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1.
Arch Sex Behav ; 52(4): 1535-1547, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36856958

RESUMEN

Social shame and stigma surround menstruation, which may compromise women's health and rights in various contexts. Men's attitudes are particularly important because men often hold positions of power that influence women's experience. This study examined factors associated with menstrual attitudes, including heteronormative attitudes, sexism, and family influences. A cross-sectional Qualtrics panel survey (n = 802; aged 18-44; 50.8% female) was performed. We tested a revised menstrual attitudes scale based on items drawn from previously validated measures. Data were analyzed using a structural equation modeling framework. Factor analysis identified and confirmed a 5-factor model for menstrual attitudes. Men endorsed more negative attitudes toward menstruation than women; however, this difference was largely explained by factors other than gender in the structural equation model. After controlling for family and demographic characteristics, attitudes toward openness and secrecy surrounding menstruation were most strongly associated with gender role expectations and hostile sexism. Benevolent sexism was associated with finding menstruation debilitating, denying menstrual symptoms, and endorsing avoidance of activities during menstruation. Heteronormative and sexist attitudes were associated with more negative menstrual attitudes, while increased menstrual knowledge was associated with more positive menstrual attitudes. The difference in menstrual attitudes between males and females was explained largely by heteronormative attitudes and sexism. This suggests that attitudes toward menstruation are closely linked to social ideals about men and women.


Asunto(s)
Menstruación , Sexismo , Adulto , Humanos , Femenino , Masculino , Estudios Transversales , Actitud , Hombres
2.
BMC Pregnancy Childbirth ; 18(1): 181, 2018 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-29793438

RESUMEN

BACKGROUND: Congenital cytomegalovirus (CMV) infection is the most common intrauterine infection. The only way to protect against congenital CMV infection is to practice CMV prevention behaviors. CMV seroprevalence rates are high in Hispanic women. It is unknown whether communication strategies should differ by ethnicity. The purpose of this study was to understand differences between U.S. Hispanic and non-Hispanic women's attitudes toward CMV prevention behaviors and examine the relationship between perceived subjective norms and these attitudes. METHODS: This was a cross-sectional study using an online panel. Participants were U.S. women of childbearing age. The dependent variable was attitude toward practicing CMV prevention behaviors, specifically avoiding sharing cups, food, and utensils with a child and not kissing a child on the lips. RESULTS: Among 818 women (50% Hispanic), 16.8% of Hispanic women and 9.7% of non-Hispanic women (p = 0.002) reported familiarity with CMV. Attitudes toward CMV prevention through avoiding sharing behaviors (M Hispanic = 5.55 vs. M non-Hispanic  = 5.20; p = 0.002) and not kissing a child on the lips (M Hispanic = 4.80 vs. M non-Hispanic = 4.21; p = 0.001) were positive for both ethnicities, but higher for Hispanic women. Hispanic women (M = 5.11) reported higher perceived behavioral control for avoiding kissing a child on the lips than non-Hispanic women (M = 4.63; p = 0.001). Hispanic women who were U.S. born or spoke English primarily more frequently kissed a child on the lips or engaged in sharing behaviors. Additionally, those who spoke Spanish mostly held more positive attitudes toward not kissing on the lips. Significant predictors for more positive attitudes toward CMV prevention behaviors were associated with perceived subjective norms, perceived behavioral control and pre-survey participation in risk behaviors. CONCLUSIONS: Hispanic women have more positive attitudes toward CMV prevention behaviors than non-Hispanic women, however in regression models other factors are more important predictors of positive attitudes than ethnicity. In developing strategies to encourage women to practice CMV prevention behaviors, a focus on further understanding and increasing subjective norms and perceived control over those behaviors may be warranted.


Asunto(s)
Infecciones por Citomegalovirus/psicología , Conductas Relacionadas con la Salud/etnología , Conocimientos, Actitudes y Práctica en Salud , Hispánicos o Latinos/psicología , Prevención Primaria/métodos , Adolescente , Adulto , Comparación Transcultural , Estudios Transversales , Citomegalovirus , Infecciones por Citomegalovirus/etnología , Infecciones por Citomegalovirus/prevención & control , Femenino , Humanos , Análisis de Regresión , Encuestas y Cuestionarios , Estados Unidos , Adulto Joven
3.
J Youth Adolesc ; 47(4): 793-806, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-28664311

RESUMEN

Adolescent self-regulation is increasingly seen as an important predictor of sexual risk-taking behaviors, but little is understood about how changes in self-regulation affect later sexual risk-taking. Family financial stress may affect the development of self-regulation and later engagement in sexual risk-taking. We examined whether family financial stress influences self-regulation in early adolescence (age 13) and growth in self-regulation throughout adolescence (from age 13-17 years). We then assessed the effects of family financial stress, baseline self-regulation, and the development of self-regulation on adolescent sexual risk-taking behaviors at age 18 years. Using a curve-of-factors model, we examined these relationships in a 6-year longitudinal study of 470 adolescents (52% female) and their parents from a large northwestern city in the United States. Results indicated that family financial stress was negatively associated with baseline self-regulation but not with growth in self-regulation throughout adolescence. Both baseline self-regulation and growth in self-regulation were predictive of decreased likelihood of engaging in sexual risk-taking. Family financial stress was not predictive of later sexual risk-taking. Intervening to support the development of self-regulation in adolescence may be especially protective against later sexual risk-taking.


Asunto(s)
Conducta del Adolescente/psicología , Conflicto Familiar/psicología , Asunción de Riesgos , Autocontrol , Conducta Sexual/psicología , Adolescente , Análisis Factorial , Femenino , Humanos , Estudios Longitudinales , Masculino , Relaciones Padres-Hijo , Medio Social , Estados Unidos
4.
BMC Womens Health ; 17(1): 134, 2017 Dec 20.
Artículo en Inglés | MEDLINE | ID: mdl-29262815

RESUMEN

BACKGROUND: The purpose of this study was to evaluate the effect of message framing on women's intention to perform cytomegalovirus (CMV) prevention behaviors involving handwashing, not sharing food and eating utensils, not kissing a child on the lips and not placing a pacifier in the mouth after it was in a child's mouth. METHODS: An online panel of women 18-40 years, who were pregnant or planning a pregnancy were randomized in a 2 × 2 factorial design to receive 1 of 4 CMV fact sheets. The fact sheets were framed as either what could be gained or be lost by following (or not) the recommendations and the likelihood of being affected by CMV (i.e., small chance or one of the most common infections in infants). The questionnaire measured CMV knowledge, participation in CMV risk or prevention behaviors, perceived severity of and susceptibly to CMV, and the perceived control over and the efficacy of recommended prevention behaviors. The dependent variable, intention to modify behavior, was an index score that ranged from 0 to 16 with higher values indicating greater intention. Linear regression was used to evaluate the association between all independent variables and overall behavioral intention. RESULTS: The sample included 840 women; 15.5% were familiar with CMV. Behavioral intention was high (M = 10.43; SD = 5.13) but did not differ across the message frames (p = 0.23). Overall, behavioral intention was predicted by CMV knowledge, message credibility, perceived severity of CMV, perceived behavioral control and response efficacy. Significant interactions with gain vs. loss frame were observed for perceived behavioral control (p = 0.03) and response efficacy (p = .003). CONCLUSIONS: Framing CMV messages by what women stand to gain or lose interacts with perceived behavioral control and response efficacy to influence behavioral intention. Perceived behavioral control and response efficacy were most predictive of behavioral intention overall regardless of frame. Messaging that focuses on these two variables, particularly for avoiding kissing a child on the lips and sharing food, cups and utensils, may result in greater gains in intention to participate in CMV prevention behaviors.


Asunto(s)
Actitud Frente a la Salud , Infecciones por Citomegalovirus/prevención & control , Adhesión a Directriz , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/métodos , Mujeres Embarazadas/psicología , Envío de Mensajes de Texto/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Lactante , Embarazo , Encuestas y Cuestionarios , Estados Unidos , Adulto Joven
5.
J Youth Adolesc ; 46(1): 45-62, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-27460827

RESUMEN

The ability to control one's emotions, thoughts, and behaviors is known as self-regulation. Family stress and low adolescent self-regulation have been linked with increased engagement in risky sexual behaviors, which peak in late adolescence and early adulthood. The purpose of this study was to assess whether adolescent self-regulation, measured by parent and adolescent self-report and respiratory sinus arrhythmia, mediates or moderates the relationship between family financial stress and risky sexual behaviors. We assessed these relationships in a 4-year longitudinal sample of 450 adolescents (52 % female; 70 % white) and their parents using structural equation modeling. Results indicated that high family financial stress predicts engagement in risky sexual behaviors as mediated, but not moderated, by adolescent self-regulation. The results suggest that adolescent self-regulatory capacities are a mechanism through which proximal external forces influence adolescent risk-taking. Promoting adolescent self-regulation, especially in the face of external stressors, may be an important method to reduce risk-taking behaviors as adolescents transition to adulthood.


Asunto(s)
Conducta del Adolescente/psicología , Familia/psicología , Renta , Autocontrol , Conducta Sexual/psicología , Estrés Psicológico , Adolescente , Femenino , Humanos , Masculino , Relaciones Padres-Hijo , Asunción de Riesgos
6.
Health Promot Pract ; 17(2): 226-34, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26272884

RESUMEN

The changing landscape of health care as a result of the Patient Protection and Affordable Care Act (ACA) may provide new opportunities for health education specialists (HES). The purpose of this study was to survey HES in the United States on their knowledge and attitudes of the ACA and assess their perceptions of job growth under the law. A random sample of 220 (36% response rate) certified HES completed a 53-item cross sectional survey administered online through Qualtrics. Findings were compared to public opinion on health care reform. HES are highly favorable of the law (70%) compared to the general public (23%). A total of 85% of respondents were able to list a provision of the ACA, and most (81%) thought the ACA would be successful at increasing insured Americans. Over half (64.6%) believe job opportunities will increase. Those who viewed the law favorably were significantly more likely to score better on a knowledge scale related to the ACA. HES understand publicized provisions but are uncertain about common myths and specific provisions related to Title IV, "Prevention of Chronic Disease and Improving Public Health." Directed and continuing education to HES regarding the ACA is warranted.


Asunto(s)
Actitud del Personal de Salud , Educadores en Salud/psicología , Patient Protection and Affordable Care Act , Adulto , Anciano , Femenino , Educadores en Salud/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Estados Unidos , Adulto Joven
7.
Arch Sex Behav ; 44(4): 885-94, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-24718674

RESUMEN

This study examined characteristics of self-identified heterosexual women who were concordant or discordant in their sexual behavior and the association of discordance and sexual partnering among those aged 15-44 years from the 2006-2010 National Survey of Family Growth (n = 7,353). Sexual concordance was defined as reporting a heterosexual identity and no female partners in the past year; discordance was reporting a heterosexual identity and having at least one female partner in the past year. Sexual partnering was defined as being concurrent, serially monogamous or monogamous with a male partner in the previous year. Polytomous logistic regression models evaluated the association between sexual discordance and sexual partnering. Among self-identified heterosexual, sexually active women, 11.2 % reported ever having had a same sex partner. Heterosexually discordant women who had both male and female partners in the previous year were 5.5 times as likely to report having a concurrent relationship (95 % CI 2.77-11.09) and 2.4 times as likely to report engaging in serially monogamous relationships (95 % CI 1.19-4.97) with male partners. Discordance between heterosexual identity and same sex behavior is a factor in risky behaviors. Women who have sex with women and men may act as bridges for the transmission of STDs, particularly to their female partners. Sexual education should include information inclusive of non-heteronormative behaviors and identities to provide sexual minorities with the tools and information they need. Clinical guidelines should ensure that all women are offered counseling and screening for reproductive and sexual health.


Asunto(s)
Heterosexualidad/psicología , Homosexualidad Femenina , Parejas Sexuales , Adolescente , Adulto , Femenino , Humanos , Modelos Logísticos , Masculino , Asunción de Riesgos , Conducta Sexual/estadística & datos numéricos , Enfermedades de Transmisión Sexual/transmisión , Adulto Joven
8.
BMC Public Health ; 15: 98, 2015 Feb 07.
Artículo en Inglés | MEDLINE | ID: mdl-25884406

RESUMEN

BACKGROUND: Concurrency and serial monogamy may increase risk for STIs when gaps fall within the infectious period. This study examined the association between early sexual debut and concurrent or serial sexual partnering among heterosexual adult women. METHODS: We identified 6,791 heterosexually active women, ages 21-44, from the 2006-2010 National Survey of Family Growth, a multi-stage probability sample of women in the United States. Self-reported age at first intercourse was categorized as <15, 15-17 and ≥18 years (referent). Sexual partnering was defined as concurrency (within the same month), serial monogamy with either a 1-3 month, or ≥4 month gap between partners, or monogamy (referent) in the year prior to interview. Polytomous logistic models provided adjusted odds ratios (aOR) and 95% confidence intervals (CI). RESULTS: Concurrent partnerships in the year prior to interview were reported by 5.2% of women. Serial monogamy with a 1-3 month gap was reported by 2.5% of women. Compared with women whose sexual debut was ≥18 years, those <15 years at sexual initiation had 3.7 times the odds of reporting concurrent partnerships (aOR: 3.72; 95% CI: 2.46-5.62). Women <15 years of age at sexual debut had twice the odds of serial monogamy with gap lengths of 1-3 months between partners (aOR1-3 months: 2.13; 95% CI 1.15-3.94) as compared to women ≥18 years at sexual debut. CONCLUSIONS: Sexual debut at <15 years is associated with both concurrency and serial monogamy with 1-3 month gaps between partners in U.S. women aged 21-44.


Asunto(s)
Conducta Sexual/estadística & datos numéricos , Parejas Sexuales , Adulto , Factores de Edad , Coito , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Oportunidad Relativa , Riesgo , Asunción de Riesgos , Estados Unidos , Adulto Joven
9.
Matern Child Health J ; 19(9): 2020-8, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25652065

RESUMEN

Lack of familial support, particularly from fathers or partners, has been identified by the U.S. Surgeon General as a barrier to breastfeeding. Although partners have been identified as an important source of breastfeeding support, research on U.S. men's knowledge about and attitudes towards breastfeeding is limited. An internet panel survey of 502 U.S. males aged 21-44 years was conducted. It included the 17-item Iowa Infant Feeding Attitude Scale (IIFAS), a series of questions assessing prior exposure to breastfeeding and demographic questions. Frequencies, proportions and means were calculated and analysis of variance used to test differences in the mean IIFAS scale score across demographic groups. A multiple linear regression model was used to identify predictors of IIFAS score. The sample was largely white, non-Hispanic (65.7%), college educated (44.4%) and married (47%). The mean IIFAS score was 57 (SD = 8.13; range 25-84). In the adjusted regression model, being white, non-Hispanic, having a college education, having siblings who were breastfed and observing ten or more different women breastfeeding were significantly associated with higher IIFAS scores. In a sample of U.S. men of reproductive age, breastfeeding knowledge and attitudes as measured by the IIFAS are neutral. Race, education, and exposure to breastfeeding are important predictors of breastfeeding attitudes in males as measured by the IIFAS.


Asunto(s)
Actitud Frente a la Salud , Lactancia Materna/psicología , Padre/psicología , Conocimientos, Actitudes y Práctica en Salud , Internet/estadística & datos numéricos , Adulto , Lactancia Materna/estadística & datos numéricos , Humanos , Masculino , Apoyo Social , Encuestas y Cuestionarios , Estados Unidos
10.
J Occup Environ Hyg ; 12(11): 785-94, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26030088

RESUMEN

Residential temperature and humidity are associated with multiple health effects. Studies commonly use single-point measures to estimate indoor temperature and humidity exposures, but there is little evidence to support this sampling strategy. This study evaluated the relationship between single-point and continuous monitoring of air temperature, apparent temperature, relative humidity, and absolute humidity over four exposure intervals (5-min, 30-min, 24-hr, and 12-days) in 9 northern Utah homes, from March-June 2012. Three homes were sampled twice, for a total of 12 observation periods. Continuous data-logged sampling was conducted in homes for 2-3 wks, and simultaneous single-point measures (n = 114) were collected using handheld thermo-hygrometers. Time-centered single-point measures were moderately correlated with short-term (30-min) data logger mean air temperature (r = 0.76, ß = 0.74), apparent temperature (r = 0.79, ß = 0.79), relative humidity (r = 0.70, ß = 0.63), and absolute humidity (r = 0.80, ß = 0.80). Data logger 12-day means were also moderately correlated with single-point air temperature (r = 0.64, ß = 0.43) and apparent temperature (r = 0.64, ß = 0.44), but were weakly correlated with single-point relative humidity (r = 0.53, ß = 0.35) and absolute humidity (r = 0.52, ß = 0.39). Of the single-point RH measures, 59 (51.8%) deviated more than ±5%, 21 (18.4%) deviated more than ±10%, and 6 (5.3%) deviated more than ±15% from data logger 12-day means. Where continuous indoor monitoring is not feasible, single-point sampling strategies should include multiple measures collected at prescribed time points based on local conditions.


Asunto(s)
Monitoreo del Ambiente/instrumentación , Vivienda , Humedad , Temperatura , Reproducibilidad de los Resultados , Factores de Tiempo , Utah
11.
J Environ Health ; 77(3): 22-8, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25603651

RESUMEN

Handheld temperature and relative humidity (T/RH) meters are commonly used in residential indoor air surveys. Although popular, T/RH meters are prone to sensor drift and consequent loss of accuracy, and thus instrument manufacturers often recommend annual calibration and adjustment. Field-use conditions, however, have been shown to accelerate electronic sensor drift in outdoor applications, resulting in out-of-tolerance measurements in less than one year. In the study described in this article, sensor drift was evaluated under residential field use for 30 handheld T/RH meters to predict needed calibration intervals based on hierarchical linear modeling. Instruments were used in 43 home visits over a 93-day period and were calibrated (without adjustment) 49 times over the study period with a laboratory standard. Analysis of covariance showed significant drift among temperature sensors for all three instrument types (p < .0001) and among humidity sensors in two instruments. The authors' study suggests calibration frequency should be based on instrument performance under specific sampling conditions rather than on predetermined time intervals.


Asunto(s)
Aire/análisis , Monitoreo del Ambiente/instrumentación , Vivienda , Humedad , Temperatura , Calibración , Modelos Lineales , Reproducibilidad de los Resultados , Factores de Tiempo
12.
Front Public Health ; 11: 1223953, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37601196

RESUMEN

Background: The purpose of this study was to examine whether positive adult experiences (PAEs) were associated with lower odds for anxiety and depression even in the presence of high adverse childhood experiences (ACEs) or low positive childhood experiences (PCEs). Methods: The sample was comprised of 435 adults (48% female), ages 18-56 years and who were living in the United States. Participants completed a survey about their childhood experiences, PAEs, and mental health. A series of multiple logistic regression models were estimated in Stata 17 to examine the aims. Results: Positive childhood experiences were associated with higher PAE scores, but ACEs did not significantly correlate with PAEs. Positive adult experiences were associated with lower odds of moderate-to-severe anxiety and depression, especially among those who had experienced high ACEs or low PCEs. Younger adults were more likely to experience a positive benefit from PAEs compared to adults 35 years and older. Conclusion: Even when ACEs were high or PCEs were low, adults with high PAEs had lower odds for moderate-to-severe anxiety and/depression. Positive adult experiences may be an opportunity to turn the tide for individuals who experienced childhood adversity and/or low levels of support or connection.


Asunto(s)
Experiencias Adversas de la Infancia , Humanos , Adulto , Femenino , Masculino , Salud Mental , Ansiedad/epidemiología , Trastornos de Ansiedad/epidemiología , Modelos Logísticos
13.
Med Care ; 50(7): 562-8, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-22688787

RESUMEN

INTRODUCTION: Half of the states in the United States mandate that health insurers cover contraceptives. Health care reform includes recommendations to extend these mandates nationally through the essential benefits package. This study evaluates the association of state-level insurance mandates and consistent contraceptive use among privately insured women aged 15-44. STUDY DESIGN: The National Survey of Family Growth (2006-2008) included 2276 privately insured women at risk for unintended pregnancy. Multilevel logistic regression models provided estimates of the association between state-level insurance coverage mandates and consistent contraceptive use. RESULTS: Among privately insured women, 18% reported a ≥1-month gap in contraceptive use. Compared with women living in states with no mandates, those in states with comprehensive mandates had increased odds of consistent contraceptive use among privately insured women [adjusted odds ratio (aOR), 1.64; 95% confidence interval (CI), 1.08-2.50], but not uninsured women (aOR, 0.77; 95% CI, 0.38-1.55). Partial mandates were not associated with consistent contraceptive use. DISCUSSION: Consistent contraceptive use among women with private insurance is higher in the states with mandates compared with those without mandates.


Asunto(s)
Conducta Anticonceptiva/estadística & datos numéricos , Anticonceptivos Femeninos , Seguro de Servicios Farmacéuticos/legislación & jurisprudencia , Seguro de Servicios Farmacéuticos/estadística & datos numéricos , Programas Obligatorios/economía , Embarazo no Deseado , Adolescente , Adulto , Anticoncepción/economía , Anticoncepción/estadística & datos numéricos , Femenino , Humanos , Cobertura del Seguro/estadística & datos numéricos , Pacientes no Asegurados/estadística & datos numéricos , Embarazo , Factores Socioeconómicos , Gobierno Estatal , Estados Unidos , Salud de la Mujer , Adulto Joven
14.
J Am Coll Health ; : 1-8, 2022 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-35471936

RESUMEN

Objective: Previous research suggests that both adverse childhood experiences (ACEs), positive childhood experiences (PCEs), and current life experiences are associated with emotional wellbeing and mental health. The purpose of this study was to explore the influence of these life experience and coping processes on college student emotional and mental health. Participants: College students (N = 555) were recruited from a large western university. Methods: Participants completed an online cross-sectional survey measuring early and current life experiences, cognitive and emotional coping efforts, and emotional and mental health outcomes. Data were analyzed using structural equation modeling. Results: There was an indirect effect of PCEs on emotional and mental health through cognitive and emotional coping efforts. No association was observed between ACEs and mental health. Conclusions: Increases in PCEs are protective, enhance coping efforts, and strengthen emotional and mental health outcomes among college students.

15.
Acta Psychol (Amst) ; 220: 103430, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34662773

RESUMEN

BACKGROUND: Previous studies have indicated the advantageous childhood experiences (counter-ACEs) may improve health in adulthood regardless of adverse childhood experiences (ACEs) scores. However, these studies have primarily been conducted in low-risk communities, and little is known whether the results are similar in low-income settings. OBJECTIVE: The purpose of this study was to examine the effects of ACEs and counter-ACEs on mental and physical health in a low-income sample. A secondary objective was to assess the effects of repeated and prolonged exposure to ACEs on later health. PARTICIPANTS AND SETTING: The sample included 206 low-income adults living in the western United States who completed a survey about their childhood experiences and adult health. METHODS: A series of logistic regression analyses were performed to examine the effects of ACEs and counter-ACEs on adult health. RESULTS: Irrespective of ACEs, counter-ACEs were associated with lower odds of having two or more emotional and cognitive health problems and lower odds of suicidality in the past 12 months. When accounting for counter-ACEs, ACEs were associated with higher odds of having ever smoked and suicidality in the past 12 months, though these odds were attenuated compared to the unadjusted models. In the presence of repeated or prolonged ACEs exposure, counter-ACEs were associated with lower odds of having ever smoked and emotional and cognitive health problems. CONCLUSIONS: The findings suggest that helping children develop healthy relationships within their family, community, and school may lead to improved health in adulthood even in the presence of poverty and childhood adversity.


Asunto(s)
Experiencias Adversas de la Infancia , Pobreza , Adulto , Niño , Estado de Salud , Humanos , Encuestas y Cuestionarios , Estados Unidos
16.
Obstet Gynecol ; 138(6): 871-877, 2021 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-34735383

RESUMEN

OBJECTIVE: To assess pharmacy participation in and accessibility of pharmacist-prescribed contraception after legislation effective in the state of Utah in 2019. METHODS: A secret-shopper telephone survey was used to assess participation in pharmacist-prescribed contraception. Geospatial analysis was used to map the distribution of participating pharmacies by population characteristics. RESULTS: Of all operating Class A retail pharmacies in Utah, 127 (27%) were providing pharmacist-prescribed contraception 1 year after implementation of the Utah standing order. Oral contraceptive pills were widely accessible (100%); however, other allowed methods were not (vaginal ring 14%; contraceptive patch 2%). Consultation fees and medication costs varied widely. Participating pharmacies were mainly concentrated in population centers. Assuming access to a personal vehicle, urban areas with a high percentage of Hispanic people (Utah's largest minority race or ethnicity group) have access to a participating pharmacy within a 20-minute driving distance. However, access in rural areas with a high percentage Hispanic or other minority were limited. We identified 235 (40%) census tracts with a high proportion of Utah's residents living below the poverty line or of minority race or ethnicity who also had low access to pharmacist-prescribed contraception. CONCLUSIONS: Although the pharmacy-based model is intended to increase access to contraception, practical availability 1 year after the authorization of pharmacist-prescribed contraception in Utah suggests that this service does not adequately serve rural areas, particularly rural areas with a high proportion of minorities and those living below the federal poverty line.


Asunto(s)
Anticoncepción/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Servicios Farmacéuticos/estadística & datos numéricos , Farmacéuticos/estadística & datos numéricos , Farmacia/estadística & datos numéricos , Adolescente , Adulto , Costos de los Medicamentos/estadística & datos numéricos , Femenino , Implementación de Plan de Salud , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Servicios Farmacéuticos/legislación & jurisprudencia , Farmacias/legislación & jurisprudencia , Farmacias/estadística & datos numéricos , Pobreza/estadística & datos numéricos , Derivación y Consulta/economía , Derivación y Consulta/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Utah , Adulto Joven
17.
PLoS One ; 15(9): e0239693, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32970761

RESUMEN

OBJECTIVE: To examine perceptions, behaviors, and impacts surrounding COVID-19 early in the pandemic response. MATERIALS AND METHODS: A cross-sectional survey of 1,030 U.S. adults was administered on March 31st, 2020. This survey examined attitudes toward media, government, and community responses to COVID-19 by political ideology and sociodemographic factors. Knowledge, anxieties, and impacts of COVID-19 were also assessed. RESULTS: Conservatives were more likely to report that COVID-19 was receiving too much media coverage and people were generally overreacting; liberals were more likely to report the government had not done enough in response to the pandemic. Females and those with lower income experienced more COVID-19 related economic anxieties. Those working and with children at home reported higher social, home, and work disruption. Social distancing behaviors were more common among liberals and were associated with increases in depressive symptoms. General knowledge about COVID-19 was widely exhibited across the sample, however, Black and Hispanic respondents were less likely to correctly answer questions about the availability of a vaccine and modes of transmission. CONCLUSIONS: Public health experts should consider the political climate in crafting messaging that appeals to the values of those across the political spectrum. Research on the COVID-19 pandemic should continue to monitor the effects of social distancing on mental health and among vulnerable populations.


Asunto(s)
Infecciones por Coronavirus/psicología , Conocimientos, Actitudes y Práctica en Salud , Neumonía Viral/psicología , Política , Opinión Pública , Aislamiento Social , Adulto , Anciano , Ansiedad , Betacoronavirus , COVID-19 , Control de Enfermedades Transmisibles/métodos , Estudios Transversales , Depresión , Femenino , Humanos , Internet , Masculino , Medios de Comunicación de Masas , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Encuestas y Cuestionarios , Estados Unidos
18.
Child Abuse Negl ; 108: 104644, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32795716

RESUMEN

BACKGROUND: Research indicates that adverse childhood experiences (ACEs) can lead to poorer adult health, but less is known how advantageous childhood experiences (counter-ACEs) may neutralize the negative effects of ACEs, particularly in young adulthood. PURPOSE: We examined the independent contributions of Adverse Childhood Experiences (ACEs) and Advantageous Childhood Experiences (counter-ACEs) that occur during adolescence on five young adult health indicators: depression, anxiety, risky sexual behaviors, substance abuse, and positive body image. PARTICIPANTS AND SETTING: The sample included 489 adolescents from a large northwestern city in the United States who were 10-13 years at baseline (51 % female). METHODS: Flourishing Families Project survey data were used for this secondary analysis using structural equation modeling. Adolescents and their parents completed an annual survey. ACEs and counter-ACEs were measured over the first five years of the study. The five health indicators were measured in wave 10 when participants were 20-23 years old. RESULTS: Participants had on average 2.7 ACEs and 8.2 counter-ACEs. When both ACEs and counter-ACEs were included in the model, ACEs were not predictive of any of the health indicators and counter-ACEs were predictive of less risky sex (-.12, p < .05), substance abuse (-.12, p < .05), depression (-.11, p < .05), and a more positive body image (.15, p < .01). Higher ratios of counter-ACEs to ACEs had a particularly strong effect on improved young adult health. CONCLUSIONS: Counter-ACEs that occur in adolescence may diminish the negative effects of ACEs on young adult health and independently contribute to better health.


Asunto(s)
Experiencias Adversas de la Infancia , Adolescente , Adulto , Experiencias Adversas de la Infancia/estadística & datos numéricos , Ansiedad , Niño , Depresión/etiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Trastornos Relacionados con Sustancias , Encuestas y Cuestionarios , Estados Unidos , Adulto Joven
19.
Inquiry ; 57: 46958020923537, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32500768

RESUMEN

Communities and populations are comprised of individuals and families who together affect the health of the community. The family unit is an unparalleled player for maintaining health and preventing disease for public health because members may support and nurture one another through life stages. Preliminary research confirms that family-oriented health promotion and disease prevention are promising strategies because the family unit is both a resource and a priority group needing preventative and curative services across the life course. Although there are growing numbers of successful efforts, family health systems are generally underutilized in health promotion practice. This lack of utilization in policy and practice have hampered the collection of robust evidence for family health. This paper purports that families are important actors in public health. Yet, since no one pattern for healthy families is known, public health practitioners can consider six principle-based approaches to legitimately and respectfully advance the families' innate potential for health promotion and disease prevention. Each perspective aims to foster higher capacity for family health systems to function appropriately in public health practice. Health promotion practitioners and researchers can explore family health perspectives with the potential for systems policy and practice adjustments in public health.


Asunto(s)
Atención a la Salud/normas , Salud de la Familia/normas , Política de Salud , Promoción de la Salud , Evaluación de Resultado en la Atención de Salud , Adolescente , Adulto , Niño , Humanos
20.
Front Public Health ; 8: 587125, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33330329

RESUMEN

Families strongly influence the health of communities and individuals across the life course, but no validated measure of family health exists. The absence of such a measure has limited the examination of family health trends and the intersection of family health with individual and community health. The purpose of this study was to examine the reliability and validity of the Family Health Scale (FHS), creating a multi-factor long-form and a uniform short-form. The primary sample included 1,050 adults recruited from a national quota sample Qualtrics panel. Mplus version 7 was used to analyze the data using a structural equation modeling framework. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) confirmed a 32-item, 4-factor long-form scale. The four factors included (1) family social and emotional health processes; (2) family healthy lifestyle; (3) family health resources; and (4) family external social supports. A 10-item short-form of the FHS was also validated in the initial sample and a second sample of 401 adults. Both the long-form and short-form FHS correlated in the expected direction with validated measures of family functioning and healthy lifestyle. A preliminary assessment of clinical cutoffs in the short-form were correlated with depression risk. The FHS offers the potential to assess family health trends and to develop accessible, de-identified databases on the well-being of families. Important next steps include validating the scale among multiple family members and collecting longitudinal data.


Asunto(s)
Salud de la Familia , Psicometría/normas , Adulto , Análisis Factorial , Humanos , Reproducibilidad de los Resultados , Encuestas y Cuestionarios/normas
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