Prevention Science最新文献

Coalition initiatives that use evidence-based practices (EBPs) have been shown to reduce youth substance use. Despite the importance of promoting community coalitions' EBP use, there is little empirical evidence about how to do so. This study aimed to identify distinct coalition profiles that foster EBP use by examining clusters of coalitions characteristics and the type of coalition model followed. We analyzed data from 67 coalitions participating in the Coalition Check-Up, a cluster randomized trial designed to increase community anti-drug coalition capacity. Using k-means clustering approach, we identified subgroups of coalitions based on two domains of coalition capacity-functioning and collaborative structure, each also considering coalition model type. We then examined, using analysis of variance (ANOVA), the degree to which each subgroup of coalitions used EBPs. We found that (a) coalitions with higher levels of functioning characterized by sustainability, science-based approaches to prevention, community knowledge, and efficiency, using explicit theory-based models were associated with higher use of EBPs, (b) coalitions with lower levels of collaborative structure defined by formalized procedures, decentralization, sectoral diversity, and intersectoral communication, using explicit theory-based models were associated with higher EBP use, and (c) low functioning coalitions using no model were associated with the lowest level of EBP use. Characterizing coalitions' functioning, collaborative structure, and models used may help coalition leaders and technical assistance providers enhance coalition capacity that enables the use of EBPs. Findings also indicated the importance of using explicit theory-based models to increase coalition impact.

Each year, millions of families with children in the United States (US) come into contact with the criminal legal system (CLS), the deleterious consequences of which are well documented. Families exposed to the CLS often face many stressors and may benefit from supports and services designed to enhance parent-child relationships and connect them to health-promoting resources and services. Early childhood family home visiting (FHV) is a two-generation strategy to support pregnant women and families with infants and young children, many of whom encounter the CLS. Yet, little is known about the CLS experiences of families receiving FHV. This scoping review summarizes the published research on CLS experiences among FHV-enrolled families in the US. Seven online databases were used to identify research published between 1967 and 2022. Following PRISMA guidelines, articles were required to focus on FHV and CLS involvement. Twenty-eight articles met inclusion criteria; five were systematic reviews or meta-analyses, 22 were primary sources with quantitative measures of CLS, and one was a qualitative study. Among the primary quantitative sources, more than half (55%) included CLS measures to describe the sample and the others included CLS variables as outcomes. CLS involvement was a common experience among families receiving FHV services. This scoping review provides an important first step in describing the existing research on FHV participants' CLS involvement and can inform future efforts to serve this group of families.

Sensitive parenting early in life sets children up for healthy development, and this type of parenting draws on the parent's compassion and physiological regulation. Loving-kindness meditations (LKM) increase compassion and reduce physiological responses to stressors and so may support sensitive parenting. The current study tested the effects of a LKM on parent sensitivity and salivary alpha amylase (sAA) during a parent-child interaction. One hundred and thirty-six parents (114 mothers, 22 fathers) of toddlers (18-36 months, M = 28.85 months, SD = 5.13) participated in an online survey and were randomly assigned to listen to either a LKM, focused-imagery audio, or podcast during a video call before engaging in a play-based interaction with their toddler. Parent sAA was collected from parents at five points throughout the video call. LKM did not significantly increase parent sensitivity (B = 0.06, p = 0.86); however, there was limited variability in sensitivity in this sample (M = 6.01, SD = 0.89). The LKM did affect sAA activity (B =  - 0.66, p < 0.05) such that parents in the LKM group gradually decreased sympathetic activity across the research session, whereas the podcast group increased sAA levels after the parent-child interaction. Overall, these findings suggest that engaging in compassion and self-compassion can change the pattern of stress physiology in parents of toddlers while parenting.

The objective of the present paper is to apply an intersectional lens to HIV prevention behavior disparities among LGBTQ+ adolescents across multiple social positions (racial, ethnic, gender, and sexual identities) and access to LGBTQ+-inclusive school resources (sex education and gender-sexuality alliances). Data are from the 2022 LGBTQ National Teen Survey (N = 10,871). Descriptive analyses and chi-square tests were conducted for social position, LGBTQ+-inclusive school resources, and HIV prevention variables. Social positions and two LGBTQ+-inclusive school resources were then entered into exhaustive chi-square automatic interaction detection models of HIV prevention behaviors (heard of/taken pre-exposure prophylaxis, HIV-testing, and consistent condom use). Groups with the highest and lowest prevalence of HIV prevention behaviors are described. LGBTQ+-inclusive school resources, especially sex education, were promotive of HIV prevention behaviors and mitigated some disparities across social positions. However, some disparities by social positions persisted. Gay or queer cisgender boys were consistently in the highest prevalence HIV prevention behavior groups, whereas youth who self-reported they were bisexual/pansexual, asexual, sexual identity questioning, straight or a sexual identity not listed, especially those who lacked LGBTQ+-inclusive school resources, were overrepresented in the low prevalence groups. LGBTQ+-inclusive school resources are important sources of HIV prevention information and may mitigate some HIV-related disparities.

Maternal smoking during pregnancy exhibited an adverse influence on asthma, but its joint effect with genetic factors remained elusive. Moreover, whether there existed a moderating role of genetic susceptibility in this effect on childhood/adolescent-onset asthma (COA) and adult-out asthma (AOA) was unknown. We employed the UK Biobank cohort to estimate the effect of maternal smoking during pregnancy on the risk of offspring asthma (41,828 AOA and 15,120 COA). We investigated genetic influence on asthma and assessed the moderating role of genetic susceptibility in this effect by incorporating polygenetic risk score (PRS) and performing a stratified analysis in distinct genetic risk populations. Hazard ratio (HR) and 95% confidence intervals (CIs) were reported. We found that participants whose mother smoked during pregnancy were more likely to occur asthma (HR = 1.14, 95%CIs 1.12 ~ 1.16), with similar effects for AOA and COA. Additionally, we observed a significant association between genetic factors and asthma (HR = 1.70, 95%CIs 1.66 ~ 1.74), with a higher genetic influence on COA (HR = 2.16, 95%CIs 2.09 ~ 2.23) compared to AOA (HR = 1.84, 95%CIs 1.76 ~ 1.93). Furthermore, we revealed that genetic factors could modify the effect of maternal smoking during pregnancy on asthma especially among childhood and adolescents, with participants having high genetic risk versus low genetic risk (HR = 1.13 vs. 1.02, P = 0.035). We provided supportive evidence that maternal smoking during pregnancy and the genetic factors increased the risk of offspring asthma in whole population. We further revealed that genetic susceptibility exerted more pronounced influence on COA compared to AOA, and played a moderating role in this effect.

Little is known about factors that predict attendance in strengths-focused, culturally grounded, family-based programming to prevent adverse childhood experiences (ACEs) among Indigenous populations in the USA. An understanding of these factors may help to create initiatives to reduce barriers to attending programming that could reduce ACEs and other health inequities among structurally minoritized populations. The purpose of the current study was to explore this critical gap in the literature. Participants were 66 caregivers and their 107 children 10 to 14 (N = 66 families) randomly assigned to the treatment group. Baseline measures were used to predict program attendance (total number of sessions and any attendance). Results for caregivers showed that higher intimate partner violence victimization and perpetration and depression predicted program attendance (number of sessions and any attendance). For children, girls were more likely to attend at least one session than boys. Predictors of the total number of sessions for children included being a girl, lower depression, higher awareness (emotion regulation), higher parent-child communication, higher harsh parenting, higher caregiver positive reinforcement, and higher family cohesion. These findings have important implications for reducing potential barriers to program attendance as well as motivational interviewing approaches for specific subpopulations that may enhance attendance in a strengths-focused, culturally grounded, family-based programming to reduce ACEs.

There is a lack of evidence-based programs to support the prevention of child behavior problems designed specifically for foster and kinship caregivers from historically minoritized groups. Drawing on existing best-practice recommendations for tailoring interventions to new cultural and social contexts, this study evaluates initial evidence of the acceptability and feasibility of adapting the Chicago Parent Program (CPP) for foster and kinship care. An expert panel of foster and kinship caregivers, clinicians, and other professionals with experience in CPP and child welfare arenas was convened to review and adapt CPP materials in collaboration with researchers. The adapted program was then delivered to 12 foster and kinship caregivers, who completed surveys and qualitative interviews to provide feedback about the revised program. Caregiver satisfaction with the program was generally high. In interviews, caregivers emphasized that group sessions resonated with them (theme 1), that they appreciated the opportunity to connect with the program via mandated foster care clinic visits (theme 2), and that adapted components of the program delivery (theme 3), and materials (theme 4) were relevant. Caregivers also noted barriers with behavior management and logistical challenges that made it more difficult to attend regularly and complete practice assignments, which was reflected in reduced participation rates during the pilot. Overall, these findings suggest that careful and empirically driven adaptation to effective parent-focused prevention programs can be achieved for foster and kinship caregivers, leading to high potential impact for a population that has generally been under-resourced and experiences high need and mental health burden.

Developmental monitoring and promotion efforts are keys to identifying potential developmental concerns and connecting young children to intervention services. Evidence-based home visiting programs are one avenue for developmental monitoring and promotion, particularly for families with young children who may need extra support (e.g., families living in poverty, families dealing with substance use). In the present qualitative study, we interviewed parents (N = 23) and providers (N = 18) from three home visiting programs to understand the ways in which home visiting engages in developmental monitoring and promotion. Findings indicated that children participating in home visiting were regularly screened for developmental concerns (developmental monitoring). Providers also discussed screener results with parents and provided activities and materials to encourage parents to engage in positive parenting behaviors (developmental promotion). Barriers to monitoring and promotion were also uncovered and included family buy-in and logistical constraints. Implications suggest enhanced provider training to overcome barriers and greater policy and funding support for home visiting to extend the reach of home visiting and bolster developmental monitoring and promotion efforts.

This commentary explores challenges and innovations in prevention science that arose during the COVID-19 pandemic, with a focus on measurement issues and the contextual influences on data collection and intervention delivery. The pandemic necessitated a rapid shift to remote data collection and virtual interventions, many of which proved effective and scalable, as demonstrated by studies in this special issue. Innovations such as remote observational assessments improved reliability, reduced costs, and increased accessibility. However, the pandemic also revealed how contextual factors influence measurement properties for key constructs, with examples from this issue showing shifts in scale dimensionality and item functioning over time. These findings underscore the importance of considering context when designing and interpreting quantitative measures. I argue that by embracing heterogeneity in exposures and outcomes, prevention researchers can improve the precision and relevance of their work.

Qualitative content analysis of an HIV testing and communication skill-building session explored the development of sexual agreements and HIV risk prevention strategies among emerging adult (18 to 24 years old) sexual minority men (SMM) to inform HIV testing services for younger SMM in relationships. In total, 29 intervention sessions were transcribed and coded for analysis. Most youth identified as cisgender male (86.2%), gay (72.4%), and as Latino/x (41.4%) or non-Hispanic White (37.9%). Results revealed that the process of forming a sexual agreement with one's main partner, as well as the composition of sexual agreements, was generally similar to those found in studies of adult SMM. HIV transmission risk reduction was not a central goal for establishing a sexual agreement for SMM emerging adults in this study; however, behavioral strategies for managing HIV risk did vary across casual partner types. SMM frequently used condoms with anonymous or new non-primary partners but relied on other HIV prevention strategies (e.g., sexual history, disclosing HIV status, pre-exposure prophylaxis) with regular non-primary partners. Sexual health service providers should assess for risk separately across non-primary partner types and collaborate with clients to discuss appropriate preventative strategies.