Process evaluation of intervention program for prevention of early sexual activity and alcohol use among Hispanic teenagers

Hispanic teens are a high-risk population for initiation of early sexual activity and alcohol use which in turn has numerous social and health consequences. One strategy to address prevention of these behaviors is to implement a capacity building intervention that promotes parent child communication, encompasses their cultural values and community participation. This study describes the process evaluation of a pilot intervention program amongst Hispanic teens and their families living along the Texas-Mexico border. “Girls Lets Talk” is a small group intervention with 10-14 year old teens and their female adult family members that involves education regarding effects of alcohol use and sexual activity as well as activities for monitoring and refusal skills to prevent risky behaviors. Two waves of the program each consisting of at least seven mother daughter dyads were conducted. During the designing process, community advisory board meetings and focus groups were held to review course materials and ensure they were appropriate to the Mexican American culture. Parent and adolescent surveys were administered at the beginning and end of the intervention to assess for psychosocial outcome variables. All sessions received high mean satisfactory scores (mean of 4.00 or better on a five point scale) for both adult and adolescent participants. Qualitative feedback was obtained via debriefing sessions to evaluate experience as well as alter recruitment strategies. A Wilcoxon Sign Rank analysis of the pre and post intervention surveys was done that showed significant changes in some outcome variables such as intentions and confidence for monitoring behaviors for adults and beliefs regarding sexual activity. “Girls Lets Talk” is a promising example of how a process evaluation plan can help develop a theory based health promotion program using the community based participatory research approach. The intervention may also be effective in altering intentions and enhancing self-efficacy among parents and teens in order to decrease risky behaviors such as early sexual activity and alcohol use.^

Young Jewish adults sexual behaviors Peer, parental and surrounding influences

A qualitative study was conducted on young Jewish adults to determine cultural sexual health patterns with in the Jewish adolescent community. The young Jewish adults were recruited through Jewish social settings, such as Hillel Student Centers in Austin and Houston, Texas. Jewish was self-defined. A young adult, for this study, was defined as being between the ages of 18 and 23. Both female and males are needed in the study group. Individual interviews revealed 35 themes identifying the cultural, parental, peer, and surrounding factors that affect sexual behaviors during Jewish adolescence. Overall, this research demonstrates the need to further study and understand the culture and behaviors with in the Jewish community to then create a tailored intervention on healthy sexuality.^

Parent Loss in Adolescence and its Impact on Sense of Self: When an Adolescent Boy Loses His Mother.

Adolescence is a developmental phase that involves physical, emotional, and cognitive changes. Often this period is one of transition that requires significant adjustment both with the individual and the family. It is considered to start with puberty, sometime between the ages of 10 and 13, and end with the transition into adulthood (Kruse & Walper, 2008). Puberty is a term that is used to describe the physical changes that generally occur during adolescence. It is an aspect of the changes that occur during the overarching phase of development. Within adolescence, individuals are confronted with many developmental tasks such as establishing an individual identity, making decisions about the future, and moving from dependence on families to independence (Austrian, 2008).There are many changes that occur during adolescence, including sexual maturation and functioning, endocrine developments, and skeletal and muscular changes. Boys will see a growth of body, pubic, and facial hair, their voice will deepen, and they will begin having erections and wet dreams (Kruse & Walper, 2008). The accelerated transformation of this phase generally has an emotional impact and individuals may feel concerned or self-conscious about their appearance. Ausubel, Montemayor, and Svajian (1977) suggest that adolescents may be more sensitive during this period of development. This sensitivity may be in part due to the rapid growth resulting in a sense of awkwardness in appearance and physical coordination.

A importância da metodologia das oficinas formativas na educação sexual na escola

Enquadramento: O interesse pelo tema Educação Sexual germinou da conscientiza-ção de que a sexualidade está na essência do homem, com o ideal de ser experimentada e vivida; procura-se cada vez mais expandir esses conhecimentos com responsabilidade e naturalidade, principalmente frente à responsabilidade de educadores por participar de uma capacitação oferecida pelo grupo do Instituto Kaplan Programa / PROJETO VALE SONHAR. Objetivo: Proposemo-nos analisar a importancia da metodologia das oficinas formati-vas na Educação Sexual na Escola;Determinar a eficácia das oficinas nos conhecimentos sobre sexualidade nos adolescentes;Construir conhecimento sobre sexualidade, desmitifi- cando conceitos. Método: Foi desenvolvida uma intervenção formativa com aplicação de 03 (três) ofi-cinas, em que foram avaliados os conhecimentos antes e após a intervenção formativa. Du-rante estas oficinas foram aplicados questionários e coleta de depoimentos dos participantes. A amostra foi constituída por adolescentes de ambos os sexos, que frequentavam o 1º ano do ensino médio na Escola Estadual de Educação Básica Costa Rêgo, no ano letivo de 2013 e 2014. Resultados: Os conhecimentos sobre planejamento familiar, infecções sexualmente transmissíveis e reprodução dos adolescentes na maioria aumentaram após a intervenção formativa no âmbito da afetividade/sexualidade na adolescência. Os conhecimentos estão relacionados com a idade no sentido em que são os mais novos que demonstram mais co-nhecimentos. Na separação dos conhecimentos por sexo são as meninas que manifestam mais conhecimentos, assim como os residentes em meio urbano. A existência de irmãos, a idade e escolaridade dos pais não influenciam os conhecimentos dos adolescentes. Obser-vou-se também que os adolescentes que já tinham iniciado relações sexuais são aqueles que detêm menos conhecimentos. Conclusão: Os dados mostram que as oficinas realizadas e os questionários servi-ram para conscientização dos alunos e contribuiu para a redução dos índices de evasão escolar por motivos de gravidez, mostrando assim a importância de se tratar de educação sexual no ambiente escolar. Palavras-chave: Adolescência, Sexualidade, Educação Sexual, Planejamento Famili-ar, Infecções Sexualmente Transmissíveis.

Sexual Behavior Patterns and Condom Use in Newly Sexually Active Female University Students

Thesis (Master's)--University of Washington, 2016-06

A transdisciplinary approach to adolescent forensic mental health

Objective: To examine new strategies which may be implemented to address the significant mental health and substance abuse problems of young people within the juvenile justice system. Method: Wide-ranging literature review of mental health problems within the juvenile justice population is given, illustrating the high prevalence of mental health problems within this cohort of young people. Reference is made to the differing demographics and agendas of the American justice system compared to that found in Australia. Results: It is suggested that new initiatives stemming from quality Australian studies are required in order to facilitate reform within adolescent forensic mental health. Psychiatrists need to be at the forefront of innovative policy delivery within the juvenile justice system. Conclusions: A transdisciplinary approach is required to meet the changing needs of young people within the juvenile justice system. Such a system of care recognizes that these young people and their families have multiple needs that cross traditional boundaries and a collaborative approach across agencies is essential at both the policy and practical level. Psychiatrists have an important role to play in the development of these services. A systemic process to address such needs is offered.

Genetic and environmental influences on extreme personality dispositions in adolescent female twins

Background: The objective was to determine whether the pattern of environmental and genetic influences on deviant personality scores differs from that observed for the normative range of personality, comparing results in adolescent and adult female twins. Methods: A sample of 2,796 female adolescent twins ascertained from birth records provided Junior Eysenck Personality Questionnaire data. The average age of the sample was 17.0 years ( S. D. 2.3). Genetic analyses of continuous and extreme personality scores were conducted. Results were compared for 3,178 adult female twins. Results: Genetic analysis of continuous traits in adolescent female twins were similar to findings in adult female twins, with genetic influences accounting for between 37% and 44% of the variance in Extraversion (Ex), Neuroticism (N), and Social Non-Conformity (SNC), with significant evidence of shared environmental influences (19%) found only for SNC in the adult female twins. Analyses of extreme personality characteristics, defined categorically, in the adolescent data and replicated in the adult female data, yielded estimates for high N and high SNC that deviated substantially (p < .05) from those obtained in the continuous trait analyses, and provided suggestive evidence that shared family environment may play a more important role in determining personality deviance than has been previously found when personality is viewed continuously. However, multiple-threshold models that assumed the same genetic and environmental determinants of both normative range variation and extreme scores gave acceptable fits for each personality dimension. Conclusions: The hypothesis of differences in genetic or environmental factors responsible for N and SNC among female twins with scores in the extreme versus normative ranges was partially supported, but not for Ex.

Physical activity and strength of the femoral neck during the adolescent growth spurt: A longitudinal analysis

Loading of the femoral neck (FN) is dominated by bending and compressive stresses. We hypothesize that adaptation of the FN to physical activity would be manifested in the cross-sectional area (CSA) and section modulus (Z) of bone, indices of axial and bending strength, respectively. We investigated the influence of physical activity on bone strength during adolescence using 7 years of longitudinal data from 109 boys and 121 girls from the Saskatchewan Paediatric Bone and Mineral Accrual Study (PBMAS). Physical activity data (PAC-Q physical activity inventory) and anthropometric measurements were taken every 6 months and DXA bone scans were measured annually (Hologic QDR2000, array mode). We applied hip structural analysis to derive strength and geometric indices of the femoral neck using DXA scans. To control for maturation, we determined a biological maturity age defined as years from age at peak height velocity (APHV). To account for the repeated measures within individual nature of longitudinal data, multilevel random effects regression analyses were used to analyze the data. When biological maturity age and body size (height and weight) were controlled, in both boys and girls, physical activity was a significant positive independent predictor of CSA and Z of the narrow region of the femoral neck (P < 0.05). There was no independent effect of physical activity on the subperiosteal width of the femoral neck. When leg length and leg lean mass were introduced into the random effects models to control for size and muscle mass of the leg (instead of height and weight), all significant effects of physical activity disappeared. Even among adolescents engaged in normal levels of physical activity, the statistically significant relationship between physical activity and indices of bone strength demonstrate that modifiable lifestyle factors like exercise play an important role in optimizing bone strength during the growing years. Physical activity differences were explained by the interdependence between activity and lean mass considerations. Physical activity is important for optimal development of bone strength. (c) 2005 Elsevier Inc. All rights reserved.

Theoretical Foundations of a Study Examining Adolescent Literature and Rape Myth Acceptance

Adolescents are at the greatest risk for victimization and perpetration of sexual assault. This paper examines the current trends in literacy education which marginalize aesthetic reading experiences and using reader response theory, and argues that young adult literature may provide an opportunity to reduce rape myth acceptance in adolescents.

Sexual Health Education and Family Planning: A Vital Component of the Healthy Start Program

The paper will describe the Healthy Start program as a comprehensive sex education program and implications for preventing subsequent adolescent pregnancies.

Age Differences among Female Sex Workers in the Philippines: Sexual Risk Negotiations and Perceived Manager Advice

Consistent condom use among high risk groups such as female sex workers (FSWs) remains low. Adolescent female sex workers are especially at higher risk for HIV/STI infections. However, few published studies have compared the sexual risk negotiations among adolescent, emerging adult, and older age groups or the extent a manager’s advice about condom use is associated with an FSW’s age. Of 1,388 female bar/spa workers surveyed in the southern Philippines, 791 FSW who traded sex in the past 6 months were included in multivariable logistic regression models. The oldest FSWs (aged 36–48) compared to adolescent FSWs (aged 14–17) were 3.3 times more likely to negotiate condoms when clients refused condom use. However, adolescent FSWs received more advice from their managers to convince clients to use condoms or else to refuse sex, compared to older FSWs. Both adolescent and the oldest FSWs had elevated sexually transmitted infections (STIs) and inconsistent condom use compared to other groups. Having a condom rule at the establishment was positively associated with condom negotiation. Factors such as age, the advice managers give to their workers, and the influence of a condom use rule at the establishment need to be considered when delivering HIV/STI prevention interventions.

Un -equal opportunity: Sex and school among first and second generation Mexican immigrant adolescent girls

The purpose of this dissertation was to determine the interactions of sexuality and education among low socioeconomic status first and second generation Mexican immigrant adolescent girls. Much of the existing research differentiates between immigrant generations with little examination of the differences within a particular immigrant generation. This study utilized qualitative methods to examine how various social institutions intersected to influence the young women's decisions about education and sexuality. The methodology included more than three years of participant observation in a South Florida high school and surrounding community; structured and unstructured interviews with twenty young women, their family members, school personnel, and community activists; and surveys conducted with the young women and their parent or guardian. ^ Moving beyond the limits of essentialist immigration theories, this project revealed within group (i.e. immigrant generation) complexities as well as between group similarities. The data included in this dissertation delineate how relationships of power and control permeated the lives of first and second generation Mexican immigrant adolescent girls. The lens of this dissertation is focused on the salient issues of sexuality and education: two dominant forces in many adolescent lives. ^ I found the young women represented a variety of positions on the academic orientation and sexuality continuums and engaged in activities that both reinforced and countered their stated positions on each of these issues. Specifically, first and second generation immigrants are often viewed as maintaining opposing viewpoints about both education and female sexuality however, for these young women the within group variation was larger than the between group variation. While all the young women in this study expressed a belief in the value of education, they engaged in activities that both fortified and contradicted that expressed position. Additionally, although acculturation can lead to increased sexual activity and decreased engagement with education, the first generation immigrant young women in this study became pregnant and/or withdrew from school in equal proportions to their second generation counterparts. In summary, structural forces combined, often inadvertently, and contributed to these young women's spiraling negative academic orientation and/or rational choice of motherhood. Finally, the findings are linked to policy implications. ^

Risk and resilience factors associated with delinquent behavior among African -American adolescent males

Juvenile crime is a social problem of increasing concern to many citizens in the United States. In 2000, there were an estimated 2.4 million juvenile arrests for a variety of crimes ranging from misdemeanors to violent felony offenses. African American males are disproportionately represented among juvenile offenders in the United States. In 2000, black youth were approximately 16% of the U.S. population between the ages of 10–17; however, they accounted for 42% of juvenile arrests for violent crime. ^ This study explored putative factors associated with juvenile offending among a sample of African American adolescent males. The independent variables in this study were academic achievement, religiosity, parenting styles and discrimination. The dependent variables were delinquent behavior and arrest. The data used in this study were from a larger NIDA funded longitudinal study that included approximately 425 African American youths. The data collection method involved structured interviews and questionnaires. The participants for the original study were selected via random sampling from all students attending middle school in Miami-Dade County. The study examined the hypotheses that African American males retrospectively reporting (a) high academic achievement, (b) high religiosity, (c) authoritarian parenting and (d) low perceptions of discrimination are less likely to be involved in delinquent behavior and are also less likely to be arrested. ^ Results indicated that among African American adolescent males, delinquent behavior had a significant relationship (p < .05) with academic achievement, perceived discrimination and the interaction between perceived discrimination and experienced discrimination. Arrest was significantly related to academic achievement (p < .001), religious perception (p < .05), and church attendance (p < 05). Neither dependent variable was significantly related to parenting styles. ^ The findings indicated that experimental studies are needed to clarify cause and effect relationship among the variables associated with juvenile offending among African American males, which may differ from those associated with juvenile offending among other groups. ^

An investigation of the relationship between maltreatment and alcohol and other drug (AOD) problems in African -American and Hispanic adolescent girls

Maltreatment experienced in childhood or adolescence is a known risk factor for later problem alcohol and/or other drug (AOD) use (Bailey & McCloskey, 2005; Shin, Edwards, Heeren, 2009). A growing body of empirical work has found significant associations between adolescent girls’ AOD use and maltreatment experiences. However, questions remain as to how this relation unfolds with African-American and Hispanic adolescent girls. Guided by four relational models that have been proposed in the literature, this study examined the links between maltreatment, trauma symptoms, and alcohol and/or other drug (AOD) problems in a sample of 170 African-American and Hispanic adolescent girls who were participants in a school-based AOD use intervention. Results of this study revealed that maltreatment experiences (physical and emotional abuse) were positively related to trauma symptoms, which were positively related to AOD problem severity, alcohol abuse, alcohol dependency, drug abuse, and drug dependency. Perceived discrimination moderated this relation between sexual abuse and trauma symptoms, such that more perceived discrimination resulted in a stronger effect of sexual abuse on trauma symptoms. Ethnic identity moderated the relation between sexual abuse and AOD problem severity, such that ethnic identity demonstrated protective properties in the relation between sexual abuse and AOD problem severity. My research adds to extant knowledge on the relation between maltreatment and AOD use in adolescent girls and suggests the importance of developing interventions targeting maltreatment and AOD use concurrently.

Maltreatment, Psychiatric Symptoms and Human Immunodeficiency Virus/Sexual Transmitted Infection Risk Behavior Among Youth with Alcohol and Other Drug Use Problems: A Person-Centered Analysis

Multi-problem youth undergoing treatment for substance use problems are at high behavioral risk for exposure to sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Specific risk factors include childhood adversities such as maltreatment experiences and subsequent forms of psychopathology. The current study used a person-centered analytical approach to examine how childhood maltreatment experiences were related to patterns of psychiatric symptoms and HIV/STI risk behaviors in a sample of adolescents (N = 408) receiving treatment services. Data were collected in face-to-face interviews at two community-based facilities. Descriptive statistics and Latent Profile Analysis (LPA) were used to (a) classify adolescents into groups based on past year psychiatric symptoms, and (b) examine relations between class membership and forms of childhood maltreatment experiences, as well as past year sexual risk behavior (SRB). LPA results indicated significant heterogeneity in psychiatric symptoms among the participants. The three classes generated via the optimal LPA solution included: (a) a low psychiatric symptoms class, (b) a high alcohol symptoms class and (c) a high internalizing symptoms class. Class membership was associated significantly with adolescents’ self-reported scores for childhood sexual abuse and emotional neglect. ANOVAs documented significant differences in mean scores for multiple indices of SRB indices by class membership, demonstrating differential risk for HIV/STI exposure across classes. The two classes characterized by elevated psychiatric symptom profiles and more severe maltreatment histories were at increased behavioral risk for HIV/STI exposure, compared to the low psychiatric symptoms class. The high internalizing symptoms class reported the highest scores for most of the indices of SRB assessed. The heterogeneity of psychiatric symptom patterns documented in the current study has important implications for HIV/STI prevention programs implemented with multi-problem youth. The results highlight complex relations between childhood maltreatment experiences, psychopathology and multiple forms of health risk behavior among adolescents. The results underscore the importance of further integration between substance abuse treatment and HIV/STI risk reduction efforts to improve morbidity and mortality among vulnerable youth.