Screening for patients with alcohol problems: severity of patients identified by the CAGE.

Primary care physicians are well situated to identify patients with substance abuse problems and motivate them to seek appropriate assistance, but active programs are the exception. A study in a community setting was undertaken to assess the CAGE (the first letters of key words in a series of four questions about drinking: cut down; annoyed; guilty; and eye-opener), instrument in the routine screening for alcohol problems in both new and established patients. The screening process identified subjects for a pilot evaluation of a motivational interview designed to encourage problem-solving behavior. This article focuses on the screening results and the use of the CAGE instrument. During June and July of 1990, 687 patients of two primary care physicians belonging to a large group practice were asked to complete a health questionnaire that included the CAGE. Those who responded affirmatively to at least two of the four CAGE questions were requested to participate in follow-up assessment of problems associated with alcohol and health. The type and severity of alcohol problems experienced by patients who scored positive on the CAGE are described. Prevalence of a positive score on the CAGE was 8.6 percent with males, smokers, and blue collar and unemployed persons being more likely to score positive. The positive predictive value was .68. Primarily, persons with moderate alcohol problems were identified. Results show that the CAGE instrument is a useful screening device for identifying those with mild to moderate substance abuse problems, increasing the opportunity for intervention prior to serious medical complications. The instrument is easily administered, and has demonstrated relatively high levels of sensitivity and specificity. When combined with assessment and motivational interviews, the CAGE shows promise in the secondary prevention of substance abuse and related health problems.     

The bumpy road to ‘becoming’: capturing the stories that teenage mothers told about their journey into motherhood

Understanding the experience of women who become mothers during their teenage years is central to ensuring that the support that is offered is appropriate to meet their needs. This paper reports on a small part of a larger ethnographic study that captured the lived experience of young mothers who were between the ages of 16 and 19 years that potentially typifies and illuminates the experiences of young women who become mothers in their teenage years. By collecting data from narrative interviews as well as participant and non‐participant observations over an extended period of time it was possible to identify how the young women experienced a range of difficulties as they made their transition into motherhood. Drawing on the findings, this paper argues that this transition for teenage mothers can be significantly different from the experience of older mothers, and it identifies the importance of appropriate support to mediate the challenges that they face. Understanding the young women's journey to ‘becoming’ is critical when planning services because if their experience of support is negative, it can lead to increased levels of maternal stress and reluctance to engage with support services.     

Women’s Experiences of Pornography: A Systematic Review of Research Using Qualitative Methods

Given the proliferation of pornography in personal, relational, and social realms, it is vital to understand women’s experiences of this accessible, stimulating, and versatile sexual material. We therefore conducted the first systematic review of research using qualitative methods published in English in peer-reviewed journals. Our search of five databases yielded 22 eligible articles. Thematic analysis of results revealed four broad themes: women encountering pornography, pornography and the self, pornography in the context of relationships, and making sense of pornography. Discussion of themes and subthemes included reflections on women’s explanations of intentional and unintentional encounters with pornography, conflicted perceptions of themselves in relation to female pornography actors, diverse perceived effects of pornography on intimate relationships, and tensions between women’s arousal to pornography and their values. It was evident that women’s experiences of pornography are complex and nuanced, often paradoxical, varying among and within individuals. Our synthesis of results and assessment of limitations suggest (a) that researchers need to define what they mean by pornography and specify any content used in their research and (b) that understanding would be enriched by research that is culturally contextualized and acknowledges public discourses about pornography.     

School context and American Indian substance use

The present study extends prior research exploring the role of school contextual factors in predicting individual adolescent substance use by examining how a school’s racial composition is associated with American Indian adolescent tobacco and marijuana use. Using a subsample of 523 American Indian students from the restricted use Add Health data, we consider both individual and school contextual factors across 99 schools. Our results suggest that a school’s racial composition is associated with individual tobacco and marijuana use among American Indian youth, but in different ways depending upon the substance. Our findings illustrate the importance of extending research on the correlates of substance use for racial and ethnic minorities beyond studies examining African-Americans and/or Hispanics.     

Indigenous data,indigenous methodologies and indigenous data sovereignty

The field of Indigenous methodologies has grown strongly since Tuhiwai Smith’s 1999 groundbreaking book Decolonizing Indigenous Methodologies. For the most part however, there has been a marked absence of quantitative methodologies with the methods aligned with Indigenous methodologies predominantly qualitative. This article proposes that the absence of an Indigenous presence from Indigenous data production has resulted in an overwhelming statistical narrative of deficit for dispossessed Indigenous peoples around the globe. Using the theoretical concept of Indigenous Lifeworlds this article builds on the core premises of Walter and Andersen’s 2013 book Indigenous quantitative methodologies. Arguing for a fundamental disturbance of the Western logics of statistical data the article details recent developments in the field including the emergence of the Indigenous Data Sovereignty movement. The article also explores Indigenous quantitative methodologies in practice using the case study of a Tribal Epidemiology Centre in New Mexico.     

Congregational Composition and Explanations for Racial Inequality Among Black Religious Affiliates

Prior research suggests that congregational characteristics are associated with the racial attitudes of Black churchgoers. This study examines the relationship between congregational diversity and beliefs about the Black/White socioeconomic gap among Black religious adherents. Drawing upon pooled data from the General Social Survey and the National Congregations Study, we fit binary logistic regression models to estimate the association between congregational diversity and the explanations of Black/White economic inequality among Black religious adherents. Findings from our study reveal that congregational diversity is one factor that accounts for intragroup differences in racial attitudes among Black religious affiliates. Relative to Blacks that attend religious services in overwhelmingly Black congregations, Blacks that attend religious services in congregations that are overwhelmingly White are significantly less likely to attribute Black/White socioeconomic gaps to a lack of educational opportunities. Our study demonstrates that congregational diversity is a source of intragroup variation in racial attitudes among Black religious affiliates, which may attenuate the ability of such congregations to bridge racial divisions.     

Who Is the Residential Parent? Understanding Discrepancies in Unmarried Parents' Reports

Research examining parental reports of children's living arrangements has often relied on information about legally ordered custody agreements following divorce. This analysis used data from matched pairs of parents (N = 1,156) in the Fragile Families and Child Wellbeing Study who live apart to compare mother and father reports of their child's residence 5 years after a nonmarital birth. The authors found that over one third of unmarried parents disagreed about who their child lived with and that conflicting reports were much more likely when fathers spent nights with the mother (an indicator of part‐time cohabitation) and had overnights with the child on their own. The results further suggest that discrepancies in unmarried parents' reports were more closely associated with the complexity and ambiguity of their living situations than with the quality of their relationships with each other. Implications for measuring children's living arrangements in families formed outside of marriage are discussed.