A culture of care: How Lotus House Women's Shelter heals program participants through genuineness, space, high expectations, dignity, individualized attention, and community.

The present study was designed to examine perceptions of Lotus House Women's Shelter from the perspective of former program participants, for the purpose of informing shelter programming and policies. Our qualitative research followed a community-based participatory research framework. Fifty diverse women graduates of Lotus House Women's Shelter participated in eight focus groups to discuss their experiences with Lotus House and other shelters. Findings from this study highlight the elements that create a "culture of care" within an organization. Participants described Lotus House shelter culture as genuine, defined by dignity and respect, having high expectations for guest independence and accountability, giving space to rest and recuperate, recognizing and accommodating individual needs and experiences, and fostering a sense of community. Creating an organizational "culture of care" is an avenue by which any shelter or related organization can enhance the experience of program participants.

Adolescent girls with a history of Commercial Sexual Exploitation (CSE): Perceptions and characteristics of social networks.

BACKGROUND: Previous research has demonstrated that social support systems such as family, peers, or social services can play a role in adolescent girls' involvement in commercial sexual exploitation (CSE) (Hargreaves- Cormany & Patterson, 2016; Phillips, 2015, Reid & Piquero, 2016). OBJECTIVES: Few studies have specifically explored the meanings adolescent girls with a history of CSE give to their social networks and how these may be associated with CSE vulnerability. The current study examines how important networks are labeled and characterized by these youth. PARTICIPANTS: This study identifies the social networks used by eight racial/ethnic minority adolescent girls who have experienced CSE. METHODS: Using individual interviews, participants were asked to identify individuals and systems with which they interact and provide meanings about these social supports' roles and value in their lives. Additionally, the degree to which participants viewed each source as influential was explored. Thematic analysis was used to analyze the data. Social Network Theory guided the analysis. RESULTS: Two major themes emerged from the data: a) the social networks perceived as influential in the participants' daily lives and b) the perception of the social network's characteristics as negative or positive. Both positive and negative social networks contained some of the same members. CONCLUSION: The current findings point to key social networks for racial/ethnic minority adolescent girls and the potential role of these networks regarding girls' CSE vulnerability. The duality of some network members illustrate the importance of viewing the role of social networks as both complex and dynamic for girls who have experienced CSE. Clinicians should take care to consider the role of intersectional factors when treating members of this community.

Nonconsensual Porn as a Form of Intimate Partner Violence: Using the Power and Control Wheel to Understand Nonconsensual Porn Perpetration in Intimate Relationships.

Over the last decade, nonconsensual porn (NCP), or the sharing of sexually explicit material without a person's consent, has become a growing problem with potentially far-reaching adverse consequences for victims. The purpose of this article is to propose and consider a framework for advancing the field's understanding of NCP within the context of intimate relationships including situating NCP relative to other forms of relational abuse. Specifically, we examined the extent to which NCP in intimate partner relationships was perpetrated using tactics from the Power and Control Wheel through a summative content analysis of U.S. news stories on NCP from 2012 to 2017. This analysis established that NCP has been perpetrated using all eight of the abuse metatactics in the Power and Control Wheel, with the three most common being emotional abuse, coercion and threats, and denial/blame/minimization. Treating NCP in relationships as a potential form of partner violence provides a basis on which to understand the etiology, manifestation, motives, and impact of this form of abuse and informs practitioners' ability to design prevention efforts and engage a trauma-informed response to survivors.

A Network Analysis of Domestic Violence Beliefs Among Young Adults in India.

This study sought to describe the system of beliefs on gender, attitudes toward women, and wife beating, in young adults who live in Mysore, India. Furthermore, it identified structural sex differences in the interplay of values among these matters that can affect individual and community views toward domestic violence. Drawing from survey data gathered from 265 young adult Indian men and women, this study used network analysis to graph a correlation network of beliefs and attitudes toward domestic violence. Node, scale, and network structure descriptions allowed for comparisons among male and female participant responses. The findings support the assertion that there are sex differences among the system of beliefs toward wife beating among Indian young adults. Gender ideology, masculine role in relationships, and legal and social consequences of wife beating emerged as the most important values to focus on when addressing young men's beliefs of domestic violence and attitudes toward women. In contrast, values influencing women's perceptions of domestic violence are more complex and related to multiple beliefs about women's power, family structure, and social and legal implications of domestic violence. The results highlight the importance of recognizing gender differences in the connectivity between gender and wife beating beliefs when designing interventions. There is a need for efforts to accurately target these values and attitudes to more effectively address gendered attitudes and beliefs about domestic violence in this population.

Hispanic women's perceptions of teenage sexting: qualitative analyses using a sexual scripting framework.

Research on sexting perceptions and practices among high school students is extensive; however, this work has focused on predominately White samples, ignoring Hispanic adolescent young women's experiences and interpretations related to sexting. This study used qualitative methods to examine Hispanic college women's reflections on their engagement in and perceptions of image-based sexting during high school. A total of 56 Hispanic college women participated in individual-interviews about high school sexting. Approximately 20% of participants reported sexting images of themselves during high school. The common perception among participants who did not sext was that girls who sent sexualised images of themselves in high school were attention seekers or responding to a request from a boy. Those who sent sexts reported having sent the images of themselves within the context of a romantic relationship. Teenage girls whose sexualised images were widely circulated were viewed negatively by both sexters and non-sexters and faced negative social repercussions. The results highlight the influence of traditional gendered sexual scripting norms on sexting perceptions irrespective of behavioural intentions.

An integrative behavior theory derived model to assess factors affecting HPV vaccine acceptance using structural equation modeling.

The study examined factors that affect parental intention-to-vaccinate adolescent daughters with HPV vaccine in Mysore district, India. A cross-sectional study was conducted among 1609 parents of adolescent girls attending schools in Mysore District between February 2010 and October 2011. A validated questionnaire was used to assess parental attitudes, beliefs related with HPV infection, cervical cancer, HPV vaccine and vaccination in general. Structural equation modeling was used to estimate parameters and assess whether a model based on the integrative behavior theory would fit the current data. More than two-thirds (78.0%) of parents would accept vaccinating their daughters with HPV vaccine. Intention to HPV vaccination significantly increased with increase in the perception of parents about the benefits (standardized regression coefficient (ß) = 0.39) or sources of information about HPV vaccine (ß = 0.24), but intention decreased significantly with an increase in the perception about barriers to HPV vaccination ß = -0.44). The effect of beliefs about severity of HPV infection or cervical cancer (ß = 0.20), and beliefs about benefits (ß = 0.20) or barriers (ß = -0.25) to vaccination in general on intention to HPV vaccination were significantly mediated by parental attitudes and source of information about the vaccine. Geographical location significantly moderated the awareness about HPV on beliefs about severity of HPV infection or cervical cancer (ß = 0.33), and the effect of religion on norms related to HPV vaccination (ß = 0.19). Fit of the model to the data was acceptable. This study identified modifiable parental attitudes about HPV vaccine and beliefs related with HPV infection, cervical cancer and vaccination, which predicted parental intention-to-vaccinate their daughters with HPV vaccine in India. Health education interventions tailored to counter parental negative attitudes and beliefs about HPV vaccine and vaccination in general would be important for the community to promote HPV vaccination.

Knowledge, gender, and guidance: Factors influencing Indian mothers responses to Attention Deficit Hyperactivity Disorder (ADHD).

In the current study, we examined the socio-demographic characteristics and attitudes of Indian mothers, their knowledge about behaviors related to Attention Deficit Hyperactivity Disorder (ADHD) and the relationship with ADHD diagnosis among their children. Previous research showed 11.3% of primary school children in India have been diagnosed with ADHD, yet little research has been conducted on how mothers perceive these behaviors. A survey was completed by 100 mothers with children aged between 4-12 years. The Centers for Disease Control (CDC) ADHD Checklist for Children was used to assess the presence of ADHD symptoms in Indian children. The surveys were analyzed to identify maternal ADHD knowledge, socio-demographic characteristics and attitudes associated with ADHD within the context of Indian culture using SPSS. It was determined that the gender of the child, the geographical location the mother was raised, willingness of mother to seek professional help, mother's knowledge on handling child's behavior and mother's knowledge on ADHD were significantly associated with ADHD. Further analyses revealed that a lack of knowledge of ADHD and handling child's behavior were most associated with anADHD diagnosis based on the CDCADHD checklist.

Using the Theory of Planned Behavior to Examine Beliefs About Verbal Sexual Coercion Among Urban Black Adolescents.

This study used the theory of planned behavior to identify urban Black adolescents' beliefs about male-to-female verbal sexual coercion. Interviews were conducted with 91 urban, Black adolescents (53 boys and 38 girls) to identify their behavioral, normative, and control beliefs about verbal sexual coercion perpetration (for males) and resistance (for females). Boys reported that perpetrating verbal sexual coercion could result in negative relationship outcomes, and the main benefit of using this tactic was to obtain sex. Unsupportive peers and some male family members were seen as encouraging boys to use verbal sexual coercion, whereas parents were seen as opposed to the use of coercion. Being in a private context with a girl and having persuasive skill were seen as facilitating the use of coercion, whereas being with an experienced or skilled girl was a barrier. For girls, positive relationship outcomes and sexual health risks were the benefits and pitfalls of resisting verbal sexual coercion. "Real" friends and family were described as supporting girls' resistance to coercion, while "fake" friends, promiscuous girls, and male peers were seen as not supporting resistance. Girls believed being in a safe, public context would make it easier to resist coercion, while being in a stable relationship with an attractive and persistent partner would make it more difficult to resist. Knowing urban, Black adolescents' beliefs about verbal sexual coercion is the first step toward predicting and intervening on their perpetration and resistance behaviors.

Human Papillomavirus Vaccine Acceptability among Parents of Adolescent Girls in a Rural Area, Mysore, India.

STUDY OBJECTIVE: The purpose of this study was to examine factors predicting human papillomavirus (HPV) vaccine acceptability among parents of adolescent girls in a rural area in Mysore district, India. DESIGN: Cross-sectional. SETTING: Mysore, India. PARTICIPANTS: Parents of school-going adolescent girls. INTERVENTIONS: Parents completed a validated self-administered questionnaire. MAIN OUTCOME MEASURES: Parental willingness to vaccinate their daughters with HPV vaccine. RESULTS: Of the 831 parents who participated in this study, 664 (79.9%) were willing to vaccinate their daughter with HPV vaccine sometime soon if they were invited to receive it. Higher odds of parental willingness to vaccinate their daughters with HPV vaccine was observed among those who believed that HPV vaccine is safe (adjusted odds ratio [aOR], 2.11; 95% confidence interval [CI], 1.01-4.45); their daughter might become sexually active (aOR, 1.84; 95% CI, 1.08-3.13); they have support of other family members to vaccinate their daughter (aOR, 2.86; 95% CI, 1.47-5.57); and that HPV infection causes severe health problems (aOR, 1.64; 95% CI, 1.04-2.57). In contrast, parents who believed that there is low risk that their daughter will get cervical cancer (aOR, 0.52; 95% CI, 0.29-0.95); that the family will disapprove of getting their daughter vaccinated (aOR, 0.45; 95% CI, 0.22-0.76); that the injection might cause pain (aOR, 0.53; 95% CI, 0.31-0.89), and were older-age parents (aOR, 0.96; 95% CI, 0.93-0.99) had lower odds of willingness to vaccinate daughters with HPV vaccine. CONCLUSION: Acceptance of HPV vaccination for daughters was high among rural parents in Mysore, India. However, health education to reduce the belief that injection is painful and that daughters are at low risk to get cervical cancer is important to further improve parental HPV vaccine acceptability in Mysore. Public health education should target older-aged parents and extended family members.

Barriers to HPV Vaccination Among Unvaccinated, Haitian American College Women.

Background: Haitian women residing in the United States are disproportionately affected by cervical cancer. Human papillomavirus (HPV) vaccine has been licensed in the United States since 2006. Vaccination rates are less than optimal overall, and the rates are particularly low among young black women. We investigated barriers to HPV vaccination in a sample of Haitian American college women. Methods: Thirty self-identified Haitian American women, aged 17-26 years, were recruited from a large university campus in southeastern United States (n=30). They completed in-depth face-to-face interviews. The research team analyzed the transcripts using thematic analysis. Results: More than half of the participants (n=18) had not yet initiated the HPV vaccine series. Most of the unvaccinated participants stated that they had received a provider recommendation for the vaccine. Lack of provider recommendation, negative vaccine perception and attitudes, and side effect concerns constituted barriers to vaccination. Conclusions: Haitian American college women at high risk of cervical cancer have cited several barriers to HPV vaccination, with the most prominent being lack of physician recommendation. Healthcare providers should continue recommending the vaccine to college women as many of them may not have received a recommendation. When recommending the HPV vaccine, discussions should be framed with the intent to positively influence HPV vaccine perceptions and ultimately vaccine attitudes.

Urban-Rural Inequities in the Parental Attitudes and Beliefs Towards Human Papillomavirus Infection, Cervical Cancer, and Human Papillomavirus Vaccine in Mysore, India.

STUDY OBJECTIVE: The aim of this study was to compare the parental attitudes and beliefs about human papillomavirus (HPV), cervical cancer, and HPV vaccine between urban and rural areas, India. DESIGN: Cross-sectional. SETTING: Mysore, India. PARTICIPANTS: Parents of school-going adolescent girls. INTERVENTIONS: Parents completed a self-administered questionnaire. MAIN OUTCOME MEASURES: Attitudes and beliefs about HPV, cervical cancer, and HPV vaccine. RESULTS: A total of 1609 parents from urban (n = 778) and rural (n = 831) areas participated in this study. Most of the parents had never heard about HPV (73.6%), did not know that their daughters could get an HPV infection (62.7%) or cervical cancer (64.1%) in the future, and believed that HPV vaccine was not effective (67.1%). Parents living in the urban area were more likely to believe that HPV infection (adjusted odds ratio [aOR], 2.69; 95% confidence interval [CI], 1.43-5.06) and cervical cancer (aOR, 2.68; 95% CI, 1.83-3.91) could cause serious health problems than those living in the rural area. The odds of agreeing that HPV vaccination will make girls sexually active was lower among urban than rural parents (aOR, 0.55; 95% CI, 0.33-0.94). There was no significant difference among parents in the urban and rural areas in their beliefs about susceptibility of their daughter to HPV infection or cervical cancer, and beliefs about the safety and ability of HPV vaccine to protect against cervical cancer. CONCLUSION: Rural parents might be reluctant to recommend behaviors that can help prevent HPV infection and cervical cancer such as HPV vaccination for their daughters.

Addressing Prevention Among HIV-Uninfected Women in PMTCT Programs in South India.

With nearly one million HIV-infected women in India, prevention of mother-to-child transmission (PMTCT) programs serve an important role. While PMTCT programs focus on mothers living with HIV infection, offering them to uninfected pregnant women may prevent maternal HIV infections. To inform future efforts to offer PMTCT programs to uninfected women, we conducted focus groups with 24 uninfected women in the South Indian state of Karnataka who had given birth within the previous 2 years to explore their perceptions and experiences about HIV education and screening during pregnancy. Although all the participants had undergone HIV testing at a public health facility during pregnancy, they reported little knowledge about HIV transmission or prevention. Revisions are needed in existing PMTCT program curricula and instruction methods before they can be offered to uninfected women as an HIV prevention strategy.

Impact of Louisiana's HPV Vaccine Awareness Policy on HPV Vaccination Among 13- to 17-Year-Old Females.

The Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) immunization for 11- to 12-year-old adolescents. In 2008, Louisiana required the school boards to distribute HPV vaccine information to parents or guardian of students in Grades 6 to 12. This article investigates the impact of this policy on HPV vaccination among 13- to 17-year-old female adolescents using National Immunization Survey-Teen (NIS-Teen) data. Drawing on the data from the 2008 to 2012 NIS-Teen, we compared the difference in proportions of females who have been vaccinated before and after the policy. Using difference-indifference estimation, we explored the change in vaccination rates before and after the policy implementation in Louisiana compared with Alabama and Mississippi, two states that did not have such a policy in place. The difference-in-differences estimates for HPV vaccination were not significant. Physician recommendation for HPV vaccination was significantly associated with vaccination among females in Louisiana and Alabama (adjusted odds ratio [aOR] = 7.74; 95% confidence interval [CI; 5.22, 11.5]), and for those in Louisiana and Mississippi (aOR = 7.05; 95% CI [4.6, 10.5]). Compared to the proportion of female adolescents who had received physician recommendation in Alabama or Mississippi, the proportion in Louisiana did not increase significantly in the postpolicy period. HPV vaccination rates did not increase significantly in Louisiana compared to Alabama or Mississippi following the implementation of the policy. Despite Louisiana's policy, physician recommendation remains the key determinant of HPV vaccination. HPV vaccine awareness does not necessarily result in HPV vaccination.

Influence of Parental Conflict Resolution Strategies on Hispanic College Women's Experiences With Verbal Aggression.

The study investigates the relation between interparental verbal aggression, parent-daughter verbal aggression, and verbal aggression in female Hispanic college student's dating relationships ( N = 599). Results showed that mothers' high levels of verbal conflict with fathers were predictive of having high levels of verbal conflicts with their daughters. This in turn, predicted daughters' use of verbal conflict with their intimate partner. Similarly, fathers' high levels of verbal conflict with mothers were predictive of having high levels of verbal conflicts with their daughters. However, this was not found to be predictive of daughters' use of verbal conflict with their intimate partner.

Impact of Virginia's School-Entry Vaccine Mandate on Human Papillomavirus Vaccination Among 13-17-Year-Old Females.

BACKGROUND: The link between human papillomavirus (HPV) and anogenital cancers is well established in the literature. Many states have passed laws requiring funding for HPV education or vaccination. Mandatory HPV vaccination policies have been considered and passed in several states; yet their effectiveness has not been evaluated. This study sought to assess the impact of Virginia's HPV vaccine mandate for school-entry on HPV vaccine uptake among females aged 13-17 years. METHODS: Data from the National Immunization Survey-Teen for the 2008-2012 period were used, and 3,203 adolescent females were included in the analysis. We performed difference-in-differences estimation and logistic regression with a policy and period interaction term. Virginia was considered the treatment state, and South Carolina and Tennessee were the comparison states to account for nonpolicy factors that may have affected vaccination rates during the time period considered in the analysis. RESULTS: There was no evidence of an effect of Virginia's HPV vaccine mandate for school-entry on vaccination rates or on physician vaccination recommendation using either the difference-by-differences analysis or the policy and period interaction term in the logistic regression. Physician recommendation was the factor most strongly associated with vaccination in the Virginia-South Carolina analysis (adjusted odds ratio [aOR] = 9.33; 95% confidence interval [CI]: 6.11-14.3) and in the Virginia-Tennessee analysis (aOR = 9.33; 95% CI: 6.11-14.3). CONCLUSION: Study findings suggest that Virginia's HPV vaccine mandate for school-entry did not lead to a significant increase in HPV vaccination among adolescent females or physician recommendations. However, physician recommendation was the factor most strongly associated with vaccination.

Factors Motivating HPV Vaccine Uptake Among Vaccinated and Nonvaccinated Hispanic Young Adult Women.

INTRODUCTION: To identify factors influencing human papillomavirus (HPV) vaccination up taking decision making among vaccinated and nonvaccinated Hispanic college women. PARTICIPANTS: Hispanic young women between the ages of 18 and 24 years (N = 49). In total, 26 had not received the HPV vaccine, and 23 had started/completed the vaccine series. METHOD: Participants registered for the study via a psychology research pool at a large public university in the southeast United States after institutional review board approval. After completing a demographic information and HPV knowledge Web-based survey, participants were individually interviewed. RESULTS: Differences in HPV vaccine knowledge emerged between vaccinated and nonvaccinated women. Fear of side effects, perceptions of risk, and sources of encouragement influenced willingness to be vaccinated against HPV. Health care providers played a central role in addressing concerns and promoting vaccination. CONCLUSIONS: Health care providers must address and integrate unique decision-making processes influencing Hispanic young adult women's perceptions of HPV vaccination.

Young Hispanic Men and Human Papillomavirus Vaccination Choices.

This exploratory descriptive study examined perceived vulnerabilities to human papillomavirus (HPV) and the correlation to factors influencing vaccine beliefs and vaccine decision making in young Hispanic males attending a large public urban university. Only 24% of participants believed that the HPV vaccine could prevent future problems, and 53% said they would not be vaccinated. The best predictors of HPV vaccination in young Hispanic men were agreement with doctor recommendations and belief in the vaccine's efficacy. Machismo cultural norms influence young Hispanic men's HPV-related decision making, their perceptions of the vaccine, and how they attitudinally act on what little HPV information they have access to. This study provides culturally relevant information for the development of targeted health education strategies aimed at increasing HPV vaccination in young Hispanic men.

Social Networks Influence Hispanic College Women's HPV Vaccine Uptake Decision-making Processes.

This qualitative study was designed to assess current and preferred social networks that influence human papillomavirus (HPV) vaccine decision making in a sample of Hispanic college women. Individual, semi-structured interviews were conducted with 41 Hispanic college women attending a large southeastern Hispanic-serving institution. Television commercials and discussions with mothers were found to be the most influential social networks for current HPV vaccination beliefs. Internet sites, close family members, and healthcare providers' communications were preferred social networks for HPV vaccine information. Perceived accessibility and sense of comfort influenced the order in which these social networks' communications would be accepted. Findings suggest that Hispanic college women utilize specific social networks to gather information and make decisions about HPV vaccination. Continued efforts are needed to promote further understanding of the purpose of the HPV vaccine via these preferred sources of information.

Effects of language of assessment on the measurement of acculturation: measurement equivalence and cultural frame switching.

The present study used a randomized design, with fully bilingual Hispanic participants from the Miami area, to investigate 2 sets of research questions. First, we sought to ascertain the extent to which measures of acculturation (Hispanic and U.S. practices, values, and identifications) satisfied criteria for linguistic measurement equivalence. Second, we sought to examine whether cultural frame switching would emerge--that is, whether latent acculturation mean scores for U.S. acculturation would be higher among participants randomized to complete measures in English and whether latent acculturation mean scores for Hispanic acculturation would be higher among participants randomized to complete measures in Spanish. A sample of 722 Hispanic students from a Hispanic-serving university participated in the study. Participants were first asked to complete translation tasks to verify that they were fully bilingual. Based on ratings from 2 independent coders, 574 participants (79.5% of the sample) qualified as fully bilingual and were randomized to complete the acculturation measures in either English or Spanish. Theoretically relevant criterion measures--self-esteem, depressive symptoms, and personal identity--were also administered in the randomized language. Measurement equivalence analyses indicated that all of the acculturation measures--Hispanic and U.S. practices, values, and identifications-met criteria for configural, weak/metric, strong/scalar, and convergent validity equivalence. These findings indicate that data generated using acculturation measures can, at least under some conditions, be combined or compared across languages of administration. Few latent mean differences emerged. These results are discussed in terms of the measurement of acculturation in linguistically diverse populations.