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Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the U.S. with over 80 million infected individuals. High-risk strains are associated with 6 different cancers. Although infection is preventable, U.S. vaccination rates remain suboptimal and there are noted disparities between urban and rural communities due to economic barriers, lack of access, and low awareness and education.Methods: The current pilot study sought to overcome these barriers through an interprofessional collaborative enrolling a community pharmacy in a rural, medically underserved Alabama county as a Vaccines for Children (VFC) provider to provide free vaccines to eligible adolescents. Program evaluation was conducted to determine the intervention's feasibility. Potential efficacy was assessed by analyzing county-level HPV vaccination uptake and completion rates using state immunization registry data.Results: Over the 8-month study, 166 total vaccines were administered to 89 adolescents ages 10-18, including 55 doses of HPV vaccine, 53 doses of Tdap vaccine, 45 doses of meningococcal vaccine, and 13 doses of influenza vaccine. Among these adolescents, mean age was 12.6 years old, and 64 (71.9%) were VFC patients. The pharmacy recorded an increase in total vaccine administration of 158.8%, an increase in prescription revenue of 34.8%, and an increase in total revenue by 24.4% during the course of the study, compared to the previous year.Conclusions: Findings from the current work demonstrate the potential of this strategy and can serve as a blueprint for statewide and national dissemination and implementation to ultimately increase access to vaccination services, increase vaccination rates, and reduce urban-rural vaccine disparities. [ABSTRACT FROM AUTHOR]

National trends show that African American adolescents, relative to most other demographic groups, are more religious, and show fewer declines in religiosity, despite drastic decreases in religiosity among youth over the past 25 years. These broad findings are limiting because they fail to acknowledge religious heterogeneity among African American teens. Further, there are few empirical investigations of the transmission of religiosity within African American families. Building on a recent study that identified three distinctive profiles of intrinsic religiosity in a sample of low-income African American adolescents who were followed over four years (N = 326; Youth Mage = 12.1, SD = 1.6 years; 54% female), the present study examined contributions of maternal religiosity and family emotional climate in distinguishing these profiles. Univariate analyses revealed that maternal religious attendance and commitment, adolescents' felt acceptance from mothers and the emotional climate in the home differentiated youth who retained high levels of intrinsic religiosity (41%) from youth who declined in religiosity (37%) or who had low levels of religiosity (22%). Multivariate analyses showed that after accounting for demographic covariates, felt acceptance from mothers differentiated adolescents with high versus low levels of religiosity; both maternal religious attendance and felt acceptance from mothers distinguished adolescents who retained high levels of religiosity from youth who declined in religiosity. Implications for family dynamics in African American adolescent religious development and well-being are discussed. [ABSTRACT FROM AUTHOR]

Youth in foster care have higher lifetime rates of sexual abuse victimization than their peers who are not in foster care. This sexual abuse occurs before, during, and after their placement. Yet there is a dearth of qualitative research focused on the characteristics of the abuse and the disclosure experiences of youth in foster care. We aimed to understand potential barriers to disclosure for youth who were abused while in foster care. Our study used anonymous, archival data of 143 one-on-one chat sessions on the US based National Sexual Assault Online Hotline (NSAOH) with youth currently living in foster care who sought help for sexual abuse. Hotline staff summarized youth's disclosure experiences and barriers using an assessment that included open-ended responses. We used thematic analysis to code text segments. Youth in foster care most often discussed that the abuse was being perpetrated by a foster family member (66 %). Disclosure barriers included concerns for physical safety, not wanting to move placements, not trusting the system to keep them safe, and not wanting to disclose again after previously receiving a negative reaction to their disclosure. Youth in foster care who seek help for sexual abuse while in the foster care system have unique barriers to disclosure. This study underscores the need for more qualitative research with youth in foster care and includes safety recommendations and implications for training and education of those who work with youth in foster care. [ABSTRACT FROM AUTHOR]

Recent evidence suggests parent-adolescent discrepancies regarding adolescent disclosure can provide insight into parent-child relations and adolescent adjustment. However, pathways linking discrepancies to adjustment are not well known. We tested a model linking parent-adolescent discrepancies in disclosure to adolescent substance use through affiliation with deviant peers. Using three annual waves of data from a community-based study (N = 357; 91% African American; 53% female; Mage = 13.13 years, SD = 1.62 years at baseline), findings revealed that adolescent-reported secrecy and deviant peer affiliation were positively associated with substance use one and two years later, respectively, but there was no evidence of mediation. The results highlight associations of adolescent secrecy and adjustment, and the role peers play in adolescent substance use behaviors. [ABSTRACT FROM AUTHOR]

The article identifies the challenges involved in the delivery of services for chronic diseases in low-income and middle-income from a health-systems perspective. It examines the possible contribution of interventions to tackle chronic conditions to enhancing the capacity of health systems to deliver comprehensive health services. Also considered are the global political commitments to chronic diseases and to health-systems strengthening.