College-attending young men's sexual and reproductive health knowledge, attitudes and practices.

ObjectiveMale involvement in contraceptive practice remains low. Family planning and pediatric health associations have recommended an emphasis on long-acting reversible contraceptives (LARC) in clinical counseling with adolescents and young adults, raising concerns about the resulting adverse impact on sexually transmitted infection (STI) rates. Participants: College-attending men responded to an internet based questionnaire (n=31) and a phone-based qualitative interview (n=25). Methods: Our survey solicited attitudes toward and knowledge of contraceptive methods and assessed communication practices with sexual partners regarding use of contraception and disease prevention. Results: Knowledge about female methods of contraception was low, with a comparatively high level of knowledge about Plan B. Parents and health care providers were cited as the most helpful sources of information. Conversations about protection with sexual partners were reported by most men, due mainly to fear of unplanned pregnancy, not STI. Conclusion: Addressing couple communication and dual protection among college-attending men needs greater emphasis.

Opioid use disorder research and the Council for the Advancement of Nursing Science priority areas.

BACKGROUND: Chronic diseases, such as opioid use disorder (OUD) require a multifaceted scientific approach to address their evolving complexity. The Council for the Advancement of Nursing Science's (Council) four nursing science priority areas (precision health; global health, determinants of health, and big data/data analytics) were established to provide a framework to address current complex health problems. PURPOSE: To examine OUD research through the nursing science priority areas and evaluate the appropriateness of the priority areas as a framework for research on complex health conditions. METHOD: OUD was used as an exemplar to explore the relevance of the nursing science priorities for future research. FINDINGS: Research in the four priority areas is advancing knowledge in OUD identification, prevention, and treatment. Intersection of OUD research population focus and methodological approach was identified among the priority areas. DISCUSSION: The Council priorities provide a relevant framework for nurse scientists to address complex health problems like OUD.

National nursing science priorities: Creating a shared vision.

BACKGROUND: Nursing science is essential to advance population health through contributions at all phases of scientific inquiry. Multiple scientific initiatives important to nursing science overlap in aims and population focus. PURPOSE: This article focused on providing the American Academy of Nursing and nurse scientists in the Unites States with a blueprint of nursing science priorities to inform a shared vision for future collaborations, areas of scientific inquiry, and resource allocation. METHODS: The Science Committee convened four times and using Delphi methods identified priorities with empirical evidence and expert opinion for prioritization, state of the science, expert interest, and potential target stakeholders. DISCUSSION: Nursing science priorities for 2017 were categorized into four themes including: (a) precision science, (b) big data and data analytics, (c) determinants of health, and (d) global health. CONCLUSION: Nurse scientists can generate new knowledge in priority areas that advances the health of the world's populations.

Development of Instructional Competencies for Assessing and Managing Suicide Risk for Baccalaureate Nursing Education: A Modified Delphi Study.

Suicide is a major health problem and a leading cause of death throughout the world. A primary goal for suicide prevention is reforming health professional education in order to increase the competence of health professionals in assessing and managing suicide risk. Nursing leadership is involved in this reform, yet nurses frequently lack the competence to care for patients in suicidal crisis. An identified gap in baccalaureate nursing education is instructional competencies for assessing and managing suicide risk. A modified Delphi study was used. The study began with a focus group which was conducted in order to develop the Round I Survey which included forty-four competencies. After scoring these competencies, thirty-four were scored for inclusion, two were dropped and eight were revised according to panel members' comments. The Round II Survey comprised the eight revised competencies which were scored for inclusion, resulting in forty-two competencies in the final set of instructional competencies. Forty-two instructional competencies were developed: fourteen pre-assessment instructional competencies, fifteen assessment instructional competencies, and thirteen management instructional competencies. Incorporating these instructional competencies into baccalaureate nursing education might increase the competence of nursing students, and thus new nurses, in caring for patients at risk for suicide. These instructional competencies provide a first step to address the challenging task of intervening with patients at risk for suicide.

Identifying Health Promotion Needs Among Dominican-American Adolescents.

PURPOSE: Immigration from the Dominican Republic to the United States has grown rapidly. Yet, although adolescent pregnancy and obesity are common concerns among Hispanics, little is known specifically about Dominican adolescent health. This study was undertaken to assess Dominican-American adolescents' health concerns and their perceptions about their health promotion needs. DESIGN AND METHODS: Dominican-American adolescents (N=25) were recruited in a pediatric clinic in New York City which primarily serves a Dominican population. Eligibility criteria included age 13-21years, self-identifying as Dominican ethnicity, and able to speak and read English. They completed a questionnaire, with demographic questions and questions about their risk behaviors including sexual and substance use. After completing the questionnaire, they participated in a semi-structured interview addressing their health education experiences and suggestions for such programs. Quantitative data were analyzed using frequencies to provide a demographic and behavioral profile. Qualitative data were analyzed using thematic analysis. RESULTS: Twenty-five adolescents, ages 13-21years, (female N=19, male N=6) participated in the study. Most were in school (92%) and were sexually experienced (68%). Programmatic preferences included in-person programs rather than online. They spontaneously addressed the importance of cultural issues, and the need to address several issues in addition to sexuality, including obesity and substance use. CONCLUSIONS: Programming for this population should address a broad conceptualization of health, and incorporate Dominican cultural issues. PRACTICE IMPLICATIONS: Nurses working with adolescents of Dominican origin, should provide health education that incorporates the specific needs of this population, including culturally congruent face-to-face interventions.

No Rush to Motherhood: The Lived Experience of African American Never Pregnant Sexually Active Female Teens.

PURPOSE: The aim of this study was to gain a deeper understanding of the lived experiences of underserved minority sexually active teenaged girls' successful avoidance of unwanted pregnancy. DESIGN AND METHOD: Merleau-Ponty's methodology and van Manen's method of doing phenomenological research guided and facilitated the process of the study. 7 participants were eligible and all of them were interviewed for this study. RESULTS: Six main themes were identified: sense of emotional safety; sense of being free from a potential pregnancy; feeling supported by family and friends; connections built on trust and communication; regard for self through self-esteem and self-confidence; and sense of having life goals. CONCLUSION: The interpretive statement of 'these teen-agers experienced a sense of emotional safety, support by family and friends, trust and connection with family, friends and healthcare providers, and self-confidence resulting in the opportunity to develop life goals and feel strongly motivated to be free from pregnancy' was developed after further reflection upon the study themes. PRACTICE IMPLICATIONS: Healthcare providers, primarily nurses, can use the findings of this study to improve their interactions with sexually active never pregnant female teens.

Toward an understanding of the context of anal sex behavior in ethnic minority adolescent women.

Understanding the context of anal sex behavior among ethnic minority adolescent women has public health implications for behavioral sexual health promotion and risk reduction interventions. African-American (n = 94) and Mexican-American (n = 465) women (14-18 years of age) enrolled in a clinical trial completed semi-structured interviews to assess psychosocial and situational factors and relationships to sexual risk behavior, substance use, sexually transmitted infection/HIV acquisition, and violence. Bivariate analyses with comparisons by anal sex experiences identified differences by ethnicity and higher self-reported histories of sexual risk behaviors, substance use, violence, and stressful psychosocial and situational factors among adolescent women experiencing anal sex. Predictors of anal sex identified through logistic regression included Mexican-American ethnicity, ecstasy use, methamphetamine use, childhood sexual molestation, oral sex, and sex with friends for benefits.

Core competency model for the family planning public health nurse.

OBJECTIVES: A core competency model for family planning public health nurses has been developed, using a three stage Delphi Method with an expert panel of 40 family planning senior administrators, community/public health nursing faculty and seasoned family planning public health nurses. DESIGN AND SAMPLE: The initial survey was developed from the 2011 Title X Family Planning program priorities. The 32-item survey was distributed electronically via SurveyMonkey(®). RESULTS: Panelist attrition was low, and participation robust resulting in the final 28-item model, suggesting that the Delphi Method was a successful technique through which to achieve consensus. CONCLUSIONS: Competencies with at least 75% consensus were included in the model and those competencies were primarily related to education/counseling and administration of medications and contraceptives. The competencies identified have implications for education/training, certification and workplace performance.

Heterosexual anal intercourse among Black and Latino adolescents and young adults: a poorly understood high-risk behavior.

The purpose of this study was to gain a better understanding of the context of heterosexual anal intercourse (HAI) among adolescents. Black and Latino youth were recruited at an urban college and an inner-city adolescent clinic. Participants completed a sexual behavioral questionnaire and the Sexual Relationship Power Scale (SRPS). A total of 61 young people, all of whom were sexually experienced, completed the survey (53 females; 8 males). Of these respondents, 20% reported engaging in HAI (N = 12), and 50% reported HAI refusal. The Relationship Control subscale scores of the SRPS were significantly inversely correlated with a history of HAI. Those who reported HAI or HAI refusal were invited to participate in an interview; 15 participants were interviewed. Most women found HAI distasteful, though some enjoyed it and instigated it. Most participants did not associate HAI with HIV-infection risk, and few used condoms. Some reported no longer using condoms for vaginal or oral intercourse after not using condoms for HAI and vice versa. The data suggest that there is no sexual script for HAI. HAI appears to be a complex behavior. Conventional views about it, as a way to preserve virginity or prevent pregnancy, may not be adequate. More research is needed to understand this behavior.

Prevalence and correlates of heterosexual anal intercourse among Black and Latina female adolescents.

Anal intercourse (AI) is a recognized HIV risk behavior, yet little is known about AI among adolescent girls and young women. The authors studied the prevalence and correlates of heterosexual AI (HAI) among Black and Latina adolescent girls and young women. The data come from two randomized clinical trials (RCTs) of HIV prevention interventions with Black and Latina adolescent girls and young women. In the second RCT, a Sexual Relationship Power Scale was added to the questionnaire. Thirty-five percent of participants in the first RCT (N =244) and 23% of those in the second RCT (N =101) reported engaging in HAI, most without a condom. Significant correlations existed between HAI and a high-risk sexual history. HAI is prevalent in this population. Nurses must educate female adolescent patients about risks associated with HAI.

Determinants of Latina obesity in the United States: the role of selective acculturation.

Obesity has reached epidemic proportions in the United States. Hispanic American women in particular have higher rates of obesity than their non-Hispanic White counterparts. In this article, the authors review the existing literature on acculturation as it relates to obesity and health behaviors among U.S. Hispanic women. In addition, a conceptual framework is proposed to examine factors contributing to obesity through "selective acculturation." This concept challenges traditionally held unilateral assumptions that underscore Hispanic women's unhealthful behavioral patterns by explaining a process whereby Hispanic women both maintain some older health-related behaviors and acquire new ones once they settle in a new culture.

A brief, low-cost, theory-based intervention to promote dual method use by black and Latina female adolescents: a randomized clinical trial.

HIV/AIDS disproportionately affects young women of color. Young women who use hormonal contraception are less likely to use condoms. Brief, inexpensive HIV-prevention interventions are needed for high-volume clinics. This study was a randomized clinical trial of two interventions: (a) a video made for this study and (b) an adaptation of Project RESPECT counseling. Four hundred Black and Latina teenage women completed a questionnaire about their sexual behaviors and were randomly assigned to (a) see the video, (b) get counseling, (c) see the video and get counseling, or (d) receive usual care. At 3-month follow-up, those who saw the video and received counseling were 2.5 times more likely to have used a condom at last intercourse with their main partner than teens in the usual care group. These differences did not persist at 12-month follow-up. This suggests that a brief intervention can positively affect condom use in the short term.

Developing a culturally appropriate video to promote dual-method use by urban teens: rationale and methodology.

This article describes the development and production of a video targeted to urban adolescent women who use hormonal contraception. Research has shown that this population is at high risk for nonuse of condoms. Extensive preliminary qualitative and quantitative studies were done to understand the situations in which young women do and do not ask their partners to use a condom. Combining constructs from the health belief model, social cognitive learning theory and the theory of reasoned action with insights gleaned from the preliminary studies, the researchers developed a video that features two young HIV-positive women and two young HIV-negative men. Focus groups with young women helped the researchers edit the video to its current length of 21 minutes. Responses from the focus groups suggest that the video has a strong impact on young women. The video is currently part of a randomized controlled trial of two HIV prevention interventions.

Adolescents and emergency contraception.

The United States has a high rate of teen pregnancies. The Food and Drug Administration recently approved hormonal emergency contraception (EC), which can be used after unprotected intercourse to reduce the likelihood that a pregnancy will occur. Several pill regimens that are now available by prescription only are safe and effective if used within 72 hours of unprotected intercourse. However, teens generally have a low level of awareness of EC, and because the pills are available only by prescription, teens must request a prescription from their pediatric nurse practitioner quickly. Therefore, it may be prudent to provide EC to sexually active teens before the need for it arises.