Chia Kuei Lee

Parental consent for newborn screening in southern Taiwan

Objects: With the advent of genetic technologies, many genetic/metabolic disorders can be detected asymptomatically but might be untreatable, and the benefits and risks of screening for them are not fully known. The purpose of this study is to explore current practice with regard to the parental consent process in newborn screening (NBS). Design: Staff in 23 obstetric clinics/hospitals that conduct NBS in one city of southern Taiwan were interviewed. Using content analysis, 15 interview transcripts, eight completed questionnaires, and other relevant documents from the 23 clinics/hospitals were analysed to reveal the framework of the parental consent process in NBS in southern Taiwan. Main measures: Three categories—informed consent, informed dissent, and no informed/consent—were developed to analyse the parental consent process in NBS. Results: The parental consent procedures in NBS and the quality of the information provided before obtaining consent vary widely. Because the traditional NBS was incorporated into routine paediatric practices in most clinics/hospitals, the most frequently encountered consent model is “informed dissent” (60.9%) and “no informed/consent” (30.4%); while an “informed consent” model (45.5%) is the frequent model for screening rare metabolic/genetic disorders. Conclusions: Specific guidelines to regulate the parental consent process for NBS are essential. Further studies should investigate parental responses to NBS, taking these as the basis on which to establish an informed consent model in Taiwan.

Self-schema as a non-drinker: a protective resource against heavy drinking in Mexican-American college women

Alcohol use is considered less acceptable for women than men in the Mexican culture. However, recent studies of Mexican-American (MA) women show that prevalence and rates of alcohol use are escalating, particularly in those with high acculturation to Western standards. Building on recent studies that demonstrated that drinking-related identities (self-schemas) are important predictors of alcohol use in college populations, this secondary data analysis investigated the association between acculturation, MA cultural values, and acculturative stress, drinking-related self-schemas and heavy drinking over time in college-enrolled MA women. Data were drawn from a 12-month longitudinal study of self-schemas and health-risk behaviors in 477 college-enrolled MA women. Drinking-related self-schemas, acculturation, MA cultural values and acculturative stress were measured at baseline, and heavy drinking was measured at baseline, 3, 6, 9 and 12 months. Thirty-six percent of women had a non-drinker self-schema but only 3% had a drinker self-schema. Higher spirituality was protective against heavy drinking, and this effect can be partially explained by presence of a non-drinker self-schema. Interventions that emphasize the personal relevance of being a non-drinker and support the importance of spirituality may help to prevent heavy drinking in MA college women.

Drinker Identity: Key Risk Factor for Adolescent Alcohol Use

BACKGROUND Adolescent alcohol use continues to be a critical public health problem with both short- and long-term negative health consequences. Defining oneself in terms of alcohol, a drinking-related identity, has been shown to predict high levels of alcohol use. Because adolescence is the developmental period during which identity development is most salient, preventing the development of the drinker identity and early identification of youth who have a developing drinker identity may be important for prevention and early intervention. METHODS We review the theory- and evidence-based literature about identity development and the effects of a drinker identity on alcohol use behaviors in adolescents, discuss potential determinants of the drinker identity, and discuss future implications for practice and research. RESULTS There is some evidence that the drinker identity forms in early adolescence and becomes more well-developed during adolescence. The drinker identity predicts alcohol use behaviors both concurrently and over time in adolescence and young adulthood. There is also some evidence that early exposure to alcohol may contribute to formation of the drinker identity. CONCLUSIONS Identity-based approaches may be promising strategies to identify adolescents who are at risk for alcohol use and to intervene with early prevention or treatment within the school setting.

Effects of a healthy-eater self-schema and nutrition literacy on healthy-eating behaviors among Taiwanese college students

Unhealthy eating behaviors contribute to obesity and chronic illness. This study examined the relative contributions of a healthy-eater self-schema (a self-conception as a healthy eater) and nutrition literacy on healthy-eating behaviors and whether nutrition literacy was a mediator among Taiwanese college students. A total of 1216 undergraduate students from six universities in Taiwan participated in the study from April to June 2016. Healthy-eating behaviors, nutrition literacy, healthy-eater self-schema and known determinants of eating behaviors (e.g. nutrition-related information, health status, nutrition knowledge needs, sex, year in college and residence) were measured by a self-report questionnaire. A hierarchical multiple regression and mediation analysis were conducted with the known determinants of eating behaviors as covariates. Results showed that a healthy-eater self-schema and nutrition literacy explained 9% and 12% of the variance in healthy-eating behaviors, respectively, and both had unique effects on healthy-eating behaviors. The effect of a healthy-eater self-schema on healthy-eating behaviors was partially mediated through nutrition literacy. Findings suggest that both a healthy-eater self-schema and nutrition literacy should be considered when promoting healthy-eating behaviors. Additionally, nutrition literacy interventions should be tailored to the healthy-eater self-schema status and emphasize the personal relevance of being a healthy-eater to improve the interventions effectiveness.

Measurement of body dissatisfaction in college-enrolled Mexican American Women: A Rasch-based examination of the validity and reliability of the EDI-III

Measures of body dissatisfaction have not been validated for Mexican American (MA) women, who evaluate their bodies differently than Caucasian women. In this study, the psychometric properties of the EDI-III, Body Dissatisfaction Subscale (BDS) were examined in a sample of college-enrolled MA women using the Rasch Rating Scale Model. Criterion validity was also addressed. BDS evidenced good item fit, person and item reliability, once poorly correlated items were removed. Two qualitatively distinct dimensions of body dissatisfaction were identified: (1) overall body shape and stomach, and (2) the lower body. Validity of the scales was supported. Results suggest: MA womens satisfaction with overall body shape is not synonymous with attitudes toward their lower body.