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Purpose: To assess effectiveness, 1-year post-intervention, of a program delivered in jails with women to improve cervical health literacy (CHL) and up-to-date Papanicolaou (Pap) screening. Design: Pre-post design to evaluate Pap screening and CHL effects 1 year after our original randomized wait-list control study. Setting: Surveys conducted in Kansas City, 2015 to 2017 (baseline in 2014). Participants: Adult women (n = 133). Intervention: One-week (10-contact-hour), small-group, CHL program. Measures: Surveys to assess CHL components and up-to-date Pap screening. Analysis: χ2 and t tests, followed by best-subsets logistic regression using sociodemographic and CHL components to fit an optimal model for up-to-date screening 1-year post-intervention. Results: 73% (133/182) women retained at 1-year. From pre-intervention, 6 of 8 CHL components improved (.01 > P > .001). Up-to-date Pap screenings increased over pre-intervention (72%-82%, P < .05). Best-subset model to predict up-to-date screening included age; public benefits; medical insurance; 5 CHL components (knowledge, benefits, barriers, seriousness, susceptibility). Conclusion: A brief intervention to promote cervical health literacy, delivered with women during a jail detention, can lead to sustained improvements in CHL and prevention practices.

Becoming a Responsible Teen (BART) is a community-based, HIV risk reduction curriculum shown to increase safer sex behaviors among African American adolescents. However, BART does not address common barriers to sexual health care access, which may limit program efficacy. We used a community-engaged adaptation process to maximize program relevance and health outcomes by incorporating a broad ecological perspective. Adolescent and staff advisory boards at a community-based organization recommended modifications (e.g., delete references to Kwanzaa, update language, localize incentives) and supported inclusion of critical on-site health services, such as sexually transmitted infection testing and condom provision. We conducted a trial of adapted BART (one session/week for 8 weeks) with 36 adolescents at two community organizations (mean age = 15.5 years, 52% female; 61% reported previous sexual intercourse). Most received on-site sexually transmitted infection testing (61%) and condoms (70%). Adolescents demonstrated significant improvements in self-efficacy for safer sexual practices (p < .02), AIDS risk knowledge (p < .001), condom knowledge (p < .001), and condom attitudes (p < .04). Adolescents and staff were satisfied with the revised curriculum and found on-site services acceptable. Based on improvements in constructs influencing behavior and the successful delivery of services essential for optimal health, future studies to assess efficacy and sustainability of the adapted curriculum appear warranted.

Females currently make up 15% of U.S. military service members. Minimal attention has been paid to families of female National Guard members who have been deployed and their subsequent reintegration challenges. This cross-sectional Internet-based survey of female members of four National Guard units compared those who were and were not deployed. Instruments, guided by the variables of the Family Resilience Model, measured individual, family, and deployment-related factors. Bivariate analysis and ordinal logistic regression were done to assess differences between the groups. Of the 239 National Guard members surveyed, deployed women ( n = 164) had significantly higher levels of posttraumatic stress disorder (PTSD; p < .001) and lower coping skills ( p = .003) than non-deployed women ( n = 75). Perceptions of overall family functioning were higher among deployed when compared with never deployed women. Results indicate community interventions that focus on strengthening coping skills of female Guard members would be useful for this population.

This study describes an evaluation of a community-based psychoeducational intervention, called The Family Series Workshop, for caregivers of community-dwelling persons with Alzheimer’s disease or related dementias (ADRD). In a one-group pretest–posttest design, participants (n = 35) attended six weekly sessions. Caregiver stress, coping, and caregiving competence were evaluated along with demographic characteristics of participants. There was a significant improvement found for caregiving competence, and a marginally significant increase in coping with humor. Using regression analysis we also found that coping with humor, along with stress, were significant predictors of caregiving competence. These findings indicate that it is possible to increase caregiving competence utilizing a “grassroots” approach and that it is feasible to hold educational, group discussions on a plethora of challenging caregiving topics.

The primary objective of this article was to describe the development and pilot implementation of a brief jail-based cervical health promotion intervention. The intervention was guided by a preliminary study of incarcerated women’s cervical health knowledge, awareness, and health literacy, as well as a social and feminist approach to intervention development. We developed and conducted a pilot implementation of the Sexual Health Empowerment Project to increase cervical health knowledge, reduce barriers related to beliefs about cervical cancer, and improve self-efficacy and confidence in navigating health systems. This article offers a framework for how empirically and theory-based interventions are developed and tailored for a jail setting. Future work should include the evaluation of the long-term effects of such a disease-specific program on health behaviors and outcomes among high-risk and vulnerable groups of women as they leave jails and enter communities.

Loss of muscle strength, flexibility, and balance are strong predictors of falls in the elderly. Objectives: The goal of this research was to investigate the effectiveness of a 10-week, strength-based exercise program delivered by Extension professionals. Methods: Matched pair t tests were used to compare differences in five measures of fitness collected from 808 participants (mean age = 65.4 years) at the start and finish of the exercise program. Results: Following programming, participants significantly improved strength, flexibility, and balance. Discussion: Results indicate that an evidence-based program can be translated into a community Extension program that is able to improve the fitness level of seniors.

This article outlines the development and feasibility of an HIV and IPV prevention intervention. Researchers formed a partnership with a group of women representative of the population that the intervention was intended to reach using methods derived from participatory action research. The use of health protective behaviors changed from pre- to postintervention in the clinically desirable direction. Results indicated that intervention delivery was feasible in the novel setting of a large urban day care center. This intervention has promise as a strategy to reduce HIV among low-income women; however, a controlled study is indicated to further examine intervention efficacy.

The purpose of this study is to explore the prevalence and associated behaviors of dating violence among a population of girls in the juvenile justice system. A sample of 590 girls from an urban juvenile justice system completed a questionnaire assessing attitudes and self-efficacy about and occurrence of dating violence. The analysis developed a random effect model to determine a risk profile for dating violence. The strongest predictors of dating violence were (a) initial sexual experience at age 13 or earlier, (b) unwillingness of initial sexual experience, (c) drug use, and (d) low self-efficacy about preventing dating violence. The high prevalence of dating violence and associated behaviors among participants suggests the importance of implementing primary prevention programs to assist preteen girls in delaying initial sexual intercourse and in learning techniques to prevent dating violence.

For most young women and young men throughout the world, adolescence is a time for the discovery and expression of sexuality. The process of this essential human behavior often occurs without accurate information about normal development, physiological processes, and the potential physical, social, and psychological results of sexual exploration. Much of the insufficient information available to adolescents in the United States and elsewhere is not accidental, but can be directly attributed to U.S. government policies, some of which infringe upon the human and reproductive rights of adolescents. Established U.S. policy that promotes abstinence-only programming through selective funding is a violation of adolescent reproductive rights, both at home and abroad. The authors explore why receiving accurate and appropriate sex education is a basic human right for adolescents, and provide suggestions about effective ways to address violations of this right.

Purpose The purpose of this study is to investigate the effect of chromium picolinate supplementation on insulin sensitivity in HIV disease. Methods The study consisted of six HIV-positive patients (3 female; 3 male) with insulin resistance (IR) determined by a hyperinsulinemic-euglycemic clamp. Insulin sensitivity was determined as the rate of infused glucose necessary to maintain euglycemia during an infusion of insulin (Rd). Subjects were infused with 1.2 mU insulin/kg body weight per minute to elevate plasma insulin levels to ˜ 40 microU/mL, sufficient to suppress hepatic glucose production in other insulin-resistant states. Dextrose was administered intravenously at variable rates to maintain plasma glucose at 90 mg/dL. Plasma glucose was assessed from arterialized blood, obtained by the heated hand technique. Insulin resistance was determined between the second and third hour of insulin infusion. Plasma glucose was determined by the glucose oxidase method. To normalize for differences in body composition, insulin sensitivity is expressed as mg glucose/kg lean body mass (LBM) per minute. Lean body mass was determined by dual-energy x-ray absorptiometry (DEXA) performed with a total body scanner. Patients with an Rd Results Insulin sensitivity significantly increased after 8 weeks of chromium picolinate (p 40% improvement in Rd. One subject9s insulin sensitivity was unchanged post-chromium. Conclusion Supplementation with chromium picolinate may improve insulin sensitivity in HIV disease. Further study is required. (Table)

Background Myopathic pain is a feared complication of HMG CoA reductase inhibitor (statin) therapy, due to associated rhabdomyolysis. The incidence of rhabdomyolysis is low, but myalgias, fatigue and weakness are frequent in statin treated patients and often play a decisive role in patient adherence to the prescribed treatment. Preliminary evidence has implicated mitochondrial defects in ATP production as responsible for these symptoms in patients on chronic statin therapy. Methods Prospectively studied patients on chronic statin therapy (with simvastatin or atorvastatin) with complaints of muscle pain, weakness, fatigue had their myalgias graded on a validated pain scale (range 0-10). Creatine phosphokinase (CPK) values were obtained and correlated with the patients9 self-rated discomfort, statin choice and dosage. The patients participated in a randomized blinded trial of coenzyme Q10 or vitamin E supplementation with the statin choice and dosage held constant. Pain scale and CPK were repeated at the end of 1 month. Statistical testing included measurement of correlation coefficients, Fisher exact test with significance at p Results A total of 41 patients (16 atorvastatin 10-80 mg/day; 25 simvastatin 10-80 mg/day) were enrolled. On entry the average pain score was 4.7 (range 0-8) and the average CPK was 138.8 (range 34-573 mg/dL). There was no significant baseline correlation between pain score and CPK (lowest versus highest CPK quartile 5.4 versus 4.2 mean pain score; p = NS). There was no significant difference in baseline pain score between atorvastatin versus simvastatin (5 versus 4.5 respectively; p = NS) treated patients and no significant correlation in either group of pain severity with statin choice (correlation coefficients -0.13 atorvastatin, -0.47 simvastatin) or dose. After one month pain scores improved (-3 mean) in 20 patients and remained the same or worsened (+0.7 mean) in 21 patients. There was no relation between the magnitude or direction of change in pain score and the change in the repeat CPK. The mean CPK increased by 15.3 mg/dL in the improved pain group and decreased by 14.7 mg/dL in the group with the same or worsened pain; p = NS. Conclusions Myalgias, fatigue and weakness not associated with marked increases in CPK are frequent in patients treated with statins. Traditional CPK testing is unreliable for confirming the presence and severity of the patient9s symptoms and assessing changes in severity. Further work is necessary to develop an objective marker to detect, confirm and quantitate myalgias, fatigue, and weakness associated with statin therapy.