Donna Baptiste

Beyond the “Birds and the Bees”: Gender Differences in Sex‐Related Communication Among Urban African‐American Adolescents

The current study examined gender differences in communication about sex-related topics in a community sample of urban, African-American mothers and adolescents living in impoverished neighborhoods with high HIV rates. One hundred and sixty-two mother-adolescent dyads completed self-report measures of sex-related communication. Youth also reported on their sexual risk. We identified the range of sexual-based topics that adolescents discussed with their mothers, fathers, friends, and at school. The relationship between the frequency of sexual communication and sexual risk was examined. We also investigated congruency between adolescent and mother report about whether sexual-based discussions occurred. Consistent with prior research, girls talked to their mothers, fathers, friends, and at school about sex-related topics more than boys. Findings indicated that mothers not only communicated more frequently about sexual issues with their daughters than sons but that parental messages for girls were more protective. Greater sexual communication with mother was significantly associated with decreased HIV risk in the past 90 days and increased protection from HIV. Inconsistencies between mother and adolescent reports about sexual communication were marginally associated with decreased protection from HIV. Findings reveal the protective effect of sexual communication and the general lack of congruence between mother and adolescent reports of sexual communication.

Collaborating With an Urban Community to Develop an HIV and AIDS Prevention Program for Black Youth and Families.

This article describes a collaboration between academic researchers and residents of a low-income, inner-city community to develop and deliver an HIV and AIDS prevention program for Black youth. The Chicago HIV Prevention and Adolescent Mental Health Project (CHAMP) Program was developed and implemented to decrease HIV and AIDS risk exposure among youth living in a community that has been dramatically affected by HIV and AIDS. The article outlines (a) phases in the collaborative process to develop the program; (b) strategies used to embed contextually relevant themes and activities that address individual and systemic factors influencing HIV and AIDS risk; (c) a process model, based on the CHAMP experience, that can be replicated to develop programs for other youth problems; (d) descriptions of the CHAMP preadolescent and early adolescent curricula; (e) and how university- and community-based facilitators were trained to collaborate as a team to implement the CHAMP Program. Information is also provided about delivering the program in a distressed urban setting.

Creating mechanisms for meaningful collaboration between members of urban communities and university-based HIV prevention researchers

Summary This article provides a description of a Community/University Collaborative Board, a formalized partnership between representatives from an inner-city community and university-based researchers. This Collaborative Board oversees a number of research projects focused on designing, delivering and testing family-based HIV prevention and mental health focused programs to elementary and junior high school age youth and their families. The Collaborative Board consists of urban parents, school staff members, representatives from community-based agencies and university-based researchers. One research project, the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project) Family Program Study, an urban, family-based HIV prevention project will be used to illustrate how the Collaborative Board oversees a community-based research study. The process of establishing a Collaborative Board, recruiting members and developing subcommittees is described within this article. Examples of specific issues addressed by the Collaborative Board within its subcommittees, Implementation, Finance, Welcome, Research, Grant writing, Curriculum, and Leadership, are detailed in this article along with lessons learned.

Family-Based HIV Preventive Intervention : Child Level Results from the CHAMP Family Program

Summary Social indicators suggest that African American adolescents are in the highest risk categories of those contracting HIV/AIDS (CDC, 2001). The dramatic impact of HIV/AIDS on urban African American youth have influenced community leaders and policy makers to place high priority on programming that can prevent youths exposure to the virus (Pequegnat & Szapocznik, 2000). Program developers are encouraged to design programs that reflect the developmental ecology of urban youth (Tolan, Gorman-Smith, & Henry, 2003). This often translates into three concrete programmatic features: (1) Contextual relevance; (2) Developmental-groundedness; and (3) Systemic Delivery. Because families are considered to be urban youths best hope to grow up and survive multiple dangers in urban neighborhoods (Pequegnat& Szapocznik, 2000), centering prevention within families may ensure that youth receive ongoing support, education, and messages that can increase their capacity to negotiate peer situations involving sex. This paper will present preliminary data from an HIV/AIDS prevention program that is contextually relevant, developmentally grounded and systematically-delivered. The collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP) is aimed at decreasing HIV/AIDS risk exposure among a sample of African American youth living in a poverty-stricken, inner-city community in Chicago. This study describes results from this family-based HIV preventive intervention and involves 88 African American pre-adolescents and their primary caregivers. We present results for the intervention group at baseline and post intervention. We compare post test results to a community comparison group of youth. Suggestions for future research are provided.

Motivators and Barriers to Participation of Ethnic Minority Families in a Family-Based HIV Prevention Program

Summary Involving low-income, ethnic minority families in lengthy HIV prevention programs can be challenging. Understanding the motivators and barriers to involvement may help researchers and practitioners design programs that can be used by populations most at risk for HIV exposure. The present study discusses motivators and barriers to involvement in the Collaborative HIV Prevention and Adolescent Mental Health Project (CHAMP), using data from a sample of 118 families that participated at varying levels in the twelve sessions of the program. Most participants chose motivators that reflect their perceptions of individual and/or family needs (“CHAMP might help me, mine, and other families”), and of characteristics of the program, such as CHAMP staff were friendly, CHAMP was fun. Among barriers to involvement, respondents expressed concerns about confidentiality, and about being judged by program staff. Respondents also reported experiencing many stressful events in their families (e.g., death and violence in the family) that may have been barriers to their involvement. Knowing these motivators and barriers, researchers and practitioners can enhance involvement in HIV prevention programs.

Preventing HIV/AIDS among trinidad and Tobago teens using a family-based program: Preliminary outcomes

Summary This paper describes a family-based HIV/AIDS prevention project currently underway in Trinidad and Tobago—an English speaking twin-island nation in the Caribbean. The project involves a partnership between U.S.-based researchers and a social service agency on the Islands. It describes the development and adaptation of the intervention and reports preliminary outcomes from a pilot intervention (n= 32). Findings indicate high participant retention; statistically significant pre to posttest changes in HIV/AIDS knowledge and awareness; parent/youth discussions at home; condom self-efficacy; and parental monitoring. Findings are discussed within the context of collaborative HIV/AIDS prevention research.

Integrating Women's Human Rights into Global Health Research: An Action Framework

This article uses Scale of Change theory as a framework to guide global health researchers to synergistically target womens health outcomes in the context of improving their right to freedom, equity, and equality of opportunities. We hypothesize that health researchers can do so through six action strategies. These strategies include (1) becoming fully informed of womens human rights directives to integrate them into research, (2) mainstreaming gender in the research, (3) using the expertise of grass roots womens organizations in the setting, (4) showcasing womens equity and equality in the organizational infrastructure, (5) disseminating research findings to policymakers in the study locale to influence health priorities, and (6) publicizing the social conditions that are linked to womens diseases. We explore conceptual and logistical dilemmas in transforming a study using these principles and also provide a case study of obstetric fistula reduction in Nigeria to illustrate how these strategies can be operationalized. Our intent is to offer a feasible approach to health researchers who, conceptually, may link womens health to social and cultural conditions but are looking for practical implementation strategies to examine a womens health issue through the lens of their human rights.

Increasing Parent Involvement in Youth HIV Prevention: A Randomized Caribbean Study.

This article presents preliminary findings of a randomized HIV prevention study in Trinidad and Tobago in the Caribbean. The study centers on a family HIV workshop aimed at strengthening parenting skills that are empirically linked to reducing adolescent HIV exposure and other sexual risks. These skills include parental monitoring; educating youth about HIV, sex, and other sexually transmitted infections (STIs); and discussing cultural and interpersonal pressures to have sex. Participants include 180 primary caregivers and their 12-14-year-old adolescents randomized to either the Trinidad and Tobago family HIV Workshop (N = 92) or a general workshop (N = 88). Intervention and control group participants completed pretest and posttest measures on parenting and HIV risk outcomes. Compared to controls, intervention parents reported improvements in HIV knowledge (d = .79); attitudes toward AIDS (d = .42); general communication with adolescents (d = .94); conversations with adolescents about sex (d = .95); conversations about sexual risks and values (d = .43); monitoring of adolescents (d = .34); conflicts with adolescents (d = .30); and intensity of daily parenting hassles (d = .35). Intervention and control parents did not differ in behavioral control, use of positive parenting techniques, and expansion of support networks. Implications for addressing rising HIV risks among young people in Trinidad and Tobago and the Caribbean are discussed.

Social support for African American low-income parents: The influence of preadolescents' risk behavior and support role on parental monitoring and child outcomes

Summary Urban parents, particularly single mothers living within inner-city communities, often struggle to obtain sufficient social support for themselves and for parenting. Support for these parents is particularly important given the prevalence of risk-taking behaviors among youth in these communities, which necessitates vigilant monitoring of these youth. The current study explored from whom low-income mothers obtain social support, the influence of child externalizing on source of social support, and how social support and child behavior interrelate with parental monitoring and supervision. Contrary to expectations, parental monitoring at time 1 did not predict child externalizing at time 2, but, as expected, a significant negative association was noted at time 1 between these constructs. Higher time 1 child externalizing did predict lower time 2 maternal monitoring, suggesting frustrated efforts by mothers to monitor high externalizing children. Mothers reporting strong support networks, however, showed higher levels of monitoring, and mothers who turned to children for social support also showed a tendency to monitor more closely. Although mothers of high externalizing children reported poor support quality, mothers did not discriminate between high and low externalizing children when choosing source of social support. These findings suggest the importance of monitoring prior to child initiation into risk-taking behavior, and the possible role of children in strengthening support networks.

Transferring a university-led HIV/AIDS prevention initiative to a community agency

Summary Given the urgent need for HIV/AIDS interventions that will reverse current infection trends among urban minority youth, identifying effective and socially relevant approaches is of primary concern. HIV/AIDS prevention initiatives that are housed in, and led by, communities may address the limits of laboratory-based inquiry for this complex and socially-situated health issue. In this article, we describe the process of moving a researcherled, HIV/AIDS prevention research program—the Collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP)—from a university laboratory to a community mental health agency with the goal of strengthening program access, effectiveness, and sustainability over time. We outline the framework, timeline, and responsibilities involved in moving the program, research, and technology from its original university base to a local community agency. From the challenges faced and lessons learned during this complex transfer process, we hope to enhance understanding of ways in which we can narrow the gap between academic and community leadership of HIV/AIDS prevention research.