Terry Peak

Multi-ethnic comparison of risk and protective factors for adolescent pregnancy.

Data from a longitudinal cohort study, the National Longitudinal Survey of Youth, are used to examine the differences in risk and protective factors for adolescent pregnancy among four ethnic groups—non-Hispanic Whites, non-Hispanic Blacks, Hispanics, and American Indians. The objective is the identification of differential predictors for adolescent pregnancy among each ethnic group included in the analyses, as well as better comprehension of the differences among women who experienced a teen pregnancy compared to those who did not. The model for this sample of 5,053 women indicates that higher self-esteem and a higher level of maternal education are protective factors; living in poverty as a young teen, substance use, and adolescent marriage are factors associated with an increased risk for teen pregnancy. Further, the results indicate that unique sets of predictors exist for each ethnic group. Implications of these findings are discussed.

The Impact of a Spouse-Caregiver Support Group on Care Recipient Health Care Costs

Frail elderly veterans who received care at a Department of Veterans Affairs medical center and whose spouse-caregivers participated in support groups to which they had been randomly assigned had lower health care costs over a 1-year period than did control participants. The greatest impact was observed for participants perceived by their spouse-caregivers to be in the poorest health. What is important to consider about this result in terms of health care policymaking is that support groups targeted for spouse-caregivers of elderly veterans in poor health produced significant outpatient, inpatient, and total cost savings for the care recipients, and were cost effective.

A Needs Assessment of Latino Men’s Health Concerns:

Historically, Latino men are an understudied group. Researchers know little about the impact of culture or gender on health concerns. In this study, focus groups with Latino men were held that investigated their health concerns, barriers, motivators, and access to health information and health services. Additionally, the researchers wished to determine if a church-based design might help reach men who might not be responsive to more traditional health education or public health routes. Results included that the Latino male participants in this study wanted health information but wanted it to be more specific and in an accessible format. They also desired more Spanish-speaking health care providers and were acutely interested in low-cost health care. Prevention was not of much interest to these participants. Church-attending participants were interested in church-based health education.

Therapeutic Processes in Peer Led and Professionally Led Support Groups for Caregivers

A comparison of peer led and professionally led support groups for caregivers of frail older persons living in the community demonstrates that both types of groups are effective. Findings reveal that it was the opportunity to ventilate pent-up feelings and emotions, the validation of caregiving experiences, the affirmation of coping abilities, the encouragement for continuing to provide care and cope with the situation, the exploration of alternative caregiving arrangements, the mutual support, and the mutual sharing of information about community resources and coping strategies that appeared to be the most helpful therapeutic ingredients of both types of groups. The greater attention to problem solving work and the learning of specific coping skills in the professionally led groups was not reflected in differential outcomes in the two support group conditions.

It used to be that if it weren't broken and bleeding profusely, I would never go to the doctor: men, masculinity, and health.

Masculine gender scripts have been influential in health decision making in men. In addition, although past research has identified some success in using churches as sites for health education with women, little is known if similar programs would be successful with men. It is also unclear if religious beliefs influence the health attitudes and behaviors of men. Four focus groups with men from four religious denominations were conducted to learn about their health beliefs, attitudes, and behaviors, with the following themes emerging: men’s health fears, health promotion behaviors, spousal influence, aging and men’s health, and church-based health influence. Finally, the interaction of masculine gender scripts within these themes was considered.

Adult Protective Services and Animal Welfare: Should Animal Abuse and Neglect Be Assessed During Adult Protective Services Screening?

Past research has examined links among animal abuse, child maltreatment, and intimate partner violence and demonstrated the importance of addressing the needs of both human and animal victims. We hypothesized that there might be a similar link between animal abuse and older adult welfare issues. As a first step in the earlier research was the development of a screening protocol that shed light on the link between domestic violence and animal abuse, we decided to follow a similar route to explore this new topic by asking state government representatives about their experiences, if any, with this topic. Here we report the results of a national survey of state Adult Protective Services agencies regarding their protocols for assessing animal welfare issues in the context of older adult maltreatment. We also describe a model assessment protocol we developed in collaboration with the Utah Division of Aging and Adult Services.

A Critical Perspective on the Role of Psychotropic Medications in Mental Health Courts

Mental health courts represent an opportunity for individuals diagnosed with a mental illness and involved in the criminal justice system to participate in community-based treatment in lieu of incarceration. Individuals who agree to participate also agree to court-ordered mental health treatment that often includes a requirement to take prescribed psychotropic medications. Despite controversies concerning medications’ efficacy and growing evidence of long-term harms, a critical discussion of medications’ role in mental health courts remains absent in the literature. We review current research findings related to psychotropic medications and pose legal and ethical questions of their mandated status in mental health courts. We offer recommendations for mental health courts to adopt evidence-based policies that prioritize participant self-determination in regard to medication-taking and discuss challenges to implementing our recommendations.

Current Perspectives on Latino Men’s Health

Health concerns for Latinos, the largest ethnic minority in the United States, merit attention by policy makers. Given the importance of the Latino population to the economic well-being of the United States, ensuring good health for this group is crucial. Lack of access to health care is the most obvious barrier to maintaining good health for Latinos, but it is not the only important factor. Sociocultural factors, including acculturation, culturally competent health professionals, immigration status, income, and education are also influential to health concerns. Recommendations to decrease health disparities among Latino men include theoretically based health interventions, better integration of research findings, working with local communities, and incorporating Latino masculine values into both health care and health education. Given the importance of the sociocultural factors, the discussion that follows emphasizes these and the interaction of these factors with Latino cultural values.

Aging Men’s Health-Related Behaviors

This conceptual review summarizes the current research on older men and their health-related behaviors with special attention given to the influence of the hegemonic masculinity framework over the life span. The authors consider whether masculinity precepts can be modified to enable men to alter their gendered morbidity/mortality factors and achieve healthier and longer lives. Also included is an overview of the gender-based research and health education efforts to persuade men to adopt more effective health-related behaviors or health practices earlier in the life span. Given the current attention being paid to men’s health, for example, their higher risk of morbidity and mortality both generally and at younger ages, and the associated health care costs tied to those risks, the ethical and economic implications of this review may prove useful.

Latino Health Behavior: An Exploratory Analysis of Health Risk and Health Protective Factors in a Community Sample

Background. Demographic and cultural factors have been found to affect health behaviors in Latinos in both positive and negative ways, but few studies have examined the impact of culture and adherence to machismo norms on health behaviors in a mixed gender community sample of Latinos. Of particular interest was if positive (caballerismo) or negative aspects of machismo would affect Latino health behaviors. Methods. A paper survey was given to a community sample of Latinos in northern Utah to explore the variables that affect both health promoting and health risking behaviors in this cross-sectional study (final N = 144 participants). Results. Life satisfaction, self-reported health, health insurance status, language preference, and gender were significantly related to overall health score. Surprisingly, the cultural variables of fatalism, machismo, and caballerismo were nonsignificant in all analyses. Conclusion. Access to health care mediated by health insurance and self-reported health status may be the most effective way to encourage Latinos to engage in protective health behaviors.