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PurposeLittle is known about fatherhood in middle adolescence. To better understand their sexual health needs, we describe relationship characteristics, perception of masculinity, and associated sexually transmitted infection (STI) risk behaviors in a community-based sample of urban middle adolescent boys who have fathered a child or been involved with a pregnancy.MethodsWe used venue-based sampling to recruit 339 boys (aged 14-17 years) in neighborhoods with high STI prevalence. We administered a brief survey on sexual relationship and pregnancy history, STI risk, juvenile justice involvement, and masculinity.ResultsFifteen percent had either fathered a child or been involved with a pregnancy. In multivariate analysis, controlling for age and ethnicity, adolescent fathers were more likely to be involved with juvenile justice and engage in STI risk behaviors. These included condom nonuse and partner checking a cell phone. Although of borderline significance, older partners, past STI testing, and drug or alcohol use at last sex improved model fit.ConclusionAdolescent fathers have distinct relational and sexual health needs. Their specific needs should be targeted by prevention programs.

OBJECTIVES:Middle adolescent males are a difficult group to recruit for community sexually transmitted infection (STI) prevention research. We describe a process of community engagement, and venue-based sampling of 14-17-year-old adolescent males, and compare rates of STIs and STI risk behaviors by venue. METHODS:Community engagement consisted of (1) informational meetings with organizations; (2) participation in community meetings and events; (3) hiring community members as study personnel; and (4) an adolescent advisory board recruited from the community. Venues were identified and assessed at different times of the day and days of the week using a structured tool. At selected venues, males ages 14-17 years were invited to participate in a brief survey and provide a urine sample and an optional anal swab for DNA-based STI testing. RESULTS:Venues were assessed (n = 249), and 31 were selected for recruitment, including parks, apartment complexes, community events, entertainment venues, a community school, and community programs for LGBT (gay, lesbian, bisexual, transgender) and adjudicated youth. We enrolled 667 participants, average age 15.7 years. Participants reported high rates of sexual and STI risk behaviors, but had low rates of STIs. These rates differed by venue, with more structured venues recruiting youth reporting fewer STI risk behaviors and less structured venues within the highest STI prevalence zip code recruiting youth reporting more STI risk behaviors. CONCLUSION:Venue-based sampling is a feasible mechanism to target recruitment and enrollment adolescent males with high STI risk behaviors in community settings, with risk profiles varying by setting.

Little empirical research has examined the effects of case characteristics on high‐quality teamwork within family meetings in child welfare. We attempted to fill this gap using 497 child welfare cases in a Midwestern state in the United States. We found that overall teamwork was negatively associated with domestic violence, frequent placement moves, and a permanency plan of adoption, whereas teamwork was positively associated with the length of involvement in the child welfare system. We also examined the relationships between the case characteristics and two components of teamwork. The results showed that domestic violence and the length of the involvement were equally significant factors for both team formation and functioning. The permanency plan of adoption was a significant factor for team formation, but not for team functioning. Finally, family voices and frequent team meetings appeared to be stronger factors for improving both team formation and functioning. The results suggest that families in the child welfare system have different experiences in forming and functioning high‐quality family team meetings. Therefore, it is necessary to customize specific processes and strategies to promote teamwork depending on the child and family's characteristics and situations. [ABSTRACT FROM AUTHOR]

A Midwestern state's child welfare agency contracted with a university to evaluate a 5-year Title IV-E Waiver Demonstration Project. As part of the process study, evaluators employed case study analysis to investigate Waiver knowledge and effects as reported by Regional and Executive Managers across 4 years of the demonstration period. Data from 78 interviews reveal enhanced levels of manager-evaluator rapport and integrated Waiver knowledge across years of data collection. This study highlights the value of middle managers as rich data sources, studying process through qualitative methods in child welfare evaluation, and how consistent relationships can support partnerships over time. [ABSTRACT FROM AUTHOR]

Concrete services are goods and services, such as rent, utilities, healthcare, or other tangible services, that are purchased directly by child welfare agencies to help support the short-term needs of a family. Practice wisdom in social work details the importance of meeting basic needs in order for clients to be able to concentrate on completing the case plan. Some literature has mentioned the importance of concrete services for child welfare practice. However, research has been limited about utilization of these services and their impact on child welfare outcomes. The current mixed methods study examines expenditures for concrete services across four categories over a four-year period in one Midwestern state. The justifications for caseworker concrete service requests and the perceptions of regional and executive managers regarding the effectiveness of the use of concrete services are also examined. Descriptive analysis revealed distributions varied by age and concrete service type. Both caseworker justifications and regional manager interviews revealed the same general themes for children: support of child safety, permanency, and well-being are supported with the use of concrete services. [ABSTRACT FROM AUTHOR]

Purpose: Early sexual onset contributes to poor health outcomes through the life course. We use the social behavioral model to examine the behaviors and attitudes associated with early sexual onset and the intention to delay sex in middle school youth., Methods: Youth in rural communities with high rates of hepatitis C and HIV filled out a survey prior to implementation of an evidence-based sex education program. Participants were asked if they had ever had sex and whether they planned to abstain from sex until the end of high school. We collected demographics, attitudes about abstinence, agency for sexual refusal, parent communication, sexual health knowledge, and history of system involvement. Logistic regression was utilized to examine factors associated with each outcome., Findings: Our sample included 6,799 students, 12.7 years old ± 0.9 and 50.3% female. 5.1% had ever had sex and 73.9% planned to abstain until the end of high school. Early sexual onset was associated with older age, negative attitudes toward abstinence, lower agency for sexual refusal, more frequent parent communication about sex, history of child welfare, and history of juvenile involvement. Planning to abstain until the end of high school was associated with being younger, female, positive attitudes toward abstinence, higher agency for sexual refusal, less communication with parents about sex, more communication with parents about relationships, not having a history of foster involvement, and not having a history of juvenile involvement., Conclusions: Age, agency, and parent communication were all associated with both outcomes. Our findings highlight the importance of early comprehensive, trauma-informed sex education., (© 2024 The Author(s). The Journal of Rural Health published by Wiley Periodicals LLC on behalf of National Rural Health Association.)

Purpose: In the past 2 years, nearly all 50 states have debated bills seeking to ban minors' access to gender-affirming medical interventions, with many being passed into law. This study documents gender-diverse youths' (GDY) and their caregivers' experiences as they grapple with how such laws impact their families. Methods: Sixteen GDY and 16 caregivers participating in a longitudinal study of the impact of gender-affirming care on GDYs' well-being were interviewed about how the legal and social discourse was impacting them and their families. When interviewed, some participants had completed only the initial intake, others had completed the intake and an initial medical consultation, and a few had recently started gender-affirming hormones. Thematic analysis was used to identify common threads in the youths' and caregivers' experiences. Results: Four main themes were identified: Direct effects of losing access to gender-affirming medical interventions, reflecting how losing access to care would impact well-being; growing hostility toward the gender-diverse community, noting increasing social negativity; personal and social upheaval, reflecting the many aspects of families' lives affected; and galvanization into social action, documenting drives to effect social change. Conclusion: Laws banning gender-affirming medical interventions impact GDY and their families beyond limiting access to medical care. They increase the social stressors, cause social network disruptions, increase hostility toward the gender-diverse community, and lead some GDY and caregivers to engage more politically to protect their community. Gender-affirming health care providers need to recognize how the social and political environment impact GDY and their families to provide high-quality, person-centered care.

Survivors of childhood cancer and other immunocompromised children are at high risk for the development of secondary human papillomavirus (HPV)-associated cancers. In this overview, the authors examine the epidemiology of vaccine efficacy, the natural history of HPV infections, and accelerated HPV-associated cancer development in these populations. The authors highlight the opportunities for preventive care and future research directives., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)