Interpregnancy Interval and Birth Outcomes: A Propensity Matching Study in the California Population

Maternal and Child Health Journal - Previous studies that used traditional multivariable and sibling matched analyses to investigate interpregnancy interval (IPI) and birth outcomes have reached...     

Impact of a longitudinal community HIV intervention targeting injecting drug users' stage of change for condom and bleach use

PURPOSE: To evaluate the impact of the Long Beach AIDS Community Demonstration Project, a community-based HIV-prevention intervention incorporating principles from the Transtheoretical model in its design and evaluation. DESIGN: Repeated cross-sectional sampling with matched intervention and comparison communities. SETTING: Neighborhoods in Long Beach, California, having a high prevalence of drug abuse and prostitution. SUBJECTS: 3081 injecting drug users who were sexually active and/or shared injection equipment. INTERVENTION: Trained peer volunteers distributed fliers featuring role model stories targeted to the population's stage of change. Fliers were packaged with bleaching kits and/or condoms. MEASURES: Primary outcome measures were exposure to the intervention, condom carrying, and stage of change for disinfecting injection equipment with bleach and for using condoms with main and other partners. RESULTS: Toward the end of the study, 77% of injection drug users in the intervention area reported being exposed to the intervention. In the intervention area, rates of condom carrying increased from 10 to 27% (p < .001), and there was an increase from 2.32 to 3.11 in mean stage of change for using condoms with other partners, while stage of change decreased in the comparison area (p < .01). Mean stage of change for using condoms with a main partner also increased in the intervention area, but the difference was not significant after controlling for change in the comparison area. Subjects with recent project exposure had higher stage-of-change scores for using condoms with a main partner (p < .05) and other partners (p < .01) and for cleaning injection equipment with bleach (p < .05). CONCLUSIONS: The results demonstrate the effectiveness of the AIDS Community Demonstration Project intervention for reaching injecting drug users in the community and for motivating the adoption of risk-reducing practices.     

Substance abuse risk reduction: Verbal mediational training for children by parental and nonparental models

Little is known regarding the etiology and maintenance of substance abuse, especially factors which place children at higher risk for later drug use. The present study evaluated the impact of a 12‐week verbal mediational program (Think Aloud), which teaches children and parents cognitive and social problem‐solving skills and addresses early childhood risk factors related to the onset of drug use in adolescence. Fifty children and parents were included in the present study and were randomly divided into four groups: two groups received either a verbal mediation condition comprising the Think Aloud training or time to complete homework assignments. Each of the topic groups was subdivided into two groups, one in which the parents served as models and one in which the experimenter served as the model. Measures of family cohesion, expressiveness, and conflict, family organization and control, social skills, level of disruptiveness of the child's peer choice, academic competence, and the child's problem behaviors were administered to the parents and the teachers pre‐ and postinterventivefy. Children in the verbal mediation condition with parental models were expected to show the greatest reduction in risk factor scores, and children in the verbal mediation condition with the experimenter model were predicted to show the second greatest reduction in risk factor scores at posttest. Results of the study demonstrated partial support for experimental hypotheses in that the children involved in the Think Aloud program showed improvement on four of the six factors on posttest measures. The superiority of the parental model was not found.     

Perceived Family and Friend Support and the Psychological Well-Being of American and Chinese Elderly Persons

This study examines two sources of informal support??perceived family and friend support??and the psychological well-being??self-esteem, depression and loneliness??of 150 Chinese and 145 American elders. There were no significant differences between the elderly American and Chinese persons?? mean scores on family and friend support. The multiple linear regression analyses with interaction terms (country x family support and country x friend support), however, indicated that the relationship between family support and depression and family support and loneliness was stronger for the Chinese elderly than the US elderly. Conversely, the relationship between friend support and depression and friend support and loneliness is stronger for US elderly than Chinese elderly. The implications of these findings for social work practice in both countries is discussed.