Tiffany Chenneville

Challenging the Sounds of Silence: A Qualitative Study of Gay-Straight Alliances and School Reform Efforts

We explore the efficacy of one increasingly familiar strategic intervention designed to disrupt antigay school environments—Gay–Straight Alliances (GSAs). Despite the increasing popularity of GSAs, there has been little research on the ways in which they do—and do not—impact school climate. The ubiquity of antigay and homophobic attitudes throughout schools highlights the importance of documenting the advantages and disadvantages of this tactical intervention. Using research with GSA student members, GSA advisors, high school principals, and district-level administrators from a case study of high schools, we identify school practices that either support or destabilize antigay school environments: Silence and passive resistance, the provision of safe spaces, and attempts and challenges to breaking the silence. We then explore the limitations of current efforts to create safe-school environments for sexual minority youth and end by discussing how systemic school reform efforts could be used to transform the broader social context.

Destabilizing Anti-Gay Environments through Gay-Straight Alliances: Possibilities and Limitations through Shifting Discourses.

Abstract Drawing upon research with Gay-Straight Alliance (GSA) advisors, high-school principals, and two district-level administrators, we examine the potential and limits of the safe-space discourse that encompasses the aims of GSAs. We argue that this discourse conceals heteronormative school environments, which supplies the groundwork for hostility perpetrated against LGBT students. We then delineate three strategies–organizational, pedagogical, and systemic–toward altering the safe-space discourse to a forward-looking, social-justice discourse that fosters the eradication of heteronormative school processes.

The Roles of Religiosity and Spirituality in Moral Reasoning

To better understand the influence of religiosity and spirituality on moral reasoning, 1,037 college students completed a survey including demographic questions, a religiosity measure, a spirituality measure, and Forsyths Ethical Position Questionnaire. Religiosity and spirituality positively correlated with moral idealism, whereas spirituality negatively correlated with moral relativism. However, religiosity and spirituality accounted for a very little variability in moral reasoning, suggesting that they do not directly influence moral reasoning. In addition, female participants reported higher spirituality, but there were no gender differences on a spirituality measure. Future research is needed to examine other factors that may influence moral reasoning.

Medical decisional capacity among children with HIV

Abstract Medical decisional capacity (DC) refers to the ability to understand, appreciate, and make meaningful decisions about ones health. This is an important construct for children living with HIV whose involvement in their medical care has important implications for disease management. In this study, we assessed the relationship among DC, developmental stage, intellectual ability, and social–emotional functioning of children with and without HIV infection (n=50). We hypothesized a positive correlation between variables, but did not expect to find a difference in DC between groups. Results provided partial support for our hypotheses. There was a positive relationship between developmental stage and understanding, which is but one dimension of DC. Children with HIV infection obtained significantly lower scores on measures of intellectual and adaptive functioning, but there was no significant difference in DC between groups. Findings suggest that children living with HIV have the capacity to meaningfully participate in their healthcare despite lower intellectual and adaptive functioning.

Decisional Capacity Among Youth with HIV: Results from the MacArthur Competence Tool for Treatment

We assessed the decisional capacity (DC) of 72 youth with HIV, ages 13-24, using the MacArthur Competence Tool for Treatment, a structured interview that assesses DC along the following dimensions: understanding, appreciation, reasoning, and the ability to express a choice. Using previously established cutoff scores, results suggested 100% of youth were competent in the area of appreciation, but only 62% and 60% were competent in the areas of understanding and reasoning, respectively. Additional descriptive analyses reveal more detailed information regarding specific strengths and weaknesses within each of the dimensions of decisional capacity. These findings have important implications for health literacy initiatives, medical education, and treatment for youth with HIV, and support the need for adherence and secondary prevention interventions that include a decisional capacity component.

Assessing Institutional Ethics Committees in India Using the IRB-RAT

Institutional ethics committees (IECs) are currently still in their infancy in low- to middle-income countries (LMICs), which may have important implications with regard to the oversight of the protection of human participants. Understanding how these IECs currently function is a critical first step in helping LMICs build infrastructures that support the protection of research participants and improve the scientific quality of health research worldwide. We assessed the functioning of the IECs at two medical colleges in Gujarat, India, by administering the Institutional Review Board Researcher’s Assessment Tool (IRB-RAT) to 42 IEC and faculty members. The IRB-RAT includes eight scales assessing various domains related to how investigators and members perceive their ethics committees. Results from t tests revealed significant differences between ideal ratings and descriptive ratings on each of the IRB-RAT scales with ideal ratings being higher than current descriptive ratings on all of the scales (<.001). These findings suggest areas that can be targeted for improvement and also provide important information about the values of Indian IECs.

Decisional Capacity among Minors with HIV: A Model for Balancing Autonomy Rights with the Need for Protection.

The purpose of this article is threefold: (a) to describe the relevant ethical and legal issues associated with decisional capacity among minors and to discuss the importance of these concepts for children and adolescents living with HIV, (b) to provide a framework for assessing the decisional capacity of children and adolescents with HIV, and (c) to present a model for thinking about how to use this assessment data to guide action along the protection-autonomy continuum.

Health-related quality of life and mental health indicators in adolescents with HIV compared to a community sample in the Southeastern US

ABSTRACT Although many studies have investigated the impact of HIV on cognitive, physical, academic, and psychosocial functioning, little is known about the self-perception of health-related quality of life (HRQOL), subjective well-being (SWB), social-emotional well-being, and psychopathology risks of adolescents with HIV. This study aimed to address gaps in the literature by exploring the psychosocial outcomes of adolescents with HIV from a strength-based assessment approach, as opposed to a traditional deficit-based approach. Specifically, we explored the relationship between HRQOL, SWB, social-emotional strengths, and psychopathology symptoms to develop a more comprehensive understanding of the physical and psychological well-being of adolescents with HIV (n = 42) compared to a community-based sample (n = 42) in the Southeastern US. Participants completed self-report measures, and data were analyzed for significant correlations, group differences between adolescents with HIV and a community-based sample, and social-emotional predictors of physical functioning and SWB. For adolescents with HIV, several HRQOL indicators were positively correlated with life satisfaction and social-emotional strengths indicators and negatively correlated with negative affect and psychopathology symptoms. Additionally, there was a significant main effect of parents’ marital status on participants’ perceptions of their social functioning and psychopathology symptoms. When differences in parents’ marital status were controlled for, the overall mean ratings of participants’ HRQOL, SWB, social-emotional strengths, and psychopathology risks did not significantly differ between groups. Furthermore, parents’ marital status and self-rated empathy skills significantly predicted physical functioning of adolescents with HIV, but no significant or meaningful variables were found to predict their SWB. These findings highlight the need for further research on the use of a comprehensive assessment framework to enhance our understanding of the overall well-being of adolescents with HIV.

Disclosure of HIV Status Among Female Youth With HIV

Minority female youth are significantly affected by the HIV epidemic. The purpose of this pilot study was to explore sexual behavior practices, disclosure of HIV status, attitudes about disclosure, and knowledge of HIV disclosure laws among female youth with HIV (YWH). Findings suggest that the majority of YWH studied have been sexually active since their HIV diagnosis, although the nature and extent of sexual activity varied. Rates of nondisclosure to sexual partners varied based on the type of question asked, but at least some of the YWH in this sample reported sexual activity with a partner who was unaware of the participant’s HIV status. YWH appear to be more likely to disclose before, as opposed to after, sexual activity. Although most YWH believe disclosure to sexual partners is important for a variety of reasons, many reasons exist for nondisclosure, including fear of rejection and limited communication skills. The majority of YWH in this sample were aware of the potential legal ramifications of nondisclosure although fear of legal repercussions was not the most important factor related to disclosure. These findings favor the implementation of HIV disclosure interventions over the enactment of HIV criminalization laws as a strategy for reducing HIV transmission.

Decisional capacity and medication adherence among youth with HIV

This exploratory study examined the degree to which decisional capacity (DC) is associated with measures of self-reported medication adherence. We hypothesized that youth with higher levels of DC would report greater levels of antiretroviral medication adherence. Seventy-two (72) youth with HIV aged 13–24 participated in this study. Data collection included administration of the MacArthur Competence Tool for Treatment and measures of adherence (i.e., seven-day self-report interview, visual analog scale, and biological indicators). Data were analyzed using descriptive statistics, intercorrelations, and multiple and Poisson regression analyses. Youth with HIV who exhibited greater understanding of their disease were more likely to report fewer missed doses in the last seven days. Findings build upon literature in the areas of DC and health literacy and highlight the potential utility of enhancing HIV disease understanding among youth with HIV.