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Commercial sexual exploitation of children (CSEC) has emerged as a critical child protection and public health concern in recent years. While the phenomenon is prevalent globally, its impact is compounded in sub-Saharan Africa owing to the cultural and socioeconomic challenges that leave many households in the region vulnerable. The present study synthesized existing evidence using the socioecological model as a guiding framework to assess the risk and protective factors associated with CSEC in sub-Saharan Africa. A protocol for the study was published in PROSPERO (CRD42022331832) with pre-specified inclusion and exclusion criteria. Studies were screened and extracted from eight databases: PsycINFO, Scopus, Web of Science, PROQUEST (Social Science Premium), PubMed, CINAHL, EMBASE, and MEDLINE via Ovid. After an initial screening of 4,377 papers, seven studies were found eligible for the final review. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide for reporting systematic reviews. Included studies were appraised and rated using the Cambridge Quality Checklist and GRADE. Findings revealed risk factors, including adverse childhood experience and victimization, females aged 16 years and older, school dropouts, technology influence, child and parental alcohol use, and separation from caregivers. On the other hand, protective factors such as the number of female adolescents in a household, frequent health screening in schools, children being in school, and high parental monitoring were found to be associated with a lower risk of CSEC. Based on these findings, we recommend that interventions in sub-Saharan Africa adopt a holistic approach that addresses identified risk factors while harnessing protective factors to combat CSEC effectively. [ABSTRACT FROM AUTHOR]

Exposure to intimate partner violence (IPV) incurs significant public health consequences. Understanding risk markers can accelerate prevention and response efforts, important in settings like Sub-Saharan Africa (SSA) where resources are scarce. In this study, four databases were searched to identify studies that examined risk markers for male-to-female physical IPV. With application of the socioecological model, we analyzed 11 risk markers for male physical IPV perpetration (with 71 effect sizes) and 16 risk markers for female physical IPV victimization (with 131 effect sizes) in SSA from 51 studies. For male IPV perpetration, we found medium-to-large effect sizes for six risk markers: perpetrating emotional abuse and sexual IPV, witnessing parental IPV, being abused as a child, cohabitating (not married), and exhibiting controlling behaviors. We found small effect sizes for substance use. Employment, age, marital status, and education were not significant risk markers. For female IPV victimization, a medium effect size was found for post-traumatic stress symptoms. Small effect sizes were found for reporting depressive symptoms, being abused as a child, witnessing parental IPV, and reporting drug and alcohol use. Rural residence, approval of violence, length of relationship, income, education, employment, age, marital status, and religiosity were not significant risk markers. Findings highlight opportunities for screening and intervention at the couple level, show the need to test and incorporate interventions for IPV in mental health treatment, and emphasize the importance of further research on sociodemographic risk markers and the interventions that target them. [ABSTRACT FROM AUTHOR]

Sexual minority men (SMM) face persistent stigma in Zambia. From a holistic perspective, we aim to explore its impacts within and between multiple socioecological levels, demonstrating how their interactions create a vicious cycle of barriers to the well-being of SMM. In-depth interviews were conducted with 20 purposively recruited SMM from Lusaka, Zambia. All interviews were audio-recorded, after written consent, transcribed verbatim, and iteratively coded employing inductive (i.e., data-driven) approaches for thematic analysis using NVivo. Results suggest three key themes: (1) interpersonal socially perpetuated sexual minority stigma (SMS); (2) multidirectional interactions between psychosocial well-being and risk-taking behaviors; and (3) institutionally perpetuated SMS as a barrier to seeking and receiving health care. SMS permeates across all levels of the socioecological model to negatively impact the psychosocial well-being of SMM while acting also as a barrier to accessing HIV prevention and care. Our study necessitates structural public health intervention to decrease stigma and discrimination against SMM in Zambia, in efforts to increase their psychosocial well-being as well as their access to and utilization of HIV care by breaking the vicious cycle of SMS that pervades through the intrapersonal, interpersonal, and institutional levels of the socioecological model. [ABSTRACT FROM AUTHOR]

Sport participation can play a key role in older adults' successful aging as it provides an enjoyable opportunity for leisure-time physical activity. Research focusing on the benefits of sport participation in later life and facilitators for involvement has been increasing in the past several years. Drawing on the socioecological model, this study investigated select socioecological factors that predict older adults' sport participation from a holistic perspective. An online survey provided quantitative data from 1203 adults aged 50 and older across the United States. Results from logistic regression analyses showed that personal characteristics, individual behavior, environment/policy, and life course effects were significant predictors of sport participation in later life. The findings in this study enhance our understanding of factors related to older adults' sport participation and are also of value to practitioners seeking to promote sport participation among older adults. [ABSTRACT FROM AUTHOR]

Sport official's experience of abuse in their role is well documented, but the additional gendered barriers that women officials face are not. This study used Concept Mapping to explore the most important and frequent barriers that women referees and officials in Australian basketball face. Results were analyzed according to the Socio-Ecological Framework with a feminist lens, which demonstrated the complexity and interconnectedness of barriers between different levels. While participants were not specifically asked about gendered experiences, the results indicated that barriers were overwhelmingly gendered at every level, including discriminatory resourcing, lack of senior women, and concerningly, incidents of sexual harassment. This research sheds new light on the experience of women officials and the organizational and societal barriers that limit their careers and make their workplace unsafe. Finally, it discusses where the locus of responsibility lies in addressing these issues for women sport officials, placing emphasis on the role of organizations. [ABSTRACT FROM AUTHOR]

Sugar-sweetened beverage (SSB) consumption in the Latinx population has been a topic of increasing interest due to higher rates of consumption in this population, as well as higher prevalence of chronic health conditions, such as diabetes and obesity. SSB behaviors are influenced by multiple factors across the socio-ecological model. Understanding these factors can inform future intervention development and improve SSB consumption and overall health. Therefore, this narrative review identifies factors contributing to SSB consumption, as well as interventions conducted to address SSB consumption in the Latinx population residing in the United States. Contributing factors that are not currently addressed in published interventions are highlighted with the intent to inform the development of future comprehensive interventions. [ABSTRACT FROM AUTHOR]

Puerto Rico is a territory of the United States, making Puerto Ricans vulnerable to damaging colonial policy. The purpose of this article is to utilize the socioecological model (SEM) to evaluate how the Jones Act impacted Puerto Rico after Hurricane María, examining colonialist policy as a social determinant of health (SDOH) in Puerto Rico.Levels of the SEM used in this examination included: individual, institutional, community, policy, and context.Evaluation of the Jones Act using the model demonstrated relationships between all socioecological levels. The Jones Act caused delays and increased prices for goods needed to rebuild community utility infrastructure, which led to extended closures of institutions like workplaces, schools, and hospitals, and ultimately contributed to increased acute and chronic physical and mental illness among Puerto Ricans.This evaluation establishes that colonialist policy negatively impacts the health of Puerto Ricans, positioning colonialism as an SDOH. [ABSTRACT FROM AUTHOR]

This rapid qualitative exploratory study focused on perceptions of adopting risk-reduction measures, such as face masks, on campuses within institutions of higher education in the United States. It was intended to identify safety measures to reduce virus spread and develop community-informed public health messaging to promote COVID-19 risk-reduction strategies within campus communities. This study was approved by the institutional review board where the study took place. A total of 113 stakeholders, including students, staff, and faculty attended one of nine focus groups. We use the socioecological model to illustrate the use of COVID-19 public health measures in private and public spaces and how macro-level processes, specifically sociocultural values of personal freedom and social responsibility shape the meaning and interpretation of COVID-19 public health measures. A rapid qualitative data analysis was conducted. This analysis was characterized by three steps: (1) transcription of the interviews, (2) completion of a summary template per focus group analysis (data reduction strategy), and (3) matrix analyses involving a cross-case analysis of the nine focus groups conducted. Based on study findings, we offer community-centered recommendations for safe and healthy reopening of large public research institutions. This article contributes to the foundation of scientific literature that qualitatively describes evidence-based strategies for safe reopening of places of education and employment in the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This study tests a socioecological model of relapse and recovery using latent class growth mixture modeling to identify neighborhood, social network and individual-level predictors of alcohol dependence trajectories among a large, longitudinal sample of problem drinkers recruited from substance use treatment settings. We identified four distinct alcohol dependence trajectories: Stable Recovery/Low (Class 1); Relapsing/Rising (Class 2); Late Recovery/Declining (Class 3); and Chronic/High (Class 4). Neighborhood context (poverty and density of bars), social network characteristics (less involvement with Alcoholics Anonymous [AA], continued affiliation with heavy drinkers), and individual predisposing (psychiatric severity) and need (returning to treatment) characteristics each distinguished individuals in the Relapsing/Rising class from individuals in the Stable Recovery/Low class. Social network characteristics (AA involvement and continued affiliation with heavy drinkers) were the primary distinguishing factors for individuals in the Chronic/High class compared to the Late Recovery/Declining class. Study findings can be used to promote recovery and help prevent relapse by: guiding development of community-level interventions to improve social and physical environments; identifying potentially modifiable factors (social network support for sobriety, participation in self-help) to reduce negative consequences among problem drinkers who remain in high-risk neighborhoods; and contributing to ongoing discussions about new and continued licensing of alcohol outlets and regulation of alcohol sales to prevent alcohol problems in high-risk areas and among high-risk people. [ABSTRACT FROM AUTHOR]

Multiple factors may influence the risk of exposure to childhood violence and repeated victimization, although most research has focused on individual rather than contextual factors. Moreover, it is unclear whether family background factors associated with exposure to childhood violence also are associated with revictimization in young adulthood. This article investigates individual and contextual factors associated with childhood abuse and revictimization. Data from a community telephone survey, collected at two different time points (N = 1,011, 16-33 years of age), were used. Logistic regression analysis was applied to analyze family background factors in childhood violence–exposed cases and non-exposed controls. Similar analyses were conducted for the relationship of individual and contextual variables in the revictimized and the non-revictimized groups. The adjusted analyses showed that social problems (≥2 or more social problems: odds ratio [OR] = 2.89, 95% confidence interval [CI] = [1.41, 5.94]) and frequent binge drinking (OR = 1.21, 95% CI = [1.05, 1.40]) were significantly associated with repeated victimization whereas social support decreased the odds (OR = 0.74, 95% CI = [0.55, 0.99]). Family problems and low family cohesion growing up (although measured at Wave 2) were significantly associated with childhood exposure to violence, but not with revictimization. Our findings emphasizes that it is useful to separate factors associated with childhood abuse from factors related to revictimization to identify current ecological aspects that can be addressed to prevent further abuse. [ABSTRACT FROM AUTHOR]

Professionals interested in advancing best practices in worksite wellness have been calling for more organizational and environmental approaches that will advance a culture of health. We seem to be getting the message across because a recent national survey shows that "supportive social and physical environment" is one of the 5 elements used to define a comprehensive program that has increased the most from 29.2% naming this as part of their approach in 2004 to 56% of companies in 2017. Yet 2 worksite health promotion studies that garnered media attention this past year offer telling examples of what occurs when researchers conflate or confuse the effectiveness of a health education program with a socioecological approach. I would suggest we replace the term "comprehensive programs" with "socioecological approach" or a "culture of health approach" or, at least, "a comprehensive approach," anything but continued use of the oxymoronic term "comprehensive program." [ABSTRACT FROM AUTHOR]

The high prevalence of gender-based violence (GBV) in armed conflict has been documented in various national contexts, but less is known about the complex pathways that constitute the relation between the two. Employing a community-based collaborative approach, we constructed a community-informed socioecological conceptual model from a feminist perspective, detailing howarmed conflict relates to GBV in a conflict-affected rural community in Northeastern Uganda. The research questions were as follows: (1) How does the community conceptualize GBV? and (2) How does armed conflict relate to GBV? Nine focus group discussions divided by gender, age, and profession and six key informant interviews were conducted. Participants' ages ranged from 9 to 80 years (n=34 girls/women, n= 43 boys/men). Grounded theory was used in analysis. Participants conceptualized eight forms of and 22 interactive variables that contributed to GBV. Armed conflict affected physical violence/quarreling, sexual violence, early marriage, and land grabbing via a direct pathway and four indirect pathways initiated through looting of resources, militarization of the community, death of a parent(s) or husband, and sexual violence. The findings suggest that community, organizational, and policy-level interventions, which include attention to intersecting vulnerabilities for exposure to GBV in conflict-affected settings, should be prioritized. While tertiary psychological interventions with women and girls affected by GBV in these areas should not be eliminated, we suggest that policymakers and members of community and organizational efforts make systemic and structural changes. [ABSTRACT FROM AUTHOR]

The newly established national Safe Routes to School (SRTS) program has the potential to positively influence individuals, communities, and the environment regardless of race, ethnicity, or socioeconomic status. Many communities are applying their interest in physical activity promotion toward creating policies and programs to encourage active travel, though many barriers exist. SRTS legislation provides funds to address some of the barriers and improve the ability of students to safely walk and bicycle to school. SRTS requires that 70% to 90% of the funds be used for infrastructure projects (i.e., engineering treatments, such as sidewalk construction), and 10% to 30% for noninfrastructure activities, such as education, encouragement, and enforcement. The socioecological model (SEM) is widely used in public health and includes five levels of influence on behavior, from individual to public policy. Application of the SEM to SRTS provides a framework for a comprehensive approach to improve active travel to school. [ABSTRACT FROM AUTHOR]

The authors develop a hybrid model of health care use that blends features of the traditional Aday-Andersen behavioral model with the socioecological modeling perspective. They use the model to conceptualize the various levels of influence expected from socioecological variables in individuals' mammography use decisions, build contextual variables from fine-grained data into four different types of geographic areas, and then use two- and three-level modeling of personal and area-level contextual factors to explain observed behavior. The central focus is on whether differentiating the conceptualized levels of influence seems to materially affect regression findings. The test could conceivably be confounded by the modifiable areal unit problem, but little evidence for this is found. Findings for California women suggest that distinctions do matter in how the levels of influence are defined for local neighborhood contextual factors. Studies using only county-level contextual factors will miss some meaningful associations related to interpersonal/proximate-level factors. [ABSTRACT FROM AUTHOR]

This article highlights the processes and intermediate outcomes of a pilot project to increase mammography rates of women in an American Indian tribe in New Mexico. Using a socioecological framework and principles of community-based participatory research, a community coalition was able to (a) bolster local infrastructure to increase access to mammography services; (b) build public health knowledge and skills among tribal health providers; (c) identify community-specific knowledge, attitudes, and beliefs related to breast cancer; (d) establish interdependent partnerships among community health programs and between the tribe and outside organizations; and (e) adopt local policy initiatives to bolster tribal cancer control. These findings demonstrate the value of targeting a combination of individual, community, and environmental factors, which affect community breast cancer screening rates and incorporating cultural strengths and resources into all facets of a tribal health promotion intervention. [ABSTRACT FROM AUTHOR]