Carole Harris

Relative influences of perceived parental monitoring and perceived peer involvement on adolescent risk behaviors: An analysis of six cross-sectional data sets.

PURPOSE To assess: (a) the relative impact of monitoring and peer involvement among six cohorts of African-American youth in their mid-adolescent years, over a decade of research in one urban area, and (b) the consistency of the impact of the two influences over time. METHODS Baseline data were collected from six cohorts involving 1279 low income African-American youth aged 13 to 16 years involved in community based studies conducted over a decade in an urban area. Self-reported behaviors, and perceptions of parental monitoring and peer risk-involvement were assessed through structured questions. Data were analyzed by frequency distribution, one-way ANOVA, and multiple logistic regression. RESULTS There was a rapid increase in sexual activity and substance use behaviors during mid-adolescence. Monitoring had a protective influence on substance use behaviors and sexual activity, but had no impact on condom use or drug trafficking. Peer involvement influenced all evaluated risk behaviors. The influences overall did not statistically change over time. CONCLUSIONS Despite the marked increase in risk behaviors during mid-adolescence, monitoring and peer involvement both influenced adolescent behaviors across each cohort.

Longitudinal influence of perceptions of peer and parental factors on African American adolescent risk involvement

To explore the long-term contributions of perceived peer and parental influences on adolescent risk and protective behaviors (sexual involvement, condom use, and drug use), we assessed self-reported behaviors and perceptions of peer risk involvement and parental supervision and communication among 383 low-income, urban African Americans aged 9 to 15 years at baseline over a 4-year, period. Baseline perceptions of peer sexual involvement were significantly associated with youth sexual behavior at baseline and were predictive of sexual involvement through all 4 years of follow-up. Perceived parental monitoring was inversely correlated with sexual involvement ment through 3 years of follow-up. Perceptions of peer condom use were associated with increased levels of condom use at baseline and through 6 months of follow-up. Positive parental communication was correlated with increased condom use. Drug use was higher among youths who perceived peers or family members to be using drugs and was inversely correlated with increased parental monitoring and supervision. Stepwise regression revealed peer and parental influences for all three behaviors. Perceptions of both peer and parental behaviors influence long-term risk and protective behaviors of adolescents. Therefore, parents should be included in adolescent riskreduction intervention efforts. Inclusion of friends and/or changing youth perceptions of peer involvement may also be effective intervention strategies.

Exploring the Relationship Between Parental Concern and the Management of Childhood Obesity

Parental concern about child weight has been identified as a factor in parental monitoring and regulation of child diet. However, little is known about factors that influence parental concern or about how concern may influence parent management of child physical activity. The objectives of the current study were to identify the factors associated with parental concern about child weight and determine if parental concern is associated with specific actions to improve diet and increase physical activity. A stratified random sample of 1,500 parents of children in kindergarten, 2nd, 4th, 5th, 7th, and 9th grade were interviewed. Interviews addressed: (a) child and parent physical activity, (b) child and family nutrition, (c) child and parent BMI weight category, (d) interactions with health care providers, (e) parent obesity knowledge, (f) school assessment of BMI, and (g) parent perception of and concern about child weight. Child gender, weight status, and parent perception of child weight were significant predictors of parental concern. Parents were significantly more likely to report concern if their child was female, they believed their child to be overweight/obese, or their child was overweight/obese as indicated by BMI percentile. Concerned parents were significantly more likely to limit child screen time, take steps to improve child diet, and increase child physical activity than were parents who reported no concern. Treatment and prevention efforts should emphasize parental concern and awareness about child weight by providing accurate feedback on child weight status and education regarding the health risks associated with childhood overweight and obesity. Schools can play an important role in this process through the incorporation of BMI screenings.

An investigation of the validity of the quality of Well-Being Scale with pediatric oncology patients.

The usefulness of the Quality of Well-Being scale (QWB) in a sample of pediatric cancer patients was investigated. The parents of 30 children who were 4 to 18 years old and who were being treated for cancer, were administered the QWB. Performance status ratings from the parents and physician, toxicity ratings, treatment information, and routine laboratory values were also collected. Correlational analyses indicated that QWB scores were significantly related to ratings of performance status and that children who had experienced more surgeries and hospitalizations were assessed as more impaired on the QWB. The childs age, toxicity of treatment experience to date, and laboratory values were not significantly related to QWB findings. The potential utility of the QWB as a component of quality-of-life assessment is discussed.

Risk and Protective Factors Associated with Gang Involvement among Urban African American Adolescents

Data from 349 urban African American youth were analyzed to explore whether the differences in exposure to violence, resilience, and distress symptoms between gang members and nonmembers resulted from the risk behaviors in which youth participated or from the gang membership itself. Youth with current or past gang membership documented higher levels of risk involvement, lower levels of resilience, higher exposure to violence, and higher distress symptoms. These associations persisted even after controlling for age, gender, or risk involvement. This study provides evidence that gang membership itself may be associated with increased risk and ill-effects on psychological well-being and that strong family involvement and resiliency protect against gang involvement.

Effects through 24 months of an HIV/AIDS prevention intervention program based on protection motivation theory among preadolescents in the Bahamas.

OBJECTIVES. The purpose of this work was to report the intervention effects of Focus on Youth in the Caribbean (youth HIV intervention), an HIV prevention intervention based on protection motivation theory, through 24 months of follow-up on sexual risk and protection knowledge, perceptions, intentions, and behavior among Bahamian sixth-grade youth. METHODS. We randomly assigned 1360 sixth-grade youth (and their parents) attending 15 government elementary schools in the Bahamas to 1 of 3 conditions: (1) youth HIV intervention plus a parental monitoring/communication/HIV education intervention; (2) youth HIV intervention plus a parental goal-setting intervention; or (3) an environmental protection intervention plus the parental goal-setting intervention. Baseline and 4 follow-up surveys at 6-month intervals were conducted. Intervention effects were assessed using the mixed model for continuous outcome variables and the generalized linear mixed model for dichotomous outcome variables. RESULTS. Through 24 months of follow-up, youth HIV intervention, in combination with the parent interventions, significantly increased youths’ HIV/AIDS knowledge, perceptions of their ability to use condoms, perception of the effectiveness of condoms and abstinence, and condom use intention and significantly lowered perceived costs to remaining abstinent. There was a trend for higher condom use among youth in the Focus on Youth in the Caribbean groups at each follow-up interval. CONCLUSIONS. Focus on Youth in the Caribbean, in combination with 1 of 2 parent interventions administered to preadolescents and their parents in the Bahamas, resulted in and sustained protective changes on HIV/AIDS knowledge, sexual perceptions, and condom use intention. Although rates of sexual experience remained low, the consistent trend at all of the follow-up periods for higher condom use among youth who received youth intervention reached marginal significance at 24 months. Additional follow-up is necessary to determine whether the apparent protective effect is statistically significant as more youth initiate sex and whether it endures over time.

Quality of life assessment in pediatric oncology: A retrospective review of phase III reports

BACKGROUND although the quality of life of cancer patients has been a topic of increasing interest, the research literature to date has generally noted minimal reporting of these data in adult clinical trials. PURPOSE the purpose of this investigation was to examine the frequency with which these measures are reported in pediatric cancer clinical trials. METHOD published reports of 70 Phase III clinical trials from the Pediatric Oncology Group and Childrens Cancer Group were reviewed for presentation of quality of life and toxicity data. RESULTS approximately 3% of these reports included quality of life data, while toxicities were noted for over 75% CONCLUSIONS quality of life endpoints are not reflected in clinical trial reports. Education as to the potential usefulness of these data, as well as recognition of the barriers that exist to using such measures must be addressed.

Effects on condom use of an HIV prevention programme 36 months postintervention: a cluster randomized controlled trial among Bahamian youth

Data are lacking on long-term effects of HIV behavioural intervention programmes. In this study, we report intervention effects 36 months postintervention on condom use and relevant outcome variables from the theory-based programme ‘Focus on Youth in the Caribbean’ (FOYC). Participants (1360 sixth-grade youth) were randomized by school into: (1) FOYC, plus one of two brief parent interventions or (2) the control condition ‘Wondrous Wetlands’, plus a brief parent intervention. Mixed effect analysis demonstrated significant programme effects, including enhanced HIV/AIDS knowledge (effect size D = 0.44, 95% confidence interval [CI]: 0.43, 0.46), increased self-efficacy of (D = 0.42, 95% CI: 0.30, 0.54), skills for (D = 0.62, 95% CI: 0.56, 0.64) and intention to use a condom (D = 0.20, 95% CI: 0.03, 0.37). Youth who received FOYC plus the parental monitoring intervention had higher condom use rates (odds ratio = 1.49, 95% CI: 0.97, 2.28). Feedback effects from key variables were also detected, supporting the sustained effect.

Assessing BMI in West Virginia Schools: Parent Perspectives and the Influence of Context

West Virginia is a state at the forefront of the obesity epidemic and one that is experiencing immense health and economic costs as a result. The childhood obesity research discussed in this article was conducted over the past 10 years through 4 projects that range from a school-based cardiovascular risk screening program to an evaluation of state legislation targeting childhood obesity via modifications in the school environment. In the course of these projects, we have collected BMI and other health indices on students, provided feedback to students and their parents, and assessed the obesity and health-related beliefs of West Virginians through individual and focus-group interviews and questionnaires. Our work has been accomplished by using an active-consent process, and BMI has typically been only 1 component of the comprehensive health data we collect and feedback we provide. Collaboration with state and local partners and regular dissemination of our findings have been key elements of the approach taken. The research and policy implications of our findings and approach are discussed.

Development and Validation of a Parental Monitoring Instrument: Measuring How Parents Monitor Adolescents' Activities and Risk Behaviors.

The aim of this article is to describe the development and validation of the Parental Monitoring Instrument (PMI). The PMI was administered to a sample of 518 parent—adolescent (aged 12 to 17 years) dyads. Initial findings provide evidence of instrument reliability and validity. The exploratory factor analysis results suggested a seven-factor solution that explained approximately 48% of the variance. An analysis of the questions reveals reasonable interpretations of the seven factors: direct, indirect, restrictive, school, health, computer, and phone monitoring. Administration of the PMI may further our understanding of how parental monitoring is associated with adolescent activities and risk behaviors, setting the stage for informed strategies to improve parent—adolescent relationships.