- Email: [email protected]
35. Stronglinks: An Arts-Based Program Exploring Urban Ethnic Adolescent Girls' Experiences, Coping and Relationships
Poster Abstracts / 50 (2012) S16 –S95
Conclusions: At the end of this workshop, participants were be able to 1) identify their own inner scripts, 2) develop more effective ways of communicating in romantic relationships and 3) identify negative patterns in their relationships. Sources Of Support: This intervention is supported by the Infectious Disease and Environmental Health Administration at the Maryland Department of Health and Mental Hygiene.
S31
related to sex motives to gain approval from others or to feel better about the self. School-based sexual health programs can target the promotion of healthy sex motives of intimacy and enhancement to reduce peer sexual harassment and document outcomes. Sources of Support: Canadian Institutes for Health Research; Social Sciences and Humanities Research Council of Canada. 34.
SESSION I: TRAUMA 33. PEER SEXUAL HARASSMENT AND SEX MOTIVES: A GENDERED ANALYSIS Sheila K. Marshall, PhD, Elizabeth Saewyc, PhD. University of British Columiba Purpose: Peer sexual harassment in schools has been linked to mental health problems and increased risk behaviors among victimized boys and girls. Although the health consequences of receiving sexual harassment in schools are known, no extant investigations address students’ motivations for engaging in harassment of peers. This study examines whether five motivations for sex (intimacy, enhancement, self-affirmation, partner approval, and peer approval) contribute to explaining variance in peer verbal and physical sexual harassment among high school students. Methods: A survey was administered during class periods to students in grades 8 to 12 (N⫽1012) attending an ethnically diverse public high school in Vancouver, Canada. A single self-report item identified the individuals who had ever experienced social sexual behaviors from kissing to vaginal or anal intercourse (n⫽383, 37.8% of original sample; 50.3% female, mean age ⫽ 15.02). These students completed 24 items from the Sexual Motives Scale (Cooper, Shapiro, & Powers, 1998) to assess intimacy, enhancement (satisfy sexual needs), self-affirmation, partner approval, and peer approval. Peer sexual harassment was assessed using 10 items from the AAUW Sexual Harassment Survey. These items were divided into two subscales: verbal (e.g., “Spread sexual rumors about someone.”) and physical (e.g., “Touched, grabbed or pinched in a sexual way.”) sexual harassment. Analyses were conducted separately for boys and girls because research shows consistent gender differences in sex motives among adults and adolescents and gender differences in rates of sexual harassment among high school students. Due to non-normal distributions, Spearman’s rho was used to examine associations between verbal and physical harassment and sex motives. Results: Higher rates of verbal sexual harassment were reported by boys (n ⫽ 145; 76.3%) and girls (n ⫽ 116; 60.1%) than physical sexual harassment (boys, n ⫽ 79; 41.5%; girls, n ⫽ 65; 33.6%). Consistent with extant research, the rates of both types of harassment were higher among boys than girls. Boys’ engagement in verbal sexual harassment was significantly correlated with each of the sex motives (rs ranged from .20 for intimacy to .41 for self-affirmation motives). Girls’ verbal sexual harassment was significantly associated with self-affirmation (rs ⫽ .33) and partner (rs ⫽ .24) and peer approval (rs ⫽ .17). Boys’ physical sexual harassment was significantly associated with self-affirmation (rs ⫽ .16) and peer approval (rs ⫽ .18). Girls’ physical sexual harassment was significantly correlated with self-affirmation (rs ⫽ .19) and partner (rs ⫽ .21) and peer approval (rs ⫽ .26). Conclusions: Girls and boys engage in verbal and physical sexual harassment therefore programs promoting healthy and respectful relationships should attend to boys as targets of harassment as well as girls. For both boys and girls, engaging in peer sexual harassment is
MAINTAINING THE SAFETY NET: THE ROLE OF HRSA-SUPPORTED HEALTH CENTERS IN EMERGENCY PREPAREDNESS AND RESPONSE Avril M. Houston, MD, MPH. Health Resources and Services Administration Purpose: Coupled with developmental transitions that occur during adolescence, experiencing a natural disaster can be particularly traumatic. The devastation of the familiar environment (i.e. home, school, community) can be long lasting, challenge adolescents’ sense of invulnerability and undermine their belief that the world is a safe place. The purpose of this study to describe the role of the Health Resources and Services Administration in supporting the ACCESS family health center, the medical home of all adolescents residing in Smithville, MS, during the EF-5 tornado that touched down on April 27, 2011. Methods: Quantitative and qualitative data were used to assess HRSA’s emergency response to the community health center including review of emergency management standards, HRSA situational reports, the HRSA Data Warehouse, Mississippi Trauma Care System Reports and informational interviews with key staff members of the ACCESS Family Care Center. Data analysis included descriptive statistics for quantitative data and content analysis for qualitative data. Results: HRSA bureaus and offices provided situational awareness and status updates that resulted in improved communication and coordination among federal agencies and community organizations for the only community health center and usual source of outpatient care for 10,000 patients, of which 1100 were adolescents. The clinic medical providers, which were participants of HRSA’s National Health Service Corps, were the first on the scene to triage and manage the injuries until additional assistance arrived from the local hospital. Although the medial and dental clinics were destroyed, medical supplies, medications and a scanner to scan paper records into an electronic health record system were secured quickly so that the clinics were able to resume operations within two days using a mobile unit. Conclusions: HRSA-supported community health centers can support a community’s emergency preparedness and response to natural disasters. The medical home staff can assist adolescents, not only with the physical impacts of the disaster, but also support them as they manage their reactions after the immediate threat has ceased. In addition to adhering to the Emergency Management Standards for Health Centers, it is important to conduct tabletop drills and develop relationships with state and local organizations in order to prepare and be able to respond to disasters. Sources of Support: None. 35. STRONGLINKS: AN ARTS-BASED PROGRAM EXPLORING URBAN ETHNIC ADOLESCENT GIRLS’ EXPERIENCES, COPING AND RELATIONSHIPS Christina Tortolani, PhD1, Lindsay Amper, PhD2. 1
Brown Medical School 2La Rabida Children’s Hospital
S32
Poster Abstracts / 50 (2012) S16 –S95
Purpose: Ethnic adolescent girls who are growing up in urban communities are often faced with unique difficulties and struggles that include community violence, peer group instability, family stressors, poverty and discrimination. The primary purpose of this study was to work with an existing youth program, Responsive Advocacy of Life and Learning (RALLY), and the group of girls it served, to develop and evaluate an arts-based program, StrongLinks. The curriculum was designed to help girls who may have experienced traumatic events to express themselves in healthful ways, bolster resiliency, and build on their strengths in a safe environment. This study also aimed to explore their life experiences, relationships and coping strategies. Methods: A participatory action research approach was used; therefore, researchers were also the program leaders. As stakeholders of the program, the girls were asked to share their personal experiences, opinions and perspectives to contribute to the development, implementation and evaluation of the program and inform the researchers of what was culturally relevant and effective in their learning and growth.Program evaluation occurred through: the analysis of pre and post group semi- structured interviews with the girls; researchers’ process notes; and journal entries made by the girls. Qualitative information from the semi-structured interviews, journals, and process notes were transcribed and coded. The participants were 11 urban adolescent girls from a variety of cultural backgrounds including Puerto Rican, Guatemalan, Dominican, Cuban, Brazilian, Salvadorian, Haitian and Caucasian. The majority of these girls disclosed experiencing at least one traumatic life event. Results: The qualitative data indicated meaningful aspects of relational growth, knowledge and awareness through group participation. Expressive activities were found to be a critical element of the program for the girls. Many indicated that through the activities they had learned valuable coping skills, had improved relationships with girls inside of the group, and found an avenue to express feelings and thoughts that they had not typically been able to express, particularly around experiences of trauma. The girls emphasized the importance of having fun and just “being kids” within an all- female program. Additionally, having a choice in how to express their individuality was another important finding that emerged. Conclusions: The present research findings demonstrate the salience of gender-sensitive programs focused on relationships, coping and expressive arts among urban adolescent girls who have been exposed to trauma. Future programs should utilize such art-based techniques to facilitate self – expression, should adopt a strengthbased perspective and should create same-sex groups. Sources of Support: None. 36. ACADEMIC STRESS, SOCIAL TRAUMA, AND DISTURBED SLEEP IN A LARGE POPULATION OF COLLEGE STUDENTS: INTERCONNECTIONS AND HEALTH IMPLICATIONS J. Roxanne Prichard, PhD, Jeanne Cunningham, MA. University of St. Thomas Purpose: To discover the content and frequency of situations college students find to be traumatic or deeply troubling and to assess the associations between these traumatic experiences and indices of academic performance, physical health, risk taking behaviors, sleep, stress, and emotional well-being. Methods: 1,400 students from a representative sample of undergraduates from an urban Midwestern university were invited to complete a survey modeled after the National College Health Assessment instrument; 52% of those invited completed the survey. Stu-
dents were asked to indicate which factors (e.g., death of a loved one, relationship problems, financial concerns, academic stress; etc) they had found to be ‘traumatic or very difficult to handle’ within the last 12 months and whether or not they had experienced a recent abusive intimate relationship. The total number of traumatic events and experiences indicated was summed and divided into quartiles. The association between this summed trauma index and negative health outcomes (diagnosed physical illnesses; disturbed sleep; drug and alcohol abuse; risk-taking behaviors; negative moods) was assessed by ANOVA. Factors contributing to a student’s perceived overall stress level were assessed by stepwise linear regression. Results: Fifty percent of students reported one or fewer traumatic events or concerns within the last 12 months, another quarter reported 2 or 3 events or worries, and the top quartile experienced a mean of 5.5 traumatic events or concerns (range 4-16). Eight percent of students indicated that they had experienced a recent abusive relationship; 14% struggled with the death of a loved one; and 75% reported at least one situation they found to be traumatic or very difficult to handle. The most common of these concerns were academic and financial stresses (40%); problems with intimate or other social relationships (27%); career concerns (22%) and their physical appearance (20%). Students in the top quartile were significantly more likely to engage in risk-taking behaviors (alcohol and drug abuse, not wearing a seatbelt, self-injurious behaviors), be diagnosed with a physical illness, experience restricted sleep and excessive daytime sleepiness, have lower grades, and experience more intense negative emotions (hopelessness and overwhelming anxiety, depression, and anger). Furthermore, the summed trauma index and restricted sleep accounted for 26% of students’ overall perceived stress, whereas exercise, physical health, and mental illness diagnoses were not significant predictors of stress. Conclusions: Students identified social, financial and academic stressors as very difficult to handle. Although these stressors might not fall under the typical category of traumatic events, they are nonetheless experienced as deeply disturbing and are associated with wide-ranging negative health outcomes. These self-identified traumatic experiences and concerns likely exacerbate sleep difficulties, just as restricted, poor quality sleep reduces emotional resiliency, thereby establishing a downward health spiral of increased risk-taking behaviors and decreased self-care. Sources of Support: No external financial support. 37. CHARACTERISTICS OF DEATHS IN YOUNG PEOPLE IN NOTTINGHAM AND NOTTINGHAMSHIRE 2008-2011: IDENTIFYING CONTRIBUTING AND MODIFIABLE FACTORS IN UNEXPECTED ADOLESCENT DEATHS Laura Bryson, MBBS, Joy Moran, BScN, Rebecca J. Sands, MBBS, Fiona Straw, MBBS, Damian M. Wood, MBBS. Nottingham University Hospitals NHS Trust Purpose: Background: Unexpected adolescence death is uncommon however adolescent mortality has overtaken mortality in younger children with the main causes of mortality being unintentional injury, suicide, homicide, malignancy and cardiac disease. The multiagency Child Death review process in Nottingham and Nottinghamshire, launched in April 2008, contributes to the forensic investigation of a child death as well as identifying any ongoing medical or bereavement needs of surviving family members. A standardised data collection process is used to enquire into the cause of death and to identify contributing, associated factors and modifiable factors along with any gaps in service provision. The child death review
Conclusions: At the end of this workshop, participants were be able to 1) identify their own inner scripts, 2) develop more effective ways of communicating in romantic relationships and 3) identify negative patterns in their relationships. Sources Of Support: This intervention is supported by the Infectious Disease and Environmental Health Administration at the Maryland Department of Health and Mental Hygiene.
S31
related to sex motives to gain approval from others or to feel better about the self. School-based sexual health programs can target the promotion of healthy sex motives of intimacy and enhancement to reduce peer sexual harassment and document outcomes. Sources of Support: Canadian Institutes for Health Research; Social Sciences and Humanities Research Council of Canada. 34.
SESSION I: TRAUMA 33. PEER SEXUAL HARASSMENT AND SEX MOTIVES: A GENDERED ANALYSIS Sheila K. Marshall, PhD, Elizabeth Saewyc, PhD. University of British Columiba Purpose: Peer sexual harassment in schools has been linked to mental health problems and increased risk behaviors among victimized boys and girls. Although the health consequences of receiving sexual harassment in schools are known, no extant investigations address students’ motivations for engaging in harassment of peers. This study examines whether five motivations for sex (intimacy, enhancement, self-affirmation, partner approval, and peer approval) contribute to explaining variance in peer verbal and physical sexual harassment among high school students. Methods: A survey was administered during class periods to students in grades 8 to 12 (N⫽1012) attending an ethnically diverse public high school in Vancouver, Canada. A single self-report item identified the individuals who had ever experienced social sexual behaviors from kissing to vaginal or anal intercourse (n⫽383, 37.8% of original sample; 50.3% female, mean age ⫽ 15.02). These students completed 24 items from the Sexual Motives Scale (Cooper, Shapiro, & Powers, 1998) to assess intimacy, enhancement (satisfy sexual needs), self-affirmation, partner approval, and peer approval. Peer sexual harassment was assessed using 10 items from the AAUW Sexual Harassment Survey. These items were divided into two subscales: verbal (e.g., “Spread sexual rumors about someone.”) and physical (e.g., “Touched, grabbed or pinched in a sexual way.”) sexual harassment. Analyses were conducted separately for boys and girls because research shows consistent gender differences in sex motives among adults and adolescents and gender differences in rates of sexual harassment among high school students. Due to non-normal distributions, Spearman’s rho was used to examine associations between verbal and physical harassment and sex motives. Results: Higher rates of verbal sexual harassment were reported by boys (n ⫽ 145; 76.3%) and girls (n ⫽ 116; 60.1%) than physical sexual harassment (boys, n ⫽ 79; 41.5%; girls, n ⫽ 65; 33.6%). Consistent with extant research, the rates of both types of harassment were higher among boys than girls. Boys’ engagement in verbal sexual harassment was significantly correlated with each of the sex motives (rs ranged from .20 for intimacy to .41 for self-affirmation motives). Girls’ verbal sexual harassment was significantly associated with self-affirmation (rs ⫽ .33) and partner (rs ⫽ .24) and peer approval (rs ⫽ .17). Boys’ physical sexual harassment was significantly associated with self-affirmation (rs ⫽ .16) and peer approval (rs ⫽ .18). Girls’ physical sexual harassment was significantly correlated with self-affirmation (rs ⫽ .19) and partner (rs ⫽ .21) and peer approval (rs ⫽ .26). Conclusions: Girls and boys engage in verbal and physical sexual harassment therefore programs promoting healthy and respectful relationships should attend to boys as targets of harassment as well as girls. For both boys and girls, engaging in peer sexual harassment is
MAINTAINING THE SAFETY NET: THE ROLE OF HRSA-SUPPORTED HEALTH CENTERS IN EMERGENCY PREPAREDNESS AND RESPONSE Avril M. Houston, MD, MPH. Health Resources and Services Administration Purpose: Coupled with developmental transitions that occur during adolescence, experiencing a natural disaster can be particularly traumatic. The devastation of the familiar environment (i.e. home, school, community) can be long lasting, challenge adolescents’ sense of invulnerability and undermine their belief that the world is a safe place. The purpose of this study to describe the role of the Health Resources and Services Administration in supporting the ACCESS family health center, the medical home of all adolescents residing in Smithville, MS, during the EF-5 tornado that touched down on April 27, 2011. Methods: Quantitative and qualitative data were used to assess HRSA’s emergency response to the community health center including review of emergency management standards, HRSA situational reports, the HRSA Data Warehouse, Mississippi Trauma Care System Reports and informational interviews with key staff members of the ACCESS Family Care Center. Data analysis included descriptive statistics for quantitative data and content analysis for qualitative data. Results: HRSA bureaus and offices provided situational awareness and status updates that resulted in improved communication and coordination among federal agencies and community organizations for the only community health center and usual source of outpatient care for 10,000 patients, of which 1100 were adolescents. The clinic medical providers, which were participants of HRSA’s National Health Service Corps, were the first on the scene to triage and manage the injuries until additional assistance arrived from the local hospital. Although the medial and dental clinics were destroyed, medical supplies, medications and a scanner to scan paper records into an electronic health record system were secured quickly so that the clinics were able to resume operations within two days using a mobile unit. Conclusions: HRSA-supported community health centers can support a community’s emergency preparedness and response to natural disasters. The medical home staff can assist adolescents, not only with the physical impacts of the disaster, but also support them as they manage their reactions after the immediate threat has ceased. In addition to adhering to the Emergency Management Standards for Health Centers, it is important to conduct tabletop drills and develop relationships with state and local organizations in order to prepare and be able to respond to disasters. Sources of Support: None. 35. STRONGLINKS: AN ARTS-BASED PROGRAM EXPLORING URBAN ETHNIC ADOLESCENT GIRLS’ EXPERIENCES, COPING AND RELATIONSHIPS Christina Tortolani, PhD1, Lindsay Amper, PhD2. 1
Brown Medical School 2La Rabida Children’s Hospital
S32
Poster Abstracts / 50 (2012) S16 –S95
Purpose: Ethnic adolescent girls who are growing up in urban communities are often faced with unique difficulties and struggles that include community violence, peer group instability, family stressors, poverty and discrimination. The primary purpose of this study was to work with an existing youth program, Responsive Advocacy of Life and Learning (RALLY), and the group of girls it served, to develop and evaluate an arts-based program, StrongLinks. The curriculum was designed to help girls who may have experienced traumatic events to express themselves in healthful ways, bolster resiliency, and build on their strengths in a safe environment. This study also aimed to explore their life experiences, relationships and coping strategies. Methods: A participatory action research approach was used; therefore, researchers were also the program leaders. As stakeholders of the program, the girls were asked to share their personal experiences, opinions and perspectives to contribute to the development, implementation and evaluation of the program and inform the researchers of what was culturally relevant and effective in their learning and growth.Program evaluation occurred through: the analysis of pre and post group semi- structured interviews with the girls; researchers’ process notes; and journal entries made by the girls. Qualitative information from the semi-structured interviews, journals, and process notes were transcribed and coded. The participants were 11 urban adolescent girls from a variety of cultural backgrounds including Puerto Rican, Guatemalan, Dominican, Cuban, Brazilian, Salvadorian, Haitian and Caucasian. The majority of these girls disclosed experiencing at least one traumatic life event. Results: The qualitative data indicated meaningful aspects of relational growth, knowledge and awareness through group participation. Expressive activities were found to be a critical element of the program for the girls. Many indicated that through the activities they had learned valuable coping skills, had improved relationships with girls inside of the group, and found an avenue to express feelings and thoughts that they had not typically been able to express, particularly around experiences of trauma. The girls emphasized the importance of having fun and just “being kids” within an all- female program. Additionally, having a choice in how to express their individuality was another important finding that emerged. Conclusions: The present research findings demonstrate the salience of gender-sensitive programs focused on relationships, coping and expressive arts among urban adolescent girls who have been exposed to trauma. Future programs should utilize such art-based techniques to facilitate self – expression, should adopt a strengthbased perspective and should create same-sex groups. Sources of Support: None. 36. ACADEMIC STRESS, SOCIAL TRAUMA, AND DISTURBED SLEEP IN A LARGE POPULATION OF COLLEGE STUDENTS: INTERCONNECTIONS AND HEALTH IMPLICATIONS J. Roxanne Prichard, PhD, Jeanne Cunningham, MA. University of St. Thomas Purpose: To discover the content and frequency of situations college students find to be traumatic or deeply troubling and to assess the associations between these traumatic experiences and indices of academic performance, physical health, risk taking behaviors, sleep, stress, and emotional well-being. Methods: 1,400 students from a representative sample of undergraduates from an urban Midwestern university were invited to complete a survey modeled after the National College Health Assessment instrument; 52% of those invited completed the survey. Stu-
dents were asked to indicate which factors (e.g., death of a loved one, relationship problems, financial concerns, academic stress; etc) they had found to be ‘traumatic or very difficult to handle’ within the last 12 months and whether or not they had experienced a recent abusive intimate relationship. The total number of traumatic events and experiences indicated was summed and divided into quartiles. The association between this summed trauma index and negative health outcomes (diagnosed physical illnesses; disturbed sleep; drug and alcohol abuse; risk-taking behaviors; negative moods) was assessed by ANOVA. Factors contributing to a student’s perceived overall stress level were assessed by stepwise linear regression. Results: Fifty percent of students reported one or fewer traumatic events or concerns within the last 12 months, another quarter reported 2 or 3 events or worries, and the top quartile experienced a mean of 5.5 traumatic events or concerns (range 4-16). Eight percent of students indicated that they had experienced a recent abusive relationship; 14% struggled with the death of a loved one; and 75% reported at least one situation they found to be traumatic or very difficult to handle. The most common of these concerns were academic and financial stresses (40%); problems with intimate or other social relationships (27%); career concerns (22%) and their physical appearance (20%). Students in the top quartile were significantly more likely to engage in risk-taking behaviors (alcohol and drug abuse, not wearing a seatbelt, self-injurious behaviors), be diagnosed with a physical illness, experience restricted sleep and excessive daytime sleepiness, have lower grades, and experience more intense negative emotions (hopelessness and overwhelming anxiety, depression, and anger). Furthermore, the summed trauma index and restricted sleep accounted for 26% of students’ overall perceived stress, whereas exercise, physical health, and mental illness diagnoses were not significant predictors of stress. Conclusions: Students identified social, financial and academic stressors as very difficult to handle. Although these stressors might not fall under the typical category of traumatic events, they are nonetheless experienced as deeply disturbing and are associated with wide-ranging negative health outcomes. These self-identified traumatic experiences and concerns likely exacerbate sleep difficulties, just as restricted, poor quality sleep reduces emotional resiliency, thereby establishing a downward health spiral of increased risk-taking behaviors and decreased self-care. Sources of Support: No external financial support. 37. CHARACTERISTICS OF DEATHS IN YOUNG PEOPLE IN NOTTINGHAM AND NOTTINGHAMSHIRE 2008-2011: IDENTIFYING CONTRIBUTING AND MODIFIABLE FACTORS IN UNEXPECTED ADOLESCENT DEATHS Laura Bryson, MBBS, Joy Moran, BScN, Rebecca J. Sands, MBBS, Fiona Straw, MBBS, Damian M. Wood, MBBS. Nottingham University Hospitals NHS Trust Purpose: Background: Unexpected adolescence death is uncommon however adolescent mortality has overtaken mortality in younger children with the main causes of mortality being unintentional injury, suicide, homicide, malignancy and cardiac disease. The multiagency Child Death review process in Nottingham and Nottinghamshire, launched in April 2008, contributes to the forensic investigation of a child death as well as identifying any ongoing medical or bereavement needs of surviving family members. A standardised data collection process is used to enquire into the cause of death and to identify contributing, associated factors and modifiable factors along with any gaps in service provision. The child death review