Search

The role of pregnant adolescents as perpetrators of intimate partner violence (IPV) is not well understood. Socioecological factors associated with IPV (physical assault and injury, and psychological aggression) perpetrated by pregnant adolescents and the association between IPV and attitudes toward the use of physical punishment to discipline children were examined among 246 pregnant adolescents. Pregnant adolescents were more likely to report perpetrating both physical assault (24%) and psychological aggression (52.7%) than being the recipient (12.2% and 38.6%, respectively) and having been physically injured (7%) than inflicting injury (4.1%). Risk factors for perpetrating physical assault included prior assault by partner, being African American, exposure to community violence, being in trouble with the police, and multiple lifetime drug use. IPV perpetrators had more favorable attitudes toward the use of physical punishment. Interventions should address IPV and parenting attitudes in young couples to maximize the health and safety of both mother and unborn child.

This quasi-experimental study compared family formation and perceived partner support among pregnant adolescents in a prenatal care program. Participants were assigned to either an intervention group utilizing centering pregnancy (CP) prenatal care and case management, or to a comparison group receiving case management only. Partners were invited to participate in CP group sessions. This study included 173 predominantly minority pregnant adolescents ages 15–18 years who were enrolled in a prenatal program and followed one month postpartum. Family formation included living and relationship arrangements. Perceived partner support included six domains of perceived social provisions. Data were collected through participants’ self-reports using computer-assisted self-interviews. Changes in family formation and perceptions of partner support from baseline to postpartum did not differ between intervention and comparison groups. Male partners who attended at least one CP session were perceived as more supportive at both the beginning and end of the program than partners who did not attend any sessions. After combining groups, pregnant adolescents reported a significant shift in family formation and increased monetary support from partners from baseline to postpartum. Partner support is important for ensuring positive pregnancy outcomes. Additional strategies are needed to engage young fathers who do not readily provide support during pregnancy.

The study identified factors associated with human immunodeficiency virus (HIV) risk perception among 283 African American young adult females attending family planning clinics. This included partner communication, a forced sex experience, social support, self-efficacy, and risk behaviors. Relative to adolescents who perceived themselves to be at low/high risk for HIV, adolescents with medium HIV risk had the highest number of lifetime and recent sexual partners, were significantly less comfortable in communicating with partners about sexual issues, and reported low sex and condom self-efficacy. Additionally, the medium group had the highest proportion of participants who reported a forced sex experience. The findings suggest that a forced sex experience may affect females’ ability to accurately assess sexual risk. Screening for trauma and helping adolescents accurately appraise their HIV risk is essential for risk reduction.

This study aimed to identify health issues that affect young men and the barriers they experience in accessing care. Participants were 48 minority men 18-28 years old, distributed among 9 focus groups. Four main themes emerged in the study. First, the authors identified sexually transmitted infections, mental health problems, and drug use as major health issues. Second, participants identified attitudinal and institutional barriers to accessing care. This included denial; fear; embarrassment; perception that it is not considered manly to seek help; cost; and accessibility. Third, focus group participants felt that services have to be augmented in order to address the specific needs of men. Last, participants suggested strategies to attract men to family planning clinics that are consistent with a youth culture. Focus groups are effective in obtaining input in order to augment services for men.

Objective. Adolescents and young adults remain at high risk for new HIV infections and for unknowingly transmitting the virus to others. Yet, they have demonstrated low rates of testing due to barriers such as stigma and difficulty accessing testing services. Few existing programs have successfully integrated family planning and HIV care services to improve testing and diagnosis rates among young adults and adolescents, particularly those of minority groups. This study describes the process of implementing HIV services into family planning clinics and how to train staff in routine, opt-out testing. Methods. This study used HIV screening data from 10 family planning clinics serving adolescents and young adults in Houston, Texas. A total of 34,299 patients were tested for HIV during a 48-month study period, from January 2010 through December 2014. Results. Patients tested included minors Conclusion. Routine, opt-out HIV testing integrated into family planning clinics increased rates of testing acceptance, receipt of test results, and HIV-positive diagnoses among adolescents and young adults.

Health care utilization of reproductive health care services among males is an emerging issue. This study examined ethnicity as a factor in reproductive health care utilization among 1,606 African American and Hispanic young males attending family planning clinics. Seventy percent were African American and 30% were Hispanic. Across groups, the most received service was treatment for a sexually transmitted infection (STI). African American males were more likely than Hispanic males to have health insurance, report a prior visit to a family planning/STI clinic, and have a history of an STI. Hispanic males had higher rates of employment. The most common source of referral for family planning services for both groups was either a current girlfriend or female friend. Hispanic males were more likely to use family as a referral source than African American males. Differences were also noted in regard to interest in health topics with African American males most interested in STI prevention and getting a job and Hispanic males in services related to working-out/eating well, controlling anger, feeling depressed, and getting along with family. Young males’ perceptions of what they consider to be important health care needs should be assessed carefully in order to maintain their interest in returning to the clinics.

The purpose of this study was to examine ethnic and marital status differences in family structure, risk behaviors and service requests among African American and Hispanic adolescent fathers participating in a community-based fatherhood program. Demographic factors, risk behaviors, and service requests were gathered at program entry. The results indicated that each group demonstrated distinct patterns associated with family structure, sexual risk behaviors, substance use, and criminal behavior. In comparison to African American fathers, Hispanic fathers were younger and were more likely to be married and present at the delivery of their child. African American fathers reported having more children than Hispanic fathers. Disparities in school-related measures were also found, with African American fathers having higher high school graduation rates than Hispanic fathers. The impact of marriage on risk behaviors had mixed results. Services requests were similar for both groups. The finding that different ethnic groups have specific patterns of risk behaviors highlights the importance of considering the ethnic composition of a population when developing future research and interventions.

To examine individual, interpersonal, family, and community correlates associated with moderate-to-severe depressive symptoms among pregnant adolescents. A total of 249 primarily African American and Hispanic pregnant adolescents ages 15–18 years were recruited into either an intervention group utilizing Centering Pregnancy prenatal care and case management, or to a comparison group receiving case management only. Moderate-to-severe depressive symptoms were defined as a score ≥16 on the Center for Epidemiologic Studies Depression Scale (CES-D). Intervention and comparison groups did not significantly differ on demographic characteristics or depression scores at baseline. A total of 115 (46.1 %) participants met criteria for moderate-to-severe depressive symptoms at entry into the program. Pregnant adolescents who were moderately-to-severely depressed were more likely to be African American, to have reported limited contact with the father of the baby, and to have experienced prior verbal, physical or sexual abuse. Depressed adolescents also experienced high levels of family criticism, low levels of general support, and exposure to community violence. A significant number of pregnant adolescents were affected by depression and other challenges that could affect their health. Comprehensive interventions addressing these challenges and incorporating partners and families are needed.

This study examined whether an assessment tool combining HIV-related risk behaviors and symptoms would increase HIV testing and return for post-test counseling among 466 adolescents attending family planning clinics. The results indicted that high-risk behaviors were common among these adolescents. The majority (78.3%) identified themselves as not using condoms consistently, almost a quarter (24.7%) reported a history of STDs and 129 (27.7%) reported they had pierced their bodies. A total of 214 (45.9%) received HIV testing. Two (0.4%) adolescents, one male and one female, tested positive for HIV. Of the 214 adolescents who underwent testing, 183 (85.5%) returned to the clinic for post-test counseling. The results of this study indicated that adolescents who reported risk behaviors and symptoms were not more likely than those who reported no risk behaviors and symptoms to request testing and return for post-test counseling. In light of these results, the authors review the protocols associated with testing and post-test counseling and propose solutions that can potentially improve these processes. The authors recommend integrating a risk assessment tool with HIV testing in family planning clinics as testing and return for post-test counseling rates were high.

Young fathers (N = 143) ages 16-33 participated in an assessment of risk behaviors, service needs, and mental health issues upon entering a fatherhood program. Almost 70% were unemployed, 39% were school dropouts, 47% used alcohol, 40% had problems with the law, and 42% had been in jail. The most frequently reported mental health issues were problems related to relationships, neighborhood, family, tobacco use, police, and being a parent. Fathers also identified feeling states of anger, sadness/depression, nervousness/tension, helplessness, and aggression. Although risk behaviors and mental health issues were identified, fathers did not request services to address them; rather, their most frequently requested service needs were related to jobs and vocational training. The article suggests that an assessment of mental health issues that focuses on a strengths perspective might yield a better evaluation of both mental health issues and service needs. The article addresses ways that program planners could enhance realistic participation.

The goal of this study was to examine the effect of resiliency and family support on depression symptoms among 110 indigent adolescents attending a family planning clinic in a large urban city in southwestern USA. Findings suggested that several of the resiliency domains, on the Individual Protective Factors Index, as well as family support measured by the Family Support Scale, were associated with depression symptoms. Scores on the self-concept and positive outlook dimensions of the Personal Competence domain, the confidence and assertiveness dimensions of the Social Competence domain, and family support correlated with depression symptoms. The findings also suggested that 16.4% of the teens in this clinic would be classified as clinically depressed and as needing further evaluation. It seems reasonable to conclude that resilient adolescents may possess characteristics, beliefs, and supports which enable them to cope with life stressors more effectively and avoid depressive symptoms than those who are not as resilient. Given the prevalence and extent of depression among adolescents, it is important to develop interventions to foster attachment and enhance individual protective factors in primary prevention programs as such interventions may ameliorate the effects of high-risk environments.

One hundred and twenty eight young fathers participated in an assessment of risk behaviors and service needs prior to entering a program for young fathers. Of this group, 73% were unemployed, 69% were school drop-outs, almost 40% had substance abuse problems, close to 30% had committed a felony, and less than half had declared paternity for their children. The majority of these young fathers desired employment services and educational/vocational training. Despite their risk behaviors, young fathers did not want substance abuse counseling, child support services, or help in obtaining a GED. There appears to be a discrepancy between the problems and needs, and the services which these young fathers requested. Many young fathers believed employment would be a panacea to all their problems. These findings suggest that more attention should be given to examining these issues in programs targeting young fathers. Services such as preventive health and mental health should be considered prior to the final goals of employment and establishment of paternity.

Introduction: Harris County, Texas is the 3rd largest county in the United States, and home to a large ratio of racial/ethnic minorities and immigrants. It has one of the highest rates of cervical cancer, where nearly all cases are caused by human papillomavirus (HPV), with the incidence rate highest among African Americans and Hispanics/Latinos. A wealth of medical resources exist, yet HPV-related cancers have failed to improve over the past 10 years. Youth are particularly at risk for HPV infection and are more likely to not receive the HPV vaccine. The aim of this research was to better understand the factors influencing HPV vaccination among youth in Harris County and to develop an evidence-based approach to improve vaccine uptake. Methods: A socio-ecological framework was used to identify key stakeholders. Data was collected using a mixed methods approach between October 2014 and October 2015 in Harris County, Texas. One focus group and 31 focused interviews were conducted with parents of 5-18 year old children. Seven key informant interviews were conducted with school nurses; a political leader; and health professionals from adolescent health clinics, pediatric hospitals, health centers, community-based organizations (CBOs), and medical institutions. Three community advisory board (CAB) meetings were held with school nurses and board members; physicians; and health professionals from health departments, CBOs, and educational and advocacy organizations. Results: Parents Most parents lacked knowledge of HPV and the vaccine. Many felt the best way to receive education was from their providers. Others expressed interest in receiving education from schools, the media, seminars, and community involvement. Spanish-speaking parents emphasized the need for more linguistically appropriate literature. Some parents voiced discomfort with vaccinating 9-12 year olds, mainly due to safety concerns and vaccine efficacy. Physicians' recommendations were an influential factor in some parents' decision making regarding vaccination. Other key stakeholders Lack of education about HPV infection and the vaccine was cited as a major barrier to vaccination. CAB participants often felt misinformed by their providers, and stated some physicians lack time to hold discussions and fail to provide confident recommendations. Perceived negative side effects; cultural and religious beliefs; lack of reminders for the 2nd and 3rd doses; and labeling the vaccine as a cervical cancer and sexual vaccine were noted as other barriers. Health clinics felt some providers' recommendation approaches were a barrier. Mistrust of the healthcare system was reported as common in Hispanic/Latino communities, and lack of engagement in preventable activities was described as common in African American and immigrant communities. It was stressed that education targeting parents, use of the opt-out approach for provider recommendations, and promoting the vaccine as a cancer-prevention vaccine are essential to increasing HPV vaccine uptake. Conclusions: Comprehensive educational interventions at the provider-, school-, and community-level are needed to ensure that physicians, parents, patients, and educators receive accurate information. Provider trainings can equip physicians with the accurate knowledge needed to make confident recommendations; emphasize use of the opt-out approach for recommendations; and provide them with multilingual educational materials to share with parents and patients. Collaborative efforts with school board members and parent organizations/associations can encourage inclusion of HPV in the curriculum, and foster discussions among parents and educators. Community-based interventions should focus on innovative, culturally-appropriate ways to disseminate education messages in medically, underserved communities. Citation Format: Aba Coleman, Marva Mallory, Jane Montealegre, Peggy Smith, Ruth Buzi, Michael Scheurer, Maria Daheri, Maria Jibaja-Weiss, Matthew Anderson. Understanding the influential factors to human papillomavirus vaccination among youth in Harris County, Texas: A qualitative study. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A46.

33 young males attending a family-planning clinic were asked about the consequences of child abuse as it affects behavioral problems of teens and their interest in programs that deal specifically with these problems. Nine reported they had been victims of abuse. Most believed that drug and alcohol misuse and suicide were the major consequences of child abuse. Fifteen were interested in programs for prevention of child abuse but not for specific problems such as substance misuse and smoking cessation. This study's findings suggest that family-planning clinics with services for males must address their behavioral as well as medical needs.This study examines how males view the consequences of child abuse in terms of behavioral problems and how receptive they might be to prevention programs. The participants were 33 young males (mean age, 18.4 years) attending a family planning clinic in a county hospital in the US. This group was composed of 21 African Americans, 9 Hispanics, and 3 European-Americans. They were asked seven questions related to the contribution of child abuse to later problems of teens, such as school dropout, crime, drugs, alcohol, prostitution, suicide, and teenage pregnancy. Additional information about their interest in specific programs was also elicited to address these behavioral problems, and personal experience with abuse. Findings show that 9 males reported that they had been victims of abuse. Most believed that drug and alcohol misuse and suicide were the major consequences of child abuse. About 15 males were interested in general programs for child abuse prevention; 12 were interested in smoking cessation programs, 10 in substance abuse programs, and 6 in suicide prevention programs. Moreover, 19 believed that child abuse is a problem in their communities. The findings of this study indicate that family planning clinics with services for males must address their behavioral as well as their medical needs.

A study of 263 pregnant and postpartum indigent and minority teens was conducted in order to examine their perceptions of the consequences of child abuse and their own child abuse history. Teens identified drug and alcohol abuse and teen suicide as the most serious consequences of abuse. Interestingly, they did not identify pregnancy as a consequence. Twenty-seven percent reported a history of abuse. Identifying behavioral and emotional consequences of abuse is important because it affects both the well-being of the adolescent mother and her child. An experience of abuse and its behavioral consequences may interfere with a teen's ability to benefit from parenting intervention programs. Therefore, parenting programs may wish to consider the necessity of screening for a history of abuse as well as adding components on behavioral problems adolescent mothers are concerned about. Additionally, there is a need to reach out to pregnant, parenting and future parents in other settings such as prisons, psychiatric, and residential centers, since issues of abuse may coexist with other behaviors.

This study examined the association between depression, risk behaviors, parental communication, and perceived barriers related to condom use among adolescents attending family-planning clinics. A total of 751 minority women participated in the study. The authors collected data on demographic characteristics, depression, risk behaviors, parental communication about sex-related topics, and perceptions about partner attitudes. Results indicated that 15.2% of adolescents reported depressive symptoms. Depressive symptoms were associated with risk behaviors such as low condom use, substance use, reduced parental communication, and negative perceptions about condom use. These findings suggest that to provide a comprehensive healthcare service to adolescents, the focus of treatment must be expanded beyond the scope of the traditional family planning model. Issues such as depression, risk behaviors, and family communication have to be incorporated in prevention programs to increase the effectiveness of services aimed at risk reduction among adolescents.

The aim of the study was to investigate behavioral and sociodemographic characteristics of a sample of 45 male adolescents with sexually transmitted diseases who attended family planning clinics. Low rates of compliance with follow-up care were noted. Only 13 (28.9%) males returned to the clinic for their scheduled appointments. Neither behavioral nor sociodemographic variables were related to compliance.

A study examining the health and behavioral consequences of child abuse was conducted among 263 parenting and 257 never-pregnant teens attending a reproductive health clinic. Both groups of teens identified the following major consequences: suicide, prostitution, school drop-out, crime and substance abuse. However, only parenting teens expressed interest in prevention programs that would address these consequences. Traditional child abuse prevention programs are focused on parenting issues and rarely address health and behavioral consequences of abuse. These health and behavioral consequences of abuse may make adolescents vulnerable to abuse their own children as well as interfere with their psychosocial development. Therefore, the authors recommend integrating health and behavioral issues into child abuse prevention programs.