Development of a Theory-based, Sociocultural Instrument to Assess Black Maternal Intentions to Vaccinate Their Daughters Aged 9 to 12 Against HPV.

The human papillomavirus (HPV) vaccine could assist in reducing the cervical cancer disparity existing between Black and White women. Understanding factors influencing Black maternal intentions to vaccinate their daughter is essential in improving vaccination uptake. However, existing instruments do not comprehensively assess factors (e.g., culture) influencing maternal intentions. This paper describes the development of the Human Papillomavirus Vaccination Survey for Black Mothers with Girls Aged 9 to 12 (HPVS-BM), the first instrument to measure knowledge, attitudes, subjective norms, and cultural beliefs relating to Black maternal intentions to vaccinate their daughters aged 9 to 12 years against HPV. The items and scales were refined using content review by experts, as well as cognitive interviews and pilot testing with target audience participants. The final version of the HPVS-BM was administered to 242 Black mothers with adolescent daughters. Internal reliability was determined using Cronbach's alpha. An a priori hypothetical model was developed to determine convergent and discriminant validity. All scales of the HPVS-BM had an acceptable internal reliability of 0.70 or higher. The intention scale of HPVS-BM was significantly correlated (p < .05) with perceived benefits, perceived barriers, and subjective norms, supporting strong convergent validity. Moderate discriminant construct validity was also demonstrated. Exhibiting good psychometrics, this instrument could be used by healthcare researchers and professionals to develop programs to increase HPV vaccination among Black adolescent females aimed at reducing the racial disparities in cervical cancer. Further psychometric testing of this survey tool for understanding factors influencing maternal intentions is warranted.

Social modeling influences and alcohol consumption during the first semester of college: a natural history study.

The authors examine both the alcohol consumption pattern of freshmen students during their first semester and the degree to which social modeling of peer behavior impacts consumption. A total of 534 students, residing on campus, were prospectively examined at four 30-day intervals. Data were evaluated on the basis of age, gender, and the effects of time using generalized estimating equations (GEEs). Results reflected nonsignificant increases in the amount of alcohol consumed; however, affiliations with alcohol-consuming peer groups was significantly associated with increased alcohol consumption. The mean number of drinks consumed in the past 30 days remained the same for whites (χ(2) = 3.35, 3 df, P = .3411) but increased slightly for blacks (χ(2) = 7.99, 3 df, P = .0462). Prevention programs should include screening for growth in alcohol consumption among first-year university students, and such screenings should include the extent and nature of affiliation with peers who consume alcohol.

Drinking likelihood, alcohol problems, and peer influence among first-year college students.

Excessive alcohol consumption is a predominant health concern on college campuses in the United States. A stepwise multiple regression analysis was used to examine the predictive values of demographic factors in relation to alcohol subscales (Drinking Context Scale, College Alcohol Problems Scale-revised, and Social Modeling Scale) with the outcome of number of drinking days in the past 30 days among a sample (n = 224) of first-year college students. The final model predicted 37.5% of the variability in drinking days in the past month. All variables, except for race, were significantly associated with the outcome (p < .05).

A Physician's Recommendation for Human Papillomavirus Vaccination: What Makes African-American Mothers Compliant?

BACKGROUND: Improving human papillomavirus (HPV) vaccination among African-American (AA) female adolescents to reduce the cervical cancer burden is important and cost-effective. The study objective is to identify factors most influential to AA mothers' likelihood to comply with a physician's recommendation to get their daughters the HPV vaccine. METHODS: We conducted a cross-sectional survey. Participants were recruited through online and community sites (ie, schools, community centers, etc.) in Alabama. A total of 280 AA mothers and their adolescent daughters completed the survey. A binary logistic regression was used to determine factors influencing mother's likelihood to adhere with a physician's recommendation to get their daughters the HPV vaccine. RESULTS: The most significant factors influencing mother's likelihood to comply with physician's recommendation were culture: future-time orientation (P = 0.001), perceived barriers of HPV vaccination (P = 0.007), perceived susceptibility to HPV (P = 0.047) and perceived benefits of HPV vaccination (P = 0.002). Further exploration of perceived barriers and perceived benefits found mother's perception that the HPV vaccine is a good way to protect my daughter's health as the only significant benefit. No measures of perceived barriers were significant. CONCLUSIONS: A physician's recommendation should advise AA mothers on the risk of HPV and the importance of HPV vaccination at an early age to reduce cervical cancer risk. It should further address mothers' perceived disadvantages of HPV vaccination (eg, side effects). Incorporating this information in physician recommendation practices could increase HPV vaccination rates with implications in reducing the cervical cancer burden among this high-risk population.

Drinking locations prior to impaired driving among college students: implications for prevention.

Drinking and driving is perhaps the most serious problem associated with heavy drinking among college students in the United States. In this study, the authors examined drinking locations prior to impaired driving in a college student sample. They administered the Impaired Driving Assessment to 91 college students identified as high risk for drinking and driving. Participants reported an average of 7.98 (SD = 7.67) impaired driving episodes during the past 5 weeks. Using a random effects model, the authors found that location was a significant predictor of blood alcohol content (BAC), F(6,89.6) = 3.62, p = 0.0029. After drinking alcohol at a party, students' average estimated BAC prior to driving (geometric M = 0.089) was significantly greater than all other drinking locations (geometric M = 0.033). The findings of this study provide insight into drinking locations prior to impaired driving and can be used by college health practitioners to develop appropriate interventions to reduce the magnitude of this problem.

Improving nurse staffing measures: discharge day measurement in "adjusted patient days of care".

Previous research cannot account for the discrepancy between registered nurse (RN) reports of understaffing and studies showing slight improvement. One reason may be that "adjusted patient days of care" (APDC) underestimates patient load. Using data from all Pennsylvania acute care general hospitals for the years 1994 through 1997, we found that APDC is underestimated by two hours. After adjusting APDC, we examined the difference in nurse staffing over the period 1991-2000 before and after the adjustment. We found a significant difference between unadjusted and adjusted measures. However, when applied to the changes in nurse staffing between 1991 and 2000, the difference was not enough to account for the discrepancy between reports and data. Other measurement and conceptual problems may exist in terms of patients' increasing acuity levels, patients' declining lengths of stay and the associated greater proportion of nurse time devoted to admission and discharge, and lack of recent data in some empirical studies.

Challenges and recommendations to enforcement of alcohol policies on college campuses: an administrator's perspective.

OBJECTIVE: The purpose of this study was to examine challenges and recommendations (identified by college administrators) to enforcing alcohol policies implemented at colleges in the southeastern United States. METHODS: Telephone interviews were conducted with 71 individuals at 21 institutions. RESULTS: Common challenges included inconsistent enforcement, mixed messages received by students, and students' attitudes toward alcohol use. The most common recommendations were ensuring a comprehensive approach, collaboration with members of the community, and enhanced alcohol education.

Validation of the Drinking Context Scale (DCS-9) for use with non-adjudicated first-year college students.

The Drinking Context Scale (DCS-9) has been used to measure the impact of drinking during social, emotional, and situational contexts. Psychometric properties remain unevaluated in a population of non-adjudicated first-year college students in the southeast. Liseral 8.8 was used to test the factorial validity of the DCS, using Confirmatory Factor Analysis. The original three factor model for the DCS represented acceptable fit to the data (chi(2)=36.72, df=24, p=0.047, CFI=0.991, SRMR=.0406) supporting its use with first-year college students. Invariance between gender, ethnic group, and geographical regions should be examined by future researchers.

Validation of the College Alcohol Problem Scale-revised (CAPS-r) for use with non-adjudicated first-year students.

First-year students in transition to college are at increased risk for consuming greater amounts of alcohol and are subject to subsequent alcohol-related problems. The 8-item College Alcohol Problem Scale-revised (CAPS-r) has been used to measure alcohol-related problems in adjudicated undergraduates and psychology majors. However, structural validity of the CAPS-r has not been examined in a general first-year student population. Confirmatory factor analysis (CFA) was used to test the structural validity of this two-factor model using LISREL 8.5. The original two-factor measurement model for the 8-item CAPS-r represented acceptable fit to the data (chi(2)=37.52, df=19, p=.007, CFI=.968, SRMR=.0449), supporting its use with first-year college students. Future studies need to examine invariance across ethnic, gender, and geographical groups.