Asian American Women's Recall of Conversations With Their Mothers About Sexual Health: A Secondary Analysis of Qualitative Data.

ABSTRACT: Between 2010 and 2016, Asian Americans (AA) had a 35% increase in HIV diagnosis. Although mother-daughter sexual communication was found to be protective in minority populations, the opposite is true among AAs. The purpose of this study was to explore AA women's experiences of sexual communication with their mothers. Secondary qualitative analysis using analytic expansion with a phenomenological approach was used. Thematic analysis was used to search for common patterns and themes that emerged using qualitative description methodology. Twenty East and Southeast AA cisgender women, ages 18-33 years, were interviewed. The primary finding was an intergenerational gap with two themes: (a) mothers' attitudes about sexual communication and (b) content of sexual communication. Indirect sexual communication included cautionary messages consistent with previous studies. AA mothers' strong cultural beliefs created a barrier to communication. Future research should focus on the young women who want open sexual communication and could influence the next generation.

Community gender systems and a daughter's risk of female genital mutilation/cutting: Multilevel findings from Egypt.

We tested a feminist social-ecological model to understand community influences on daughters' experience of female genital mutilation/cutting (FGMC) in Egypt, where over 90% of women ages 15-49 are cut. FGMC has potential adverse effects on demographic and health outcomes and has been defined as a human-rights violation. However, an integrated multilevel-level framework is lacking. We theorized that a more favorable community-level gender system, including stronger gender norms opposing FGMC and expanded extra-familial opportunities for women in the village or neighborhood, would be associated with a daughter's lower risk of FGMC and would strengthen the negative association of a mother's opposition to FGMC with her daughter's risk of cutting. Using a national sample of 14,171 mother-daughter dyads from the 2014 Egypt Demographic and Health Survey, we estimated multilevel discrete-time hazard models to test these relationships. Community gender norms opposing FGMC had significant direct, negative associations with the hazard that a daughter was cut, but women's opportunities outside the family did not. Maternal opposition to FGMC was negatively associated with cutting a daughter, and these associations were stronger where community opposition to FGMC and opportunities for women were greater. Results provided good support for a gender-systems framework of the multilevel influences on FGMC. Integrated, multilevel interventions that address gender norms about FGMC and structural opportunities for women in the community, as well as beliefs about the practice among the mothers of at-risk daughters, may be needed for sustainable declines in the practice.

Protecting young Black female sexuality.

In the USA, Black girls and women face significant health disparities and disproportionately experience violence, racism, discrimination, stereotype messaging and elevated STI/HIV rates. Research shows the importance of familial systems and effective communication in decreasing risky behaviours among Black girls. This grounded theory study explored the sociocultural conditions that influence the process of becoming a sexual Black woman. Analytic results of interviews with 20 Black women identified protection as a major category associated with Black female sexual development and related risk behaviour. This paper describes the role of Black women as protectors of young Black female sexuality, the sociocultural protective strategies they used across the life course and the consequences of absent protection. Findings can inform future evidence-based, culturally sensitive interventions to promote the sexual health and development of Black girls and women in the USA.

'He supported me 100%': Mexican-immigrant fathers, daughters, and adolescent sexual health.

Objective: First and second generation Mexican-origin adolescents in the U.S. face social and economic disadvantage and sexual health disparities. Although fathers can support child and adolescent development, the literature has portrayed Mexican-origin immigrant fathers as emotionally distant and sexist. This study aims to treat migration as a social determinant of health to examine father-daughter relationships and adolescent sexual health in Mexican-origin immigrant families.Methods: Integrating qualitative data from life history interviews with 21 Mexican-origin young women in immigrant families with quantitative data on first and second generation Mexican-origin young women in the National Longitudinal Study of Adolescent to Adult Health, this study describes father-daughter relationships, examines the association between father-daughter relationships and daughters' early sexual initiation, and considers the impact of migration on the father-daughter relationship and sexual health among Mexican-origin young women.Results: Qualitative data identify four types of father-daughter relationships: 'good,' hostile, distant, and conflicted. Supporting the qualitative patterns, quantitative data find that positive or 'good' father-daughter relationship quality is significantly associated with reduced risk of early sexual initiation. Importantly, father-daughter separation across borders and economic inequality facing immigrant families is associated with hostile or distant father-daughter relationship quality and increased risk of early sexual initiation.Conclusions: Reports of good father-daughter relationships are common and may protect against early sexual initiation in Mexican-origin immigrant families. Policies that keep families together and reduce economic inequality among immigrants may also reduce sexual health disparities among immigrant adolescents.

Widening cracks in patriarchy: mothers and daughters navigating gender norms in a Mumbai slum.

Inequitable gender norms can be harmful to girls' and boys' health and sexuality. Programmatic approaches that help renegotiate gendered power relationships are sorely needed. This qualitative study reveals how Parivartan, a sport-based intervention in a Mumbai informal settlement, helped families resist inequitable gender norms that limited girls' mobility in public spaces. Fifteen girl athletes were interviewed in two rounds of face-to-face in-depth interviews. Results identify the strategies girls' mothers used to support their daughters' participation in the programme when they feared their husbands' disapproval. Rather than openly confronting their husbands, mothers worked from within the patriarchal gender order, through its 'cracks', for instance initially hiding their daughters' participation from their husbands. At an appropriate moment, girls' mothers revealed to their husbands about their daughters playing sports, convincing them of the usefulness of the programme. Girls' participation profoundly and positively affected relationships between daughters, mothers and fathers. Over time, parents' trust that girls would not compromise family honour increased, eventually changing the acceptability of girls' playing sport in public in spite of the patriarchal gender order. Concluding remarks offer key implications for effective interventions, highlighting the historical nature of gender transformation processes.

"Like a mother-daughter relationship": Community health intermediaries' knowledge of and attitudes to abortion in Karnataka, India.

Community Health Intermediaries (CHIs)- ANMs, ASHAs, and pharmacists- are key to realising task-sharing efforts to increase abortion access in LMICs, but their knowledge of and attitudes to abortion remains underexplored. Evidence on abortion task-sharing has focused primarily on CHIs' technical and clinical abilities, overlooking social contexts and norms that influence attitudes and behaviours. This mixed-methods study describes the abortion knowledge, attitudes, and roles of three cadres of CHIs in rural districts of Karnataka, India. Quantitative data on CHIs' abortion attitudes (n = 118) were collected using the Stigmatising Attitudes, Behaviours, and Actions Scale (SABAS), followed by in-depth interviews (n = 21) with a subset of the population over eight months in 2017. Findings show that CHIs, present at multiple points in women's abortion trajectories, serve as barriers or facilitate access to abortion care. Their abortion attitudes reflect social contexts and environments, drawing on social norms surrounding fertility, woman- and mother-hood. They demonstrate poor knowledge of abortion laws, conflating them with sex-selection laws. CHIs also reflect poor knowledge of abortion methods. They report little to no training on abortion. CHIs contend with entrenched social and structural inequalities in carrying out their tasks, affecting the kind and quality of care they are able to provide. Understanding CHIs' experiences, knowledge and attitudes can advance abortion care-provision, support task-sharing efforts, and potentially improve the quality of women's abortion-seeking experiences.

Self-Assessment of the Body and Social Competences in the Group of Mothers and Their Adult Daughters.

The main research objective of this study was seeking the predictive role of general self-esteem and the body image in social competences among women and their biological daughters. As it stands, there is a lack of research showing the mothers and their adult daughters at the same time in the context of measuring the same psychological variables, i.e., general self-esteem, self-assessment of the body and specific social competences in the scope of behaviour in intimate situations, situations requiring social exposure and assertiveness. The study group comprised 102 individuals; 51 pairs of mothers (40-64 years old, M = 51.33) and their biological daughters (19-25 years old, M = 22.49). The following instruments were used: The Rosenberg Self-esteem Scale, the Contour Drawing Rating Scale, the Body Esteem Scale, the Social Competence Scale, categorized interview (to measure BMI and collect data describing the criteria for selection to the research group). The significance of the differences and the stepwise regression analysis were performed. The results of the study demonstrated the following to be significant predictors of social competences in subjects: General self-esteem B = 0.615, discrepancy real-obligatory body image B = 0.275 among daughters, and physical condition B = 0.362 in mothers. The general self-esteem of daughters positively influences all verified types of their social competences (competences in intimate situations, in case of social exposure and ability to be assertive). However, it is the significant predictor only for mothers' competences in dealing with situations of social exposure. Discrepancy real-obligatory body image: Seems to be the predictor of daughters' social competences conditioning effectiveness in situations requiring assertiveness. The physical condition among mothers seems to be especially important for their assertiveness and effectiveness in intimate situations. The conflict between the real and the ideal body image is also an important aspect in predicting the assertiveness in the group of mothers. The study results can prove to be helpful in creating preventive and educational programs focused on self-esteem and social competencies in women, including the context of the relation between mothers and their daughters.

Differences between sons and daughters in the intergenerational transmission of wealth.

Persistent interest lies in gender inequality, especially with regard to the favouring of sons over daughters. Economists are concerned with how privilege is transmitted across generations, and anthropologists have long studied sex-biased inheritance norms. There has, however, been no focused cross-cultural investigation of how parent-offspring correlations in wealth vary by offspring sex. We estimate these correlations for 38 wealth measures, including somatic and relational wealth, from 15 populations ranging from hunter-gatherers to small-scale farmers. Although small sample sizes limit our statistical power, we find no evidence of ubiquitous male bias, at least as inferred from comparing parent-son and parent-daughter correlations. Rather we find wide variation in signatures of sex bias, with evidence of both son and daughter-biased transmission. Further, we introduce a model that helps pinpoint the conditions under which simple mid-point parent-offspring wealth correlations can reveal information about sex-biased parental investment. Our findings are relevant to the study of female-biased kinship by revealing just how little normative descriptors of kinship systems, such as patrilineal inheritance, capture intergenerational correlations in wealth, and how variable parent-son and parent-daughter correlations can be. This article is part of the theme issue 'The evolution of female-biased kinship in humans and other mammals'.

Do cultural values have a role in health equity? A study of Latina mothers and daughters.

OBJECTIVES: Recently, there has been a call to better understand Latino health and arrive at effective approaches for achieving health equity via research focusing on the association between cultural factors and health. This study examined whether familism, a cultural value that emphasizes warm and close family relationships, would attenuate the negative effects that perceived stress, a psychological process that can worsen health, can have on two physical health indicators- number of health conditions and bodily pain. METHOD: Latina mothers (n = 85, Mage = 52.68, SD = 6.60) with Type 2 diabetes and their daughters (n = 86, Mage = 27.69, SD = 7.61) whose weight put them at risk for also developing the condition were recruited to take part in a larger intervention study aimed at improving weight loss/dietary intake. Participants completed measures of familism, perceived stress, health conditions, and bodily pain. RESULTS: Results indicated that in the daughters, familism and perceived stress interacted to predict health conditions and bodily pain. As familism decreased, stress was associated with more health conditions and more bodily pain. These interactions were not significant for the mothers. CONCLUSIONS: First, familism has the potential to buffer the negative effect of stress in ways that are protective for health among Latinas at risk for diabetes. Second, this buffering effect has boundary conditions, suggesting that a better understanding is needed of how, for whom, and under what circumstances familism can be beneficial for health. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Father-Son Communication About Consistent and Correct Condom Use.

: media-1vid15852345835001PEDS-VA_2018-1609Video Abstract OBJECTIVES: With this study, we explore communication about consistent and correct condom use among African American and Latino male adolescents ages 15 to 19 and their fathers. METHODS: Twenty-five father-son dyads completed semistructured interviews designed to elicit specific preferences for teaching and learning about consistent and correct condom use and strategies for addressing common condom use errors and problems. For analysis, we used in vivo coding and vertical and horizontal analysis techniques. RESULTS: Fathers and sons agreed that communication about condom use is feasible and acceptable. However, fathers tended to convey vague messages regarding protecting oneself from the negative consequences of sexual activity. Furthermore, both fathers and sons reported barriers hindering conversations. Secondly, the style and frequency of condom use conversations can help overcome barriers and support father-son relationship management. Talking frequently in 1-on-1 settings and using strategies to reduce discomfort made communication easier. Lastly, fathers and sons reported distinct preferences for teaching and learning about condom use. Sons wanted fathers to give specific guidance on the use and management of condoms. Fathers expressed interest in opportunities for improving their own condom knowledge and skills. Fathers identified gaps in their own condom use knowledge as a limitation to effective instruction of their sons. CONCLUSIONS: A father-focused communication intervention about condom use is feasible and acceptable. Enhancing the intergenerational benefits of father-son communication by addressing specific father-son preferences and learning needs for condom use instruction, as well as communication barriers, represents a novel mechanism for reducing male sexual reproductive health disparities.

HPV vaccine acceptance among African-American mothers and their daughters: an inquiry grounded in culture.

BACKGROUND: Much of the research on African-Americans' HPV vaccine acceptance has largely focused on racial/ethnic differences related to cognitive, socio-economical, and structural factors that contribute to differences in HPV vaccine acceptance and completion. A growing body of literature suggest that cultural factors, such as mistrust of healthcare providers (HCPs) and the healthcare system, religion, and social norms related to appropriate sexual behaviors, also plays a prominent role in their HPV vaccine acceptance. However, these studies were limited in their use of theoretical approaches necessary to conceptualize and operationalize culture. OBJECTIVE: To explore the influence of culture on African-American mothers' and daughters' HPV vaccine acceptance using the PEN-3, a culturally-centered conceptual framework. METHODS: Grounded theory techniques were used to explore cultural factors that influenced the acceptance of the HPV vaccine among African-American mothers (n = 28) and their daughters (n = 34). RESULTS: Positive attitudes towards vaccination stemmed from beliefs that the HPV vaccine has cancer prevention benefits and that vaccinations in general protected against infectious diseases. Negative attitudes stemmed from beliefs that the HPV vaccine was too new, not effective, daughters were too young, and that vaccines were not a one-size-fits-all intervention. Majority of mothers and daughters indicated that their religious doctrine did not impede their HPV vaccination decisions. For a few mothers, religious beliefs could not be separated from their HPV vaccination decisions and ultimately deterred HPV vaccine acceptance. HCP recommendations were valued however mothers were often dissatisfied with the detail of information communicated. Support networks provided both positive and negative types of social support to mothers and daughters. The media highlighted the cancer prevention benefits of the HPV vaccine and unintentionally communicated negative information of the HPV vaccine, which deterred HPV vaccine acceptance. CONCLUSION: Study findings can inform the development of culturally appropriate interventions that advances the evidence on cervical cancer prevention.

Clinician offering is a key factor associated with HPV vaccine uptake among Mexican mothers in the USA and Mexico: a cross-sectional study.

OBJECTIVE: To compare the knowledge, beliefs, and practices regarding HPV vaccination among mothers of vaccine-eligible girls in Mexico and the USA. METHODS: Similar samples of Mexican mothers with vaccine-eligible daughters were surveyed at two clinics in Cuernavaca, Morelos, from July to October 2012 (n = 200) and at two clinics in Oxnard, California, from August to November 2013 (n = 200). RESULTS: Although mothers in the USA had less knowledge and more negative attitudes toward the vaccine than their counterparts in Mexico, vaccine uptake rates were higher in the USA (49% vs. 40%). US mothers were more likely to have discussed and been offered the HPV vaccine by a clinician than mothers in Mexico. In multivariate analyses, having been offered the HPV vaccine was the most important predictor of vaccine uptake. CONCLUSIONS: Our results suggest that healthcare access or other system, clinic, or provider factors are the main drivers of vaccine receipt in this binational sample of Mexican mothers. Interventions and programs that encourage clinicians to offer the HPV vaccine should be developed to increase vaccine uptake in both countries.

Mothers and teenage daughters walking to health: using the behaviour change wheel to develop an intervention to improve adolescent girls' physical activity.

OBJECTIVES: The majority of adolescent girls fail to meet public health guidelines for physical activity. Engaging mothers in the promotion of physical activity for their daughters may be an important strategy to facilitate behaviour change. The aim of this study was to use the behaviour change wheel (BCW) framework to design the components of an intervention to improve adolescent girls' physical activity. STUDY DESIGN: Cross-sectional study to inform intervention development. METHODS: The BCW framework was used to (1) understand the behaviour, (2) identify intervention functions and (3) select content and implementation options. A circular development process was undertaken by the research team to collectively design the intervention in accordance with the steps recommended by the BCW. RESULTS: The BCW design process resulted in the selection of six intervention functions (education, persuasion, incentivization, training, modelling, enablement) and 18 behaviour change techniques delivered via group-based, face-to-face mode. Behaviour change technique groupings include: goals and planning; feedback and monitoring; social support; shaping knowledge; natural consequences; comparison of behaviour; associations; comparison of outcomes; reward and threat; identity; and, self-belief. CONCLUSIONS: The BCW process allowed an in-depth consideration of the target behaviours and provided a systematic framework for developing the intervention. The feasibility and preliminary efficacy of the programme will be examined.

Culturally-grounded mother-daughter communication-focused intervention for Thai female adolescents.

Teenage pregnancy-prevention interventions have fallen short in significantly decreasing risk of pregnancy for Thai populations. The "breaking the voice" ("rak luk khun tong pood") culture-appropriate teenage pregnancy-prevention program was developed using community-based research. Qualitative analyses of focus group data identified salient factors related to sexual communication and behavior. The integration of focus group results with theoretical constructs guided the development of an intervention to reduce risky sexual behavior by increasing communication between mothers and their adolescent daughters. A total of 157 mother-daughter dyads from congested areas in Bangkok participated in pilot testing of the intervention by the use of a survey. The findings indicated a significant increase in the frequency of and number of sexual risk communication (P < .05). There was a significant increase in perceived power in relationship control, ability to prevent sexual risk, assertiveness, and ability to decrease sexual risk among daughters (P < .05). "Breaking the voice" represents a female-focused and culturally-relevant intervention to combat teenage pregnancy.

Giving Our Daughters What We Never Received: African American Mothers Discussing Sexual Health With Their Preadolescent Daughters.

African American girls experience disparate rates of pregnancy and acquisition of sexually transmitted infections, including human immunodeficiency virus, when compared to their non-Hispanic White counterparts. Among African American girls, current pregnancy rates are equal to the national crisis levels of teen pregnancy reported in 1990. This qualitative elicitation study was conducted to gain insight into the ways in which African American mothers and their daughters, between the ages of 9 and 14, communicate about sexual health. Early sexual health communication between mothers and daughters is known to enhance the sexual health outcomes of girls. A series of four focus groups and three in-depth interviews were conducted between July and September 2014. The theory of planned behavior was the organizing framework. Theoretical constructs that guided this study were attitudes, perceived behavioral control, and subjective norms. Results showed that what African American women share with their daughters about sexual health stems from their personal faith, values, and experiences. Findings from this study can inform interventions to provide support for this understudied population. Moreover, there are implications for health-care providers, particularly school nurses, who are in an ideal position to help increase mothers' self-efficacy to engage in sexual health conversations with their young daughters.

Beyond "Lots of Hugs and Kisses": Expressions of Parental Love From Parents and Their Young Children in Two-Parent, Financially Stable Families.

Given that parental love is essential for children's optimal development, the current study gathered examples of how parental love was demonstrated within parent-child relationships. Fifty-eight two-parent, financially stable families consisting of a mother, father, and young child (3-7 years old) from the Midwest were interviewed regarding how they demonstrated or perceived parental love. Results from an inductive thematic analysis revealed considerable variability in how parental love was demonstrated, with five themes emerging that overlapped between parents and their children: playing or doing activities together, demonstrating affection, creating structure, helping or supporting, and giving gifts or treats. Some gendered patterns among these themes were found with mothers emphasizing physical and verbal affection and fathers highlighting their more prominent role as playmates. The lay examples provided by parents and children in this exploratory study extend previous conceptualizations of parental love and underscore the importance of parents being attuned and responsive to the specific needs of their children.

Comparison of African American and Caucasian Caregiver Self-Efficacy.

Self-efficacy influences one's behavior and can determine the degree to which one is motivated to take action. The current study explores changes in caregiver self-efficacy pre- and post-participation in a Resources for Enhancing Alzheimer's Caregiver Health (REACH II) program, a multi-component intervention aimed at caregivers of individuals with Alzheimer's disease. The study specifically compared this construct in African American and Caucasian populations, which may give indications of how to empower dementia caregivers and whether REACH II is culturally sensitive and thus, an important component to examine. Nurses are the connection between families and community resources and must serve as referral sources to programs that work. Although African American and Caucasian caregivers showed comparable rates of increase in self-efficacy, African American caregivers started and ended at higher rates of self-efficacy for obtaining respite and overall self-efficacy. Applications of the results and directions for future research are discussed. [Journal of Gerontological Nursing, 44(3), 16-21.].

Maternal emotional feeding practices and adolescent daughters' emotional eating: Mediating roles of avoidant and preoccupied coping.

The current study examined the link between early childhood emotional feeding and adolescent girls' emotional eating, using maladaptive coping styles as the underlying mechanisms mediating these associations. We examined adolescent girls' and mothers' retrospective reports of emotional feeding during childhood, as well as adolescent girls' current reports of their coping behaviors (i.e., preoccupied and avoidant) and emotional eating. Findings showed that adolescent girls' and mothers' retrospective reports of early emotional feeding were positively associated with adolescent girls' emotional eating. Preoccupied coping, but not avoidant coping, mediated the associations between early emotional feeding (reported by adolescents and mothers) and adolescents' current emotional eating. In conclusion, findings suggest that early childhood feeding experiences are linked to the development of maladaptive coping and emotional eating among adolescent girls.

Eye-tracking-based assessment suggests preserved well-being in locked-in patients.

We assessed quality of life (QoL) and psychological well-being in patients with amyotrophic lateral sclerosis-induced locked-in state and their next of kin in a fully unbiased manner using eye-tracking computer systems. Eleven of 30 screened patients and 9 next of kin completed study procedures. Patients reported good QoL, which appeared to be at the cost of the QoL of their next of kin. Next of kin rated their own or patients' QoL similarly, but they identified different areas as important as compared with patients. Our results are of importance for the discussion of end-of-life decisions and the evaluation of patients' presumed wishes as well as for psychosocial interventions. Ann Neurol 2017;81:310-315.

Can concern for the long-term care of older parents explain son preference at birth in India?

This study examines whether concern for the long-term care of older parents is the primary reason for son preference in India. Controlling for important socioeconomic factors that are believed to affect son preference, we find that concern for long-term care is the principal cause of son preference in India. Sons serve as the primary caregivers to elderly parents, while daughters are mostly engaged in caring for parents-in-law. This trend is more acute in rural than in urban areas. Our study also finds a strong implication of the filial relationship for the long-term care of elderly parents.