Perceived consequences of teenage childbearing among adolescent girls in an urban sample.

PURPOSE: The purpose of this study was to examine the perceived positive consequences of teenage childbearing among female adolescents, and to determine whether perceived consequences of teenage childbearing are associated with other attitudes and sexual risk behaviors. METHODS: The sample consisted of 584 female students attending three urban high schools in Los Angeles, California. The respondents' mean age was 15.8 years, and 72% were Hispanic/Latina. Respondents completed a paper-and-pencil survey assessing their attitudes and risk behaviors relevant to teenage pregnancy. Multiple regression and logistic regression analyses were used to examine the associations between perceived consequences of teenage childbearing and demographic variables, educational variables, parental characteristics, psychosocial variables, attitudes, and sexual behavior. RESULTS: Higher scores on a scale of perceived positive consequences of teenage childbearing were associated with increased risk of sexual intercourse and unprotected sexual intercourse. Higher scores on this scale were found among girls who were Latinas, were non-U.S. natives, had low levels of expected educational attainment, had low parental monitoring, had good communication with parents, and wished to have many children. CONCLUSION: Potential strategies for preventing adolescent pregnancy include educating girls about the difficulties of teenage childbearing, countering their positive illusions about the expected benefits, and teaching them more adaptive ways to meet their emotional needs.     

Prospective association between dieting and smoking initiation among adolescents

PURPOSE: To examine the relation between dieting and smoking initiation among adolescents. DESIGN: Prospective data from a nationally representative study were used. SETTING: Two waves (1994 to 1996) of the National Longitudinal Study of Adolescent Health. SUBJECTS: The sample included 7795 non-Latino Caucasian and non-Latino African-American adolescents. MEASURES: Dieting status was the independent variable and trying smoking and initiation of regular smoking were the dependent variables. Covariates included age, ethnicity, overweight status, false self-perception about being overweight, and availability of cigarettes at home. ANALYSIS: Logistic regression and latent transition analyses were used. RESULTS: Females had a higher prevalence of dieting (55%) when compared with males (25%). Dieting initiation was a significant predictor for initiation of regular smoking among females (OR = 1.94, p = .010), but not among males. Inactive dieting was a significant predictor among males (OR = 1.74, p = .031), but not among females. Compared to nondieters, initiating and consistent female dieters reported a higher probability of transitioning to having tried regular smoking, although results from logistic regression suggested that the association between consistent dieting and initiation of regular smoking was not significant. CONCLUSIONS: There is a positive relation between initiating dieting and initiating regular smoking among females, but among males it is the inactive dieters who show a positive relationship. Results illustrate the importance of examining the association between dieting and the initiation of regular smoking.     

Dieting and smoking initiation in early adolescent girls and boys: a prospective study

OBJECTIVES: This analysis tested the relation between dieting frequency and risk of smoking initiation in a longitudinal sample of adolescents. METHODS: From 1995 to 1997, 1295 middle school girls and boys participated in a nutrition and physical activity intervention study. The prospective association between dieting frequency at baseline and smoking initiation 2 years later was tested. RESULTS: Compared with girls who reported no dieting at baseline, girls who dieted up to once per week had 2 times the adjusted odds of becoming smokers (odds ratio = 2.0; 95% confidence interval = 1.1, 3.5), and girls who dieted more often had 4 times the adjusted odds of becoming smokers (odds ratio = 3.9; 95% confidence interval = 1.5, 10.4). CONCLUSIONS: Dieting among girls may exacerbate risk of initiating smoking, with increasing risk with greater dieting frequency.     

Human papillomavirus vaccine initiation among adolescent girls in high-risk communities

Background

We assessed human papillomavirus (HPV) vaccine uptake among adolescent girls, parents’ intentions to vaccinate daughters, and barriers and facilitators of vaccination in a population at elevated risk for cervical cancer.

Methods

Between October 2007 and June 2008, telephone surveys were conducted with randomly selected parents/guardians of 11-18 year old girls attending public middle and high schools serving economically disadvantaged populations in Los Angeles County.

Results

We surveyed 509 predominantly Hispanic (81%) and African American (16%) parents; 71% responded in Spanish. Overall, 23% reported their daughter had received ≥1 dose of HPV vaccine. Although 93% of daughters had seen a doctor in the past year, only 30% reported that a provider recommended HPV vaccine. Characteristics positively associated with odds of having initiated HPV vaccine were having heard of the vaccine (adjusted odds ratio [aOR] 2.6), belief in vaccine effectiveness (aOR 2.9), and doctor recommendation (aOR 48.5). Negative attitudes toward HPV vaccine (aOR 0.2) and needing more information about it (aOR 0.1) were negatively associated with vaccine initiation. Of those with unvaccinated daughters (n = 387), 62% said they “probably/definitely will” vaccinate within the next year and 21% were undecided or didn’t know; only 11% said they definitely won’t.

Conclusions

About one-quarter of adolescent girls in this at-risk community had initiated HPV vaccine by mid-2008. Provider recommendation was the single most important factor associated with vaccination. Because a substantial proportion of parents remain undecided about HPV vaccine, health care providers can play a key role by providing needed information and offering HPV vaccine to all eligible adolescents.     

Perceived health status among the new urban homeless

Homelessness may be the leading social problem in the United States in the mid 1980s. While there may be anywhere from 250,000 to three million homeless persons, few empirically based published studies are available concerning the correlates of mental and physical health status among the homeless. Los Angeles, where the present study was conducted, has been designated by the U.S. Department of Housing and Urban Development to have one of the largest homeless populations (34,000-50,000) in the U.S. The current study is based on 269 in-depth interviews with homeless men and women in Los Angeles County, California. The homeless were found to be younger, better educated and disproportionately non-white compared to the profiles of the skidrow homeless of the past decades. Nearly half the men were veterans of military services, including 30% who were veterans of the Vietnam War. Respiratory infections and hypertension were the most prevalent health problems. The data suggest that a large segment of the homeless persons were depressed, 15.6% reported lifetime prevalence of hospitalization for emotional or nervous problems, and 12.6% reported hospitalization for substance abuse disorders. Multiple regression was utilized to test the validity of a perceived health status index as measured among the homeless and to identify the correlates of health. The health index reflect primarily an affliction by a chronic disease, the severity of an acute condition, the duration of depressed mood, and the alcoholism symptomatology. Length of unemployment, education, gender, and number of nights spent in a shelter were the best predictors of poor health in this population. Evidence from this study, as well as others, suggests that efforts should be made to avoid using the term homeless metaphorically. The causes of homelessness are multiple and complex and the resulting subgroups among the homeless population have different problems which require a variety of strategies to meet their needs.     

School connectedness and daily smoking among boys and girls: the influence of parental smoking norms

BACKGROUND: The objective was to test whether an association between school connectedness and smoking exists among Danish school children, and if so, to examine whether parental smoking attitude and parental smoking behaviour influenced this association. METHODS: Data were collected by the Danish contribution to the cross-national study Health Behaviour in School-Aged Children (HBSC) 1998. Analyses were performed on questionnaire-based data from 1537 students at grade nine from a random sample of schools in Denmark. RESULTS: An independent inverse association was found between school connectedness and smoking among both boys and girls. Parents' attitude to their children's smoking significantly modified this association among boys. Among girls the modifying effect was less marked. Neither among boys nor girls did parental smoking behaviour significantly modify the association between school connectedness and smoking, although a modifying tendency was observed among girls. CONCLUSIONS: The smoking behaviour of Danish adolescents may be influenced by complicated interactions of varying sets of experienced smoking norms, and any research project or preventive programme focusing on the influence of school life on adolescent smoking behaviour needs to consider the family smoking norms. Additionally, the results stress the important role of gender by indicating that the smoking behaviour of girls may be more sensitive to restricting social influences than the smoking behaviour of boys.     

A new measure of smoking initiation and progression among adolescents

OBJECTIVE: To develop a new measure of smoking initiation and progression among adolescents. METHOD: This study used data from 2504 regular and alternative high school students to evaluate the psychometric properties of a new 3-item, 5-stage measure of smoking initiation and progression. RESULTS: The categorization method showed good 4-week test-retest reliability (.83 among boys and .87 among girls). The demographic distribution of adolescents into stages was consistent with previous research. CONCLUSION: This 5-stage classification method could be a useful framework for describing variation along the smoking up-take and progression continuum.     

Perceived smoking prevalence at school-level and children's smoking initiation: a multi-level analysis of a cross-sectional data in Taiwan

OBJECTIVES: Literature on the influence of smoking prevalence at school-level on the smoking initiation among elementary school children is scarce. The aim of the current study was to explore this in school clusters stratified according to student's perceived smoking prevalence in the school while adjusting for social impact of individual students. METHOD: The data was obtained from a survey administered to 13 elementary schools in Taoyuan County, a final sample of 1585 3rd and 4th grade students. Multi-level logistic regression analysis (MLRA) was used to examine the influence variable at school-level as well as individual socio-environment level had on smoking status of elementary schools students. RESULTS: Attending a school where the students reported a perception of high smoking prevalence had a greater effect on smoking behavior in boys than girls when compared with students attending a lower smoking prevalence school, after adjustment for student-level characteristics. CONCLUSIONS: Our study confirmed that a broader school environment with a high student perception of smoking prevalence is associated with children's smoking behavior in boys. The findings further indicate the need for enforcement of anti-smoking policies within schools with higher smoking rates to reduce visibility of smoking among school children.     

Perceived risks and benefits of smoking: differences among adolescents with different smoking experiences and intentions

BACKGROUND: Explanations of adolescent smoking often make reference to adolescents' beliefs that they are invulnerable to harm. However, empirical examination of whether adolescents do acknowledge risks. Further, few studies have considered perceived benefits in adolescents' behavioral decisions. This study examined perceived smoking-related physical and social risks and benefits between adolescents who have vs. have not smoked and do vs. do not intend to smoke. METHODS: Three hundred and ninety-five students (mean age = 14.0) completed a survey concerning their smoking experiences, intentions, and perceived risks and benefits of smoking. RESULTS: Adolescent smokers and those who intend to smoke estimated their chance of experiencing a smoking-related negative outcome as less likely than did nonsmokers and non-intenders. Smokers and intenders also reported the chance of addiction as less likely than did others. In contrast, adolescent smokers and intenders perceived the chance of experiencing a smoking-related benefit as more likely than did nonsmokers and non-intenders. CONCLUSIONS: The data suggest that rather than solely focusing on health risks as a way to deter adolescent smoking, the role of perceived social risks and benefits in adolescents' smoking may be an additional critical focus for intervention. In addition, efforts should be made to increase adolescents' awareness of the addictive nature of cigarettes.     

What girls need: recommendations for preventing violence among urban girls in the US

The last decade saw increases in arrests of girls for violent behavior and a corresponding concern that girls' involvement in violence was increasing in the USA. However, there are few empirical studies of the dynamics of violence by girls, leaving providers of violence prevention programs and policy-makers without evidence on which to base gender-appropriate prevention strategies. To address this gap, qualitative interviews were conducted with a diverse sample of 61 urban girls aged 11-17. Findings were compared with quantitative interviews from the prospective cohort of 961 girls from whom these respondents were drawn, from the Project on Human Development in Chicago Neighborhoods. Mixed-method techniques were employed. Qualitative data were analyzed for girls' recommendations for preventing involvement in violence. Data from the larger cohort were used to test these recommendations quantitatively. Due to study design, in the qualitative sample, 36 girls (64%) were involved in recent violence, most often with or against other girls. Pro-social behavior was common among both violent and nonviolent girls. In the overall cohort sample, 24.9% of girls reported violent perpetration and 97% reported pro-social activities. Eight themes regarding staying safe and preventing violence emerged from the qualitative interviews: girls stayed safe by staying home, avoiding dangerous people, staying busy with after-school activities, remaining calm when confronted, using escorts, and fighting back if attacked. Girls' protective influences included: empathic parental involvement, positive relationships with peers and older youth, and involvement in safe and constructive activities. These findings emphasize that safety in community, school, and family settings is critical for girls in avoiding violence and other risky behaviors. Violence prevention programs should focus on enhancing girls' relationships with mothers, older girls, and friends their age.     

成都市城市居民吸烟、被动吸烟及成功戒烟现状调查

目的了解四川省成都市城市居民吸烟、被动吸烟及成功戒烟现状, 为制定新的控烟措施提供参考依据。方法采用整群随机抽样方法对在成都市6个主城区抽取的4 994名18~69周岁城市居民进行问卷调查。结果成都市城市居民的吸烟率为25.31%(1 264/4 994),被动吸烟率为48.78%(1 482/3 038),成功戒烟率为10.65%(107/1 005);成都市不同特征城市居民比较, 不同性别、年龄、文化程度、职业城市居民吸烟率、被动吸烟率、成功戒烟率差异均有统计学意义(均P<0.001)。结论成都市居民的吸烟率较低, 但被动吸烟率较高, 且成功戒烟率不高。     

Perceived,expressed and observed prosociality among four-year-old girls and boys in childcare centres

This article examines the prosociality of four-year-old girls and boys in childcare centres. More specifically, it aims to measure gender differences in prosociality among children, based on three sources and methods of evaluation: (1) the early childhood educator's (ECE) perception (perceived prosociality), (2) the children's own responses to hypothetical interpersonal problem-solving situations (expressed prosociality) and (3) observation of the children's prosocial behaviour during symbolic play with a peer (observed prosociality). In line with many studies in this field, the results show that girls are perceived by their ECEs as being more prosocial than boys. However, analyses of the data on expressed prosociality and observed prosociality did not reveal a significant gender effect. These results are discussed with respect to the influence that differential perceptions based on gender have on the assessment of children's prosociality. Some possible explanations for this gender gap, particularly in educational contexts, are put forward.     

Cigarette smoking and cessation behaviors among urban blacks and whites

Smoking behaviors among blacks and whites were studied in a population-based sample of 2,626 residents of Minneapolis-St. Paul, MN. More blacks than whites were found to be smokers, before and after adjusting for age and education differences. More whites than blacks were former smokers, but the prevalence of those who had never smoked was comparable for whites and blacks. Among smokers, the mean number of cigarettes smoked per day was lower among blacks than whites, but more blacks were found to smoke cigarettes with high "tar" (dry particulate matter) and nicotine content. Men smokers were found to smoke more than women smokers, young people smoked more than older people, and those with a high school education or less smoked more than those with more than a high school education. Smoking cessation behavior consisted mostly of a variety of strategies that began with reducing cigarette consumption, followed by changing to lower tar brands, attempting to quit, and actually quitting. In general, a higher percentage of whites than blacks reported smoking cessation behaviors. A greater percentage of white than black women had tried cigarette brands lower in tar and nicotine within the previous year. Among men, a lower percentage of black than white smokers had tried quitting, and fewer black men planned to quit in the future. Blacks appeared to lag behind whites in their efforts to quit smoking. Smoking behavior continues to be problematic for both blacks and whites. Studies are needed to explain better the racial differences in smoking and smoking cessation behaviors, and to facilitate programs to encourage cessation.     

Parent perceptions important for HPV vaccine initiation among low income adolescent girls

Objective

The study aims were to assess the influence of provider recommendations on parental vaccine perceptions and identify the most potent parent vaccine perceptions for HPV vaccine series initiation considering provider recommendation strength.

Methods

We administered a questionnaire and assessed HPV vaccine claims among a stratified-random sample of parents of 9–17 year old girls enrolled in Florida's Medicaid and the Children's Health Insurance Program. Using multivariate analyses, we evaluated the associations between: (1) parent vaccine perceptions and provider recommendation strength, and (2) parent vaccine perceptions and HPV vaccine series initiation (≥1 vaccine claim or positive parental report) controlling for provider recommendation strength.

Results

The majority of the 2422 participating parents agreed that the HPV vaccine was safe (61%), would not make girls more likely to have sex (69%), and prevented cervical cancer (71%). About half (44%) reported receiving a strong provider recommendation. Compared to parents without recommendations, parents with strong recommendations had 2 to 7 times higher odds of agreeing that: vaccines are safe, the HPV vaccine is safe, not concerned about side effects, and the vaccine prevents cervical cancer. Even when considering provider recommendation strength, HPV vaccine series initiation was more likely among girls of parents who agreed rather than disagreed that the HPV vaccine was safe [odds ratio (OR) = 5.8, 95% confidence interval (CI) = 3.1, 11.1], does not cause sex (OR = 2.0, 95% CI = 1.2, 3.4), prevents cervical cancer (OR = 2.0, 95% CI = 1.0, 3.4), and prevents HPV infections (OR = 1.8, 95% CI = 1.0, 3.0).

Conclusions

Parent concerns about HPV vaccine are similar to their concerns about other vaccines. Providers should focus HPV vaccine discussions with parents on vaccine safety and illness prevention.     

Perceived neighborhood environment and walking for specific purposes among elderly Japanese

Background

Recent research has revealed the importance of neighborhood environment as a determinant of physical activity. However, evidence among elderly adults is limited. This study examined the association between perceived neighborhood environment and walking for specific purposes among Japanese elderly adults.

Methods

This population-based, cross-sectional study enrolled 1921 participants (age: 65–74 years, men: 51.9%). Neighborhood environment (International Physical Activity Questionnaire Environmental Module) and walking for specific purposes (ie, transportation or recreation) were assessed by self-report. Multilevel logistic regression analyses with individuals at level 1 and neighborhoods at level 2 were conducted to examine the association between environment and walking, after adjustment for potential confounders.

Results

Access to exercise facilities, social environment, and aesthetics were associated with total neighborhood walking. Odds ratios (95% CI) were 1.23 (1.00–1.51), 1.39 (1.14–1.71), and 1.48 (1.21–1.81), respectively. Regarding walking for specific purposes, social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Environmental correlates differed by specific types of walking and by sex. Transportation walking significantly correlated with a greater variety of environmental attributes. Sex differences were observed, especially for transportation walking. Bicycle lanes, crime safety, traffic safety, aesthetics, and household motor vehicles were significant correlates among men, while access to shops, access to exercise facilities, and social environment were important among women.

Conclusions

Specific environment–walking associations differed by walking purpose and sex among elderly adults. Social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Improving these environmental features might be effective in promoting physical activity among elderly Japanese.Key words: physical activity, transportation, recreation, policy     

Sexual initiation among adolescent girls and boys: trends and differentials in sub-Saharan Africa

This paper examined trends in adolescent sexual initiation in sub-Saharan Africa, with emphasis on differentials in social determinants across gender and contexts. Data were drawn from Demographic and Health Surveys in 8 countries that had at least 2 surveys conducted approximately 5 years apart, each with distinct questionnaires for women and men of reproductive age regardless of marital status. The data were useful both for testing of substantive hypotheses about the correlates of adolescent sexual intercourse as well as for elaborating sexual health interventions in contexts of development. The main analytical tool was multivariate logistic models using a generalized estimating equation to consider the probability of a young man or young woman having first intercourse during adolescence. In some countries, observed declines over time in the proportion of adolescents having had sex were not statistically significant after taking into account changes in background characteristics, especially education. Important gender differentials were also found. While secondary schooling was associated with lower probability of early sex among girls in all countries, the relationship was often in the opposite direction among boys. Influences of other sociodemographic and community status variables were generally less important.     

中国城市青少年学生吸烟流行现状

目的了鳃我国青少年吸烟流行现状。方法全国18个省、自治区和直辖市采取多阶段整群随机抽样方法，随机抽取城市大、中学生集体填写匿名问卷。结果213253名大、中学生参与调查，其中男生占48．5％（103483／213253），女生占51．5％（109770／213253）。大、中学生中33．1％尝试吸烟，13．3％现在吸烟，2．0％重度吸烟；16．6％首次吸烟年龄≤13岁。男生、高年级学生、职业高中学生、重组和其他家庭的学生吸烟行为报告率较高。结论我国青少年开始吸烟年龄较早。男性青少年吸烟行为严重，但女性上升趋势明显。