Contraceptive behavior among unmarried young women: A theoretical framework for research

Adoption of the most effective methods of contraception requires individual decision-making and negotiation with contraceptive providers. In order to take account of both behavioral elements, a two-dimensional framework for understanding contraceptive adoption and continuation by unmarried young is proposed, incorporating a "social-psychological model" of individual decision-making and an "interpersonal model" of factors affecting provider-client interaction. The social-psychological model is based on an earlier value-expectancy theory of behavior motivation as applied to health-related behaviors. The interpersonal model is derived from conflict-bargaining perspectives on professional-client interaction; it is suggested that expectations for this interaction are based on a limited number of internalized "models": the "professional"; the "bureaucratic"; the "commercial"; and the "parental." Insofar as client and professional "models" disagree, communication may break down and client understanding and/or acceptance of provider advice cannot be assured. The components of the social-psychological and interpersonal models are described in detail, and a combined framework is proposed.     

An innovative approach to selecting an executive director

As a guide for how to select a new executive director, a family agency adopted the search committee process from higher education. The approach included clarifying agency goals and the director's qualifications, a board-staff screening, and interviews held jointly with public representatives before final board selection.     

Parental survival data: Some results of the application of Ledermann's model life tables

Summary Ledermann's one- and two-parameter model life tables are used in order to summarize and compare adult mortality estimates derived from parental survival data, and also to link parental survival with child survival data. The Ledermann models provide an alternative to the logit model used by Brass and Hill. Examination of life tables derived from actual child and adult mortality estimates reveals that although the two types of models yield similar overall levels of mortality, they show marked differences in the estimated patterns by sex and age. It has not been possible to disentangle completely how much of this divergence is due to the models themselves and how much to inadequacies in the data available. Finally, we question whether it is always wise to establish a full life table from child and adult mortality estimates when these are based on data which refer to different periods of exposure to the risk of dying, without allowance for possible distortions resulting from mortality change.     

Reducing Refusal Rates for Telephone Interviews

In two experiments, refusal rates to telephone interviews werenot affected by substantial changes in the introductory remarksof the interviewer. A prior letter significantly lowered refusalrates in a third experiment. In all three, interviewer sex hadno effect.     

Multiproblem families: A social-psychological perspective

Summary It is generally conceded that our allied mental health professions have fallen short in our attempts to provide adequate services to those people whose need is most desperate, those individuals and families ambiguously and condescendingly designated multiproblem. It could be said that we, the caregivers, have been unwilling or unable to be good enough mothers to these, our motherless children. In fact, the early, formative experience of the people with whom we are concerned has invariably been marked by gross discontinuities in mothering; the consequent defects in controlling, regulatory psychic structure (ego defects) are most prominently manifested in the chaotic life-style which characterizes these individuals and families. Our task as caregivers, when viewed from this perspective, is clear: we must somehow bring order out of disorder. But, with tragic regularity, disorder prevails; the provider of service succumbs to the same painful feelings of disorganization, bewilderment, frustration, and helplessness with which his client struggles, and, eventually, both give up in despair. What is more, this sense of fragmentation and futility pervades the institutions responsible for provision of services. Client, caregiver, and institution, all are trapped in the same tortuous maze. How, then, are we to extricate ourselves? Certainly not by drafting yet another master plan which promises everything and delivers nothing. Both realistic and humanistic considerations dictate more modest goals: We might not be able to rescue everyone who needs assistance, but we can help a few. And, whatever approach we may adopt, the service we offer can only be effective if it is based upon a sustained and sustaining (in essence, maternal) relationship.Sometimes I Feel Like a Motherless Child