Dimensions of gender relations and reproductive health inequity perceived by female undergraduate students in the Mekong Delta of Vietnam: a qualitative exploration

Introduction Increasing evidence indicates that gender equity has a significant influence on women’s health; yet few culturally specific indicators of gender relations exist which are applicable to health. This study explores dimensions of gender relations perceived by female undergraduate students in southern Vietnamese culture, and qualitatively examines how this perceived gender inequity may influence females’ sexual or reproductive health. Methods Sixty-two female undergraduate students from two universities participated in eight focus group discussions to talk about their perspectives regarding national and local gender equity issues. Results Although overall gender gaps in the Mekong Delta were perceived to have decreased in comparison to previous times, several specific dimensions of gender relations were emergent in students’ discussions. Perceived dimensions of gender relations were comparable to theoretical structures of the Theory of Gender and Power, and to findings from several reports describing the actual inferiority of women. Allocation of housework and social paid work represented salient dimensions of labor. The most salient dimension of power related to women in positions of authority. Salient dimensions of cathexis related to son preference, women’s vulnerability to blame or criticism, and double standards or expectations. Findings also suggested that gender inequity potentially influenced women’s sexual and reproductive health as regards to health information seeking, gynecological care access, contraceptive use responsibility, and child bearing. Conclusion Further investigations of the associations between gender relations and different women’s sexual and reproductive health outcomes in this region are needed. It may be important to address gender relations as a distal determinant in health interventions in order to promote gender-based equity in sexual and reproductive health.

Comparison of two mentoring programs for at -risk Black adolescents: A traditional one -to -one mentoring program and a school -to -work transitional program

The purposes of this study were: (a) to compare the impact of One-to-One (OTO) mentoring interventions administered in the high school setting, and the workplace of the students who participated in the School-to-Work (STW) transitional program, and (b) to identify how the participants perceived their experience in the OTO mentoring program and the STW transitional program. A qualitative approach was used to identify how participants perceived their mentoring experiences with the STW and OTO mentoring programs by utilizing focus groups and content analysis. A quantitative approach was used to compare the statistical differences of outcomes between the STW and OTO mentoring programs, by utilizing descriptive statistics, independent samples t-tests, chi-square analyses, and logistic regression. The sample was limited to participants in the STW and OTO mentoring programs resulting in 21 participants for the qualitative approach and 114 participants for the quantitative approach. ^ Results from the qualitative approach indicated that focus group participants in the STW program were satisfied with the program and the relationship with their mentors. They also suggested that the STW program be lengthened to include the entire academic year. Participants from the OTO focus group were dissatisfied with their program due to inadequate mentor involvement. Results from the quantitative approach showed that the increase in school attendance for the STW program's at-risk Black male youth was statistically significant compared to the OTO program participants; the STW program participants displayed a better outlook for attending college that was statistically significant compared to those in the OTO program; and the OTO program participants displayed a better outlook for permanent employment compared to those in the STW program. ^ Therefore, this study finds that mentoring can contribute to reducing school absences and high school completion in order for at-risk Black adolescents to attend college. It is recommended that the OTO program be restructured to eliminate the disparity that exists regarding the administration of the STW program and the OTO program. ^

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. ^

A model of self -transformative identity development in troubled adolescent youth

Within the Stage II program evaluation of the Miami Youth Development Project's (YDP) Changing Lives Program (CLP), this study evaluated CLP intervention effectiveness in promoting positive change in emotion-focused identity exploration (i.e. feelings of personal expressiveness; PE) and a "negative" symptom of identity development (i.e. identity distress; ID) as a first step toward the investigation of a self-transformative model of identity development in adolescent youth. Using structural equation modeling techniques, this study found that participation in the CLP is associated with positive changes in PE (path = .841, p < .002), but not changes in ID. Increase in ID scores was found to be associated with increases in PE (path = .229, p < .002), as well. Intervention effects were not moderated by age/stage, gender, or ethnicity, though differences were found in the degree to which participating subgroups (African-American/Hispanic, male/female, 14-16 years old/17-19 years old) experience change in PE and ID. Findings also suggest that moderate levels of ID may not be deleterious to identity exploration and may be associated with active exploration. ^

Investigating group processes in a positive youth development program for multi -problem youth

This study investigated group processes as potential mediators or moderators of positive development outcome and negative reduction intervention response by evaluating the utility of a group measure modified from a widely known measure of group impact found in the group therapy research literature. Four group processes were of primary interest, (1) Group Impact; (2) Facilitator Impact; (3) Skills Impact; and (4) Exploration Impact as assessed by the Session Evaluation Form (SEF). Outcome measures included the Personally Expressive Activities Questionnaire (PEAQ), Erikson Psycho-Social Index (EPSI) and the Zill Behavior Items, Behavior Problem Index (ZBI (BPI)). The sample consisted of 121 multi-ethnic participants drawn from four alternative high schools from the Miami-Dade County Public School system. Utilizing a Latent Growth Curve Modeling approach with Structural Equation Modeling (SEM) statistics, preliminary analyses were conducted to evaluate the psychometric properties of the SEF and its role in the mediation or moderation of intervention outcome. Preliminary results revealed evidence of a single higher order factor representing a "General" global reaction, which was hypothesized to be a "Positive Group Climate" construct to the program as opposed to the four distinct group processes that were initially hypothesized to affect outcomes. The results of the evaluation of the mediation or moderation role of intervention outcome of the single "General" global latent factor ("Positive Group Climate" construct) did not significantly predict treatment response on any of the outcome variables. Nevertheless, the evidence of an underlying "General" global latent factor ("Positive Group Climate" construct) has important future directions for research on positive youth development programs as well as in group therapy research.

The influence of gender on perceived treatment need among a community sample of substance users

Purpose: Most individuals do not perceive a need for substance use treatment despite meeting diagnostic criteria for substance use disorders and they are least likely to pursue treatment voluntarily. There are also those who perceive a need for treatment and yet do not pursue it. This study aimed to understand which factors increase the likelihood of perceiving a need for treatment for individuals who meet diagnostic criteria for substance use disorders in the hopes to better assist with more targeted efforts for gender-specific treatment recruitment and retention. Using Andersen and Newman's (1973/2005) model of individual determinants of healthcare utilization, the central hypothesis of the study was that gender moderates the relationship between substance use problem severity and perceived treatment need, so that women with increasing problems due to their use of substances are more likely than men to perceive a need for treatment. Additional predisposing and enabling factors from Andersen and Newman's (1973/2005) model were included in the study to understand their impact on perceived need. Method: The study was a secondary data analysis of the 2010 National Survey on Drug Use and Health (NSDUH) using logistic regression. The weighted sample consisted of a total 20,077,235 American household residents (The unweighted sample was 5,484 participants). Results of the logistic regression were verified using Relogit software for rare events logistic regression due to the rare event of perceived treatment need (King & Zeng, 2001a; 2001b). Results: The moderating effect of female gender was not found. Conversely, men were significantly more likely than women to perceive a need for treatment as substance use problem severity increased. The study also found that a number of factors such as race, ethnicity, socioeconomic status, age, marital status, education, co-occurring mental health disorders, and prior treatment history differently impacted the likelihood of perceiving a need for treatment among men and women. Conclusion: Perceived treatment need among individuals who meet criteria for substance use disorders is rare, but identifying factors associated with an increased likelihood of perceiving need for treatment can help the development of gender-appropriate outreach and recruitment for social work treatment, and public health messages.

A visual critical ethnography of youth develoment in a Rio de Janeiro favela

Favelas are Brazilian informal housing settlements that are areas of concentrated poverty. In Rio de Janeiro, favelas are perceived as areas of heightened criminal activity and violence, and residents experience discrimination, and little access to quality education and employment opportunities. In this context, hundreds of non-formal educational arts and leisure programs work to build the self-esteem and identity of youth in Rio's favelas as a way of preventing the youth from negative local influences. The Morrinho organization, located in the Pereira da Silva favela in Rio, uses art as a way for the local male youth to communicate their lived reality. This study used a visual critical ethnographic methodology to describe the way in which the Morrinho participants interpret living in a favela. Seventeen semi-structured interviews with young men aged 15 to 29, the feature-length documentary film on the organization, 206 researcher produced documentary style photographs of the Morrinho artwork, and the researcher's field notes were analyzed. Truth claims, ways of seeing as communicated through words and actions, were induced through a cyclical process of reconstructive horizon analysis that incorporated the societal context and critical theory. The participants communicated their concerns about life in a favela; however, they did not describe their societal positions in terms of complete marginalization. They named multiple benefits of living in Pereira da Silva, discussed positive and negative experiences in school, and described ways they circumvented discrimination. Morrinho as an organization was described as an enthralling game and a social project that benefited dozens of local youth. Character development was a valuable result of participation at Morrinho. The Morrinho artwork communicates a nuanced vision of both benevolent and violent social actors, and counters the overwhelmingly negative dominant characterization of Rio de Janeiro's favelas. This study has implications for an inclusive critical pedagogy and the use of art as a means to facilitate a transformative education. Further research is recommended to explore terminology used to refer to favelas, and perceptions that favela residents have of their experiences in public education.

Influence of gender and life stressors on longitudinal depression treatment outcomes among older primary care patients

Purpose: Depression in older females is a significant and growing problem. Females who experience life stressors across the life span are at higher risk for developing problems with depression than their male counterparts. The primary aim of this study was (a) to examine gender-specific differences in the correlates of depression in older primary care patients based on baseline and longitudinal analyses; and (b) to examine the longitudinal effect of biopsychosocial risk factors on depression treatment outcomes in different models of behavioral healthcare (i.e., integrated care and enhanced referral). Method: This study used a quantitative secondary data analysis with longitudinal data from the Primary Care Research in Substance Abuse and Mental Health for Elderly (PRISM-E) study. A linear mixed model approach to hierarchical linear modeling was used for analysis using baseline assessment, and follow-up from three-month and six-month. Results: For participants diagnosed with major depressive disorder female gender was associated with increased depression severity at six-month compared to males at six-month. Further, the interaction between gender and life stressors found that females who reported loss of family and friends, family issues, money issues, medical illness was related to higher depression severity compared to males whereas lack of activities was related to lower depression severity among females compared to males. Conclusion: These findings suggest that gender moderated the relationship between specific life stressors and depression severity similar to how a protective factor can impact a person's response to a problem and reduce the negative impact of a risk factor on a problem outcome. Therefore, life stressors may be a reliable predictor of depression for both females and males in either behavioral health treatment model. This study concluded that life stressors influence males basic comfort, stability, and survival whereas life stressors influence females' development, personal growth, and happiness; therefore, life stressors may be a useful component to include in gender-based screening and assessment tools for depression. ^

An investigation of the effects of a school-based intervention on feelings of personal expressiveness in multi-problem adolescent youth

This study was conducted to determine the effects of the Changing Lives Program intervention on troubled adolescents' feelings of personal expressiveness, believed to be one domain of positive identity development. Forty-three intervention and twenty nonintervention comparison control participants were given a battery of pre-, post-, and follow-up assessments including the Personally Expressive Questionnaire (Waterman, 1995), which was used to derive participants' feelings of personal expressiveness scores. Using Repeated Measures Analysis of Multivariate Analysis (RMANOVA), a significant four-way interaction of Time X Condition X Gender X Ethnicity was found relative to the Control, Roy's Ɵ = .166, F(2,47) = 3.899, p < .027 indicating that intervention participants' feelings of personal expressiveness did increase significantly relative to the control group. Furthermore, the results suggest differential outcomes based on ethnicity, suggesting the need for future study with respect to specificity of effects and mechanisms of identity formation in differing ethnic subgroups.

Through the Prisms of Gender and Power: Agency in International Courtship between Colombian Women and American Men

Since 1999 Colombia has experienced dramatic increases in emigration, particularly the emigration of women towards the U.S. as fiancées of U.S. citizens or residents. Parallel to this trend is the increased number of websites facilitating these Colombian-American matches. This dissertation investigates the agency of Colombian women and American men who pursue romantic courtship through the services of International Marriage Brokers (IMBs) from the “Gendered Geographies of Power” (GGP) framework of analysis. It examines how both groups’ social locations, their positioning in multiple axes of differentiation including gender, nationality and social class, affects how and why they exert their agency across and within different geographic scales. Most importantly, it investigates the role the imagination plays (imagination work) in both men and women’s agency, an aspect of the GGP framework that has been under-researched and theorized to date. The research also finds that this imagination work is promoted and cultivated in deeply gendered ways by IMBs seeking to profit off this transnational courtship. Employing data collected via interviews and content analysis of IMBs’ websites, the dissertation analyzes comparatively the expectations each group (women, men and IMBs) bring to their imagination work and experiences of the courtship marketplace. A central question posed and answered in the dissertation is “What do women and men courting each other in cyberspace seek and do they find it?” The dissertation finds that the men seek “traditional” women and the women seek “liberated” less “macho” men. Ironically, the men find Colombian women who are among the most “liberated” women in their homeland but who downplay this aspect of themselves in order to strategically find a more modern man and migrate abroad where they expect to find greater personal and professional opportunities.

Adaptation of Trailing Spouses: Does Gender Matter?

The adaptation to a new country is a complex and stressful process that is compounded when changes in status and identity have to be made. This exploratory study examined the adaptation of international company transferee spouses when they decide to follow the transferee on overseas assignments. Research to date indicates that the spouses’ dissatisfaction with life abroad is the leading cause of transferees breaking contract and prematurely returning home. The causes of this dissatisfaction are still not clear and this study sought greater clarification, particularly examining the experiences of male as well as female trailing spouses. The study, thus, takes gender as a main variable to consider. It explores how gendered expectations inherent in the structures of society inflect and inform the decisions, attitudes, and behaviors that affect the adaptations of trailing spouses living in a foreign habitus. The study is based on eight months of ethnographic research in two culturally different locations, Kuala Lumpur, Malaysia and Brussels, Belgium. Forty-two American international company transferee spouses were recruited (seven males and thirty-five females). The data analysis revolved around five main themes: (1) the comparison of male with female trailing spouses’ experiences, (2) the effect of location on spouses’ adaptation, (3) the communities that spouses integrate into, (4) variations in personal work and family histories, and (5) conditions of exit. The analysis engaged multiple theories regarding gender, sociological adaptation, and psychological adaptation. Results indicate that both socio-cultural and psychological factors affect adaptation and that gender matters very significantly, particularly along two axes: (1) gendered structures in our society create different reasons why males and females become trailing spouses, (2) the gendered social constructions of role expectations make the experience of being a trailing husband different from being a trailing wife. In addition spouses’ status as parents (or not) and their “readiness for change” were found to be important predictors of positive spousal adaptation. In contrast, significant ties with families in the home country and strong professional identity with career projections were important predictors of negative spousal adaptation.

A model of self-transformative identity development in troubled adolescent youth

Within the Stage II program evaluation of the Miami Youth Development Project's (YDP) Changing Lives Program (CLP), this study evaluated CLP intervention effectiveness in promoting positive change in emotion-focused identity exploration (i.e. feelings of personal expressiveness; PE) and a "negative" symptom of identity development (i.e. identity distress; ID) as a first step toward the investigation of a self-transformative model of identity development in adolescent youth. Using structural equation modeling techniques, this study found that participation in the CLP is associated with positive changes in PE (path = .841, p < .002), but not changes in ID. Increase in ID scores was found to be associated with increases in PE (path = .229, p < .002), as well. Intervention effects were not moderated by age/stage, gender, or ethnicity, though differences were found in the degree to which participating subgroups (African- American/Hispanic, male/female, 14-16 years old/17-19 years old) experience change in PE and ID. Findings also suggest that moderate levels of ID may not be deleterious to identity exploration and may be associated with active exploration.

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.

Supporting inclusiveness through concepts of gender

Some dads wear nail polish! Is the tooth fairy a boy or a girl? My Grade Two students’ voices were integral in developing each of the action research cycles as students became co-creators of knowledge. I gathered data through a personal journal, observations, reflections, work samples, interviews and classroom artifacts. The research question was focused on creating a safe and caring classroom environment by selecting appropriate instructional strategies based on developing my students’ concept of gender. Findings included students’ acceptance of differences, emulation of gender stereotypes, the significance of role models and student empowerment. Conclusions examined the influence that behaviour has on instructional strategies, creating allies among primary students, the importance of teacher training and the influence that students have in their classroom. Thoughts towards future research include the need for further parent engagement and more exploration of the impact that the school environment has in the classroom.

The Politics of Gender Socialization

This manuscript is comprised of three papers that examine the far-reaching and often invisible political outcomes of gender role socialization in the United States. These papers focus primarily on two areas: political confidence amongst girls and women, and the effects of gender on survey measurement and data quality.

Chapter one focuses on political confidence, and the likelihood that women will run for political office. Women continue to be underrepresented at all levels of political leadership, and their lack of political ambition, relative to men, has been identified as a primary cause. In this paper, I explore the relationship between an individual's masculinity and femininity and her development of political ambition. Using original survey data from the 2012 Cooperative Congressional Election Study (CCES), I first empirically demonstrate that gender (masculinity/femininity) and sex (male/female) are unique elements of identity and, moreover, are both independently related to political ambition. I then explore the relevance of gender for the study of candidate emergence, testing whether and how masculinity and femininity might be related to political ambition are supported empirically. While the results suggest that masculinity is positively associated with the development of political ambition, the relationship between femininity and candidate emergence seems to be more complicated and not what prevailing stereotypes might lead us to expect. Moreover, while the relationship between masculinity and political ambition is the same for men and women, the relationship between femininity and political ambition is very different for women than it is for men. This study suggests that gender role socialization is highly related with both men's and women's desire to seek positions of political leadership.

Chapter two continues this exploration of gendered differences in the development of political ambition, this time exploring how social attractiveness and gendered perceptions of political leadership impact the desire to hold political office.Women are persistently underrepresented as candidates for public office and remain underrepresented at all levels of government in the United States. Previous literature suggests that the gendered ambition gap, gender socialization, insufficient recruitment, media scrutiny, family responsibilities, modern campaign strategies, and political opportunity structures all contribute to the gender imbalance in pools of officeholders and candidates. To explain women's reticence to run, scholars have offered explanations addressing structural, institutional, and individual-level factors that deter women from becoming candidates, especially for high positions in the U.S. government. This paper examines a previously unexplored factor: how dating and socialized norms of sexual attraction affect political ambition. This study investigates whether young, single, and heterosexual women's desire for male attention and fear of being perceived as unattractive or "too ambitious" present obstacles to running for office. The results of these experiments suggest that social expectations about gender, attraction and sexuality, and political office-holding may contribute to women's reticence to pursue political leadership. Chapter two is a co-authored work and represents the joint efforts of Laura Lazarus Frankel, Shauna Shames, and Nadia Farjood.

Chapter 3 bridges survey methodology and gender socialization, focusing on how interviewer sex affects survey measurement and data quality. Specifically, this paper examines whether and how matching interviewer and respondent sex affects panel attrition--respondents dropping out of the study after participating in the first wave. While the majority of research on interviewer effects suggests that matching interviewer and respondent characteristics (homophily) yields higher quality data, little work has examined whether this pattern holds true in the area of panel attrition. Using paradata from the General Social Survey (GSS), I explore this question. My analysis reveals that, despite its broader positive effects on data quality, matching interviewer and respondent sex increases likelihood to attrit. Interestingly, this phenomenon only emerges amongst male respondents. However, while assigning female interviewers to male respondents decreases their propensity to attrit, it also increases the likelihood of biased responses on gender related items. These conflicting outcomes represent a tradeoff for scholars and survey researchers, requiring careful consideration of mode, content, and study goals when designing surveys and/or analyzing survey data. The implications of these patterns and areas for further research are discussed.

Together, these papers illustrate two ways that gender norms are related to political outcomes: they contribute to patterns of candidate emergence and affect the measurement of political attitudes and behaviors.