Society for Prevention Research (SPR): Annual Meeting

WASHINGTON – Exposure to violence in childhood significantly increased the odds of early dating and sexual behavior in adolescents, based on data from 177 high-risk black girls in a low-income urban setting. The findings were presented at the annual meeting of the Society for Prevention Research.

"Currently, young African American adolescent girls are at disproportionate risk for poor sexual health outcomes," said Helen Wilson, Ph.D., of the college of health professions at the Rosalind Franklin University of Medicine and Science, Chicago.

Data from the Centers for Disease Control and Prevention indicate that black women aged 15-24 years have the highest rates of gonorrhea and chlamydia in the United States, she added.

However, there is not consistent evidence that black girls are more likely to take sexual risks, she said.

"There is growing recognition that violence exposure is associated with sexual risk," she said. Violence exposure also disproportionately affects youths who grow up in low-income, urban communities, she noted.

In this study, Dr. Wilson and her colleagues reviewed data from 177 girls who were participating in a longitudinal study on mother-daughter relationships and HIV risk behavior. Data were initially collected at baseline (when the girls were aged 12-16 years) and at 6, 12, 18, and 24 months.

"There is growing recognition that violence exposure is associated with sexual risk."

In a recent follow-up, the same participants responded to questions using the Lifetime Trauma and Victimization History. Sexual behavior was assessed via the AIDS Risk Behavior Assessment at all time points during the study.

Overall, 44% of the girls reported some type of violence during childhood (defined as having experienced physical or sexual victimization and/or having witnessed violence before 12 years of age).

The girls who reported exposure to childhood violence were significantly more likely than those who reported no childhood violence exposure to report sexual experience, inconsistent condom use, and a higher number of sexual partners. This trend persisted across all six time points. In addition, more extensive involvement in dating relationships in early adolescence helped to explain this relationship, said Dr. Wilson.

The results were limited by the retrospective nature of the self-reports and a lack of data about sexual partners, Dr. Wilson said, as well as a lack of generalizability of the findings to other adolescent girls. But these findings suggest that early interventions in this population might help to delay sexual activity and reduce sexual risk in low-income girls with histories of exposure to violence.

"Addressing general dating behavior should be part of such interventions," Dr. Wilson said. "Girls who are already involved in dating relationships may benefit most from early interventions to promote healthy romantic relationships and reduce sexual risk," she noted.

More research is needed about the role of partner relationships in linking violence exposure to sexual risk in high-risk adolescent girls, said Dr. Wilson. Prospective studies beginning with clear evidence of violence exposure in childhood would support stronger conclusions about this relationship, she added.

Dr. Wilson had no financial conflicts to disclose. The research was supported by a grant from the National Institute of Mental Health.

WASHINGTON – Exposure to violence in childhood significantly increased the odds of early dating and sexual behavior in adolescents, based on data from 177 high-risk black girls in a low-income urban setting. The findings were presented at the annual meeting of the Society for Prevention Research.

"Currently, young African American adolescent girls are at disproportionate risk for poor sexual health outcomes," said Helen Wilson, Ph.D., of the college of health professions at the Rosalind Franklin University of Medicine and Science, Chicago.

Data from the Centers for Disease Control and Prevention indicate that black women aged 15-24 years have the highest rates of gonorrhea and chlamydia in the United States, she added.

However, there is not consistent evidence that black girls are more likely to take sexual risks, she said.

"There is growing recognition that violence exposure is associated with sexual risk," she said. Violence exposure also disproportionately affects youths who grow up in low-income, urban communities, she noted.

In this study, Dr. Wilson and her colleagues reviewed data from 177 girls who were participating in a longitudinal study on mother-daughter relationships and HIV risk behavior. Data were initially collected at baseline (when the girls were aged 12-16 years) and at 6, 12, 18, and 24 months.

"There is growing recognition that violence exposure is associated with sexual risk."

In a recent follow-up, the same participants responded to questions using the Lifetime Trauma and Victimization History. Sexual behavior was assessed via the AIDS Risk Behavior Assessment at all time points during the study.

Overall, 44% of the girls reported some type of violence during childhood (defined as having experienced physical or sexual victimization and/or having witnessed violence before 12 years of age).

The girls who reported exposure to childhood violence were significantly more likely than those who reported no childhood violence exposure to report sexual experience, inconsistent condom use, and a higher number of sexual partners. This trend persisted across all six time points. In addition, more extensive involvement in dating relationships in early adolescence helped to explain this relationship, said Dr. Wilson.

The results were limited by the retrospective nature of the self-reports and a lack of data about sexual partners, Dr. Wilson said, as well as a lack of generalizability of the findings to other adolescent girls. But these findings suggest that early interventions in this population might help to delay sexual activity and reduce sexual risk in low-income girls with histories of exposure to violence.

"Addressing general dating behavior should be part of such interventions," Dr. Wilson said. "Girls who are already involved in dating relationships may benefit most from early interventions to promote healthy romantic relationships and reduce sexual risk," she noted.

More research is needed about the role of partner relationships in linking violence exposure to sexual risk in high-risk adolescent girls, said Dr. Wilson. Prospective studies beginning with clear evidence of violence exposure in childhood would support stronger conclusions about this relationship, she added.

Dr. Wilson had no financial conflicts to disclose. The research was supported by a grant from the National Institute of Mental Health.

WASHINGTON – Exposure to violence in childhood significantly increased the odds of early dating and sexual behavior in adolescents, based on data from 177 high-risk black girls in a low-income urban setting. The findings were presented at the annual meeting of the Society for Prevention Research.

"Currently, young African American adolescent girls are at disproportionate risk for poor sexual health outcomes," said Helen Wilson, Ph.D., of the college of health professions at the Rosalind Franklin University of Medicine and Science, Chicago.

Data from the Centers for Disease Control and Prevention indicate that black women aged 15-24 years have the highest rates of gonorrhea and chlamydia in the United States, she added.

However, there is not consistent evidence that black girls are more likely to take sexual risks, she said.

"There is growing recognition that violence exposure is associated with sexual risk," she said. Violence exposure also disproportionately affects youths who grow up in low-income, urban communities, she noted.

In this study, Dr. Wilson and her colleagues reviewed data from 177 girls who were participating in a longitudinal study on mother-daughter relationships and HIV risk behavior. Data were initially collected at baseline (when the girls were aged 12-16 years) and at 6, 12, 18, and 24 months.

"There is growing recognition that violence exposure is associated with sexual risk."

In a recent follow-up, the same participants responded to questions using the Lifetime Trauma and Victimization History. Sexual behavior was assessed via the AIDS Risk Behavior Assessment at all time points during the study.

Overall, 44% of the girls reported some type of violence during childhood (defined as having experienced physical or sexual victimization and/or having witnessed violence before 12 years of age).

The girls who reported exposure to childhood violence were significantly more likely than those who reported no childhood violence exposure to report sexual experience, inconsistent condom use, and a higher number of sexual partners. This trend persisted across all six time points. In addition, more extensive involvement in dating relationships in early adolescence helped to explain this relationship, said Dr. Wilson.

The results were limited by the retrospective nature of the self-reports and a lack of data about sexual partners, Dr. Wilson said, as well as a lack of generalizability of the findings to other adolescent girls. But these findings suggest that early interventions in this population might help to delay sexual activity and reduce sexual risk in low-income girls with histories of exposure to violence.

"Addressing general dating behavior should be part of such interventions," Dr. Wilson said. "Girls who are already involved in dating relationships may benefit most from early interventions to promote healthy romantic relationships and reduce sexual risk," she noted.

More research is needed about the role of partner relationships in linking violence exposure to sexual risk in high-risk adolescent girls, said Dr. Wilson. Prospective studies beginning with clear evidence of violence exposure in childhood would support stronger conclusions about this relationship, she added.

Dr. Wilson had no financial conflicts to disclose. The research was supported by a grant from the National Institute of Mental Health.

WASHINGTON  – A culturally tailored family intervention program significantly reduced current drug use and risky sexual behaviors in high-risk Hispanic youth, in a randomized trial of more than 200 teens.

Data from the Monitoring the Future survey showed high rates of problem behavior in Hispanic youth, said Guillermo Prado, Ph.D., of the division of epidemiology and population health sciences at the University of Miami. He and his colleagues hypothesized that a family-centered intervention (called Familias Unidas) could reduce these behaviors.

The multiparent group intervention focused on positive parenting, communication with teens about sex, and family support. "Part of the group session is dedicated to helping the parents create social support networks," similar to what they might have had in their countries of origin, he said. "We hypothesized that our family intervention would have an impact and that the results would be mediated by improvements in family function."

The researchers recruited 242 Hispanic delinquent youth and their families from the juvenile justice system or the Miami–Dade County Public Schools system. The youth were randomized to either Familias Unidas (120) or a community practice program that served as a control (122). The average age of the participants was 15 years, and 35% were foreign born. The average household income ranged from $15,000 to $19,000 annually.

Overall, teens in the intervention group showed a significant drop in reported illicit drug use, compared with the controls, Dr. Prado reported at the annual meeting of the Society for Prevention Research.

Approximately 30% of teens in the intervention group were using drugs at baseline, but this number dropped to 20% at 6 months, followed by a leveling off of drug use, compared with steady increases in the control group over time.

Alcohol dependence was not a formal diagnosis, Dr. Prado noted. However, the trajectory for alcohol dependence among controls was very flat; while the intervention group showed a decrease from 15% at baseline to 5% by 12 months’ follow-up. The lack of impact of the intervention on current alcohol use (as opposed to dependence) was an interesting finding, he said.

"In Hispanic culture, alcohol use is considered more normative," and parents are less likely to notice teens’ alcohol consumption until there are signs of alcohol dependence, which might explain this finding, he said.

With respect to the percentage of youth who have sex while under the influence of alcohol or drugs, there was a significant increase in the control group over time, compared with a steady level in the intervention group.

On further analysis, "our family-based intervention is most efficacious for families who report high family risk (such as poor communication and low parental involvement)," Dr. Prado noted.

Data from a post hoc analysis suggests that the effectiveness of Familias Unidas varies by parental environmental exposure, including levels of immigration stress and levels of social support, which could be areas for future research, he noted.

Dr. Prado said he had no relevant financial conflicts.

WASHINGTON  – A culturally tailored family intervention program significantly reduced current drug use and risky sexual behaviors in high-risk Hispanic youth, in a randomized trial of more than 200 teens.

Data from the Monitoring the Future survey showed high rates of problem behavior in Hispanic youth, said Guillermo Prado, Ph.D., of the division of epidemiology and population health sciences at the University of Miami. He and his colleagues hypothesized that a family-centered intervention (called Familias Unidas) could reduce these behaviors.

The multiparent group intervention focused on positive parenting, communication with teens about sex, and family support. "Part of the group session is dedicated to helping the parents create social support networks," similar to what they might have had in their countries of origin, he said. "We hypothesized that our family intervention would have an impact and that the results would be mediated by improvements in family function."

The researchers recruited 242 Hispanic delinquent youth and their families from the juvenile justice system or the Miami–Dade County Public Schools system. The youth were randomized to either Familias Unidas (120) or a community practice program that served as a control (122). The average age of the participants was 15 years, and 35% were foreign born. The average household income ranged from $15,000 to $19,000 annually.

Overall, teens in the intervention group showed a significant drop in reported illicit drug use, compared with the controls, Dr. Prado reported at the annual meeting of the Society for Prevention Research.

Approximately 30% of teens in the intervention group were using drugs at baseline, but this number dropped to 20% at 6 months, followed by a leveling off of drug use, compared with steady increases in the control group over time.

Alcohol dependence was not a formal diagnosis, Dr. Prado noted. However, the trajectory for alcohol dependence among controls was very flat; while the intervention group showed a decrease from 15% at baseline to 5% by 12 months’ follow-up. The lack of impact of the intervention on current alcohol use (as opposed to dependence) was an interesting finding, he said.

"In Hispanic culture, alcohol use is considered more normative," and parents are less likely to notice teens’ alcohol consumption until there are signs of alcohol dependence, which might explain this finding, he said.

With respect to the percentage of youth who have sex while under the influence of alcohol or drugs, there was a significant increase in the control group over time, compared with a steady level in the intervention group.

On further analysis, "our family-based intervention is most efficacious for families who report high family risk (such as poor communication and low parental involvement)," Dr. Prado noted.

Data from a post hoc analysis suggests that the effectiveness of Familias Unidas varies by parental environmental exposure, including levels of immigration stress and levels of social support, which could be areas for future research, he noted.

Dr. Prado said he had no relevant financial conflicts.

WASHINGTON  – A culturally tailored family intervention program significantly reduced current drug use and risky sexual behaviors in high-risk Hispanic youth, in a randomized trial of more than 200 teens.

Data from the Monitoring the Future survey showed high rates of problem behavior in Hispanic youth, said Guillermo Prado, Ph.D., of the division of epidemiology and population health sciences at the University of Miami. He and his colleagues hypothesized that a family-centered intervention (called Familias Unidas) could reduce these behaviors.

The multiparent group intervention focused on positive parenting, communication with teens about sex, and family support. "Part of the group session is dedicated to helping the parents create social support networks," similar to what they might have had in their countries of origin, he said. "We hypothesized that our family intervention would have an impact and that the results would be mediated by improvements in family function."

The researchers recruited 242 Hispanic delinquent youth and their families from the juvenile justice system or the Miami–Dade County Public Schools system. The youth were randomized to either Familias Unidas (120) or a community practice program that served as a control (122). The average age of the participants was 15 years, and 35% were foreign born. The average household income ranged from $15,000 to $19,000 annually.

Overall, teens in the intervention group showed a significant drop in reported illicit drug use, compared with the controls, Dr. Prado reported at the annual meeting of the Society for Prevention Research.

Approximately 30% of teens in the intervention group were using drugs at baseline, but this number dropped to 20% at 6 months, followed by a leveling off of drug use, compared with steady increases in the control group over time.

Alcohol dependence was not a formal diagnosis, Dr. Prado noted. However, the trajectory for alcohol dependence among controls was very flat; while the intervention group showed a decrease from 15% at baseline to 5% by 12 months’ follow-up. The lack of impact of the intervention on current alcohol use (as opposed to dependence) was an interesting finding, he said.

"In Hispanic culture, alcohol use is considered more normative," and parents are less likely to notice teens’ alcohol consumption until there are signs of alcohol dependence, which might explain this finding, he said.

With respect to the percentage of youth who have sex while under the influence of alcohol or drugs, there was a significant increase in the control group over time, compared with a steady level in the intervention group.

On further analysis, "our family-based intervention is most efficacious for families who report high family risk (such as poor communication and low parental involvement)," Dr. Prado noted.

Data from a post hoc analysis suggests that the effectiveness of Familias Unidas varies by parental environmental exposure, including levels of immigration stress and levels of social support, which could be areas for future research, he noted.

Dr. Prado said he had no relevant financial conflicts.

WASHINGTON – A two-part behavioral, educational intervention reduced rates of postpartum depression in black and Hispanic women by approximately one-third for up to 6 months, based on data from a randomized trial of 540 new mothers.

"The burden of postpartum depressive symptoms is especially high in low-income black and Latina women," Dr. Elizabeth Howell of Mount Sinai Medical Center in New York said.

Previous studies have suggested that factors such as poor social support, overload from the demands of daily life, and physical symptoms contribute to postpartum depression, she said at the annual meeting of the Society for Prevention Research.

In this study, Dr. Howell and her colleagues developed a behavioral, educational intervention to reduce postpartum depression in a high-risk population of minority women. The intervention included a 15-minute review of a patient-education booklet and partner summary sheet with a trained bilingual social worker before the women left the hospital. The second part of the intervention was a phone call from the social worker at 2 weeks post partum to assess the women’s symptoms, symptom management skills, and other issues. When needed, the social worker helped the 270 women in this group develop action plans to manage symptoms and access community resources. The findings also were published in the May issue of Obstetrics & Gynecology (2012;119:942-9).

"The burden of postpartum depressive symptoms is especially high in low-income black and Latina women," Dr. Elizabeth Howell said.

The educational pamphlet presented possible triggers of postpartum depression as normal elements of the postpartum experience, such as hair loss, bleeding, back pain, incision pain or episiotomy site pain, infant colic, and feeling sad or blue.

The 270 in the control group received a list of community resources instead of the detailed pamphlet, and a 2-week control phone call.

The study participants were evaluated for depression (defined as a score of 10 or greater on the Edinburgh Postnatal Depression Scale) before randomization and at 3 weeks, 3 months, and 6 months.

Overall, positive depression scores were significantly less common in the intervention group, compared with the controls, at 3 weeks (9% and 15%, respectively). Depression scores remained less common in the intervention group, compared with controls, at 3 months (8% vs. 13%) and 6 months (9% vs. 14%), although these differences did not reach statistical significance.

In an intent to treat analysis, mothers in the intervention group had a 33% reduced risk of screening positive for depression for up to 6 months post partum.

The mean age of the women was 28 years, 62% were Hispanic, and 41% were having their first child.

The study was limited by the relatively low rate of positive depressive symptoms, compared with data from other studies of high-risk minority women, the researchers noted. However, the results suggest that factors reported to contribute to postpartum depression can be addressed and modified.

"It is important to note that the effect during the first 6 months post partum would likely benefit the infant, mother, and family," they added.

Dr. Howell had no financial conflicts to disclose. The study was funded by the National Institutes of Health.

WASHINGTON – A two-part behavioral, educational intervention reduced rates of postpartum depression in black and Hispanic women by approximately one-third for up to 6 months, based on data from a randomized trial of 540 new mothers.

"The burden of postpartum depressive symptoms is especially high in low-income black and Latina women," Dr. Elizabeth Howell of Mount Sinai Medical Center in New York said.

Previous studies have suggested that factors such as poor social support, overload from the demands of daily life, and physical symptoms contribute to postpartum depression, she said at the annual meeting of the Society for Prevention Research.

In this study, Dr. Howell and her colleagues developed a behavioral, educational intervention to reduce postpartum depression in a high-risk population of minority women. The intervention included a 15-minute review of a patient-education booklet and partner summary sheet with a trained bilingual social worker before the women left the hospital. The second part of the intervention was a phone call from the social worker at 2 weeks post partum to assess the women’s symptoms, symptom management skills, and other issues. When needed, the social worker helped the 270 women in this group develop action plans to manage symptoms and access community resources. The findings also were published in the May issue of Obstetrics & Gynecology (2012;119:942-9).

"The burden of postpartum depressive symptoms is especially high in low-income black and Latina women," Dr. Elizabeth Howell said.

The educational pamphlet presented possible triggers of postpartum depression as normal elements of the postpartum experience, such as hair loss, bleeding, back pain, incision pain or episiotomy site pain, infant colic, and feeling sad or blue.

The 270 in the control group received a list of community resources instead of the detailed pamphlet, and a 2-week control phone call.

The study participants were evaluated for depression (defined as a score of 10 or greater on the Edinburgh Postnatal Depression Scale) before randomization and at 3 weeks, 3 months, and 6 months.

Overall, positive depression scores were significantly less common in the intervention group, compared with the controls, at 3 weeks (9% and 15%, respectively). Depression scores remained less common in the intervention group, compared with controls, at 3 months (8% vs. 13%) and 6 months (9% vs. 14%), although these differences did not reach statistical significance.

In an intent to treat analysis, mothers in the intervention group had a 33% reduced risk of screening positive for depression for up to 6 months post partum.

The mean age of the women was 28 years, 62% were Hispanic, and 41% were having their first child.

The study was limited by the relatively low rate of positive depressive symptoms, compared with data from other studies of high-risk minority women, the researchers noted. However, the results suggest that factors reported to contribute to postpartum depression can be addressed and modified.

"It is important to note that the effect during the first 6 months post partum would likely benefit the infant, mother, and family," they added.

Dr. Howell had no financial conflicts to disclose. The study was funded by the National Institutes of Health.

WASHINGTON – A two-part behavioral, educational intervention reduced rates of postpartum depression in black and Hispanic women by approximately one-third for up to 6 months, based on data from a randomized trial of 540 new mothers.

"The burden of postpartum depressive symptoms is especially high in low-income black and Latina women," Dr. Elizabeth Howell of Mount Sinai Medical Center in New York said.

Previous studies have suggested that factors such as poor social support, overload from the demands of daily life, and physical symptoms contribute to postpartum depression, she said at the annual meeting of the Society for Prevention Research.

In this study, Dr. Howell and her colleagues developed a behavioral, educational intervention to reduce postpartum depression in a high-risk population of minority women. The intervention included a 15-minute review of a patient-education booklet and partner summary sheet with a trained bilingual social worker before the women left the hospital. The second part of the intervention was a phone call from the social worker at 2 weeks post partum to assess the women’s symptoms, symptom management skills, and other issues. When needed, the social worker helped the 270 women in this group develop action plans to manage symptoms and access community resources. The findings also were published in the May issue of Obstetrics & Gynecology (2012;119:942-9).

"The burden of postpartum depressive symptoms is especially high in low-income black and Latina women," Dr. Elizabeth Howell said.

The educational pamphlet presented possible triggers of postpartum depression as normal elements of the postpartum experience, such as hair loss, bleeding, back pain, incision pain or episiotomy site pain, infant colic, and feeling sad or blue.

The 270 in the control group received a list of community resources instead of the detailed pamphlet, and a 2-week control phone call.

The study participants were evaluated for depression (defined as a score of 10 or greater on the Edinburgh Postnatal Depression Scale) before randomization and at 3 weeks, 3 months, and 6 months.

Overall, positive depression scores were significantly less common in the intervention group, compared with the controls, at 3 weeks (9% and 15%, respectively). Depression scores remained less common in the intervention group, compared with controls, at 3 months (8% vs. 13%) and 6 months (9% vs. 14%), although these differences did not reach statistical significance.

In an intent to treat analysis, mothers in the intervention group had a 33% reduced risk of screening positive for depression for up to 6 months post partum.

The mean age of the women was 28 years, 62% were Hispanic, and 41% were having their first child.

The study was limited by the relatively low rate of positive depressive symptoms, compared with data from other studies of high-risk minority women, the researchers noted. However, the results suggest that factors reported to contribute to postpartum depression can be addressed and modified.

"It is important to note that the effect during the first 6 months post partum would likely benefit the infant, mother, and family," they added.

Dr. Howell had no financial conflicts to disclose. The study was funded by the National Institutes of Health.