Testing the application of a Western scientific theory of AIDS risk behavior among adolescents in Ethiopia.
(25/746)
OBJECTIVE: To test whether a theoretical scheme developed in the United States within the framework of Western science could be applied to a study of HIV risk behaviors among Ethiopian youths. METHODS: Informal interviews and focus group discussions were conducted to determine the relevance of particular AIDS-related risk and protective factors suggested by Jessor's theoretical framework and to generate additional risk and protective factors that were not suggested by a review of the (predominantly Western) literature on adolescent risk behavior. Data from informal interviews and focus group discussions were used to develop survey instruments and procedures for administering survey instruments A pilot study among 99 youths was conducted to examine the reliability and construct validity of the survey instrument. RESULTS: Based on information from focus group discussions and informal interviews, we confirmed the relevance of particular AIDS-related risk and protective factors. The definition of existing constructs was expanded and additional risk and protective factors were incorporated into the existing framework. Existing items and procedures for administering survey instruments were improved and new items were generated. The reliability of survey instruments was determined and improved whenever possible. CONCLUSIONS: We discuss the value of these preliminary steps for securing external validity by identifying theoretical constructs that are relevant to the population at hand and the use of a survey instrument that adequately captures these constructs and provides reliable information. (+info)
Adolescent perceptions of maternal approval of birth control and sexual risk behavior.
(26/746)
OBJECTIVES: This study examined the relationship between adolescent perceptions of maternal approval of the use of birth control and sexual outcomes across a 12-month period. METHODS: A subsample of the Longitudinal Study of Adolescent Health database was used in the context of a prospective design. Approximately 10,000 students in grades 7 to 11 were interviewed twice, 1 year apart. RESULTS: Adolescent perceptions of maternal approval of birth control were associated with an increased likelihood of sexual intercourse over the next 12 months for virgins at wave 1. The perceptions also were related to an increase in birth control use but showed an ambiguous relation to the probability of pregnancy. High relationship satisfaction between adolescents and mothers was associated with a higher probability of birth control use and a lower probability of both sexual intercourse and pregnancy. CONCLUSIONS: The results suggest that perceived parental approval of birth control may increase the probability of sexual activity in some adolescents. "Safer sex" messages must be conveyed by parents with thought and care. (+info)
Long-term outcomes of an abstinence-based, small-group pregnancy prevention program in New York City schools.
(27/746)
CONTEXT: Despite drops in U.S. teenage birthrates, questions continue to arise about how best to reduce the country's adolescent birthrate. School-based programs continue to be considered one of the best ways to reach adolescents at risk of early sexual activity. METHODS: A total of 312 students completed a pretest, a posttest and a follow-up one year after the posttest: 125 who had participated in a 3-4-month-long abstinence-based small-group intervention led by trained social workers, and 187 in a comparison group that received no special services. RESULTS: There were few significant differences between the intervention and comparison groups at posttest. At the one-year follow-up, however, intervention students had significantly better scores on locus of control, their relationship with their parents and (among males only) their attitudes about the appropriateness of teenage sex. Measures of depression, self-esteem, intentions to have sex, attitudes toward teenage pregnancy and various behaviors did not differ significantly between groups. By the time of the one-year follow-up, there was no difference between study groups among females in the initiation of sexual intercourse. Among the males, initiation of sexual intercourse appeared to be higher in the intervention group than in the comparison group, but the difference was not statistically significant. Positive outcomes were especially limited among students who were already sexually active at the start of the study, a finding that emphasizes the difficulties of reaching adolescents who are already at high risk for pregnancy CONCLUSIONS: A small-group abstinence-based intervention focusing on mental health can have some impact on adolescents' attitudes and relationships (particularly with their parents). Long-term evaluations are important for determining the effects of an intervention, as it is difficult to change adolescent risk behavior. (+info)
Weight gain on the combined pill--is it real?
(28/746)
Britain has one of the highest teenage pregnancy rates in Western Europe at 8.8 per 1000 live births. Adolescents are very preoccupied with body image and fear weight gain with use of the combined oral contraceptive (COC) pill. Compliance with contraception continues to be a major issue. Is there a real evidence of weight gain? Or are there discrepancies between adolescent perceptions of weight gain with COC use and available scientific evidence? We carried out a comprehensive literature search and did not find evidence for the purported weight gain with use of low dose COCs. Adolescents need reassurance by gynaecologists, general practitioners, family planning doctors and mass media to remove such misperceptions. This will contribute in some way to reduce the high unintended pregnancy rates. (+info)
The effects of race/ethnicity, income, and family structure on adolescent risk behaviors.
(29/746)
OBJECTIVES: The study examined the unique and combined contributions of race/ethnicity, income, and family structure to adolescent cigarette smoking, alcohol use, involvement with violence, suicidal thoughts or attempts, and sexual intercourse. METHODS: Analyses were based on the National Longitudinal Study of Adolescent Health. A nationally representative sample of 7th to 12th graders participated in in-home interviews, as did a resident parent for 85.6% of the adolescent subjects. The final sample included 10,803 White, Black, and Hispanic 7th to 12th graders. RESULTS: White adolescents were more likely to smoke cigarettes, drink alcohol, and attempt suicide in the younger years than were Black and Hispanic youths. Black youths were more likely to have had sexual intercourse; both Black and Hispanic youths were more likely than White teens to engage in violence. Controlling for gender, race/ethnicity, income, and family structure together explained no more than 10% of the variance in each of the 5 risk behaviors among younger adolescents and no more than 7% among older youths. CONCLUSIONS: Findings suggest that when taken together, race/ethnicity, income, and family structure provide only limited understanding of adolescent risk behaviors. (+info)
Predictors of parent-rated credibility in a clinical psychotherapy trial for adolescent depression.
(30/746)
The authors have reported that adolescents with major depressive disorder had a higher remission rate with cognitive-behavioral therapy (CBT) than with systemic behavioral family therapy (SBFT) or nondirective supportive therapy (NST). Parent-rated treatment credibility deteriorated from baseline to end of treatment if patients were treated with SBFT or NST, compared with CBT. The present study evaluated the following variables as predictors of change in parent- rated credibility over time across the three treatment cells: severity of child's and parents' depression at baseline; parent-rated family climate at baseline; clinician age, gender, and years of clinical experience; and change in severity of child's depression and in family climate. The greater the baseline depression of children treated with CBT and NST, but not SBFT, the more favorable the change in parent-rated credibility at the end of treatment. Findings suggest that any improvement (for CBT) or a supportive therapeutic contact (for NST) may appeal to parents of severely depressed children. (+info)
Depression in children and adolescents.
(31/746)
Depression among children and adolescents is common but frequently unrecognized. It affects 2 percent of prepubertal children and 5 to 8 percent of adolescents. The clinical spectrum of the disease can range from simple sadness to a major depressive or bipolar disorder. Risk factors include a family history of depression and poor school performance. Evaluation should include a complete medical assessment to rule out underlying medical causes. A structured clinical interview and various rating scales such as the Pediatric Symptom Checklist are helpful in determining whether a child or adolescent is depressed. Evidence-based treatment guidelines from the literature are limited. Psychotherapy appears to be useful in most children and adolescents with mild to moderate depression. Tricyclic antidepressants and selective serotonin reuptake inhibitors are medical therapies that have been studied on a limited basis. The latter agents are better tolerated but not necessarily more efficacious. Because the risk of school failure and suicide is quite high in depressed children and adolescents, prompt referral or close collaboration with a mental health professional is often necessary. (+info)
Modeling adolescent development and alcohol use in animals.
(32/746)
Though certain characteristics found in human adolescents are clearly unique, there are other key characteristics of this developmental stage that are common across a number of species. Animal models offer researchers unique insight into the effects of alcohol on the adolescent. This age period is particularly important for study, because this is the time during which many people first experiment with alcohol. It is possible that features of the adolescent brain may in fact predispose a youngster to behave in ways that place him or her at particular risk for experimenting with alcohol or other drugs. In addition to behavioral changes, a number of important physiological alterations occur during adolescence, including changes in brain regions implicated in modulating the reinforcing effects of alcohol and other drugs of abuse. (+info)