Background Child marriage is a human rights violation disproportionately impacting girls in low- and middle-income countries. In the Middle East region, conflict and displacement have prompted concerns that families are increasingly resorting to child marriage to cope with economic insecurity and fears from sexual violence. This study set out to examine child marriage among Syrian refugees residing in Egypt with the aim of understanding drivers of child marriage in this context of displacement as well as how child marriage affects refugee girls’ wellbeing. Methods This analysis draws from 15 focus group discussions (FGD) conducted with married and unmarried girls, as well as parents of adolescent girls in three governorates in Egypt. FGDs included a participatory ranking exercise and photo-elicitation. Additionally, we conducted 29 in-depth interviews with girls and mothers, as well as 28 key informant interviews with health providers, community leaders, and humanitarian actors. The data was thematically analyzed using a combination of inductive and deductive coding. Results A prevalent phenomenon in pre-war Syria, child marriage has been sustained after the influx of Syrian refugees into Egypt by pre-existing cultural traditions and gender norms that prioritize the role of girls as wives and mothers. However, displacement into Egypt engendered different responses. For some families, displacement-specific challenges such as disruptions to girls’ education, protection concerns, and livelihood insecurity were found to exacerbate girls’ vulnerability to child marriage. For others, however, displacement into urban areas in Egypt may have contributed to the erosion of social norms that favored child marriage, leading to marriage postponement. Among girls who were married early, we identified a range of negative health and social consequences, including lack of family planning use, disruption to schooling and curtailment of girls’ mobility as well as challenges with marriage and birth registration which accentuated their vulnerability. Conclusion Efforts to address child marriage among Syrian refugees must acknowledge the different ways in which displacement can influence child marriage attitudes and practices and should capitalize on positive changes that have the potential to catalyze social norm change. Moreover, targeted, focused and contextualized interventions should not only focus on preventing child marriage but also on mitigating its impacts.

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Cardiovascular disease is the leading cause of mortality in the United States, accounting for one fourth of deaths. Higher rates of obesity put Hispanic and Black men at increased risk. The American Heart Association cites diet quality, physical activity, and body weight as alterations responsive to health promotion intervention. Prevention strategies need to begin in adolescence and the emerging adulthood years to impact cumulative risk factors. A scoping review identified search terms and this was followed by a systematic review of Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed databases for articles published in English from January 1, 2002, through May 11, 2017. This review explores community-based content, delivery, recruitment, or retention strategies used with young men of color aged 15 to 24 years. Of 17 articles describing 16 individual interventions and 1 describing multiple interventions (with samples ranging from 37 to 4,800), 13 reported significant results in one or more domains. No studies specifically targeted the needs of young men and only three had more than 50% male participants. There was a gap in studies that addressed young men in the ages of interest with most interventions reaching participants aged 11 to 19 years. Cultural tailoring was addressed through recruitment setting, interventionist characteristics, community involvement, and theoretical frameworks such as motivational interviewing that allow individual goal setting. Because young men seek access to preventive health services less than young women, it is suggested that interventions that are community based or use push technology (send information directly to the user) be increased.

Objectives: This study assesses the prevalence of and risk factors for child marriage in Yemen, which was experiencing a nationwide conflict at the time of the study. Study Design: We conducted a survey of internally displaced persons (IDPs) and host communities using a stratified multistage cluster sampling design. Each household included an interview with a female adult (n=1210), a household roster (n=8400), and one female adolescent interview (n=1210). We used multivariate logistic regression to assess the association between child marriage and various risk factors. We also used data from focus groups (n=411) and key informant interviews (n=30) to explore community perspectives and understand contextual factors relating to child marriage. Results: Prevalence of child marriage among IDP females aged 10-19 was 18.1% compared to 12.7% among hosts. In the regression model, being older (aOR=1.95), never attending school (aOR=3.94), place of origin of Saada (aOR=4.41), and unemployment of the female adult (aOR=2.84) showed increased odds of child marriage. Head of household unemployment (aOR=0.58) and completed higher education (aOR=0.42) showed decreased odds. Qualitatively, economic factors were cited as central factors in decision-making, both for host communities and even more so for IDPs. Perceptions of marriage readiness and negative consequences of child marriage were dependent on gender normative expectations. Conclusions: Displaced girls experience child marriage more than boys or host girls . Displacement effects economic security and household power dynamics, which affects marriage decision-making and girl s ability to self-advocate. Efforts to address child marriage in Yemen should include livelihood support, with awareness and conflict management components that start in pre-adolescence and include married and unmarried girls.