Marilyn J. Hoppe

Using Focus Groups to Discuss Sensitive Topics with Children

The Childrens Health Awareness Project is presented as a case study of the use of focus groups for gathering sensitive information from children. General focus group techniques are described, as are the benefits and limitations of focus group methodology for social science applications. Recommendations are offeredfor other investigators planning to use this methodology to gather information from children, especially when sensitive topics are to be addressed.

Condom use, frequency of sex, and number of partners: Multidimensional characterization of adolescent sexual risk‐taking

Sexual health research often relies on single risk indicators. However, multi‐variable composites may better capture the underlying construct of risk‐taking. Latent Profile Analysis identified subgroups based on condom use consistency, partner numbers, and sex frequency among 605 adolescents. Three profiles were identified for each of grades 8 to 10 (Condom Users, Few Partners, and Risk‐Takers) and 4 in grades 11 and 12 (Condom Users, One Partner, Two Partners, and Risk‐Takers). Inconsistent condom use groups reported more non‐condom (and often less effective) birth control use and STD and pregnancy histories. Females had greater representation in the Few Partners, One Partners, and Two Partners groups, which also contained increasing proportions of participants in each subsequent year. Males had greater representation in the Risk‐Takers group. A profile approach to measurement has methodological advantages, can add to substantive knowledge, and can inform content, timing, and targets of sexual health interventions.

Does “High = High Risk”? An Event-Based Analysis of the Relationship Between Substance Use and Unprotected Anal Sex Among Gay and Bisexual Men

This study examined the relationship between substance use and condom use using a study design that remedied some of the methodological problems noted in prior research. A community sample of 147 gay men completed daily diaries in which they reported their substance use and sexual behaviors for 8 weeks. This method helped ensure the contiguity of substance use and sexual behaviors, established the temporal relationships between them, and controlled for confounding individual differences that could cause both substance use and sexual risktaking. A within-subjects analysis showed no significant relationships between condom use and alcohol and/or drug use consumed within 4 hr of having anal sex. Condoms were more likely to be used with casual than with steady partners and were more likely to be used by HIV− men. These results suggest that the relationships found in prior studies could be due to measurement differences or confounding personality or situational factors.

Reducing Parental Risk Factors for Children's Substance Misuse: Preliminary Outcomes with Opiate-Addicted Parents

Parents in methadone treatment were offered an experimental intervention, Focus on Families, designed to reduce their risk of relapse and their childrens risk of substance use. Experimentally assigned volunteers participated in systematic group training in relapse prevention and parenting skills, and received home-based case management services. Immediate posttreatment outcome results reported here include analyses of covariance controlling for baseline measures. Analyses show experimental parents held more family meetings to discuss family fun, displayed stronger refusal/relapse coping skills, demonstrated stronger sense of self-efficacy in role-play situations, and had lower levels of opiate use than control subjects. No significant differences in family bonding, family conflict, or other measures of drug use were found. The utility of intervening with drug-addicted parents in methadone treatment is discussed in light of these findings.

Negative and Positive Factors Associated With the Well-Being of Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning (LGBTQ) Youth.

Factors associated with the well-being of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth were qualitatively examined to better understand how these factors are experienced from the youths’ perspectives. Largely recruited from LGBTQ youth groups, 68 youth participated in focus groups (n = 63) or individual interviews (n = 5). The sample included 50% male, 47% female, and 3% transgender participants. Researchers used a consensual methods approach to identify negative and positive factors across 8 domains. Negative factors were associated with families, schools, religious institutions, and community or neighborhood; positive factors were associated with the youth’s own identity development, peer networks, and involvement in the LGBTQ community. These findings suggest a pervasiveness of negative experiences in multiple contexts, and the importance of fostering a positive LGBTQ identity and supportive peer/community networks. Efforts should work towards reducing and eliminating the prejudicial sentiments often present in the institutions and situations that LGBTQ youth encounter.

THE RELATIVE COSTS AND BENEFITS OF TELEPHONE INTERVIEWS VERSUS SELF-ADMINISTERED DIARIES FOR DAILY DATA COLLECTION

This article compares two methods of collecting daily data: self-administered diaries and telephone interviews. Study participants included 44 men and 56 women between the ages of 16 and 35 who participated in a larger study of drinking, drug use, and sexual activity. Participants were randomly assigned to either the written diary or the telephone interview conditions; question wording and format were identical in both conditions. Daily data were collected for a period of 8 weeks. Results indicate that although telephone interviews resulted in slightly more missed days of data collection, they generally yielded less item-level missing data, produced cleaner data and therefore were less costly to process, and were as palatable to participants as self-administered diaries. Except for reports of drinking and vegetable consumption, telephone and diary conditions did not differ in the amount of behavior reported; more drinking and vegetable consumption were reported with telephone interviews, however. Telephone interviews also imposed considerably higher overall personnel costs.

Children's Knowledge and Beliefs about AIDS: Qualitative Data from Focus Group Interviews

Focus groups were used as a qualitative technique to elicit knowledge and attitudes of children in Grades 3 to 6 about acquired immune deficiency syndrome (AIDS). Twenty-seven small groups of children responded to open-ended questions about general AIDS knowledge; transmission, causation, consequences, and prevention of AIDS; emotional response to AIDS; and susceptibility. Results indicate that children have a high level of awareness about AIDS and correct knowledge about the modes of human immunodeficiency virus (HIV) transmission. They understand that AIDS is a serious illness that cannot be cured and know the main ways of preventing HIV infection. Participants had more difficulty explaining causation and greatly overestimated the number of people their age and in high school that might be infected. They also had difficulty applying accurate knowledge to the hypothetical situation of encountering a child with AIDS in school. Misconceptions about AIDS exist at all grade levels, but appear more prevalent in lower grades, whereas increased complexity seems to characterize responses of older children. Recommendations for health educators are made.

Daily data collection of sexual and other health‐related behaviors

Is daily data collection of sexual and other health‐related behaviors reactive? This question was examined by exploring trends in daily reports of sexual intercourse, condom use, drinking, smoking, and vegetable and fruit consumption over a 2‐month period. The trends were examined for evidence of fatigue effects and socially desirable responding. The effects of data collection method and gender were also examined. Results from a hierarchical linear modeling analysis showed a significant trend toward decreased reporting of drinking, smoking, and sexual intercourse, but no significant trends in fruit and vegetable consumption or condom use. These patterns are not consistent with fatigue effects or socially desirable responding. The results are discussed in relation to choosing data collection methods that minimize error.

Children's beliefs about smoking

Childrens beliefs about smoking were examined in a multi-ethnic urban sample of 4th through 7th grade children. Results showed that, relative to those in earlier grades, children in higher grades held more positive beliefs about the positive outcomes of smoking and the long-term negative consequences of smoking, but there was no association between grade level and beliefs about the immediate negative consequences of smoking. Children in higher grades also perceived more favorable norms toward smoking. There were few gender or race/ethnicity differences at these ages in childrens beliefs about smoking. These outcome and normative beliefs were related to smoking behavior. Of the nine beliefs about the effects of smoking, all but two were significantly related to smoking behavior.

Children's Beliefs About Drinking

This paper reports the results of a study in which age (grade level), racial/ethnic, and gender differences in beliefs and perceived norms about drinking were examined in a multi-ethnic urban sample of 4th through 7th grade children. Results showed that older children held beliefs and perceived norms that were more favorable toward drinking than younger children. The major difference between older and younger children lay in their differential estimates of the likelihood of certain consequences occurring and not in their evaluation of these consequences of drinking. Further, older children not only displayed less motivation to comply with their parents and greater motivation to comply with their peers, but they also perceived their parents, as well as their peers, as less disapproving of drinking than did younger children. There were few gender or race/ethnicity differences at these ages in childrens beliefs and perceived norms about drinking.