This study examined the relationship between violence exposure in three different contexts (home, school, and community) and internalizing and externalizing outcomes in early adolescents. We modeled both context-specific and cumulative effects of exposure to violence. After controlling for a number of risk factors associated with violence exposure, violent incidents encountered at school and at home were consistently related to multiple outcomes. Violence exposure in the community was related only to aggressive fantasies but not to other externalizing or internalizing problems. High levels of violence exposure in the community attenuated the relationship between home violence and internalizing symptoms and school violence and externalizing problems. Cumulative exposure to violence was related to all aspects of adjustment, but the number of contexts in which violence occurred did not predict beyond the effects of cumulative exposure. Finally, high levels of cumulative violence exposure were associated with a plateau or decrease in emotional distress.

Relatively little is known about how parents influence the health and well-being of lesbian, gay, and bisexual (LGB) adolescents and young adults. This gap has led to a paucity of parent-based interventions for LGB young people. A systematic literature review on parental influences on the health of LGB youth was conducted to better understand how to develop a focused program of applied public health research. Five specific areas of health among LGB young people aged 10-24 years old were examined: (a) sexual behavior; (b) substance use; (c) violence and victimization; (d) mental health; and (e) suicide. A total of 31 quantitative articles were reviewed, the majority of which were cross-sectional and relied on convenience samples. Results indicated a trend to focus on negative, and not positive, parental influences. Other gaps included a dearth of research on sexual behavior, substance use, and violence/victimization; limited research on ethnic minority youth and on parental influences identified as important in the broader prevention science literature; and no studies reporting parent perspectives. The review highlights the need for future research on how parents can be supported to promote the health of LGB youth. Recommendations for strengthening the research base are provided.

Until recently, few children with chronic illnesses such as sickle cell disease (SCD) lived past late adolescence. Substantial reductions in mortality mean a growing number of adolescents with SCD reach adulthood. Consensus among researchers and health care providers (HCP) from multiple disciplines is that critical attention to and more empirical research on the transition from pediatric to adult care is needed. We address the following questions: (1) How do pediatric and adult providers demonstrate involvement in transition? (2) What is expected of adolescents when they move to adult care? and (3) Do providers think there is a need for a systematic transition program? A cross-sectional, multi-format survey research study utilizing open-ended and forced-choice questions was conducted to compare responses between pediatric and adult providers from multiple disciplines. Data were collected from 227 HCP in three waves. Significant bivariate results (p < 0.05) reflected differing opinions regarding transition expectations and program need, especially among female providers, those practicing in urban areas, and providers who treat both adolescent and adult clients in comparison with their counterparts. Discussion includes implications for program development, social service and public health practice, and future research.

The objective was to present the 'voice' of adolescents with sickle cell disease (SCD) as part of the discussion of transition issues by identifying and documenting their expressed concerns and expectations, as well as what program priorities they perceive would facilitate a smooth transition to adult care. Cross-sectional data were collected by means of structured questionnaire interviews, using standard instruments. A volunteer sample of 172 adolescents with SCD aged 14 years and older still in pediatric care within community-based and medical center SCD programs across the United States was recruited. Statistically significant results indicated the top concerns of adolescents were: lack of information relating to their transition to adult care; fear of leaving the healthcare provider with whom they were already familiar; fear that adult care providers might not understand their needs; belief that an SCD transition program was needed and that it should focus on provider support; information provision about adult care programs; ways to meet adult care providers; and ways to help healthcare providers understand their needs. We conclude that many adolescents with SCD have concerns and fears about their transition to adult care. Based on findings from this study, it is recommended that transition programs address structural and interpersonal issues of adolescents and providers if they are to be successful. Strategies by which this can be achieved are recommended, including the need to encourage, support and provide assistance for peer education, outreach programs and peer-led instructions, since these hold great promise as approaches that are adolescentcentered and adolescent-delivered.

Purpose To explore perceptions of facilitators/barriers to sexual and reproductive health (SRH) care use among an urban sample of African American and Hispanic young men aged 15–24, including sexual minorities. Methods Focus groups were conducted between April 2013 and May 2014 in one mid-Atlantic U.S. city. Young men aged 15–24 were recruited from 8 community settings to participate in 12 groups. Moderator guide explored facilitators/barriers to SRH care use. A brief pre-group self-administered survey assessed participants’ sociodemographics and SRH information sources. Content analysis was conducted and three investigators independently verified the themes that emerged. Results Participants included 70 males: 70% were aged 15–19, 66% African American, 34% Hispanic, 83% heterosexual and 16% gay/bisexual. Results indicated young men’s perceptions of facilitators/barriers to their SRH care use come from multiple levels of their socio-ecology, including cultural, structural, social and personal contexts, and dynamic interrelationships existed across contexts. A healthcare culture focused on women’s health and traditional masculinity scripts provided an overall background. Structural level concerns included cost, long visits, and confidentiality; social level concerns included stigma of being seen by community members and needs regarding healthcare provider interactions; and personal level concerns included self-risk assessments on decisions to seek care and fears/anxieties about STI/HIV testing. Young men also discussed SRH care help-seeking sometimes involved family and/or other social network members and needs related to patient-provider interactions about SRH care. Conclusions Study findings provide a foundation for better understanding young men’s SRH care use and considering ways to engage them in care.

The purpose of this study was to highlight associations between sexual orientation and risk outcomes in late adolescence and early adulthood using an expanded measure of sexual orientation. Recent data indicate higher levels of risk behavior in a newly identified population, mostly heterosexuals, as compared to heterosexuals. Comparisons among groups using an expanded measure of sexual orientation such as this, however, often do not include all possible groups or may restrict comparisons between groups. Data were derived from the National Longitudinal Study of Adolescent Health (Add Health); participants identified as heterosexual, mostly heterosexual, bisexual, mostly gay, or gay. Main risk outcomes were parental mistreatment, home displacement, thoughts of suicide, depressive symptoms, frequency of drinking, and delinquency. A priori planned comparisons examined differences between: (a) heterosexual vs. mostly heterosexual, (b) gay vs. mostly gay, (c) mostly heterosexual vs. bisexual, (d) mostly gay vs. bisexual, (e) mostly heterosexual vs. mostly gay, (f) heterosexual vs. gay, (g) heterosexual vs. bisexual, and (h) gay vs. bisexual. Mostly heterosexual youth were at significantly greater risk than heterosexual youth on all outcomes but did not differ from bisexual or mostly gay youth. Heterosexuals were at lower risk as compared to mostly heterosexuals and bisexuals. This study provides further evidence of differential risk associations for sexual minorities.

Background Expedited partner therapy (EPT) is a potential partner treatment strategy. Significant efforts have been devoted to policies intended to facilitate its practice. However, few studies have attempted to evaluate these policies. Methods We used data on interviewed gonorrhea cases from 12 sites in the STD Surveillance Network (SSuN) in 2010 (n=3,404). Patients reported whether they had received EPT. We coded state laws relevant to EPT for gonorrhea using Westlaw legal research database, and the general legal status of EPT in SSuN sites from CDC’s website in 2010. We also coded policy statements by medical and other boards. We used chi-squares to compare receipt of EPT by legal/policy variables, patient characteristics and provider type. Variables significant at p<.10 in bivariate analyses were included in a logistic regression model. Results Overall, 9.5% of 2,564 interviewed gonorrhea patients reported receiving EPT for their partners. Receipt of EPT was significantly higher where laws and policies authorizing EPT existed. Where EPT laws for GC existed and EPT was permissible, 13.3% of patients reported receiving EPT as compared to 5.4% where there were no EPT laws and EPT was permissible, and 1.0% where there were no EPT laws and EPT was potentially allowable (p<.01). EPT was higher where professional boards had policy statements supporting EPT (p<.01). Receipt of EPT did not differ by most patient characteristics or provider type. Policy-related findings were similar in adjusted analyses. Conclusions EPT laws and policies were associated with higher reports of receipt of EPT among interviewed gonorrhea cases.

Findings have implications for improving young men's SRHC delivery beyond the narrow scope of STD/HIV care.