Richard J. Fehring

The Influence of Religiosity, Gender, and Language Preference Acculturation on Sexual Activity Among Latino/a Adolescents

The purpose of this study was to determine the main and interactive effects of religiosity, gender, and language preference acculturation on sexual activity among 570 Latino/a adolescents from the 2002 National Survey of Family Growth. Results indicated that adolescents who viewed religion as very important, had frequent church attendance, and had more traditional attitudes on sexuality were less likely ever to have sex compared with adolescents who were less religious. Those with frequent church attendance and high traditional attitudes had fewer lifetime and recent sex partners. Unassimilated religious youth were less likely ever to have sex, had fewer lifetime and recent sexual partners, and a later age of sexual debut. Females were less likely to have had sex, had fewer recent and lifetime partners, and had a later age of coital debut than males. Religiosity had a healthy dampening of sexual activity among Latino/a adolescents and, in particular, among those who were less assimilated.

Accuracy of the peak day of cervical mucus as a biological marker of fertility

The (PD) peak day of cervical mucus is an important biologic marker for the self-determination of the optimal time of fertility in a womans menstrual cycle. The purpose of this article is to provide evidence (literature and empiric) for the accuracy of the PD of cervical mucus as a biologic marker of peak fertility and the estimated day of ovulation. An analysis of data from four published studies that compared the self-determination of the PD of cervical mucus with the urinary luteinizing hormone (LH) surge was conducted. The four studies yielded 108 menstrual cycle charts from 53 women participants. The 108 cycles ranged in length from 22 to 75 days (mean 29.4 SD 6.0). Ninety-three of the 108 cycles had both an identified PD and LH surge. Data charts showed that 97.8% of the PD fell within +/-4 days of the estimated day of ovulation. Use of a standardized mucus cycle scoring system indicated that the peak in cervical mucus ratings was highest on the day of the LH surge. Self-determination of the PD of cervical mucus is a very accurate means of determining peak fertility and a fairly accurate means of determining the day of ovulation and the beginning of the end of the fertile time.

Effects of Biofeedback-Aided Relaxation on the Psychological Stress Symptoms of College Students

The purpose of this study was to compare the effects of Bensons relaxation technique (BRT) with Bensons technique augmented with GSR biofeedback (i.e., biofeedback-aided relaxation, BAR) on the psychological stress symptoms of well college students. Seventy-eight normotensive college students were randomly assigned to one of three groups: the BRT group, the BAR group, and a control group. The BRT and BAR students were asked to practice their respective relaxation technique daily for an eight-week period. Pre- and postintervention, all subjects were administered a state-anxiety inventory and a profile-of-mood state (POMS) test. Posttest analysis indicated that the BAR group had significantly lower state anxiety and POMS than the BRT and control groups (p less than 0.05). It was evident from the results that BAR did augment BRT in lowering psychological stress symptoms. Part of the effectiveness was due to the expectation of relief on the part of the BAR group. It was recommended that nurses study the effects of BAR in clinical settings.

Religiosity and Sexual Activity Among Older Adolescents

This study investigates religiosity, sexual activity, and sexual permissiveness among older adolescents. Eighty-two college students completed a survey that measured religiosity, sexual permissiveness, self-esteem, frequency of recent sexual encounters, and motivators for sexual activity or abstinence. Guilt, prayer, organized religious activity, and religious well-being predicted fewer sexual encounters. Orthodox beliefs, participation in organized religious activities, and highly-rated importance of faith predicted less permissive sexual attitudes. We conclude that guilt and religious activity can be good motivators for decreasing sexual encounters. We recommend that health practitioners encourage participation in religious activity among adolescents.

Religiosity and Sexual Risk Behaviors Among Latina Adolescents: Trends from 1995 to 2008

PURPOSE The purpose of this study was to determine trends in the influence of religiosity on sexual activity of Latina adolescents in the United States from 1995 to 2008 and to determine if differences existed between the Mexican American and other Latina groups. METHODS The sample comprised the subset of unmarried, 15-21-year-old (mean 17 years) Latina female respondents in the 1995 (n=267), 2002 (n=306), and 2006-2008 (n=400) National Survey of Family Growth (NSFG) datasets. Associations between religiosity (importance of religion and service attendance) and history of ever having sex, number of sex partners, and age of sexual debut were investigated. RESULTS Less than one half of Latinas in 1995 (44%) and in 2006-2008 (44%) reported that religion was very important to them, whereas in 2002, 50% reported it was important. Only in 1995 did Latinas who viewed religion as very important have a significantly lower level of sexual initiation. In 1995 and in 2006-2008, Latinas who held religion as very important had significantly fewer partners. In all three cohorts, the higher religious importance group had higher virgin survival rates. Across cohorts, approximately one third of respondents reported frequent religious attendance. In all cohorts, frequent attenders were less likely to have had sex, had fewer partners, and had older age at sexual debut. The survival rate as virgins for Mexican origin Latinas was higher in 1995 and 2002 compared to non-Mexican Latinas but was almost the same in 2006-2008. CONCLUSIONS Religiosity had a protective association with sexual activity among Latina adolescents. The association of importance of religion with sexual activity has diminished from 1995 to 2008, however, whereas the importance of service attendance has remained stable. The influence of religion was more apparent among the Latinas of Mexican origin, but this greater influence also diminished by 2006-2008.

Basal Body Temperature Assessment: Is It Useful to Couples Seeking Pregnancy?

Advanced practice nurses in primary care settings are often asked to give appropriate advice to couples seeking pregnancy. This article examines the issue of basal body temperature (BBT), a time-honored way to establish the presence of ovulatory cycles, and asks if BBT is an outdated recommendation. The article also reviews the benefits and limitations of recommending BBT to couples seeking pregnancy in light of recent fecundity research.

Randomized comparison of two Internet-supported fertility-awareness-based methods of family planning.

BACKGROUND The aim was to compare the efficacy and acceptability of two Internet-supported fertility-awareness-based methods of family planning. STUDY DESIGN Six hundred and sixty-seven women and their male partners were randomized into either an electronic hormonal fertility monitor (EHFM) group or a cervical mucus monitoring (CMM) group. Both groups utilized a Web site with instructions, charts and support. Acceptability was assessed online at 1, 3 and 6 months. Pregnancy rates were determined by survival analysis. RESULTS The EHFM participants (N=197) had a total pregnancy rate of 7 per 100 users over 12 months of use compared with 18.5 for the CMM group (N=164). The log rank survival test showed a significant difference (p<.01) in survival functions. Mean acceptability for both groups increased significantly over time (p<.0001). Continuation rates at 12 months were 40.6% for the monitor group and 36.6% for the mucus group. CONCLUSION In comparison with the CMM, the EHFM method of family planning was more effective. All users had an increase in acceptability over time. Results are tempered by the high dropout rate.

Characteristics of the Menstrual Cycle After Discontinuation of Oral Contraceptives

BACKGROUND Menstrual cycle function may continue to be altered after discontinuation of oral contraceptives (OC). Few studies have been published on the effects of recent OC use on menstrual cycle parameters; none have examined characteristics of the menstrual flow or the quality of cervical mucus. The purpose of this retrospective matched cohort study is to assess biomarkers of the menstrual cycle after discontinuation of OCs. METHODS Among a sample of women who daily recorded observations of menstrual cycle biomarkers, 70 women who had recently discontinued OCs were randomly matched by age and parity with 70 women who had not used OCs for at least 1 year. Outcomes investigated included overall cycle length, length of the luteal phase, estimated day of ovulation, duration of menstrual flow, menstrual intensity, and mucus score. Differences between recent OC users and controls were assessed using random effects modeling. RESULTS Recent OC users had statistically significantly lower scores for mucus quality for cycles 1 and 2. Additionally, OC users had a later estimated day of ovulation that was statistically significant in cycle 2 and a decreased intensity of menstrual flow that was significant in the first four cycles (difference = -0.48 days). In random effects modeling, all these parameters were significantly different for the first six cycles combined. CONCLUSIONS Menstrual cycle biomarkers are altered for at least two cycles after discontinuation of OCs, and this may help explain the temporary decrease in fecundity associated with recent OC use.

Pilot evaluation of an internet-based natural family planning education and service program.

OBJECTIVE To evaluate the efficacy, knowledge of fertility, and acceptability of a web-based natural family planning (NFP) education and service program. DESIGN A 6-month repeated measure longitudinal evaluation pilot study. SETTING A university based online website. PARTICIPANTS The website was piloted with 468 volunteer women seeking NFP services. Of these participants, 222 used the automatic online fertility charting system to avoid pregnancy. The 222 charting participants had a mean age of 29.9 years (SD=5.6), 2.2 children (SD=1.9), 37% were postpartum, and 47% had regular menstrual cycle lengths. INTERVENTION Nurse-managed web-based NFP education and service program. OUTCOMES Pregnancies were confirmed by an online self-assessed pregnancy evaluation form. A 10-item fertility quiz and 10-item acceptability survey was administered online. RESULTS Among the 222 users avoiding pregnancy, at 6 months of use, there were two correct-use unintended pregnancies that provided a pregnancy rate of 2% and seven total unintended pregnancies providing a typical use pregnancy rate of 7%. Mean knowledge of fertility increased significantly from time of registration (8.96, SD=1.10) to 1 month of use (9.46, SD=.10), t=4.60, p<.001). Acceptability increased nonsignificantly from 1 month of use (45.6; SD=8.98) to 6 months of use (48.4; SD=8.77). CONCLUSION The nurse-managed online NFP system seems to provide adequate knowledge of fertility and help participants meet pregnancy intentions. Acceptability of such a system of NFP is still in question.

Efficacy of the Marquette Method of Natural Family Planning

PurposeTo determine the effectiveness of the Marquette Method (MM) of natural family planning (NFP) as a method of avoiding pregnancy. Study Design and MethodsThis was a 12-month retrospective evaluation of the MM system of NFP. Two hundred and four women (mean age, 28.6 years) and their male partners (mean age, 30.3 years) who sought to learn a method for avoiding pregnancy with the MM from four clinical sites were taught to track their fertility by self-observation of cervical mucus, by use of an electronic monitor that measures urinary levels of estrone-3-glucuronide and luteinizing hormone, and by use of basal body temperature. All unintended pregnancies were evaluated by professional nurses as to whether they were intended or not. Pregnancy rates over 12 months of use were determined by survival analysis. ResultsThere were a total of 12 unintended pregnancies, only 1 with correct use. The 12-month “correct use” pregnancy rate was 0.6 (i.e., 99.4% effective) and the “typical use” (total pregnancy rate) was 10.6 (i.e., 89.4% effective) per 100 users. Clinical ImplicationsWhen used correctly, the MM system of NFP is an effective means of avoiding pregnancy. The efficacy of the MM system includes proper preparation of the professional nurse NFP teachers.