Social cognitions associated with pubertal development in a sample of urban, low-income, African-American and Latina girls and mothers

Breasts, Butts, and Thighs—Oh My! Weight Spurt and Body Image Messages in Girls’ Puberty Books

Analyze popular girls’ puberty books to understand what messages they portray about weight spurt and body image. A critical ethnography was conducted of 13 best-selling books about girls’ puberty. This analysis specifically focused on messages about weight gain/spurt and body image presented in the books and whether these were aligned with larger cultural understandings of weight gain and body image. A data-driven thematic analysis was conducted on the portions of each book relevant to weight gain and body image. The cultural fat-phobic scripts were prevalent in the books, contrasting the well-intended developmental messages. Discussions of weight tended to be negatively framed and weight gain expectations were distressingly vague. The books discussed the necessity of and biological rationale for those changes while normalizing variation in timing. The books also focused on developing a positive body image during this time. Understanding this allows us to see the pervasive, conflicting messages about weight-spurts that girls are receiving from these resources, which can be used to tailor book choice and outreach programs.

The Measurement of Female Early Adolescent Sexual Desire

We used the developmental systems model to deduce a definition of female early adolescent sexual desire. We evaluated a measure of this phenomenon with a secondary analysis of data from a randomized group sexual health intervention trial involving low-income, English-speaking, seventh grade Latinas enrolled in a Miami-Dade County public school (n = 542). As part of this study, girls completed a four-item early adolescent sexual desire (EASD) measure. Study findings supported internal consistency (Cronbach's alpha = .81 to .82) and stability over a 1-month period (r = .74). Developmental sensitivity was supported by a decline in stability over 12- (r = .66) and 24-month periods (r = .56). Validity was supported by correlations with puberty changes, sexual intentions, sexting, and sexual behavior, and hypothesized mean differences associated with dating and preference for shoes culturally associated with female sexual attractiveness (p < .01). Research implications include validation work with other ethnic/racial groups and using the EASD as a starting point for a measurement continuum tracking development of sexual desire across adolescence and into adulthood. Directions for future research also include measuring the development of sexual desire in boys and transgendered youth across adolescence and into adulthood.

Associations Between Agency and Sexual and Reproductive Health Communication in Early Adolescence: A Cross-cultural, Cross-sectional Study

PURPOSE

To assess the extent to which adolescents aged 10-14 have communicated about sexual relationships, pregnancy, and contraception and how agency in the form of voice and decision-making along with an enabling socioecological environment are associated with sexual and reproductive health (SRH) communication.

METHODS

Using data from the Global Early Adolescent Study, we included 1,367, 697, and 1,424 adolescents in Kinshasa, Cuenca, and Shanghai, respectively. Patterns of SRH communication and agency levels were described by site and sex. Multivariable logistic regressions assessed odds of SRH communication first in relation to socioecological characteristics and second with levels of agency, after adjustment for social environmental factors. Interaction terms tested sex differences in associations.

RESULTS

Experiences of SRH communication ranged from one in ten in Kinshasa to about half in Cuenca. Pregnancy was the most discussed SRH topic. Socioecological factors consistently related to SRH communication included older age and pubertal onset, while others varied by context. In multivariable analyses, voice was linked to all forms of SRH communication in Kinshasa and Cuenca with adjusted odds ratios ranging from 1.6 to 2.2, but not in Shanghai. In Cuenca, decision-making was associated with a 50% and 60% increase in odds of communication about pregnancy and contraception, respectively. In Kinshasa, a stronger association between voice and pregnancy discussions was observed for girls than boys.

CONCLUSIONS

Developmental characteristics and voice were linked to communication about SRH among young adolescents across two contexts. Results suggest agency may play a role in shaping antecedents, like communication, to sexual behaviors.

'Yeah, I've grown; I can't go out anymore': differences in perceived risks between girls and boys entering adolescence

This analysis is based on data from the Global Early Adolescent Study, which aims to understand the factors that predispose young people aged 10-14 years to positive or negative health trajectories. Specifically, interview transcripts from 202 adolescents and 191 parents across six diverse urban sites (Baltimore, Ghent, Nairobi, Ile Ife, Assuit and Shanghai) were analysed to compare the perceived risks associated with entering adolescence and how these risks differed by gender. Findings reveal that in all sites except Ghent, both young people and their parents perceived that girls face greater risks related to their sexual and reproductive health, and because of their sexual development, were perceived to require more protection. In contrast, when boys grow up, they and their parents recognised that their independence broadened, and parents felt that boys were strong enough to protect themselves. This has negative consequences as well, as boys were perceived to be more prone to risks associated with street violence and peer pressure. These differences in perceptions of vulnerability and related mobility are markers of a gender system that separates young women and men's roles, responsibilities and behaviours in ways that widen gender power imbalance with lifelong social and health consequences for people of both sexes.

Puberty Experiences of Low-Income Girls in the United States: A Systematic Review of Qualitative Literature From 2000 to 2014

PURPOSE

Puberty is a critical period of development that lays the foundation for future sexual and reproductive health. It is essential to learn about the puberty experiences of low-income girls in the United States given their increased vulnerability to negative sexual and reproductive health outcomes. To understand the present-day puberty experiences of this population, we conducted a qualitative systematic review.

METHODS

We systematically searched the peer-reviewed literature published between 2000 and 2014 on the puberty experiences of low-income girls in the United States. Reviewers screened titles, abstracts, and the full texts of articles. Using standardized templates, reviewers assessed the methodologic quality and extracted data. Data were synthesized using thematic analysis. Confidence in each finding was assessed using Confidence in the Evidence from Reviews of Qualitative research.

RESULTS

Twenty qualitative articles were included. They described the experiences of mostly African-American, Caucasian, and Hispanic girls living primarily in urban areas of Northeastern United States. Five overarching themes emerged: content of girls' puberty experiences, quality of girls' puberty experiences, messages girls receive about puberty, other factors that shape girls' puberty experiences, and relationships that shape girls' experiences of puberty.

CONCLUSIONS

The limited existing evidence suggests that low-income girls in the United States are unprepared for puberty and have largely negative experiences of this transition.

Understanding Factors that Shape Gender Attitudes in Early Adolescence Globally: A Mixed-Methods Systematic Review

Background

Early adolescence (ages 10–14) is a period of increased expectations for boys and girls to adhere to socially constructed and often stereotypical norms that perpetuate gender inequalities. The endorsement of such gender norms is closely linked to poor adolescent sexual and reproductive and other health-related outcomes yet little is known about the factors that influence young adolescents’ personal gender attitudes.

Objectives

To explore factors that shape gender attitudes in early adolescence across different cultural settings globally.

Methods

A mixed-methods systematic review was conducted of the peer-reviewed literature in 12 databases from 1984–2014. Four reviewers screened the titles and abstracts of articles and reviewed full text articles in duplicate. Data extraction and quality assessments were conducted using standardized templates by study design. Thematic analysis was used to synthesize quantitative and qualitative data organized by the social-ecological framework (individual, interpersonal and community/societal-level factors influencing gender attitudes).

Results

Eighty-two studies (46 quantitative, 31 qualitative, 5 mixed-methods) spanning 29 countries were included. Ninety percent of studies were from North America or Western Europe. The review findings indicate that young adolescents, across cultural settings, commonly express stereotypical or inequitable gender attitudes, and such attitudes appear to vary by individual sociodemographic characteristics (sex, race/ethnicity and immigration, social class, and age). Findings highlight that interpersonal influences (family and peers) are central influences on young adolescents’ construction of gender attitudes, and these gender socialization processes differ for boys and girls. The role of community factors (e.g. media) is less clear though there is some evidence that schools may reinforce stereotypical gender attitudes among young adolescents.

Conclusions

The findings from this review suggest that young adolescents in different cultural settings commonly endorse norms that perpetuate gender inequalities, and that parents and peers are especially central in shaping such attitudes. Programs to promote equitable gender attitudes thus need to move beyond a focus on individuals to target their interpersonal relationships and wider social environments. Such programs need to start early and be tailored to the unique needs of sub-populations of boys and girls. Longitudinal studies, particularly from low-and middle-income countries, are needed to better understand how gender attitudes unfold in adolescence and to identify the key points for intervention.

The Development of the Sexual Self-Concept Inventory for Early Adolescent Girls

The Sexual Self-Concept Inventory (SSCI) was developed to assess sexual self-concept in an ethnically diverse sample of urban early adolescent girls. Three scales (Sexual Arousability, Sexual Agency, and Negative Sexual Affect) were shown to be distinct and reliable dimensions of girls' sexual self-concepts. Validity was established through comparisons with established instruments. Sexual Arousability and Sexual Agency were associated with positive sexual self-esteem, positive future orientation toward sex, intentions to engage in intercourse, and lower levels of sexual experience. Negative Sexual Affect was associated with stronger abstinence attitudes and lack of intentions or orientation toward sex in the near future. The results indicate that the SSCI constitutes a valid means of assessing early adolescent girls' views of their sexuality and sexual behavior and may be of use in studies of health and risk-related decision making.

The Impact of Asynchronous Pubertal Development on Depressive Symptoms in Adolescence and Emerging Adulthood Among Females

Puberty is accompanied by numerous psychological and interpersonal challenges, including a dramatic rise in the prevalence of depression among girls. Pubertal timing has been identified as a potent predictor of depressive symptoms among females, but less is known about other features of puberty. The present study sought to address this gap in the literature by examining the effect of pubertal synchrony, the degree to which morphological indicators of puberty develop concurrently, on depressive symptoms in adolescence and emerging adulthood in a longitudinal sample. Among 355 female participants, asynchronous development at age 13 was associated with increased depressive symptoms at age 20, but not age 15. Additional analyses indicated that pubertal timing moderated the association between synchrony and depressive symptoms at age 20, such that girls who exhibited asynchronous development had the highest levels of depressive symptoms when they matured later than peers. Results provide initial empirical support for the role of pubertal synchrony in the development of depression among females and are discussed with regard to the biopsychosocial processes that may connect features of puberty with the long-term development of psychopathology.

The Student Human Papillomavirus Survey: Nurse-Led Instrument Development and Psychometric Testing to Increase Human Papillomavirus Vaccine Series Completion in Young Adults

BACKGROUND AND PURPOSE

The Student Human Papillomavirus Survey (SHPVS) was developed to examine students' perceived benefits or barriers to human papillomavirus (HPV) vaccination.

METHODS

Survey development included (a) 2-phase integrative literature reviews; (b) draft of survey items based on the literature; (c) critique of survey items by young adults, nursing and psychology faculty, and health care providers; and (d) pilot testing. The psychometric properties of the SHPVS were evaluated using classical item analysis and exploratory factor analysis (EFA) among a sample of 527 university students' ages 18-24 years.

RESULTS

The estimated Cronbach's alpha for the SHPVS is .74.

CONCLUSIONS

The SHPVS is a measure of young adults HPV perceived vulnerability, perceived severity, perceived barriers, and perceived benefits of HPV vaccination.

Pubertal Timing, Peer Victimization, and Body Esteem Differentially Predict Depressive Symptoms in African American and Caucasian Girls

This study prospectively examined pubertal timing and peer victimization as interactive predictors of depressive symptoms in a racially diverse community sample of adolescents. We also expanded on past research by assessing body esteem as a mechanism by which pubertal timing and peer victimization confer risk for depression. In all, 218 adolescents (53.4% female, 49.3% African American, 50.7% Caucasian) completed both a baseline assessment and a follow-up assessment approximately 8 months later. Early maturing Caucasian girls and late maturing African American girls experienced the greatest increases in depressive symptoms at follow-up if they experienced higher levels of peer victimization between baseline and follow-up. Furthermore, body esteem significantly mediated the relationship between pubertal timing, peer victimization, and depressive symptoms for girls of both races. The interaction of pubertal timing and peer victimization did not predict depressive symptoms for boys of either race. These results support body esteem as a mechanism that contributes to increased depression among girls in adolescence-despite a differential impact of pubertal timing for Caucasian and African American girls.

Risky sexual behaviours: The role of substance use, psychopathic traits, and attachment insecurity among adolescents and young adults in Quebec

The purpose of this study was to examine how substance use, psychopathic traits, and attachment representations explain sexual risk-taking in adolescence. Variables used to define risky sexual behaviours were age at first sexual intercourse and number of lifetime sexual partners. A sample of 1,553 adolescents and young adults completed a battery of questionnaires including measures of substance use, psychopathic traits, attachment representations, and sexual behaviours. Structural equation modelling demonstrated that, in the present sample, risky sexual behaviours were best modelled through both direct effects of avoidant attachment representations and indirect effects of psychopathic traits and abandonment anxiety through increases in substance use. This model was gender-invariant and may represent a contemporary trend toward homogenization of sexual practices among young people in Quebec.

Parental Human Papillomavirus Vaccine Survey (PHPVS): nurse-led instrument development and psychometric testing for use in research and primary care screening

BACKGROUND AND PURPOSE

Human papillomavirus (HPV) vaccine was approved for girls aged 9-24 years in 2006 to prevent HPV infection and cervical cancer. The Parental Human Papillomavirus Survey (PHPVS) was framed on theoretical constructs of the health belief model (HBM) and developed to survey parents regarding their HPV knowledge, attitudes, and intent to vaccinate.

METHODS

We evaluated the psychometric properties of the PHPVS using classical item analysis and exploratory factor analysis (EFA) among a sample of 200 parents/caregivers.

RESULTS

The EFA yielded a 4-factor unidimensional model that explained between 62% and 68% of the total variance depending on the extraction method used. The estimated Cronbach's alpha for the PHPVS was .96.

CONCLUSIONS

The PHPVS is a reliable measure of HPV knowledge, attitudes, and intent to vaccinate.

An opportunity for cancer prevention during preadolescence and adolescence: stopping human papillomavirus (HPV)-related cancer through HPV vaccination

OBJECTIVE

We conducted a descriptive study of the correlates of refusal and acceptance of human papillomavirus (HPV) vaccination by rural parents of preadolescent and adolescent children. We hypothesized that the correlates of parents who allow their children aged 9 to 13 years to get the HPV vaccine and those of parents who do not allow vaccination would differ significantly.

METHODS

This cross-sectional study was implemented during the school years 2009-2011 in the elementary and middle schools of three rural counties in Georgia. Parents were recruited at school functions to complete an anonymous validated survey.

RESULTS

Parents who chose to vaccinate their children or intended to vaccinate were twice as likely to be from a race other than African American and 2.7 times more likely to have a religion other than Baptist. Using stepwise logistic regression and after adjustment for race and religion, we found that parents who had vaccinated or intended to vaccinate had significantly higher scores on perceived barriers (1.02 times more likely to vaccinate) and lower scores on perceived benefits (1.01 times more likely to vaccinate) (model p < .001).

CONCLUSIONS

The results suggest that healthcare providers in rural areas can increase HPV vaccine uptake and reduce HPV-related cancers by using a multifaceted approach to educating their patients within the context of the patients' cultural values, geographic location, and economic situation. Such an approach could dispel misinformation and increase vaccine uptake.

Maternal navigational strategies: examining mother-daughter dyads in adolescent families of color

Mother-daughter relationships are critical to the health and well-being of adolescent girls. Understanding mothers' and daughters' perspectives on the relationship can inform health promotion strategies that may benefit both. In-depth semistructured interviews were conducted with mothers (N = 12) and their adolescent daughters (N = 16). Narrative profiles were constructed to identify participants' perceptions of each other and the relationship. Profiles were condensed into analytic poems that were compared and contrasted across roles and within and across dyads. Maternal navigational strategies of protection and preparation, and subthemes of maternal self-protection and daughter reverse protection emerged. The fabric of maternal strategies changed by girls' developmental stage, with mothers of older daughters describing an interweaving of protection and preparation. Suggestions for future family nursing and health promotion research and campaigns are provided.

Putting pubertal timing in developmental context: implications for prevention

This article examines selected findings regarding the consequences of difference in timing of pubertal onset in order to build an explanatory model of puberty in context. We also seek to shed light on possible prevention efforts targeting adolescent risk. To date, there is substantial evidence supporting early onset effects on both internalizing and externalizing problems during the adolescent decade and possibly beyond. However, such effects do not directly speak to preventive intervention. The biological, familial, and broader relationship contexts of puberty are considered along with unique contexts for early maturing girls versus boys. Finally, we identify potential strategies for intervention based on these explanatory models.

Pubertal development in Mexican American girls: the family's perspective

Mexican American (MA) girls are entering puberty earlier than in the past, yet few studies have explored the perceptions surrounding puberty among this group. We conducted separate focus groups for fathers, mothers, and daughters aged 6 to 12 years to explore perceptions of body image, pubertal development, communications, and sources of puberty-related information in MA participants. Our results revealed parental concerns about daughters' weight and pubertal development, as well as differences in their communication with their daughters. Although both parents willingly discussed pubertal issues concerning their daughters, mothers had a more active role in conveying pubertal information to daughters. Among the girls, there was a gap in knowledge about the pubertal process between the younger and older girls. Our findings present opportunities and challenges for addressing obesity as a pubertal risk factor in MA girls; however, more studies are needed to understand family beliefs and sociocultural dynamics surrounding puberty in MAs.

"That's nasty" to curiosity: early adolescent cognitions about sexual abstinence

PURPOSE

Effective sex education for early adolescents should make use of age-appropriate cultural models about sexual abstinence. However, little is known about how early adolescents view this topic. We describe developmental differences in cognitions about sexual abstinence among high-risk early adolescents.

METHODS

After institutional review board approval and informed consent, we interviewed 22 11-14-year-olds, using a qualitative, two-stage interview. Participants were first asked a series of open-ended questions about sexual abstinence, and then asked to explain their answers. Interviews were transcribed, organized by age, and read in their entirety. Codes were developed from the literature, field notes, and transcripts. Key concepts were identified and models were developed with a focus on developmental change.

RESULTS

We observed three distinct views of sexual abstinence, "That's Nasty," "Curious," and Normative. All viewed abstinence as a starting point and sex as a transition to adulthood. "That's Nasty" participants identified sex as distasteful, displayed limited understanding of sex, and viewed abstinence as appropriate for kids like themselves. Curious participants expressed a desire for information about sex, and a sense of missing something important. Normative participants viewed the transition from abstinence to sexual experience as part of a normal, albeit challenging, transition to adulthood.

CONCLUSIONS

Participants demonstrated differences in cognitions about sexual abstinence, related to age and development. The transition from viewing sex as distasteful to curiosity appears to be a time of both vulnerability and openness, and may provide an opportunity for intervention.

Sibling influence, gender roles, and the sexual socialization of urban early adolescent girls

This study examined whether older siblings influence early adolescent girls' sexual socialization. Participants were 180 girls, 12 to 14-years-old, from predominantly ethnic minority backgrounds. They completed a battery of interviewer-administered measures assessing a range of sexual cognitions and romantic and sexual behaviors. As predicted, compared with other girls, girls with older brothers placed greater value in becoming a parent, had lower levels of sexual responsivity or interest, and reported smaller age discrepancies between themselves and their partners for their first romantic kiss. Regardless of sibling sex, having older siblings was associated with more restrictive sexual cognitions and behaviors. Findings are interpreted in the context of sexual script theory.