Predictors of HIV Risk Reduction in Adolescent Girls.

PURPOSE: The purpose of the study was to explore the associations among mastery, self-esteem, and HIV risk reduction behaviors in a culturally diverse group of adolescent girls. It is important to identify and assess psychological determinants of HIV risk reduction behaviors such as mastery and self-esteem so that healthcare interventions may be tailored to maximize an adolescent's preventive efforts. STUDY DESIGN AND METHODS: Black, Latina, and White adolescent girls were recruited from an urban primary care setting in a tertiary care center. A descriptive, correlational design was used. Measures included the Pearlin Mastery Scale, Rosenberg Self-Esteem Scale, and the Adolescent Problem Severity Index. Data were collected through written surveys completed anonymously. Data were analyzed using multiple regression analysis. RESULTS: There were 224 participants. Mastery and self-esteem, variables that commonly explain health-enhancing behaviors, were not associated with HIV risk reduction behaviors either in the entire sample or cultural subgroups. There was an inverse relationship between age and HIV risk reduction behaviors in all cultural groups. There were no significant differences in HIV risk reduction behaviors among the three cultural groups. CLINICAL NURSING IMPLICATIONS: Findings suggest HIV prevention efforts by nurses should be universal regardless of an adolescent girl's presumed level of mastery and self-esteem, and that these efforts need to intensify as they age.

Interprofessional Teamwork and Collaboration Between Community Health Workers and Healthcare Teams: An Integrative Review.

OBJECTIVES: Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. METHODS: A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1) shared understanding of roles, norms, values, and goals of the team; (2) egalitarianism; (3) cooperation; (4) interdependence; and(5) synergy. RESULTS: Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamwork. CONCLUSIONS: Four studies identified in this integrative review serve as exemplars for effective interprofessional teamwork between CHWs and health care teams. Further study is needed to describe the nature of interprofessional teamwork and collaboration in relation to patient health outcomes.

Understanding motivations for abstinence among adolescent young women: insights into effective sexual risk reduction strategies.

INTRODUCTION: Pregnancy and sexually transmitted infections pose a significant threat to the health and well-being of adolescent women. Abstinence, when practiced, provides the most effective means of preventing these problems, yet the perspective of abstinent young women is not well understood. The purpose of this investigation was to characterize female adolescents' motivations for abstinence. METHOD: As part of a larger, cross-sectional quantitative study investigating predictors of HIV risk reduction behaviors, qualitative responses from study participants who never had intercourse were analyzed in a consensus-based process using content analysis and frequency counts. An urban primary care site in a tertiary care center served as the setting, with adolescent young women ages 15-19 years included in the sample. RESULTS: Five broad topic categories emerged from the data that characterized motivations for abstinence in this sample: personal readiness, fear, beliefs and values, partner worthiness, and lack of opportunity. DISCUSSION: A better understanding of the motivations for abstinence may serve to guide the development of interventions to delay intercourse.