Barbara Guthrie

African American girls' smoking habits and day-to-day experiences with racial discrimination.

BackgroundAlthough it is recognized that African Americans experience racial discrimination, relatively little research has explored the health implications of this experience. Few studies have examined the relationship between racial discrimination and specific health risks. ObjectivesTo examine the relationship between smoking habits and perceptions of racial discrimination among African American adolescent girls and to identify and test potential psychological mechanisms through which racial discrimination may operate to increase smoking among this group. MethodsA sample of 105 African American adolescent girls (mean age 15.45 years) derived from a larger cross-sectional research project comprised the sample. Univariate analyses were conducted to provide descriptive data on the participants of the study, including information about their use of licit and illicit substances. Bivariate correlational analyses were conducted to evaluate the relationship between perceptions of discrimination and smoking habits. The ability of stress to mediate the relationship between discrimination and smoking was examined by using standard analytical procedures for testing mediation models as outlined by Baron and Kenny (1986). ResultsThe sample (93%) reported experiencing discrimination and racial discrimination was highly correlated with cigarette smoking (r = .35, p > .001). Removing the effects of stress significantly reduced the relationship between racial discrimination and smoking (r = .17, p < .05), indicating that racial discrimination is related to smoking because of its stressful nature. ConclusionPerceptions of racial discrimination are related to the smoking habits of African American adolescent girls.

Risky behavior and risk in adolescents with IDDM

PURPOSE To determine: (1) the frequency of risky behaviors (alcohol and other drug use, smoking cigarettes, smokeless tobacco use, and unprotected intercourse); (2) the perception of general risks and diabetes-related risks from risky behaviors; (3) if perception of risk is related to engaging in risky behaviors; and (4) if perception of general risks and diabetes-related risks are influenced by age, gender, or race in adolescents with insulin dependent diabetes mellitus (IDDM). Decreasing risky behaviors in youth with IDDM is important because of their increased vulnerability to specific disease related physiologic and pathologic changes. METHODS A descriptive, cross-sectional design was used. Data on risky behavior and perception of risk were obtained by self-report during a regularly scheduled clinic visit. One hundred and fifty-five adolescents between ages of 10-20 years participated. Correlational and students t-test analyses were used to test relationships and group differences (age, race, gender). RESULTS Thirty-nine percent of the sample reported alcohol use, 34% reported smoking cigarettes, 8% reported smokeless tobacco use, 10% reported drug use, and 29% reported unprotected intercourse. Perception of risk to peers from these behaviors was significantly higher (t = 8.1, df 153; p < .001) than risk to self. Females reported significantly lower (t = 3.08, df 52; p < .002) risk to self than males. There was no difference in perception of risk between youth who reported participating in risky behaviors (N = 38%) and those who did not (62%). Not surprisingly, the frequency of risky behavior increased with age (F = 15.46; p < .001). CONCLUSIONS Compared to community samples of middle school children, our sample had lower rates for most risky behaviors. As with community samples, the physical risks were known and perceived to be higher for peers than self. Perception of risk was not related to self-reports of risky behaviors. The lower rate of risky behaviors might reflect the success of educational efforts directed toward diabetes management or may be due to later initiation of behaviors, especially if personal social development is delayed. Additional research is indicated in order to understand the timing and trajectory of risky behavior and whether or not perception of risk deters youth with IDDM from engaging in risky behavior.

A feminist theoretical approach to understanding health of adolescent females

This paper presents a conceptual framework derived from theorists of female developmental and psychoanalytical psychology which explains the various health concerns of adolescent females. These health concerns include the specific mental health-related issues for young girls such as depression and eating disorders. It also attempts to link the developmental transition of these young girls to these health issues as well as examine the impact of race ethnicity and socioeconomic status. Based on the discussions several strategies for health promotion are developed using the constructs of relationship and voice. First health promotion in pregnancy drug use eating disorders and depression should be addressed in the developmental framework specifically theorized for young girls. Second a diverse group of professionals should be recruited to develop programs in schools and communities.

An Integrative Review on Breast Cancer Screening Practice and Correlates Among Chinese, Korean, Filipino, and Asian Indian American Women

Abstract Breast cancer is the leading cancer diagnosed among Chinese, Filipino, and Korean women. Despite the efficacy of breast cancer screening, Asian American women have one of the lowest rates of mammography and clinical breast exam (CBE) of all U.S. ethnic groups. I provided a systematic overview to document factors related to three modalities of breast cancer screening (breast self-exam [BSE], CBE, and mammography) among four subgroups of Asian American women (i.e., Chinese, Korean, Filipino, and Asian Indian). Results showed that the existing studies provided evidence of demographic correlates to screening practice; however, fewer studies focused on cognitive and social–cultural correlates, and limited results were available with Filipino and Asian Indian groups.

A theoretical approach to studying health behaviors in adolescents: An at-risk population

Alcohol use and misuse among adolescents is a major health problem that has been targeted for intervention at the national level. Studies show that alcohol use often begins in preadolescence (8 to 11 years) and, for some youths, escalates to heavy use during senior high school. A number of factors, such as parental and peer norms and attitudes, environmental influences, and self-efficacy, have been identified as predicting alcohol use. Less is known about how school and pubertal transitions affect alcohol use or how alcohol use and misuse affect health outcome. Although a number of factors related to alcohol use and misuse have been identified, frameworks to organize these factors into a theoretically coherent schema are still being explored. The revised health-promotion model adapted for adolescents is a potentially viable framework for organizing the antecedents of alcohol use and misuse in children and adolescents. A better understanding of the mechanisms by which alcohol use and misuse are initiated and maintained will facilitate the development of interventions for diverse populations of adolescents.

Adolescents' Experiences of Childbirth: Contrasts With Adults

Most of what is known about the meaning women assign to the experience of childbirth in the United States is based primarily on studies of Euro American, highly educated, married women of middle to higher income levels. Yet almost half a million adolescents give birth annually. This exploratory, qualitative study was conducted with 25 adolescents in an alternative school, partnered with the juvenile justice system, who had given birth. An open-ended question format was used for the interviews, and analysis was conducted by using extended case methodology. The study revealed a number of differences between the existing literature reports about womens interpretations of birth and the meanings assigned to childbirth experiences by the adolescents in this study. A key difference was the relationship between the pain of childbirth and responsibility for their child. The results provide an entrée into understanding unique characteristics of giving birth as an adolescent and potential roles health care providers can play to promote a positive experience.

African-American Women Who Smoke Crack Cocaine: Sexual Trauma and the Mother-Daughter Relationship

This study evolved from previous writings that linked sexual abuse to the quality of the mother-daughter relationship. The purpose of this investigation was to examine the mother-daughter relationship among African-American women who abuse crack cocaine by comparing three different groups: women who have not experienced incest but have experienced sexual abuse; women who have experienced incest; and women who have not experienced sexual abuse. A convenience sample of 64 African-American women was used, 35 of whom were in drug abuse treatment and 29 of whom were abusing crack cocaine. Using analysis of variance studies, significant differences were found between the three groups in terms of the mother-daughter relationship. Differences were also found between the group that experienced incest and the group that experienced nonincestuous sexual abuse in terms of the amount of abuse and first age of abuse. This preliminary investigation indicates the need for further study of specific populations in this area--most notably, African-American women who abuse crack cocaine.

Gender-Specific Substance Prevention Programming: Going Beyond Just Focusing on Girls

A brief overview and history of the Female Adolescent Initiative, a program funded by the Center for Substance Abuse Prevention, is given. Findings from selected programs and a synthetic summary of what the program interventionists learned are presented. The authors use the results from these programs to develop a framework to guide the next generation of scholars who focus on gender-specific substance abuse prevention and provide specific suggestions for designing the next generation of gender-specific programs.

Maternal Influences on Asian American—Pacific Islander Adolescents’ Perceived Maternal Sexual Expectations and Their Sexual Initiation

Maternal influences on adolescents’ sexual initiation have been examined over two time points in 433 Asian American—Pacific Islander (AAPI) adolescents in a secondary analysis of the Add Health data set using structural equation modeling. A longitudinal model built on a preliminary qualitative study is used to examine the fit between data and model. Maternal perceived connectedness and adolescents’ perceived maternal sexual expectations in sexual timing are found to be protective for delaying AAPI adolescents’ sexual initiation. Unexpectedly, mothers’ perceptions of sexual discussion are not protective for delaying adolescents’ sexual initiation. The results suggest interventions should focus on promoting AAPI mothers’ perceptions of connectedness with their adolescents and adolescents’ perceptions of their mothers’ sexual expectations (as measured by adolescents’ perceived maternal disapproval attitudes and affects) in delaying sexual initiation.

Recommendations of Common Data Elements to Advance the Science of Self‐Management of Chronic Conditions

PURPOSE Common data elements (CDEs) are increasingly being used by researchers to promote data sharing across studies. The purposes of this article are to (a) describe the theoretical, conceptual, and definition issues in the development of a set of CDEs for research addressing self-management of chronic conditions; (b) propose an initial set of CDEs and their measures to advance the science of self-management; and (c) recommend implications for future research and dissemination. DESIGN AND METHODS Between July 2014 and December 2015 the directors of the National Institute of Nursing Research (NINR)-funded P20 and P30 centers of excellence and NINR staff met in a series of telephone calls and a face-to-face NINR-sponsored meeting to select a set of recommended CDEs to be used in self-management research. A list of potential CDEs was developed from examination of common constructs in current self-management frameworks, as well as identification of variables frequently used in studies conducted in the centers of excellence. FINDINGS The recommended CDEs include measures of three self-management processes: activation, self-regulation, and self-efficacy for managing chronic conditions, and one measure of a self-management outcome, global health. CONCLUSIONS The self-management of chronic conditions, which encompasses a considerable number of processes, behaviors, and outcomes across a broad range of chronic conditions, presents several challenges in the identification of a parsimonious set of CDEs. This initial list of recommended CDEs for use in self-management research is provisional in that it is expected that over time it will be refined. Comment and recommended revisions are sought from the research and practice communities. CLINICAL RELEVANCE The use of CDEs can facilitate generalizability of research findings across diverse population and interventions.