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American Indian (AI) youth are at increased risk for poor reproductive health outcomes. Parental communication and monitoring are established predictors of sexual risk-taking among adolescents. No program evaluations of sexual risk avoidance programs have focused exclusively on AI youth and parents. This study assesses the impact of the Respecting the Circle of Life (RCL) Teenage Pregnancy Prevention program on parent–youth communication and parental monitoring through a randomized controlled trial with AI youth ages 11–19 and their trusted adults (parents/caregivers) (N  = 518). RCL consists of 8-peer group and one parent–youth session. Trusted adult participants completed the Parental Monitoring Scale and the Parent Adolescent Communication Scale at baseline and 3 and 9 months post-intervention via self-report. Intervention impact was evaluated using linear regression models, which included an indicator for study group. At 3 months post, trusted adults in the intervention reported significantly higher levels of sexual health communication (P  = 0.042) and spoke to their child more often about how to get condoms (P  = 0.001), get birth control (P  = 0.014) and protect themselves from human immunodeficiency virus (P  = 0.005) compared with trusted adults in the control condition. Program impact varied by age and sex. This study adds to literature and extends findings on RCL impact. [ABSTRACT FROM AUTHOR]

Objective To examine child and caregiver anxiety and depression as predictors of children’s perception of pulmonary function, quick-relief medication use, and pulmonary function. Method 97 children with asthma, ages 7 to 11 years old, reported their anxiety and depressive symptoms and completed spirometry. Caregivers completed a psychiatric interview. Children’s predictions of their peak expiratory flow were compared with actual values across 6 weeks. Quick-relief medication use was assessed by Dosers. Results Children’s anxiety symptoms were associated with over-perception of respiratory compromise and greater quick-relief medication use. Children’s depressive symptoms were associated with greater quick-relief medication use, but not perception of pulmonary function. Children of caregivers with an anxiety or depressive disorder had lower pulmonary function than children of caregivers without anxiety or depression. Conclusions Child anxiety was associated with a subjective pattern of over-perception. Caregiver anxiety and depression were risk factors for lower lung function assessed by objective measurement. [ABSTRACT FROM AUTHOR]

Objective To further test the validity of the Biobehavioral Family Model (BBFM), a biopsychosocial approach to explaining the effects of family processes on illness, by testing the model with adolescents with asthma involved in child protective services (CPS), a sample for whom the model’s constructs are highly relevant. Methods Data are from the National Survey of Child and Adolescent Well-Being, CPS sample (n = 5,501). Adolescents with asthma (n = 101, ages 11–15 years) self-reported their negative family emotional climate (NFEC; caregiver psychological aggression and caregiver relationship quality), caregiver–adolescent relational security, and depressive symptoms. Caregivers rated adolescent health quality. Models were tested using path analyses and bootstrapping. Results Path analyses and bootstrapping results demonstrate support for the BBFM in explaining health quality for this sample. Conclusions Applying the BBFM to families involved with CPS demonstrates pathways by which family processes affect health quality of adolescents with asthma, underscoring the need for biopsychosocial assessments and services. [ABSTRACT FROM AUTHOR]

Objective The present study used a case-crossover design to investigate the association of caregiver alcohol consumption and supervision to children's injury occurrence and severity. Method A community sample of 170 mothers of toddlers was interviewed biweekly about their children's daily injuries for a period of 6 months. Results Proximal caregiver-reported alcohol use predicted higher likelihood of injury occurrence and higher injury severity, whereas caregiver-reported supervision predicted lower likelihood of injury occurrence and lower injury seventy. Conclusion Even at low levels, proximal caregiver alcohol use may contribute to higher risk for childhood injuries and more severe injuries. The combined effect of supervision and drinking on injury likelihood warrants further exploration. [ABSTRACT FROM AUTHOR]

Objective To evaluate the relationship between cognitive functioning and medication adherence in children and adolescents with perinatally acquired HIV infection. Methods Children and adolescents, ages 3-18 (N = 1,429), received a cognitive evaluation and adherence assessment. Multiple logistic regression models were used to identify associations between adherence and cognitive status, adjusting for potential confounding factors. Results Children's average cognitive performance was within the low-average range; 16% of children were cognitively impaired (MDI/FSIQ <70). Cognitive status was not associated with adherence to full medication regimens; however, children with borderline/low average cognitive functioning (IQ 70-84) had increased odds of nonadherence to the protease inhibitor class of antiretroviral therapy. Recent stressful life events and child health characteristics, such as HIV RNA detectability, were significantly associated with nonadherence. Conclusion Cognitive status plays a limited role in medication adherence. Child and caregiver psychosocial and health characteristics should inform interventions to support adherence. [ABSTRACT FROM AUTHOR]