Background: Intimate partner violence against women (IPV) and violence against children (VAC) are both global epidemics with long-term health consequences. The vast majority of research to date focuses on either IPV or VAC, however the intersections between these types of violence are a growing area of global attention. A significant need exists for empirical research on the overlap of IPV and VAC, especially in contexts with particularly high rates of both types of violence. Methods: This exploratory study includes secondary analysis of data from a cluster randomized controlled trial in Ugandan schools. Using baseline reports from a random sample of early adolescents attending school and their caregivers, this study uses a probability sample across all eligible schools of adolescent-caregiver dyads (n = 535). We categorized adolescent-caregiver dyads into four groups: those reporting VAC 'only', IPV 'only', both VAC and IPV, or 'no violence'. Two separate multinomial logistic regression models for male and female caregivers explored adolescent and caregiver characteristics associated with the VAC 'only', the IPV 'only', or the both VAC and IPV dyads, each compared to the 'no violence' dyad. Results: One third of dyads reported both IPV and VAC and nearly 75% of dyads reported VAC or IPV. Dyads reporting IPV were more likely to also report VAC. Common contributing factors for female caregiver-adolescent dyads with both VAC and IPV include lower SES, less caregiver education, higher caregiver mental distress, more frequent caregiver alcohol use, and caregivers who report less emotional attachment to their intimate partner. Male caregiver-adolescent dyads with both VAC and IPV included caregivers with less emotional attachment to their intimate partner and more attitudes accepting VAC. Conclusions: Findings reveal a significant overlap of IPV and VAC and the importance for violence prevention and response programming to consider coordinated or integrated programming. Unique results for female and male caregivers highlight the importance of a gendered approach to addressing IPV and VAC intersections. Trial registration: The trial was registered at clinicaltrials.gov, NCT01678846, on September 5, 2012.

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Background An electronic personal health record (ePHR), also known as a personal health record (PHR), has been broadly defined as an electronic application through which individuals can access, manage, and share their health information in a secure and confidential environment. Although ePHRs can benefit individuals as well as caregivers and health care providers, the use of ePHRs among individuals continues to remain low. Objective The current study aims to examine the relationship between human-technology interaction factors and ePHR use among adults and then to compare the different effects of human-technology interaction factors on ePHR use between younger adults (18-54 years old) and older adults (55 years of age and over). Methods We analyzed data from the Health Information National Trends Survey (HINTS 5 cycle 3) collected from US adults aged 18 years old and over in 2019. Descriptive analysis was conducted for all variables and each item of ePHR use. Bivariate tests (Pearson correlation coefficient for categorical variable and F test for continuous variables) were conducted over 2 age groups. Finally, after adjustments were made for sociodemographics and health care resources, a weighted multiple linear regression was conducted to examine the relationship between human-technology interaction factors and ePHR use. Results The final sample size of 1363 (average age 51.19) was divided into 2 age groups: 18 to 54 years old and 55 years old and older. The average level of ePHR use was low (mean 2.76, range 0-8). There was no significant difference in average ePHR use between the 2 age groups. Including clinical notes was positively related to ePHR use in both groups: 18 to 54 years old (β=.28, P=.005), 55 years old and older (β=.15, P=.006). Although accessing ePHRs using a smartphone app was only associated with ePHR use among younger adults (β=.29; P<.001), ease of understanding health information in ePHRs was positively linked to ePHR use only among older adults (β=.13; P=.003). Conclusions This study found that including clinical notes was positively related to ePHR use in both age groups, which suggested that including clinical notes as a part of ePHRs might improve the effective use of ePHRs among patients. Moreover, accessing ePHRs using a smartphone app was associated with higher ePHR use among younger adults while ease of understanding health information in ePHRs was linked to higher ePHR use among older adults. The design of ePHRs should provide the option of being accessible through mobile devices to promote greater ePHR use among young people. For older adults, providers could add additional notes to explain the health information recorded in the ePHRs.

Background The vast majority of children and adolescents in low and middle-income countries (LMICs) lack access to interventions for mental health problems. Schools provide a critical platform for evidence-based intervention delivery for young people. However, a significant need exists to understand the implementation context and strategies for delivering school mental health interventions in LMICs. Methods We conducted a focused ethnography to explore students’, teachers’, and caregivers’ perspectives on implementing evidence-based mental health interventions (EBIs) within a widespread violence prevention program in Uganda. Data collection occurred in Kampala, Uganda, using two schools that have previously implemented an evidence-based violence prevention program widely used in Ugandan schools schools, the Good School Toolkit (GST). Trained, local researchers facilitated four focus group discussions (FGDs) with caregivers ( n = 22), four FGDs with teachers ( n = 25), and in-depth interviews with primary school students ( n = 12). Verbatim transcripts were analyzed using a framework analysis approach. Results Participants revealed a school culture that promotes schools’ responsibility to students beyond academics, including positive teacher–student relationships. Participants recommended an implementation process that trains teachers and students in screening and referral, peer group delivery, and is accompanied by a school-wide approach to stigma reduction and mental health literacy. Participants fundamentally agreed that teachers could be trained as intervention facilitators. Conclusions This study highlights the potential advantage of leveraging an existing intervention that already addresses implementation factors, such as school culture, as a fertile platform for implementing interventions for child and adolescent mental health in LMICs. Plain language abstract Despite the growth of implementation research for child and adolescent mental health, the study of implementation science for child and adolescent mental health in low and middle-income countries (LMICs) remains scarce. Schools provide a critical platform for evidence-based intervention delivery for young people. However, a significant need exists to understand the implementation context and strategies for delivering school mental health interventions in LMICs. This study provides rich qualitative data describing the context and influences for the successful implementation of mental health interventions in LMIC schools. We conducted interviews and focus groups with teachers, students, and caregivers to determine their perspectives on implementing evidence-based mental health interventions (EBIs) within a widespread violence prevention program in Uganda. Participants revealed a school culture promoted by the existing program that promotes schools’ responsibility to students beyond academics, including positive teacher–student relationships. Findings suggest the existing program provides fertile ground for the successful implementation of evidence-based mental health interventions in schools.

BACKGROUND An electronic personal health record (ePHR), also known as a personal health record (PHR), was broadly defined as an electronic application through which individuals can access, manage, and share their health information in a secure and confidential environment. Although ePHRs can benefit individuals as well as caregivers and healthcare providers, the use of ePHRs among individuals continues to remain low. The relationship between age and ePHRs use has been documented in previous studies, which indicated younger age was related to higher ePHRs use, and patients who are younger were more likely to use ePHRs. OBJECTIVE The current study aims to examine the relationship between human-technology interaction factors and ePHRs use among adults, and then compare the different effects of human-technology interaction factors on ePHRs use between younger adults (18-54 years old) and older adults (55 years of age and over). METHODS We analyzed the from the Health Information National Trends Survey (HINTS5, Cycle 3) collected from U.S. adults aged 18 years old and over in 2019. Descriptive analysis was conducted for all variables and each item of ePHRs use. Bivariate tests (Pearson test for categorical variable and F-test for continuous variables) were conducted over four age groups. Lastly, adjusting for socio-demographics and healthcare resources, a weighted multiple linear regression was conducted to examine the relationship between human-technology interaction factors and ePHRs use. RESULTS The final sample size was 1,363 and divided into two age groups: 18-54 years old and 55 years of age and older. The average level of ePHRs use was low (Mean=2.76, range=0-8). There is no significant difference on average ePHRs use between two age groups. Including clinical notes was positively related to ePHRs use in both groups: 18-54 years old (beta=0.28, P<0.01), 55 years old and above (beta=0.15, P<0.01). While accessing ePHRs using a smartphone app was only associated with ePHRs use among younger adults (beta=0.29, P<0.001), ease to understand health information in ePHRs was positively linked to ePHRs use only among older adults (beta=0.13, P<0.01). CONCLUSIONS This study found that including clinical notes was positively related to ePHRs use in both age groups, which suggested that including clinical notes as a part of ePHRs might improve the effective use of ePHRs among patients. Moreover, accessing ePHRs using a smartphone app was associated with higher ePHRs use among younger adults while ease of understanding health information in ePHRs was linked to higher ePHRs use among older adults. The design of ePHRs should provide the option of being accessible through mobile devices to promote greater ePHRs use among young people. For older adults, providers could add additional notes to explain health information recorded in the ePHRs.