Chapel Hill, NC, United States
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Annan J.,Research and Evaluation Unit | Kaysen D.,University of Washington | Griffiths S.,University of Washington | Cetinoglu T.,International Rescue Committee | Wachter K.,University of Texas at Austin
New England Journal of Medicine | Year: 2013

BACKGROUND: Survivors of sexual violence have high rates of depression, anxiety, and post-traumatic stress disorder (PTSD). Although treatment for symptoms related to sexual violence has been shown to be effective in high-income countries, evidence is lacking in low-income, conflict-affected countries. METHODS: In this trial in the Democratic Republic of Congo, we randomly assigned 16 villages to provide cognitive processing therapy (1 individual session and 11 group sessions) or individual support to female sexual-violence survivors with high levels of PTSD symptoms and combined depression and anxiety symptoms. One village was excluded owing to concern about the competency of the psychosocial assistant, resulting in 7 villages that provided therapy (157 women) and 8 villages that provided individual support (248 women). Assessments of combined depression and anxiety symptoms (average score on the Hopkins Symptom Checklist [range, 0 to 3, with higher scores indicating worse symptoms]), PTSD symptoms (average score on the PTSD Checklist [range, 0 to 3, with higher scores indicating worse symptoms]), and functional impairment (average score across 20 tasks [range, 0 to 4, with higher scores indicating greater impairment]) were performed at baseline, at the end of treatment, and 6 months after treatment ended. RESULTS: A total of 65% of participants in the therapy group and 52% of participants in the individual-support group completed all three assessments. Mean scores for combined depression and anxiety improved in the individual-support group (2.2 at baseline, 1.7 at the end of treatment, and 1.5 at 6 months after treatment), but improvements were significantly greater in the therapy group (2.0 at baseline, 0.8 at the end of treatment, and 0.7 at 6 months after treatment) (P<0.001 for all comparisons). Similar patterns were observed for PTSD and functional impairment. At 6 months after treatment, 9% of participants in the therapy group and 42% of participants in the individual-support group met criteria for probable depression or anxiety (P<0.001), with similar results for PTSD. CONCLUSIONS: In this study of sexual-violence survivors in a low-income, conflict-affected country, group psychotherapy reduced PTSD symptoms and combined depression and anxiety symptoms and improved functioning. (Funded by the U.S. Agency for International Development Victims of Torture Fund and the World Bank; ClinicalTrials.gov number, NCT01385163.) Copyright © 2013 Massachusetts Medical Society.


Kaplan D.L.,Gotham Center | Jones E.J.,CAI | Olson E.C.,Community Epidemiology Unit | Yunzal-Butler C.B.,Research and Evaluation Unit
Journal of School Health | Year: 2013

BACKGROUND: Early sex is associated with high-risk behaviors and outcomes, including sexual risk behaviors, forced sex, physical dating violence, and becoming pregnant or impregnating someone. METHODS: Using 2005 and 2007 data from the New York City Youth Risk Behavior Survey (N=17,220), this study examined the prevalence of early sex among public high school students; associations between early sex and other sexual risk factors and violence indicators; and whether associations varied across 4 racial/ethnic groups. Bivariate and multiple logistic regression models estimated the relationship between sexual risk and violence outcomes and "early sex," defined as first having sexual intercourse before age 14. Separate models with an interaction term for early sex by race/ethnicity were also estimated. RESULTS: More than one third of students who ever had sex reported having early sex. Adolescents reporting early sex were significantly more likely than those reporting later sex to engage in most sexual risk behaviors and to experience violence. The magnitude of association varied significantly by race/ethnicity for sexual risk behaviors. CONCLUSIONS: The high prevalence of early sex, coupled with its associated high-risk behaviors and outcomes, underscores the necessity of implementing evidence-based interventions that have been found to positively impact these behaviors beginning in middle school. © 2013, American School Health Association.


Zgoba K.,Research and Evaluation Unit | Veysey B.M.,Rutgers University | Dalessandro M.,Rutgers University
Justice Quarterly | Year: 2010

This research measures group differences in recidivism before and after implementation of Megan's Law. The pre-post study consists of a total of 550 male sex offenders released during the years 1990 and 2000, of which 250 offenders were released during 1990 and 1994 (i.e., the pre-Megan's Law group) and 300 offenders were released between 1995 and 2000 (i.e., the post-Megan's Law group). Offenders were released from a general population setting and a sex offender specific treatment facility. The main variables of concern include: (1) recidivism levels, (2) days to first re-arrest, and (3) level of harm (i.e., number of sex offenses, violent offenses, and number of child victims). Statistical findings from chi-square and survival analysis testing indicate significant group differences on levels of general recidivism; however, no significant differences were identified on measures of sex offense recidivism. Implications of these findings on sex offender specific policies are discussed. © 2010 Academy of Criminal Justice Sciences.


Banks N.,Research and Evaluation Unit | Roy M.,University of Manchester | Hulme D.,University of Manchester
Environment and Urbanization | Year: 2011

In Bangladesh, urban poverty is neglected in research, policy and action on poverty reduction. This paper explores the underlying reasons for this relative neglect, which include national identity and image, the political economy of urban poverty and the structuring of knowledge creation. It argues for more comprehensive policy and programmes for the urban poor given Bangladesh's increasingly urban future and the growing magnitude of urban poverty. The impact of climate change will accelerate Bangladesh's ongoing urbanization as well as deepen the scale and severity of urban poverty. The fact that reducing urban poverty will be increasingly important in meeting national goals for poverty reduction means that policy and action must pay more attention to the urban poor. This is contingent upon two factors: first, a better understanding of the scale and nature of urban poverty and vulnerability; and second, the confrontation of powerful interests necessary to secure a national commitment to urban poverty reduction. © 2011 International Institute for Environment and Development (IIED).


Verhoeven M.,University Utrecht | Sawyer M.G.,Research and Evaluation Unit | Spence S.H.,Griffith University
Journal of Adolescence | Year: 2013

This study examined the factorial invariance of the Center for Epidemiologic Studies of Depression Scale (CES-D) across gender and time during adolescence. The factor structure of the CES-D was compared at four annual measurement waves in a community sample of 2650 Australian adolescents. Confirmatory factor analyses showed that the factor structure of the CES-D was generally invariant across gender and time. However, gender differences were found on three items: for all waves the item 'I had crying spells' was a stronger indicator for depressive affect in females than males. On the final three waves the item 'people were unfriendly' loaded significantly higher on the factor 'Interpersonal Relations' for males than females. On Wave 2 and 3 males interpreted the item 'everything I did was an effort' with a positive connotation, whereas females interpret it with a negative association. These gender-differences are discussed from both a theoretical and a methodological perspective. © 2012 The Foundation for Professionals in Services for Adolescents.


Benson J.,Research and Evaluation Unit | Andersen K.,Research and Evaluation Unit | Samandari G.,Research and Evaluation Unit
Reproductive Health | Year: 2011

Unsafe abortion is a significant contributor to worldwide maternal mortality; however, abortion law and policy liberalization could lead to drops in unsafe abortion and related deaths. This review provides an analysis of changes in abortion mortality in three countries where significant policy reform and related service delivery occurred. Drawing on peer-reviewed literature, population data and grey literature on programs and policies, this paper demonstrates the policy and program changes that led to declines in abortion-related mortality in Romania, South Africa and Bangladesh. In all three countries, abortion policy liberalization was followed by implementation of safe abortion services and other reproductive health interventions. South Africa and Bangladesh trained mid-level providers to offer safe abortion and menstrual regulation services, respectively, Romania improved contraceptive policies and services, and Bangladesh made advances in emergency obstetric care and family planning. The findings point to the importance of multi-faceted and complementary reproductive health reforms in successful implementation of abortion policy reform. © 2011 Benson et al; licensee BioMed Central Ltd.


Penkunas M.J.,Research and Evaluation Unit | Hahn-Smith S.,Research and Evaluation Unit
Journal of Behavioral Health Services and Research | Year: 2015

IMPACT (Improving Mood—Promoting Access to Collaborative Treatment) has a large body of evidence demonstrating its effectiveness for treating late-life depression in clients enrolled in a clinical research study, but little is known about how well the collaborative care model translates into treatment provided in a public mental health setting. This evaluation examines the influence of clinical and demographic characteristics in 112 older adults treated for late-life depression through publicly funded IMPACT in a large San Francisco Bay Area county. Depression severity decreased for 85% of clients between enrollment and treatments’ end and 46% of clients realized a 50% reduction in symptom severity. Depression severity at enrollment, number of treatment sessions attended, ethnicity, and gender reliably predicted depression severity at the end of treatment. Men, clients attending more therapy sessions, and clients without substance abuse diagnoses had an increased likelihood of realizing a 50% reduction in symptoms. Results highlight the success of this evidence-based treatment program offered through the public mental health system but suggest that the demographic and clinical characteristics of the population being treated must be considered when adopting evidence-based practices. © 2013, National Council for Behavioral Health.


Tewksbury R.,University of Louisville | Zgoba K.M.,Research and Evaluation Unit
International Journal of Offender Therapy and Comparative Criminology | Year: 2010

This study examines how registered sex offenders (RSOs) experience, respond to, and attribute stress regarding sex offender registration and notification process and policies. In addition, the frequency and reasons for Internet access is assessed, with a focus on how new legislation in New Jersey (P.L. 2007, C.219) limits or blocks such access. Drawing on survey data from a random sample of 1,000 RSOs in New Jersey, responses from 107 RSOs show significant levels of stress, significant losses due to restrictions on Internet access, and coping methods associated with higher and lower stress levels. The most significant loss reported by the sample related to employment search difficulties. Factors associated with increased levels of stress include using self-distraction for coping and not accepting the situation. Surprisingly, being forced to move because of financial reasons is associated with lower levels of stress. © 2010 SAGE Publications.


Penkunas M.J.,Research and Evaluation Unit | Hahn-Smith S.,Research and Evaluation Unit
Community Mental Health Journal | Year: 2016

This study investigated the demographic and clinical predictors of psychiatric hospitalization during the first 2 years of treatment for adults participating in the full-service partnership (FSP) program, based on Assertive Community Treatment, in a large county in northern California. Clinical and demographic characteristics, data on prior hospitalizations, length of enrollment, and living situation for 328 FSP participants were collected from the county’s internal billing system and the California Department of Health Care Services. In univariate models, the probability of hospitalization varied by diagnosis, age, and hospitalization history. In the multivariate model, younger age and frequent hospitalization prior to enrollment predicted hospitalization during enrollment. Findings support prior research on hospital recidivism and may be beneficial in refining future strategies for meeting the needs of adults with serious mental illness. © 2014, Springer Science+Business Media New York.


Gregson J.,Research and Evaluation Unit
Journal of nutrition education and behavior | Year: 2011

To evaluate the partnership structure of the Network for a Healthy California (Network), a social marketing program, from 2001-2007, to determine if California's program was able to establish and maintain partnerships that (1) provided access to a local audience, (2) facilitated regional collaboration, (3) included new and nontraditional partners, and (4) strengthened regional networks over time, even with significant administrative changes in 2003 and 2006. An outcome evaluation using 5 years of cross-sectional data. Data drawn from annual progress reports. Funded local agencies and regional lead agencies. Regional sociograms offered a visual assessment. Social network statistics (fragmentation and density) were calculated from sociogram data for changes over time. A social network analysis and time-series regression analysis. Sociograms demonstrated that more counties participated, more local agencies worked together, and networks were more integrated in 2007 than in 2001. Increased cohesion of Network partners was demonstrated by decreased fragmentation, and reaching out to new and existing partners was demonstrated by density. The Network developed in a way consistent with program goals. Social network analysis offers great potential for partnership and systems research. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

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