Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-25 (of 25 Records) |
Query Trace: Lesesne CA [original query] |
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"I wouldn't have felt so alone": The sexual health education experiences of transgender and gender diverse youth living in the southeastern United States
Jayne PE , Szucs LE , Lesesne CA , Grose RG , Johns MM . Perspect Sex Reprod Health 2024 BACKGROUND: Transgender and gender diverse youth experience multiple disproportionate adverse sexual health outcomes. Sexual health education teaches knowledge, attitudes, and skills for promoting sexual health, including reducing risk for sexually transmitted infection, HIV acquisition, and unintended pregnancy. Provision of sexual health education may be protective, but research remains scarce. METHODS: We conducted a multi-stage thematic analysis of 33 in-depth interviews among transgender and gender diverse youth (ages 15-24) living in the southeastern United States on their sexual health education experiences. RESULTS: Our study participants described school-based sexual health education as unhelpful due to a lack of relevant information, inadequately prepared teachers, and a perceived negative tone toward sexuality. They reported relying on online sources of sexual health information, finding relevant content and community despite some limitations. Participants desired content and pedagogy that expands beyond binary and white-centric presentations of sexuality and gender and sought resources that provide relevant, accurate, and judgment-free information while holding positive framing around sexuality and gender. CONCLUSION: There is much work needed to improve the breadth, quality, and relevance of school-based sexual health education. Sexual health education can improve by strengthening critical media literacy skills of youth; raising staff cultural competency on gender, race, and sexual identity through training and supports; using culturally relevant and inclusive curricula; and partnering with community-based organizations. Transgender and gender diverse youth would benefit from sexual health education from multiple sources which is queer-friendly, affirms their existence, and provides information on gender, race, and sexuality in positive and expansive ways. |
The relationship of school connectedness to adolescents' engagement in co-occurring health risks: A meta-analytic review
Rose ID , Lesesne CA , Sun J , Johns MM , Zhang X , Hertz M . J Sch Nurs 2022 40 (1) 10598405221096802 School connectedness is an important factor in the lives of youth and are a leverage point for optimizing youth's social, emotional, and physical health. This study presents a meta-analysis examining the relationship between school connectedness and four health domains that are prevalent in adolescence, have implications for adult health, and often co-occur: mental health, sexual health, violence, and high-risk substance use. Ninety articles published between 2009 and 2019 were included in the analysis. The study found that school connectedness had a protective average effect size across all health domains (Hedges' g = -0.345, p-value<0.001). When examined separately, school connectedness had a significant protective relationship with substance use (g = -0.379, p < 0.001), mental health (Hedges' g = -0.358, p < 0.001), violence (Hedges' g = -0.318, p < 0.001), sexual health (Hedges' g = -0.145, p < 0.001), and with co-occurring risks (Hedges' g = -0.331, p < 0.001). These results provide strong evidence that school connectedness has the potential to prevent and mitigate multiple health risks during adolescence. |
Increases in student knowledge and protective behaviors following enhanced supports for sexual health education in a large, urban school district
Rasberry CN , Young E , Szucs LE , Murray C , Sheremenko G , Parker JT , Roberts G , Lesesne CA . J Adolesc Health 2022 70 (4) 588-597 PURPOSE: School-based sexual health education (SHE) can teach students critical knowledge and skills. For effective SHE, school districts can offer support, including strong curricula and professional development. This study assessed changes in students' sexual health knowledge and sexual behaviors following implementation of enhanced support for SHE delivery in one school district. METHODS: Sexual health knowledge was assessed at the beginning and end of middle and high school health education classes in a large, urban district (n = 7,555 students). Sexual behaviors were assessed using Youth Risk Behavior Survey data from the district (2015 and 2017) and state (2017). Analyses explored differences in behavior from 2015 (n = 2,596) to 2017 (n = 3,371) among intervention district students and compared intervention district students (n = 3,371) to other students in the same state (n = 1,978). RESULTS: Hierarchical linear model regression analyses revealed significant knowledge gains among students. Logistic regression results revealed that among students in the intervention district, 6 of 16 examined behaviors moved in the intended direction from 2015 to 2017; 1 moved in the unintended direction. Logistic regression results of 2017 data revealed that in comparison of intervention district students to other students in the state, intervention district students had significantly higher odds of reporting condom use at last sex (adjusted odds ratio [AOR] = 1.36, 95% confidence interval [CI] = 1.07-1.72) and significantly lower odds of reporting having had sex with 4+ persons (AOR = .72, 95% CI = .55-.94) or alcohol or drug use before last sex (AOR = .63, 95% CI = .42-.94). CONCLUSIONS: Findings suggest potential effects of the district's SHE in increasing knowledge and improving behaviors and experiences among youth. |
"We deserve care and we deserve competent care": Qualitative perspectives on health care from transgender youth in the Southeast United States
Pampati S , Andrzejewski J , Steiner RJ , Rasberry CN , Adkins SH , Lesesne CA , Boyce L , Grose RG , Johns MM . J Pediatr Nurs 2020 56 54-59 PURPOSE: Transgender populations experience health inequities that underscore the importance of ensuring access to high quality care. We thematically summarize the health care experiences of transgender youth living in the southeast United States to identify potential barriers and facilitators to health care. DESIGN AND METHODS: Transgender youth recruited from community settings in an urban area of the southeast United States participated in individual interviews (n = 33) and focus groups (n = 9) about protective factors. We conducted a thematic analysis of data from 42 participants who described their experiences seeking and receiving health care. RESULTS: Participants reported a wide range of gender identities. The individual interview sample was majority Black (54.5%) and the mean age was 21.7 years and focus group participants were all white and the mean age was 16.8 years. Participants described numerous barriers to health care, including limited availability of gender affirming care, logistical challenges, such as gatekeeping and cost, concerns about confidentiality in relation to sexual behavior and gender identity, and inadequate cultural competency among providers regarding gender-affirming care. Facilitators included intake procedures collecting chosen pronouns and names and consistent use of them by providers, and open communication, including active listening. CONCLUSIONS: Findings underscore the need for a multi-component approach to ensure both transgender- and youth-friendly care. PRACTICE IMPLICATIONS: Providers and office staff may benefit from transgender cultural competency trainings. In addition, clinic protocols relating to confidentiality and chosen name and pronoun use may help facilitate access to and receipt of quality care. |
School district-provided supports to enhance sexual health education among middle and high school health education teachers
Szucs LE , Rasberry CN , Jayne PE , Rose ID , Boyce L , Murray CC , Lesesne CA , Parker JT , Roberts G . Teach Teach Educ 2020 92 Schools support teachers in their professional learning, just as teachers support students in their learning. To accomplish this, schools can provide support systems that enhance teachers’ knowledge, comfort, and instructional skills. This study examined the impact of two district-provided supports (curriculum and professional development) on sexual health instruction among middle and high school health education teachers. Data were abstracted and analyzed using inductive coding from 24 teacher interviews (2015–2016). Findings illustrate outcomes from both curriculum and PD on teachers’ self-reported knowledge, comfort, and skills. The district-provided supports appeared to contribute to improved teachers’ self-efficacy in delivering sexual health education. |
Student-reported school safety perceptions, connectedness, and absenteeism following a multiple-fatality school shooting - Broward County, Florida, February 14-21, 2018
Rasberry CN , Sheremenko G , Lesesne CA , Rose ID , Adkins SH , Barrios LC , Holland KM , Sims V , O'Connor K , Grasso DJ , James SR , Simon TR . MMWR Morb Mortal Wkly Rep 2020 69 (9) 231-235 From July 2009 to June 2018, the rates of multiple-victim, school-associated homicides in the United States fluctuated substantially, with evidence of a significant increase in recent years (1). Data on the effects of such incidents on students' school attendance and perceptions of safety and connectedness are limited (2,3) but important. This study used data from a neighboring within-district school before and after a multiple-fatality shooting at Marjory Stoneman Douglas High School in Parkland, Florida, on February 14, 2018. Self-administered questionnaires were completed by one group of students on February 14 just before the shooting (575) and another group during February 15-21 (502); demographics for these groups appeared similar. Linear and logistic regression analyses controlling for demographic characteristics explored differences between groups for safety-related perceptions or experiences, school connectedness, and absenteeism. Compared with students surveyed before the shooting, students surveyed in the days immediately following the shooting had lower odds of feeling safe at school, higher odds of absenteeism, and higher school connectedness scores. Findings suggest the shooting had an immediate, sizeable effect on safety perceptions and absenteeism among students in a neighboring school. Findings also suggest higher school connectedness following the shooting. Further study of school connectedness, including how to enhance and sustain it, might help schools and communities better respond to traumatic events in the community. |
Key factors influencing comfort in delivering and receiving sexual health education: Middle school student and teacher perspectives
Rose ID , Boyce L , Crittenden Murray C , Lesesne CA , Szucs LE , Rasberry CN , Parker JT , Roberts G . Am J Sex Educ 2019 14 (4) 466-489 Sexual health education (SHE) provides students with knowledge and skills to establish healthy relationships, understand sexual development, and prevent risk behaviors; therefore, it is critical to understand how to optimize the delivery and receipt of this education. Using a grounded theory approach, interviews with middle school health education teachers (n = 13) and focus groups with students (n = 41) were conducted to examine factors that influence perceived comfort delivering and receiving SHE in a public-school district. Findings identified key barriers including disruptive behavior, insufficient time, and lack of dedicated classrooms. Some key facilitators to comfort included professional development and establishing ground rules. |
The influence of health education teacher characteristics on students' health-related knowledge gains
Murray CC , Sheremenko G , Rose ID , Osuji TA , Rasberry CN , Lesesne CA , Parker JT , Roberts G . J Sch Health 2019 89 (7) 560-568 BACKGROUND: Studies have examined relationships between teacher characteristics and student achievement in courses such as math and science. This study is among the first to examine effects of teacher characteristics on student knowledge in a health course. METHODS: Student (N = 6143) pretest and posttest data were linked to teacher (N = 67) data. Changes in student knowledge scores from pre- to postcourse were explored using mixed-effects linear models. Teacher characteristics included professional development (PD) attendance, having a dedicated classroom, certification type, educational background, years' experience, and athletic coaching status. RESULTS: Teacher characteristics associated with greater student knowledge gains included: being certified to teach health versus not certified (p < .001), having a dedicated classroom versus no classroom (p = .017), and for middle school teachers, having attended >/=3 PD sessions versus </=2 (p = .023). Less knowledge gain was associated with teachers that coached versus noncoaches (p = .040) and having a health degree versus no health degree (p = .049). Post hoc analyses revealed the negative effect of health degree was only significant among coaches (p = .026). CONCLUSIONS: Findings suggest opportunities for maximizing student knowledge gains through tailored selection of health teachers and provision of appropriate teaching support. |
School climate among transgender high school students: An exploration of school connectedness, perceived safety, bullying, and absenteeism
Pampati S , Andrzejewski J , Sheremenko G , Johns M , Lesesne CA , Rasberry CN . J Sch Nurs 2018 36 (4) 293-303 This study used self-administered survey data from seven high schools in Florida with a majority Black and/or Hispanic sample to examine transgender students’ perceptions and experiences related to school climate in comparison to cisgender students. Using propensity score matching, a matched analytic sample was created of transgender and cisgender students (n = 542, including 186 transgender youth). Adjusted weighted logistic regression models indicated that transgender students were significantly more likely to report ever being bullied at school, being bullied in the past 3 months, and not going to school ≥3 days during the past 30 days. Transgender students were significantly less likely to report feeling safe at school and having positive perceptions of all five school connectedness items compared to cisgender students. Recent bullying experiences moderated the association between transgender status and past month absences. Findings can inform potential roles for school nurses in improving school climate for transgender youth. |
An evaluation of welfare and child welfare system integration on rates of child maltreatment in Colorado
Latzman NE , Lokey C , Lesesne CA , Klevens J , Cheung K , Condron S , Garraza LG . Child Youth Serv Rev 2019 96 386-395 Policies that improve the socioeconomic conditions of families have been identified as one of the most promising strategies to prevent child maltreatment, particularly neglect. In this study, we examined the impact of integrated Temporary Assistance for Needy Families (TANF) and child welfare (CW) systems on child maltreatment-related hospitalizations and Child Protective Services investigations and substantiations in nine counties in Colorado from 1996 to 2014. Regression analyses showed TANF-CW integration was associated with subsequent year, but not second-year, increases rates of substantiated child maltreatment overall and neglect specifically (that is, there was no longer a difference in the rate two years after the change in integration). Neither unemployment nor the one- or two-year lagged effect of integration were significant for investigations or child maltreatment-related hospitalizations. Increased opportunities to interact with a family in crisis using an integrated case management model may help explain these findings. Implications for future research are discussed. |
Sex differences in school safety and bullying experiences among sexual minority youth
Rose ID , Sheremenko G , Rasberry CN , Lesesne CA , Adkins SNH . J Sch Nurs 2018 34 (4) 1059840518762536 Schools play an integral role in creating safe, supportive environments for students, especially for sexual minority youth (SMY). Using 2016 questionnaire data from seven high schools in a Florida school district, we obtained a sample of 1,364 SMY. Logistic regressions controlling for sex (as applicable), age, grade, race/ethnicity, and school explored differences between SMY and nonsexual minority youth (non-SMY). Sex differences related to school environment perceptions and experiences related to safety, bullying, and hearing homophobic remarks were also explored. SMY were more likely than non-SMY to report several negative school environment perceptions and experiences. Where differences existed within SMY, male SMY were more likely than female SMY to have missed school in the past 30 days (odds ratio [ OR] = 1.66, p = .03), report avoiding spaces at school due to safety concerns ( OR = 1.38, p = .02), and report hearing homophobic remarks from teachers ( OR = 2.00, p = .01). Implications for school nursing are discussed. |
Associations between sexual risk-related behaviors and school-based education on HIV and condom use for adolescent sexual minority males and their non-sexual-minority peers
Rasberry CN , Condron DS , Lesesne CA , Hocevar Adkins S , Sheremenko G , Kroupa E . LGBT Health 2017 5 (1) 69-77 PURPOSE: With HIV and sexually transmitted disease (STD) rates disproportionately high among adolescent sexual minority males (ASMM), it is important to understand how school-based sexual health education may relate to sexual risk-related behavior among this population. This analysis explores reported HIV/AIDS- and condom-related education and sexual risk-related behaviors among ASMM and their adolescent non-sexual-minority male (non-ASMM) peers. METHODS: Students (n = 11,681) from seven Florida high schools completed paper-and-pencil questionnaires. A matched analytic sample of ASMM and non-ASMM students was created by using propensity score-matching techniques (n = 572). Logistic regressions controlling for individual and school characteristics examined reporting having been taught about AIDS or HIV in school, having been taught in school about using condoms, condom use at last sex, HIV/STD testing, and associations between these variables. RESULTS: Compared with matched non-ASMM peers, ASMM students were less likely to report having been taught about AIDS or HIV in school (odds ratio [OR] = 0.58, P = 0.04) and having used a condom at last sex (OR = 0.39, P < 0.01), but were more likely to report having been tested for HIV or STDs (OR = 1.88, P = 0.02). There were no significant differences for reporting having been taught in school about using condoms. Among non-ASMM, reporting having been taught in school about using condoms was associated with a greater likelihood of condom use at last sex (OR = 4.78, P < 0.01); this was not seen for ASMM. CONCLUSIONS: Differential reports of receiving HIV/AIDS education and differential associations between condom-related education and condom use in ASMM and non-ASMM suggest that sexual health education in schools may not be resonating with ASMM and non-ASMM in the same way. |
Overcoming challenges in school-wide survey administration
Rasberry CN , Rose I , Kroupa E , Hebert A , Geller A , Morris E , Lesesne CA . Health Promot Pract 2017 19 (1) 1524839917733476 School-based surveys provide a useful method for gathering data from youth. Existing literature offers many examples of data collection through school-based surveys, and a small subset of literature describes methodological approaches or general recommendations for health promotion professionals seeking to conduct school-based data collection. Much less is available on real-life logistical challenges (e.g., minimizing disruption in the school day) and corresponding solutions. In this article, we fill that literature gap by offering practical considerations for the administration of school-based surveys. The protocol and practical considerations outlined in the article are based on a survey conducted with 11,681 students from seven large, urban public high schools in the southeast United States. We outline our protocol for implementing a school-based survey that was conducted with all students school-wide, and we describe six types of key challenges faced in conducting the survey: consent procedures, scheduling, locating students within the schools, teacher failure to administer the survey, improper administration of the survey, and minimizing disruption. For each challenge, we offer our key lessons learned and associated recommendations for successfully implementing school-based surveys, and we provide relevant tools for practitioners planning to conduct their own surveys in schools. |
School-based HIV/STD testing behaviors and motivations among black and Hispanic teen MSM: Results from a formative evaluation
Morris E , Topete P , Rasberry CN , Lesesne CA , Kroupa E , Carver L . J Sch Health 2016 86 (12) 888-897 BACKGROUND: This evaluation explores experiences with, and motivations for, human immunodeficiency virus (HIV) and sexually transmitted disease (STD) testing among black and Hispanic school-aged young men who have sex with men (YMSM). METHODS: Participants were recruited at community-based organizations that serve YMSM in New York City, Philadelphia, and San Francisco. Eligible participants were 13- to 19-year-old black or Hispanic males who reported attraction to or sexual behavior with other males and/or identified as gay or bisexual, and attended at least 90 days of school in the previous 18 months. Participants (N = 415) completed web-based questionnaires and/or in-depth interviews (N = 32). RESULTS: In the past year, 72.0% of questionnaire participants had been tested for HIV, 13.5% of them at school or school clinic. Participants reported that they would be more likely to get an HIV test if they could be tested close to or at school (34.4%), and 64.4% would use HIV testing if offered in schools. Most interview participants reported willingness to use school-based services if they were offered nonjudgmentally, privately, and confidentially by providers with experience serving YMSM. CONCLUSION: Schools can provide opportunities to make HIV and STD testing accessible to school-aged YMSM, but the services must be provided in ways that are comfortable to them. |
The importance of school staff referrals and follow-up in connecting high school students to HIV and STD testing
Rasberry CN , Liddon N , Adkins SH , Lesesne CA , Hebert A , Kroupa E , Rose I , Morris E . J Sch Nurs 2016 33 (2) 143-153 This study examined predictors of having received HIV and sexually transmitted disease (STD) testing and having been referred by school staff for HIV/STD testing. In 2014, students in seven high schools completed paper-and-pencil questionnaires assessing demographic characteristics, sexual behavior, referrals for HIV/STD testing, and HIV/STD testing. The analytic sample (n = 11,303) was 50.7% female, 40.7% Hispanic/Latino, 34.7% Black/African American (non-Hispanic), and mean age was 15.86 (SD = 1.22). After controlling for demographic characteristics, significant predictors of reporting having been tested for HIV or STDs were reporting having received a referral for HIV/STD testing (odds ratio [OR] = 3.18; 95% CI = [2.14, 4.70]) and reporting staff following-up on the referral (OR = 3.29; 95% CI = [1.31, 8.23]). Students reporting referrals had significantly higher odds of being male (OR = 2.49; 95% CI = [1.70, 3.65]), "other" or multiracial (non-Hispanic; compared to White, non-Hispanic; OR = 2.72; 95% CI = [1.35, 5.46]), sexual minority (OR = 3.80; 95% CI = [2.57, 5.62]), and sexually experienced (OR = 2.58; 95% CI = [1.76, 3.795]). School staff referrals with follow-up may increase HIV/STD testing among students. |
Barriers and facilitators to sustaining school health teams in coordinated school health programs
Cheung K , Lesesne CA , Rasberry CN , Kroupa E , Fisher D , Robin L , Pitt Barnes S . Health Promot Pract 2016 18 (3) 418-427 Coordinated school health (CSH) programs address multiple factors related to students' overall health, thereby increasing their physical and mental readiness to learn. A formative evaluation of three school districts in 2010-2011 examined strategies for sustaining the school health teams (SHTs) that lead CSH efforts. Qualitative data from 39 interviews and 13 focus groups revealed facilitators and barriers for sustaining SHTs. Quantitative data from 68 questionnaires completed by SHT members and school principals examined factors associated with having more active SHTs and district and school characteristics SHT members believed to be important to their schools' efforts to implement CSH. Facilitators of sustaining SHTs included administrative support, staff engagement in the SHT, and shared goals and responsibility. Barriers to sustaining SHTs included limited time and competing priorities, budget and funding constraints, and staff turnover. Findings provide valuable insight into challenges and potential solutions for improving the sustainability of SHTs to enable them to better support CSH efforts. |
Communicating with school staff about sexual identity, health and safety: an exploratory study of the experiences and preferences of black and Latino teen young men who have sex with men
Lesesne CA , Rasberry CN , Kroupa E , Topete P , Carver LH , Morris E , Robin L . LGBT Health 2015 2 (3) 258-264 PURPOSE: This exploratory study examined the experiences of black and Latino teen young men who have sex with men (YMSM) and their preferences for communication with school staff about matters related to sexual orientation. METHODS: Participants for this study were recruited in three urban centers in the United States and by multiple community-based organizations serving black and Latino YMSM. Eligible youth were male, black or Latino, ages 13-19, enrolled in 90 days of school in the previous 18 months, and reported attraction to or sexual behavior with other males, or identified as gay or bisexual. Participants completed Web-based questionnaires (n=415) and/or in-depth interviews (n=32). RESULTS: Questionnaire participants reported willingness to talk to at least one school staff member about: safety, dating and relationships, and feeling attracted to other guys (63.4%, 58.4%, and 55.9%, respectively). About one-third of the sample reported they would not talk with any school staff about these topics. Exploratory analyses revealed youth who experienced feeling unsafe at school and who had higher levels of trust in the information provided by school staff were more likely to be willing to talk with school staff about safety issues, dating, or same sex attraction (aOR=2.80 and aOR=4.85, respectively). Interview participants reported being most willing to talk to staff who (1) were able and willing to help them; (2) would keep discussions confidential, and (3) expressed genuine care. Preferences for confiding in school staff perceived to be LGBT and having similar racial/ethnic background were also noted. CONCLUSION: Findings suggest school staff can serve as points of contact for reaching YMSM and professional development and interventions can be tailored to reach YMSM and connect them to services they need. Additional research is needed to understand how to increase YMSM comfort talking with school staff about sexual health or sexual identity concerns. |
Adaptation guidance for evidence-based teen pregnancy and STI/HIV prevention curricula: from development to practice
Rolleri LA , Fuller TR , Firpo-Triplett R , Lesesne CA , Moore C , Leeks KD . Am J Sex Educ 2014 9 (2) 135-154 Evidence-based interventions (EBIs) are effective in preventing adolescent pregnancy and sexually transmitted infections; however, prevention practitioners are challenged when selecting and adapting the most appropriate programs. While there are existing adaptation frameworks, there is little practical guidance in applying research in the field. To address this need, the Centers for Disease Control and Prevention (CDC) Division of Reproductive Health initiated the Adaptation Guidance Project. The project included the development of a comprehensive adaptation guidance framework and adaptation kits for select evidence-based teen pregnancy and HIV prevention programs. In addition, three innovative concepts emerged that have application to other adaptation program and evaluation efforts, including moving research into practice. First, the authors defined the core components of an EBI in three distinct ways: core content, core pedagogy, and core implementation. Second, they piloted a practitioner-friendly adaptation guidance-messaging schema-Green, Yellow, and Red Light Adaptations, and last they included fidelity/adaptation monitoring logs. This article will describe the process used to develop the adaptation guidance kits, including the main features and tools. |
Communicating with school nurses about sexual orientation and sexual health: perspectives of teen young men who have sex with men
Rasberry CN , Morris E , Lesesne CA , Kroupa E , Topete P , Carver LH , Robin L . J Sch Nurs 2014 31 (5) 334-44 Black and Latino young men who have sex with men (YMSM) are at disproportionate risk for sexually transmitted diseases (STDs), including HIV. This study informs school-centered strategies for connecting YMSM to health services by describing their willingness, perceived safety, and experiences in talking to school staff about sexual health. Cross-sectional data were collected from Black and Latino YMSM aged 13-19 through web-based questionnaires (N = 415) and interviews (N = 32). School nurses were the staff members youth most often reported willingness to talk to about HIV testing (37.8%), STD testing (37.1%), or condoms (37.3%), but least often reported as safe to talk to about attraction to other guys (11.4%). Interviews revealed youth reluctance to talk with school staff including nurses when uncertain of staff members' perceptions of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) people or perceiving staff to lack knowledge of LGBTQ issues, communities, or resources. Nurses may need additional training to effectively reach Black and Latino YMSM. |
Relationship between child care centers' compliance with physical activity regulations and children's physical activity, New York City, 2010
Stephens RL , Xu Y , Lesesne CA , Dunn L , Kakietek J , Jernigan J , Khan LK . Prev Chronic Dis 2014 11 E179 INTRODUCTION: Physical activity may protect against overweight and obesity among preschoolers, and the policies and characteristics of group child care centers influence the physical activity levels of children who attend them. We examined whether children in New York City group child care centers that are compliant with the city's regulations on child physical activity engage in more activity than children in centers who do not comply. METHODS: A sample of 1,352 children (mean age, 3.39 years) served by 110 group child care centers in low-income neighborhoods participated. Children's anthropometric data were collected and accelerometers were used to measure duration and intensity of physical activity. Multilevel generalized linear regression modeling techniques were used to assess the effect of center- and child-level factors on child-level physical activity. RESULTS: Centers' compliance with the regulation of obtaining at least 60 minutes of total physical activity per day was positively associated with children's levels of moderate to vigorous physical activity (MVPA); compliance with the regulation of obtaining at least 30 minutes of structured activity was not associated with increased levels of MVPA. Children in centers with a dedicated outdoor play space available also spent more time in MVPA. Boys spent more time in MVPA than girls, and non-Hispanic black children spent more time in MVPA than Hispanic children. CONCLUSION: To increase children's level of MVPA in child care, both time and type of activity should be considered. Further examination of the role of play space availability and its effect on opportunities for engaging in physical activity is needed. |
Advances in bridging research and practice: introduction to the second special issue on the Interactive System Framework for Dissemination and Implementation
Flaspohler P , Lesesne CA , Puddy RW , Smith E , Wandersman A . Am J Community Psychol 2012 50 271-81 The need for new ways to bridge the gap between research and practice is clear; the use of evidence-based prevention programs and implementation with fidelity in practice are strikingly limited. The Interactive Systems Framework for Dissemination and Implementation (ISF) was created to help bridge research and practice by specifying the systems and processes required to support dissemination and implementation of evidence-based programs, processes, practices, and policies. The ISF identifies three key systems necessary for this process which include the Synthesis and Translation System, the Support System, and the Delivery System. The ISF was featured in a special issue of the American Journal of Community Psychology in 2008. This special issue extends that work by including both researchers who have applied an ISF lens to aspects of their current work and researchers who have proactively applied the ISF in a process that goes across the various systems of the ISF, i.e., Synthesis and Translation, Support, and Delivery. Content areas include: children's mental health, teen pregnancy prevention, HIV prevention, violence prevention, heart disease and stroke prevention, breast cancer prevention, and substance abuse prevention. In this introductory article, we provide a brief description of the history of the ISF and a summary of the articles in the special issue. |
Developing a prevention synthesis and translation system to promote science-based approaches to teen pregnancy, HIV and STI prevention
Lewis KM , Lesesne CA , Zahniser SC , Wilson MM , Desiderio G , Wandersman A , Green DC . Am J Community Psychol 2012 50 553-71 The Interactive Systems Framework for Dissemination and Implementation (ISF) is a multi-system framework that can guide research-to-practice efforts by building and supporting the work of three interacting systems: the Prevention Delivery, Support, and Synthesis and Translation Systems. The Synthesis and Translation system is vital to bridging science and practice, yet how to develop it and train support system partners to use it is under-researched. This article bridges this gap by offering a case example of the planning, development, and use of a synthesis and translation product called Promoting Science-based Approaches to Teen Pregnancy Prevention using Getting To Outcomes. The case presented documents the process used for developing the synthesis and translation product, reports on efforts to engage the Prevention Support system to use the product, and how we approached building interaction between the Synthesis and Translation System and the Support System partners. Practice-oriented evaluation data are also presented. Implications for practice, policy and research are discussed. |
Early adolescent romantic relationships and maternal approval among inner city Latino families
Bouris A , Guilamo-Ramos V , Jaccard J , Ballan M , Lesesne CA , Gonzalez B . AIDS Behav 2012 16 (6) 1570-83 Latino youth are at high risk for acquiring HIV during adolescence. The present study documented the nature of adolescent romantic relationships among 702 Latino eighth grade students and their mothers in the Bronx, NY. The study examined adolescent romantic relationships, the association between participation in such relationships and intentions to engage in sexual risk behavior, and maternal influences on adolescent's involvement in intimate behaviors in romantic relationships. Almost 50% of youth had been in a romantic relationship, which typically lasted 3-3.5 months. Mothers tended to approve of intimate behaviors and sexual activity in romantic relationships more so for males than females. Latino youth tended to underestimate maternal disapproval of a range of intimate behaviors, and the correlations between perceived and actual maternal approval were generally low in magnitude. Finally, maternal orientations towards their adolescent engaging in romantic relationships were associated with their child's intentions to have sexual intercourse in the future. |
Geographic variation in trends and characteristics of teen childbearing among American Indians and Alaska Natives, 1990-2007
Wingo PA , Lesesne CA , Smith RA , de Ravello L , Espey DK , Arambula Solomon TG , Tucker M , Thierry J . Matern Child Health J 2011 16 (9) 1779-90 To study teen birth rates, trends, and socio-demographic and pregnancy characteristics of AI/AN across geographic regions in the US. The birth rate for US teenagers 15-19 years reached a historic low in 2009 (39.1 per 1,000) and yet remains one of the highest teen birth rates among industrialized nations. In the US, teen birth rates among Hispanic, non-Hispanic black, and American Indian/Alaska Native (AI/AN) youth are consistently two to three times the rate among non-Hispanic white teens. Birth certificate data for females younger than age 20 were used to calculate birth rates (live births per 1,000 women) and joinpoint regression to describe trends in teen birth rates by age (<15, 15-17, 18-19) and region (Aberdeen, Alaska, Bemidji, Billings, California, Nashville, Oklahoma, Portland, Southwest). Birth rates for AI/AN teens varied across geographic regions. Among 15-19-year-old AI/AN, rates ranged from 24.35 (California) to 123.24 (Aberdeen). AI/AN teen birth rates declined from the early 1990s into the 2000s for all three age groups. Among 15-17-year-olds, trends were approximately level during the early 2000s-2007 in six regions and declined in the others. Among 18-19-year-olds, trends were significantly increasing during the early 2000s-2007 in three regions, significantly decreasing in one, and were level in the remaining regions. Among AI/AN, cesarean section rates were lower in Alaska (4.1%) than in other regions (16.4-26.6%). This is the first national study to describe regional variation in AI/AN teen birth rates. These data may be used to target limited resources for teen pregnancy intervention programs and guide research. |
Family mediators of acculturation and adolescent sexual behavior among Latino youth
Guilamo-Ramos V , Bouris A , Jaccard J , Lesesne CA , Gonzalez B , Kalogerogiannis K . J Prim Prev 2009 30 395-419 The present study develops and evaluates a theoretical framework of mediators of the relationship between acculturation and adolescent sexual behavior. Four hundred Latino mother-adolescent dyads from the Bronx, New York were interviewed. The study explored the relationship between intentions to have sexual intercourse and explanatory variables such as adolescent romantic relationship status and partner preferences, maternal approval of dating, adolescent perceptions of maternal approval of dating, and maternal and adolescent levels of familismo and acculturation. Findings revealed complex dynamics between acculturation and adolescent sexual behavior. Protective and risk-inducing associations were observed, with important gender differences operating for boys and girls. Implications for the development of applied prevention programs are discussed. |
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