Alida Bouris

Adolescent expectancies, parent-adolescent communication and intentions to have sexual intercourse among inner-city, middle school youth.

Background: The incidence and prevalence of pregnancy and sexually transmitted infections among American adolescents remain unacceptably high.Purpose: This research examines adolescent intentions to have sexual intercourse, their expectancies about having sexual intercourse, and maternal communication about the expectancies of engaging in sexual intercourse.Methods: Six hundred sixty-eight randomly selected inner-city middle school students and their mothers completed self-administered questionnaires. Adolescents reported their intentions to have sexual intercourse and the perceived positive and negative expectancies of doing so. Both mothers and adolescents reported on the frequency of communication about these expectancies.Results: Boys reported higher intentions, more positive expectancies, and lower levels of maternal communication than did girls. Expectancies statistically significantly associated with intentions focused on the positive physical, social, and emotional advantages of having sex rather than on concerns about pregnancy and HIV/AIDS. With some exceptions, maternal communication was associated with adolescents-expectancies about engaging in sexual intercourse. However, only modest correlations between maternal and adolescent reports of communication were observed.Conclusions: Results indicate that intervention programs should address the positive expectancies youth have about having sex, not just the threat of pregnancy and HIV/AIDS, and should address potential gender differences in expectancies between boys and girls.

Multiple Regression Analyses in Clinical Child and Adolescent Psychology.

A major form of data analysis in clinical child and adolescent psychology is multiple regression. This article reviews issues in the application of such methods in light of the research designs typical of this field. Issues addressed include controlling covariates, evaluation of predictor relevance, comparing predictors, analysis of moderation, analysis of mediation, assumption violations, outliers, limited dependent variables, and directed regression and its relation to structural equation modeling. Analytic guidelines are provided within each domain.

Paternal Influences on Adolescent Sexual Risk Behaviors: A Structured Literature Review

BACKGROUND AND OBJECTIVE: To date, most parent-based research has neglected the role of fathers in shaping adolescent sexual behavior and has focused on mothers. The objective of this study was to conduct a structured review to assess the role of paternal influence on adolescent sexual behavior and to assess the methodological quality of the paternal influence literature related to adolescent sexual behavior. METHODS: We searched electronic databases: PubMed, PsychINFO, Social Services Abstracts, Family Studies Abstracts, Sociological Abstracts, and the Cumulative Index to Nursing and Allied Health Literature. Studies published between 1980 and 2011 that targeted adolescents 11 to 18 years and focused on paternal parenting processes were included. Methodological quality was assessed by using an 11-item scoring system. RESULTS: Thirteen articles were identified and reviewed. Findings suggest paternal factors are independently associated with adolescent sexual behavior relative to maternal factors. The most commonly studied paternal influence was emotional qualities of the father-adolescent relationship. Paternal communication about sex was most consistently associated with adolescent sexual behavior, whereas paternal attitudes about sex was least associated. Methodological limitations include a tendency to rely on cross-sectional design, nonprobability sampling methods, and focus on sexual debut versus broader sexual behavior. CONCLUSIONS: Existing research preliminarily suggests fathers influence the sexual behavior of their adolescent children; however, more rigorous research examining diverse facets of paternal influence on adolescent sexual behavior is needed. We provide recommendations for primary care providers and public health practitioners to better incorporate fathers into interventions designed to reduce adolescent sexual risk behavior.

HIV/AIDS and Tourism in the Caribbean: An Ecological Systems Perspective

The Caribbean has the highest HIV rates outside of sub-Saharan Africa. In recent decades, tourism has become the most important Caribbean industry. Studies suggest that tourism areas are epicenters of demographic and social changes linked to HIV risk, such as transactional sex, elevated alcohol and substance use, and internal migration. Despite this, no formative HIV-prevention studies have examined tourism areas as ecologies that heighten HIV vulnerability. HIV/AIDS research needs to place emphasis on the ecological context of sexual vulnerability in tourism areas and develop multilevel interventions that are sensitive to this context. From our review and integration of a broad literature across the social and health sciences, we argue for an ecological approach to sexual health in Caribbean tourism areas, point to gaps in knowledge, and provide direction for future research.

Family network proportion and HIV risk among Black men who have sex with men

Objectives:Black men who have sex with men (BMSM) have the highest rates of HIV in the United States. Despite increased attention to social and sexual networks as a framework for biomedical intervention, the role of family in these networks and their relationship to HIV prevention have received limited attention. Methods:A network sample (N = 380) of BMSM (n = 204) and their family members (n = 176) was generated through respondent-driven sampling of BMSM and elicitation of their personal networks. The proportion of personal network members who were family was calculated, and the weighted logistic regression was used to assess the relationship between this proportion and unprotected anal intercourse, sex-drug use (SDU), and group sex (GS), as well as intravention efforts to discourage these risk behaviors among their MSM social networks. Results:45.3% of respondents listed at least 1 family member in their close personal network. Greater family network proportion (having 2 or more family members in the close network) was associated with less SDU [adjusted odds ratio (AOR) 0.38, 95% CI: 0.17 to 0.87] and participation in GS (AOR 0.25, 95% CI: 0.10 to 0.67). For intravention, BMSM with greater family proportion were more likely to discourage GS (AOR 3.83, 95% CI: 1.56 to 9.43) and SDU (AOR 2.18, 95% CI: 1.35 to 3.54) among their MSM friend network. Moreover, increased male family network proportion was associated with lower HIV risk and greater intravention than increased female network proportion. Conclusions:Nearly half of BMSM have a close family member with whom they share personal information. Combination prevention interventions might be made more potent if this often overlooked component of personal networks was incorporated.

The Linking Lives health education program: a randomized clinical trial of a parent-based tobacco use prevention program for african american and latino youths.

OBJECTIVES We evaluated the effectiveness of a parent-based add-on component to a school-based intervention to prevent cigarette smoking among African American and Latino middle school youths. METHODS Mother-adolescent dyads (n=1386) were randomly assigned to 2 groups: (1) a school-based smoking-prevention intervention or (2) the same intervention with a parent-based add-on component called Raising Smoke-Free Kids. Mothers in the experimental condition received the parent add-on component. Mothers in the control condition received information on selecting a high school. All adolescents received a version of Project Towards No Tobacco Use (TNT). The primary outcome was a reduction in adolescent cigarette smoking. Follow-up data were obtained from 1096 mother-adolescent dyads at 15 months postintervention. RESULTS At follow-up, the odds of smoking cigarettes were reduced by 42% for adolescents in the parent add-on condition versus the TNT-only condition. Mothers in the parent add-on condition were more likely than were mothers in the TNT-only condition to set rules about risk-sensitive social activities and to be perceived as trustworthy by their child. Group differences also were found in the frequency and quality of mother-adolescent communication. CONCLUSIONS Including parent add-on components in school-based smoking prevention programs can reduce smoking behavior on the part of inner-city middle school youths.

Family Mediators of Acculturation and Adolescent Sexual Behavior Among Latino Youth

The present study develops and evaluates a theoretical framework of mediators of the relationship between acculturation and adolescent sexual behavior. Four hundred Latino mother–adolescent dyads from the Bronx, New York were interviewed. The study explored the relationship between intentions to have sexual intercourse and explanatory variables such as adolescent romantic relationship status and partner preferences, maternal approval of dating, adolescent perceptions of maternal approval of dating, and maternal and adolescent levels of familismo and acculturation. Findings revealed complex dynamics between acculturation and adolescent sexual behavior. Protective and risk-inducing associations were observed, with important gender differences operating for boys and girls. Implications for the development of applied prevention programs are discussed.

A Comparative Study of Interventions for Delaying The Initiation of Sexual Intercourse Among Latino And Black Youth

CONTEXT Latino and black adolescents are disproportionately affected by STDs, including HIV, and unintended pregnancies. Few parent-based interventions have targeted these youth, focused on early adolescence and had high participation rates. METHODS Between 2003 and 2009, a randomized clinical trial was conducted with 2,016 Latino and black mother-adolescent dyads in New York City. Adolescents were eligible if they were in grade 6 or 7. Dyads were assigned to one of three conditions: a parent-based intervention, Families Talking Together (FTT); an adolescent-only intervention, Making a Difference! (MAD); or a combined FTT+MAD intervention. Respondents completed questionnaires at baseline and 12 months later. Single-degree-of-freedom contrasts and logistic regression analysis were used to evaluate differences in outcomes by intervention. RESULTS The proportion of youth who reported ever having engaged in vaginal intercourse increased over the study period by eight percentage points among those in the MAD group, five points in the FTT group and three points in the combined group; the differences among these increases were not statistically significant. Adolescents in the two FTT groups were significantly more likely than those in the MAD group to indicate that their mother had talked to them about not having intercourse (79% vs. 68%). They also scored higher than youth in the MAD group on measures of communication and perceived maternal attributes, and lower on activities that might lead to risky behaviors. CONCLUSIONS The proportions of adolescents who initiated intercourse during the study period were not significantly different across groups, implying that the interventions were comparable. Findings suggest that FTT may have led to improved parenting behaviors.

Project nGage: Network supported HIV care engagement for younger black men who have sex with men and transgender persons

Background Young Black men who have sex with men and transgender persons (YBMSMT) aged 13–29 carry the nation’s highest burden of new HIV infections. Studies indicate that YBMSMT have poor retention in care, which is associated with reduced medication adherence and increased virologic failure. Objective Project nGage is a randomized controlled (RCT) trial evaluating the feasibility and preliminary efficacy of a brief, dyadic intervention designed to promote adherence to HIV primary care in safety-net clinics. Network visualization is used to identify and engage a support confidant (SC) from participants’ social networks. A social work interventionist then meets with the SC and SC-participant dyad to activate and maintain HIV-specific social support. Methods Project nGage is operating in two phases. In Phase I, the Team refined study protocols based on pilot testing. In Phase II, 94 HIV infected YBMSMT ages 16–29 will be recruited, enrolled and randomly assigned to receive Project nGage or treatment as usual (TAU). The primary outcome is appointment attendance; the secondary outcomes are medication adherence and viral load. Results Implementation challenges include coordinating sites, managing dyadic intervention logistics, and recruiting non-adherent patients or those who have fallen out of care. The team continues to address implementation issues as the study progresses. Conclusions Project nGage is addressing a gap in HIV care-related research by focusing on supportive relationships as a mechanism through which to promote retention in care. Pending study results, a larger RCT would compare the relative effectiveness of the Project nGage intervention versus TAU over 18 to 24 months.

Mother-Adolescent Communication About Tobacco Use in Urban Puerto Rican and Dominican Families

Research on parent-adolescent communication about cigarette smoking in Latino families remains relatively scarce. This dearth of information is worrisome given the high rates of tobacco use among Latino adolescents and the large burden borne by adult Latinos in smoking-related morbidity and mortality. This study presents qualitative data on parent-adolescent communication about cigarette smoking in a sample of urban Latino families. The authors conducted 12 focus groups with 40 Puerto Rican and Dominican mother-adolescent dyads (N = 80) residing in the Bronx community of New York. The findings indicate that the mothers were comfortable discussing smoking-related issues with their children. Adolescents expressed a desire to discuss tobacco-related issues with their mothers, although some feared parental punishment. The results highlight a gap in parental knowledge and efficacy regarding social influences to smoke. Results are discussed in the context of developing focused interventions aimed at reducing cigarette smoking among Latino youth.