Attitude of Parents and Teachers towards Adolescent Reproductive and Sexual Health Education

Objective

To assess parents’ and teachers’ attitude towards Adolescent Reproductive Sexual Health Education (ARSHE).

Methods

The study group consisted of a random sample of 795 parents and 115 teachers belonging to three urban schools (one boys only, one girls only and one co-education) and one co-education rural school at Thiruvananthapuram district, Kerala, where an ICMR supported ARSHE intervention programme was done subsequently. A self-administered questionnaire for parents and teachers developed by an ICMR taskforce for ARSHE programme was used to assess their opinion on the need, content and the appropriate person to provide adolescent reproductive sexual health education in a school setting.

Results

65.2% of parents and 40.9% teachers have not discussed growth and development issues with their adolescents. Only 5.2% teachers and 1.1% parents discussed sexual aspects with adolescents. 44% of parents agreed that information on HIV/AIDS/STD should be provided. More than 50% of parents were not sure whether information on topics like masturbation, dating, safe sex, contraceptives, pregnancy, abortion and childcare should be provided to adolescents.

Conclusions

Results pointed out the need for introducing reproductive and sexual education in the school setting. Only 1.1% of parents and 5.2% teachers actually discussed sexual aspects with adolescents which highlights the need for parent and teacher awareness programs before ARSHE is introduced in the schools.

     

Influences of Chronic Physical and Mental Health Conditions on Child and Adolescent Positive Health

ObjectivePediatric positive health refers to children's assessments of their well-being. The purpose of this study was to contrast positive health for children aged 8 to 17 years with and without chronic physical and mental health conditions.MethodsData were drawn from the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) research program. Participants included 1764 children ages 8 to 17 years from 13 ECHO cohorts. We measured positive health using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global Health and Life Satisfaction patient-reported outcome (PRO) measures. We used multiple regression to examine cross-sectional associations between the PROs and parent-reported health conditions and sociodemographic variables. We defined a meaningful difference in average scores as a PROMIS T-score difference of >3.ResultsThe sample included 45% 13 to 17-year-olds, 50% females, 8% Latinx, and 23% Black/African-American. Fifty-four percent had a chronic health condition. Of the 16 chronic conditions included in the study, only chronic pain (β = -3.5; 95% CI: -5.2 to -1.9) and depression (β = -6.6; 95% CI: -8.5 to -4.6) were associated with scoring >3 points lower on global health. Only depression was associated with >3 points lower on life satisfaction (β = -6.2; 95% CI: -8.1 to -4.3). Among those with depression, 95% also had another chronic condition.ConclusionsMany children with chronic conditions have similar levels of positive health as counterparts without chronic conditions. The study results suggest that negative associations between chronic conditions and positive health may be primarily attributable to presence or co-occurrence of depression.     

Controlled Trial of a Brief Cognitive–Behavioural Intervention in Adolescent Patients with Depressive Disorders

Fifty-three child and adolescent psychiatric patients with depressive disorders were randomly allocated to brief cognitive-behaviour therapy (CBT) or to a control treatment, relaxation training. Forty-eight patients completed the treatment phase of the trial, which comprised 5–8 treatment sessions. Post-treatment assessments showed a clear advantage of CBT over relaxation on measures of both depression and overall outcome. However, there were no significant differences between the treatments on comorbid anxiety and conduct symptoms. At follow-up, the differences between the groups were reduced, partly because of a high relapse rate in the DTP group and partly because subjects in the relaxation group continued to recover.     

Parental Experiences Transitioning Their Adolescent With Epilepsy and Cognitive Impairments to Adult Health Care

IntroductionThe objective of this study was to explicate processes that parents of adolescents with epilepsy and cognitive impairments undergo as they help their adolescents transition to adult health care.MethodA qualitative grounded theory methodology was used in this study. Theoretical sampling techniques were used to recruit seven ethnically diverse parents of adolescents 18 years or older with epilepsy and cognitive impairments from the community in a large metropolitan area in the southern United States. Data collection and analysis occurred simultaneously using coding and constant comparison analysis.ResultsThe substantive theory Journey of Advocacy was developed from interviewing the participants. The theory has five categories: crisis sparks transition, parents in turmoil, parents as advocates, web of information, and captive waiting. Parents emerged as strong advocates in the transition process.DiscussionTransitioning this group of adolescents to adult health care was an unplanned, complex, multisystem process. This study affirms the need to develop a transition program that acknowledges the unique challenges of transitioning adolescents with cognitive impairments and the interrelationship between these parents and other systems.     

Adolescent physical activity and inactivity vary by ethnicity: The National Longitudinal Study of Adolescent Health.

OBJECTIVES: To determine the extent to which physical activity and inactivity patterns vary by ethnicity among subpopulations of US adolescents. STUDY DESIGN: Nationally representative data from the 1996 National Longitudinal Study of Adolescent Health of >14,000 US adolescents (including 3135 non-Hispanic blacks, 2446 Hispanics, and 976 Asians). METHODS: Hours per week of inactivity (TV viewing, playing video or computer games) and times per week of moderate to vigorous physical activity were collected by using questionnaire data. Multinomial logistic regression models of physical activity and inactivity were used to adjust for sociodemographic factors. RESULTS: Large ethnic differences are seen for inactivity, particularly for hours of television or video viewing per week (non-Hispanic blacks, mean = 20.4; non-Hispanic whites, mean = 13.1). Physical activity (>/=5 bouts of moderate to vigorous physical activity per week, 5-8 metabolic equivalents) is lowest for female and minority adolescents. Ethnic differences are far greater for inactivity than for moderate to vigorous physical activity. CONCLUSION: Minority adolescents, with the exception of Asian females, have consistently higher levels of inactivity. Results vary by sex; males have higher inactivity and physical activity, whereas lowest physical activity is found for non-Hispanic black and Asian females, although Asian females also have low inactivity and low levels of overweight. Overall, efforts to reduce the problem of adolescent overweight should focus on increasing activity levels of adolescents, particularly female, older, and major minority subpopulations.     

Effectiveness of a Reproductive Sexual Health Education Package among School Going Adolescents

Objective

To assess the effectiveness of a school based “Adolescent Reproductive Sexual Health Education (ARSHE) Package” in improving students’ knowledge on reproductive sexual health matters.

Methods

An ARSHE package originally developed at Child Development Centre, Kerala, modified and approved by ICMR taskforce group was administered in three urban schools (One boys only, one girls only and one co-education) and one co-education rural school at Thiruvananthapuram district, Kerala. The study sample consisted of 1,586 adolescents including 996 boys and 560 girls of class IX and XI. Pre and post intervention knowledge regarding reproductive sexual health matters was assessed using a self-administered questionnaire.

Results

In the pre-intervention period, it was observed that majority of adolescents were poorly informed about reproductive sexual health matters, particularly about contraceptives. As compared to boys, girls had much poorer knowledge about prevention of pregnancy and after intervention; there was a statistically significant increase in the knowledge in both boys and girls. Among girls percentage of poor knowledge had reduced significantly from 64.1% to 8.3% and among boys from 37.7% to 3.5%. Similarly, increase in knowledge level was also observed in various other aspects of reproductive and sexual health including, STI, HIV/AIDS and perceptions about premarital sex.

Conclusions

The study results revealed the feasibility and effectiveness of school based reproductive and sexual health education intervention programs for adolescents.

     

Examining the Efficacy of Short-Term NDT Intervention Using a Case Study Design:

The efficacy of short-term neurodevelopmental treatment (NDT) intervention was examined using a case study design. A methodology described in Part 1 of this article was developed to measure progress after an eight-week thereapy program that included pre-and posttest measures of motor skills and movement quality as well as weekly therapist and parent observations. This article describes the resutls of the eight-week NDT intervention program on three case examples. They include a two-year-old child with spastic deplegia, a six-year-old child with right hemiparesis, and a 12-month-old with spastic quadriplegia, severe hearing and visual impairments, and severe feeding disorder. Gains observiced after the eight week NDT therapy program are discussed in detail.     

User Preferences for the Design of a Mobile Health System to Support Transition-Age Youth With Epilepsy

BackgroundTransition-age youth with epilepsy (TAYWE) experience poor self management and adverse health outcomes. The purpose of this study was to gain the perspectives of TAYWE, their caregivers, and clinicians to inform the design of a mobile health (mHealth) system to support the self-management needs of TAYWE.MethodsIndividual semi-structured interviews and focus groups were conducted with TAYWE, their caregivers, and clinicians who manage their care.ResultsSixteen TAYWE and seven caregivers participated in focus group sessions, and four clinicians were interviewed. Participants expressed the need for an mHealth system that addressed privacy, supervision of caregiver involvement, a user-friendly system design, and motivation to sustain ongoing use. Three themes evolved: current mobile app use, mHealth systems features and functions, and implementation concerns.DiscussionData from this study informs the design of an mHealth system to support self-management in TAYWE and identifies important areas for practitioners to address when providing health care to TAYWE.     

The Roles of Teasing and Social Support in Adolescent Internalizing and Externalizing Behavioral Outcomes

The purpose of this study was to better understand the relations between teasing and various internalizing and externalizing outcome variables, as well as the potential for social support to mediate the relations between teasing and these outcome variables. A total of 651 9th–12th grade students in a suburban/semi-rural school district located in the midwestern United States participated in the study. Research has shown that teasing is related to negative outcomes. The present study adds to existing literature by demonstrating a small but statistically significant link between certain types of teasing and distress about that teasing with certain types of risk behavior. An unexpected finding was that higher rates of teasing about academic performance predicted lower rates of risk behavior. Social support was demonstrated to mediate teasing and some externalized outcomes.     

Evaluation of the Implementation of a Multicomponent Intervention to Improve Health Care Provider Communication About Human Papillomavirus Vaccination

Objective

To evaluate the relative use, usefulness, and facilitators and barriers to use as perceived by providers of 5 different components in a human papillomavirus vaccine communication intervention—which was found to be effective at improving human papillomavirus vaccination rates.