The purpose of this study was to explore U.S. parents' and caregivers' understanding about children's bullying-what bullying is and how to address it. We analyzed 2017, 2018, and 2019 Fall ConsumerStyles online panel survey data from U.S. parents/caregivers of children ages 10 to 17 years (N = 1,516), including 20 items representing statements consistent or inconsistent with the bullying prevention evidence and best practices. Percentage of endorsement for each item and a summary measure of understanding about bullying were calculated. The association between low overall understanding about bullying and sociodemographic characteristics was explored. Most parents identified bullying as harmful (77%), repetitive (63%), and involving power imbalance (51%). At least half of parents answered 13 or more items (20 total) consistent with the bullying prevention evidence or best practices. Being male, non-Hispanic Black or Hispanic, having high school or less education, and small household size were associated with higher odds of low overall understanding about bullying. Awareness of parents' understanding about bullying and how to appropriately address it is vital for bullying prevention. Findings can inform the strategic development of bullying prevention health messages for parents.

PURPOSE: This practical implementation report describes a comprehensive teen dating violence prevention model-Dating Matters(®)-and the approach taken to maximize its potential for widespread dissemination through development of the Dating Matters Toolkit. Dating Matters has evidence of effectiveness for preventing teen dating violence and other adolescent risk behaviors from a multi-site randomized controlled trial. Identifying strategies that reduce barriers to the dissemination and implementation of evidence-based comprehensive prevention models, like Dating Matters, is critical to their widespread adoption. Lessons learned from creating the Toolkit can inform the development and dissemination of similar comprehensive prevention strategies and speed their adoption and use in the field. APPROACH: We engaged in a multi-pronged, data-driven approach to maximize adoption, implementation, and maintenance of the Dating Matters model based on multiple data sources and lessons learned from the demonstration project, while retaining core components and content of the evaluated model. Potential barriers to the national dissemination of Dating Matters were identified in four key areas: training, technical assistance, model flexibility, and accessibility. A series of modifications were made to the implementation model to address these challenges and facilitate scale-up prior to national dissemination. We outline these challenges and describe solutions implemented through the development of the Dating Matters Toolkit. OUTCOMES: The Dating Matters Toolkit includes web-based facilitator training, enhanced implementation support through a new staff role and community of practice, online comprehensive implementation guidance and resources, and added flexibility to improve feasibility and adoption in communities during capacity-building. Findings from an initial evaluation of the Toolkit suggest users perceived the comprehensive model as feasible and accessible with enough implementation support. Most expressed interest in adopting the model. Users described cost and stakeholder buy-in as remaining barriers. Ongoing improvements to the Toolkit to address these challenges and future research to evaluate its effectiveness are planned.

To establish commonalities and differences in social norms related to corporal punishment among Black, Latino, and White parents, we first examine survey data from a random sample of a nationally representative opt-in internet panel (n = 2500) to establish the frequency of corporal punishment among parents of children under five (n = 540) and their perceptions of the frequency of use of corporal punishment in their community and whether they ought to use corporal punishment. We disaggregate by race/ethnicity and education to identify higher risk groups. To better understand the beliefs underlying these perceptions among the higher risk group (i.e., less educated), we used a grounded theory approach to analyze data from 13 focus groups (n = 75) segmented by race/ethnicity (i.e., Black, Latino, or White), gender (i.e., mothers or fathers), and population density (i.e., rural or urban). Survey findings revealed that 63% of parents spanked, albeit the majority seldom or sometimes. Spanking was most frequent among Latinos (73%) and lowest among White parents (59%). While all participants across racial/ethnic groups believed the majority of parents spanked, even more than the proportion that actually do, about half believed they ought to spank. Perceptions of the frequency and acceptability of corporal punishment were associated with use of corporal punishment. The qualitative findings highlight more similarities than differences across Black, Latino, and White communities. The findings suggest social norms change efforts might focus on parents with less education and influencing perceptions around whether they ought to spank.

BACKGROUND: Productivity losses can arise when employees miss work to seek care for sexually transmissible infections (STIs). We estimated the average productivity loss per acute case of four nonviral STIs: chlamydia, gonorrhoea, syphilis and trichomoniasis. METHODS: We extracted outpatient claims from 2001-2005 MarketScan databases using International Classification Disease ver. 9 (ICD-9) codes. We linked claims with their absence records in the Health and Productivity Management database by matching enrolee identifiers and the service dates from the claims such that our final data included only those who were absent because they were sick and were diagnosed with an STI on the day of their visit. To ensure that the visit was for the STIs being examined, we restricted the criteria to records with the specified ICD-9 codes only, excluding claims with other codes. We estimated the average number of hours absent and multiplied it by the mean hourly wage rate including benefits ($29.72 in 2011 United States dollars) to estimate the average productivity loss per case. RESULTS: The average productivity losses per case were: $262 for chlamydia, $197 for gonorrhoea, $419 for syphilis and $289 for trichomoniasis. There were no significant differences between males and females. CONCLUSIONS: Among those who take sick leave to seek care, productivity losses associated with treating nonviral STIs may be higher than their estimated direct medical costs. These productivity cost estimates can help to quantify the overall STI burden, and inform cost-effectiveness analyses of prevention and control efforts.

BACKGROUND: Given the growing popularity of administrative data for health research, information on the differences and similarities between administrative data and customary data sources (e.g. surveillance) will help to inform the use of administrative data in the field of sexually transmissible infections (STIs). The objective of this study was to compare the incidence rates of three nonviral STIs from a large health insurance administrative database (MarketScan) with surveillance data. METHODS: We computed and compared STI rates for 2005-10 from MarketScan and national surveillance data for three major nonviral STIs (i.e. chlamydia (Chlamydia trachomatis), gonorrhoea (Neisseria gonorrhoeae) and syphilis (Treponema pallidum)). For administrative data, we assessed the sensitivity of the rates to enrolee inclusion criteria: continuous (≥320 member-days) versus all enrolees. Relative rates were computed for 5-year age groups and by gender. RESULTS: The administrative database rates were significantly lower (P<0.01) than those in the national surveillance data, except for syphilis in females. Gonorrhoea and syphilis rates based on administrative data were significantly lower (P<0.01) for all enrolees versus continuous enrolees only. The relative STI rates by age group from the administrative data were similar to those in the surveillance data. CONCLUSIONS: Although absolute STI rates in administrative data were lower than in the surveillance data, relative STI rates from administrative data were consistent with national surveillance data. For gonorrhoea and syphilis, the estimated rates from administrative data were sensitive to the enrolee inclusion criteria. Future studies should examine the potential for administrative data to complement surveillance data.

In recent years, illness and death due to chronic disease in the US Associated Pacific Islands (USAPI) jurisdictions have dramatically increased. Effective chronic disease surveillance can help monitor disease trends, evaluate public policy, prioritize resource allocation, and guide program planning, evaluation, and research. Although chronic disease surveillance is being conducted in the USAPI, no recently published capacity assessments for chronic disease surveillance are available. The objective of this study was to assess the quality of existing USAPI chronic disease data sources and identify jurisdictional capacity for chronic disease surveillance. The assessment included a chronic disease data source inventory, literature review, and review of surveillance documentation available from the web or through individual jurisdictions. We used the World Health Organization's Health Metric Network Framework to assess data source quality and to identify jurisdictional capacity. Results showed that USAPI data sources are generally aligned with widely accepted chronic disease surveillance indicators and use standardized data collection methodology to measure chronic disease behavioral risks, preventive practices, illness, and death. However, all jurisdictions need to strengthen chronic disease surveillance through continued assessment and expanded support for valid and reliable data collection, analysis and reporting, dissemination, and integration among population-based and institution-based data sources. For sustained improvement, we recommend investment and technical assistance in support of a chronic disease surveillance system that integrates population-based and institution-based data sources. An integrated strategy that bridges and links USAPI data sources can support evidence-based policy and population health interventions.