Search

Adolescents who engage in unprotected intercourse are at risk of pregnancy and sexually transmitted infection (STI). Although adolescents in rural areas participate in levels of sexual risk taking similar to that of nonrural youth, few data are available identifying factors that influence condom use among rural adolescents. The purpose of this study is to determine the predictive value of selected personal, environmental, and behavioral factors for condom use among rural adolescents in grades 9-12. A cross-sectional survey was conducted among sexually active youth ("N" = 613), ages 14-19, in three rural school districts in the Northeast. Using logistic regression, identified predictors for condom use include personal standards (odds ratio [OR] = 2.45; confidence interval [CI]: [2.39, 6.47]), condom use goals (OR = 1.32; CI [1.21, 1.45]), condom use at first intercourse (OR = 3.93; CI [2.39, 6.47]) and male gender. School nurses are encouraged to incorporate identified predictors of condom use when considering interventions promoting safer sexual behaviors among rural youth. (Contains 6 tables and 1 figure.)

Community-based participatory research (CBPR) is an approach to research and evaluation that is receiving increased attention in the field of public health. Our report discusses the application of this approach to research and evaluation with an Early Head Start (EHS) program in Pittsburgh, Pa. Our primary purpose is to illustrate the key elements that contributed to effective collaboration among researchers, EHS practitioners, and parents of EHS children in the conduct of the study. The focus is not on research findings but on research process. Our goal is to make the practices of CBPR visible and explicit so they can be analyzed, further developed, and effectively applied to a range of public health issues in a diversity of community contexts.

Purpose: To explore the personal experiences, challenges, and practices of parish nurses in their communities. Method/Design: The overall study used a mixed methods concurrent embedded design to describe parish nurses' experiences with diabetes education and preconception counseling in their practice. Also included were descriptions of generalized practices. Therefore, this current report will focus on these broader experiences. Focus group data were collected using face-to-face, teleconference, and video conferencing formats with 48 nurses who consider themselves to be parish nurses and analyzed with content analysis. Findings: Four qualitative themes were identified in the data: (1) Gaining Entry Through Trust, (2) Enhanced Focus on Spiritual Caring, (3) Accomplishing Much Despite Challenges, and (4) Practice Making a Difference. Parish nurses are uniquely situated to provide holistic care for the mind, body, and spirit of their patients. Despite the many positive aspects, parish nurses experience unique challenges, such as funding their practice and working independently. Conclusions: The parish nurses can play a vital role in providing holistic care to patients in a faith-based community. Future work is needed to address the challenges of parish nurses such as access to continuing education programs related to health topics of concern to their community members. [ABSTRACT FROM AUTHOR]

Purpose American Indian and Alaska Native (AIAN) women are disproportionately affected by gestational diabetes mellitus (GDM). GDM is a risk factor for subsequent diagnosis of type 2 diabetes (T2D) in both mother and offspring, yet there is minimal research being conducted in this population. The purpose of this portion of a larger 5-year study is to examine AIAN women's experiences of having GDM or T2D during pregnancy, inform the development of a GDM risk reduction and preconception counseling (PC) program tailored to AIAN girls, and enhance mother-daughter communication and support within the program. Methods AIAN women with TD2 or a history of GDM (N = 5) were interviewed to understand their unique perspectives on diabetes and pregnancy, behaviors to reduce risk, and content for a PC education program for AIAN girls. Interviews were digitally recorded, transcribed verbatim, and analyzed using the constant comparison method to construct themes across the interviews. Results Four primary themes were constructed: lack of knowledge on GDM and GDM risk factors, importance of AIAN culture for health and wellness, suggestions for communication with AIAN girls to reduce risk of GDM, and the emotional impact of GDM diagnosis. Conclusions Participants wished they had known about risk factors for GDM and how to reduce their own risk of developing GDM. Findings from this study have been used to adapt an existing PC program, originally developed for non-AIAN girls with diabetes, for AIAN girls who do not have diabetes but have risk factors for developing GDM in future pregnancies. [ABSTRACT FROM AUTHOR]

This article examines the role of technical assistance (TA) in supporting the replication of proven HIV interventions. Effective interventions have now been identified across a spectrum of risky behaviors, including unsafe sex, violence, and alcohol and other substance use. The provision of TA helps new users overcome obstacles and encourages ownership and integration of the innovation into practice. The HIV prevention community is increasingly recognizing the role of TA in disseminating knowledge and best practices to communities to improve services at the local level. As an increasing number of effective HIV prevention interventions have been identified, an important component of TA has been the dissemination of information on the types of interventions that work best and under what circumstances. Before getting started, agencies needed guidance to understand how, where, and for whom the intervention would be implemented and to mobilize the support needed for smooth and continued delivery. Although TA requirements may differ according to the characteristics of the intervention, the types of TA provided across the REP interventions were strikingly similar.

This article describes the orientation and training used in one of the Replicating Effective Programs (REP) projects supported by the U.S. Centers for Disease Control and Prevention (CDC) and identifies some critical issues to be considered based on lessons learned. The Real AIDS Prevention Project (RAPP) is a multicomponent, community-based HIV prevention intervention based on research originally funded by CDC as part of the HIV Prevention in Women and Infants Demonstration Projects. RAPP, the model developed by Family Health Council, Inc. in Pittsburgh, Pennsylvania was selected for inclusion in the REP project as an example of this multisite intervention. A community-based social service agency in a small city near Pittsburgh then conducted a trial run of the full intervention package. In addition to the outreach specialist, the RAPP staff consisted of peer network volunteers. Although each of the REP projects had different interventions, audiences, and training, a comparison of experiences identified a number of common issues. As research is translated to practice, orientation and training must build on the materials in the intervention package and serve as a basis for the identification and provision of technical assistance.

The article presents information on the Women and Infants Demonstration Project (WIDP), a behavioral intervention research effort funded by the U.S. Centers for Disease Control (CDC). The major goal of the WIDP is to design, implement, and evaluate a community-level HIV prevention intervention effort that promotes behavioral change in a broad cross section of reproductive-aged women. The WIDP was developed as a refinement and expansion of the AIDS Community Demonstration Projects, an earlier research effort sponsored by the CDC focusing on decreasing behaviors that put people at risk for HIV infection. The WIDP intervention protocols are based on behavioral and social science theory and practice. Social learning theory is the second theoretical base for the WIDP. Initial project activities in each WIDP site included formative research efforts, which involved extensive interviewing of community leaders and residents. A critical component of the WIDP intervention is the production and distribution of community-tailored HIV/STD and pregnancy prevention role-model stories, which are cultural and gender specific.

While there is research on survivors of domestic violence in India and the United States (U.S.), little is known about the sociocultural factors related to domestic violence among Hindu Asian Indian immigrant women (AIIW) in the U.S. The objectives of this study were to a) test the feasibility of conducting domestic violence research among Hindu AIIW; b) investigate domestic violence prevalence and correlations with other characteristics; and c) test the cultural appropriateness of completed measures on social support, acculturation status, and domestic violence. Over 50% of respondents had experienced abuse, often perpetrated by family. Participants had high levels of social support and acculturation, regardless of their abuse status. Participants were receptive to this research, suggesting that domestic violence research among Hindu AIIW is feasible. High prevalence of violence among Hindu AIIW suggests they are at high risk for experiencing abuse; lack of variability in social support and acculturation scale responses suggest the need to further test instruments among Hindu AIIW. [ABSTRACT FROM AUTHOR]