Is abstinence education theory based? The underlying logic of abstinence education programs in Texas.

Authors examined the logic (or the implicit theory) underlying 16 abstinence-only-until-marriage programs in Texas (50% of all programs funded under the federal welfare reform legislation during 2001 and 2002). Defined as a set of propositions regarding the relationship between program activities and their intended outcomes, program staff's implicit theories were summarized and compared to (a) data from studies on adolescent sexual behavior, (b) a theory-based model of youth abstinent behavior, and (c) preliminary findings from the national evaluation of Title V programs. Authors interviewed 62 program directors and instructors and employed selected principles of grounded theory to analyze interview data. Findings indicated that abstinence education staff could clearly articulate the logic guiding program activity choices. Comparisons between interview data and a theory-based model of adolescent sexual behavior revealed striking similarities. Implications of these findings for conceptualizing and evaluating abstinence-only-until-marriage (or similar) programs are examined.

Defining abstinence: views of directors, instructors, and participants in abstinence-only-until-marriage programs in Texas.

This study examined how program directors, instructors, and participant youth from a sample of federally funded abstinence-only-until-marriage education programs in Texas define the term "abstinence" and its object (from what one abstains). A sample of eight programs, from the 32 federally funded programs in the state (funded in fiscal year 2000-2001), were selected for indepth case studies. Interviews were conducted with 29 program staff (10 directors and 19 instructors). Six focus group sessions were held with youth participating in the programs. Interview and focus group transcripts were analyzed qualitatively, with salient themes being coded and counted. Results are presented in terms of frequency of mention of each theme/code. Most respondents (80% of program directors, 89% of instructors, 83% of focus groups) provided definitions of abstinence containing both positive and negative elements. Positive-patterned definitions emphasized specific attitudes and behaviors that must be internalized by youth (Internal Management; Values/Attitudes Incorporation; Abstinence as an Option; Investment in the Future). Negative definitions stressed restraint and avoidance, and focused on the objects of abstinence (Sexual/Vaginal Intercourse; Oral Sex; Anal Sex; Pre-Coital Behaviors; Behaviors with Purpose of Sexual Arousal; Non-Sexual Behaviors). Each element was mentioned by at least 26% of program staff and in at least 17% of youth focus groups. Results indicated substantial variability in how the term "abstinence" is defined. Such variability has implications for development of abstinence education programs, as well as for implementation of valid, equitable, and useful evaluations.

Barriers to the provision of genetic services by primary care physicians: a systematic review of the literature.

PURPOSE: The purpose of this literature review is to report primary care physicians' perceived barriers concerning the provision of genetic services. METHODS: Sixty-eight papers were identified in six electronic databases. Only publications classified as empirical studies (N = 18) were included in this review. RESULTS: Barriers identified most frequently in reviewed studies were inadequate knowledge of basic genetics, lack of detailed or updated family histories, lack of confidence, and lack of referral guidelines. CONCLUSION: Although many primary care physicians perceive genetics as a low practice priority, they do report a need for educational programs in genetics, informational resources, and referral guidelines.

Perceptions of Mexican American clients receiving genetic services in South Texas.

OBJECTIVES: The objectives of this study were to assess the perceptions among medically indigent Mexican American clients in South Texas receiving genetic services, and the effects of these perceptions on the utilization of genetic services. METHODS: Using a qualitative ethnographic approach, 16 caretakers of children with genetic conditions and 7 prenatal clients were interviewed. Interview data were analyzed using the NUD*IST 4 computer program. RESULTS: Clients reported challenges with understanding and utilizing genetic services due to language and communication barriers, poverty, cultural differences, and system issues. CONCLUSION: Client perceptions of genetic services were influenced by experiences with other biomedical providers and traditional healers, and by anxieties precipitated by unfamiliar concepts and approaches to medical care. Recommendations are made to improve provision of genetic services.