Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
August 18, 2006
1. New Knowledge Path Edition: Diabetes in Children and
Adolescents
2. Report Demonstrates Importance of Different Regional
Economies in Children's Vulnerability to Poverty
3. Research Brief Highlights Findings About U.S.
Adolescents' Use of Contraception
4. Article Looks at Adolescent Perception of Sexual
Abstinence
5. Authors Test an HIV-Prevention Intervention for Latino
Adolescents
6. Article Examines Parental English Proficiency and
Children's Health Services Access
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Readers: MCH Alert will not be published for the next 2 weeks. The next
issue is scheduled for September 8, 2006.
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1. NEW KNOWLEDGE PATH EDITION: DIABETES IN CHILDREN AND ADOLESCENTS
The MCH Library released a new knowledge path edition about diabetes in
children and adolescents that includes resources about the types of
diabetes, its prevalence, treatment and care, and lowering the risk of
complications. This electronic resource guide also identifies tools for
staying abreast of new developments in pediatric diabetes research. The
knowledge path is intended for health professionals, program
administrators, educators, and researchers, and a separate section
identifies resources for families. View it online at http://www.mchlibrary.info/KnowledgePaths/kp_diabetes.html.
MCH Library knowledge paths on other maternal and child health topics
are available at http://www.mchlibrary.info/KnowledgePaths/index.html.
The MCH Library welcomes feedback on the usefulness and value of these
knowledge paths. A feedback form is available at http://www.mchlibrary.info/KnowledgePaths/feedback.html.
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2. REPORT DEMONSTRATES IMPORTANCE OF DIFFERENT REGIONAL ECONOMIES IN
CHILDREN'S VULNERABILITY TO POVERTY
The New Poor: Regional Trends in Child Poverty Since 2000 examines
regional differences in the family characteristics of children who
experienced the greatest increases in poverty between 2000 and 2004.
The report, published by the National Center for Children in Poverty,
is based on data from the U.S. Current Population Survey and includes
estimates for children living in households with at least one parent,
relative, or custodian. All results presented in the report are
statistically significant after accounting for parents' education,
parents' employment, parents' nativity, child's race, and type of
residential area. A summary and a discussion of policy implications are
included. The report is available at http://nccp.org/media/npr06_text.pdf.
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3. RESEARCH BRIEF HIGHLIGHTS FINDINGS ABOUT U.S. ADOLESCENTS' USE OF
CONTRACEPTION
Trends and Recent Estimates: Contraceptive Use Among U.S. Teens focuses
on trends and characteristics of contraceptive use among adolescents in
the United States, including contraceptive use at first sex and most
recent sex, as well as specific method used. The research brief,
published by Child Trends, presents an analysis of recently released
nationally representative data from a survey of never-married
adolescents ages 15-19. Patterns of adolescent contraceptive use are
examined by gender, race and ethnicity, and age. A summary and a
discussion of policy implications are also included. The brief is
available at http://www.childtrends.org/Files/ContraceptivesRB.pdf.
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4. ARTICLE LOOKS AT ADOLESCENT PERCEPTION OF SEXUAL ABSTINENCE
"Our findings of confusion around the definition of sexual abstinence
underscore the need for a clear operational definition of abstinence in
research and programs," write the authors of an article published in
the August 2006 issue of the Journal of Adolescent Health. Sexual
abstinence is an important component of adolescent sexually transmitted
infection and pregnancy prevention. Despite high levels of public
investment in "abstinence only" interventions, research is needed to
more clearly define sexual abstinence, as well as the factors that
influence adolescent decision-making around abstinence. The purposes of
the study described in this article were to (1) examine how early and
middle adolescents conceptualize abstinence, (2) identify developmental
and contextual issues influencing abstinence decisions, and (3) explore
the roles of gender and behavioral experience.
Study participants were 42 adolescents (ages 11-17) recruited during
routine visits at a community hospital pediatric clinic that serves a
low-income community with high rates of early sexual onset. Two-stage
face-to-face interviews were used to assess how participants
conceptualized sexual abstinence.
The authors found that
- Participants knew that abstinence had something to do with sex,
but many were unsure of its exact meaning. However, although the term
"abstinence" was misunderstood, the concept of choosing not to have sex
was clear and relevant.
- Participants viewed abstinence as a natural stage of development:
people are abstinent for some time during their lives and then
transition to sexual activity when they feel "ready." According to
participants, readiness was influenced by individual characteristics;
relationship characteristics; and a balance of health, family, and
social risks and benefits.
- Participants considered the transition from abstinence to sexual
activity as an irreversible, life-changing decision.
- Age and sexual experience influenced how participants determined
readiness for sexual activity.
The authors conclude that "Adolescents are likely to be best served by
placing abstinence back within the framework of broader sexuality
education. This would provide adolescents with the information and
decision-making skills to evaluate relationships, develop communication
within relationships, and accurately assess their own level of
readiness."
Ott MA, Pfeiffer EJ, Fortenberry D. 2006. Perceptions of sexual
abstinence among high-risk early and middle adolescents. Journal of
Adolescent Health 39(2):192-197. Abstract available at http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T80-4KJN3G6-G&_user=10&_handle=V-WA-A-W-BW-MsSAYVA-UUA-U-AACYBAZYEY-AACCYEDZEY-ZZEBYZCA-BW-U&_fmt=summary&_coverDate=08%2F31%2F2006&_rdoc=14&_orig=browse&_srch=%23toc%235072%232006%23999609997%23629345!&_cdi=5072&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=5722971242591f902c4b63528c357714.
Readers: More information is available from the MCH Library's
bibliography, Abstinence Education, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_abstined.html&-MaxRecords=all&-DoScript=auto_search_abstined&-search.
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5. AUTHORS TEST AN HIV-PREVENTION INTERVENTION FOR LATINO ADOLESCENTS
"Participation in the HIV risk-reduction intervention resulted in fewer
reports of sexual intercourse and number of sexual partners . . . and
caused an increase in consistent condom use and frequency of condom use
compared with the control intervention," state the authors of an
article published in the August 2006 issue of Archives of Pediatrics
and Adolescent Medicine. Data about the efficacy of behavioral
interventions to reduce sexual risk behavior among Latino adolescents
are sparse. Moreover, no randomized controlled intervention trials have
been conducted with Latino adolescents who are monolingual Spanish
speakers. The article presents findings from a study to test the
efficacy of a culture- and theory-based intervention designed to reduce
HIV sexual risk behavior among Latino adolescents.
The sample for the analysis included 553 self-identified Latino
adolescents (ages 13-18) who were recruited from three northeast
Philadelphia high schools and community-based organizations within
these schools' neighborhoods. The adolescents were stratified by
gender, primary language, ethnicity (Latino and non-Latino), and age,
and then randomly assigned to one of two intervention groups: (1) HIV
risk-reduction curriculum or (2) health-promotion curriculum. The
interventions were similar in organization, format, length, and
delivery modes. Functionally equivalent versions of the curricula in
English and Spanish were implemented using trained bilingual
facilitators. Several self-report measures of sexual activity and
condom use were assessed before and after intervention and at 3, 6, and
12 months. Additional measures were used to increase the validity of
self-reported sexual behavior.
The authors found that
- At follow-up, adolescents in the HIV risk-reduction group were
less likely to report having had sexual intercourse in the past 3
months than were adolescents in the health-promotion group. Similarly,
at follow-up, adolescents in the risk-reduction group were less likely
to report having multiple partners compared with adolescents in the
health-promotion group.
- Adolescents in the risk-reduction group were more likely to
report using condoms consistently and less likely to report days of
unprotected sex than were adolescents in the health-promotion group.
- Among adolescents who were sexually inexperienced at baseline,
those in the risk-reduction group had fewer days of unprotected sex
compared with adolescents in the health-promotion group.
- Among Spanish speakers, the odds of having used a condom at last
sexual intercourse were nearly 5 times higher for adolescents in the
risk-reduction group than for those in the health-promotion group.
"This study is an important contribution in assisting Latino
adolescents to decrease HIV sexual risk behavior," conclude the
authors, adding that "much more research is needed with Latino
adolescents to address the health disparity in HIV and AIDS."
Villarruel AM, Jemmott JB, Jemmott LS. 2006. A randomized controlled
trial testing an HIV prevention intervention for Latino youth. Archives
of Pediatrics and Adolescent Medicine 160(8):772-777. Abstract
available at http://archpedi.ama-assn.org/cgi/content/short/160/8/772.
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6. ARTICLE EXAMINES PARENTAL ENGLISH PROFICIENCY AND CHILDREN'S HEALTH
SERVICES ACCESS
"We found that, in California, children of parents who do not speak
English very well are more likely to lack health insurance and more
likely to go to other countries for health care," state the authors of
an article published in the August 2006 issue of the American Journal
of Public Health. Several studies have found that individuals in the
general population with limited English proficiency face barriers to
accessing and receiving health care. The article examines the
association between parents' level of English proficiency and their
child's access to health care.
Data for the study were drawn from the 2001 California Health Interview
Survey, a random-digit-dialed telephone survey of adults, adolescents,
and children conducted in English, Spanish, Chinese, Vietnamese,
Korean, and Khmer. If a respondent selected English as the language
spoken at home, the person was classified as an English speaker at
home. Those not speaking English at home were asked whether they spoke
English very well, fairly well, or not well. If the interview was
conducted in a language other than English, respondents were asked if
they spoke English very well, well, not well, or not at all. Measures
of health care access included type of health insurance, usual source
of care, contact with the doctor, emergency room visits, delaying or
forgoing care, traveling to another country for health care or
prescription drugs, and discrimination in health care. Covariates
included child's age, gender, citizenship status, area of residence,
and medical insurance; parent education; and family income level.
Researchers examined data on the demographics of children (N=12,797)
and the prevalence of selected access characteristics by the English
proficiency of the responding parent. Researchers also examined the
independent effects of English proficiency on health care access, while
controlling for confounding variables.
The authors found that, compared with children from households in which
the respondent was classified as an English speaker at home,
- Children of parents who spoke English not well or not at all were
significantly more likely to lack health insurance.
- Children from households in which English was not the language
spoken at home were less likely to visit the emergency room within the
past 12 months and less likely to report having delayed or forgone care.
- Children from households in which English was not the language
spoken at home were more likely to have gone to other countries for
health care and prescription medications.
- Children from households in which the parents spoke English not
well or not at all were less likely to have parents who reported being
discriminated against in health care.
"We found that, in California, children of parents who do not speak
English very well are no more likely than other children to lack a
usual source of care or to not have seen a doctor within the past 12
months," state the authors. They conclude that "further research on
access to care among immigrant families and the role of health services
received outside the United States is needed."
Yu S, Huang J, Schwalberg RH, et al. 2006. Parental English proficiency
and children's health services access. American Journal of Public
Health 96(8):1449-1455. Abstract available at http://www.ajph.org/cgi/content/abstract/AJPH.2005.069500v1?ct.
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MCH Alert © 1998-2006 by National Center for Education in Maternal
and
Child Health and Georgetown University. MCH Alert is produced by
Maternal and Child Health Library at the National Center for Education
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