Violence exposure and young people s vulnerability mental

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358 A Clarke et al, CYP s exposure to violence by adults at home either same data set than is usually possible We have maximised. through witnessing or victimisation had medium effect the potential of these data recognising that data collected. sizes range 0 51 0 74 for anxiety symptoms of depres specifically for research purposes would have allowed. sion and lower self esteem compared to CYP not exposed more flexibility and rigour in the analysis. Gunnlaugsson et al 2011 Similarly CYP s exposure to The expanded hypothesis for this study was that in. violence in their own relationships has been associated addition to known associations between domestic and or. with increased rates of anxiety and depressive symptoms relationship violence and mental health physical health. Barter and Stanley 2016 In a meta analysis the effect and health risk behaviours the presence of domestic and or. size for trauma symptoms flashbacks hyperarousal and relationship violence may be a proxy indicator for a wider. withdrawal amongst CYP exposed to violence by adults at set of health vulnerabilities connected with psychological. home either through witnessing or victimisation com and physiological stress responses WHO 2013 family. pared to non exposed was 1 58 Davies et al 2008 Sui disruption or sub optimal care giving environments. cidal ideation amongst CYP that witnessed family violence Shonkoff and Garner 2011 Therefore it was conducted. in the previous year was 11 4 compared to 3 5 amongst without predetermining selected variables to identify the. non witnessing CYP p 0 001 Turner et al 2012 CYP spectrum of health and well being risk experienced by. exposed to parental violence are more likely to be a victim CYP affected by domestic and or relationship violence and. and perpetrator of bullying than non exposed peers Odds spoke to the corresponding research question What are the. ratios for bullying victimisation ranged from 2 6 wit mental and physical health and vulnerability risks experi. nessing to 20 3 victimisation and from 1 8 witnessing enced by CYP in Lancashire affected by domestic and or. to 17 victimisation and risk increased with frequency and relationship violence. severity Lucas et al 2016 CYP reporting being bullied or. cyber bullied were also more likely to be victimised in. their own relationship ORs 2 5 and 3 0 respectively Methods. Peters et al 2017, CYP who witnessed parental partner violence were also A secondary data analysis of the School Health Needs. twice as likely to report poorer general health Helweg Assessment SHNA cross sectional survey of Year 9. Larsen et al 2011 and more likely to have higher body 13 14 years pupils attending secondary schools in two. mass index Gooding et al 2015 Young women exposed local authorities in north west England was performed. to dating violence were more likely to suffer eating dis. orders and sleep disturbances Barter and Stanley 2016 The SHNA survey. and to report greater physical ailments Haynie et al 2013. CYP who witnessed or were victims of family violence The annual SHNA exercise implemented across two local. reported feeling undeserving of attention affection and authorities by school nursing teams since 2011 included all. suspicious of others intentions Calvete et al 2018 primary and secondary schools covered by Lancashire Care. Similarly young adults who witnessed parental violence NHS Foundation Trust approximately 500 It is designed. were distrustful felt unsafe van Rosmalen Nooijens et al to assess and respond to the individual and collective health. 2017 and less likely to seek professional help Lepisto rights and needs of CYP The process draws together data. et al 2010 and intelligence from existing public health sources school. The data source for this study is an annual school health leaderships and CYP The collated intelligence provides a. needs assessment undertaken in the north west of England meaningful understanding of health needs and priorities in. This is a unique data set as neither schools nor health each school community Anonymised survey data aggre. services in the UK are required to undertake health needs gated to larger populations are used to inform service. assessments of this type or coverage The data are pri design public health planning policymaking and decision. marily collected to inform service provision and local making. public health policy across localities and within individual. schools and supports clinical care to individual pupils In Sample. this study CYP s potential vulnerability from violence in. their domestic family and dating relationships was col All pupils in Year 9 13 14 years attending government. lapsed into one category and termed domestic and or high schools covered by health services from Lancashire. relationship violence Care NHS Trust were considered eligible The sampling. Despite not primarily being a research tool the breadth frame was 13 557 pupils and surveys undertaken between. of topics covered in the survey allows for a wider range of September 2016 and December 2017 were included for. health and well being outcomes to be analysed within the analysis. Violence exposure and young people s vulnerability mental and physical health 359. Recruitment Data analysis, School nurses attended special assemblies to explain verbally The data set was exported and analysed in IBM SPSS. and via written age appropriate information about the pur version 24 0 Frequencies for demographic variables were. pose of the survey Pupil s participation was voluntary with obtained and chi squared tests were used to ascertain. reassurance of no penalty for non participation Pupils were whether CYP s report of being affected by domestic and or. assured that individual information would not be shared with relationship violence differed between demographic groups. school without their permission and would be held in their Table 1 Logistic regression was used for analyses of all. confidential health service records but that anonymised data outcomes with CYP s report of being affected by domestic. would be shared with schools and public health planners and or relationship violence as the predictor variable of. interest and regression outcomes defined as a positive or a. Data collection negative health outcome Negative outcomes indicators. are those that would be considered to have a negative. The survey was initially constructed as a composite tool using impact on CYP s health and well being Table 2 Each. questions drawn from validated questionnaires such as the regression was adjusted for gender and ethnicity separately. Global Student School based Health Survey WHO 2003 the as well as allowing for possible statistical interaction. WHO Multi country Study on Women s Health and Domestic between gender and ethnic group Sensitivity analysis to. Violence against Women WHO 2005 the Strengths and assess whether missing survey answers relating to domestic. Difficulties Questionnaire Goodman et al 1998 and tools and or relationship violence affected the findings con. used commonly by non governmental organisations Local cluded them to be missing at random and those estimates. testing and contextualisation of new questions were under of odds ratios obtained in the main analysis have little bias. taken where existing and appropriate questions could not be. found These were matched to fields of enquiry determined by Ethics and governance. domains of the UK Government s Healthy Child Programme. DH 2009 Every Child Matters agenda DfES 2003 and Favourable ethical opinion for the secondary data analysis. priorities of school age service users Survey tools and pro was granted by the University of Central Lancashire Sci. cesses have been subject to annual multi stakeholder review ence Technology Engineering Medicine and Health ethics. for the previous 6 years resulting in further refinements and committee Reference STEMH864 It was asserted that. revisions in framing and content To optimise the tool for most 13 14 year olds would be competent to decide whether. readability advice was sought with regards to the format to participate or not if provided with sufficient appropriate. paper colour type face and font size to reduce barriers for information Based on Articles of the UN Convention on the. CYP with dyslexia Rights of the Child it was concluded that Year 9 pupils were. The self reporting survey questionnaire collected named the primary rights holders over that decision and that par. data about gender ethnicity sexual and gender identity ental consent for survey participation was not sought. with thirty questions 49 items 38 binary 4 Likert scale Therefore pupils determined their own participation with. 2 multiple choice and 5 open text about mental and the exception of pupils who required additional attention. physical health access and experience of health care from school nurses to gain competence or parental consent. healthy and risk behaviours vulnerabilities and sexual and where competence could not be achieved. reproductive health Sociodemographic data about family. structure or socioeconomic status were not collected. Question 17 of the survey Have you ever been affected by Results. domestic abuse violence including physical or emotional. abuse in your family or other relationships is the pre Results are presented in line with our hypothesis that CYP. dictor variable of interest for this analysis in Lancashire affected by domestic and or relationship. School nurses distributed the survey in classrooms and violence will report greater levels of mental health phys. remained during completion to address any questions about ical health and health risk vulnerabilities. participation or survey questions Completed surveys were. returned to school nurse offices where they were reviewed to Response rate and prevalence. identify pupils requiring follow up and the data were entered. into pupil s health records Anonymised data were entered A total of 9626 Year 9 pupils responded equating to 71 of. into a web based database and collated in a password pro eligible Year 9 pupils Of the 9626 responses received. tected Excel spreadsheet 9273 provided information for the domestic and or. 360 A Clarke et al, Table 1 Demographic frequencies of young people participating in Asian British had the lowest reported prevalence rate. Lancashire School Health Needs Assessment survey England 4 5 followed by students identifying as White 7 4. September 2016 to December 2017,Mixed 9 and Black or Black British 10 3.
Affected by n in Chi squared CYP who reported being affected by domestic and or. domestic and or categorya test relationship violence had significantly poorer health and. relationship violence, well being across multiple domains in comparison with. Male 5 6 4623 v2 2 20 97 CYP not affected Table 2,Female 7 8 4527 p 0 001. Other gender 15 4 26 Mental health,Total 9176, Cisgenderb 6 5 6352 v2 1 7 70 CYP affected by domestic and or relationship violence. Non cisgender 13 3 105 p 0 006 report poorer mental health states than non affected CYP. Total 6457 CYP affected by domestic and or relationship violence. White 7 4 6560 v2 3 27 35 were six times more likely to not feel happy OR 6 02 95. Mixed 9 0 289 p 0 001 CI 4 88 7 46 and nearly five times more likely to feel. Asian or Asian 4 5 2246 lonely OR 4 85 95 CI 4 03 5 85 They were also more. British likely to feel angry OR 3 50 95 CI 2 92 4 20 less. Black or Black 10 3 68 hopeful about their future OR 3 02 95 CI 2 50 3 65. British and to have negative perceptions about their body weight. Total 9163 OR 2 22 95 CI 1 87 2 63 Affected CYP were also. Straight 6 2 8628 v2 3 89 39 nearly six times OR 5 88 95 CI 4 88 7 09 more likely. Gay lesbian 11 7 60 p 0 001 to undertake acts of deliberate self harm. Bisexual 21 1 209 Greater experience of bullying as victim or perpetrator. Other 15 3 118 was associated with being affected by domestic and or. Total 9015 relationship violence Affected CYP were four times more. 9273 reported information for the violence variable the category. likely to experience cyber bullying OR 4 00 95 CI, total reflects the missing values within that category 3 30 4 83 more likely to have been bullied OR 3 76. Cisgender a person who self identifies their gender as that of their 95 CI 3 10 4 57 or taken part in bullying OR 3 8 95. birth sex CI 2 81 5 15 and were less likely to know how to get help. about bullying OR 2 13 95 CI 1 64 2 78, relationship violence variable with 353 missing values In Physical health.
total 4623 participants were identified as male 4527 as. female and 26 as other 628 6 8 pupils reported that CYP affected by domestic and or relationship violence. they had been affected by domestic and or relationship reported poorer general health and well being states More. violence and all chi squared tests showed significance reported having enduring health conditions that needed. Table 1 shows demographic frequencies for pupils affected regular health support OR 1 65 95 CI 1 35 2 01 and. by domestic and or relationship violence poorer oral care and diet they were less likely to brush. There were prevalence differences across demographic their teeth twice daily OR 2 19 95 CI 1 71 2 79 and. variables of gender gender identity ethnicity and sexual have regular dental care OR 2 48 95 CI 1 72 3 56. identity of being affected by domestic and or relationship They reported not eating as regularly breakfast dinner and. violence More girls than boys 7 8 and 5 6 respec tea evening meal the previous day OR 2 53 95 CI. Violence exposure and young people s vulnerability mental and physical health Andrew Clarke1 4 Philippa Olive2 Naseerah Akooji3 Karen Whittaker2 Received 12 July 2019 Revised 4 February 2020 Accepted 10 February 2020 Published online 18 February 2020 The Author s 2020 Abstract Objectives To analyse the impact of being affected by domestic and or relationship violence in

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