Brianna M. Magnusson

Early Age at First Intercourse and Subsequent Gaps in Contraceptive Use

BACKGROUND Sexual debut before age 15 years has been associated with increased sexual risk behaviors among teens, but little is known about its effects beyond adolescence. This study examines the relationship between the age at first intercourse and subsequent contraceptive gaps. METHODS We identified 3538 sexually active, fertile women participants from the 2006-2008 National Survey of Family Growth. Women were classified as consistent contraceptive users or inconsistent/nonusers. Age at first intercourse with a man was determined by self-report and categorized as <15, 15-17, and ≥18 years. RESULTS Twenty-three percent reported gaps in contraceptive use in the year prior to interview. Compared with women who were 18 or older at first intercourse, women who were <15 years of age at the time of first intercourse were nearly two times as likely to report a gap in contraceptive use (adjusted odds ratio: 1.93; 95% confidence interval: 1.23-3.00). CONCLUSIONS Age at first intercourse is associated with inconsistent or nonuse of contraceptives in later life. Primary prevention efforts should be established to empower girls to make informed and autonomous decisions about sexual debut. Personalized contraceptive counseling has been demonstrated as being effective in increasing contraceptive use and compliance and should be offered to all women, with particular focus on women who report an early age at first intercourse or other factors associated with inconsistent contraceptive use.

Contraceptive insurance mandates and consistent contraceptive use among privately insured women.

Introduction:Half of the states in the United States mandate that health insurers cover contraceptives. Health care reform includes recommendations to extend these mandates nationally through the essential benefits package. This study evaluates the association of state-level insurance mandates and consistent contraceptive use among privately insured women aged 15–44. Study Design:The National Survey of Family Growth (2006–2008) included 2276 privately insured women at risk for unintended pregnancy. Multilevel logistic regression models provided estimates of the association between state-level insurance coverage mandates and consistent contraceptive use. Results:Among privately insured women, 18% reported a ≥1-month gap in contraceptive use. Compared with women living in states with no mandates, those in states with comprehensive mandates had increased odds of consistent contraceptive use among privately insured women [adjusted odds ratio (aOR), 1.64; 95% confidence interval (CI), 1.08–2.50], but not uninsured women (aOR, 0.77; 95% CI, 0.38–1.55). Partial mandates were not associated with consistent contraceptive use. Discussion:Consistent contraceptive use among women with private insurance is higher in the states with mandates compared with those without mandates.

Growth in Adolescent Self-Regulation and Impact on Sexual Risk-Taking: A Curve-of-Factors Analysis

Adolescent self-regulation is increasingly seen as an important predictor of sexual risk-taking behaviors, but little is understood about how changes in self-regulation affect later sexual risk-taking. Family financial stress may affect the development of self-regulation and later engagement in sexual risk-taking. We examined whether family financial stress influences self-regulation in early adolescence (age 13) and growth in self-regulation throughout adolescence (from age 13–17 years). We then assessed the effects of family financial stress, baseline self-regulation, and the development of self-regulation on adolescent sexual risk-taking behaviors at age 18 years. Using a curve-of-factors model, we examined these relationships in a 6-year longitudinal study of 470 adolescents (52% female) and their parents from a large northwestern city in the United States. Results indicated that family financial stress was negatively associated with baseline self-regulation but not with growth in self-regulation throughout adolescence. Both baseline self-regulation and growth in self-regulation were predictive of decreased likelihood of engaging in sexual risk-taking. Family financial stress was not predictive of later sexual risk-taking. Intervening to support the development of self-regulation in adolescence may be especially protective against later sexual risk-taking.

Women's attitudes toward practicing cytomegalovirus prevention behaviors

Congenital cytomegalovirus (CMV) infection causes severe disabilities and developmental delays. Womens awareness of CMV is low. Only about half of healthcare providers report counseling women about behaviors to reduce CMV risk and public health education is limited. Routine CMV counseling is not recommend. Providers may lack time to counsel women; other conditions may take priority for counseling; there may be a perception that women are reluctant to follow advice. This cross-sectional descriptive study examined womens attitudes toward CMV prevention behaviors. Data were collected from an online panel of 840 U.S. women 18–40 years of age, who had a child < 5 years of age, and were pregnant or planning a pregnancy in the next 12 months. Questions assessed CMV awareness, frequency of past behaviors that transmit CMV, and attitudes toward eight CMV prevention behaviors. Only 15.5% of women were somewhat or very familiar with CMV. Very few women (6.1%) reported hearing from their provider about CMV. Women held positive attitudes toward the CMV prevention behaviors and perceived them as feasible. Least positive attitudes were toward not kissing a child on the lips and not sharing foods. Predictors of positive attitudes were CMV awareness, past behavior, talking to a healthcare provider, and perceived risk reduction. Healthcare providers and public health practitioners should collaborate to increase CMV awareness. Encouraging behaviors to reduce saliva sharing may result in greater gains in reducing CMV infection.

Comparison of Single-Point and Continuous Sampling Methods for Estimating Residential Indoor Temperature and Humidity

Residential temperature and humidity are associated with multiple health effects. Studies commonly use single-point measures to estimate indoor temperature and humidity exposures, but there is little evidence to support this sampling strategy. This study evaluated the relationship between single-point and continuous monitoring of air temperature, apparent temperature, relative humidity, and absolute humidity over four exposure intervals (5-min, 30-min, 24-hr, and 12-days) in 9 northern Utah homes, from March-June 2012. Three homes were sampled twice, for a total of 12 observation periods. Continuous data-logged sampling was conducted in homes for 2–3 wks, and simultaneous single-point measures (n = 114) were collected using handheld thermo-hygrometers. Time-centered single-point measures were moderately correlated with short-term (30-min) data logger mean air temperature (r = 0.76, β = 0.74), apparent temperature (r = 0.79, β = 0.79), relative humidity (r = 0.70, β = 0.63), and absolute humidity (r = 0.80, β = 0.80). Data logger 12-day means were also moderately correlated with single-point air temperature (r = 0.64, β = 0.43) and apparent temperature (r = 0.64, β = 0.44), but were weakly correlated with single-point relative humidity (r = 0.53, β = 0.35) and absolute humidity (r = 0.52, β = 0.39). Of the single-point RH measures, 59 (51.8%) deviated more than ±5%, 21 (18.4%) deviated more than ±10%, and 6 (5.3%) deviated more than ±15% from data logger 12-day means. Where continuous indoor monitoring is not feasible, single-point sampling strategies should include multiple measures collected at prescribed time points based on local conditions.

Perceptions of Public Breastfeeding Images and Their Association With Breastfeeding Knowledge and Attitudes Among an Internet Panel of Men Ages 21–44 in the United States

Background: Men’s attitudes toward public breastfeeding may influence a woman’s decisions about breastfeeding and her perceived comfort with public breastfeeding. Research aim: This study aimed to evaluate factors associated with men’s visual perception of images of public breastfeeding. Methods: A 95-item online survey was administered to 502 U.S. men ages 21 to 44. Respondents were presented with four images of women breastfeeding and asked to evaluate agreement with 15 adjectives describing each image. Based on factor analysis, 13 of these adjectives were combined to create the Breastfeeding Images Scale for each image. An 8-item Situational Statements Scale and the 17-item Iowa Infant Feeding Attitude Scale (IIFAS) were used to assess breastfeeding knowledge and attitudes. Multiple regression was used to evaluate the association between breastfeeding attitudes and knowledge and the Breastfeeding Images Scale. Results: The image depicting a woman breastfeeding privately at home had the highest mean score of 71.95, 95% confidence interval (CI) [70.69, 73.22], on the Breastfeeding Images Scale, compared with 61.93, 95% CI [60.51, 63.36], for the image of a woman breastfeeding in a public setting. The overall mean scale score for the IIFAS was 56.99, 95% CI [56.27, 57.70], and for the Situational Statements Scale was 28.80, 95% CI [27.92, 29.69]. For all images, increasing breastfeeding knowledge and attitudes measured by the IIFAS and the Situational Statements Scale were associated with a more positive perception of the image. Conclusion: Images of public breastfeeding are viewed less favorably by men in the sample than are images of private breastfeeding. Knowledge and attitudes toward breastfeeding are positively associated with perception of breastfeeding images.

Health Education Specialists' Knowledge, Attitudes, and Perceptions of the Patient Protection and Affordable Care Act.

The changing landscape of health care as a result of the Patient Protection and Affordable Care Act (ACA) may provide new opportunities for health education specialists (HES). The purpose of this study was to survey HES in the United States on their knowledge and attitudes of the ACA and assess their perceptions of job growth under the law. A random sample of 220 (36% response rate) certified HES completed a 53-item cross sectional survey administered online through Qualtrics. Findings were compared to public opinion on health care reform. HES are highly favorable of the law (70%) compared to the general public (23%). A total of 85% of respondents were able to list a provision of the ACA, and most (81%) thought the ACA would be successful at increasing insured Americans. Over half (64.6%) believe job opportunities will increase. Those who viewed the law favorably were significantly more likely to score better on a knowledge scale related to the ACA. HES understand publicized provisions but are uncertain about common myths and specific provisions related to Title IV, “Prevention of Chronic Disease and Improving Public Health.” Directed and continuing education to HES regarding the ACA is warranted.

Executive functions and health behaviors associated with the leading causes of death in the United States: A systematic review.

Research indicates that executive functioning may predict health behavior. This systematic review provides an overview of the relationship between domains of executive functioning and health behaviors associated with the leading causes of death in the United States. A total of 114 articles met the inclusion criteria (adult sample, published in English between 1990 and November 2016) and were reviewed and synthesized. Results indicated that although many studies had mixed findings, at least one executive function component was associated with every health behavior. Based on these results, health professionals should consider the role of executive functions in behavior change interventions.

Media Agenda Setting Regarding Gun Violence before and after a Mass Shooting

Gun violence is related to substantial morbidity and mortality with surrounding discussions framed and shaped by the media. This study’s objective was to explore national news media’s reporting of gun violence around a mass shooting. National news pieces were coded according to categories of gun violence, media frames, entities held responsible, responses, and reporting of the public heath approach. Individuals were held responsible for gun violence in 63% of pieces before and 32% after the shooting. Lawmakers were held responsible in 30% of pieces before and 66% after. Background checks were a proposed gun violence prevention method in 18% of pieces before and 55% after Sandy Hook, and lethality reduction of firearms was in 9% before and 57% after. Following a mass shooting, the media tended to hold government, not individuals, primarily responsible. The media often misrepresented the real picture of gun violence and key public health roles.

Age at Menarche and Risky Sexual Partnerships in Adulthood: Does a Biosocial Model Explain Any Associations?

BACKGROUND The purpose of this study was to examine the association between menarcheal age and subsequent sexual partnering in women aged 21-44 years. METHODS Data from the 2006-2010 National Survey of Family Growth were used (n=7,962). Menarcheal age was defined as ≤ 11, 12-14, or ≥ 15 years. Sexual partnering was defined as being concurrent, serially monogamous or monogamous in the previous year. Polytomous logistic regression models evaluated the association between age of menarche and sexual partnering. RESULTS Nearly 6% reported concurrent partnerships and ∼ 4% serial monogamy. Age of menarche was not associated with subsequent concurrent sexual partnering (adjusted odds ratio relative to ≥ 18 years [aOR ≤ 11]: 1.09; 95% confidence interval [CI]: 0.57-2.09; aOR12-14: 1.13; 95% CI: 0.64-1.99) or serial monogamy (aOR ≤ 11: 0.75; 95% CI: 0.41-1.38; aOR12-14: 0.71; 95% CI: 0.39-1.29). CONCLUSIONS Early menarche is not a risk factor for sexual partnering in adulthood. However, menarche provides an opportunity for education to aid young women to make decisions regarding sexual debut and sexual partnering that are healthy for them.