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Background: The prevalence of Post Traumatic Stress Disorder (PTSD) has been rising since the start of the COVID-19 pandemic, and affects females, sexual and gender minorities, and individuals with social risks at higher rates., Objective: This study examines if the prevalence of PTSD increased from 2019 to 2022 among patients who received care in a national network of safety-net, community-based health centers with integrated behavioral health programs that serve patients at high risk for PTSD., Methods: We analyzed electronic health record data from patients with 1 or more behavioral health visits during 2019 to 2022 using repeated cross-sectional data to visualize trends. Change in PTSD prevalence based on the diagnoses associated with each visit from 2019 to 2022 was assessed using a general linear mixed model adjusted for patient-level factors., Results: Over 4 years, 182 419 distinct patients received care for PTSD, with prevalence increasing from 2019 to 2022 (OR = 1.09, 95% CI = 1.08, 1.10). Females (OR = 1.81, 95% CI = 1.78, 1.84), LGBTQIA individuals (OR = 1.29, 95% CI = 1.26, 1.33), gender diverse individuals (OR = 1.36, 95% CI = 1.29, 1.42), and patients who reported 1 or more social determinants of health needs (OR = 1.52, 95% CI = 1.46, 1.57) were more likely to have a diagnosis of PTSD., Conclusions: In a worrying trend, PTSD prevalence has increased among people receiving integrated behavioral health care at community-based health centers, with disparities observed in subpopulations. Continued effort and investment are needed to meet this increasing need in safety-net settings, particularly for those subpopulations observed to have higher prevalence., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Improving hypertension control is a national priority. Electronic health record data have the potential to augment traditional surveillance systems. This study aimed to assess hypertension prevalence and control at the state level using a previously established electronic health record-based phenotype for hypertension., Methods: Adult patients (N=11,031,368) were included from the IQVIA ambulatory electronic medical record-U.S. 2019 data set. IQVIA ambulatory electronic medical record comprises electronic health records from >100,000 providers and includes patients from every U.S. state and Washington DC. Authors compared hypertension prevalence and control estimates against those from the Behavioral Risk Factor Surveillance System 2019. Results were age-standardized and stratified by state and sociodemographic characteristics. Statistical analyses were conducted in 2022-2023., Results: IQVIA ambulatory electronic medical record-U.S. patients had a median age of 55 years, and 56.7% were women. Overall age-standardized hypertension prevalence was higher in IQVIA ambulatory electronic medical record-U.S. (35.0%) than in the Behavioral Risk Factor Surveillance System (29.7%), however, state-level geographic patterns were similar, with the highest burden in the South and Appalachia. Similar patterns were also observed by sociodemographic characteristics in both data sets: hypertension prevalence was higher in older age groups (than younger), men (than women), and Black patients (than other races). Hypertension control varied widely across states: among states with >1% data coverage, control rates were lowest in Nevada (51.1%), Washington DC (52.0%), and Mississippi (55.2%); highest in Kansas (73.4%), New Jersey (72.3%), and Iowa (71.9%)., Conclusions: This study provided the first-ever estimates of hypertension control for all states and Washington DC. Electronic health record-based surveillance could support hypertension prevention and control efforts at the state level., (Published by Elsevier Inc.)

Background: A year has passed since COVID-19 began disrupting systems. Although children are not considered a risk population for the virus, there is accumulating knowledge regarding children's escalating risk for maltreatment during the pandemic., Objective: The current study is part of a larger initiative using an international platform to examine child maltreatment (CM) reports and child protective service (CPS) responses in various countries. The first data collection, which included a comparison between eight countries after the pandemic's first wave (March-June 2020), illustrated a worrisome picture regarding children's wellbeing. The current study presents the second wave of data across 12 regions via population data (Australia [New South Wales], Brazil, United States [California, Pennsylvania], Colombia, England, Germany, Israel, Japan, Canada [Ontario, Quebec], South Africa)., Method: Regional information was gathered, including demographics, economic situation, and CPS responses to COVID-19. A descriptive analysis was conducted to provide an overview of the phenomenon., Results: Across all of the countries, COVID-19 had a substantial negative impact on the operation of CPSs and the children and families they serve by disrupting in-person services. One year into the COVID-19 pandemic, new reports of CM varied across the regions. 1 In some, the impact of COVID-19 on CPS was low to moderate, while in others, more significant changes created multiple challenges for CPS services., Conclusions: COVID-19 created a barrier for CPS to access and protect children. The dramatic variance between the regions demonstrated how social, economic and structural contexts impact both CM reports and CPS responses., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Purpose: Few studies have tried to understand the factors related to HPV vaccination among Hispanics living in rural communities in the United States (US). Nationally, HPV vaccination among Hispanics is suboptimal (26.1%) compared to the HealthyPeople 2020 goal of 80% and even more suboptimal in rural communties. This study aimed to determine the salient factors among Hispanic parents for vaccinating their children against HPV and for designing a future HPV prevention intervention for Hispanics., Design and Methods: A descriptive qualitative design was used. Saturation was reached after conducting four focus groups with 23 Hispanic parents from rural communities in South Florida. Directed content analysis using the Theory of Planned Behavior (TPB) constructs was used to analyze the transcripts., Results: All TPB constructs were identified as salient factors for HPV vaccination including background factors, attitudes towards the behavior, perceived norms, perceived behavioral control, actual control, intention, and behavior., Conclusions: Addressing HPV vaccination by developing educational programs based on the TPB and tailored to meet the needs of Hispanic parents is urgently needed to prevent HPV among Hispanics in rural US communities. This approach can also serve as a directive to target HPV vaccination among Hispanics in other rural areas in the US., Practice Implications: Pediatric nurses must proactively promote and recommend the HPV vaccine (HPVV), educate parents on having sex-related discussions with their children, include children in the HPVV education and decision, bundle the HPVV with other child vaccines, and utilize reminder systems to ensure completion of the vaccine series., (Published by Elsevier Inc.)

Introduction: A negative relationship between adverse childhood experiences and both physical and mental health in adulthood is well established, as is the positive impact of parenting on child development and future health. However, few studies have investigated unique influences of adverse childhood experiences and positive parenting together within a large, diverse early childhood sample., Methods: The study used data on all children aged 0-5 years (n=29,997) from the National Survey of Children's Health 2011/2012 to examine effects of positive parenting practices and adverse childhood experiences on early childhood social-emotional skills and general development. All analyses were performed in 2017 and 2018., Results: More than a third of the sample reported experiencing at least one adverse childhood experience. More than a fourth (26.7%) met study criteria for social-emotional deficits, and 26.2% met criteria for developmental delay risks. The number of adverse childhood experiences exhibited negative marginal associations with social-emotional deficits and developmental delay risks, whereas the number of positive parenting practices showed independent protective effects. Risks associated with an absence of positive parenting were often greater than those of four or more adverse childhood experiences, even among no/low adversity families. The population attributable fractions for social-emotional deficits and developmental delay risks were 17.3% and 13.9% (translating to prevalence reductions of 4.5% and 3.6%) when adopting all positive parenting practices and 4.5% and 7.2% (prevalence reductions of 1.2% and 1.9%) when eliminating adverse childhood experiences., Conclusions: The number of adverse childhood experiences was associated with both social-emotional deficits and developmental delay risks in early childhood; however, positive parenting practices demonstrated robust protective effects independent of the number of adverse childhood experiences. This evidence further supports promotion of positive parenting practices at home, especially for children exposed to high levels of adversity., (Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

The Latino population in the United States is quickly growing, and its unintended pregnancy rate is increasing. To decrease unintended pregnancies, couples must mutually agree on family planning. Communication between partners is one key factor identified in successful family planning for couples. Therefore, the purpose of this study was to examine sexual communication and its associations with sexual relationship power, general communication, and views on family planning. The Actor-Partner Interdependence Model was used to analyze dyadic influences of the chosen variables. Forty immigrant Latino couples were recruited from prenatal care clinics. The study results were grouped according to the three types of power structures: exhibition of men's traditional machismo values, exhibition of women's increased power in their relationships, and exhibition of men's and women's own empowerment with sexual communication. There was a negative association between men's views on family planning and women's sexual communication (exhibition of machismo values); a negative association between women's sexual relationship power and their partners' sexual communication (exhibition of women's increased power); and positive associations between men's and women's general communication and sexual communication (exhibition of men's and women's own empowerment). Dyadic influences of sexual communication and associated variables need to be incorporated into interventions to facilitate family planning for couples.

The ability to influence partners' actions within an intimate relationship (sexual relationship power [SRP]) is a key concept in achieving optimum family planning (FP) among U.S. Latinos. The purpose of this study was to examine the associations between relationship/FP factors and SRP. The actor-partner interdependence model was used to analyze data for 40 couples. Both men's and women's sexual communications were positively associated with SRP, only women's relationship satisfaction was positively associated with SRP, women's general communication was negatively associated with men's SRP, and men's contraception attitudes were negatively associated with SRP. Couples interventions are needed, which account for SRP and gender differences. These findings provide direction for developing targeted interventions to achieve better FP for Latino couples.