International Public Health Commons^™

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 …

Need For Cognition And Message Complexity In Motivating Fruit And Vegetable Intake Among Callers To The Cancer Information Service, Pamela Williams-Piehota, Judith Pizarro, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey

Department of Public Health Scholarship and Creative Works

This field experiment examined the impact of an individual's need for cognition (NFC; the tendency to enjoy thinking deeply about issues), complex versus simple messages, and the interaction of NFC and message type on encouraging fruit and vegetable consumption. Callers to the Cancer Information Service of the National Cancer Institute (N = 517) were asked to participate in the experiment at the end of their call. Individual NFC was assessed, and participants were assigned randomly to receive a telephone message promoting fruit and vegetable consumption that was either complex and multifaceted or simple and straightforward. Similarly constructed brochures were mailed …

Strategies For Encouraging The Abandonment Of Female Genital Cutting In West Africa: Experiences From Senegal, Burkina Faso, And Mali, Nafissatou J. Diop, Ian Askew

Reproductive Health

This article explores efforts to encourage abandonment of female genital cutting (FGC) in Senegal, Burkina Faso, and Mali. The strategy of encouraging traditional practitioners to stop performing FGC is not effective as community-level support for the practice remains high. Training health staff significantly improved healthcare providers' levels of knowledge about FGC and its complications. Consequently, it was recommended that such training be incorporated into preservice medical training. The use of community-based strategies like the Village Education Program (VEP) showed the most promise, as their multifaceted approach addresses knowledge, attitudes, actions, and communal support in an integrated manner. The way forward …

Analyse De L'Evolution De La Pratique De L'Excision Au Burkina Faso: L'Environment Institutionel, Politique Et Programmatique De La Lutte Contre La Pratique De L'Excision, Nafissatou J. Diop, Zakari Congo, Aina Ouedraogo, Alphosine Sawadogo, Lydia Saloucou, Ida Tamini

Reproductive Health

La présente analyse du projet Frontiers du Population Council fait un tour historique des événements majeurs de la lutte contre la pratique de l’excision au Burkina Faso avant d’aborder les conventions internationales auxquelles le pays a adhéré ainsi que les textes nationaux adoptés en ce qui concerne les droits de l’homme, spécifiquement le droit des femmes et des enfants. Elle analyse également l’application de la loi à travers l’évolution des cas de condamnation depuis l’adoption de la loi. Enfin, elle s’intéressera à quelques programmes d’intervention mis en place en identifiant les acquis et les limites. Ce travail fait partie d’une …

Decreasing Barriers For Teens: Evaluation Of A New Teenage Pregnancy Prevention Strategy In School-Based Clinics, Abbey C. Sidebottom, Amanda Birnbaum, Sarah S. Nafstad

Department of Public Health Scholarship and Creative Works

Sidebottom et al seek to evaluate the effects of the change in distribution systems on students' receipt of requested contraceptives and demand for contraceptive school-based clinics (SBC). The result of the study reveals that the average number of requests per student was higher under the voucher system, possibly as a consequence of expires vouchers resulting in repeated requests. The findings also suggest that SBCs could go a step further in reducing adolescents' barriers to accessing contraceptives by adopting an on-site direct delivery system..

Zimbabwe: Cbd Roles Modified To Address Zimbabwe's Hiv/Aids Crisis, Frontiers In Reproductive Health

Reproductive Health

In September 1999, the Zimbabwe National Family Planning Council (ZNFPC) and the Population Council initiated a one-year study to assess the performance of ZNFPC’s community-based distribution (CBD) program. A continual decline in the program’s productivity, combined with the expanding HIV/AIDS epidemic, indicated a need to reconsider ZNFPC’s objectives and revise the roles and responsibilities of its full-time, salaried CBD agents. The study examined the productivity, costs, and potential sustainability of the CBD program. Researchers gathered information by reviewing program documents through 1999. They also interviewed program managers, district and community nurses, and community leaders and CBD agents from eight regions. …

Community Involvement In The Prevention Of Mother-To-Child Transmission Of Hiv: Insights And Recommendations, Naomi Rutenberg, Mary Lyn Field-Nguer, Laura Nyblade

HIV and AIDS

Mother-to-child transmission is the primary route of HIV infection in children under 15 years of age. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. Clinical trials in several countries have shown that mother-to-child transmission of HIV can be greatly reduced through administering antiretroviral therapy to pregnant women. These trials culminated in a recommendation by UNAIDS and its partners in the Interagency Task Team for the Prevention of Mother-to-Child Transmission that prevention of perinatal transmission should be a part of the standard package of care for HIV-positive women and their children. …

Women, Communities, And The Prevention Of Mother-To-Child Transmission Of Hiv: Issues And Findings From Community Research In Botswana And Zambia, Laura Nyblade, Mary Lyn Field-Nguer

HIV and AIDS

This paper discusses research in Botswana and Zambia that showed gaps in community knowledge about HIV transmission, particularly from mother to child, and yielded insights into community perspectives about the barriers to using voluntary counseling and testing services; the stigma and fear associated with HIV; traditional norms on breastfeeding; and the role of family and community members in women’s decisions to participate in programs to prevent mother-to-child transmission of HIV. A separate Population Council publication (“Community involvement in the prevention of mother-to-child transmission of HIV: Insights and recommendations”) offers recommendations for community involvement strategies that will encourage program planners to …

Kenia: Detectar La Sifilis Durante La Consulta Prenatal Resulta Costo-Efectivo, Frontiers In Reproductive Health

Reproductive Health

La Organización Mundial de la Salud ha estipulado que la detección y tratamiento de sífilis para todas las mujeres embarazadas resulta eficaz en función de los costos si al menos el 0.1 por ciento de ellas están infectadas. Para atender el problema de la alta tasa de sífilis entre mujeres embarazadas (6.5–7.3%), el Concejo de la Ciudad de Nairobi (CCN) introdujo en 1989 la detección y tratamiento de sífilis materna en sus clínicas de atención prenatal. Sin embargo, su enfoque centralizado—que requiere llevar las muestras de sangre recolectadas a un laboratorio central para hacer la prueba—era ineficiente. Por lo tanto, …

Ghana: Community Workers Can Communicate Sti And Hiv/Aids Messages Effectively, Frontiers In Reproductive Health

Reproductive Health

To support the Government of Ghana’s plan to expand community-based distribution (CBD) programs, the Planned Parenthood Association of Ghana (PPAG) and the Population Council conducted a study in 1999 of the CBD programs of 13 nongovernmental agencies. The study also assessed in depth PPAG’s CBD program, which is the country’s largest and oldest. Data sources included interviews with 301 CBD agents, 27 supervisors, and 20 clinicians in rural and urban areas in 16 districts; observations of 51 PPAG agents interacting with 6 clients each; and 15 focus group discussions with community members, former CBD agents, and CBD clients. CBD programs …

Kenya: On-Site Antenatal Syphilis Services Are Cost-Effective, Frontiers In Reproductive Health

Reproductive Health

The World Health Organization has determined that screening and treating all pregnant women for syphilis is cost-effective if at least 0.1 percent of pregnant women have syphilis. To address the high rate of syphilis among pregnant women (6.5–7.3 percent), the Nairobi City Council (NCC) introduced maternal syphilis screening and management in its antenatal clinics in 1989. However, its centralized approach—taking collected blood samples to a central laboratory for testing—was inefficient. Therefore, in 1992 the NCC tested a decentralized approach in 9 of its 54 antenatal clinics, which featured on-site rapid testing of women by clinic staff and same-day treatment of …

A Participatory Evaluation Of The Life-Skills Training Programme In Myanmar, Unicef, Population Council

Poverty, Gender, and Youth

In 1993 UNICEF/Myanmar launched an innovative project aimed at preventing the further spread of HIV/AIDS through the promotion of reproductive health. One of the activities undertaken was life-skills training for women and youth, conducted in collaboration with the Myanmar Red Cross Society (MRCS) and the Myanmar Maternal and Child Welfare Association (MMCWA). The objective of the training activities was to encourage and promote informed decision-making and care-seeking behavior among youth and women. The training aims to provide detailed and accurate information concerning sexuality, birth spacing, sexually transmitted diseases, and HIV/AIDS, and to provide skills for youth and women to enable …

Dual Protection In An Integrated Community-Based Program: A Case Study Of Tanzania Family Health/Ministry Of Health Project In Mbeya, Grace Mbekem, Jane Chege

Reproductive Health

One of the most pressing challenges for health programs in most sub-Saharan African countries is effectively addressing the increasing prevalence of HIV/AIDS. Recent evidence suggests that controlling sexually transmitted diseases (STDs) through undertaking preventive measures, early diagnosis, and treatment significantly slows the spread of HIV/AIDS. In regard to STI/HIV, Maternal and Child Health (MCH) and Family Planning (FP) clients are described as “low risk” groups. However, in a number of sub-Saharan African countries, the reported levels of STDs are significantly high enough to justify use of limited resources to target this group for STD services. MCH/FP programs have begun to …

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 …

Integrando La Sexualidad En La Planificación Familiar: La Experiencia De Tres Proyectos De Vih/Ets En América Latina Y El Caribe, Julie Becker, Elizabeth Leitman, Mahmoud F. Fathalla

Poverty, Gender, and Youth

Esta edición de Quality/Calidad/Qualité relata la experiencia de tres asociaciones de planificación familiar afiliadas con la International Planned Parenthood Federation/Western Hemisphere Region que han tratado de incorporar una estrategia de prevención del VIH/SIDA en su esquema de trabajo cotidiano. Se examina cómo BEMFAM/Brasil, ASHONPLAFA/Honduras, y FAMPLAN/Jamaica han logrado una transición hacia una oferta de servicios de planificación familiar más enfocada en los clientes mismos y más explícita en el tratamiento de temas sexuales. En cada uno de los tres países, el personal recibió capacitación especial que no sólo los habilitó para proveer información sobre el VIH/SIDA, sino que también les …

Introducing Sexuality Within Family Planning: The Experience Of Three Hiv/Std Prevention Projects From Latin America And The Caribbean, Julie Becker, Elizabeth Leitman, Mahmoud F. Fathalla

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité relates the experience of three family planning associations affiliated with the International Planned Parenthood Federation/Western Hemisphere Region that have tried to incorporate an HIV/AIDS prevention strategy into their existing family planning programs and services. It examines how BEMFAM/Brazil, ASHONPLAFA/ Honduras, and FAMPLAN/Jamaica have made a transition toward a range of family planning services more focused on the clients themselves and more explicit in the treatment of sexual themes. In each of the three countries, the staff received special training that not only enabled them to provide information on HIV/AIDS, but also helped them adopt a broader …

Proceedings Of The Workshop On Integrating Reproductive Tract Infection Case Management In Lgu Health Centers, Population Council

Reproductive Health

This report documents the proceedings of a training workshop on reproductive tract infection (RTI) case management for physicians, nurses, and midwives in selected health centers of the Philippines. The training started with presentation of focus group discussion results emphasizing existing beliefs and perceptions of the community regarding RTIs. The results of the situation analysis served as an eye opener for many in that clients with RTI-related symptoms were found to be rather rare and not systematically managed in the health clinics. Many providers report that since they are not trained to handle such cases, they refer whoever comes with symptoms …

Integrating Rti Services In Primary Health Care System: Observations From An Operations Research In Uttar Pradesh, India, M.E. Khan, Saumya Ramarao, R.B. Gupta, Bella C. Patel, Leila Caleb-Varkey, Jayanti Tuladhar, Sanjeev Kumar, John Townsend

Reproductive Health

Evidence from community studies indicates that significant proportions of Indian women (30 percent) may have reproductive tract infections (RTIs). Given that women are in general asymptomatic and that even symptomatic women may not seek care, the estimates are the minimum levels of prevalence. Most women do not seek treatment for RTIs for such reasons as lack of awareness, acceptance that RTIs are part of women's lives, and lack of treatment facilities. On the supply side, in the public sector the treatment for RTIs is limited with most services provided through STD clinics in urban areas. Seeking treatment at STD clinics …

Community-Based Aids Prevention And Care In Africa—Dissemination Of Phase I Findings: Report Of Five National Workshops, Population Council

HIV and AIDS

Given the constraints faced by the health care infrastructure in responding to the AIDS crisis in sub-Saharan Africa, and the limitations of traditional educational approaches in motivating people to modify their sexual behavior within the African context, community-based efforts at AIDS prevention, and care of those affected, are the first lines of defense against the disease. Thus, they deserve greater scrutiny, to learn from the experiences and to continue and expand their efforts. The “Community-Based AIDS Prevention and Care in Africa: Building on Local Initiatives” project is being carried out by the Population Council with support from Glaxo Wellcome. The …

Community-Based Aids Prevention And Care In Africa: Workshop Report, Andrea Eschen

HIV and AIDS

Representatives from community-based AIDS prevention and care programs in five sub-Saharan African countries spoke about their programs’ strengths, shortcomings, and hopes for the future at a meeting organized by the Population Council that took place on June 5, 1993, in Berlin just prior to the IXth International Conference on AIDS. Participants’ experiences and insights demonstrated the ingenuity and imagination that communities have generated to prevent the spread of HIV and AIDS and how they have taken action where government activities have fallen short. The workshop brought representatives of these programs together with staff of governmental and nongovernmental organizations, funding institutions, …