Kate Ksobiech

Reducing alcohol use, sex risk behaviors, and sexually transmitted infections among Filipina female bar workers: effects of an ecological intervention.

This article presents the outcomes of a quasi-experimental community-based research intervention initiative targeting sexually transmitted infections (STIs) testing and condom use among Filipina female bar workers (FBWs). Established at the peer, organizational, and policy levels, bar managers and peer educators from 110 different establishments, in 4 southern Philippines regions, were trained. Only FBWs in the combination peer educator and manager training intervention condition significantly increased STI testing from baseline to follow-up. STI testing was significantly associated with higher HIV/AIDS knowledge, lower probability of contracting HIV, and increased condom use. Based on the findings, future research on the adaptability of this intervention to FBWs residing in HIV epicenters is warranted.

Exploring the relationship between premarital sex and cigarette/alcohol use among college students in Taiwan: a cohort study.

BackgroundCigarette/alcohol use and premarital sex, and their subsequent consequences on the well-being of college students, are international health promotion issues. However, little is known about the temporal relationship of these risk behaviors among Taiwanese college students.MethodsThis study utilizes data from the Taiwan Youth Project, a cohort sample of 20-year-olds (N = 2,119) with a 2-year follow-up, to explore the relationship between adolescent cigarette/alcohol use, and subsequent premarital sex. To incorporate the Taiwanese context where the normative value of abstinence until marriage remains strong, multivariate logistic regression models included data on premarital sex attitudes, stressful life events, peer influence, as well as family and individual factors which might influence this relationship.ResultsThe sample consists of 49% male and 51% female college students. About 16% of the sample report having had premarital sex by age 20. After excluding sexually active youth, 20% of males and 13% of females report engaging in premarital sex in the 2-year follow-up interview. Multivariate logistic regression analyses reveal adolescent alcohol use is significantly associated with a higher likelihood of engaging in premarital sex for both genders; adolescent smoking is significantly associated with premarital sexual activity among males, but not females. Our results indicate liberal premarital sexual attitudes and stressful personal events are also significantly associated with premarital sexual activity.ConclusionsThese findings suggest health promotion programs for college students need to take developmental and gender perspectives into account. Future research to incorporate a broader, multi-cultural context into risk reduction materials is recommended.

Adolescent Internet use and its relationship to cigarette smoking and alcohol use: A prospective cohort study

The present study aims to investigate the longitudinal impact of situational Internet use on future cigarette smoking and alcohol use among male and female adolescents. A Northern Taiwanese cohort sample of adolescents with no prior use of cigarettes (n=1445) or alcohol (n=1468) was surveyed at age 16 and again 4 years later. Information regarding where, why, and length of time spent using the Internet was gathered from the 16-year-old participants. Outcome information regarding cigarette/alcohol use was gathered via a follow-up questionnaire at age 20. Multivariate regressions were used to incorporate peer, individual and family characteristics as measured at age 16 and create models of future cigarette and alcohol use at age 20. The analyses demonstrated that adolescent Internet use, particularly where such use took place, has a significant impact on future cigarette smoking and alcohol use, adjusted for conventional factors, and its relationship differs significantly by gender. Female adolescents with Internet café use appear to be especially likely to develop these two risky behaviors. The why of Internet use is also a predictor of future cigarette smoking. Finally, time spent using the Internet is significantly related to alcohol use; greater use of the Internet is associated with higher levels of drinking. The results revealed that different risky behaviors are differentially influenced by separate components of adolescent Internet use. These findings suggest that programs aimed at promoting adolescent health could potentially benefit Taiwanese adolescents by including components related to situational Internet use and taking gender into consideration.

Clinic appointment attendance for sexually transmitted infection screening among Filipina sex workers: A multilevel analysis

Abstract This study evaluates putative individual- and contextual-level social risk factors that may influence the likelihood that Filipina female sex workers (FSWs) attend and utilize health services for STI screening. Face-to-face interviews were conducted with 1004 FSWs and their 86 employers. Research staff also collected clinic appointment attendance data. Hierarchical linear modelling was used to estimate the simultaneous effects of individual- and workplace-level factors. Results showed that both individual- and contextual-level characteristics were associated with STI screening appointment attendance. Individual characteristics found to have significant effects on clinic attendance included occupation, income, length of work and commercial sex involvement. City of establishment was a workplace characteristic significantly associated with appointment attendance. In addition to cross-level interactions, the impact of individual-level occupation depended upon characteristics of the workplace. These findings suggest that individual health service utilization is contingent upon contextual-level risk factors in the workplace. Intervention implications aimed at increasing clinic attendance are discussed.

The effects of mid-life socioeconomic disadvantage and perceived social support on trajectories of subsequent depressive symptoms among older Taiwanese women

BackgroundScant research has taken a life-course perspective to explore the longitudinal impact of socioeconomic disadvantage and perceived social support on the psychological well-being of older women. We sought to explore whether socioeconomic disadvantage and perceived social support in mid-life are associated with subsequent depressive symptomatology among older Taiwanese women.MethodsThis study was based on data from the Taiwan Longitudinal Study on Aging conducted on a nationally representative sample (n = 1,073) of women aged 50 and above with a 12-year follow up. Mid-life socioeconomic disadvantage was assessed by socioeconomic status (SES) (i.e., educational attainment, major lifetime occupation in adulthood, and employment status) and economic strain. Perceived social support included three dimensions: listening, caring, and sick care. We used the short form of the Center of Epidemiological Studies-Depression (CES-D) scale that measures depressive symptomatology within two domains (negative affect and lack of positive affect). Growth curve models were employed to predict the relationships between mid-life socioeconomic disadvantage, perceived social support, and subsequent depressive trajectories, controlling for aging effects.ResultsMultivariate analyses demonstrated older women in a socioeconomic disadvantaged position are more likely to report higher initial levels of depressive symptoms in both domains; lack of formal education did not exacerbate depressive symptoms in the lack of positive affect domain over time. In addition, mid-life perceived positive social support in caring and sick care was associated with lower initial levels of depressive symptoms in both domains.ConclusionsOur results suggest independent effects of mid-life socioeconomic disadvantage and perceived social support on subsequent depressive symptomatology among older Taiwanese women.

“They Do a Wonderful Job of Surviving”: Supportive Communication Exchanges Between Volunteers and Users of a Choice Food Pantry

ABSTRACT In a qualitative study examining supportive communication, 34 users of a choice food pantry and 20 volunteers who guide users through the pantry shopping experience provided information about the nature and meaning of supportive communication exchanged during their normal pantry interactions. The study revealed that 4 types of social support link volunteer–client communication: (a) emotional (expressions of trust, intimacy, and caring); (b) appraisal (expressions of affirmation and positive self-evaluation); (c) instrumental (practical assistance); and (d) informational (useful information and advice). The findings have important implications for creating supportive environments within choice pantries. Specifically, the role of both informational and appraisal support deserves more attention when considering the growing marginally food insecure population.

National health insurance and life satisfaction in late life: longitudinal findings from a natural experiment in Taiwan

BACKGROUND To determine whether the availability of National Health Insurance (NHI) is associated with a longitudinal increase in life satisfaction among older Taiwanese adults. METHODS This study used data from the Taiwan Longitudinal Study on Aging, a nationally representative sample (n = 3778) of older adults aged 60 and above. Participants were interviewed prior to the establishment of NHI and on multiple occasions thereafter over the next 18 years. Growth curve models were employed to estimate the NHI effects on life satisfaction across various pre-NHI insurance groups over time while taking concurrent medical care utilization and health status into consideration. RESULTS While somewhat complex and explained in detail herein, multivariate analyses found a significant increase in life satisfaction among older Taiwanese adults over the 12-year period since the establishment of NHI. Further, while the pre-NHI uninsured had a significantly lower level of life satisfaction than the pre-NHI insured government employees (β = -1.78, P < 0.05), even after controlling for concurrent medical care utilization and health status, the difference in life satisfaction was significantly reduced by NHI over time. CONCLUSIONS NHI reduces the barriers to medical care utilization and improves life satisfaction among older Taiwanese adults, particularly for individuals who were uninsured prior to NHI.

Associations between Birth Health, Maternal Employment, and Child Care Arrangement among a Community Sample of Mothers with Young Children

Although a large body of literature exists on how different types of child care arrangements affect a childs subsequent health and sociocognitive development, little is known about the relationship between birth health and subsequent decisions regarding type of nonparental child care as well as how this relationship might be influenced by maternal employment. This study used data from the Los Angeles Families and Neighborhoods Survey (L.A.FANS). Mothers of 864 children (ages 0–5) provided information regarding birth weight, maternal evaluation of a childs birth health, childs current health, maternal employment, type of child care arrangement chosen, and a variety of socioeconomic variables. Child care options included parental care, relative care, nonrelative care, and daycare center. Multivariate analyses found that birth weight and subjective rating of birth health had similar effects on child care arrangement. After controlling for a childs age and current health condition, multinomial logit analyses found that mothers with children with poorer birth health are more likely to use nonrelative and daycare centers than parental care when compared to mothers with children with better birth health. The magnitude of these relationships diminished when adjusting for maternal employment. Working mothers were significantly more likely to use nonparental child care than nonemployed mothers. Results suggest that a childs health early in life is significantly but indirectly related to subsequent decisions regarding child care arrangements, and this association is influenced by maternal employment. Development of social policy aimed at improving child care service should take maternal and family backgrounds into consideration.

The ambiguous nature of college students’ condom use scripts

This study examined students’ perceptions regarding condom use scripts (N=280). Using an experimental research design, this study sought to determine whether subjects would perceive a hypothetical female‐initiated condom use scenario to be more realistic than a male‐initiated condom use scenario. Sexually conservative females who received the female‐initiated scenario perceived it to be more realistic than sexually conservative females who received the male‐initiated scenario. Sexually active females, sexually conservative males, and sexually active males reported no significant differences regarding the perceived realism of the condom initiation scripts. These findings suggest that traditional sexual scripts are less prevalent than previously reported, and that discussions about condom use prior to first sex are uncertain communication episodes.

The influence of early sexual debut and pubertal timing on psychological distress among Taiwanese adolescents.

This study examined the relative influence of early sexual debut (ESD) and pubertal timing on psychological distress from adolescence to young adulthood in Taiwan, a non-Western society with a distinct cultural and family context. Data were from a cohort sample of 15-year-olds (N = 2595) first interviewed in 2000, with four follow-ups during a 7-year period. Psychological distress was assessed by a reduced form of the Symptom Checklist-90 Revised. ESD was defined by first intercourse at age 15 or younger. Multivariate analyses via growth curve modeling found a greater increase in psychological distress over time in adolescents with ESD (β = .28, p < .05). Early-pubertal adolescents were at greater risk for the onset of psychological distress (β = .46, p < .05). Further, early pubertal adolescents with an ESD appeared to be especially likely to be distressed (β = 3.39, p < .05). In addition, analyses showed a non-linear trajectory of psychological distress between the ages of 15 and 22, with distress escalating (β = .45, p < .001) as age increased before tapering off as adolescents became young adults (β = −.03, p < .001). Results suggest the contributing influence of both ESD and pubertal timing on distress trajectories, independent of parental and family characteristics.