Cultural tailoring and feasibility assessment of a sexual health middle school curriculum: a pilot test in Puerto Rico.

BACKGROUND: To assess the need for cultural tailoring of an effective sexual health middle school curriculum, "It's Your Game: Keep It Real" (IYG), prior to implementation in Puerto Rican (PR) middle schools. METHODS: Seventy-three seventh-grade bilingual students participated in IYG curriculum activities (both group-based and computer-based) in two 2-hour testing sessions in spring 2008. Rating scales of acceptability, understandability, credibility, ease of use, and motivational appeal and qualitative feedback via open-ended responses and group process provided insight into needed surface and deep structure cultural tailoring. RESULTS: Students rated IYG highly on cultural tailoring and motivational parameters and were highly engaged by the lesson content. School personnel rated IYG as a feasible strategy for use in PR middle schools. While surface cultural elements (eg, characters, attire, body language) were identified as important foci for adaptation, content related to deeper cultural elements such as core behaviors, risky situations, attitudes, and specific skills were considered as relevant to PR youth as to their US counterparts. CONCLUSION: Effective human immunodeficiency virus, sexually transmitted disease, and pregnancy skills training prevention programs such as IYG that are developed for minority US youth may offer a feasible option for international implementation when extensive cultural adaptation is not a viable option.

Chronic back pain and associated work and non-work variables among farmworkers from Starr County, Texas.

OBJECTIVES: This study estimated the prevalence of chronic back pain among migrant farmworker family members and identified associated work and non-work variables. METHODS: Migrant farmworkers (n = 390 from 267 families) from Starr County, Texas were interviewed in their home once a year for 2 years. The original survey included items measuring demographics, smoking, sleep, farm work, and chronic back pain. For this cross-sectional analysis, multi-level logistic regression was used to identify associated work and other variables associated with chronic back pain while accounting for intraclass correlations due to repeated measures and multiple family members. RESULTS: The prevalence of chronic back pain during the last migration season ranged from 9.5% among the youngest children to 33.3% among mothers. Variables significantly associated with chronic back pain were age (odds ratio [OR], 1.03, per year increase), depressive symptoms while migrating (OR, 8.72), fewer than 8 hours of sleep at home in Starr County (OR, 2.26), fairly bad/very bad quality of sleep while migrating (OR, 3.25), sorting crops at work (OR, 0.18), and working tree crops (OR, 11.72). CONCLUSION: The role of work exposures, depressive symptoms, and sleep in chronic back pain among farmworkers warrants further examination. Refinements in outcome and exposure assessments are also needed given the lack of a standardized case definition and the variety of tasks and crops involved in farm work in the United States.

Knowledge and Risk Perception Regarding HPV Among Latino Alternative School Students in Houston, Texas.

Human Papillomavirus (HPV) is the most common STI among youth in the U.S. As alternative school students are at higher risk of acquiring STIs compared to regular high school students, this study examined HPV knowledge and risk perception among Latino youth attending 9 alternative high schools in Houston, Texas. HPV knowledge measures assessed prevalence, health consequences, symptoms, transmission, and risk reduction strategies. Three measures assessed perceived risk. The sample included 414 youth (58.4% female) with a mean age of 16.6 years (SD = 1.86); 63.8% were sexually experienced. Most (76.0%) were U.S.-born to parents from Mexico, Central or South America (70.8% of mothers and 77.8% of fathers, respectively); 61.7% had parents with less than a high school education. Results indicate that youth answered 1 out of 5 HPV knowledge items correctly (mean = 1.3, SD = 1.45); 35.8% identified skin-to-skin contact during sex as the most common mode of HPV transmission, and 72.5% selected condoms as an effective HPV risk reduction strategy followed by avoiding multiple partners (55.8%), abstinence (47.5%), monogamous relationships (26.8%) and HPV vaccination (22.3%). Only twenty-seven youth (6.5%) perceived themselves to be at high risk for contracting HPV. Regression analyses examining the association between demographic variables, sexual behavior, HPV knowledge, and HPV risk perception, showed significant associations for mothers' place of birth only - youth whose mothers were born outside of the U.S. had significantly lower HPV knowledge than those with American-born mothers (p < 0.007). Findings indicate the need for enhanced educational efforts among Latino alternative school youth regarding the prevalence of HPV and effective risk reduction strategies.