Papers by Susan Tortolero
Journal of School Health, 2013
Whereas dating violence among high school students has been linked with sexual risk-taking and su... more Whereas dating violence among high school students has been linked with sexual risk-taking and substance use, this association has been understudied among early adolescents. We estimated the prevalence of physical and nonphysical dating violence in a sample of middle school students and examined associations between dating violence, sexual, and substance use behaviors. Logistic regression models for clustered data from 7th grade students attending 10 Texas urban middle schools were used to examine cross-sectional associations between dating violence victimization and risk behaviors. The sample (N = 950) was 48.5% African American, 36.0% Hispanic, 55.7% female, mean age 13.1 years (SD 0.64). About 1 in 5 reported physical dating violence victimization, 48.1% reported nonphysical victimization, and 52.6% reported any victimization. Adjusted logistic regression analyses indicated that physical, nonphysical, and any victimization was associated with ever having sex, ever using alcohol, and ever using drugs. Over 50% of sampled middle school students had experienced dating violence, which may be associated with early sexual initiation and substance use. Middle school interventions that prevent dating violence are needed.
Bookmarks Related papers MentionsView impact
ABSTRACT. Background. Adolescents in the United States are engaging in sexual activity at early a... more ABSTRACT. Background. Adolescents in the United States are engaging in sexual activity at early ages and with multiple partners. The mass media have been shown to affect a broad range of adolescent health-re- lated attitudes and behaviors including violence, eating disorders, and tobacco and alcohol use. One largely un- explored factor that may contribute to adolescents’ sexual activity is their
Bookmarks Related papers MentionsView impact
BACKGROUND: The teen birth rate in Texas is among the highest in the nation, yet sex education in... more BACKGROUND: The teen birth rate in Texas is among the highest in the nation, yet sex education in public schools remains a contentious political issue for most school districts. The University of Texas Prevention Research Center (UTPRC) has embarked on a concerted effort to promote adolescent sexual health in public schools in Harris County following the principles of community-based participatory research. The We Can Do More (WCDM) campaign has used statistics and imagery to define the issue and to mobilize teachers, parents, and administrators to adopt evidence-based programs for sex education in local schools. METHOD: We employed a longitudinal case study research design to examine the dialogic processes through which school districts reached a decision about the development of a sex education policy and the adoption of specific curricula. Our methods included participant observation of school health advisory council and school board meetings in 2009 and 2010 (n = 42); we also co...
Bookmarks Related papers MentionsView impact
Teen birth rates and teen pregnancy prevention strategies vary widely across individual states in... more Teen birth rates and teen pregnancy prevention strategies vary widely across individual states in the US, which has the highest overall teen birth rate among developed nations. California and Texas, the two most populous states currently accounting for a quarter of all teen births, have taken very different approaches to addressing adolescent reproductive health. This case study examines the racial/ethnic composition and socioeconomic factors of these two states from 1981 to 2008. State programs and policies implemented between 1991 and 2008 as well as changes in access to contraception and public–private partnerships are discussed. Based on the lessons learned from California, a similar multifaceted campaign in Texas may be effective in reducing teen births.
Bookmarks Related papers MentionsView impact
Sex Education
This study examined parental monitoring (PM) as a potential moderator of the relation between par... more This study examined parental monitoring (PM) as a potential moderator of the relation between parent–child communication (PCC) and pre-coital sexual behaviours (PCSB) in an urban, minority, early adolescent population. Seventh-grade students (n = 1609) reported PCC, PM and PCSB. Multivariable logistic regression was conducted to assess for moderation. PM moderated the association between PCC and PCSB. Specifically, young people reporting both high PCC and high PM had the lowest odds of PCSB. Findings suggest that PCC is more protective in combination with high PM. However, young people reporting low levels of PM had an increased probability of PCSB with higher levels of PCC. No moderating effect between PCC, PM and PCSB was found by race/ethnicity or gender. However, race/ethnicity was found to moderate the effect of PCC on PCSB. This knowledge highlights the protective role of parental factors on PCSB and may inform the development of more effective parent-based adolescent sexual h...
Bookmarks Related papers MentionsView impact
Technological Developments in Education and Automation, 2009
E-learning applications are becoming ubiquitous in the classroom. However, they are more commonly... more E-learning applications are becoming ubiquitous in the classroom. However, they are more commonly implemented within the context of flat, 2D content presentation and testing. In some cases an immersive, 3D learning environment may be more compelling, yet implementation of these systems is often costly and resource-intensive, requiring high-cost development tools and hard to find skill sets. This paper describes a
Bookmarks Related papers MentionsView impact
American Journal of Public Health, 2014
We examined whether It&am... more We examined whether It's Your Game . . . Keep It Real (IYG) reduced dating violence among ethnic-minority middle school youths, a population at high risk for dating violence. We analyzed data from 766 predominantly ethnic-minority students from 10 middle schools in southeast Texas in 2004 for a group randomized trial of IYG. We estimated logistic regression models, and the primary outcome was emotional and physical dating violence perpetration and victimization by ninth grade. Control students had significantly higher odds of physical dating violence victimization (adjusted odds ratio [AOR] = 1.52; 95% confidence interval [CI] = 1.20, 1.92), emotional dating violence victimization (AOR = 1.74; 95% CI = 1.36, 2.24), and emotional dating violence perpetration (AOR = 1.58; 95% CI = 1.11, 2.26) than did intervention students. The odds of physical dating violence perpetration were not significantly different between the 2 groups. Program effects varied by gender and race/ethnicity. IYG significantly reduced 3 of 4 dating violence outcomes among ethnic-minority middle school youths. Although further study is warranted to determine if IYG should be widely disseminated to prevent dating violence, it is one of only a handful of school-based programs that are effective in reducing adolescent dating violence behavior.
Bookmarks Related papers MentionsView impact
Games for Health Journal, 2015
Sexual health discussions between parents and their preadolescent youth can delay sexual debut an... more Sexual health discussions between parents and their preadolescent youth can delay sexual debut and increase condom and contraceptive use. However, parents frequently report being uncomfortable talking with their youth about sex, often reporting a lack of self-efficacy and skills to inform and motivate responsible decision making by youth. Intergenerational games may support parent-youth sexual health communication. The purpose of this study was to explore parent and youth perspectives on a proposed intergenerational game designed to increase effective parent-youth sexual health communication and skills training. Eight focus groups were conducted: four with parents (n=20) and four with their 11-14-year-old youth (n=19), to identify similarities and differences in perspectives on gaming context, delivery channel, content, and design (components, features, and function) that might facilitate dyadic sexual health communication. Participants concurred that a sex education game could improve communication while being responsive to family time constraints. They affirmed the demand for an immersive story-based educational adventure game using mobile platforms and flexible communication modalities. Emergent themes informed the development of a features inventory (including educational and gaming strategies, communication components, channel, and setting) and upper-level program flow to guide future game development. This study supports the potential of a game to be a viable medium to bring a shared dyadic sexual health educational experience to parents and youth that could engage them in a motivationally appealing way to meaningfully impact their sexual health communication and youth sexual risk behaviors.
Bookmarks Related papers MentionsView impact
Cyberpsychology, Behavior, and Social Networking, 2014
Most studies on the impact of playing violent video games on mental health have focused on aggres... more Most studies on the impact of playing violent video games on mental health have focused on aggression. Relatively few studies have examined the relationship between playing violent video games and depression, especially among preadolescent youth. In this study, we investigated whether daily violent video game playing over the past year is associated with a greater number of depressive symptoms among preadolescent youth, after controlling for several well-known correlates of depression among youth. We analyzed cross-sectional data collected from 5,147 fifth-grade students and their primary caregivers who participated in Wave I (2004-2006) of Healthy Passages, a community-based longitudinal study conducted in three U.S. cities. Linear regression was conducted to determine the association between violent video game exposure and number of depressive symptoms, while controlling for gender, race/ethnicity, peer victimization, witnessing violence, being threatened with violence, aggression, family structure, and household income level. We found that students who reported playing high-violence video games for ≥2 hours per day had significantly more depressive symptoms than those who reported playing low-violence video games for <2 hours per day (p<0.001). The magnitude of this association was small (Cohen's d=0.16), but this association was consistent across all racial/ethnic subgroups and among boys (Cohen's d values ranged from 0.12 to 0.25). Our findings indicate that there is an association between daily exposure to violent video games and number of depressive symptoms among preadolescent youth. More research is needed to examine this association and, if confirmed, to investigate its causality, persistence over time, underlying mechanisms, and clinical implications.
Bookmarks Related papers MentionsView impact
Background: The application of technology for adolescent sexual health education is increasing, t... more Background: The application of technology for adolescent sexual health education is increasing, though few studies have examined the use of health games for HIV/STI and pregnancy prevention and less still that focus on parent-child communication. The Secret of Seven Stones (SSS) is a home-based online adventure game designed to transcend the “sex talk” to engage parents and youth (11-14 yrs.) in a developmentally appropriate HIV, STI, and pregnancy prevention educational experience. Purpose: To describe game development, functionality, and prototype usability testing results. Methods: A stepped development process (Intervention Mapping) guided the application of behavioral theory, empiric data, and qualitative (focus group and semi-structured interview) needs assessment from a collaborative parent-youth advisory group. Design documents and an SSS prototype level were developed. Usability tests were conducted using “talk aloud” and rating (survey) protocols with youth (n=6) under lab...
Bookmarks Related papers MentionsView impact
Pediatrics, 2014
Despite epidemic childhood obesity levels, we know little about how BMI changes from preadolescen... more Despite epidemic childhood obesity levels, we know little about how BMI changes from preadolescence to adolescence and what factors influence changes. We studied 3961 randomly selected public school students and 1 parent per student in 3 US metropolitan areas in fifth and again in tenth grades. In each grade, we measured child and parent height/weight and calculated BMI category. We examined whether baseline sociodemographic characteristics, child health-related factors, and parental obesity were significantly associated with exit from and entry into obesity from fifth to tenth grade. Fifth- and tenth-graders were 1%/2% underweight, 53%/60% normal weight, 19%/18% overweight, and 26%/20% obese, respectively. Among obese tenth-graders, 83% had been obese as fifth-graders and 13% had been overweight. Sixty-five percent of obese fifth-graders remained obese as tenth-graders, and 23% transitioned to overweight. Multivariately, obese fifth-graders who perceived themselves to be much heavi...
Bookmarks Related papers MentionsView impact
AIDS Research and Treatment, 2012
Bookmarks Related papers MentionsView impact
Journal of abnormal child psychology, Jan 20, 2014
The extent to which risk profiles or correlates of conduct disorder (CD) and oppositional defiant... more The extent to which risk profiles or correlates of conduct disorder (CD) and oppositional defiant disorder (ODD) symptoms overlap among youth continues to be debated. Cross-sectional data from a large, representative community sample (N = 4,705) of African-American, Latino, and White fifth graders were used to examine overlap in correlates of CD and ODD symptoms. About 49 % of the children were boys. Analyses were conducted using negative binomial regression models, accounting for several confounding factors (e.g., attention deficit/hyperactivity disorder symptoms), sampling weights, stratification, and clustering. Results indicated that CD and ODD symptoms had very similar correlates. In addition to previously established correlates, several social skills dimensions were significantly related to ODD and CD symptoms, even after controlling for other correlates. In contrast, temperamental dimensions were not significantly related to CD and ODD symptoms, possibly because more proximal...
Bookmarks Related papers MentionsView impact
Early sexual initiation is associated with increased risk of unintended pregnancy and sexually tr... more Early sexual initiation is associated with increased risk of unintended pregnancy and sexually transmitted infection(STI). Effective HIV/STI/pregnancy prevention interventions for middle school youth are urgently needed. "It's Your Game, Keep It Real" (IYG) is a curriculum delivered in 7th and 8th grade that combines classroom activities with individualized, tailored computer-based activities embedded in a 'virtual world' environment. Interactive multimedia can offer a confidential, tailored, and motivational educational experience. Virtual world game interfaces offer further potential to immerse the learner. The purpose of this study was to evaluate the multimedia education program component of IYG on student attitudes of importance of the curriculum content, self-efficacy regarding refusal skills, and usability parameters of ease of use, credibility, understandability, acceptability, and motivation to determine that a broader efficacy field test would be indicated. Results of the study indicated acceptable usability criteria and impact on short-term psychosocial outcomes. IYG is currently being evaluated in a randomized controlled trial in ten Texas middle schools.
Bookmarks Related papers MentionsView impact
Annals of Epidemiology, 2007
Bookmarks Related papers MentionsView impact
Creative Education, 2014
Bookmarks Related papers MentionsView impact
Women's Health Issues, 1999
Bookmarks Related papers MentionsView impact
PsycTESTS Dataset, 2000
Bookmarks Related papers MentionsView impact
Background: HIV, sexually transmitted infections (STIs), and pregnancy are significant public hea... more Background: HIV, sexually transmitted infections (STIs), and pregnancy are significant public health problems among U.S. youth. Some effective programs exist to delay sex among middle school students; yet, the requirement for instructor facilitation and training costs can compromise their wide-scale, high fidelity dissemination. A completely computer-based program may help increase dissemination. Methods: It’s Your Game (IYG)-Tech, a 13-lesson computer-based program, was developed and evaluated in a randomized controlled trial in 19 Southeast Texas middle schools. A-CASI surveys were administered before the program was implemented (in 8th grade) and one year later. Sexual behavior and psychosocial variables were measured. Results: The analytic sample (n=1374) was 59% female, 17.3% Black, 73.7% Hispanic, mean age was 14.32 (SD=0.59). Intervention students reported greater STI/condom knowledge, more positive beliefs and norms about abstinence, and greater condom use self-efficacy than...
Bookmarks Related papers MentionsView impact
Pediatric Asthma, Allergy & Immunology, 2001
Bookmarks Related papers MentionsView impact
Uploads
Papers by Susan Tortolero