Explaining Condom Use Disparity Among Black and Hispanic Female Adolescents

The study examined condom use among 204 Black and Hispanic female adolescents who attended family planning clinics. Partner attitude, partner communication, parental communication and social support measures were used in a multinomial logistic regression model to predict condom use at last intercourse. The results indicated that adolescents who perceived that their partners had a positive attitude toward condom use were 1.37 times more likely to report condom use compared to those whose partners did not have a positive attitude. Additionally, adolescents who reported communicating with partners about condoms were .37 times more likely to use condoms compared to those who did not communicate with their partners. These findings suggest that increasing condom use among female adolescents will require addressing primarily partner factors. Male partners must also be included in interventions to increase condom use.     

Crossover of resources and well-being within employee-partner dyads: through increased schedule control

ABSTRACT

This study examined whether one partner’s additional resources obtained from a workplace intervention influence the other partner’s perception of having those resources at home (crossover of resources). We also examined whether one partner’s decreased stress by increased work resources crosses over to the other partner’s stress levels (crossover of well-being). Longitudinal data came from IT employees and their married/cohabiting partners in midlife (N?=?327). A randomized workplace intervention significantly increased employee-reported schedule control at the 6-month follow-up, which, in turn, increased partner-reported employees’ work schedule flexibility to handle family responsibilities at the 12-month follow-up. The intervention also decreased partners’ perceived stress at the 12-month follow-up through the processes by which increases in schedule control predicted decreases in employees’ perceived stress, which further predicted decreased levels of partners’ perceived stress. Notably, crossover of resources and well-being were found in couples who lived with children in the household, but not in couples without children. Our findings suggest that benefits of workplace support can permeate into the family domain, by increasing partner-perceived family resources and well-being.     

The effects of domestic violence during pregnancy on maternal and infant health

The present study examined the impact of domestic violence on maternal and infant health by assessing maternal health during pregnancy and infant health at two months postpartum. Two hundred and two women (68 battered and 134 non-battered) were recruited from the community and completed both pregnancy and 2-month postpartum interviews. Results revealed that domestic violence during pregnancy was associated with numerous health problems for mothers and infants including more health problems during pregnancy, more likelihood of premature labor, later entrance into prenatal care, lower infant birth weight, greater utilization of health care resources, and more prenatal substance use. After income was controlled, the relationship between violence and timing of prenatal care and infant birth weight became nonsignificant. Maternal social support was found to protect against the effects of violence for several health outcomes. The current findings suggest the need for domestic violence screening during pregnancy, as well as clinical interventions for battered, pregnant women in order to prevent serious physical and emotional problems for both mothers and their infants.     

Black adolescents' participation in a prenatal care program

This study explores the relationship between socio-demographic variables and the participation in a prenatal care program among Black adolescents living in a southern community. The analysis of data found that the number of months pregnant and type of living arrangement significantly influenced participation. Greater participation was found among adolescents in the first trimester of pregnancy and those who lived with their mothers only or in other living arragements than with both parents. These findings suggest outreach to sustain participation and the need for additional research with Black adolescents in two-parent families.This study was made possible by funding from the University of Alabama Research Grants Committee, 1988.     

Transition from the Lactational Amenorrhea Method to other modern family planning methods in rural Bangladesh: Barrier analysis and implications for behavior change communication program intervention design

The timely transition from Lactational Amenorrhea Method (LAM)² to another modern family planning method contributes to healthy spacing of pregnancies by increasing the adoption of family planning during the first year postpartum. Yet, literature suggests challenges in completing a timely LAM transition. To guide program implementation in Bangladesh, this study identified factors influencing women's transition decisions.Eighty postpartum women, comprising 40 who transitioned from LAM³ and 40 who did not,⁴ participated. Half of each group participated in in-depth interviews to explore the decision-making process. All participants responded to a “Barrier Analysis” questionnaire to identify differences in eight behavioral determinants.More than half of transitioners switched to another modern method before or within the same month that LAM ended. Of the 18 transitioners who delayed,⁵ 15 waited for menses to return. For non-transitioners, key barriers included waiting for menses to return, misconceptions on return to fertility, and perceived lack of familial support. The LAM transition can help women prevent unintended pregnancy during the first year postpartum. Increased emphasis on counseling women about the risk of pregnancy, and misconceptions about personal fertility patterns are critical for facilitating the transition. Strategies should also include interventions that train health workers and improve social support.     

Alcohol Use Among Concerned Partners of Heavy Drinking Service Members and Veterans

Heavy drinking in relationships is complex and we focus on an understudied sample of concerned partners (CPs) worried about their U.S. service member/veteran partner's drinking. We evaluated the link between CP drinking and their own mental health, and how CP drinking moderated the efficacy of a web‐based intervention designed to address CPs' mental health and communication. CPs (N = 234) were randomly assigned to intervention or control and completed assessments at baseline and 5 months later. CP drinking was associated with greater CP depression, anxiety, and anger independent of partner drinking. Moreover, the intervention was more efficacious in reducing depression for heavy drinking CPs. CPs are often an overlooked population and resources to help support them are needed.     

The development of Maisha,a video-assisted counseling intervention to address HIV stigma at entry into antenatal care in Tanzania

HIV stigma has a profound impact on clinical outcomes and undermines the quality of life of people living with HIV (PLWH). Among HIV-negative individuals, misinformation and prejudicial attitudes about HIV can fuel stigma and contribute to discrimination against PLWH. Antenatal care (ANC), with its focus on universal HIV testing, provides a unique entry point to address HIV stigma. This study describes the development of a counseling intervention to address HIV stigma among women and their partners attending a first ANC appointment in Tanzania. Formative work to inform the intervention consisted of qualitative interviews with 32 pregnant and postpartum women (both women living with HIV and HIV-negative women) and 20 healthcare workers. Data were analyzed iteratively, using a thematic analysis approach, to identify intervention targets. The resulting intervention, Maisha (Swahili for “Life”), includes three sessions informed by the HIV Stigma Framework and Cognitive-Behavioral Therapy: a video and brief counseling session prior to HIV testing and, for those who test seropositive for HIV, two additional sessions building on the video content. A pilot test of the intervention is in process. Addressing HIV stigma at the first ANC visit can help individuals living with HIV to overcome stigma-related barriers to the initiation and maintenance of HIV care, and can reduce stigmatizing attitudes among those who test negative for HIV.     

The Effect of Support Expectations on Prenatal Attachment: An Evidence-Based Approach for Intervention in an Adolescent Population

This study was designed to determine the significant variables predicting prenatal attachment in an adolescent population. Scientifically supported knowledge of the factors enhancing attachment plays a crucial role in assisting social workers and other health care professionals to accurately assess and intervene to decrease pregnancy risks. Previous prenatal attachment studies demonstrated conflicting findings due to problems from using different theoretical frameworks and research methodologies. In order to ensure consistency, this study infused an attachment theory perspective. Bowlby’s attachment theory, Levitt’s support expectations model, and research from prenatal relationship studies were integrated. The social survey sampled 129 minority status pregnant adolescents attending public school. Measurements included the Prenatal Attachment Inventory (PAI) and the Support Expectations Index (SEI). Regression analyses revealed that support expectation was a powerful predictor of prenatal attachment with pregnancy planning and less stress adding importantly to explain over 33% of the variance. Support expectation was a greater predictor of prenatal attachment than the actual support available. Findings also supported the construct of prenatal attachment as the initial stage of development of the life cycle. Janis B. Feldman is an Assistant Professor, University, of Texas-Pan American.     

Reactions to a partner-assisted emotional disclosure intervention: direct observation and self-report of patient and partner communication

Partner-assisted emotional disclosure is a couple-based intervention designed to help patients disclose cancer-related concerns to their spouses-partners. We previously found that, compared with an education/support control condition, partner-assisted emotional disclosure led to significant improvements in relationship quality and intimacy for couples in which the patient initially reported holding back from discussing cancer-related concerns (Porter et al., 2009, Cancer, 115, 4326-4338). The purpose of this study was to examine the process data from couples who participated in the disclosure sessions including (a) observational ratings of couples' communication during the sessions; (b) couples' ratings of their communication during the sessions; and (c) associations between participants' observed communication and their baseline psychological/relationship functioning. As rated by trained observers, couples' communication was in the moderate range of adaptive skills. Self-report data indicated that participants had positive perceptions of their communication. Observational and self-report ratings were weakly associated. Patients reporting lower levels of relationship quality, higher levels of holding back, and higher partner avoidance at baseline were rated by observers as more expressive during the sessions. Overall, these findings suggest that the intervention was acceptable to couples and was particularly helpful for patients who had difficulty talking with their partners on their own without skills training.     

The risk of Telling: A Dyadic Perspective on Romantic Partners’ Responses to Child Sexual Abuse Disclosure and Their Associations with Sexual and Relationship Satisfaction

Among 70 community couples who reported childhood sexual abuse (CSA) and disclosure to their partner, this study examined associations between survivors’ perception of partner responses to their disclosure, and both partners’ sexual and relationship satisfaction. Participants completed self‐report questionnaires online. Results of path analyses within an actor–partner interdependence model indicated that survivors’ perceived partner responses of emotional support to disclosure were associated with their own and their partners’ higher sexual satisfaction. Survivors’ perceived responses of being stigmatized/treated differently by the partner were associated with their own and their partners’ poorer relationship satisfaction. Findings suggest that survivor‐perceived partner responses to the disclosure of CSA can have a positive and a negative impact on the sexual and relationship satisfaction of both partners.     

Low‐Income Latina Mothers' Expectations for Their Pregnant Daughters' Autonomy and Interdependence

Forty‐five pregnant Latina adolescents and their mothers (23 English‐speaking, 22 Spanish‐speaking) were videotaped conversing about feelings and plans related to the adolescent's pregnancy. The prevalence of the mothers' messages about the daughter's reliance on the family unit (interdependence) and the daughter's self‐sufficiency (autonomy) were related to adolescents' reported and observed feelings about their pregnancies, pending motherhood challenges, and their relationships with their mothers. Increased interdependence messages appeared to denote positive family relations among Spanish‐speaking dyads, in that these adolescents reported more positive feelings about their pregnancy, perceived that their mothers felt more positive, and perceived more maternal social support and open communication. The role of interdependence messages was less clear for adolescents from English‐speaking families. Higher levels of maternal autonomy messages had positive associations for both groups, in that it was related to higher disclosure about concerns about childcare needs among adolescents from English‐speaking families, and about educational goals for adolescents from Spanish‐speaking families.     

Positively Impacting Maternal Stress and Parental Adjustment through Community-Based Relationship Education (RE)

Relationship education (RE) is a brief, strength-based psychoeducational intervention for couples that demonstrates strong outcomes to decrease individual and couple stress. The current study examined changes in relationship and family adjustment for expectant mothers following RE intervention. Participants included 91 pregnant women (64.8% racial or ethnic minorities) who participated in a community-based RE program. In examination of pre and post-intervention relationship assessment scale and parental stress and coping inventory results, RE intervention contributed to increased relationship satisfaction, and reduced parental distress, as well as to improved social support and family-based support scores among participants. In addition, relationship stress is a major contributor to stress during pregnancy that adds vulnerability for the health of low-income and ethnic minority expectant mothers and their children. Findings indicate the effectiveness of RE to significantly reduce stress for expectant mothers. Therefore, the use of RE as a low-cost and accessible intervention to combat stress provides positive implications for this vulnerable population.     

Adolescents' Pregnancy Intentions, Wantedness, and Regret: Cross-Lagged Relations With Mental Health and Harsh Parenting

The authors used cross-lagged analyses to examine the across-time influences on and consequences of adolescents' pregnancy intentions, wantedness, and regret. One hundred pregnant Latina adolescents were studied during pregnancy and at 6 and 12 months postpartum. The results revealed 4 main findings: (a) similar to what has been found in adult women, adolescents' lower prenatal pregnancy intendedness and wantedness predicted initial difficulties in parenting; (b) frequent depression symptoms predicted subsequent lower pregnancy intendedness and wantedness; (c) adolescents' poor mental health and harsh parenting of their child predicted subsequent higher childbearing regret, and (d) high childbearing regret and parenting stress were reciprocally related across time. In addition, adolescents' wantedness of their pregnancy declined prenatally to postbirth, and strong pregnancy intendedness and wantedness were not concurrently related to adolescents' poor prenatal mental health. The findings reveal how adolescents' thoughts and feelings about their pregnancies are influenced by and predictive of their mental health and parenting experiences.     

Enhancing Potency Among Male Adolescents at Risk to Drug Abuse: An Action Research

Potency defined as one’s self-control, self-confidence, and the belief that society is just and significant, is considered to be an important personality resource for coping with life stressors. The aim of the current study was to examine the impact of a two- stage intervention model on the level of potency. The intervention model consisted of physically and mentally challenging boot camp (five days) and group therapy (24 sessions). The sample consisted of 34 adolescents at risk of drug abuse divided into two groups, a study and comparison group. Participants were administered self-report questionnaires before and after the intervention. The following scales were measured: potency, self-esteem, optimism, social support from friends and family, and past traumatic experiences. Results indicated that the levels of potency, self-esteem, and optimism were significantly higher in the study group compare to the comparison group. In addition, there was a decline of all the variables in the comparison group at the second time of data collection, indicating that intervention during adolescence is critical.     

Pregnancy risk among older youth transitioning out of foster care

Youth served in the foster care system have higher rates of pregnancy than general population youth; yet we have little information about risk and protective factors to target in order to prevent early pregnancy in this population. We assessed early pregnancy risk and protective factors known for general population adolescents for their relevance to youth in the foster care system. Using data from a longitudinal study of 325 older youth from the foster care system, we examined bivariate and multivariate relationships between these factors and pregnancy between ages 17 and 19 using logistic regression. Models examined the risk for early parenting separately by gender. The pregnancy rate increased by 300% between ages 17 and 19. At 19, 55% of females had been pregnant, while 23% of males had fathered a child. Although this study assessed multiple known factors, few were significant for this high risk group. Females who were not sexually active at age 17 were less likely to become pregnant, but those who reported using birth control were as likely to become pregnant as those who did not. Also, females with a history of arrest were more likely to have a pregnancy between 17 and 19. Males who left the foster care system before their 19th birthday were more likely to make someone pregnant. Youth from the foster care system are at exceptional risk of early pregnancy, regardless of their maltreatment history, religiosity, school connectedness, or academic achievement, particularly in the years between 17 and 19. This high risk group needs pregnancy prevention interventions and access to effective birth control.     

Social networks, informal child care, and inadequate supervision by mothers

The purpose of this study is to determine whether less informal child care support from family and friends is related to supervisory neglect and, if there is a relationship, to test several explanations for why some mothers receive less child care. Thirty-two low-income mothers who did not adequately supervise their children were matched to 32 mothers who provided adequate supervision. The results showed the mothers who provided inadequate supervision received less child care support from their partners and relatives, but not their friends. These differences appear to be linked to several properties of the mothers' social networks. For example, the majority of the mothers who provided inadequate supervision either did not have a partner or knew them for less than one year. They had fewer family members living nearby and more negative relationships with them than the mothers who provided adequate supervision. To reduce chronic supervisory neglect, mothers may need assistance with both informal and formal child care support.     

The Burden of Sexual Problems: Perceived Effects on Men’s and Women’s Sexual Partners

Sexual dysfunction sometimes negatively affects the individual, his or her partner, and the relationship. We investigated the relationship between the distress experienced by men and women with orgasmic phase difficulties and the perceived distress of their partner(s). We also identified predictors of perceived partner distress, and related self and partner distress to severity of the problem and relationship quality. Data were drawn from 374 men with premature ejaculation (PE) and 377 women with anorgasmia who responded to a survey regarding their sexual functioning, including their distress about their condition and the perceived distress of their partners. Results yielded an overall distress score consisting of combined self and perceived partners distress, with women showing a higher overall score and higher perceived partner distress than men. For men, significant predictors of perceived partner distress included self-distress, relationship quality, interest in sex, and arousal difficulty; for women, only the level of self-distress significantly predicted perceived partner distress. These findings indicate the burden of experiencing sexual difficulty, identify factors related to perceived partner distress, and demonstrate differences in self versus partner distress across men and women. Overall, such findings reiterate the strong need for the inclusion of the partner in any attempted remediation of a sexual problem.     

Increasing college access for youth aging out of foster care: Evaluation of a summer camp program for foster youth transitioning from high school to college

Young people who transition from the foster care system face many challenges including lack of support and other educational barriers. They are less likely to graduate from high school than their counterparts and go on to college yet despite challenges, many succeed and take advantage of higher education programs.In Michigan, a state with one of the highest percentage of youth in foster care, Michigan State University developed a small scale, targeted intervention to help transitioning foster youth achieve their goals of pursuing higher education. Led by the School of Social Work in collaboration with other colleges and disciplines, it was demonstrated that a campus based learning program for transitioning foster youth can help contribute toward a perceived increase in knowledge and information about college life, funding and admissions procedures. The educational process involved peer support, role modeling, mentoring and active learning sessions led by the faculty and students who were often foster care alumni themselves. Leaders and speakers came from a range of disciplines, institutions and organizations. This approach and curriculum contributed to perceptions of the camp as enhancing life skills, self-concept, empowerment and sense of purpose. Consequently, this program contributed to the resilience of those who attended and potentially helped build steps from care to higher education.     

High Educational Aspirations Among Pregnant Adolescents Are Related to Pregnancy Unwantedness and Subsequent Parenting Stress and Inadequacy

On the basis of theories of maternal identity development, role conflict, and childbearing motivation, the authors tested whether high educational aspirations among pregnant adolescents are related to the unwantedness of the pregnancy and whether pregnancy unwantedness leads to subsequent parenting stress and inadequacy. Longitudinal data from 100 first‐time‐pregnant, unmarried Latina adolescents (M age = 17.3 years) were analyzed. Results from structural equation path modeling confirmed these associations, with strong educational ambitions related to greater unwantedness of the pregnancy, which led to feeling trapped by parenting at 6 months postpartum, which in turn was related to unaffectionate parenting and feeling inadequate in mothering at 1 year postpartum. The potential long‐term negative consequences of high educational aspirations for pregnant adolescents' adjustment to parenting are discussed.     

Formative evaluation of a motivational intervention for increasing physical activity in underserved youth

The present study was designed to develop an innovative motivational intervention (based on Self-Determination Theory and Social Cognitive Theory) to increase physical activity (PA) in underserved adolescents. Sixty-four adolescents (35 females, 29 males; 50% minority; 65% on reduced lunch program; ages 11-13 yr) participated in either an 8-week motivational intervention after-school (n = 32) or a typical after-school program (n = 32). The conceptual framework for the intervention targeted the social environment (perceived autonomy, perceived social support, participation, fun), cognitive mediators (perceived choice, self-efficacy, and relatedness/belongingness), and motivational orientation (intrinsic motivation, commitment, positive self-concept). Formative evaluation data was collected by staff through daily forms throughout the 8-week program and through observational data completed by independent objective observers during 2 weeks of the program. The major themes that were identified addressed theoretical concepts regarding the intervention and logistical issues in delivering the intervention. The data revealed information regarding the importance of the cognitive appropriateness of the PA and motivational activities, the environmental climate for promoting nurturing relationships, developing specific strategies for increasing intrinsic rather than extrinsic reinforcement, and developing methods for preventing social "cliques" and gender conflicts to maintain an appropriate level of support in the social climate. Themes for training staff included focusing on team building, leadership, and nurturing. This formative evaluation is being used to formalize a randomized trial to test the effects of a student-centered motivational intervention on increasing PA in underserved 6th graders.