Karen M. Perrin

Internet Use and Social Networking Among Middle Aged and Older Adults

In this study, the associations between Internet use and the social networks of adults over 50 years of age were examined. A sample (n = 2284) from the 2004 wave of the Health and Retirement Survey was used. In regression models considering a number of control variables, frequency of contact with friends, frequency of contact with family, and attendance at organizational meetings (not including religious services) were found to have a significant positive association with Internet use for adults over 50. Results add to the body of research that suggests Internet use can strengthen social networks, looking specifically at adults over 50.

Women's Reactions to HPV Diagnosis: Insights from In-Depth Interviews

ABSTRACT Research links certain types of the human papillomavirus (HPV) to subsequent development of cervical cancer. Women (n = 52) recently diagnosed with HPV following an abnormal Pap smear participated in in-depth interviews to explore their knowledge of HPV, their emotional responses to diagnosis, and the extent of their disclosure of their HPV diagnosis to others. Women had many knowledge deficits about HPV. Emotions related primarily to stigma, fear, self-blame, powerlessness, and anger. Most women disclosed their disease to significant others, usually to a sexual partner. Womens lack of accurate knowledge may contribute to the array of emotions they experience. Whereas education about HPV may reduce the potency of these emotions, information alone may be inadequate for achieving optimal patient care. Health care providers can be important in treating the emotional elements associated with diagnosis as well as the condition itself.

The Psychosocial Burden of HPV A Mixed-method Study of Knowledge, Attitudes and Behaviors among HPV+ Women

Despite an increased awareness and ‘normalization’ of Human Papillomavirus (HPV) following the release of the HPV vaccine, the psychosocial impact of an HPV infection, the most common sexually transmissible infection (STI), must not be overshadowed. This study employed in-depth interviews (N = 52) and quantitative surveys (N = 154) to assess the knowledge, emotional impact and behavioral consequences of an HPV-related diagnosis in women who had received abnormal Pap test results. Findings revealed confusion over test results and themes related to stigma, fear, self-blame, powerlessness and anger emerged. The promotion of the HPV vaccine should not obfuscate the psychosocial burden associated with an HPV diagnosis.

Abstinence-Only Education: How We Got Here and Where We're Going

This paper examines the history of abstinence education in the United States and the empirical evidence of its effectiveness in preventing teenage pregnancy. It concludes that abstinence education has not yet been proven effective, and therefore recommends that federal policy and funding should be directed towards teen pregnancy prevention programs that have demonstrated success.

HPV knowledge among HPV+ women.

OBJECTIVE To assess knowledge and information seeking among women recently receiving an HPV+ diagnosis. METHODS A 2-phase mixed methods design was used. In both phase I (qualitative) and phase II (quantitative), women with scheduled gynecological exams and Pap smears at clinic sites were approached to participate. RESULTS Women expressed confusion about HPV, and most could not correctly articulate the meaning of their diagnosis. Women do engage in further information seeking, especially through the Internet. CONCLUSION Identifying gaps in knowledge among HPV+ women who need clear messages to facilitate their comprehension of the diagnosis is an important public health activity.

Factors contributing to intervention fidelity in a multi-site chronic disease self-management program

Background and objectivesDisease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design.MethodsThe Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance.ResultsThis report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation.ConclusionEffective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity.

Continuing education about physically abusive relationships: does education change the perceptions of health care practitioners?

BACKGROUND The purpose of this study is to determine the effectiveness of mandatory continuing education for domestic violence. METHOD This study surveyed health care professionals attending the 1993 and 1997 National Perinatal Association Conference in Florida to determine change their awareness and identification of pregnant women involved in physically abusive relationships. RESULTS Even though in 1993 Florida initiated a mandatory 1-hour continuing education credit on domestic violence, the findings report that there were no statistically significant changes for awareness and identification. However, there was a statistically significant increase in the availability of patient education materials within the 4-year period. CONCLUSION Both the 1993 and 1997 respondents expressed a desire for more professional education related to domestic violence.

The Shifting Sands for Applicants to Maternal and Child Health Training Programs

Objective: Anecdotal evidence suggests that fewer students today than in decades past are applying to maternal and child health (MCH) graduate training programs with previous clinical degrees. The purpose of this study was to determine the extent to which applicants accepted to an MCH training program demonstrated a shift away from the tradition of having a prior health professional degree and discuss options needed to provide responsive training. Methods: Twenty years of demographic face sheet data (1983 through 2002) for admitted applicants to the MCH training program at the University of South Florida College of Public Health were examined. Results: Quantitative analysis of admission records confirmed the anecdotal data. Todays applicants are more likely to possess undergraduate nonclinical backgrounds rather than clinical health professional training. Statistically significant differences were found between the students with clinical and without clinical degrees for ethnicity, GRE score, GPA, and the length of time needed to complete the MPH degree. Conclusion: Adjustments in MCH curricula may be necessary to be responsive to the “shifting sands” of clinical and public health work experience among program applicants. However, curriculum modifications need to be ones that maintain the zeal of the new generation of MCH students without diluting the rigor of traditional professional preparation. Some possible responses of training programs are suggested.

Awareness of Diagnosis and Knowledge of HPV in Women Patients: Data from a Multi-Site Study.

Abstract Background: Persistent infection with high-risk types of human papillomavirus (HPV) is associated with cervical and other anogenital cancers. Purpose: This paper reports results of awareness of an HPV diagnosis and HPV knowledge from a multi-site study of HPV knowledge, attitudes and behavior, and the impact of an HPV diagnosis on women and their partners. Methods: During September 2003 - November 2005, a survey containing shared and site-specific items was administered to 736 women who had received HPV DNA testing in conjunction with cytology for cervical cancer screening. Results: Overall, there was low knowledge about HPV transmissibility, curability and the effects of an HPV diagnosis across all sites regardless of a womans racial/ethnic and/or socio-demographic background. Further, only about 50% of the women were aware of their HPV diagnosis even after receiving their results and counseling from a health care professional. Discussion: There is need for consistent and clear information about HPV and HPV DNA testing as part of cervical cancer screening. Research concerning methods or best practices for improving communication between practitioner and patient about testing, diagnosis, counseling, behavioral consequences and follow-up care may be warranted. Translation to Health Education Practice: General messages as well as population-specific messages need to be developed and disseminated to reduce confusion emanating from HPV diagnosis. Modes for delivering messages may need to vary. Further research should address message content and delivery.

A Comparison of Risk Factors Between Incarcerated and Nonincarcerated Female Juvenile Offenders

ABSTRACT This study provides a comparative analysis between female juvenile offenders with a lesser offense who attend an alternative day treatment program and those girls with a more serious offense who were sentenced to a residential treatment facility. Anonymous descriptive data were obtained from the closed cases of clients from the PACE Center for Girls (n=47), an alternative school setting for at-risk girls, and the Northside Mental Health Hospital—Girls Intensive Residential Learning Services Program (n=67). The mean age was 17 years old. Given that the statistically significant data focused primarily on physical and mental health, it is proposed that communities could decrease the exorbitant cost of residential treatment by providing access to adequate physical and mental health services to the female juvenile offenders at day treatment facilities, including health education. Additionally, increased access to health education and screening in schools and community settings might reduce the number of adolescents who require these treatments. These findings may provide valuable information for practitioners, policy makers, health educators, and communities regarding the design and implementation of female juvenile offender programs.