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• 1. [Article] Conceptualization of Autism in the Latino Community and its Relationship with Early Diagnosis

  Objective—Early identification of autism spectrum disorders (ASD) has been linked to improved long-term developmental outcomes. However, Latino children are diagnosed later than white non- Latino children. ...

  Citation × Citation Citation Abstract Copy Title: Conceptualization of Autism in the Latino Community and its Relationship with Early Diagnosis Author: Zuckerman, Katharine E., Sinche, Brianna, Cobian, Martiza, Cervantes, Marlene, Mejia, Angie, Becker, Thomas, Nicolaidis, Christina Year: 2014 Objective—Early identification of autism spectrum disorders (ASD) has been linked to improved long-term developmental outcomes. However, Latino children are diagnosed later than white non- Latino children. We aimed to qualitatively assess the understanding and conceptualization of ASD in the Latino community in order to understand potential community barriers to early diagnosis. Method—We conducted 5 focus groups and 4 qualitative interviews with 30 parents of typicallydeveloping Latino children in Oregon. Participants were asked structured questions concerning video vignettes that follow a Latina mother from the time she begins to worry about her 3-year-old son's behaviors to the time he receives an ASD diagnosis. Focus groups and interviews were audio-recorded, transcribed and independently coded. Coded data were analyzed using thematic analysis. Results—Many Latino families in the study had not heard of ASD or had little information about it. Families sometimes assumed ASD red flags were normal or could be attributed to family dysfunction. Families also had concerns about provider communication and access to language services. Having a child with a developmental delay was associated with embarrassment, rejection, and family burden, making it difficult for parents to raise developmental concerns with providers. Conclusion—Pediatric providers should not assume that Latino parents have heard of ASD or know its symptoms. Providers should be aware that parents may be reluctant to mention concerns due to cultural factors. The health care system needs to improve resources for Latino parents with limited English proficiency. Policies should encourage the use of developmental screening in primary care Title: Conceptualization of Autism in the Latino Community and its Relationship with Early Diagnosis Author: Zuckerman, Katharine E., Sinche, Brianna, Cobian, Martiza, Cervantes, Marlene, Mejia, Angie, Becker, Thomas, Nicolaidis, Christina Year: 2014 Objective—Early identification of autism spectrum disorders (ASD) has been linked to improved long-term developmental outcomes. However, Latino children are diagnosed later than white non- Latino children. We aimed to qualitatively assess the understanding and conceptualization of ASD in the Latino community in order to understand potential community barriers to early diagnosis. Method—We conducted 5 focus groups and 4 qualitative interviews with 30 parents of typicallydeveloping Latino children in Oregon. Participants were asked structured questions concerning video vignettes that follow a Latina mother from the time she begins to worry about her 3-year-old son's behaviors to the time he receives an ASD diagnosis. Focus groups and interviews were audio-recorded, transcribed and independently coded. Coded data were analyzed using thematic analysis. Results—Many Latino families in the study had not heard of ASD or had little information about it. Families sometimes assumed ASD red flags were normal or could be attributed to family dysfunction. Families also had concerns about provider communication and access to language services. Having a child with a developmental delay was associated with embarrassment, rejection, and family burden, making it difficult for parents to raise developmental concerns with providers. Conclusion—Pediatric providers should not assume that Latino parents have heard of ASD or know its symptoms. Providers should be aware that parents may be reluctant to mention concerns due to cultural factors. The health care system needs to improve resources for Latino parents with limited English proficiency. Policies should encourage the use of developmental screening in primary care Close

• 2. [Article] Motivational Interviewing at the Intersections of Depression and Intimate Partner Violence among African American Women

  This article focuses on design, training, and delivery of a culturally-tailored, multi-faceted intervention which used motivational interviewing (MI) and case management to reduce depression severity among ...

  Citation × Citation Citation Abstract Copy Title: Motivational Interviewing at the Intersections of Depression and Intimate Partner Violence among African American Women Author: Wahab, Stéphanie, Trimble, Jammie, Mejia, Angie, Mitchell, S. Renee, Thomas, Mary Jo, Timmons, Vanessa, Waters, A. Star, Raymaker, Dora, Nicolaidis, Christina Year: 2014 This article focuses on design, training, and delivery of a culturally-tailored, multi-faceted intervention which used motivational interviewing (MI) and case management to reduce depression severity among African American survivors of intimate partner violence (IPV). We present the details of the intervention and discuss its implementation as a means of creating and providing culturally appropriate depression and violence services to African American women. We used a CBPR approach to develop and evaluate the multi-faceted intervention. As part of the evaluation, we collected process measures about the use of MI, assessed MI fidelity, and interviewed participants about their experiences with the program. Title: Motivational Interviewing at the Intersections of Depression and Intimate Partner Violence among African American Women Author: Wahab, Stéphanie, Trimble, Jammie, Mejia, Angie, Mitchell, S. Renee, Thomas, Mary Jo, Timmons, Vanessa, Waters, A. Star, Raymaker, Dora, Nicolaidis, Christina Year: 2014 This article focuses on design, training, and delivery of a culturally-tailored, multi-faceted intervention which used motivational interviewing (MI) and case management to reduce depression severity among African American survivors of intimate partner violence (IPV). We present the details of the intervention and discuss its implementation as a means of creating and providing culturally appropriate depression and violence services to African American women. We used a CBPR approach to develop and evaluate the multi-faceted intervention. As part of the evaluation, we collected process measures about the use of MI, assessed MI fidelity, and interviewed participants about their experiences with the program. Close

• 3. [Article] Failure of Intimate Partner Violence Screening Among Patients with Substance Use Disorders

  Objectives: This study examined the relationship between substance use disorder (SUD) and intimate partner violence screening (IPV) and management practices in the emergency department (ED). Methods: This ...

  Citation × Citation Citation Abstract Copy Title: Failure of Intimate Partner Violence Screening Among Patients with Substance Use Disorders Author: Choo, Esther K., Nicolaidis, Christina, Jenkinson, Robert H., Cox, Jessi M., McConnell, Kenneth J. Year: 2010 Objectives: This study examined the relationship between substance use disorder (SUD) and intimate partner violence screening (IPV) and management practices in the emergency department (ED). Methods: This was a retrospective cohort study of adult ED patients presenting to an urban, tertiary care teaching hospital over a 4-month period. An automated electronic data abstraction process identified consecutive patients and retrieved visit characteristics, including results of three violence screening questions, demographic data, triage acuity, time of visit, and ICD-9 diagnosis codes. Data on management were collected using a standardized abstraction tool by two reviewers masked to the study question. Multivariate logistic regression was used to determine predictors of screening and management. Results: In 10,071 visits, 6,563 violence screens were completed. IPV screening was documented in 33.5% of patients with alcohol-related diagnoses (95% CI = 27.7% to 39.3%, ?2 = 116.78, p < 0.001) and 53.3% of patients with drug-related diagnoses (95% CI = 44.3% to 62.3%, ?2 = 7.69, p = 0.006), compared to 66.1% of patients without these diagnoses (95% CI = 65.2% to 67.1%). In the multivariate analysis, alcohol (OR 0.30, 95% CI = 0.22 to 0.40) and drug use (OR 0.56, 95% CI = 0.38 to 0.83) were associated with decreased odds of screening. Of completed screens, 429 (6.5%) were positive, but violence was addressed further in only 55.7% of patients. Substance abuse did not appear to affect the odds of having positive screens addressed further by providers (OR 1.96, 95% CI = 0.39 to 10.14). Conclusions: This study found an association between SUD and decreased odds of IPV screening. Failure to screen for IPV in the setting of substance use may represent a missed opportunity to address a critical health issue, and be a barrier to successful intervention. Title: Failure of Intimate Partner Violence Screening Among Patients with Substance Use Disorders Author: Choo, Esther K., Nicolaidis, Christina, Jenkinson, Robert H., Cox, Jessi M., McConnell, Kenneth J. Year: 2010 Objectives: This study examined the relationship between substance use disorder (SUD) and intimate partner violence screening (IPV) and management practices in the emergency department (ED). Methods: This was a retrospective cohort study of adult ED patients presenting to an urban, tertiary care teaching hospital over a 4-month period. An automated electronic data abstraction process identified consecutive patients and retrieved visit characteristics, including results of three violence screening questions, demographic data, triage acuity, time of visit, and ICD-9 diagnosis codes. Data on management were collected using a standardized abstraction tool by two reviewers masked to the study question. Multivariate logistic regression was used to determine predictors of screening and management. Results: In 10,071 visits, 6,563 violence screens were completed. IPV screening was documented in 33.5% of patients with alcohol-related diagnoses (95% CI = 27.7% to 39.3%, ?2 = 116.78, p < 0.001) and 53.3% of patients with drug-related diagnoses (95% CI = 44.3% to 62.3%, ?2 = 7.69, p = 0.006), compared to 66.1% of patients without these diagnoses (95% CI = 65.2% to 67.1%). In the multivariate analysis, alcohol (OR 0.30, 95% CI = 0.22 to 0.40) and drug use (OR 0.56, 95% CI = 0.38 to 0.83) were associated with decreased odds of screening. Of completed screens, 429 (6.5%) were positive, but violence was addressed further in only 55.7% of patients. Substance abuse did not appear to affect the odds of having positive screens addressed further by providers (OR 1.96, 95% CI = 0.39 to 10.14). Conclusions: This study found an association between SUD and decreased odds of IPV screening. Failure to screen for IPV in the setting of substance use may represent a missed opportunity to address a critical health issue, and be a barrier to successful intervention. Close

• 4. [Article] Lessons about Recruiting Primary Care Practices to Domestic Violence Trainings

  A few studies have evaluated continuing medical education programs on domestic violence, but they have generally used convenience samples and have not provided information regarding their recruitment strategies ...

  Citation × Citation Citation Abstract Copy Title: Lessons about Recruiting Primary Care Practices to Domestic Violence Trainings Author: Winkle, Jim, Nicolaidis, Christina Year: 2005 A few studies have evaluated continuing medical education programs on domestic violence, but they have generally used convenience samples and have not provided information regarding their recruitment strategies or the proportion of eligible providers that attended the interventions. (Davis, Kaups, Campbell, & Parks, 2000; Haney, Kachur, & Zabar, 2003; McCauley, Jenckes, & McNutt, 2003) In one study that did provide such information, investigators faxed invitations to 1887 physicians, of which only 121 (6%) responded that they were interested despite a $50-$100 incentive to participate in a short on-line program with free Continuing Medical Education (CME) credits (Harris, Kutob, Surprenant, Maiuro, & Delate, 2002). We attempted to recruit healthcare workers from all primary care practices in Washington County, Oregon to attend a DV training program. This paper uses our experience to demonstrate the challenges and successes of different strategies and make recommendations for future recruitment efforts. Title: Lessons about Recruiting Primary Care Practices to Domestic Violence Trainings Author: Winkle, Jim, Nicolaidis, Christina Year: 2005 A few studies have evaluated continuing medical education programs on domestic violence, but they have generally used convenience samples and have not provided information regarding their recruitment strategies or the proportion of eligible providers that attended the interventions. (Davis, Kaups, Campbell, & Parks, 2000; Haney, Kachur, & Zabar, 2003; McCauley, Jenckes, & McNutt, 2003) In one study that did provide such information, investigators faxed invitations to 1887 physicians, of which only 121 (6%) responded that they were interested despite a $50-$100 incentive to participate in a short on-line program with free Continuing Medical Education (CME) credits (Harris, Kutob, Surprenant, Maiuro, & Delate, 2002). We attempted to recruit healthcare workers from all primary care practices in Washington County, Oregon to attend a DV training program. This paper uses our experience to demonstrate the challenges and successes of different strategies and make recommendations for future recruitment efforts. Close

• 5. [Article] Collaboration Strategies in Non-Traditional CBPR Partnerships: Lessons from an Academic-Community Partnership with Autistic Self-Advocates

  Background: Most community-based participatory research (CBPR) projects involve local communities defined by race, ethnicity, geography, or occupation. Autistic self-advocates, a geographically dispersed ...

  Citation × Citation Citation Abstract Copy Title: Collaboration Strategies in Non-Traditional CBPR Partnerships: Lessons from an Academic-Community Partnership with Autistic Self-Advocates Author: Nicolaidis, Christina, Raymaker, Dora, McDonald, Katherine, Dern, Sebastian, Ashkenazy, Elesia, Boisclair, Cody, Robertson, Scott, Baggs, Amanda Year: 2011 Background: Most community-based participatory research (CBPR) projects involve local communities defined by race, ethnicity, geography, or occupation. Autistic self-advocates, a geographically dispersed community defined by disability, experience issues in research similar to those expressed by more traditional minorities. Objectives: We sought to build an academic–community partnership that uses CBPR to improve the lives of people on the autistic spectrum. Methods: The Academic Autistic Spectrum Partnership in Research and Education (AASPIRE) includes representatives from academic, self-advocate, family, and professional communities. We are currently conducting several studies about the health care experiences and well-being of autistic adults. Lessons Learned: We have learned a number of strategies that integrate technology and process to successfully equalize power and accommodate diverse communication and collaboration needs. Conclusions: CBPR can be conducted successfully with autistic self-advocates. Our strategies may be useful to other CBPR partnerships, especially ones that cannot meet in person or that include people with diverse communication needs. Title: Collaboration Strategies in Non-Traditional CBPR Partnerships: Lessons from an Academic-Community Partnership with Autistic Self-Advocates Author: Nicolaidis, Christina, Raymaker, Dora, McDonald, Katherine, Dern, Sebastian, Ashkenazy, Elesia, Boisclair, Cody, Robertson, Scott, Baggs, Amanda Year: 2011 Background: Most community-based participatory research (CBPR) projects involve local communities defined by race, ethnicity, geography, or occupation. Autistic self-advocates, a geographically dispersed community defined by disability, experience issues in research similar to those expressed by more traditional minorities. Objectives: We sought to build an academic–community partnership that uses CBPR to improve the lives of people on the autistic spectrum. Methods: The Academic Autistic Spectrum Partnership in Research and Education (AASPIRE) includes representatives from academic, self-advocate, family, and professional communities. We are currently conducting several studies about the health care experiences and well-being of autistic adults. Lessons Learned: We have learned a number of strategies that integrate technology and process to successfully equalize power and accommodate diverse communication and collaboration needs. Conclusions: CBPR can be conducted successfully with autistic self-advocates. Our strategies may be useful to other CBPR partnerships, especially ones that cannot meet in person or that include people with diverse communication needs. Close

• 6. [Article] Association of Childhood Physical and Sexual Abuse with Intimate Partner Violence, Poor General Health and Depressive Symptoms among Pregnant Women

  Objective We examined associations of childhood physical and sexual abuse with risk of intimate partner violence (IPV). We also evaluated the extent to which childhood abuse was associated with self-reported ...

  Citation × Citation Citation Abstract Copy Title: Association of Childhood Physical and Sexual Abuse with Intimate Partner Violence, Poor General Health and Depressive Symptoms among Pregnant Women Author: Barrios, Yasmin V., Gelaye, Bizu, Zhong, Qiuyue, Nicolaidis, Christina, Rondon, Marta B., Garcia, Pedro J., Mascaro Sanchez, Pedro A., Sanchez, Sixto E., Williams, Michelle A. Year: 2015 Objective We examined associations of childhood physical and sexual abuse with risk of intimate partner violence (IPV). We also evaluated the extent to which childhood abuse was associated with self-reported general health status and symptoms of antepartum depression in a cohort of pregnant Peruvian women. Methods In-person interviews were conducted to collect information regarding history of childhood abuse and IPV from 1,521 women during early pregnancy. Antepartum depressive symptomatology was evaluated using the Patient Health Questionnaire-9. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI). Results Any childhood abuse was associated with 2.2-fold increased odds of lifetime IPV (95%CI: 1.72–2.83). Compared with women who reported no childhood abuse, those who reported both, childhood physical and sexual abuse had a 7.14-fold lifetime risk of physical and sexual IPV (95%CI: 4.15–12.26). The odds of experiencing physical and sexual abuse by an intimate partner in the past year was 3.33-fold higher among women with a history of childhood physical and sexual abuse as compared to women who were not abused as children (95%CI 1.60–6.89). Childhood abuse was associated with higher odds of self-reported poor health status during early pregnancy (aOR = 1.32, 95%CI: 1.04–1.68) and with symptoms of antepartum depression (aOR = 2.07, 95%CI: 1.58–2.71). Conclusion These data indicate that childhood sexual and physical abuse is associated with IPV, poor general health and depressive symptoms in early pregnancy. The high prevalence of childhood trauma and its enduring effects of on women’s health warrant concerted global health efforts in preventing violence. Title: Association of Childhood Physical and Sexual Abuse with Intimate Partner Violence, Poor General Health and Depressive Symptoms among Pregnant Women Author: Barrios, Yasmin V., Gelaye, Bizu, Zhong, Qiuyue, Nicolaidis, Christina, Rondon, Marta B., Garcia, Pedro J., Mascaro Sanchez, Pedro A., Sanchez, Sixto E., Williams, Michelle A. Year: 2015 Objective We examined associations of childhood physical and sexual abuse with risk of intimate partner violence (IPV). We also evaluated the extent to which childhood abuse was associated with self-reported general health status and symptoms of antepartum depression in a cohort of pregnant Peruvian women. Methods In-person interviews were conducted to collect information regarding history of childhood abuse and IPV from 1,521 women during early pregnancy. Antepartum depressive symptomatology was evaluated using the Patient Health Questionnaire-9. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI). Results Any childhood abuse was associated with 2.2-fold increased odds of lifetime IPV (95%CI: 1.72–2.83). Compared with women who reported no childhood abuse, those who reported both, childhood physical and sexual abuse had a 7.14-fold lifetime risk of physical and sexual IPV (95%CI: 4.15–12.26). The odds of experiencing physical and sexual abuse by an intimate partner in the past year was 3.33-fold higher among women with a history of childhood physical and sexual abuse as compared to women who were not abused as children (95%CI 1.60–6.89). Childhood abuse was associated with higher odds of self-reported poor health status during early pregnancy (aOR = 1.32, 95%CI: 1.04–1.68) and with symptoms of antepartum depression (aOR = 2.07, 95%CI: 1.58–2.71). Conclusion These data indicate that childhood sexual and physical abuse is associated with IPV, poor general health and depressive symptoms in early pregnancy. The high prevalence of childhood trauma and its enduring effects of on women’s health warrant concerted global health efforts in preventing violence. Close