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Footman A, Kanney N, Niccolai LM, Zimet GD, Overton ET, Davies SL, Van Der Pol B. Parents' Acceptance of COVID-19 Compared to Human Papillomavirus Vaccines. J Adolesc Health 2022; 71:673-678. [PMID: 36208985 PMCID: PMC9533113 DOI: 10.1016/j.jadohealth.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/21/2022] [Accepted: 07/31/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE The first vaccine against SARS-CoV-2 (COVID-19) for adolescents 16 years and older in the United States received Emergency Use Authorization in December 2020. Soon after its approval, parents expressed concerns about vaccine safety for adolescents. Similar concerns about vaccine safety partially explain suboptimal human papillomavirus (HPV) vaccine uptake. This qualitative study explores similarities and differences in parents' attitudes about these two vaccines. METHODS Parents were recruited through social media and at health centers in Alabama. Semi-structured interviews with parents of adolescents aged 9-17 years were conducted before and after Alabama expanded age eligibility to those 16 and older. Topics included knowledge about HPV and COVID-19 vaccines, and parents' intentions to have children vaccinated. Interviews were analyzed using thematic analysis. RESULTS From March 11, 2021 to April 24, 2021, 21 in-depth interviews were conducted. Parents discussed the importance of HPV and COVID-19 vaccines for protecting their children's health but differences between the two related to community protection. Parents were concerned about vaccine safety but media coverage about the COVID-19 vaccine led to more favorable attitudes about the benefits of vaccination, which was not observed for HPV vaccines. Instead for HPV vaccination, parents wanted their healthcare providers' opinions about the vaccine before making a vaccination decision. DISCUSSION Parents had similar concerns about HPV and COVID-19 vaccines. Although provider recommendations can improve vaccine uptake, local news reports were seen to have a positive impact on COVID-19 vaccine acceptance in lieu of provider recommendation. Disseminating information online could be beneficial to promote HPV and COVID-19 vaccines.
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Affiliation(s)
- Alison Footman
- University of Alabama at Birmingham, School of Public Health, Birmingham, Alabama.
| | - Nita Kanney
- University of Alabama at Birmingham, School of Public Health, Birmingham, Alabama
| | - Linda M Niccolai
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
| | - Gregory D Zimet
- Indiana University, School of Medicine, Indianapolis, Indiana
| | | | - Susan L Davies
- Tulane University, School of Social Work, New Orleans, Louisiana
| | - Barbara Van Der Pol
- University of Alabama at Birmingham, School of Public Health, Birmingham, Alabama; University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama
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Abstract
IMPORTANCE In the United States, adolescents who are lesbian, gay, or bisexual (LGB) face disparities across physical and mental health outcomes compared with non-LGB youth, yet few studies have looked at patterns of health care utilization by sexual orientation. OBJECTIVE To compare health care utilization indicators for LGB and non-LGB youth. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed wave 3 data from Healthy Passages, a longitudinal observational study of diverse public school students in Birmingham, Alabama; Houston, Texas; and Los Angeles County, California. Multivariable logistic regression models tested sexual-orientation differences in the past 12-month health care utilization measures, controlling for youth age, gender, race and ethnicity, household education, income, and marital status. Data collection began in 2010 when students were in the 5th grade (mean [SE] age, 11.13 [0.01] years) (wave 1) and continued 2 years later (wave 2, 7th grade) and 5 years later (wave 3, 10th grade). Permission to be contacted was provided for 6663 children, and 5147 (77%) participated in audio computer-assisted self-administered interviews. This study included 4256 youth (640 LGB, 3616 non-LGB) who completed interviews at wave 1 and wave 3 and answered key items used in this analysis. Analyses were completed in June 2021. EXPOSURES Sexual orientation (LGB vs non-LGB). MAIN OUTCOMES AND MEASURES Health care utilization and communication difficulty with a physician in the past 12 months. RESULTS Among 4256 youths included in the study at baseline in 5th grade (wave 1), 2171 (48.9%) were female; 1502 (44.5%) were Hispanic or Latino; 1479 (28.9%) were Black; the mean (SE) age was 11.19 (0.03) years; and 640 (14.5%) were LGB at wave 3. Compared with non-LGB youth, a higher proportion of LGB youth reported not receiving needed medical care in the last 12 months (adjusted odds ratio [aOR], 1.68; 95% CI,1.38-2.05), most commonly for sexually transmitted infections, contraception, and substance use. LGB youth more frequently reported difficulty communicating with their physician (aOR, 1.71; 95% CI, 1.27-2.30) than non-LGB youth. CONCLUSIONS AND RELEVANCE This study's results found that health care utilization differs by sexual orientation for youth. These findings suggest that clinician training is needed to address the health care needs of LGB youth. Routinely capturing sexual orientation data might enable tracking of health care utilization indicators for LGB youth.
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Affiliation(s)
- Sari L. Reisner
- Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Division of Endocrinology, Diabetes & Hypertension, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Camila Mateo
- Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | | | | | | | - Dennis Li
- Northwestern University, Evanston, Illinois
| | - Mark Schuster
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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Davies SL, Smith TL, Murphy B, Crawford MS, Kaiser KA, Clay OJ. CITY Health II - using entertainment education and social media to reduce HIV among emerging adults: A protocol paper for the Beat HIVe project. Contemp Clin Trials 2020; 99:106167. [PMID: 33031956 DOI: 10.1016/j.cct.2020.106167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/28/2020] [Accepted: 10/01/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite multiple efforts to reduce HIV rates among African American young adults, a significant racial disparity persists and continues to grow among this population. New approaches are needed to reach this at-risk group and engage them in prevention efforts. The Community Influences Transitions of Youth Health (CITY Health II) study aims to increase HIV preventive behaviors to decrease HIV rates among 18-25 year old African American emerging adults living in resource-poor southern urban communities. METHODS CITY Health II is a 5-year HIV prevention study that evaluates the efficacy of a peer-driven entertainment education intervention compared to an attention-control intervention using a cluster randomized trial design. Participants were recruited through respondent-driven sampling (RDS) to participate in a social media intervention. We enlisted eight musicians and groups to help us create an entertaining and educational web-based video series, "The Beat HIVe", for study participants to view on smartphones and share with peers on social media. Data collection interviews at baseline, 3-month, and 6-month follow-up assessed socio-demographics, risk and protective behaviors, social networks, and peer norms. Analyses will determine if participation is associated with improved HIV-related outcomes; examine whether intervention changes are mediated by perceived social norms and outcome expectations; determine whether intervention benefits vary by sociodemographic characteristics related to mediators, intervention outcome, or level of engagement; and examine the relationship between participant dose of intervention and outcomes. DISCUSSION Outcomes will inform ways to engage African American emerging adults through entertainment education and other strategies for increasing optimal sexual health behaviors. TRIAL REGISTRATION NCT04320186.
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Affiliation(s)
- Susan L Davies
- Department of Health Behavior, University of Alabama at Birmingham, USA.
| | - Tamika L Smith
- Department of Health Behavior, University of Alabama at Birmingham, USA
| | - Bailey Murphy
- Department of Health Behavior, University of Alabama at Birmingham, USA
| | - M Scott Crawford
- Department of Health Behavior, University of Alabama at Birmingham, USA
| | - Kathryn A Kaiser
- Department of Health Behavior, University of Alabama at Birmingham, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama at Birmingham, USA
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Corcoran JL, Davies SL, Knight CC, Lanzi RG, Li P, Ladores SL. Adolescents' perceptions of sexual health education programs: An integrative review. J Adolesc 2020; 84:96-112. [PMID: 32896710 DOI: 10.1016/j.adolescence.2020.07.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 05/26/2020] [Accepted: 07/30/2020] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Adolescents are key stakeholders in sexual health education, yet they are rarely consulted when developing sexual health programs. Their voices are integral to improving the delivery of relevant and appropriate school-based sexual health education to promote safer adolescent sexual behaviors. METHODS An integrative review was conducted utilizing three databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete, PubMed, and Education Resources Information Center (ERIC). The PRISMA and matrix method were used to search the literature and synthesize the findings from 16 articles regarding adolescent perceptions of school-based sexual health education. RESULTS The main themes that emerged from this review included: (a) factors influencing adolescent perceptions of sexual health education programs, (b) characteristics of good sexual health education programs, and (c) areas of improvement in sexual health education programs. CONCLUSION Adolescents overwhelmingly requested honest, comprehensive content delivered by nonjudgmental, well-educated health professionals in a comfortable environment.
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Affiliation(s)
| | - Susan L Davies
- University of Alabama at Birmingham School of Public Health, United States.
| | - Candace C Knight
- University of Alabama at Birmingham School of Nursing, United States.
| | - Robin G Lanzi
- University of Alabama at Birmingham School of Public Health, United States.
| | - Peng Li
- University of Alabama at Birmingham School of Nursing, United States.
| | - Sigrid L Ladores
- University of Alabama at Birmingham School of Nursing, United States.
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Jetelina KK, Reingle Gonzalez JM, Cuccaro PM, Peskin MF, Pompeii L, Atem F, Elliott MN, Earnshaw VA, Davies SL, Schuster MA. Mechanisms and Frequency of Violent Injuries Among Victims and Perpetrators of Bullying. J Adolesc Health 2019; 64:664-670. [PMID: 30612808 DOI: 10.1016/j.jadohealth.2018.10.295] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/02/2018] [Accepted: 10/26/2018] [Indexed: 01/17/2023]
Abstract
PURPOSE This article aims to (1) evaluate whether bullying typology predicts violent injury; (2) longitudinally examine whether violent injury trajectories differ across bullying typology as children age; and (3) longitudinally determine whether children who consistently reported perpetration or victimization (i.e., reported bullying at fifth, seventh, and 10th grade) were different from children who inconsistently reported perpetration or victimization. METHODS Longitudinal data were obtained from 4,297 children at three waves (fifth, seventh, and 10th grade) in three United States communities. Children were categorized into four mutually exclusive bullying typologies: neither victim nor perpetrator; victim only; perpetrator only; victim-perpetrator. Children self-reported mechanisms of violent injuries that needed medical attention in the past year. Regression models were used to evaluate the relationship between bullying group and the likelihood of violent injury over time. RESULTS Seventeen percent (n=857) of children in fifth grade reported a violent injury. Prevalence of overall violent injuries, and specifically firearm and knife injuries, increased over time. Children who reported perpetration in the absence of victimization were at increased odds for violent injury (adjusted odds ratio = 1.41, 95% confidence interval: 1.24, 1.60) compared with children who reported neither victimization nor perpetration, while children who reported victimization in the absence of perpetration were at decreased odds (adjusted odds ratio=.84, 95% confidence interval: .73, .97). A significant linear dose-response relationship was observed between duration of bullying perpetration and violent injury. CONCLUSIONS The relationship between bullying perpetration and violent injury over time was strong. Future research should investigate potential mediating behaviors, such as weapon access, which might explain the observed relationship.
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Affiliation(s)
- Katelyn K Jetelina
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, Texas.
| | | | - Paula M Cuccaro
- University of Texas Health Science Center, School of Public Health, Houston, Texas
| | - Melissa F Peskin
- University of Texas Health Science Center, School of Public Health, Houston, Texas
| | - Lisa Pompeii
- University of Texas Health Science Center, School of Public Health, Houston, Texas
| | - Folefac Atem
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, Texas
| | | | | | - Susan L Davies
- Department of Health Behavior, UAB Center for the Study of Community Health, Birmingham, Alabama
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Jetelina KK, Reingle Gonzalez JM, Cuccaro PM, Peskin MF, Pompeii L, Atem F, Elliott MN, Earnshaw VA, Davies SL, Schuster MA. Self-reporting discrepancies of bullying victimization and perpetration measures. Ann Epidemiol 2019; 32:58-63. [DOI: 10.1016/j.annepidem.2019.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/11/2018] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
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Tucker JA, Simpson CA, Chandler SD, Borch CA, Davies SL, Kerbawy SJ, Lewis TH, Crawford MS, Cheong J, Michael M. Utility of Respondent Driven Sampling to Reach Disadvantaged Emerging Adults for Assessment of Substance Use, Weight, and Sexual Behaviors. J Health Care Poor Underserved 2018; 27:194-208. [PMID: 27763465 DOI: 10.1353/hpu.2016.0006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Emerging adulthood often entails heightened risk-taking with potential life-long consequences, and research on risk behaviors is needed to guide prevention programming, particularly in under-served and difficult to reach populations. This study evaluated the utility of Respondent Driven Sampling (RDS), a peer-driven methodology that corrects limitations of snowball sampling, to reach at-risk African American emerging adults from disadvantaged urban communities. Initial "seed" participants from the target group recruited peers, who then recruited their peers in an iterative process (110 males, 234 females; M age = 18.86 years). Structured field interviews assessed common health risk factors, including substance use, overweight/obesity, and sexual behaviors. Established gender-and age-related associations with risk factors were replicated, and sample risk profiles and prevalence estimates compared favorably with matched samples from representative U.S. national surveys. Findings supported the use of RDS as a sampling method and grassroots platform for research and prevention with community-dwelling risk groups.
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Goldfarb SS, Locher JL, Preskitt J, Becker D, Davies SL, Sen B. Associations between participation in family activities and adolescent school problems. Child Care Health Dev 2017; 43:361-368. [PMID: 28101953 DOI: 10.1111/cch.12434] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 11/13/2016] [Accepted: 11/17/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Adolescent risk outcomes related to school issues are widespread, with about 20% parents reporting poor school engagement amongst their youth. Previous literature suggests that adolescents who report strong bonds with their parents are often identified as being less likely to engage in risky behaviours, such as substance use. The current study sought to examine the association between the frequencies of selected family activities and school problems amongst adolescents after adjustments for family connectedness and other characteristics. METHODS Data were drawn from the National Longitudinal Survey of Youth, 1997. Of the 8984 youth interviewed, 3855 also had a sibling interviewed who met the selection criteria. School problem outcomes measured were suspension occurrence, poor grades and highest grade completed low for age. Independent variables of interest were self-reported frequency of family dinner, fun and religious activities in a typical week. Multivariable logistic models were estimated for each outcome, and multivariable linear probability models were estimated adjusting for family fixed effects. RESULTS Adjusting for family connectedness, there were significant associations between certain family activities and adolescent school problem measures. However, these results did not remain significant in models with family fixed effects, suggesting that associations could be driven by family-level confounders. DISCUSSION This study did not find strong evidence of a protective relationship between family activities and school problems. Therefore, it suggested that programme and policymakers be cautious in overstating the importance of family activities in preventing adolescent risk outcomes until true causal relationships can be determined.
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Affiliation(s)
- S S Goldfarb
- College of Medicine, Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL, USA
| | - J L Locher
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - J Preskitt
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - D Becker
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - S L Davies
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - B Sen
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA
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Davies SL, DiClemente RJ, Wingood GM, Person SD, Crosby RA, Harrington KF, Dix ES. Relationship Characteristics and Sexual Practices of African American Adolescent Girls Who Desire Pregnancy. Health Educ Behav 2016; 31:85S-96S. [PMID: 15296694 DOI: 10.1177/1090198104266037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined associations between African American adolescent girls' desire to become pregnant and their sexual and relationship practices. Odds ratios and 95% confidence intervals were used to detect significant associations between pregnancy desire and the assessed correlates. Of 522 participants (14 to 18 years old), 67 (12.8%) were pregnant and were thus excluded from this analysis. Of the remaining 455 adolescents, 107 (23.6%) expressed some desire to be pregnant at the time of assessment. Adolescents who desired pregnancy were significantly more likely to report having had sex with a casual partner and to use contraception inconsistently. Factors involving an adolescent girl's relationship with her partner (e.g., being in a relationship, length of relationship, time spent with boyfriend, or satisfaction with boyfriend) were not significantly associated with the desire for pregnancy. Effective pregnancy and sexually transmitted disease prevention programs for female adolescents should address their level of pregnancy desire.
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Affiliation(s)
- Susan L Davies
- Center for Health Promotion, Department of Health Behavior, University of Alabama at Birmingham, School of Public Health, 227 Ryals Building, Birmingham, AL 35294, USA.
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Jetelina KK, Reingle Gonzalez JM, Cuccaro PM, Peskin MF, Elliott MN, Coker TR, Mrug S, Davies SL, Schuster MA. The Association Between Familial Homelessness, Aggression, and Victimization Among Children. J Adolesc Health 2016; 59:688-695. [PMID: 27646498 DOI: 10.1016/j.jadohealth.2016.07.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/13/2016] [Accepted: 07/10/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the relationship between the number of periods children were exposed to familial homelessness and childhood aggression and victimization. METHODS Survey data were obtained from 4,297 fifth-grade children and their caregivers in three U.S. cities. Children and primary caregivers were surveyed longitudinally in 7th and 10th grades. Family homelessness, measured at each wave as unstable housing, was self-reported by the caregiver. Children were categorized into four mutually exclusive groups: victim only, aggressor only, victim-aggressor, and neither victim nor aggressor at each time point using validated measures. Multinomial, multilevel mixed models were used to evaluate the relationship among periods of homelessness and longitudinal victimization, aggression, and victim aggression compared to children who were nonvictims and nonaggressors. RESULTS Results suggest that children who experienced family homelessness were more likely than domiciled children to report aggression and victim aggression but not victimization only. Multivariate analyses suggested that even brief periods of homelessness were positively associated with aggression and victim aggression (relative to neither) compared to children who were never homeless. Furthermore, childhood victimization and victim aggression significantly decreased from 5th grade to 10th grade while aggression significantly increased in 10th grade. CONCLUSIONS Children who experienced family homelessness for brief periods of time were significantly more likely to be a victim-aggressor or aggressor compared to those who were never homeless. Prevention efforts should target housing security and other important factors that may reduce children's likelihood of aggression and associated victimization.
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Affiliation(s)
- Katelyn K Jetelina
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas Regional Campus, Dallas, Texas.
| | - Jennifer M Reingle Gonzalez
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Dallas Regional Campus, Dallas, Texas
| | - Paula M Cuccaro
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, Texas
| | - Melissa F Peskin
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, Texas
| | | | - Tumaini R Coker
- Department of Pediatrics, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Sylvie Mrug
- Department of Psychology, University of Alabama Birmingham, Birmingham, Alabama
| | - Susan L Davies
- Department of Health Behavior, UAB Center for the Study of Community Health, Birmingham, Alabama
| | - Mark A Schuster
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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Tucker JA, Cheong J, Chandler SD, Lambert BH, Pietrzak B, Kwok H, Davies SL. Prospective Analysis of Behavioral Economic Predictors of Stable Moderation Drinking Among Problem Drinkers Attempting Natural Recovery. Alcohol Clin Exp Res 2016; 40:2676-2684. [PMID: 27775161 DOI: 10.1111/acer.13245] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 09/23/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND As interventions have expanded beyond clinical treatment to include brief interventions for persons with less severe alcohol problems, predicting who can achieve stable moderation drinking has gained importance. Recent behavioral economic (BE) research on natural recovery has shown that active problem drinkers who allocate their monetary expenditures on alcohol and saving for the future over longer time horizons tend to have better subsequent recovery outcomes, including maintenance of stable moderation drinking. This study compared the predictive utility of this money-based "Alcohol-Savings Discretionary Expenditure" (ASDE) index with multiple BE analogue measures of behavioral impulsivity and self-control, which have seldom been investigated together, to predict outcomes of natural recovery attempts. METHODS Community-dwelling problem drinkers, enrolled shortly after stopping abusive drinking without treatment, were followed prospectively for up to a year (N = 175 [75.4% male], M age = 50.65 years). They completed baseline assessments of preresolution drinking practices and problems, analogue behavioral choice tasks (Delay Discounting, Melioration-Maximization, and Alcohol Purchase Tasks), and a Timeline Followback interview including expenditures on alcohol compared to voluntary savings (ASDE index) during the preresolution year. RESULTS Multinomial logistic regression models showed that, among the BE measures, only the ASDE index predicted stable moderation drinking compared to stable abstinence or unstable resolutions involving relapse. As hypothesized, stable moderation was associated with more balanced preresolution allocations to drinking and savings (odds ratio = 1.77, 95% confidence interval = 1.02 to 3.08, p < 0.05), suggesting it is associated with longer-term behavior regulation processes than abstinence. CONCLUSIONS The ASDE's unique predictive utility may rest on its comprehensive representation of contextual elements to support this patterning of behavioral allocation. Stable low-risk drinking, but not abstinence, requires such regulatory processes.
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Affiliation(s)
- Jalie A Tucker
- Department of Health Education & Behavior, University of Florida, Gainesville, Florida
| | - JeeWon Cheong
- Department of Health Education & Behavior, University of Florida, Gainesville, Florida
| | - Susan D Chandler
- Department of Health Education & Behavior, University of Florida, Gainesville, Florida
| | - Brice H Lambert
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | - Brittney Pietrzak
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | - Heather Kwok
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | - Susan L Davies
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
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Coker TR, Elliott MN, Toomey SL, Schwebel DC, Cuccaro P, Emery ST, Davies SL, Visser SN, Schuster MA. Racial and Ethnic Disparities in ADHD Diagnosis and Treatment. Pediatrics 2016; 138:peds.2016-0407. [PMID: 27553219 PMCID: PMC5684883 DOI: 10.1542/peds.2016-0407] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We examined racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis and medication use and determined whether medication disparities were more likely due to underdiagnosis or undertreatment of African-American and Latino children, or overdiagnosis or overtreatment of white children. METHODS We used a population-based, multisite sample of 4297 children and parents surveyed over 3 waves (fifth, seventh, and 10th grades). Multivariate logistic regression examined disparities in parent-reported ADHD diagnosis and medication use in the following analyses: (1) using the total sample; (2) limited to children with an ADHD diagnosis or symptoms; and (3) limited to children without a diagnosis or symptoms. RESULTS Across all waves, African-American and Latino children, compared with white children, had lower odds of having an ADHD diagnosis and of taking ADHD medication, controlling for sociodemographics, ADHD symptoms, and other potential comorbid mental health symptoms. Among children with an ADHD diagnosis or symptoms, African-American children had lower odds of medication use at fifth, seventh, and 10th grades, and Latino children had lower odds at fifth and 10th grades. Among children who had neither ADHD symptoms nor ADHD diagnosis by fifth grade (and thus would not likely meet ADHD diagnostic criteria at any age), medication use did not vary by race/ethnicity in adjusted analysis. CONCLUSIONS Racial/ethnic disparities in parent-reported medication use for ADHD are robust, persisting from fifth grade to 10th grade. These findings suggest that disparities may be more likely related to underdiagnosis and undertreatment of African-American and Latino children as opposed to overdiagnosis or overtreatment of white children.
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Affiliation(s)
- Tumaini R. Coker
- Department of Pediatrics, Mattel Children’s Hospital, David Geffen School of Medicine at UCLA, Los Angeles, California,RAND, Santa Monica, California
| | | | - Sara L. Toomey
- Division of General Pediatrics, Boston Children’s Hospital and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - David C. Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Paula Cuccaro
- Center for Health Promotion and Prevention Research, University of Texas–Houston, School of Public Health, Houston, Texas
| | - Susan Tortolero Emery
- Center for Health Promotion and Prevention Research, University of Texas–Houston, School of Public Health, Houston, Texas
| | - Susan L. Davies
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Mark A. Schuster
- RAND, Santa Monica, California,Division of General Pediatrics, Boston Children’s Hospital and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Dudovitz RN, Chung PJ, Elliott MN, Davies SL, Tortolero S, Baumler E, Banspach SW, Schuster MA. Relationship of Age for Grade and Pubertal Stage to Early Initiation of Substance Use. Prev Chronic Dis 2015; 12:E203. [PMID: 26583575 PMCID: PMC4655482 DOI: 10.5888/pcd12.150234] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Introduction Studies suggest students who are substantially older than the average age for their grade engage in risky health behaviors, including substance use. However, most studies do not account for the distinct reasons why students are old for their grade (ie, grade retention vs delayed school entry) or for their pubertal stage. Thus, whether the association between age for grade and substance use is confounded by these factors is unknown. We sought to determine whether age, grade, or pubertal stage were associated with early substance use. Methods Cross-sectional Healthy Passages Wave I survey data from 5,147 fifth graders and their caregivers in Alabama, California, and Texas from 2004 through 2006 were analyzed in 2014. Logistic regressions examined whether older age for grade, grade retention, delayed school entry, or pubertal stage were associated with use of any substance, cigarettes, alcohol, or other drugs. Results Seventeen percent of fifth graders reported trying at least 1 substance. Among boys, advanced pubertal stage was associated with increased odds of cigarette, alcohol, or other drug use, whereas delayed school entry was associated with lower odds of any substance, alcohol, or other drug use. Among girls, advanced pubertal stage was associated only with higher odds of alcohol use, and delayed school entry was not associated with substance use. Neither older age for grade or grade retention was independently associated with substance use after controlling for potential confounders. Conclusion Advanced pubertal stage may be a more important risk factor for substance use than age for grade. Pediatricians should consider initiating substance use screening earlier for patients with advanced pubertal stage.
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Affiliation(s)
- Rebecca N Dudovitz
- Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, 10833 Le Conte Ave, 12-358 CHS, MC: 175217, Los Angeles, CA 90095.
| | - Paul J Chung
- University of California Los Angeles, Los Angeles, California, and RAND Corp, Santa Monica, California
| | | | | | | | | | - Stephen W Banspach
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mark A Schuster
- Division of General Pediatrics, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts
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Johnson ER, Davies SL, Aban I, Mugavero MJ, Shrestha S, Kempf MC. Improving parental stress levels among mothers living with HIV: a randomized control group intervention study. AIDS Patient Care STDS 2015; 29:220-8. [PMID: 25734870 DOI: 10.1089/apc.2014.0187] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Limited knowledge exists regarding parenting efficacy interventions for mothers living with HIV (MLH). This study evaluated the impact of a supportive group intervention on lowering parenting stress among MLH. Eighty MLH were randomized to a parenting (N=34) or health focused (control) (N=46) group intervention. Pre- and post-intervention stress levels were assessed using the Parental Stress Index-Short Form (PSI/SF). Differences in PSI/SF scores were examined using ANOVA, and predictors of PSI/SF scores were evaluated using multivariable linear regression. Findings indicate that both groups experienced significant decreases in parenting stress from baseline to post-intervention (p=0.0001), with no significant differences between interventions. At baseline, 41% of participants were identified as highly stressed and 30% as clinically stressed, with PSI/SF scores above the 85(th) and 90(th) percentile, respectively. Amongst the highly stressed subpopulation, significant improvements in PSI/SF scores for Parental Distress PSI/SF (p=0.039), Difficult Child PSI/SF (p=0.048), and total PSI/SF (p=0.036) were seen, with greater improvements in the parenting intervention. Among the clinically stressed subpopulation, significant improvements in total post-intervention PSI/SF scores were seen (p=0.049), with greater improvements in the parenting intervention. Results indicate that screening for high levels of stress should be considered in clinical practice to effectively implement stress-reducing interventions among MLH.
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Affiliation(s)
- Erica R. Johnson
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Susan L. Davies
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | - Inmaculada Aban
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael J. Mugavero
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sadeep Shrestha
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mirjam-Colette Kempf
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama
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Scott A, Messersmith WA, Jimeno A, Davies SL. Panitumumab in the treatment of colon cancer: A biomarker dilemma. Drugs Today (Barc) 2014; 50:679-90. [PMID: 25374966 DOI: 10.1358/dot.2014.50.10.2221787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Panitumumab is a fully human monoclonal antibody targeting epidermal growth factor receptor (EGFR) approved for use in colorectal cancer (CRC). Critical information regarding biomarkers in CRC has been discovered through the investigation of panitumumab treatment. The discovery of anti-EGFR resistance in the setting of Kirsten rat sarcoma viral oncogene (KRAS) and more recently, neuroblastoma RAS viral oncogene (NRAS) mutations in CRC has changed the focus of therapy for metastatic disease to one based on the molecular characteristics of the tumor. This review will give a brief background on panitumumab and its current uses in CRC.
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Affiliation(s)
- A Scott
- University of Colorado Denver, Aurora, Colorado, USA
| | | | - A Jimeno
- University of Colorado Denver, Aurora, Colorado, USA.
| | - S L Davies
- University of Colorado Denver, Aurora, Colorado, USA.
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Ladapo JA, Elliott MN, Kanouse DE, Tortolero SR, Windle M, Cuccaro PM, Davies SL, Schuster MA. Tobacco use and smoking intentions among U.S. fifth-grade students. J Adolesc Health 2014; 55:445-51. [PMID: 24794053 PMCID: PMC4143448 DOI: 10.1016/j.jadohealth.2014.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 03/20/2014] [Accepted: 03/20/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE To identify the risk and protective factors for cigarette smoking and future intentions among racially/ethnically diverse preadolescent children. METHODS We analyzed data from 5,119 fifth-grade children and their parents living in three U.S. metropolitan areas. Using the multivariate logistic regression models, we examined how cigarette smoking and intentions to smoke within 1 year are associated with (1) number of friends who smoke, (2) parental disapproval of smoking, (3) parental communication about not smoking, (4) performance in school, and (5) educational aspirations. RESULTS Twenty-nine percent of the children were black, 44% were Hispanic, 22% were white, and 5% were of another race/ethnicity. Mean age was 11.1 years. The prevalence of ever smoking a cigarette among black, Hispanic, and white children was 9.8%, 5.6%, and 4.9%, respectively. In adjusted analyses, children were more likely to have smoked a cigarette if their friends smoked (adjusted odds ratio [aOR] 5.1, 95% confidence interval [CI] 3.8-6.9), they frequently had trouble with schoolwork (aOR 2.1, 95% CI 1.5-3.1), or their parents were not college graduates (aOR 2.0, 95% CI 1.2-3.5 for high school graduate). They were less likely to have smoked cigarettes if their parents disapproved of smoking (aOR .3, 95% CI .1-.6). Parental communication (aOR .1, 95% CI .0-.6) and disapproval (aOR .2, 95% CI .1-.7) had protective associations for future intentions among children who had ever and had never smoked, respectively. CONCLUSIONS Fifth-graders share many of the same risk factors for smoking identified in older adolescents, some of which are modifiable. Antismoking policies and programs should be designed for preadolescents as well as adolescents, and campaigns targeting parents should place greater emphasis on communication and expressed disapproval of smoking.
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Affiliation(s)
- Joseph A. Ladapo
- Department of Population Health, New York University School of Medicine, New York, NY
| | | | | | | | - Michael Windle
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA
| | | | - Susan L. Davies
- Department of Health Behavior, University of Alabama-Birmingham School of Public Health, Birmingham, AL
| | - Mark A. Schuster
- Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Boston, MA,Department of Pediatrics, Harvard Medical School, Boston, MA
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17
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Tortolero SR, Peskin MF, Baumler ER, Cuccaro PM, Elliott MN, Davies SL, Lewis TH, Banspach SW, Kanouse DE, Schuster MA. Daily violent video game playing and depression in preadolescent youth. Cyberpsychol Behav Soc Netw 2014; 17:609-15. [PMID: 25007237 DOI: 10.1089/cyber.2014.0091] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Most studies on the impact of playing violent video games on mental health have focused on aggression. Relatively few studies have examined the relationship between playing violent video games and depression, especially among preadolescent youth. In this study, we investigated whether daily violent video game playing over the past year is associated with a greater number of depressive symptoms among preadolescent youth, after controlling for several well-known correlates of depression among youth. We analyzed cross-sectional data collected from 5,147 fifth-grade students and their primary caregivers who participated in Wave I (2004-2006) of Healthy Passages, a community-based longitudinal study conducted in three U.S. cities. Linear regression was conducted to determine the association between violent video game exposure and number of depressive symptoms, while controlling for gender, race/ethnicity, peer victimization, witnessing violence, being threatened with violence, aggression, family structure, and household income level. We found that students who reported playing high-violence video games for ≥2 hours per day had significantly more depressive symptoms than those who reported playing low-violence video games for <2 hours per day (p<0.001). The magnitude of this association was small (Cohen's d=0.16), but this association was consistent across all racial/ethnic subgroups and among boys (Cohen's d values ranged from 0.12 to 0.25). Our findings indicate that there is an association between daily exposure to violent video games and number of depressive symptoms among preadolescent youth. More research is needed to examine this association and, if confirmed, to investigate its causality, persistence over time, underlying mechanisms, and clinical implications.
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Affiliation(s)
- Susan R Tortolero
- 1 Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health , Houston, Texas
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18
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Davies SL, Cheong J, Lewis TH, Simpson CA, Chandler SD, Tucker JA. Sexual risk typologies and their relationship with early parenthood and STI outcomes among urban African-American emerging adults: a cross-sectional latent profile analysis. Sex Transm Infect 2014; 90:475-7. [PMID: 24860103 DOI: 10.1136/sextrans-2013-051334] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Identifying sexual risk patterns associated with HIV/sexually transmitted infections (STI) and early parenthood within population subgroups is critical for targeting risk reduction interventions. METHODS Latent Class Analysis (LCA) was used to identify sexual behaviour typologies to predict sexual risk outcomes among 274 (63% female) unmarried, sexually active African-American emerging adults (M age=19.31 years) living in disadvantaged urban neighbourhoods. Participants were enrolled in a larger cross-sectional observational study of risk and protective behaviours. LCA defined membership into discrete risk classes based on reported sex risk behaviours. RESULTS Three groups were identified: The 'low contraception use' risk class (32%) had low rates of condom or other birth control use, moderate rates of sexual initiation before age 16 years, and the highest pregnancy/early parenthood and STI rates. The predominately male 'early sex' risk class (32%) had higher rates of early initiation and multiple partners, risks that were countered by higher contraception and condom use. Both these risk groups showed higher probability to use substances before sex relative to the 'low sex risk' class (36%), which showed low rates on all risk behaviours. CONCLUSIONS LCA identified distinct risk clusters that predicted sexual health outcomes and can inform targeted interventions for a minority youth population disproportionately affected by HIV, other STIs, and early parenthood.
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Affiliation(s)
- Susan L Davies
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham and the UAB Center for AIDS Research, Birmingham, Alabama, USA
| | - JeeWon Cheong
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham and the UAB Center for AIDS Research, Birmingham, Alabama, USA
| | - Terri H Lewis
- Department of Pediatrics, University of Colorado, Denver, Colorado, USA
| | - Cathy A Simpson
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham and the UAB Center for AIDS Research, Birmingham, Alabama, USA
| | - Susan D Chandler
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham and the UAB Center for AIDS Research, Birmingham, Alabama, USA
| | - Jalie A Tucker
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham and the UAB Center for AIDS Research, Birmingham, Alabama, USA
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19
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Thind H, Davies SL, Lewis T, Pekmezi D, Evans R, Baskin ML. Does Short Sleep Lead to Obesity Among Children and Adolescents? Current Understanding and Implications. Am J Lifestyle Med 2014. [DOI: 10.1177/1559827614533911] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Childhood obesity continues to be a major public health concern in the United States. This work reviews the current understanding of the relationship between sleep duration and obesity among children and adolescents. A systematic search was conducted for papers published between January 2000 and July 2013 using keywords: (sleep) and (overweight or obesity or obese or body mass index or BMI or adiposity or body fat or fat) and (children or child or youth or teen or pediatric or adolescent or paediatric or childhood or adolescence or boy or girl). Reference lists of relevant articles and reviews or meta-analysis articles were checked to identify additional studies. Only empirical work and longitudinal studies that focused on children and adolescents were included in this review. The search identified 22 longitudinal studies. The majority of the reviewed studies support the presence of an inverse relationship between sleep duration and obesity. However, in some studies the relationship was not significant in adjusted analyses. Differences as a function of age and gender were also noted. Despite more than a decade of research, the debate on the association between sleep duration and obesity continues. Further research with repeated assessments, valid objective measures, and better control of potential confounding variables is warranted.
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Affiliation(s)
- Herpreet Thind
- Centers for Behavioral and Preventive Medicine, Brown Medical School and The Miriam Hospital, Providence, Rhode Island (HT)
- Department of Health Behavior, University of Alabama at Birmingham, Alabama (SLD, DP)
- Kempe Center, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, Colorado (TL)
- Department of Human Studies, University of Alabama at Birmingham, Alabama (RE)
- Division of Preventive Medicine, University of Alabama at Birmingham, Alabama (MLB)
| | - Susan L. Davies
- Centers for Behavioral and Preventive Medicine, Brown Medical School and The Miriam Hospital, Providence, Rhode Island (HT)
- Department of Health Behavior, University of Alabama at Birmingham, Alabama (SLD, DP)
- Kempe Center, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, Colorado (TL)
- Department of Human Studies, University of Alabama at Birmingham, Alabama (RE)
- Division of Preventive Medicine, University of Alabama at Birmingham, Alabama (MLB)
| | - Terri Lewis
- Centers for Behavioral and Preventive Medicine, Brown Medical School and The Miriam Hospital, Providence, Rhode Island (HT)
- Department of Health Behavior, University of Alabama at Birmingham, Alabama (SLD, DP)
- Kempe Center, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, Colorado (TL)
- Department of Human Studies, University of Alabama at Birmingham, Alabama (RE)
- Division of Preventive Medicine, University of Alabama at Birmingham, Alabama (MLB)
| | - Dorothy Pekmezi
- Centers for Behavioral and Preventive Medicine, Brown Medical School and The Miriam Hospital, Providence, Rhode Island (HT)
- Department of Health Behavior, University of Alabama at Birmingham, Alabama (SLD, DP)
- Kempe Center, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, Colorado (TL)
- Department of Human Studies, University of Alabama at Birmingham, Alabama (RE)
- Division of Preventive Medicine, University of Alabama at Birmingham, Alabama (MLB)
| | - Retta Evans
- Centers for Behavioral and Preventive Medicine, Brown Medical School and The Miriam Hospital, Providence, Rhode Island (HT)
- Department of Health Behavior, University of Alabama at Birmingham, Alabama (SLD, DP)
- Kempe Center, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, Colorado (TL)
- Department of Human Studies, University of Alabama at Birmingham, Alabama (RE)
- Division of Preventive Medicine, University of Alabama at Birmingham, Alabama (MLB)
| | - Monica L. Baskin
- Centers for Behavioral and Preventive Medicine, Brown Medical School and The Miriam Hospital, Providence, Rhode Island (HT)
- Department of Health Behavior, University of Alabama at Birmingham, Alabama (SLD, DP)
- Kempe Center, School of Medicine, University of Colorado Anschutz Medical Campus, Denver, Colorado (TL)
- Department of Human Studies, University of Alabama at Birmingham, Alabama (RE)
- Division of Preventive Medicine, University of Alabama at Birmingham, Alabama (MLB)
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Bogart LM, Elliott MN, Klein DJ, Tortolero SR, Mrug S, Peskin MF, Davies SL, Schink ET, Schuster MA. Peer victimization in fifth grade and health in tenth grade. Pediatrics 2014; 133:440-7. [PMID: 24534401 PMCID: PMC4530298 DOI: 10.1542/peds.2013-3510] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Children who experience bullying, a type of peer victimization, show worse mental and physical health cross-sectionally. Few studies have assessed these relationships longitudinally. We examined longitudinal associations of bullying with mental and physical health from elementary to high school, comparing effects of different bullying histories. METHODS We analyzed data from 4297 children surveyed at 3 time points (fifth, seventh, and tenth grades) in 3 cities. We used multivariable regressions to test longitudinal associations of bullying with mental and physical health by comparing youth who experienced bullying in both the past and present, experienced bullying in the present only, experienced bullying in the past only, or did not experience bullying. RESULTS Bullying was associated with worse mental and physical health, greater depression symptoms, and lower self-worth over time. Health was significantly worse for children with both past and present bullying experiences, followed by children with present-only experiences, children with past-only experiences, and children with no experiences. For example, 44.6% of children bullied in both the past and present were at the lowest decile of psychosocial health, compared with 30.7% of those bullied in the present only (P = .005), 12.1% of those bullied in the past only (P < .001), and 6.5% of those who had not been bullied (P < .001). CONCLUSIONS Both chronic and current bullying are associated with substantially worse health. Clinicians who recognize bullying when it first starts could intervene to reverse the downward health trajectory experienced by youth who are repeated targets.
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Affiliation(s)
- Laura M. Bogart
- Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts;,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | | | - David J. Klein
- Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts;,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Susan R. Tortolero
- The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas; and
| | - Sylvie Mrug
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Melissa F. Peskin
- The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas; and
| | | | - Elizabeth T. Schink
- Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Mark A. Schuster
- Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts;,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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21
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Boehme AK, Davies SL, Moneyham L, Shrestha S, Schumacher J, Kempf MC. A qualitative study on factors impacting HIV care adherence among postpartum HIV-infected women in the rural southeastern USA. AIDS Care 2013; 26:574-81. [DOI: 10.1080/09540121.2013.844759] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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22
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Bogart LM, Elliott MN, Kanouse DE, Klein DJ, Davies SL, Cuccaro PM, Banspach SW, Peskin MF, Schuster MA. Bogart et al. respond. Am J Public Health 2013; 103:e1-2. [PMID: 24028223 DOI: 10.2105/ajph.2013.301570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Laura M Bogart
- Laura M. Bogart and Mark A. Schuster are with the Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA, and the Department of Pediatrics, Harvard Medical School, Boston. Marc N. Elliott and David E. Kanouse are with RAND Corporation, Santa Monica, CA. David J. Klein is with the Division of General Pediatrics, Department of Medicine, Boston Children's Hospital. Susan L. Davies is with the Department of Health Behavior, School of Public Health, University of Alabama, Birmingham. Paula M. Cuccaro and Melissa F. Peskin are with the Center for Health Promotion and Prevention Research, University of Texas Health Science Center, Houston. Stephen W. Banspach is with the National Center for Chronic Disease Prevention and Health Promotion, Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
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23
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Bogart LM, Elliott MN, Kanouse DE, Klein DJ, Davies SL, Cuccaro PM, Banspach SW, Peskin MF, Schuster MA. Association between perceived discrimination and racial/ethnic disparities in problem behaviors among preadolescent youths. Am J Public Health 2013; 103:1074-81. [PMID: 23597387 DOI: 10.2105/ajph.2012.301073] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the contribution of perceived racial/ethnic discrimination to disparities in problem behaviors among preadolescent Black, Latino, and White youths. METHODS We used cross-sectional data from Healthy Passages, a 3-community study of 5119 fifth graders and their parents from August 2004 through September 2006 in Birmingham, Alabama; Los Angeles County, California; and Houston, Texas. We used multivariate regressions to examine the relationships of perceived racial/ethnic discrimination and race/ethnicity to problem behaviors. We used values from these regressions to calculate the percentage of disparities in problem behaviors associated with the discrimination effect. RESULTS In multivariate models, perceived discrimination was associated with greater problem behaviors among Black and Latino youths. Compared with Whites, Blacks were significantly more likely to report problem behaviors, whereas Latinos were significantly less likely (a "reverse disparity"). When we set Blacks' and Latinos' discrimination experiences to zero, the adjusted disparity between Blacks and Whites was reduced by an estimated one third to two thirds; the reverse adjusted disparity favoring Latinos widened by about one fifth to one half. CONCLUSIONS Eliminating discrimination could considerably reduce mental health issues, including problem behaviors, among Black and Latino youths.
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Affiliation(s)
- Laura M Bogart
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA 02115, USA
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Schuster MA, Elliott MN, Kanouse DE, Wallander JL, Tortolero SR, Ratner JA, Klein DJ, Cuccaro PM, Davies SL, Banspach SW. Racial and ethnic health disparities among fifth-graders in three cities. N Engl J Med 2012; 367:735-45. [PMID: 22913683 DOI: 10.1056/nejmsa1114353] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND For many health-related behaviors and outcomes, racial and ethnic disparities among adolescents are well documented, but less is known about health-related disparities during preadolescence. METHODS We studied 5119 randomly selected public-school fifth-graders and their parents in three metropolitan areas in the United States. We examined differences among black, Latino, and white children on 16 measures, including witnessing of violence, peer victimization, perpetration of aggression, seat-belt use, bike-helmet use, substance use, discrimination, terrorism worries, vigorous exercise, obesity, and self-rated health status and psychological and physical quality of life. We tested potential mediators of racial and ethnic disparities (i.e., sociodemographic characteristics and the child's school) using partially adjusted models. RESULTS There were significant differences between black children and white children for all 16 measures and between Latino children and white children for 12 of 16 measures, although adjusted analyses reduced many of these disparities. For example, in unadjusted analysis, the rate of witnessing a threat or injury with a gun was higher among blacks (20%) and Latinos (11%) than among whites (5%), and the number of days per week on which the student performed vigorous exercise was lower among blacks (3.56 days) and Latinos (3.77 days) than among whites (4.33 days) (P<0.001 for all comparisons). After statistical adjustment, these differences were reduced by about half between blacks and whites and were eliminated between Latinos and whites. Household income, household highest education level, and the child's school were the most substantial mediators of racial and ethnic disparities. CONCLUSIONS We found that harmful health behaviors, experiences, and outcomes were more common among black children and Latino children than among white children. Adjustment for socioeconomic status and the child's school substantially reduced most of these differences. Interventions that address potentially detrimental consequences of low socioeconomic status and adverse school environments may help reduce racial and ethnic differences in child health. (Funded by the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Mark A Schuster
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA 02115, USA.
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Davies SL, Thind HR, Chandler SD, Tucker JA. Enhancing resilience among young people: the role of communities and asset-building approaches to intervention. Adolesc Med State Art Rev 2011; 22:402-x. [PMID: 22423458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Adolescent development is a complex, interactive process that involves individuals, families, peer groups, institutions, and communities. Resilience is a process reflecting one's ability to respond positively to the multitude of risks inherent in growth and development. This article focuses on strategies for enhancing resilience and health outcomes among young people. We explore the conditions under which young people, their families, and community institutions promote positive health outcomes. We review emerging issues with an emphasis on building social capital and cohesion to foster resilience through family and community relationships and resources. We provide examples of evidence-based interventions, including those with demonstrated cost-effectiveness. Informed by these data, we make recommendations for the practice of adolescent medicine and further research focused on physician involvement in strengthening family and community resilience and social capital to improve the lives of young people.
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Affiliation(s)
- Susan L Davies
- Department of Health Behavior, School of Public Health, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
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Abstract
Despite challenges facing HIV-positive women in the U.S., some maintain strong desires and intentions for motherhood. We explore correlates of desire for another child-particularly current parenting experiences (number of children, parenting efficacy, parenting satisfaction, parenting practices, parental distress, and child-related quality of life), age, spirituality/religiosity, stress, coping, hopelessness, partner's desire for a child, social support, and stigma-among a sample of HIV-positive mothers (n = 96) in Alabama. Partner's desire for a child, participation in private religious practices, avoidant coping, and parity were significantly associated with desire for a child in multivariate models. Such findings indicate a need for reproductive counseling and education that is sensitive to the role of religious norms and values in fertility decision-making and suggest opportunities for partnership with faith-based organizations. Further studies examining the impact of relationship dynamics on childbearing desires among U.S. women living with HIV/AIDS are also needed.
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Affiliation(s)
- Natalie G De La Cruz
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, RPHB 227, 1530 3rd Ave S, Birmingham, AL 35294, USA.
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Goodman C, Davies SL, Dinan S, See Tai S, Iliffe S. Activity promotion for community-dwelling older people: a survey of the contribution of primary care nurses. Br J Community Nurs 2011; 16:12-17. [PMID: 21278643 DOI: 10.12968/bjcn.2011.16.sup11.s12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
STUDY AIMS To discover the current level of nurse-led involvement in activity promotion for older people in primary care and to explore the knowledge and attitudes of primary care nurses about health benefits of activity promotion for older people. BACKGROUND The importance of improving and maintaining activity levels in later life is well established. However, intervention studies show that the uptake of and adherence to physical activity programmes by older people are highly variable. The optimal approach to activity promotion for older people is not well understood. Although many activity promotion schemes and evaluations assume that specialist exercise trainers are needed, it remains unclear who is best placed to facilitate activity promotion for older people, and if this is something in which existing primary care practitioners (specifically nurses) could and should take a leading role. METHODS This study surveyed all nurses and health visitors working in five primary care organizations in an inner city area. A semi-structured postal questionnaire asked about their knowledge and attitudes to the benefits of exercise in later life, their current levels of involvement in promoting physical activity with older people, and their personal activity levels. FINDINGS The overall response rate was 54% (n=521). The responses of 391 district nurses and practice nurses are presented here. Nurses had the commitment and (depending on the focus of their work) different opportunities to promote physical activity with older patients. There were organizational and individual constraints on their ability to be involved in this aspect of health promotion work themselves, or to refer older people to local activity promotion schemes. Nurses did not have a structured approach when promoting physical activity with older people and had only a partial awareness of the limitations of their knowledge or skills when promoting activity with older people. CONCLUSIONS For promotion of physical activity by older people to be meaningfully incorporated into primary care nursing work there is a need to develop a more strategic approach that can optimize the opportunities and interest of primary care nurses and develop the knowledge and skills of the workforce in this area of nursing work.
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Abstract
The Making Our Mothers Stronger (MOMS) Project is a randomized controlled behavioral trial, comparing a stress-reduction and social support intervention (Healthy MOMS) to a parenting skills intervention (Parenting Skills for MOMS) for mothers living with HIV. Outcomes include maternal mental and physical health, parenting behaviors, and children's behavior. To ensure that these interventions were tailored to the needs of HIV+ mothers, extensive formative work was conducted with members of the intended audience and relevant service providers. Findings from focus groups and semi-structured interviews highlighted the need for Healthy MOMS to: (1) include appropriate approaches to group discussion and problem solving; (2) address the stressors of being both a parent and a woman living with HIV; and (3) enhance social support. Six weekly group sessions focused on topics including coping with stress and anxiety; enhancing nutrition, exercise, and sexual health; improving medical adherence; improving communication with health care providers; and communicating health needs to family, friends, and co-workers. Initial anecdotal responses from participants suggest that the Healthy MOMS intervention addresses several salient issues for the growing population of HIV+ mothers who can benefit from long-term support in adapting to this chronic disease.
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Affiliation(s)
- Susan L Davies
- Department of Health Behavior, School of Public Health, University of Alabama, Birmingham, AL, USA.
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Horton RW, Katona CL, Theodorou AE, Hale AS, Davies SL, Tunnicliffe C, Yamaguchi Y, Paykel ES, Kelly JS. Platelet radioligand binding and neuroendocrine challenge tests in depression. Ciba Found Symp 2007; 123:84-105. [PMID: 3028729 DOI: 10.1002/9780470513361.ch6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The purpose of this work was to examine the number and function of alpha 2-adrenoceptors and the number of serotonin uptake sites in depressed patients and controls. Platelet alpha 2-adrenoceptors and platelet serotonin uptake sites were labelled with [3H]yohimbine and [3H]imipramine respectively. Central alpha 2-adrenoceptor function was assessed by growth hormone and other responses to challenge with the alpha 2-agonist clonidine. No overall difference in the binding parameters was observed between the control and depressed groups, but the results highlight the importance of drug-free interval, menopausal status and membrane protein concentration within the binding assays in the interpretation of such studies. The growth hormone response to clonidine tended to be blunted in depressed females and was significantly blunted in the subgroup of depressives who failed to suppress plasma cortisol concentrations in response to dexamethasone. Depressed subjects also showed a smaller decrease in diastolic blood pressure and a smaller increase in sedation than control subjects.
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Davies SL, Moral MA. Clinical development of levetiracetam for amyotrophic lateral sclerosis. Drug News Perspect 2006; 19:572-3. [PMID: 17220961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This month's Spotlight on... focuses on the current clinical development of the antiepileptic drug levetiracetam for amyotrophic lateral sclerosis. We highlight the experimental rationale behind its progress into patient cohorts with regards to targeting three currently untreatable aspects of human amyotrophic lateral sclerosis: cramps, spasticity and disease progression.
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Davies SL, DiClemente RJ, Wingood GM, Person SD, Dix ES, Harrington K, Crosby RA, Oh K. Predictors of inconsistent contraceptive use among adolescent girls: findings from a prospective study. J Adolesc Health 2006; 39:43-9. [PMID: 16781960 DOI: 10.1016/j.jadohealth.2005.10.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2005] [Revised: 09/13/2005] [Accepted: 10/26/2005] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess the independent effects of various behavioral and psychosocial antecedents on contraceptive use among a sample of low-income African-American adolescent females. METHODS Stepwise logistic regression was used to calculate odds ratios for baseline predictors of inconsistent contraceptive use six months later. Study participants include 375 nonpregnant African-American girls aged 14-18 years who reported sexual activity in the previous six months. Data were collected using a self-administered survey, individual interview and urine pregnancy test. RESULTS Adolescents who were inconsistent contraceptive users at follow-up were more likely to have reported a desire for pregnancy, previous inconsistent contraceptive use, less frequent communication with their partners about prevention issues, and an increased number of lifetime sexual partners at the baseline assessment. Of equal importance was the finding that a previous pregnancy or sexually transmitted infection did not influence future contraceptive behaviors. CONCLUSIONS Clinicians can play an important role in counseling adolescents about sexual health and dispelling misperceptions that hinder consistent contraceptive use. Findings from this research could have significant implications for the development of effective sexually transmitted infection (STI) and pregnancy prevention programs for adolescents and can help in guiding clinicians toward relevant treatment practices.
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Affiliation(s)
- Susan L Davies
- School of Public Health, Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama 35294-0022, USA.
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Wingood GM, DiClemente RJ, Harrington KF, Lang DL, Davies SL, Hook EW, Oh MK, Hardin JW. Efficacy of an HIV prevention program among female adolescents experiencing gender-based violence. Am J Public Health 2006; 96:1085-90. [PMID: 16670238 PMCID: PMC1470614 DOI: 10.2105/ajph.2004.053595] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the efficacy of an HIV prevention intervention among African American female adolescents reporting a history of gender-based violence. METHODS In this analysis of a subgroup of participants involved in a randomized controlled trial, consistent condom use, psychosocial mediators associated with HIV-preventive behaviors, and presence of sexually transmitted diseases were assessed at 6- and 12-month follow-ups. The intervention emphasized ethnic and gender pride, HIV knowledge, condom attitudes, healthy relationships, communication, and condom use skills. RESULTS Relative to the comparison condition, participants randomized to the intervention reported using condoms more consistently, had fewer episodes of unprotected vaginal sex, engaged in a greater proportion of protected intercourse acts, were more likely to have used a condom during their most recent intercourse, were less likely to have a new sexual partner, were less likely to have a sexually transmitted disease, and demonstrated more proficient condom skills. CONCLUSIONS Given the substantial prevalence of gender-based violence among female adolescents and the associations observed between gender-based violence, HIV risk, and HIV infection, it is essential that HIV interventions involving young women address partner violence.
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Affiliation(s)
- Gina M Wingood
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, the Emory Center for AIDS Research, Emory University, Atlanta, GA, USA.
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Wingood GM, DiClemente RJ, Mikhail I, Lang DL, McCree DH, Davies SL, Hardin JW, Hook EW, Saag M. A randomized controlled trial to reduce HIV transmission risk behaviors and sexually transmitted diseases among women living with HIV: The WiLLOW Program. J Acquir Immune Defic Syndr 2005; 37 Suppl 2:S58-67. [PMID: 15385901 DOI: 10.1097/01.qai.0000140603.57478.a9] [Citation(s) in RCA: 168] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the efficacy of an intervention to reduce HIV transmission risk behaviors and sexually transmitted diseases (STDs) and enhance HIV-preventive psychosocial and structural factors among women living with HIV. DESIGN A randomized controlled trial of 366 women living with HIV in Alabama and Georgia. INTERVENTION The intervention emphasized gender pride, maintaining current and identifying new network members, HIV transmission knowledge, communication and condom use skills, and healthy relationships. PRIMARY OUTCOME Unprotected vaginal intercourse. OTHER OUTCOMES: Proportion never used condoms, incident STDs, psychosocial factors, and number of supportive network members. RESULTS Over the 12-month follow-up, women in the WiLLOW intervention, relative to the comparison, reported fewer episodes of unprotected vaginal intercourse (1.8 vs. 2.5; P = 0.022); were less likely to report never using condoms (odds ratio [OR] = 0.27; P = 0.008); had a lower incidence of bacterial infections (Chlamydia and gonorrhea) (OR = 0.19; P = 0.006); reported greater HIV knowledge and condom use self-efficacy, more network members, fewer beliefs that condoms interfere with sex, and fewer partner-related barriers to condom use; and demonstrated greater skill in using condoms. CONCLUSION This is the first trial to demonstrate reductions in risky sexual behavior and incident bacterial STDs and to enhance HIV-preventive psychosocial and structural factors among women living with HIV.
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Affiliation(s)
- Gina M Wingood
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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Levitt NC, Propper DJ, Madhusudan S, Braybrooke JP, Echeta C, te Poele R, Davies SL, Flanagan E, Hickson ID, Joel S, Ganesan TS. Pharmacokinetically guided phase I trial of topotecan and etoposide phosphate in recurrent ovarian cancer. Br J Cancer 2005; 93:60-9. [PMID: 15956976 PMCID: PMC2361471 DOI: 10.1038/sj.bjc.6602657] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
A pharmacokinetically guided phase I study of topotecan and etoposide phosphate was conducted in recurrent ovarian cancer. The scheduling of the topoisomerase I and II inhibitors was determined using in vitro activity data. All patients had recurrent disease following prior platinum-containing chemotherapy. Patients had a World Health Organisation performance status of 0–2 and adequate bone marrow, renal and hepatic function. Treatment was with topotecan intravenously for 5 days followed immediately by a 5-day intravenous infusion of etoposide phosphate (EP), with pharmacokinetically guided dose adjustment. Plasma etoposide levels were measured on days 2 and 4 of the infusion. A total of 21 patients entered the study. In all, 48% were platinum resistant and 71% had received prior paclitaxel. The main toxicities were haematological, short lived and reversible. A total of 29% of patients experienced grade 4 thrombocytopenia and 66% grade 4 neutropenia after the first cycle. Neutropenia and thrombocytopenia was dose limiting. The maximum-tolerated dose was topotecan 0.85 mg m−2 day−1 days 1–5 followed immediately by a 5-day infusion of EP at a plasma concentration of 1 μg ml−1. The response rate (RR) was 28% in 18 evaluable patients. There was marked interpatient variability in topoisomerase IIα levels measured from peripheral lymphocytes, with no observed increase following topotecan. This regimen of topotecan followed by EP demonstrated good activity in recurrent ovarian cancer and was noncrossresistant with paclitaxel. Both the toxicity and RR was higher than would be expected from the single agent data, in keeping with synergy of action.
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Affiliation(s)
- N C Levitt
- Cancer Research UK Cancer Centre, Churchill Hospital, Oxford OX3 7LJ, UK
| | - D J Propper
- Cancer Research UK, Medical Oncology Unit, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
| | - S Madhusudan
- Cancer Research UK Cancer Centre, Churchill Hospital, Oxford OX3 7LJ, UK
| | - J P Braybrooke
- Genome Integrity Group, Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, John Radcliffe, Hospital, Oxford 0X3 9DS, UK
| | - C Echeta
- Cancer Research UK Cancer Centre, Churchill Hospital, Oxford OX3 7LJ, UK
| | - R te Poele
- Cancer Research UK, Medical Oncology Unit, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
| | - S L Davies
- Bristol Haematology and Oncology Centre, Horfield Road, Bristol BS2 8ED, UK
| | - E Flanagan
- Cancer Research UK Cancer Centre, Churchill Hospital, Oxford OX3 7LJ, UK
| | - I D Hickson
- Bristol Haematology and Oncology Centre, Horfield Road, Bristol BS2 8ED, UK
| | - S Joel
- Cancer Research UK, Medical Oncology Unit, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK
| | - T S Ganesan
- Cancer Research UK Cancer Centre, Churchill Hospital, Oxford OX3 7LJ, UK
- Cancer Research UK Cancer Centre, Churchill Hospital, Oxford OX3 7LJ, UK. E-mail:
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Harrington KF, Franklin FA, Davies SL, Shewchuk RM, Binns MB. Implementation of a family intervention to increase fruit and vegetable intake: the Hi5+ experience. Health Promot Pract 2005; 6:180-9. [PMID: 15855288 DOI: 10.1177/1524839904263681] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Family is an important, yet challenging, target for dietary intervention. This article describes the implementation of Hi5+, a family fruit and vegetable (FV) promotion program. Complementing a fourth-grade school curriculum, the seven weekly Family Fun Nites were at-home family meal sharing and game evenings. A sample of families (N = 575; 69% consented) from schools in a southeastern U.S. urban area received tailored intervention materials based on their FV attitudes and family interaction styles. A pyramidal organizational design, using peer leaders, facilitated 71% of families to complete all seven sessions, whereas 84% completed at least one session. Significant independent predictors of program completion were attending an introductory Kick-Off Nite, interactive family style, additional adults in the household, married parents, being African American, earning more than 60,000 dollars, and additional children in the household. Family-specific issues and initial program experience are important considerations for implementing a family intervention.
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Davies SL, Harrington K, Franklin FA, Shewchuk RM, Feese ML, Windle M. Hi5+: systematic development of a family intervention to increase fruit and vegetable intake. Health Promot Pract 2005; 6:190-201. [PMID: 15855289 DOI: 10.1177/1524839904263706] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes the development of a peer-led home-based intervention to increase fruit and vegetable (FV) intake and family interaction among fourth graders and their families. Hi5+ intervention content and delivery strategies were developed using two complementary processes: cognitive mapping (CM), a consumer-based approach to identifying salient issues, and intervention mapping (IM), a comprehensive planning model. Step 1 involved creating plans to guide the design, implementation, and evaluation of Hi5+. We delineated our performance objectives and then prioritized those determinants we felt were most salient and changeable. Step 2 involved selecting and utilizing cognitive and behavioral theory constructs to develop intervention methods and strategies. Step 3 involved designing and pilot testing the instructional materials and other intervention components. Step 4 entailed developing plans for program adoption and implementation, while the final step (Step 5) involved creating a comprehensive evaluation plan. Implications of this multistep approach to intervention development are discussed.
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Abstract
OBJECTIVE To evaluate the effectiveness of a smoking cessation intervention based on the transtheoretical model of change with a sample of low-income African American smokers admitted to an indigent-care hospital. METHODS The intervention incorporated components shown to be effective in increasing cessation in other populations, tailored to a bedside counseling format with follow-up contact postdischarge. RESULTS Intervention patients were significantly more likely to advance in stage than were control patients. CONCLUSION A hospital-offered bedside intervention offers promise in reaching underserved smokers with effective, though limited, cessation assistance.
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Affiliation(s)
- Susan L Davies
- Department of Health Behavior, University of Alabama at Birmingham, AL 35294-0022, USA.
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Abstract
The epithelial cells of the choroid plexuses secrete cerebrospinal fluid (CSF), by a process which involves the transport of Na(+), Cl(-) and HCO(3)(-) from the blood to the ventricles of the brain. The unidirectional transport of ions is achieved due to the polarity of the epithelium, i.e. the ion transport proteins in the blood-facing (basolateral) membrane are different to those in the ventricular (apical) membrane. The movement of ions creates an osmotic gradient which drives the secretion of H(2)O. A variety of methods (e.g. isotope flux studies, electrophysiological, RT-PCR, in situ hybridization and immunocytochemistry) have been used to determine the expression of ion transporters and channels in the choroid plexus epithelium. Most of these transporters have now been localized to specific membranes. For example, Na(+)-K(+)ATPase, K(+) channels and Na(+)-2Cl(-)-K(+) cotransporters are expressed in the apical membrane. By contrast the basolateral membrane contains Cl(-)- HCO(3) exchangers, a variety of Na(+) coupled HCO(3)(-) transporters and K(+)-Cl(-) cotransporters. Aquaporin 1 mediates water transport at the apical membrane, but the route across the basolateral membrane is unknown. A model of CSF secretion by the mammalian choroid plexus is proposed which accommodates these proteins. The model also explains the mechanisms by which K(+) is transported from the CSF to the blood.
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Affiliation(s)
- P D Brown
- School of Biological Sciences, G.38 Stopford Building, University of Manchester, Oxford Road, Manchester M13 9PT, UK.
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Davies SL, Dix ES, Rhodes SD, Harrington KF, Frison S, Willis L. Attitudes of young african american fathers toward early childbearing. Am J Health Behav 2004; 28:418-25. [PMID: 15482971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To qualitatively examine the perceptions of young fathers toward issues related to early childbearing. METHODS Focus groups were held with male partners of adolescent females who had become pregnant while participating in an HIV-prevention trial. RESULTS Primary domains that emerged included young male's desire for pregnancy, their attitudes toward father/child involvement, and their perceived social support as young fathers. CONCLUSIONS Findings may help in developing gender-appropriate interventions to delay early childbearing and prevent HIV/STD transmission.
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Affiliation(s)
- Susan L Davies
- UAB School of Public Health, Department of Health Behavior, RPHB 227, 1530 3rd Avenue, South, Birmingham, AL 35294-0022, USA.
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DiClemente RJ, Wingood GM, Harrington KF, Lang DL, Davies SL, Hook EW, Oh MK, Crosby RA, Hertzberg VS, Gordon AB, Hardin JW, Parker S, Robillard A. Efficacy of an HIV prevention intervention for African American adolescent girls: a randomized controlled trial. JAMA 2004; 292:171-9. [PMID: 15249566 DOI: 10.1001/jama.292.2.171] [Citation(s) in RCA: 362] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT African American adolescent girls are at high risk for human immunodeficiency virus (HIV) infection, but interventions specifically designed for this population have not reduced HIV risk behaviors. OBJECTIVE To evaluate the efficacy of an intervention to reduce sexual risk behaviors, sexually transmitted diseases (STDs), and pregnancy and enhance mediators of HIV-preventive behaviors. DESIGN, SETTING, AND PARTICIPANTS Randomized controlled trial of 522 sexually experienced African American girls aged 14 to 18 years screened from December 1996 through April 1999 at 4 community health agencies. Participants completed a self-administered questionnaire and an interview, demonstrated condom application skills, and provided specimens for STD testing. Outcome assessments were made at 6- and 12-month follow-up. INTERVENTION All participants received four 4-hour group sessions. The intervention emphasized ethnic and gender pride, HIV knowledge, communication, condom use skills, and healthy relationships. The comparison condition emphasized exercise and nutrition. MAIN OUTCOME MEASURES The primary outcome measure was consistent condom use, defined as condom use during every episode of vaginal intercourse; other outcome measures were sexual behaviors, observed condom application skills, incident STD infection, self-reported pregnancy, and mediators of HIV-preventive behaviors. RESULTS Relative to the comparison condition, participants in the intervention reported using condoms more consistently in the 30 days preceding the 6-month assessment (unadjusted analysis, intervention, 75.3% vs comparison, 58.2%) and the 12-month assessment (unadjusted analysis, intervention, 73.3% vs comparison, 56.5%) and over the entire 12-month period (adjusted odds ratio, 2.01; 95% confidence interval [CI], 1.28-3.17; P =.003). Participants in the intervention reported using condoms more consistently in the 6 months preceding the 6-month assessment (unadjusted analysis, intervention, 61.3% vs comparison, 42.6%), at the 12-month assessment (unadjusted analysis, intervention, 58.1% vs comparison, 45.3%), and over the entire 12-month period (adjusted odds ratio, 2.30; 95% CI, 1.51-3.50; P<.001). Using generalized estimating equation analyses over the 12-month follow-up, adolescents in the intervention were more likely to use a condom at last intercourse, less likely to have a new vaginal sex partner in the past 30 days, and more likely to apply condoms to sex partners and had better condom application skills, a higher percentage of condom-protected sex acts, fewer unprotected vaginal sex acts, and higher scores on measures of mediators. Promising effects were also observed for chlamydia infections and self-reported pregnancy. CONCLUSION Interventions for African American adolescent girls that are gender-tailored and culturally congruent can enhance HIV-preventive behaviors, skills, and mediators and may reduce pregnancy and chlamydia infection.
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Affiliation(s)
- Ralph J DiClemente
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Division of Infectious Diseases, Epidemiology and Immunology, Emory University, Atlanta, Ga 30322, USA.
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Crosby RA, DiClemente RJ, Wingood GM, Salazar LF, Harrington K, Davies SL, Oh MK. Identification of strategies for promoting condom use: a prospective analysis of high-risk African American female teens. Prev Sci 2004; 4:263-70. [PMID: 14598998 DOI: 10.1023/a:1026020332309] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Condom promotion strategies for adolescents typically include provision of STD/HIV-associated knowledge, fostering favorable attitudes toward condom use, promoting positive peer norms regarding condom use, improving condom-related communication skills and self-efficacy, and overcoming barriers to condom use. The purpose of this study was to identify which of these constructs were prospectively associated with condom use among a high-risk sample of African American adolescent females reporting sexual activity with a steady male partner. Adolescents, 14-18 years old, were recruited from schools and health clinics. Adolescents completed an in-depth survey and interview at baseline and again 6 months later. Analyses were limited to adolescents with steady partners who reported sexual activity between the baseline and 6-month follow-up assessment periods (N = 179). At baseline, five-scale measures and a single-item measure were used to assess predictive constructs. At follow-up, adolescents were asked about their frequency of condom use over various periods of recall. Multivariate models were created to control for the confounding influence of pregnancy status. The findings were remarkably distinct. The evidence strongly supported the predictive role of perceived barriers toward condom use and peer norms. The measure of sexual communication achieved significance for two of the six assessed outcomes. Alternatively, measures of attitudes toward condom use, condom negotiation self-efficacy, and knowledge about STD/HIV-prevention were consistently nonsignificant. The findings suggest that to improve effectiveness of individual-level STD/HIV prevention programs, designed for this population, program emphasis should be on reducing barriers to condom use, teaching partner communication skills, and fostering positive peer norms relevant to condom use.
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Affiliation(s)
- Richard A Crosby
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Atlanta, Georgia 30322, USA.
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Abstract
OBJECTIVE To examine predicted relationships among transtheoretical model of change measures in a sample of 211 low-income, African American hospitalized smokers. METHODS We used discriminant analysis to examine differences in decisional balance and self-efficacy across stages of change for quitting. RESULTS Differences in decisional balance and self-efficacy were concurrent with stage differences. The function discriminated among all 3 stages with the clearest differences between precontemplation and preparation. CONCLUSION Although results with this specialized sample are not generalizable, they add to the evidence that transtheoretical model of change variables are robust across populations.
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Affiliation(s)
- Connie L Kohler
- University of Alabama at Birmingham, 227 Ryals Public Health Budding, 1665 University Boulevard, Birmingham, AL 35294-0022, USA.
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Abstract
OBJECTIVE To describe the development of a consumer-oriented intervention for increasing intake of fruits and vegetables (FVs) in families (n=265). METHOD A cognitive-mapping approach was used to specify intervention performance objectives and a tailoring strategy. RESULTS MDS and hierarchical cluster analysis indicated that FV perceptions are organized into 6 clusters arrayed along 3 dimensions. In combination with 3 general family-functioning measures, 11 perceptions explained approximately 18% of the variance in parent FVI. K-means cluster analysis revealed 4 types of families. CONCLUSION Cognitive mapping provides a systematic approach for including qualitative data in the design of tailored interventions.
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Affiliation(s)
- Richard M Shewchuk
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL 35294-3361, USA.
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Affiliation(s)
- L Wu
- Imperial Cancer Research Fund Laboratories, Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DS, United Kingdom
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Wingood GM, DiClemente RJ, Bernhardt JM, Harrington K, Davies SL, Robillard A, Hook EW. A prospective study of exposure to rap music videos and African American female adolescents' health. Am J Public Health 2003; 93:437-9. [PMID: 12604490 PMCID: PMC1447759 DOI: 10.2105/ajph.93.3.437] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Gina M Wingood
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA 30322, USA.
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Davies SL, DiClemente RJ, Wingood GM, Harrington KF, Crosby RA, Sionean C. Pregnancy desire among disadvantaged African American adolescent females. Am J Health Behav 2003; 27:55-62. [PMID: 12500952 DOI: 10.5993/ajhb.27.1.6] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To examine the prevalence and correlates of wanting to become pregnant among a sample of 462 sexually active nonpregnant African American adolescent females. METHODS Multivariate logistic regression was used to calculate adjusted odds ratios, their 95% confidence intervals, and respective P values. RESULTS Significant correlates with pregnancy desire included having a male partner who desired pregnancy, having a boyfriend at least 5 years older, having low self-esteem, perceiving greater perceived barriers to condom use, and perceiving low family support. CONCLUSIONS Pregnancy prevention programs designed for economically disadvantaged African American adolescent females should address these correlates of their pregnancy desire.
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Affiliation(s)
- Susan L Davies
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
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Abstract
OBJECTIVE To examine the association between gang involvement and female adolescents' health. METHODS African American adolescent females (N = 522) completed a survey that assessed their history of gang involvement and health behaviors and provided specimens that were analyzed for marijuana use and sexually transmitted diseases. RESULTS In logistic regression analyses, adolescents with a history of gang involvement were more likely to have been expelled from school (odds ratio [OR]: 3.6), be a binge drinker (OR: 3.3), have a positive toxicologic test for marijuana (OR: 2.6), have been in 3 or more fights in the past 6 months (OR: 3.8), have a nonmonogamous partner (OR: 2.4), and test positive for Trichomonas vaginalis (OR: 2.2) and Neisseria gonorrhoeae (OR: 3.6). CONCLUSION This study extends the current research on risk behaviors associated with gang involvement to include biological markers for substance use and sexual health outcomes, namely, marijuana use and sexually transmitted diseases.
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Affiliation(s)
- Gina M Wingood
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, Georgia 30322, USA.
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Crosby R, DiClemente RJ, Wingood GM, Harrington K, Davies SL, Hook EW, Oh MK. Predictors of infection with Trichomonas vaginalis: a prospective study of low income African-American adolescent females. Sex Transm Infect 2002; 78:360-4. [PMID: 12407241 PMCID: PMC1744539 DOI: 10.1136/sti.78.5.360] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To identify psychosocial predictors of Trichomonas vaginalis infection among low income African-American adolescent females living in a high risk urban area of the United States. METHODS Baseline plus 6 and 12 month follow up data collected as part of an HIV prevention intervention trial were utilised. The baseline sample consisted of 522 African-American females, 14-18 years of age. Recruitment sites were located in low income neighbourhoods of Birmingham, Alabama, characterised by high rates of unemployment, substance abuse, violence, teenage pregnancy, and sexually transmitted infections. Self administered vaginal swab specimens were cultured for T vaginalis. Baseline measures collected as part of a self administered survey and face to face interviews were used to predict subsequent infection with T vaginalis at any of the three assessment periods conducted over the span of 1 year. RESULTS At baseline, 12.9% were diagnosed with T vaginalis. At the 6 and 12 month follow ups, T vaginalis was diagnosed in 8.9% and 10.2%, respectively. The strongest multivariate predictor of T vaginalis infection was biologically confirmed marijuana use; those using marijuana were more than six times as likely to test positive for T vaginalis (adjusted odds ratio (AOR) = 6.2, p = 0.0003). Other multivariate predictors were reporting that typical sex partners were at least 5 years older (AOR = 2.6; p = 0.005), reporting sex with non-steady partners (AOR = 1.9; p = 0.02), and history of delinquency (AOR = 1.3; p = 0.02). The odds of testing positive increased by 31% for every one unit increase on a six item scale measure of delinquency. CONCLUSIONS Infection with T vaginalis was common and significant multivariate predictors comprised a constellation of problem behaviours, each of which are potentially amenable to behavioural intervention.
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Affiliation(s)
- R Crosby
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education and Emory Center for AIDS Research, Atlanta, GA 30322, USA.
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Magadán S, Valladares M, Suarez E, Sanjuán I, Molina A, Ayling C, Davies SL, Zou X, Williams GT, Neuberger MS, Brüggemann M, Gambón F, Diaz-Espada F, González-Fernandez A. Production of antigen-specific human monoclonal antibodies: comparison of mice carrying IgH/kappa or IgH/kappa/lambda transloci. Biotechniques 2002; 33:680, 682, 684 passim. [PMID: 12238778 DOI: 10.2144/02333dd04] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Here we compare human monoclonal antibody (MAb) production from mouse strains that carry disruptions of their endogenous mouse IgH/IgK loci and harbor human IgM + Igkappa(BABkappa) or human IgM + Igkappa + IgA transloci (BABkappa,lambda). We found that whereas both strains proved effective for the isolation of antigen-specific IgM antibodies, many of the IgM MAbs elicited from BABkappa comprise human mu chains that are associated with mouse lambda chains. In contrast, BABkappa,lambda mice gave rise to fully functional, polymeric human IgM antibodies comprising both human IgH and human IgL chains. Therefore, the inclusion of a human Iglambda translocus (in addition to the human IgH + Igkappa transloci) not only diminishes problems of endogenous mouse Iglambda expression but also provides a strain of mice that yields fully human MAbs to a wide range of antigens, as witnessed by the isolation of MAbs to human blood cells, tumor cell lines, and an immunoglobulin idiotype.
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Affiliation(s)
- S Magadán
- Universidad de Vigo, Pontevedra, Spain
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Liau A, Diclemente RJ, Wingood GM, Crosby RA, Williams KM, Harrington K, Davies SL, Hook EW, Oh MK. Associations between biologically confirmed marijuana use and laboratory-confirmed sexually transmitted diseases among African American adolescent females. Sex Transm Dis 2002; 29:387-90. [PMID: 12170126 DOI: 10.1097/00007435-200207000-00004] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Numerous studies have examined the association between adolescents' marijuana use and their high-risk sexual behaviors and sexually transmitted diseases (STDs). However, the validity of the findings is questionable because most of the studies relied on self-reporting for measurement of marijuana use and key outcome (i.e., STDs). GOAL The goal was to investigate associations between biologically confirmed marijuana use and laboratory-confirmed STDs and condom use. STUDY DESIGN African American females adolescents (n = 522) completed a self-administered survey and face-to-face interview. The adolescents provided urine and vaginal swab specimens that were analyzed for marijuana metabolites and STDs, respectively. RESULTS Among the study subjects, 5.4% tested positive for marijuana. These adolescents were more likely to test positive for Neisseria gonorrhoeae (adjusted odds ratio [AOR] = 3.4) and Chlamydia trachomatis (AOR = 3.9). They were more likely to have never used condoms in the previous 30 days (AOR = 2.9) and to have not used condoms consistently in the previous 6 months (AOR = 3.6). CONCLUSION The findings represent unique biologic evidence that STDs and sexual risk behavior may co-occur with marijuana use. Interventions designed to reduce adolescents' risk of STDs and HIV infection should address marijuana use.
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Affiliation(s)
- Adrian Liau
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA 30322, USA
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