Mechanisms of Family Impact on African American Adolescents' HIV‐Related Behavior

A longitudinal model that tested mediating pathways between protective family processes and HIV‐related behavior was evaluated with 195 African American youth. Three waves of data were collected when the youth were 13, 15, and 19 years old. Evidence of mediation and temporal priority were assessed for 3 constructs: academic engagement, evaluations of prototypical risk‐taking peers, and affiliations with risk‐promoting peers. Structural equation modeling indicated that protective family processes assessed during early adolescence were associated with HIV‐related behavior during emerging adulthood and that academic engagement, evaluations of prototypical risk‐taking peers, and affiliations with risk‐promoting peers accounted for this association. Evidence of a specific pathway emerged: protective family processes→academic engagement→negative evaluations of prototypical risk‐taking peers→affiliations with risk‐promoting peers→HIV‐related behavior. Academic engagement also was a direct predictor of HIV‐related risk behavior.     

Confronting abusers: the opinions of clinicians and survivors

Confrontation of an abuser is often regarded as a powerful process in clinical work with adult survivors of childhood sexual abuse. This paper explores direct and symbolic forms of survivors confronting their abusers via a review of the current literature and the self-report of 12 female survivors, post-therapy. Six of the survivors had chosen to directly confront their abusers and six had not. Their experiences and opinions are presented together with a discussion of important issues within this area and the need for further research.     

Interstate variations in teenage fertility

The extremely wide variation among states in adolescent childbearing is examined using indicators that represent high or low modernity, i.e., percent urban, percent fundamentalism, percent black, and region (South-non-South); the intermediate variables of factors affecting exposure to intercourse (percent married females 15 to 19); and the deliberate fertility control factor of induced abortion (the state abortion-to-live birth ratio). Eighty-six percent of the variance among states in the 1974 teenage fertility rates (females 15 to 19) is explained, with region the most powerful single indicator of fertility, followed by percent married and state abortion ratio.     

Family Structure and Self-Rated Health in Adolescence and Young Adulthood

While the relationship between family structure and child well-being is well-established, little is known about the specific impact of family structure on health in adolescence and young adulthood. Using data on 12,737 respondents from Waves I and III of Add Health, we examine the association between family structure (two biological/adoptive, stepfather, and single mother families at Wave I) and self-rated health in adolescence (Wave I) and young adulthood (Wave III). We build on previous literature by investigating whether the relationship between family structure and self-rated health is mediated by demographic background, socioeconomic status, parent–child relationships, external social support, and health characteristics and behaviors, and whether the influence of these factors endures into adulthood. Overall, we find that self-rated health is reduced for respondents who lived in stepfather or single mother families during adolescence, although this effect is attenuated in young adulthood. Family structure effects at both waves are explained by socioeconomic status, social support and competence, and health characteristics and behaviors. We find little evidence that demographic background or mother–child relationships mediate the relationship between family structure and self-rated health. By young adulthood, effects of most adolescent predictors are attenuated, but health assessments are largely influenced by changes in health characteristics and behaviors, and in family type.

Telephone triage and midwifery: A scoping review

Background

Midwives use telephone triage to provide advice and support to childbearing women, and to manage access to maternity services. Telephone triage practises are important in the provision of accurate, timely and appropriate health care. Despite this, there has been very little research investigating this area of midwifery practice.

Inclusive foster care: How foster parents support cultural and relational connections for Indigenous children

How do foster parents support the relational and cultural connections of Indigenous children in care? The answer matters; the well‐being of Indigenous children depends on these connections. At one of Canada's largest Indigenous child welfare agencies, we implemented inclusive foster care, an approach requiring foster parents to engage with the family, community, and cultural life of the child for whom they care. Fifteen years later, we present findings from a thematic analysis of interviews with 13 foster parents who participated in a mixed methods study exploring inclusive foster care. We discuss foster parent strategies to support the child's family relationships: setting clear boundaries, rolling with inconsistency, and understanding the family's (hi)stories. Strategies to strengthen cultural connectedness include visiting traditional territory, using personal initiative and Indigenous knowledge, and engaging in school‐based and “multi‐purpose” cultural opportunities. Drawing on foster parent stories of success, we propose ways for social workers, foster parents, and policymakers to address the cultural and relational disruption that characterizes the experience of Indigenous children in care in colonial settler societies.     

The Relationship Between Cognitive Ability and Experiences of Vaginal,Oral, and Anal Sex in the United States

Few studies have investigated the sexual development of populations with low cognitive abilities in the United States. This article examines the relationship between cognitive ability and various sexual experiences from adolescence (ages 12 to 18) to early adulthood (ages 28 to 34). Data were from 13,845 respondents interviewed at Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health), a probability sample of adolescents in the United States followed from adolescence to adulthood. Adjusted logistic regression models were used to study relationships between cognitive ability, approximated by the Add Health Picture Vocabulary Test (AHPVT), and experiences of vaginal, oral, and anal sex. After controlling for biological sex, age, race/ethnicity, and socioeconomic status (SES), individuals in the lowest cognitive ability group had significantly lower odds of experiencing each type of sex than those in the average ability group. Although individuals in the highest cognitive ability group had significantly lower odds of experiencing vaginal intercourse than those in the average ability group, this association did not remain significant when analyses were stratified by biological sex. These differences in experiences have implications for future health and warrant further study to understand policy implications for sexual health services and education.