The role of "envisioning the future" in the development of resilience among at-risk youth

The objective was to explore the process by which adolescents develop resilience and change their risk behaviors despite multiple stressors in their environment. The design was exploratory using grounded theory to understand the process from the teens' perspectives. Semistructured interviews were conducted with 32 individuals-28 adolescents (age range 16-21 years) and 4 adults (age range 32 and 72)-on two occasions. The participants used the basic social process "envisioning the future" to become resilient and stop engaging in risk behaviors. Envisioning the future included two processes "feeling competent" and "elevating expectations" that were facilitated within the context of a relationship with a reliable, caring, and competent adult. Participants in this study became resilient despite environmental stressors by setting higher expectations for themselves and feeling self-confident. The findings of this study provide information regarding the specific behaviors that promote positive outcomes in at-risk youth and suggest ways in which public health nurses can facilitate these behaviors in both the youth and their mentors.

The nurse clinician as research participant recruiter: experience from a longitudinal intervention study

One of the most critical phases involved in carrying out a research project is participant recruitment. Recruitment into clinical trials and health programs is a primary public health challenge, particularly among adolescents. Special skills and abilities are needed to successfully recruit participants from this developmental age group. This paper describes the similarities found between the recruitment process developed for a randomized controlled trial with adolescents and the steps of the nursing process, and demonstrates that knowledge of the nursing process can assist in successfully recruiting individuals for a research study. Even without research training, clinical nurses can play a significant role in research studies because of their skills and experiences with the nursing process. Thus, nurse scientists and clinicians can work together successfully to conduct research studies and health projects that involve challenging recruitment efforts.

Heterosocial behaviors in early adolescent African American girls: the role of mother-daughter relationships

Recent epidemiological trends in HIV/AIDS have helped draw attention to minority adolescents as especially high risk for HIV acquisition. Research shows the importance of maternal-child closeness and sexual communication in decreasing adolescent risk behaviors. The information, motivation, behavioral skills model (IMB) formed the framework for this pilot study whose purpose was to examine the informational and motivational antecedents of heterosocial risks in African American middle-school-aged girls and the maternal influence on these risks. Thirty-nine mother-daughter dyads participated, of whom 54% were impoverished. The girls' intent to stay safe, perceived social norms, and closeness to mother were negatively correlated with reported participation in potentially risky situations. Early interventions may enhance mother-daughter bonding, increasing sexual communication, and decreasing girls' participation in risky behaviors. This pilot study provides direction regarding testing of the IMB model in studies focused on early adolescent behaviors and mother-daughter interactions.

Resilience to risk-taking behaviors in impoverished African American girls: the role of mother-daughter connectedness

Rates of risk behaviors (e.g., violence, substance use) for impoverished girls are exceedingly high. Some view their future pessimistically, decreasing their resilience to avoid risky behaviors. Others resist such behaviors. Connectedness with an adult promotes this resilience, but how is unclear. The purpose of this secondary analysis was to investigate the relationships among connectedness to mother, time perspective, and resilience to risk-taking behaviors in impoverished African American girls ages 11-15. Structural equation modeling was used to cross-validate this model. In contrast to the results found in earlier studies, no direct relationship emerged between maternal connectedness and resilience. Instead, future time perspective was the key mediator between connectedness and resilience. These findings suggest that an important aspect of interventions to foster resilience to risk behaviors in young girls could be to assist their mothers in developing a connected relationship with their daughters that would promote a future time perspective.

Psychosocial correlates of HIV risk behavior in adolescent girls

OBJECTIVE

To present the preintervention data collected for a pilot HIV-prevention randomized controlled trial specifically developed for single, sexually active adolescent girls.

DESIGN

Comparative, descriptive design using confidential self-administered questionnaires.

SETTING

An urban family planning clinic that provided gynecologic services to adolescents.

PARTICIPANTS

One hundred twenty-nine single, sexually active adolescent girls 15 to 19 years of age (44% minority, 34% economically disadvantaged).

MAIN OUTCOME MEASURES

In addition to demographics and risk behaviors, the following were assessed: HIV-related information (i.e., knowledge) and motivation to reduce risk (i.e., perceived vulnerability, readiness to change HIV risk behaviors, behavioral intentions, pros and cons of condom use, and confidence in condom use).

RESULTS

Assessments revealed limited HIV-related knowledge, ambivalence regarding risk reduction, and considerable risk behaviors. Compared with girls at lower risk for HIV infection (i.e., consistent condom users), those at higher risk (i.e., inconsistent or noncondom-users) were more likely to be White and older and to have better HIV-related knowledge but less motivation to reduce risk (i.e., behavioral intentions to use condoms, condom-use confidence) than girls at lower risk.

CONCLUSION

These data document (a) the need for HIV prevention interventions targeted to all sexually active adolescent girls and (b) the importance of including a motivational component in the intervention.

An HIV risk-reduction intervention in an adolescent correctional facility: lessons learned

Adolescents are now being described as the generation most at risk for human immunodeficiency virus (HIV) infection. Incarcerated young women remain a group at even greater risk, with markedly higher HIV seroprevalence rates compared with their male counterparts. In preparing for a longitudinal, randomized, controlled trial, our research team conducted a pilot project with incarcerated adolescent women. The purpose of this report is to offer clinicians and researchers interested in working with this population some insights on how to approach young women in detention and the logistics of carrying out a program in a correctional facility.

Adolescents' input on the development of an HIV risk reduction intervention

Adolescence is a developmental period often associated with sexual debut as well as risk taking. Given these considerations, HIV prevention interventions need to become an important component of adolescent health care. This article describes the use of formative research to guide intervention refinement. To refine an HIV risk reduction intervention that has been used successfully with adults, the authors conducted focus groups with 30 adolescent females. These participants identified misconceptions regarding HIV-related information and factors that influence motivation to participate in risky behaviors. They also suggested strategies for recruitment and retention in a longitudinal study. Formative research such as this can be used to develop interventions that are gender specific and developmentally and culturally appropriate for adolescents.

Mentoring students and junior faculty in faculty research: a win-win scenario

The concept of mentoring in nursing has focused primarily on moving novice nurses to a more advanced level of expertise in the clinical setting. With the growing emphasis on expanding evidence-based practice in nursing, however, mentoring within the context of research is becoming increasingly important. This article describes the many reciprocal benefits of research mentoring for students, junior faculty, and senior faculty researchers as well as for colleges of nursing and nursing science. Suggestions for implementing processes that facilitate successful mentoring within a research setting also are offered.

HIV risk behavior and psychological correlates among native American women: an exploratory investigation

Native American women are at increased risk for HIV infection, but few studies have studied this threat. To address this gap in the literature, we assessed HIV risk behavior and explored the hypothesized psychological antecedents of risk behavior in 53 Native American women. Survey results indicated that women's HIV-related knowledge was incomplete and many women still held misconceptions about HIV. One third of the sample reported having two to five sexual partners in the past 5 years, and 30% of the women reported alcohol use prior to sexual intercourse. Women who were classified at higher risk, that is, who did not use condoms consistently, felt less vulnerable to HIV and were less ready to change their risky sexual behaviors compared with their lower-risk counterparts. These findings indicate that Native American women are at risk for HIV infection and can no longer be neglected by those seeking to prevent HIV infections. Culturally congruent and gender-specific interventions that provide information and behavioral skills to Native American women as well as increase their motivation to adopt safer sexual behaviors are needed.

How male nursing students learn to care

the current definitions of caring in nursing education denote a mutual relationship between teachers and students in which they interact to provide an environment which supports the students' personal and professional development. The learning of caring in an interactional context is typical of the female experience. It is unknown if this is representative of the male experience. The lived experience of 20 male students as they learned to care as nurses was the focus of this phenomenological research study. The participants concurred that, although caring as a nurse could be learned if one was 'open to learning', teachers could only facilitate this learning; they could not directly teach it. The interactional strategies of storytelling, modelling, being cared for, the 'aha' encounter, and observing and giving care, were used by the participants in learning to care as nurses. The implications of these findings for nursing education and research are presented.