M. Katherine Hutchinson

Talking to Daddy’s Little Girl About Sex: Daughters’ Reports of Sexual Communication and Support From Fathers

Although mothers are widely acknowledged as the primary in-home sexual educators of children, fathers also play an important role in sexual socialization. Paternal involvement is linked to positive social and psychological outcomes; an increased father—daughter communication can delay sexual debut and decrease frequency of engagement in intercourse. This study examined late-adolescent females’ reports of their fathers’ contributions to their sexual socialization. Four open-ended questions were included in a larger study examining family influences of adolescent sexual risk. Daughters described how their fathers prepared them for sexuality and dating and how they could have done better. A thematic content analysis was conducted. Most daughters reported receiving little sexual information from their fathers but identified unique contributions that their fathers made or could have made to their sexual socialization. Future interventions should assist fathers to increase their comfort with sexual communication, to identify barriers, and to provide skill-building practice to promote abstinence and safer sex behaviors among their daughters.

Parental Influences of Sexual Risk Among Urban African American Adolescent Males

PURPOSE This study examined the influence of parental marital status, parent-child sexual communication, parent-child closeness on the HIV-related knowledge, safer-sex intentions, and behaviors of late adolescent urban African American males. DESIGN The study employed a cross-sectional design with retrospective recall of salient parental influences and behaviors. METHODS Data were collected via paper-and-pencil questionnaire from 134 late adolescent African American males, 18 to 22 years of age, recruited from urban communities in and around Boston, Massachusetts. Data were analyzed using bivariate correlations, paired t tests, and regression modeling. FINDINGS Young men reported greater amounts of sexual communication with mothers than fathers (p < .001). Parent-child closeness was positively correlated with amount of parent-child sexual communication with both mothers and fathers (p < .001 for both). Parent-child closeness was, in turn, associated with greater condom use self-efficacy (p < .01), less permissive sexual attitudes (p < .001), fewer sexual partners (p < .01), and less unprotected sex (p < .01). Greater amounts of parent-child sexual communication were associated with fewer sexual risk behaviors, more consistent condom use, and greater intentions to use condoms in the future. There was evidence that parental influences on sexual risk behaviors and condom use intentions were mediated through young mens condom use self-efficacy, attitudes, and beliefs. CONCLUSIONS These findings highlight the importance of the parent-child relationship and the role of parent-child communication between parents and sons. Further studies are needed to better understand the nature of father-son communication and develop strategies to help parents communicate effectively with sons. CLINICAL RELEVANCE Evidence has shown that African American adolescent males are more likely to engage in high-risk sexual behaviors. Understanding the sexual risk communication between African American adolescent males and their parents is important to developing strategies in reducing sexual risk behavior.

An integrative review of relationships between discrimination and Asian American health.

Purpose: Many ethnic minorities in the United States experience disproportionate rates of adverse health outcomes or health disparities. Factors such as socioeconomic status do not fully explain how these disparities are generated and maintained. Research has demonstrated that chronic experiences of discrimination are harmful to the health of African Americans and Latinos. However, there is a dearth of research examining Asian Americans’ experiences with discrimination and health disparities. The purpose of this integrative review was to summarize the current literature examining discrimination and the mental and physical health of Asian Americans. Design and Methods: Combinations of search terms related to discrimination, health, and Asian Americans were used to search five electronic databases. Inclusion criteria were primary research studies, published in English between 1980 and 2011, Asian American adults, and discrimination examined in relationship to a physical or mental health outcome. The search initially yielded 489 results; 14 quantitative studies met inclusion criteria. Findings and Conclusions: Quantitative studies in this review revealed several significant associations between discrimination and health outcomes in Asian Americans. Discrimination was significantly associated with depressive symptoms in seven studies. Three studies found associations between discrimination and physical health, including cardiovascular disease, respiratory conditions, obesity, and diabetes. Although the literature was limited by self-reported data, cross-sectional designs, and inconsistent definitions and measurement of discrimination, the findings suggest that discrimination is a significant contributor to poorer health and health disparities for Asian Americans. The findings clearly demonstrate the need for further nursing research in this area to inform evidence-based practice and social policy. Clinical Relevance: Patient care providers can recognize discrimination as a significant stressor or purveyor of illness and explore ways to facilitate coping and resilience with their Asian American patients. Community-based participatory research approaches can be implemented by clinicians, academicians, and Asian American community partners to address the issue of discrimination and Asian American health outcomes.

Feasibility of implementing rapid oral fluid HIV testing in an urban University Dental Clinic: a qualitative study

BackgroundMore than 1 million individuals in the U.S. are infected with HIV; approximately 20% of whom do not know they are infected. Early diagnosis of HIV infection results in earlier access to treatment and reductions in HIV transmission. In 2006, the CDC recommended that health care providers offer routine HIV screening to all adolescent and adult patients, regardless of community seroprevalence or patient lifestyle. Dental providers are uniquely positioned to implement these recommendations using rapid oral fluid HIV screening technology. However, thus far, uptake into dental practice has been very limited.MethodsThe study utilized a qualitative descriptive approach with convenience samples of dental faculty and students. Six in-depth one-on-one interviews were conducted with dental faculty and three focus groups were conducted with fifteen dental students.ResultsResults were fairly consistent and indicated relatively high levels of acceptability. Barriers and facilitators of oral fluid HIV screening were identified in four primary areas: scope of practice/practice enhancement, skills/knowledge/training, patient service/patient reactions and logistical issues.ConclusionsOral fluid HIV screening was described as having benefits for patients, dental practitioners and the public good. Many of the barriers to implementation that were identified in the study could be addressed through training and interdisciplinary collaborations.

Obstetric Fistula: What About Gender Power?

Despite over 40 years of research there has been little progress in the prevention of obstetric fistula and women continue to suffer in unacceptable numbers. Gender power imbalance has consistently been shown to have serious implications for womens reproductive health and is known to persist in regions where obstetric fistula occurs. Yet, there is limited research about the role gender power imbalance plays in childbirth practices that put women at risk for obstetric fistula. This information is vital for developing effective maternal health interventions in regions affected by obstetric fistula.

Experiences and Lessons Learned in Using Community-Based Participatory Research to Recruit Asian American Immigrant Research Participants

PURPOSE By 2050, the number of international migrants is expected to double from 214 million people. Of these, Asian immigrants are projected to comprise the largest foreign-born population in the United States by the year 2065. Asian American immigrants experience numerous health disparities, but remain under-represented in health research. The purpose of this article is to examine the experiences and lessons learned in applying community-based participatory research (CBPR) principles to access and recruit a sample of Asian American research participants. APPROACH This article reviews unique barriers to research participation among Asian Americans, describes the principles of CBPR, and provides examples of how these principles were employed to bridge recruitment challenges within a qualitative study. FINDINGS AND CONCLUSIONS CBPR facilitated greater research participation among a group of immigrant Asian Americans. Researchers must be additionally mindful of the importance of building trusting relationships with their community partners, understanding the significance of shared experiences, considering fears around immigration status, and considering ongoing challenges in identifying and reaching hidden populations. CLINICAL RELEVANCE Clinicians and researchers can employ CBPR principles to guide their work with Asian immigrant communities and other under-represented groups to facilitate access to the population, improve participant recruitment, and foster engagement and collaboration.

Screening for intimate partner and sexual violence in college women: missed opportunities

BACKGROUND Intimate partner violence (IPV) and sexual violence (SV) are significant health issues for college women. Leading organizations and experts recommend screening for IPV/SV in health care settings, including college health centers. Given the prevalence and health risks associated with IPV/SV among college women, it is important to examine screening in this population. METHODS A cross-sectional, web-based survey was administered to college women at two universities in the northeastern United States. The survey consisted of demographic questions, assessment of experiences with IPV/SV (lifetime and past 6 months), use of health care services with either a college health center or an off-campus provider, and assessment of health care setting screening practices. RESULTS The sample included 615 college women (M = 21.5 years). Lifetime experiences of IPV/SV were reported by 222 women (36.1%). Approximately 8.1% of participants (n = 51) experienced IPV/SV in the past 6 months. Almost 63% (n = 238) reported not being asked about IPV/SV at their most recent off-campus health care visit. Nearly 90% (n = 237) reported not being asked about IPV/SV at their most recent visit to the college health center. CONCLUSIONS Participants reported high rates of IPV/SV and low rates of violence screening at college health centers and off-campus settings. Routine provider screening for IPV/SV in health care settings can identify women at risk and can lead to interventions that reduce subsequent violence and improve health outcomes and referrals. Theory-based, culture-specific, multilevel interventions are needed to promote IPV/SV screening among college health providers.

Promoting research partnerships to reduce health disparities among vulnerable populations: sharing expertise between majority institutions and historically black universities.

This chapter focuses on promoting cultural competence in research and the care of vulnerable populations by establishing inter-university nursing partnership centers for health disparities research between historically Black universities and minority-serving institutions and research-intensive majority institutions. The Hampton-Penn Center to Reduce Health Disparities (HPC), an inter-university collaborative center funded through the National Institutes of Health (NIH) National Institute of Nursing Research (NINR) P20 funding mechanism, is discussed as the exemplar. The mission of the Hampton-Penn Center is to promote culturally competent research on health promotion and disease prevention and the examination of how culture, race and ethnicity and their interactions with the health care system and the larger society influence health outcomes and the occurrence of health disparities. The history, goals, and conceptual model underlying this collaborative effort between the University of Pennsylvania and Hampton University Schools of Nursing are described as are the accomplishments and lessons learned to date. Based upon the Hampton-Penn experience, recommendations for similar collaborations to reduce health disparities among vulnerable populations are made in three major areas: (a) increasing the study of the multi-system level factors that contribute to health disparities among vulnerable populations, (b) promoting the development of culturally competent research on health disparities, and (c) promoting the recruitment and training of health researchers who are themselves members of vulnerable populations.

The Association between Discrimination and the Health of Sikh Asian Indians

OBJECTIVE We investigated the relationships between self-reported discrimination (SRD) and mental and physical health (self-reported physical health conditions and direct, physiologic measures [BMI, waist-to-hip ratio, and blood pressure]) among Sikh Asian Indians (AI), a group that may be particularly discriminated against because of physical manifestations of their faith, including a tendency to wear turbans or ethnic clothing. METHODS Sikh AIs (N = 196) were recruited from Sikh gurdwaras in Queens, New York. Data were collected on SRD, social support, and self-reported health, along with multiple direct physiological measures for cardiovascular health. RESULTS Participants who wore turbans/scarves reported higher levels of discrimination than those who did not wear turbans/scarves. As hypothesized, multiple regression analysis supported that discrimination is significantly associated with poorer self-reported mental (B = -.53, p < .001) and physical health (B = -.16, p = .04) while controlling for socioeconomic, acculturation, and social support factors. The study did not support an association between SRD and physiologic measures (elevated BMI, waist-to-hip ratio, and blood pressure). CONCLUSION Consistent with previous discrimination and health reports, this study demonstrated an inverse relationship between discrimination and health among Sikh AIs, an understudied yet high-risk minority population. Community-based efforts are also needed to reduce the occurrence or buffer the effects of discrimination experienced by Sikh AIs. (PsycINFO Database Record

The Influence of Knowing Someone with AIDS on Youth HIV Sexual Risk Behaviors.

ABSTRACT Research indicates that knowing someone with HIV/ AIDS is associated with greater perceived risk of contracting HIV and changes in sexual risk behaviors. The current study with a sample of 1,172 examined whether knowing someone with HIV/AIDS influenced sexual risk communication and youth engagement in sexual intercourse using the Philadelphia Educational Longitudinal Study (PELS). Adolescents who reported personally knowing someone with AIDS were more likely to be female (p < .001) and Black (p < .007) or Hispanic (p < .019). These adolescents were 1.5 times more likely to report ever having had sex and 1.3 times more likely to have ever talked to their parent about how to avoid STDs and AIDS compared to youth who did not know someone with AIDS. Understanding if and how knowing someone with HIV/AIDS influences sexual activity may be an important approach in reducing new HIV infections.