www.CHIS.ucla.edu

The California Health Interview Survey (CHIS): Dating Violence Reported by Adolescents

Elaine Zahnd, Ph.D.

Senior Research Scientist

CHIS Research Staff

Public Health Institute

Association for Criminal Justice Research (California) Semi-Annual Meeting

Current Trends: Research and Evidence-Based Practice in CaliforniaMarch 30-31, 2006

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California’s Adolescents: A Growing Population

Important to focus on adolescents’ health and safety Our future workforce, parents and teachers Attitudes and health practices developed in adolescence continue

into adulthood and impact adult health problems

Numbers growing dramatically 4 million in 1990 (U.S. Census Bureau, 2000) 4.9 million in 2000 (U.S. Census Bureau, 2000) 23% increase statewide 1 in 8 adolescents in the U.S. lives in California

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California’s Adolescents: A Diverse Population

California’s racial and ethnic profile differs from U.S. Larger Latino and Asian/Pacific Islander population and smaller

White population

U.S. Adolescents, Ages 10-19, 2000

AI/AN-NH1%

Other2%

A/PI-NH4%

Hispanic16%

Black-NH15%

White-NH62%

California Adolescents, Ages 10-19, 2000

Other1%

AI/AN-NH1%

A/PI-NH11%

Black-NH8%

Hispanic41%

White-NH38%

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Reducing intentional injury and violence

Intentional injury and violence affect adolescents’ health and safety

Bullying and threats are increasingly seen as important precursors to violence

Dating violence frequently begins in adolescence Impact can continue into adulthood Previous research demonstrates dating violence is associated with

other risk behaviors, such as risky sexual behaviors, substance use, depression and self-injury (Berenson et al. 2001; Kreiter et al. 1999)

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CHIS Research Questions (1)

What is the prevalence of dating violence in California?

Are those who experience recent dating violence likely to talk to someone about what happened?

Are there different rates of dating violence among groups, specifically, by age, gender, race/ethnicity, or income level?

Are those who experience dating violence confident they can contact their doctor on their own about their health or safety?

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CHIS Research Questions (2)

Is dating violence associated with:

Threats of violence? Past 12 month physical fighting? Injuries? Risk behaviors: Alcohol, drug use, sexual intercourse? Health provider advice on a variety of risk behaviors? Receiving emotional or mental health counseling?

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Methods: California Health Interview Survey

Random digit dial (RDD) telephone survey

Conducted every two years

Household: Adult, adolescent, and child survey

Designed to meet state and local needs for population-based health data

Designed to track health status and disparities among California’s diverse racial and ethnic groups

Largest multi-ethnic, multi-linguistic state survey in the U.S.

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CHIS Sample Represents California’s Diverse Population

Large geographically stratified random samples 55,000 households in 2001 42,000 households in 2003 44,000 households in 2005 (target)

Collaborative partnership: UCLA, DHS, PHI

Questionnaires culturally adapted and translated Extensive cultural adaptation & English simplification process Currently translated in 5 languages:

English, Spanish, Chinese (Cantonese & Mandarin), Vietnamese and Korean

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Overview of theCHIS Adolescent Survey

Randomly selected adolescent (12-17 years) Parental or guardian permission Adolescent permission

Adolescent questionnaire topics include: General health, injuries, asthma, emotional health Physical activity, diet, drinking, drugs, sexual behaviors Health care utilization and insurance Adult supervision and resiliency Neighborhood safety, interpersonal violence Health provider preventive screening

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CHIS 2001 and 2003 Samples

Completed interviews 5,801 adolescents in CHIS 2001

4,010 adolescents in CHIS 2003

9,811 adolescents pooled CHIS 2001 and 2003 data

Unless pooled data is noted, all results are based on CHIS 2003 data

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CHIS Dating Violence Measures

Have you ever been slapped, kicked or physically hurt by a boyfriend or girlfriend, someone you are romantically involved with, not just a friend?

Has this happened at all in the past 12 months?

Did you talk to anyone about what happened?

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CHIS-Related Violence and Mental Health Measures

Past 12 months, about how many times did someone about your age threaten to hurt you or threaten to beat you up?

Past 12 months, about how many times were you actually in a physical fight with a guy or girl or a group of people around your own age?

Past 12 months, have you received any psychological or emotional counseling?

Ever had sexual intercourse?

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Dating Violence and Substance Use

Past 30 days had at least one drink of alcohol?

Number of days in the past 30 days had 5 or more drinks in a row?

Ever tried marijuana, cocaine, sniffing glue or any other drugs?

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Health Care Provider Advice

How sure are you that you can contact your doctor if you have questions or concerns about your health or safety?

When you had your last routine physical exam, did you and a doctor or other health provider talk about…

Alcohol use?

Drug use?

Emotions or moods?

Violence?

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CHIS 2001-2003 Dating Violence Results

319,000 Adolescents report being a victim of dating violence

7.7% (95% CI = 6.9-8.6)

192,000 Adolescents report past 12 month dating violence

60.2% of those who have ever experienced dating violence

No significant differences by age, gender, race/ethnicity, or FPL among those reporting past 12 month dating violence

Of those experiencing recent dating violence, only 37.7% (38,000) talked to someone about what happened to them

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Ever Experienced Dating Violence Population Percent 95% CI Estimated Number

Age Group *

12-14 6.2 4.8-8.0 68,000

15-17 8.2 7.3-9.3 251,000

Gender ***

Male 9.5 8.3-11.0 203,000

Female 5.7 4.7-7.0 116,000

Race/Ethnicity *

African Amer. 12.7 8.7-17.9 41,000

White 8.1 7.1-9.3 151,000

Latino 5.6 4.4-7.1 75,000

+ * p <0.05; *** p<0.001 Pearson Chi-square test

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Threats and Physical FightingEver Dating Violence Past 12 Months Threats

Yes ______ No______

Yes 41%*** 59%

No 21% 79%

Ever Dating Violence Past 12 Month Physical Fighting Yes ______

No______Yes 47%*** 53%

No 18% 82%

Significant differences; Rao-Scott modified Chi-square 16.81 and 30.42; p < 0.001

Teens who report past 12 month threats and physical fighting are significantly more likely to be victims of dating violence.

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Past 12 Month Injuries and Dating Violence ***Population Percent 95% CI Estimated Number

Male 17.0 15.5-18.6 548,000

Female 11.6 10.3-12.9 355,000

AI/AN 22.8 13.7-35.5 23,000

White 19.6 18.0-21.2 536,000

African Amer. 16.4 12.2-21.6 85,000

Latino 8.5 7.1-10.2 177,000

Asian/PI 7.8 5.6-10.7 51,000

0-99% FPL 9.0 7.0-11.5 116,000

100-199% FPL 12.4 10.3-14.9 169,000

200-299% FPL 15.3 12.6-18.5 141,000

> 300% FPL 17.5 16.0-19.0 476,000

TOTAL 14.3 13.3-15.4 903,000

+ *CHIS 2001+2003 data; *** p<0.001 Pearson Chi-square test

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Dating Violence: Alcohol, Drugs and Sexual Intercourse

Teens who use alcohol and/or drugs are significantly more likely to be victims of dating violence.

Alcohol use in the past 30 days [58% vs. 47%]*

Binge drinking in past 30 days [57% vs. 39%]*

Drug use ever [37% vs. 18%]***

Sexually-active teens are more likely to be victims of dating violence.

Ever sexual intercourse [46% vs. 21%] ***

* p <0.05; *** p< 0.001

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Dating Violence: Seeking Health Provider Advice

Regardless of victimization status, teens seek their doctor’s or health provider’s advice on a variety of risk factors at comparable rates:

Alcohol use [10% vs. 7%]

Drug use [10% vs. 7%]

Emotions or moods [10% vs. 7%]

Violence [9% vs. 8%]

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Confident Can Contact MD On Their Own about Health/Safety

Ever Dating Violence Very sure or Not at allsomewhat sure ______ sure______

Yes 88% 12%

No 82% 18%

CHIS 2003 data; No significant differences; Rao-Scott modified Chi-square 4.21; p>0.05

Regardless of victimization status, most teens are confident they can contact their doctor on their own about their health or safety

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Past 12 Month Mental Health or Emotional CounselingEver Dating Violence Yes NoYes 27% *** 73%

No 8% 92%

CHIS 2003 data; Rao-Scott modified Chi-square 18.68; p<0.001

Past 12 MonthDating Violence Yes NoYes 35%* 65%

No 17% 83%

CHIS 2003 data; Rao-Scott modified Chi-square 5.42; p < 0.05

Teens who report receiving past 12 month mental health or emotional counseling are significantly more likely to be victims of dating violence.

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Discussion/Conclusions

Dating Violence impacts large proportions of California’s teens

6 in 10 Teens who have ever been a victim of dating violence also report being a victim in the past 12 months

OIder Teens and males are more likely to report dating violence

Latino adolescents are less likely to report dating violence compared to White or African American teens

Dating violence is associated with other risk behaviors:

Threats and Physical Fighting Injuries Alcohol, Drug Use, and Sexual Intercourse

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Discussion/Conclusions: Help Seeking Behaviors

Teens who report dating violence are no more likely than other teens to:

Discuss risk behaviors with their health provider Have increased confidence that they can find a provider to

discuss their health or safetyOf concern, less than 4 in 10 teens who experience dating

violence tell anyone about what happened to them

Further training may encourage health providers to engage in preventive screening behaviors with teens

Good news: Teens who experience ever or past 12 month dating violence are significantly more likely to have emotional or mental health counseling compared to other teens

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“Making California’s Voices Heard on Health”

UCLA Center for Health Policy ResearchPublic Health Institute

California Department of Health Services

www.chis.ucla.edu

Explore CHIS data and get estimates from the survey