Sexual and Reproductive Health Knowledge, Attitudes, and Self-Efficacy Among Young Adult Filipino American Women.

INTRODUCTION: Little is known about Filipino American women's (FAW) sexual and reproductive health (SRH). The purpose of this study was to examine the SRH knowledge, attitudes, and self-efficacy among young adult FAW. METHOD: This was a qualitative, descriptive interpretive design. Four focus group interviews and one individual interview were conducted. Purposive sampling was used for this study. Inclusion criteria were female, Filipino American, between the ages 18 and 24 years old, and be able to understand and speak English. RESULTS: Twelve participants (n = 12) were recruited. Three themes emerged from this study: (a) sources of SRH information; (b) influence of cultural values, religion, and intergenerational factors; and (c) facilitators of and barriers to women's health services. DISCUSSION: Themes emerged from the content analysis identifying SRH disparities within the Filipino American community, which may inform future interventions and research on this topic.

Gender differences in the relationship between prescription opioid misuse and depressive symptoms and suicidality among US High School Students.

BACKGROUND: Prescription opioid misuse and suicide among adolescents are significant health challenges. PURPOSE: This study investigated whether effects of prescription opioid misuse on depressive symptoms and suicidality are greater among female than male students. METHODS: Using the 2017 Youth Risk Behavior Survey (N = 14,765), this research estimated additive interactions using risk differences as well as multiplicative interactions using odds ratios. DISCUSSION: Results showed prescription opioid misuse was associated with significantly greater risks among females than males for depressive symptoms (31.1% vs. 20.8%), suicidal ideation (27.3% vs. 19.1%), suicide attempts (18.1% vs. 11.9%) and suicide attempts requiring treatment (8.5% vs. 4.4%). In contrast, multiplicative interactions using odds ratios were all nonsignificant. CONCLUSIONS: Among students who misused prescription opioids, females compared to males had much higher average predicted margins of depressive symptoms, suicidal ideation, suicide attempts, and suicide attempts requiring treatment. Screening for depression and suicidality among adolescents who misuse prescription opioids, and vice versa, is paramount.

Trends in Depressive Symptoms and Suicidality: Youth Risk Behavior Survey 2009-2017.

BACKGROUND: Death by suicide is the second leading cause of death among adolescents globally. Healthy People 2020 set a goal to reduce by 10% the rate of suicide attempts that required treatment and designated the Youth Risk Behavior Survey (YRBS) to measure this objective. OBJECTIVES: This study used cross-sectional YRBS data (2009-2017) to (a) investigate whether gender moderates the linear time trend for the rate of depressive symptoms, suicidal ideation, and suicide attempts among high school students within the United States; (b) estimate these same measures stratified by gender; and (c) investigate whether the Healthy People 2020 goal for reduction in suicide attempts was met in 2017 for males and females. METHODS: Secondary analysis of nationally representative high school students using YRBS data 2009-2017 were analyzed using R and the R survey package. Based on Strengthening the Reporting of Observational Studies in Epidemiology guidelines (STROBE), additive interactions using rate difference were compared to multiplicative interactions using odds ratios. RESULTS: Additive interactions were identified between female gender and linear trends for depressive symptoms, suicidal ideation, and suicide attempts requiring treatment. Females, but not males, had positive linear trends for depressive symptoms, suicidal ideation, and suicide attempts requiring treatment. Suicide attempts requiring treatment among females was 36% higher in 2017 than in 2009 but decreased 13% in males during the same period. DISCUSSION: The Healthy People 2020 goal to reduce suicide attempts requiring treatment by 10% has not been met among females. The divergent trends by gender highlight the importance of surveillance measures by gender. Future research is needed to identify better suicide prevention strategies that address underlying factors and are gender specific.

Can Active Video Games Improve Physical Activity in Adolescents? A Review of RCT.

Children and adolescents are not meeting the required federal physical activity (PA) guidelines established by the United States Department of Health and Human Services. It is critical that a regular pattern of PA is established in their youth to ensure ongoing PA into adulthood. However, many programs implemented during adolescence have shown limited effects, stressing the need for more innovative approaches to generate more interest and maintenance of PA behavior in this age group. Active video games (AVGs) or exergaming may prove to be an innovate process to improve PA in children and adolescents. A literature review was conducted to explore if active video games or exergaming could be an effective intervention to improve physical activity in adolescents. Active video games, also called "exergames", are a category of video games that require movement or physical exertion to play the game. The methodology consisted of searching Academic Search Premier, CINAHL, The Cochrane Library, ERIC, PubMed, and Web of Science databases. Inclusion criteria involved only youth aged 12 to 19 years, randomized controlled trials (RCTs), and studies within the last 12 years. The following search terms were used: exergaming or active video games; physical activity or exercise; adolescents or youth; RCT or randomized clinical trial. The outcome indicates that exergaming or active video games can be an effective tool to improve PA in adolescents that will be more acceptable and sustainable than many conventional approaches.

Contributors to Depressed Mood in Black Single Mothers.

Participants: A convenience sample of 210 community dwelling Black single mothers ages 18 to 45, who reside in U.S. urban communities.Methods: A descriptive, cross-sectional design was employed. Participants responded to an open-ended question that asked about reasons for depressed mood. A directed approach to content analysis was used to categorize the responses based on existing theoretical formulations and empirical findings about the causes of depression in women. Percentages and frequencies were used to describe the results of the analysis.Findings: A total of 319 usable responses were provided. Collectively and individually the most frequent responses were consistent with Social/Environmental factors such as lack of financial resources (n = 115; 36.05%), followed by Psychological factors such as general cognitive/emotional feelings of stress (n = 60; 18.81%), and parenting stressors or daily hassles (n = 40; 12.54%). Physiologic factors such as a having physiologic or medical conditions were reported less often (n = 14; 4.39%).Conclusions/Implications: Social/Environmental and Psychological factors contribute to depressed mood more often than Physiological factors in Black single mothers. Depression prevention efforts should target the social determinants of mental health in Black single mothers who should be connected with appropriate financial, psychological, educational and social service resources in the community.

Additive Interactions Between Gender and Bullying Victimization on Depressive Symptoms and Suicidality: Youth Risk Behavior Survey 2011-2015.

BACKGROUND: Bullying victimization is common among adolescents and increases the likelihood of depressive symptoms and suicidality. Two previous meta-analyses have shown that these relationships do not significantly vary by gender. OBJECTIVES: This research investigated whether there are significant positive additive interactions between bullying victimization and female gender on depressive symptoms, suicidal ideation, suicide attempts, and suicide attempts that required treatment. METHODS: For this research, analyses of pooled data from the 2011, 2013, and 2015 Youth Risk Behavior Survey (N = 44,632) were performed to estimate measures of additive interaction, as well as measures of multiplicative interaction in order to examine whether the relationship between bullying victimization and depressive symptoms or suicidality significantly varied by gender. RESULTS: Measures of additive interaction show that the magnitude of the relationship between bullying victimization and depressive symptoms or suicidality is significantly greater among female than male individuals. In contrast, measures of multiplicative interaction indicate that the magnitude of the relationship between bullying and depressive symptoms or suicidality is not significantly greater among female than male individuals. DISCUSSION: Measures of additive interaction are relevant for nursing and population health research. Future research should further explore how and why bullying victimization appears to more profoundly affect female individuals more than male individuals and how to mitigate it.

Trends in bullying victimization by gender among U.S. high school students.

This research used four consecutive waves of data from the National Youth Risk Behavior Survey (YRBS) conducted by the Centers for Disease Control (CDC), to estimate linear time trends by gender in the prevalence of school and electronic bullying victimization among U.S. high school students (N = 61,042). Dependent variables were student self-reported school bullying victimization and electronic bullying victimization during the previous 12 months. Independent variables used to estimate multiple logistic regression models by gender were survey year, race/ethnicity, and grade level. Results showed the prevalence of school bullying increased significantly among females from 2009 (21.2%) to 2015 (24.8%), linear trend OR = 1.08 [1.04, 1.12]; and decreased significantly among males from 2009 (18.7%) to 2015 (15.8%), linear trend OR = 0.93 [0.89, 0.98]. Prevalence of electronic bullying was unchanged between 2011 to 2015 among both male and female students. Asian race, relative to White race, was associated with significantly lower rates of both school and electronic bullying victimization among females, but not males. The incidence of school and electronic bullying victimization was significantly lower among Black and Hispanic students, but not among multiple-race students, regardless of student gender. Healthy People 2020 set a goal to reduce school bullying victimization 10% by 2019. As of 2015, school bullying victimization decreased significantly among males (16% decrease); it significantly increased among females (17% increase). Future research should explore underlying factors related to these divergent trends, and develop effective strategies to reverse the alarming rise in female school bullying victimization.

Use of Theory to Examine Health Responsibility in Urban Adolescents.

The study's purpose was to examine the factors that may influence health responsibility among adolescents. More specifically, this study examined relationships among health responsibility, resilience, neighborhood perception, social support, and health promoting behaviors in adolescents, between the ages of 13 and 18years old. The Health Promotion Model was used as the theoretical framework. This study empirically tested theoretical relationships postulated in the literature between health responsibility and the variables: (a) resilience (b) social support (c) neighborhood perception (d) social support and (e) health promoting behaviors. DESIGN/METHODS: A correlational study design was used. A convenience sample of 122 adolescents in an urban setting completed questionnaires assessing health responsibility, resilience, social support, neighborhood perception, health promoting behaviors, and a demographic questionnaire. Pearson correlations were used to examine relationships among variables. RESULTS: A statistically significant relationship was found between health responsibility and healthy promoting behaviors (r=0.733, p<0.001) and between health responsibility and neighborhood perception (r=0.163, p<0.01). No relationships were found between the dependent variable of health responsibility and the independent variables of resilience and social support in this population. CONCLUSIONS: Study findings help contribute to the body of knowledge regarding the factors that influence health responsibility among urban adolescents to promote adoption and maintenance of healthy behaviors among this population. PRACTICE IMPLICATIONS: Nurses need to educate adolescents to provide them with a good understanding of the consequences of health behaviors so that they can assess their own risk and make responsible, healthy choices.

Understanding the Nonmedical Use of Prescription Medications in the U.S. High School Adolescents.

The purpose of the study was to examine relationships between sleep insufficiency, depressive symptoms, demographic factors, and the nonmedical use of prescription medications (NMUPMs) in the U.S. high school students. Data from the 2013 Youth Risk Behavioral Surveillance System were used ( n = 13,570) and analyzed using IBM SPSS 23™ (complex samples). Significant bivariate relationships were found between the NMUPMs and sleep ( p < .01), feeling sad ( p < .001), grade level ( p < .001), and race/ethnicity ( p < .01). Logistic regression analyses found that all of the independent variables were significant in predicting the likelihood of the NMUPMs. Findings underscore the potential impact of preventing NMUPMs in high school adolescents by improving their sleep behaviors and assessing adolescents for depressive symptoms.

Comparison of adolescents' HIV/AIDS knowledge and self-efficacy across two cultures.

This study examines the effectiveness of a HIV/AIDS peer education program, Teens for AIDS Prevention (TAP) in two cultures. A convenience sample of 287 (American and Nepalese) 9th grade students participated in the study. It was found that HIV/AIDS knowledge scores were significantly higher among American adolescents than their Nepalese counterparts only at pre-intervention. American adolescents had significantly higher self-efficacy scores than Nepalese adolescents both at pre-intervention and post-intervention. Adolescent peer education programs could be used to improve adolescent HIV/AIDS knowledge and self-efficacy for limiting sexual risk behavior; however for the educational programs to be effective, it is pertinent that the program is culturally appropriate to the target population.

Testing theoretical relationships: factors influencing positive health practices (PHP) in Filipino college students.

OBJECTIVE: To examine variables influencing the positive health practices (PHP) of Filipino college students to gain a better understanding of health practices in this ethnic/racial group. Cross-sectional study tested theoretical relationships postulated among (a) PHP, (b) social support (SS), (c) optimism, and (d) acculturation. PARTICIPANTS: A sample of Filipino college students (N = 226) aged 18 to 21 was obtained in June 2009. METHODS: Participants completed 4 instruments. Statistical analyses were performed using SPSS 16.0. RESULTS: Positive correlations were found between PHP and SS (r = .39, p = .01) and optimism and PHP (r = .36, p = .01). No correlation was found between PHP and acculturation. Optimism and SS predicted performance of PHP (R (2) = .18, F[2, 221] = 24.927, p < .001). A difference was found in acculturation levels between participants who grew up in the United States (t[223] = 4.5, p < .001) and those who did not. CONCLUSIONS: Findings help health practitioners and educators to better understand the underlying factors that influence PHP in this population.

Social support, acculturation, and optimism: understanding positive health practices in Asian American college students.

PURPOSE: This study developed and tested a theory to better understand positive health practices (PHP) among Asian Americans aged 18 to 21 years. It tested theoretical relationships postulated between PHP and (a) social support (SS), (b) optimism, and (c) acculturation, and between SS and optimism and acculturation. Optimism and acculturation were also tested as possible mediators in the relationship between SS and PHP. DESIGN: A correlational study design was used. A convenience sample of 163 Asian college students in an urban setting completed four questionnaires assessing SS, PHP, optimism, and acculturation and one demographic questionnaire. FINDINGS: There were statistically significant positive relationships between SS and optimism with PHP, between acculturation and PHP, and between optimism and SS. Optimism mediated the relationship between SS and PHP, whereas acculturation did not. DISCUSSION: Findings extend knowledge regarding these relationships to a defined population of Asian Americans aged 18 to 21 years. IMPLICATIONS FOR FURTHER RESEARCH: Findings contribute to a more comprehensive knowledge base regarding health practices among Asian Americans. The theoretical and empirical findings of this study provide the direction for future research as well. Further studies need to be conducted to identify and test other mediators in order to better understand the relationship between these two variables.

The effects of school poverty on adolescents' sexual health knowledge.

Using National Longitudinal Study of Adolescent Health data, hierarchical linear modeling was conducted to estimate the association of school poverty concentration to the sexual health knowledge of 6,718 adolescents. Controlling for individual socio-economic status, school poverty had modest negative effects on sexual health knowledge. Although not directly associated with sexual health knowledge, after controlling for demographic characteristics, school poverty interactions showed that sexual health knowledge was associated with higher grade point average (GPA) and age. The combination of low GPA and high-levels of school poverty was especially detrimental for students' sexual health knowledge. There are differences in the sexual health knowledge of adolescents attending low poverty and high poverty schools that can be attributed to the school environment.

HIV/AIDS knowledge and self-efficacy among Nepalese adolescents: a peer education program.

The purposes of this study were to develop and test the effectiveness of an HIV/AIDS peer education program in improving Nepalese adolescents HIV/AIDS knowledge and self-efficacy in one of the schools in Nepal. A modified format of the program "Teens for AIDS Prevention" (TAP) was used in this study. A quasi-experimental design was used to test the effectiveness of the peer education program. A convenience sample of 121 ninth grade Nepalese students from an urban high school participated at baseline. The final paired sample included 118 students. The results demonstrated a significant positive relationship between HIV/AIDS knowledge and self-efficacy. Nepalese adolescents' HIV/AIDS knowledge and self-efficacy improved after the peer education intervention. Therefore, school personnel, health care providers, and government and nongovernment organizations should consider developing and implementing school-based HIV prevention programs such as the peer education program.

Factors related to health practices: cervical cancer screening among Filipino women.

This correlational study developed and tested theory to better understand health practices, including cervical cancer screening, among young Filipino women. It tested theoretical relationships postulated among (a) positive health practices, (b) cervical cancer screening, (c) social support, (d) acculturation, and (e) optimism. A convenience sample of 89 young Filipino women in an urban setting was obtained. Participants completed a demographic sheet and five instruments. Significant positive correlations were found between PHP and social support (r = .169, p <.05) and previous cervical cancer screening behavior (r = .285, p <.01) and cervical cancer screening frequency (r = .33, p <.01). Social support was not significantly related to cervical cancer screening. Previous cervical cancer screening behavior was significantly related to optimism (r = .285, p <.01) and screening frequency (r = .924, p <.01). Optimism was significantly related to positive health practices (r = .209, p <.05) and cervical cancer screening knowledge (r = .224, p <.05) but not significantly related to previous cervical cancer screening behavior or screening frequency. Findings contribute to a more comprehensive knowledge base regarding positive health practices, including cervical cancer screenings, among young Filipino women.

Factors related to performance of health practices among asian adolescents in the United States.

PURPOSE: This study examined factors related to positive health practices (PHP) among Asian adolescents. More specifically, it tested theoretical relationships postulated between PHP and social support, optimism, self-esteem, loneliness, and acculturation in this population. METHOD: A correlational research design was used and a convenience sample of 151 Asian adolescents was obtained. Participants completed a demographic sheet and six study instruments. RESULTS: Significant positive relationships were found between reported performance of PHP and social support, optimism, self-esteem, and acculturation. A significant inverse relationship was found between loneliness and PHP. CONCLUSIONS: Study findings extend existing knowledge and contribute to a more comprehensive knowledge base regarding health practices among Asian adolescents. Having this knowledge base provides practitioners with a better understanding of the factors related to health practices in Asian adolescents and assists them in developing culturally sensitive interventions aimed at promoting PHP in this population.

Web-based weight management programs for children and adolescents: a systematic review of randomized controlled trial studies.

More than 17% of children aged 6 to 19 years living in the United States are classified as overweight. Medical costs related to overweight and obesity were recently estimated to approximate $100 billion annually. The purpose of this systematic review was to provide the scientific evidence regarding Web-based weight management programs for overweight children and adolescents. Results suggest the potential for Web-based behavioral change programs for weight management in overweight children and adolescents. Future research should emphasize rigorous methodological adequacies, develop theory-based standardized frameworks, investigate types of interventions appropriate for boys and girls in this age group, evaluate long-term effect of interventions, and examine cost as well as clinical effectiveness.

Said another way. Nurses' role in cancer control.

TOPIC: Nurses' role in cancer control. PURPOSE: Many cancers are preventable and curable, if detected early. As the largest group of healthcare professionals, nurses can play a significant role in the control of cancer. Therefore, the purpose of this discussion is to highlight ways nurses can contribute to the prevention and early detection of cancer. It is meant to stimulate nurses' own ideas about the specific role they can play in cancer control, regardless of practice setting. INFORMATION SOURCES: Existing literature, professional practice. CONCLUSION: Nurses have the ability to serve as change agents in strengthening cancer control within the systems they practice, regardless of the type of setting. Nurses can engage in a number of cancer control activities such as providing patient education on cancer risk, cancer prevention, and early detection, and in the development of policy in support of cancer control activities in practice.

Consensus guidelines: improving the delivery of clinical preventive services.

BACKGROUND: Medical directors from the largest competing health plans in the state came together in a noncompetitive way to collaborate on improving the delivery of clinical preventive service (CPS) among their provider base. They identified one consistent set of CPS guidelines based on U.S. Preventive Services Task Force recommendations, the health plan consensus guidelines (HPCG), that they could endorse as priority for guideline implementation. PURPOSE: The purposes of this study were to assess clinicians' knowledge and use of CPS recommendations as a guide to delivering preventive care services to their patients and, most importantly, to test the effectiveness of providing the HPCG to clinicians in an effort to increase knowledge and use of CPS guidelines. DESIGN: Within-subjects repeated-measures design was used. We hypothesized an increase in clinician's knowledge and use of CPS after the provision of the HPCG. METHODS: Survey methodology, including two surveys that assessed clinicians' knowledge and use of CPS in practice, was used. Health plan clinician databases were obtained from the health plans that participated in the development of the HPCG. Health plan clinicians directly involved in delivering preventive services were invited to participate in the study. Final sample included 163 clinicians. Spearman's rho correlation coefficients were determined to examine the relationships between clinician's knowledge and clinician's use of CPS guidelines. Differences between knowledge and use of CPS before and after HPCG were examined by t tests. FINDINGS: No difference was found in the familiarity with U.S. Preventive Services Task Force guidelines before and after receipt of HPCG. However, clinician's use increased significantly. PRACTICE IMPLICATIONS: A consistent set of CPS guidelines provided by competing health plans can improve the delivery of CPS among contracted health plan clinicians. This approach provides a template for competing health plans nationwide to come to consensus on guidelines that support clinicians in the delivery of CPS ().

Mediators of the relationship between social support and positive health practices in middle adolescents.

INTRODUCTION: This correlational study developed and tested theory to better understand positive health practices (PHPs) in middle adolescents. It tested theoretic relationships postulated between PHPs and (a) social support (SS), (b) optimism, and (c) loneliness, and between SS and the variables of optimism and loneliness. Optimism and loneliness were tested as possible mediators in the relationship between SS and PHPs. METHOD: A convenience sample of 204 middle adolescents was obtained. Participants completed a demographic sheet and four instruments. RESULTS: There were statistically significant positive relationships between SS (r=.44) and optimism (r=.54) with PHPs. There was a statistically significant negative relationship between loneliness (r=-.39) and PHPs. There was a statistically significant positive relationship between optimism (r=.63) and SS. There was a statistically significant negative relationship between loneliness (r=-.76) and SS. Optimism was found to partially mediate the relationship between SS and PHP; loneliness did not. DISCUSSION: Findings contribute to a more comprehensive knowledge base regarding health practices in middle adolescents.