title: Cyber dating abuse among teens using school-based health centers.
abstract: OBJECTIVE
  To estimate the prevalence of cyber dating abuse among youth aged 14 to 19 years seeking care at school-based health centers and associations with other forms of adolescent relationship abuse (ARA), sexual violence, and reproductive and sexual health indicators.
  
  
  METHODS
  A cross-sectional survey was conducted during the 2012-2013 school year (participant n = 1008). Associations between cyber dating abuse and study outcomes were assessed via logistic regression models for clustered survey data.
  
  
  RESULTS
  Past 3-month cyber dating abuse was reported by 41.4% of this clinic-based sample. More female than male participants reported cyber dating abuse victimization (44.6% vs 31.0%). Compared with no exposure, low- ("a few times") and high-frequency ("once or twice a month" or more) cyber dating abuse were significantly associated with physical or sexual ARA (low: adjusted odds ratio [aOR] 2.8, 95% confidence interval [CI] 1.8-4.4; high: aOR 5.4, 95% CI 4.0-7.5) and nonpartner sexual assault (low: aOR 2.7, 95% CI 1.3-5.5; high: aOR 4.1, 95% CI 2.8-5.9). Analysis with female participants found an association between cyber dating abuse exposure and contraceptive nonuse (low: aOR 1.8, 95% CI 1.2-2.7; high: aOR 4.1, 95% CI 2.0-8.4) and reproductive coercion (low: aOR 3.0, 95% CI 1.4-6.2; high: aOR 5.7, 95% CI 2.8-11.6).
  
  
  CONCLUSIONS
  Cyber dating abuse is common and associated with ARA and sexual assault in an adolescent clinic-based sample. The associations of cyber dating abuse with sexual behavior and pregnancy risk behaviors suggest a need to integrate ARA education and harm reduction counseling into sexual health assessments in clinical settings.
authors.affiliation: Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; rebecca.dick@chp.edu.
authors.forename: Rebecca N
authors.initials: RN
authors.lastname: Dick
authors.affiliation: Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;
authors.forename: Heather L
authors.initials: HL
authors.lastname: McCauley
authors.affiliation: Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;
authors.forename: Kelley A
authors.initials: KA
authors.lastname: Jones
authors.affiliation: University of California Davis School of Medicine, Sacramento, California;
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Tancredi
authors.affiliation: California Adolescent Health Collaborative, Public Health Institute, Oakland, California;
authors.forename: Sandi
authors.initials: S
authors.lastname: Goldstein
authors.affiliation: School of Nursing, California State University, Sacramento, California;
authors.forename: Samantha
authors.initials: S
authors.lastname: Blackburn
authors.affiliation: Department of Family Health Care Nursing, University of California San Francisco School of Nursing, San Francisco, California;
authors.forename: Erica
authors.initials: E
authors.lastname: Monasterio
authors.affiliation: Futures Without Violence, San Francisco, California; and.
authors.forename: Lisa
authors.initials: L
authors.lastname: James
authors.affiliation: Division of Global Public Health, University of California San Diego School of Medicine, La Jolla, California.
authors.forename: Jay G
authors.initials: JG
authors.lastname: Silverman
authors.affiliation: Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D003380:Courtship; D019548:Crime Victims / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D020407:Internet; D008297:Male; D016017:Odds Ratio; D012572:School Health Services / Q000706:statistics & numerical data*; D012737:Sex Factors; D012742:Sex Offenses / Q000706:statistics & numerical data*; D012725:Sexual Behavior; D060756:Social Networking; D013223:Statistics as Topic; D014481:United States; D014754:Violence / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: adolescent relationship abuse; cyber dating abuse; school health services; sexual behavior; victimization