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.

Cognitive competence and life course change in multi-problem adolescents

The dissertation reports on two studies. The purpose of Study I was to develop and evaluate a measure of cognitive competence (the Critical Problem Solving Skills Scale ��� Qualitative Extension) using Relational Data Analysis (RDA) with a multi-ethnic, adolescent sample. My study builds on previous work that has been conducted to provide evidence for the reliability and validity of the RDA framework in evaluating youth development programs (Kurtines et al., 2008). Inter-coder percent agreement among the TOC and TCC coders for each of the category levels was moderate to high, with a range of .76 to .94. The Fleiss' kappa across all category levels was from substantial agreement to almost perfect agreement, with a range of .72 to .91. The correlation between the TOC and the TCC demonstrated medium to high correlation, with a range of r(40)=.68, p<.001 to r(40)=.79, p<.001. Study II reports an investigation of a positive youth development program using an Outcome Mediation Cascade (OMC) evaluation model, an integrated model for evaluating the empirical intersection between intervention and developmental processes. The Changing Lives Program (CLP) is a community supported positive youth development intervention implemented in a practice setting as a selective/indicated program for multi-ethnic, multi-problem at risk youth in urban alternative high schools in the Miami Dade County Public Schools (M-DCPS). The 259 participants for this study were drawn from the CLP's archival data file. The study used a structural equation modeling approach to construct and evaluate the hypothesized model. Findings indicated that the hypothesized model fit the data (��2 (7) = 5.651, p = .83; RMSEA = .00; CFI = 1.00; WRMR = .319). My study built on previous research using the OMC evaluation model (Eichas, 2010), and the findings are consistent with the hypothesis that in addition to having effects on targeted positive outcomes, PYD interventions are likely to have progressive cascading effects on untargeted problem outcomes that operate through effects on positive outcomes.

The utility of an Integrated Qualitative /Quantitative Data Analytic Strategy (IQ -DAS) to evaluate the impact of youth development interventions to positive qualitative change in the life course

This study reports one of the first controlled studies to examine the impact of a school based positive youth development program (Lerner, Fisher, & Weinberg, 2000) on promoting qualitative change in life course experiences as a positive intervention outcome. The study built on a recently proposed relational developmental methodological metanarrative (Overton, 1998) and advances in use of qualitative research methods (Denzin & Lincoln, 2000). The study investigated the use the Life Course Interview (Clausen, 1998) and an integrated qualitative and quantitative data analytic strategy (IQ-DAS) to provide empirical documentation of the impact the Changing Lives Program on qualitative change in positive identity in a multicultural population of troubled youth in an alternative public high school. The psychosocial life course intervention approach used in this study draws its developmental framework from both psychosocial developmental theory (Erikson, 1968) and life course theory (Elder, 1998) and its intervention strategies from the transformative pedagogy of Freire's (1983/1970). ^ Using the 22 participants in the Intervention Condition and the 10 participants in the Control Condition, RMANOVAs found significantly more positive qualitative change in personal identity for program participants relative to the non-intervention control condition. In addition, the 2X2X2X3 mixed design RMANOVA in which Time (pre, post) was the repeated factor and Condition (Intervention versus Control), Gender, and Ethnicity the between group factors, also found significant interactions for the Time by Gender and Time by Ethnicity. ^ Moreover, the directionality of the basic pattern of change was positive for participants of both genders and all three ethnic groups. The pattern of the moderation effects also indicated a marked tendency for participants in the intervention group to characterize their sense of self as more secure and less negative at the end of the their first semester in the intervention, that was stable across both genders and all three ethnicities. The basic differential pattern of an increase in the intervention condition of a positive characterization of sense of self relative to both pre test and relative to the directionality of the movement of the non-intervention controls, was stable across both genders and all three ethnic groups. ^

Tequila at Sunrise: Spring Break Travel Motivations and Risk Behaviors of American Students in Acapulco, Mexico

Little research has been completed regarding spring break motivations and behaviors of American students in foreign destinations, specifically in Mexico. This paper looks at push and pull motivations in relation to drug and alcohol consumption and findings indicate greater drug and alcohol use among those who selected ���party reputation��� and ���to go wild��� as travel motivations. Binge drinking, sexual activity, and drug use among students on spring break in Acapulco, Mexico were also analyzed and compared to past findings within the United States. Results suggest that students are involved in heavy alcohol consumption and significant drug use. Additionally, high rates of sexual activity occur on spring break and results suggest low condom use, placing students at higher risks for the contraction of sexually transmitted infections.

The utility of an integrated qualitative/quantitative data analytic strategy (IQ-DAS) to evaluate the impact of youth development interventions on positive qualitative change in the life course

This study reports one of the first controlled studies to examine the impact of a school based positive youth development program (Lerner, Fisher, & Weinberg, 2000) on promoting qualitative change in life course experiences as a positive intervention outcome. The study built on a recently proposed relational developmental methodological metanarrative (Overton, 1998) and advances in use of qualitative research methods (Denzin & Lincoln, 2000). The study investigated the use the Life Course Interview (Clausen, 1998) and an integrated qualitative and quantitative data analytic strategy (IQDAS) to provide empirical documentation of the impact the Changing Lives Program on qualitative change in positive identity in a multicultural population of troubled youth in an alternative public high school. The psychosocial life course intervention approach used in this study draws its developmental framework from both psychosocial developmental theory (Erikson, 1968) and life course theory (Elder, 1998) and its intervention strategies from the transformative pedagogy of Freire's (1983/1970). Using the 22 participants in the Intervention Condition and the 10 participants in the Control Condition, RMANOVAs found significantly more positive qualitative change in personal identity for program participants relative to the non-intervention control condition. In addition, the 2X2X2X3 mixed design RMANOVA in which Time (pre, post) was the repeated factor and Condition (Intervention versus Control), Gender, and Ethnicity the between group factors, also found significant interactions for the Time by Gender and Time by Ethnicity. Moreover, the directionality of the basic pattern of change was positive for participants of both genders and all three ethnic groups. The pattern of the moderation effects also indicated a marked tendency for participants in the intervention group to characterize their sense of self as more secure and less negative at the end of the their first semester in the intervention, that was stable across both genders and all three ethnicities. The basic differential pattern of an increase in the intervention condition of a positive characterization of sense of self relative to both pre test and relative to the directionality of the movement of the non-intervention controls, was stable across both genders and all three ethnic groups.

Always looking on the bright side of life? : Exploring optimism and health in three UK post-industrial urban settings

The survey was jointly funded by NHS Health Scotland and the Glasgow Centre for Population Health.

Always looking on the bright side of life? : Exploring optimism and health in three UK post-industrial urban settings

The survey was jointly funded by NHS Health Scotland and the Glasgow Centre for Population Health.

Always looking on the bright side of life? : Exploring optimism and health in three UK post-industrial urban settings

The survey was jointly funded by NHS Health Scotland and the Glasgow Centre for Population Health.

The Genetics of Success: How Single-Nucleotide Polymorphisms Associated With Educational Attainment Relate to Life-Course Development.

A previous genome-wide association study (GWAS) of more than 100,000 individuals identified molecular-genetic predictors of educational attainment. We undertook in-depth life-course investigation of the polygenic score derived from this GWAS using the four-decade Dunedin Study (N = 918). There were five main findings. First, polygenic scores predicted adult economic outcomes even after accounting for educational attainments. Second, genes and environments were correlated: Children with higher polygenic scores were born into better-off homes. Third, children's polygenic scores predicted their adult outcomes even when analyses accounted for their social-class origins; social-mobility analysis showed that children with higher polygenic scores were more upwardly mobile than children with lower scores. Fourth, polygenic scores predicted behavior across the life course, from early acquisition of speech and reading skills through geographic mobility and mate choice and on to financial planning for retirement. Fifth, polygenic-score associations were mediated by psychological characteristics, including intelligence, self-control, and interpersonal skill. Effect sizes were small. Factors connecting DNA sequence with life outcomes may provide targets for interventions to promote population-wide positive development.

Genetics and the Life Course

A life-course perspective is committed to the proposition that from conception to death, all human outcomes are the result of a continual interaction between the indi- vidual and all of the environments that he or she inhabits at any given point in time. Early development is a critical period, a window of time during the life course when a given exposure can have a critical or permanent in uence on later outcomes. But the impact of exposures upon outcomes does not end at any speci c point in time, inasmuch as life is a continuing interactive and adaptive process. We now know that what applies to human beings also applies to their genomes. The ���outcome��� of any gene at any given point in time (whether or not it is used to transcribe a particular protein, what form of that protein, and how much) is a product of the interaction between the gene and the multiple environments of which it is a part, which include the epigenome, the cell, the biological human, and the assorted environments he or she occupies (e.g., geographical, socioeconomic, ethnic, etc.). Early life experiences can permanently ���reprogram��� the epigenome and gene transcription with life-long behavioral consequences. At the same time, the epigenome as well as the genome continue to be environmentally responsive throughout the life course.

Age and Life Course Location as Interpretive Resources for Decisions Regarding Disclosure of HIV to Parents and Children: Findings from the HIV and Later Life Study

Studies of disclosure among older people living with HIV (PLWH) are uninformed by critical social-gerontological approaches that can help us to appreciate how older PLWH see and treat age as relevant to disclosure of their HIV status. These approaches include an ethnomethodologically-informed social constructionism that explores how ���the��� life course (a cultural framework depicting individuals��� movement through predictable developmental stages from birth to death) is used as an interpretive resource for determining self and others��� characteristics, capacities, and social circumstances: a process Rosenfeld and Gallagher (2002) termed ���lifecoursing���. Applying this approach to our analysis of 74 life-history interviews and three focus groups with older (aged 50+) people living with HIV in the United Kingdom, we uncover the central role that lifecoursing plays in participants��� decision-making surrounding disclosure of their HIV to their children and/or older parents. Analysis of participants��� accounts uncovered four criteria for disclosure: the relevance of their HIV to the other, the other���s knowledge about HIV, the likelihood of the disclosure causing the other emotional distress, and the other���s ability to keep the disclosed confidential. To determine if these criteria were met in relation to specific children and/or elders, participants engaged in lifecoursing, evaluating the other���s knowledge of HIV, and capacity to appropriately manage the disclosure, by reference to their age. The use of assumptions about age and life-course location in decision-making regarding disclosure of HIV reflects a more nuanced engagement with age in the disclosure decision-making process than has been captured by previous research into HIV disclosure, including on the part of people aging with HIV.

Recruiting faith and non-faith based schools, adolescents and parents to a cluster randomised sexual-health trial: experiences, challenges and lessons from the mixed-methods Jack Feasibility Trial

Background: The move toward evidence-based education has led to increasing numbers of randomised trials in schools. However, the literature on recruitment to non-clinical trials is relatively underdeveloped, when compared to that of clinical trials. Recruitment to school-based randomised trials is, however, challenging; even more so when the focus of the study is a sensitive issue such as sexual health. This article reflects on the challenges of recruiting post-primary schools, adolescent pupils and parents to a cluster randomised feasibility trial of a sexual health intervention, and the strategies employed to address them. <br/>Methods: The Jack Trial was funded by the UK National Institute for Health Research (NIHR). It comprised a feasibility study of an interactive film-based sexual health intervention entitled If I Were Jack, recruiting over 800 adolescents from eight socio-demographically diverse post-primary schools in Northern Ireland. It aimed to determine the facilitators and barriers to recruitment and retention to a school-based sexual health trial and identify optimal multi-level strategies for an effectiveness study. As part of an embedded process evaluation, we conducted semi-structured interviews and focus groups with principals, vice-principals, teachers, pupils and parents recruited to the study as well as classroom observations and a parents��� survey. <br/>Results: With reference to Social Learning Theory, we identified a number of individual, behavioural and environmental level factors which influenced recruitment. Commonly identified facilitators included perceptions of the relevance and potential benefit of the intervention to adolescents, the credibility of the organisation and individuals running the study, support offered by trial staff, and financial incentives. Key barriers were prior commitment to other research, lack of time and resources, and perceptions that the intervention was incompatible with pupil or parent needs or the school ethos. <br/>Conclusions: Reflecting on the methodological challenges of recruiting to a school-based sexual health feasibility trial, this study highlights pertinent general and trial-specific facilitators and barriers to recruitment, which will prove useful for future trials with schools, adolescent pupils and parents. <br/><br/>

Intergenerational Transfers over the Life Course: Addressing Temporal and Gendered Complexities via a Human Well-being Approach

Research on intergenerational transmissions of poverty and inequality has tended to focus on material transfers. This paper refocuses attention on the intersection of material and psychosocial transfers, which reveals temporal and gendered complexities. It examines three key ideas emerging from the life course literature (relationality, intersectionality and intergenerationality) to shed light on how these complexities might be addressed. It is argued that a human wellbeing lens is potentially useful as a unifying framework to integrate these ideas as it interrogates what living well means over the life course and how it is constructed relationally.

The sexual health knowledge of people with intellectual disabilities: A review.

There is a growing recognition that people with disabilities have the same sexual needs and rights as people without disabilities. However, less attention is paid to the sexuality of people diagnosed with intellectual disabilities. This narrative review summarises what is currently known about the level of sexual health knowledge of people with intellectual disabilities. A literature review was conducted of the published literature using Google Scholar, PubMed, PsychInfo, EBSCOhost, and Science Direct. Forty eight articles were identified that addressed the question about the level of sexual health knowledge of people with intellectual disabilities. Overall, studies demonstrate that people with intellectual disabilities are highly variable in levels of sexual knowledge, but on average have a range of deficits in knowledge compared to non-disabled individuals. More tailored education and support in accessing formal and informal sources of information are needed.

Job-related strain and sexual health difficulties among heterosexual men from three european countries: The role of culture and emotional support

Introduction. Epidemiological evidence for the association between job-related stress and sexual difficulties in men is largely lacking. Little is known about the factors that may mediate or moderate this relationship. Aim. This study analyzes the association between job-related difficulties and men���s sexual difficulties. Main Outcome Measures. Job-related difficulties were measured by 10 yes/no questions that addressed a range of adverse workplace situations. The experience of sexual difficulties in the past 12 months was assessed by using seven dichotomous indicators developed in the National Study of Sexual Attitudes and Lifestyles (NATSAL) 2000. Method. Analyses were carried out using data from a 2011 online study of Portuguese, Croatian, and Norwegian men (N = 2,112). Multivariate logistic regression and mediation analysis were used to test the hypothesized association. Results. Men with job-related concerns reported lower sexual satisfaction than men without such concerns did (F = 7.53, P < 0.001). Multivariate analysis confirmed the association between job-related and sexual health concerns. The odds of experiencing one or more sexual health difficulties in the past 12 months were about 1.8 times higher among men who reported the highest levels of workplace difficulties than among men who experienced no such difficulties. The odds of reporting sexual health difficulties were significantly reduced by a higher income (adjusted odds ratio [AOR] = 0.87, P < 0.01), emotional intimacy with one���s partner (AOR = 0.93, P < 0.001), having children (AOR = 0.62���0.66, P < 0.01), and country-specific effects (AOR = 1.98���2.22, P < 0.001). In all three countries, the relationship between job-related and sexual health difficulties was mediated by anxiety and depression. Conclusions. The findings suggest that negative mood is the mechanism behind the association between workplace strain and sexual difficulties. Emotional support, such as couple intimacy and fatherhood, can reduce���independently from sociocultural and socioeconomic factors���the risk of sexual health concerns.