Psychology Commons^™

“Are You Accepting New Patients?” A Pilot Field Experiment On Telephone-Based Gatekeeping And Black Patients’ Access To Pediatric Care, Tamara Leech, Amy Irby-Shasanmi, Anne L. Mitchell

Department of Public Health Scholarship and Creative Works

Study Objectives

To determine whether the name and accent cues that the caller is Black shape physician offices’ responses to telephone‐based requests for well‐child visits.

Method and Data

In this pilot study, we employed a quasi‐experimental audit design and examined a stratified national sample of pediatric and family practice offices. Our final data include information from 205 audits (410 completed phone calls). Qualitative data were blind‐coded into binary variables. Our case‐control comparisons using McNemar's tests focused on acceptance of patients, withholding information, shaping conversations, and misattributions.

Findings

Compared to the control group, “Black” auditors were less likely to be told …

Perspectives On Conceptualizing Developmentally Appropriate Sexuality Education, Sara Silverio Marques, Eva Goldfarb, Julianna Deardoff, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

Despite recognition of the importance of a developmentally appropriate approach to sexuality education, there is little direct guidance on how to do this. This study employed in-depth interviews with experienced sexuality educators and developers of sexuality education materials to identify how this concept is understood and applied in the field. Developmentally appropriate sexuality education was conceptualized consistently across interviews to include (a) addressing developmentally relevant topics, (b) adapting content to cognitive development, (c) accommodating developmental diversity, and (d) facilitating the internalization of sexual health messages. However, these views fell short of incorporating the breadth of knowledge offered by adolescent development …

Perceptions Of Peer Sexual Behavior: Do Adolescents Believe In A Sexual Double Standard?, Michael Young, Susan Cardenas, Joseph Donnelly, Mark J. Kittleson

Department of Public Health Scholarship and Creative Works

BACKGROUND

The purpose of the study was to (1) examine attitudes of adolescents toward peer models having sex or choosing abstinence, and (2) determine whether a “double standard” in perception existed concerning adolescent abstinence and sexual behavior.

METHODS

Adolescents (N = 173) completed questionnaires that included 1 of 6 randomly assigned vignettes that described male and female peer models 3 ways: (1) no information about model's sexual behavior, (2) model in love but choosing abstinence, and (3) model in love and having sex. Participants read the vignette to which they had been assigned and responded to statements about the peer …

Sexuality Education Websites For Adolescents: A Framework-Based Content Analysis, Sara Silverio Marques, Jessica S. Lin, Summer Starling, Aubrey G. Daquiz, Eva Goldfarb, Kimberly Garcia, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

The web has unique potential for adolescents seeking comprehensive sexual health information. As such, it is important to understand the nature, scope, and readability of the content and messaging provided by sexuality educational websites. We conducted a content analysis of 14 sexuality education websites for adolescents, based on the 7 essential components (sexual and reproductive health and HIV, relationships, sexual rights and sexual citizenship, pleasure, violence, diversity, and gender) of the International Planned Parenthood Framework for Comprehensive Sexuality Education. A majority of content across all sites focused on sexual and reproductive health and HIV, particularly pregnancy and STI prevention, and …

A Community Conversation On Adolescent Pregnancy And Parenting Services: Networks Of Support, Gatekeepers To Care, And Non-Compulsory Fathering In A Black Urban Community, Tamara Leech, Elizabeth A. Adams, Marci Littlefield

Department of Public Health Scholarship and Creative Works

This study employed Community-Based Participatory Research (CBPR) methods to document needs and capacity around adolescent pregnancy and parenting in one predominately Black, low-income urban community. Using an iterative focus group method, we engaged 60 participants in a two-day community conversation. Quantitative data from an enrollment questionnaire and qualitative transcripts of the discussions are analyzed. Our results indicate that the community’s greatest capacity lies in a network of women. Men tend to participate in parenting more holistically once formal paternity is established. Neighborhood women typically introduce adolescents to prenatal care, so delays in revealing the pregnancy to them serve as a …

Developing A Measure Of Scientific Literacy For Middle School Students, Helenrose Fives, Mark Nicolich, Amanda Birnbaum, Wendy Huber

Department of Public Health Scholarship and Creative Works

Scientific literacy reflects “a broad and functional understanding of science for general education purposes” (DeBoer, 2000, p. 594). Herein, we present the ongoing development of the Scientific Literacy Assessment (SLA), a work‐in‐progress measure to assess middle school students' (ages 11–14) scientific literacy. The SLA includes a selected response measure of students’ demonstrated scientific literacy (SLA‐D) and a motivation and beliefs scale based on existing measures of self‐efficacy, subjective task value, and personal epistemology for science (SLA‐MB). Our theoretical conceptualization of scientific literacy guided the development of our measure. We provide details from three studies: Pilot Study 1 (n = …

Pregnant Teens In Foster Care: Concepts, Issues, And Challenges In Conducting Research On Vulnerable Populations, Lisa D. Lieberman, Linda L. Bryant, Kenece Boyce, Patricia Beresford

Department of Public Health Scholarship and Creative Works

Teens in foster care give birth at over twice the rate of other teens. Unique challenges exist for these vulnerable teens and babies, yet research on such populations, particularly within the systems that serve them, is limited. A demonstration project at Inwood House, a residential foster care agency in New York City, from 2000 to 2005, at the same time that the Administration for Children's Services was exploring policy and practice changes for this population, is described. Research design and implementation issues, descriptive data, and experiences provide lessons for improving the evidence base to meet the needs of pregnant teens …

Improving Sexuality Education: The Development Of Teacher-Preparation Standards, Elissa M. Barr, Eva Goldfarb, Susan Russell, Denise Seabert, Michele Wallen, Kelly L. Wilson

Department of Public Health Scholarship and Creative Works

BACKGROUND: Teaching sexuality education to support young people’s sexual development and overall sexual health is both needed and supported. Data continue to highlight the high rates of teen pregnancy, sexually transmitted diseases, including human immunodeficiency virus (HIV) infections, among young people in the United States as well as the overwhelming public support for sexuality education instruction. In support of the implementation of the National Sexuality Education Standards, the current effort focuses on better preparing teachers to deliver sexuality education. METHODS: An expert panel was convened by the Future of Sex Education Initiative to develop teacher-preparation standards for sexuality education. Their …

Violence Among Young Adults Receiving Housing Assistance: Vouchers, Race, And Transitions Into Adulthood, Tamara Leech

Department of Public Health Scholarship and Creative Works

Scholarly literature has been very attentive to violence among adolescents whose families receive vouchers. Yet, it provides little information about violence among the more than 400,000 very young adults who head households that receive vouchers. This article explores this relationship, paying particular attention to life course considerations and racial context. Data on 18–22-year-olds, numbering 208, who received housing assistance and participated in the National Longitudinal Survey of Youth 1997 in 2002 indicate that normative theoretical models may not accurately capture the relationship between the transition to adulthood and violence within this group. Results also suggest that among those who experience …

Empowerment-Based Positive Youth Development: A New Understanding Of Healthy Development For African American Youth, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

A shift occurred in research about adolescents in the general population. Research is moving away from deficits toward a resilience paradigm and understanding trajectories of positive youth development. This shift has been less consistent in research and practice with African American youth. A gap also exists in understanding whether individual youth development dimensions generate potential in other dimensions. This study presents an empowerment-based positive youth development model. It builds upon existing research to present a new vision of healthy development for African American youth that is strengths-based, developmental, culture-bound, and action-oriented. It emphasizes the relationship between person and environment, the …

Type Of High-School Credentials And Older Age Adl And Iadl Limitations: Is The Ged Credential Equivalent To A Diploma?, Sze Yan Liu, Niraj R. Chavan, M. Maria Glymour

Department of Public Health Scholarship and Creative Works

Purpose: Educational attainment is a robust predictor of disability in elderly Americans: older adults with high-school (HS) diplomas have a substantially lower disability than individuals who did not complete HS. General Educational Development (GED) diplomas now comprise almost 20% of new HS credentials issued annually in the United States but it is unknown whether the apparent health advantages of HS diplomas extend to GED credentials. This study examines whether adults older than 50 years with GEDs have higher odds of incident instrumental or basic activities of daily living (IADLs) limitations compared with HS degree holders. Methods: We compared odds of …

A Theater-Based Approach To Primary Prevention Of Sexual Behavior For Early Adolescents, Lisa D. Lieberman, Cydelle Berlin, Lori-Ann Palen, Olivia Silber Ashley

Department of Public Health Scholarship and Creative Works

Early adolescence is a crucial period for preventing teen pregnancy and sexually transmitted infections. This study evaluated STAR LO, a theater-based intervention designed to affect antecedents of sexual activity among urban early adolescents (N = 1,143). Public elementary/middle schools received the intervention or served as a wait-listed comparison group in a quasi-experimental study. Students completed pretest and posttest questionnaires. Multivariate regression models were used to examine treatment effects. Comparison students showed significantly greater increases in sexual intentions and decreases in pro-abstinence attitudes and intended age of first sex than treatment group adolescents. Comparison girls showed significantly greater increases in …

Sexuality Education, Eva Goldfarb, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

Sexuality education comprises the lifelong intentional processes by which people learn about themselves and others as sexual, gendered beings from biological, psychological, and sociocultural perspectives. It takes place through a potentially wide range of programs and activities in schools, community settings, religious centers, as well as informally within families, among peers, and through electronic and other media. Sexuality education for adolescents occurs in the context of the biological, cognitive, and social-emotional developmental progressions and issues of adolescence. Formal sexuality education falls into two main categories: behavior change approaches, which are represented by abstinence-only and abstinence-plus models, and healthy sexual development …

The Community Action Framework In Practice: An Illustration Based On The Ready By 21 Coalition Of Austin/Travis County, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

The field of positive youth development has expanded focus from articulating and measuring desired manifestations of positive well-being to assembling the environmental conditions known to promote these desired outcomes. Evidence of the effectiveness of community-level efforts promoting positive youth development is still emerging, in particular theory-driven examples of community-driven youth development. This study examined the Community Action Framework, one theory-based community youth development model, through the experiences of the Ready by 21 Austin/Travis County coalition (RB21). The coalition connects youth-serving organizations and also regional coalitions, while promoting the positive development of area youth. Participant observation, interviewing, and archival strategies were …

Subsidized Housing, Public Housing, And Adolescent Violence And Substance Use, Tamara Leech

Department of Public Health Scholarship and Creative Works

This study examines the separate relationships of public housing residents and subsidized housing residence to adolescent health risk behavior. Data included 2,530 adolescents aged 14 to 19 who were children of the National the Longitudinal Study of Youth. The author uses stratified propensity methods to compare the behaviors of each group—subsidized housing residents and public housing residents—to a matched control group of teens receiving no housing assistance. The results reveal no significant relationship between public housing residence and violence, heavy alcohol/marijuana use, or other drug use. However, subsidized housing residents have significantly lower rates of violence and hard drug use, …

Developing A School Functioning Index For Middle Schools, Amanda Birnbaum, Leslie A. Lytle, Cheryl L. Perry, David Murray, Mary Story

Department of Public Health Scholarship and Creative Works

Despite widespread recognition of schools' role in the healthy development of youth, surprisingly little research has examined the relationships between schools' overall functioning and the health‐related behavior of students. School functioning could become an important predictor of students' health‐related behavior and may be amenable to intervention. This paper describes the development and testing of the School Functioning Index (SFI) as a first step in investigating this question. The index was developed for use with middle schools and conceived as a predictor of students' violent behavior, with the potential for extending research applications to additional health and social behaviors. Using social …

Early Predictors Of Sexual Behavior: Implications For Young Adolescents And Their Parents, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

The study provides empirical evidence of the independent contribution of nonsexual romantic relationships in the seventh grade to the onset of sexual intercourse by the ninth grade for both males and females. In addition, it shows that among females, seventh graders in serious relationships with older teenagers—uniquely defined as those two or more years older—have an increased likelihood of sex in the ninth grade. Finally, the study demonstrates that seventh graders of both genders who have had serious romantic relationships were already significantly different in the sixth grade from those who have not: They had peers who were more accepting …

Perceived Smoking Environment And Smoking Initiation Among Multi-Ethnic Urban Girls, Tracy R. Nichols, Amanda Birnbaum, Sara Birnel, Gilbert J. Botvin

Department of Public Health Scholarship and Creative Works

Purpose

To examine associations between the perceived smoking environment and smoking initiation among urban multi-ethnic adolescent girls in New York City.

Methods

Self-report surveys completed in grades 7, 8, and 9 assessed girls’ (n = 858) smoking initiation, and perceived smoking environment (family smoking, friends’ smoking, smoking norms, and cigarette availability). Carbon monoxide breath samples were collected from girls using a variation of the bogus pipeline procedure.

Results

Differences were found in smoking prevalence with white girls reporting the highest prevalence of smoking at baseline and the greatest increase in smoking prevalence from seventh to eighth grade. Black girls reported …

Naturally Occurring Changes In Time Spent Watching Television Are Inversely Related To Frequency Of Physical Activity During Early Adolescence, Robert W. Motl, Edward Mcauley, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

In this longitudinal study, we examined the relationship between changes in time spent watching television and playing video games with frequency of leisure-time physical activity across a 2-year period among adolescent boys and girls (N=4594" role="presentation" style="box-sizing: border-box; margin: 0px; padding: 0px; display: inline-block; line-height: normal; font-size: 16.200000762939453px; word-spacing: normal; word-wrap: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; position: relative;">). Latent growth modelling indicated that a decrease in time spent watching television was associated with an increase in frequency of leisure-time physical activity. That relationship was strong in magnitude …

Self-Management Strategies Mediate Self-Efficacy And Physical Activity, Amanda Birnbaum, Rod K. Dishman, Robert W. Motl, James F. Sallis, Andrea L. Dunn, Greg J. Welk, Ariane L. Yung, Carolyn C. Voorhees, Jared B. Jobe

Department of Public Health Scholarship and Creative Works

Self-efficacy theory proposes that girls who have confidence in their capability to be physically active will perceive fewer barriers to physical activity or be less influenced by them, be more likely to pursue perceived benefits of being physically active, and be more likely to enjoy physical activity. Self-efficacy is theorized also to influence physical activity through self-management strategies (e.g., thoughts, goals, plans, and acts) that support physical activity, but this idea has not been empirically tested.

Scale Development For Perceived School Climate For Girls’ Physical Activity, Amanda Birnbaum, Kelly R. Evenson, Robert W. Motl, Rod K. Dishman, Carolyn C. Voorhees, James F. Sallis, John P. Elder, Marsha Dowda

Department of Public Health Scholarship and Creative Works

Objectives: To test an original scale assessing perceived school climate for girls' physical activity in middle school girls. Methods: Confirmatory factor analysis (CFA) and structural equation modeling (SEM). Results: CFA retained 5 of 14 original items. A model with 2 correlated factors, perceptions about teachers' and boys' behaviors, respectively, fit the data well in both sixth and eighth-graders. SEM detected a positive, significant direct association of the teacher factor, but not the boy factor, with girls' self-reported physical activity. Conclusions:School climate for girls' physical activity is a measurable construct, and preliminary evidence suggests a relationship with physical activity.

Why Girls? The Importance Of Developing Gender-Specific Health Promotion Programs For Adolescent Girls, Amanda Birnbaum, Tracy R. Nichols

Department of Public Health Scholarship and Creative Works

Adolescence is a time when many girls begin to develop unhealthy behaviors that can affect myriad short- and long-term health outcomes across their lifespan.2There is evidence that smoking, physical activity, and diet are habituated during adolescence, and some physiologic processes of adolescence, such as peak bone mass development, have direct effects on future health.3-4 Establishing healthy practices, beliefs and knowledge among adolescent girls will decrease morbidity and mortality among adult women and potentially affect the health of men and children through women’s role as healthcare agents. This paper provides a brief review of lifestyle health behaviors among women and girls …

Predictors Of Violent Behavior In An Early Adolescent Cohort: Similarities And Differences Across Genders, Jonathan L. Blitstein, David M. Murray, Leslie A. Lytle, Amanda Birnbaum, Cheryl L. Perry

Department of Public Health Scholarship and Creative Works

The authors assessed a cohort of 2,335 students from the Minneapolis, Minnesota, area to identify predictors of violent behavior and to determine whether the predictors varied by gender. The sample was 76% White; boys and girls were equally represented. The majority lived with two parents. A measure of violent behavior collected at the end of the eighth-grade year (2000) was entered into Poisson regression against baseline data collected at the beginning of the seventh-grade year (1998). Predictors of violent behavior influencing both boys and girls included depressive symptoms, perceived invulnerability to negative future events, paternal nonauthoritative behavior, and drinking alcohol. …

Longitudinal Invariance Of The Center For Epidemiologic Studies-Depression Scale Among Girls And Boys In Middle School, Robert W. Motl, Rod K. Dishman, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

This study tested the longitudinal factorial invariance of a theoretically consistent, higher-order model for Center for Epidemiologic Studies-Depression (CES-D) scores among adolescent girls and boys in middle school. Data were collected from 2,416 adolescents who completed a survey containing the CES-D in the fall of 1998, spring of 1999, and spring of 2000. The invariance analyses were conducted using LISREL 8.50 with maximum likelihood estimation and the Satorra-Bentler scaled chi-square statistic and standard errors. The higher-order model demonstrated longitudinal, as well as gender, invariance of the overall factor structure and first- and second-order structure coefficients, first-order factor variances, second-order factor …

A Theater-Based Approach To Primary Prevention Of Sexual Behavior For Early Adolescents, Jessica B. Janega, David M. Murray, Sherri P. Varnell, Jonathan L. Blitstein, Amanda Birnbaum, Leslie A. Lytle

Department of Public Health Scholarship and Creative Works

This article compares four mixed-model analyses valid for group-randomized trials (GRTs) involving a nested cohort design with a single pretest and posttest. This study makes estimates of intraclass correlations (ICCs) available to investigators planning GRTs addressing dietary outcomes. It also provides formulae demonstrating the potential benefits to the standard error of the intervention effect (σΔ) from adjustments for both fixed and time-varying covariates and correlations over time. These estimates will allow other researchers using these variables to plan their studies by estimating a priori detectable differences and sample size requirements for any of the four analytic options. These methods are …

School-Based Approaches To Affect Adolescents’ Diets: Results From The Teens Study, Leslie A. Lytle, David M. Murray, Cheryl L. Perry, Mary Story, Amanda Birnbaum, Martha Y. Kubik, Sherri Varnell

Department of Public Health Scholarship and Creative Works

This article reports on the outcomes of the Teens Eating for Energy and Nutrition at School (TEENS) study, a 2-year intervention study conducted in 16 middle schools with a goal of increasing students’ intakes of fruits, vegetables, and lower-fat foods. Despite positive interim results for students randomized to intervention schools, the positive effects of the intervention were not seen for the primary outcomes at the end of the 2nd year. Positive effects were seen only for a food choice score (suggesting that the students usually choose lower versus higher fat foods) and not for measures of food intake. Future studies …

School Functioning And Violent Behavior Among Young Adolescents: A Contextual Analysis, Amanda Birnbaum, Leslie A. Lytle, Peter J. Hannan, David M. Murray, Cheryl L. Perry, Jean L. Foster

Department of Public Health Scholarship and Creative Works

This paper examines associations between overall school functioning and the frequency of violent behaviors among young adolescents (ages 10–14). The sample included 16 middle schools participating in an unrelated intervention study (on nutrition) in Minneapolis, Minnesota. A School Functioning Index developed to characterize schools’ overall stability, performance, and demographics was constructed using data from public archives and school administrator surveys. Data on violent behaviors and other variables were collected in student surveys in fall 1998 and spring 1999. We used multilevel modeling to assess the effect of school functioning on violent behavior after adjusting for known individual-level covariates of violent …

Psychosocial Correlates Of Physical Activity And Sedentary Leisure Habits In Young Adolescents: The Teens Eating For Energy And Nutrition At School Study, Amanda Birnbaum, Kathryn H. Schmitz, Leslie Lytle, Glenn A. Phillips, David M. Murray, Martha Y. Kubik

Department of Public Health Scholarship and Creative Works

BACKGROUND: Low levels of physical activity (PA) and highly sedentary leisure habits (SLH) in youth may establish behavioral patterns that will predispose youth to increased chronic disease risk in adulthood. The purpose of this paper was to examine associations of demographic and psychosocial factors with self-reported PA and SLH in young adolescents. METHODS: A general linear mixed model predicted self-reported PA and SLH in the spring from demographic and psychosocial variables measured the previous fall in 3798 seventh grade students. RESULTS: PA and SLH differed by race, with Caucasian students reporting among the highest PA and lowest SLH. Perceptions of …

Long-Term Outcomes Of An Abstinence-Based, Small-Group Pregnancy Prevention Program In New York City Schools, Lisa D. Lieberman, Heather Gray, Megan Wier, Renee Fiorentino, Patricia Maloney

Department of Public Health Scholarship and Creative Works

Context: Despite drops in U.S. teenage birthrates, questions continue to arise about how best to reduce the country's adolescent birthrate. School-based programs continue to be considered one of the best ways to reach adolescents at risk of early sexual activity.

Methods: A total of 312 students completed a pretest, a posttest and a follow-up one year after the posttest: 125 who had participated in a 3-4-month-long abstinence-based small-group intervention led by trained social workers, and 187 in a comparison group that received no special services.

Results: There were few significant differences between the intervention and comparison groups at posttest. At …

Condom Availability In New York City Public High Schools: Relationships To Condom Use And Sexual Behavior., Sally Guttmacher, Lisa D. Lieberman, David Ward, Nick Freudenberg, Alice Radosh, Don Des Jarlais

Department of Public Health Scholarship and Creative Works

OBJECTIVES: This study examines the impact of the condom availability program in New York City public high schools by comparing rates of sexual activity and condom use for New York students and similar students in Chicago.

METHODS: A total of 7119 students from 12 randomly selected New York schools and 5738 students from 10 Chicago schools participated in a cross-sectional survey.

RESULTS: New York students, compared with Chicago students, reported equal rates of sexual activity but higher rates of condom use at last intercourse (odds ratio [OR] = 1.36). For higher-risk students (those with three or more sexual partners in …