs on a woman's intention to breastfeed, her initiation and successful initiation (longer than seven days) of breastfeeding. 'Significant other' was defined as the person whom the pregnant woman reported as the one whose opinion 'mattered the most to her' regarding feeding her infant. A randomly selected sub-sample of 133 women and their significant others was chosen from a larger infant feeding study. This sub-sample was heterogeneous with respect to age, education, and marital status. The women were interviewed during their third trimester of pregnancy and again at 7-10 days postpartum. Their significant others (71 percent baby's father and 29 percent baby's maternal grandmother), were interviewed during the woman's third trimester of pregnancy. Results indicate that a woman's intention to breastfeed is strongly and positively affected by the significant other's infant feeding preferences, initiation of breastfeeding is mediated through intention to breastfeed, and successful initiation of breastfeeding is also mediated through intention and is uniquely dependent on the pregnant woman's self-efficacy. [ABSTRACT FROM AUTHOR]

The purpose of the current research was to identify demographic and psychosocial factors important in the decision to breastfeed among a sample of WIC participants in a rural area. One hundred and ninety-eight women completed both a prenatal interview during their third trimester of pregnancy and a second interview within one to three weeks postpartum. Twenty-seven percent of these WIC participants initiated breastfeeding. Multiple logistic regression analysis revealed that prenatal behavioral beliefs about the consequences of breastfeeding and formula feeding were the strongest predictors of breastfeeding initiation. The results suggest that education to improve the current low rates of breastfeeding among WIC participants should emphasize that formula feeding is neither more convenient nor easier than breastfeeding, and that breastfeeding need not limit mothers in public or social settings. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The purpose of this study was to evaluate Children's Village, a life safety education facility for children. SETTING: The study took place in Washington County, Maryland, a rural county. METHODS: Eight elementary schools with 20 second grade classrooms (410 students aged 7 and 8) were selected to participate. Using a quasiexperimental design, tests were administered to two cohorts of children before (pretest) and after (post-test) they attended the Children's Village during 1993-4. Parent and teacher surveys were also completed after the program. RESULTS: Among children who attended in December 1993-January 1994, there was a significant improvement in average test scores between the pretest (58% correct) and post-test (78%). Among children who attended in April 1994, there also was a significant improvement in test scores between pretest (74%) and post-test (85%). Among parents, 70% reported that their child learned a great deal at Children's Village and 33% reported having made changes in their home as a result. The parent survey also revealed that 25% of children and 35% of adults did not always wear their seat belts, and 74% of children did not always wear bicycle helmets. Teachers' responses to the program were generally positive. CONCLUSIONS: Children's Village brought together an extensive network of community leaders, parents, and teachers dedicated to safety education of children. The curriculum had a positive impact on children's knowledge and, to a lesser extent, on parents' safety practices. Program impact could be enhanced by more emphasis on automobile restraints and helmets (behaviors that parents reported were not consistently practiced) and by expanding the village services to parents as well as children. Others considering creating similar programs need to identify community leaders willing to commit the time, effort, and resources required to develop and sustain such programs. [ABSTRACT FROM AUTHOR]

The article discusses about the computer kiosk used to advance child safety. According to the article, the effects of the kiosk intervention on parents' child safety seat, smoke alarms and poison storage knowledge and behaviors were assessed in a pediatric emergency department attending usually low-income urban families. Also examined were the effects of parent anxiety and the cause for the child's emergency department visit. Results of the test shows that intervention groups had substantially higher scores on smoke alarm, poison storage and total safety knowledge.

The purpose of this paper is to review the available literature on the intersections between HIV and violence and present an agenda for future research to guide policy and programs. This paper aims to answer four questions: (1) How does forced sex affect women's risk for HIV infection? (2) How do violence and threats of violence affect women's ability to negotiate condom use? (3) Is the risk of violence greater for women living with HIV infection than for noninfected women? (4) What are the implications of the existing evidence for the direction of future research and interventions? Together this collection of 29 studies from the US and from sub-Saharan Africa provides evidence for several different links between the epidemics of HIV and violence. However, there are a number of methodological limitations that can be overcome with future studies. First, additional prospective studies are needed to describe the ways which violence victimization may increase women's risk for HIV and how being HIV positive affects violence risk. Future studies need to describe men's perspective on both HIV risk and violence in order to develop effective interventions targeting men and women. The definitions and tools for measurement of concepts such as physical violence, forced sex, HIV risk, and serostatus disclosure need to be harmonized in the future. Finally, combining qualitative and quantitative research methods will help to describe the context and scope of the problem. The service implications of these studies are significant. HIV counseling and testing programs offer a unique opportunity to identify and assist women at risk for violence and to identify women who may be at high risk for HIV as a result of their history of assault. In addition, violence prevention programs, in settings where such programs exist, also offer opportunities to counsel women about their risks for sexually transmitted diseases and HIV. [ABSTRACT FROM AUTHOR]

Background: Many home-based interventions have been demonstrated to reduce unintentional and intentional injuries in young children aged 0-4 years, but an understanding of their inclusion in federally-funded home visiting programmes in the USA is needed., Methods: The study team administered a survey to key informants at each of the 21 home visiting models approved for United States Maternal, Infant, and Early Childhood Home Visiting program funding being implemented in 2023. Respondents were based across the United States and in other developed countries. The survey collected information about the content used by models to address unintentional injury, parental health/wellbeing, and child abuse/neglect in children aged 0-4 years., Results: Completed surveys were returned by all respondents (n=21). Most models reported the inclusion of some unintentional injury, parental health/well-being and child abuse/neglect content. While models on average covered four of the five child abuse/neglect topics listed, only five of the nine topics listed for unintentional injury and parental health/well-being were covered. Among the services used by models to address topics, covering content via standardised curriculum and referrals were the most frequent while less than one-quarter of models (n=5) provided families with safety equipment to address unintentional injury. Less than half of the models evaluated outcomes from their injury prevention services, and no models conducted cost-effectiveness evaluations., Conclusions: Home visiting programmes are a promising way to reduce injuries in children at high risk, but further development and evaluation of their injury prevention content could increase their impact in the USA., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Paediatric drowning is an injury associated with significant morbidity and mortality., Objective: The objective is to describe drowning trends, including associations with inpatient hospitalisation or fatality, in a state-wide paediatric cohort to inform prevention strategies., Methods: In this retrospective cohort study using the Health Services Cost Review Commission database, we used International Classification of Diseases, Tenth Revision (ICD-10) codes to identify patients aged 0-19 years with an outpatient (including emergency department) or inpatient medical encounter following a non-fatal or fatal drowning event between 2016 and 2019. Descriptive statistics and logistic regression were used to summarise the data and evaluate associations with inpatient hospitalisation or fatality., Results: There were 541 medical encounters for drowning events, including 483 non-fatal outpatient encounters, 42 non-fatal inpatient encounters and 16 fatal cases. Overall, most patients were boys, 0-4 years, white and lived in urban settings. White children accounted for 66% of encounters among those aged 0-4 years, whereas non-white children accounted for 62% of visits among those aged 10-19 years. Non-white children were more likely than white children to experience a fatal drowning (OR 3.6, 95% CI: 1.2 to 11.5). Adolescents were more likely than younger children to be hospitalised (OR 3.1, 95% CI: 1.6 to 6.5) and had higher charges in outpatient (p=0.002) and inpatient settings (p=0.003)., Discussion: Our study revealed high fatality rates among non-white children and high admission rates among adolescents., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

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., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Faith-based organizations (FBOs) have a scant history in the literature of implementing intimate partner violence (IPV) initiatives, though many members of faith communities consider it an important issue. Furthermore, the limited studies on this topic have not explored organizational factors that are important in the implementation of such efforts., Purpose: To investigate factors that influence the implementation of IPV prevention and response by one Catholic organization at both diocesan and parish levels., Methods: We conducted sixteen semi-structured interviews with members of Archdiocese of Chicago Domestic Violence Outreach (ACDVO) leadership. Using deductive content analysis, we drew on all 14 constructs and sub-constructs from the inner setting domain of the Consolidated Framework for Implementation Research (CFIR) for coding transcripts and characterizing factors influencing implementation success., Results: Seven CFIR constructs were useful in identifying factors that influenced implementation success of ACDVO. At the diocesan level, the organization's leadership structure, their driven culture, and in-kind available resources propelled their work. At the level of parish ministries, successful implementation was facilitated by networking and communication among parishes. At the diocesan-level, access to knowledge and information through ACDVO's Parish Support Committee, compatibility with parish values, leadership engagement, and available resources from parishes supported implementation., Conclusions: We identified modifiable and reproducible inner setting factors that influence implementation of a Catholic IPV initiative at the diocesan-level and support parish ministries in their local activities. Future work should validate these findings in other dioceses and examine non-Catholic FBO settings.

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., (© 2022 John Wiley & Sons Ltd.)

Background: Drowning is a common mechanism of injury in the pediatric population that often requires hospitalization. The primary objective of this study was to describe the epidemiology and clinical characteristics of pediatric drowning patients evaluated in a pediatric emergency department (PED), including the clinical interventions and outcomes of this patient population., Methods: A retrospective cohort study was conducted of pediatric patients evaluated in a mid-Atlantic urban pediatric emergency department from January 2017 to December 2020 after a drowning event., Results: Eighty patients ages 0-18 were identified, representing 57 79 unintentional events and 1 intentional self-injury event. The majority of patients (50%) were 1-4 years of age. The majority (65%) of patients 4 years of age or younger were White, whereas racial/ethnic minority patients accounted for the majority (73%) of patients 5 years of age or older. Most drowning events (74%) occurred in a pool, on Friday through Saturday (66%) and during the summer (73%). Oxygen was used in 54% of admitted patients and only in 9% of discharged patients. Cardiopulmonary resuscitation (CPR) was performed in 74% of admitted patients and 33% of discharged patients., Conclusions: Drowning can be an intentional or unintentional source of injury in pediatric patients. Among the patients who presented to the emergency department for drowning, more than half received CPR and/or were admitted, suggesting high acuity and severity of these events. In this study population, outdoor pools, summer season and weekends are potential high yield targets for drowning prevention efforts., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier Inc.)

Head injuries are a leading cause of death and disability in children, accounting for numerous emergency department (ED) visits. It is unclear how the COVID-19 pandemic has influenced healthcare utilization for pediatric head injuries. We hypothesize that the proportion of ED visits attributable to head injury and severity will increase during the COVID-19 era. Retrospective study using electronic health record data to compare proportion and severity of head injury for children 0-21 years of age from three urban mid-Atlantic EDs in the pre-COVID-19 era (March-June 2019) and COVID-19 era (March-June 2020). Controlling for confounders, logistic regression analyses assessed ORs of head injury outcomes. The χ 2 analyses identified differences in patient characteristics. The proportion of head injury visits within the ED population significantly increased during the COVID-19 era (adjusted OR (aOR)=1.2, 95% CI 1.1 to 1.4). Proportion of visits requiring hospitalization for head injury increased by more than twofold in the COVID-19 era (aOR=2.3, 95% CI 1.3 to 4.3). Use of head CT imaging did not significantly change in the COVID-19 era (aOR=1.0, 95% CI 0.7 to 1.6). The proportion of ED visits and hospitalizations for head injury increased during the COVID-19 era. This could be due to changes in the level of supervision and risk exposures in the home that occurred during the pandemic, as well as differences in postinjury care, level of awareness regarding injury severity, and threshold for seeking care, all of which may have influenced pediatric healthcare utilization for head injuries., Competing Interests: Competing interests: LMR is a Journal of Investigative Medicine editorial board member., (© American Federation for Medical Research 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Minor injuries are very common in the pediatric population and often occur in the home environment. Despite its prevalence, little is known about outcomes in children following minor injury at home. Understanding the impact of these injuries on children and their families is important for treatment, prevention, and policy. The objectives of our study were (1) To describe the distribution of short-term outcomes following pediatric minor injuries sustained at home and (2) To explore the relationship of injury type and patient and household demographics with these outcomes., Methods: Children (n = 102) aged 0-7 years with a minor injury sustained at home were recruited in an urban pediatric emergency department as part of the Child Housing Assessment for a Safer Environment (CHASE) observational study. Each patient had a home visit following the emergency department visit, where five parent-reported outcomes were assessed. Relationships were explored with logistic regression., Results: The most common type of injury was soft tissue (57.8 %). 13.2 % of children experienced ≥ 7 days of pain, 21.6 % experienced ≥ 7 days of abnormal activity, 8.9 % missed ≥ 5 days of school, 17.8 % of families experienced ≥ 7 days of disruption, and 9.1 % of parents missed ≥ 5 days of work. Families reported a total of 120 missed school days and 120 missed work days. Children who sustained a burn had higher odds of experiencing pain (OR 6.97), abnormal activity (OR 8.01), and missing school (OR 8.71). The parents of children who sustained a burn had higher odds of missing work (OR 14.97)., Conclusions: Families of children suffering a minor injury at home reported prolonged pain and changes in activity as well as significant school and work loss. In this cohort, burns were more likely than other minor injuries to have these negative short-term outcomes reported and represent an important target for interventions. The impact of these injuries on missed school and disruption of parental work warrants further consideration.

We study a population-based influenza vaccination program in the Netherlands, and the spillovers it has within families. Individuals aged 65 years and over qualify for the program and receive a personal invitation for a free flu shot, while ineligible individuals have to pay out-of-pocket and face additional barriers to getting vaccinated. The quasi-random variation at age 65 is exploited to analyse program impact on vaccination behavior of cohabiting partners and adult children. We find that the program induced a 10 percentage points increase in vaccination coverage among individuals at age 65. The program further led to a similar effect on vaccination take-up by cohabiting younger partners, but spillovers on children were negative. These asymmetric patterns of vaccination uptake are consistent with partners and children learning about influenza mortality risk, target group membership, and cost and benefits of vaccination, as well as salience. We conclude that public health campaigns should pay attention to the effects on voluntary preventive care participation as within-family spillovers impact the program's overall public health impact., (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Prior to the COVID-19 pandemic, 44% of all reported injuries in U.S. households occurred in the home. Spending more time at home due to the pandemic may increase the number of home injuries., Methods: A nationally representative sample of 2011 U.S. adults were surveyed online between June 17 - June 29, 2020. Propensity score weighting and T-tests were used., Results: Twenty-eight percent (28%) of households reported a home injury or ingestion during the pandemic; 13% reported experiencing both. Injuries were most often due to falls (32%). Medication ingestions were reported by 6%; household product ingestions were reported by 4%. Relative to households that experienced no injuries or ingestions, those that reported either or both were more likely to: be in urban areas, have household incomes > $100,000, and have children living in them. Among households reporting more time spent at home, those with children were significantly more likely than those without to report an injury or ingestion., Conclusions: Results help target prevention messages while U.S. families are continuing to work and learn remotely. During this pandemic and future stay-at-home orders, there is a need for public health efforts to prevent home injuries and ingestions.

When older adults reduce their driving, there can be subsequent decreases in life satisfaction. In this cross-sectional study, we used baseline data from the multi-site Longitudinal Research on Aging Drivers (LongROAD) study to examine whether social support moderates the negative association between reduced driving and life satisfaction. The outcome variable was life satisfaction, and the main predictor variable was past-year reduced driving (yes/no). Emotional, instrumental, and informational social support were measured using PROMIS v2.0 (Patient-Reported Outcomes Measurement Information System) items. We used generalized linear regression models to examine how social support moderated the association between reduced driving and life satisfaction. Statistical adjustment for social support attenuated the negative effect of reduced driving on life satisfaction by ~10% for all three types of social support.

The gap between evidence and policy is a challenge that can be bridged through strategic outreach and translation efforts. We developed and disseminated the Resource for State Policy Makers (the Resource) to lessen the information gap between state policy makers and injury prevention researchers in Maryland. Our goal was to produce and disseminate a resource for policy makers that could be replicated by public health professionals in other states and regions. The Maryland Department of Health assumed production of the Resource in 2017, with assistance from our team. Several states and regions have replicated the Resource for their own jurisdictions. This experience provides an informative case example of one approach to increasing the role of evidence in policy making.

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 ≤ 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.