Obesity in the Caribbean: comparative gender analysis of dietary and exercise behaviour [abstract]

OBJECTIVE: The study was initiated to establish guidelines for the application of theory-based health promotion strategies in diet and exercise behaviour. The selected theory is the Trans-theoretical Model of Behaviour Change. The study utilizes three of the core constructs of the trans-theoretical model: the stages of change (the central organizing construct); decisional balance; and self-efficacy in examining fruit and vegetable consumption and exercise participation among adults 18 to 65 years old. The qualitative results are highlighted in this report. METHODS: The qualitative phase of the study was conducted in four countries: Belize, Jamaica, St.Kitts/Nevis and Trinidad and Tobago. Between 7 and 10 focus group discussions were conducted in each country. The variables for selecion of participants were: age range, gender, obesity stage, residential location and socio-economic status. RESULTS: The qualitative phase results indicated that, in the population studied, size was a very important determinant of perceived beauty, social adequacy, functioning and responsiveness. Knowledge relating to lifestyle is high but there is reluctance to effect lifestyle changes in dietary intake and physical activity. Cable television was identified as contributing to these current perceptions. Men were less concerned than women about their weight. Neither fruits nor vegetables were frequently mentioned as forming a part of daily diets of the majority of participants. Physical exercise was generally regarded ad hard work. CONCLUSIONS: The qualitative results of this study show that our approach to obesity prevention requires radical change. (AU)

Characteristics of Jamaicans who smoke marijuana before sex and their risk status for sexually transmitted diseases

Because of the high prevalence of marijuana smoking in Jamaica, it is important to know if this practice is associated with increased risk for STD infections. A national sample of 2,580 randomly selected Jamaicans, aged 15 to 49 years were administered a questionnaire to measure a number of health and behavioural variables. The results indicated that more persons who smoked marijuana before sex had a history of STD infections than non-marijuana smokers, the difference was significant among men (46 percent vs 26 percent, p < 0.001) but not among women (19 percent vs 8 percent, p = 0.09). There was no difference in age, however, more of the smokers were unmarried, poorly educated and unemployed than persons who did not smoke marijuana before sex. They were also more likely to engage in high risk sex behaviours and other risk taking behaviors than non-smokers. The results of multiple logistic analyses indicated that marijuana smoking before sex was an independent risk factor for STDs among men (Odd Ratio = 2.0, p = 0.04). Although it was not possible to determine if the association was causal, the increased risk for STDs among men who smoke marijuana before sex should be incorporated into the Jamaican STD/AIDS control programme by making special efforts to encourage condom use among marijuana smokers (AU)

Working women's sexual risk taking in Jamaica

Although the rates of HIV are increasing among female populations in developing countries, there is little information available about factors influencing sexual risk taking among working class women. This paper describes some of the issues discussed by two groups of 58 women working in Jamaica: Informal Commerical Importers and women working in the Free Zone. These women discuss their economic vulnerability, expectations about the role of men as provides, multiple partners, perception of children as resources and concern about physical abuse as factors that could influence decisions about condom use. The implications of these findings are discussed for their impact of intervention programs targeting working class women in Jamaica.(AU)

Ganja smoking and sex in Jamaica - abstract

The characteristics and risk status for STD infections of Jamaicans who smoked marijuana before having sex were investigated. The study comprised 2580 individuals, aged 15 to 49 years, who were selected using a multi-stage random sampling technique. The results indicated that the prevalence of marijuana smoking before sex was higher among men (12 per cent) than among women (2 per cent). More Jamaicans who smoked marijuana before sex were unemployed and unmarried, had lower education levels and lived in poorer neighbourhoods than those who did not smoke. In addition, more of them were regular alcohol drinkers, took hard drugs and gambled. When their sex behaviour were examined, there was no difference in condom use; however, more marijuana smokers had multiple sex partners, had had STD infections and began having sex at an earlier age than the non-smokers. More male smokers had sex with prostitutes, viewed ponographic material and were involved in partner swapping than the men who did not smoke marijuana. The prevalence of anal and oral sex was higher in women who smoke marijuana before sex compared to the female non-smokers. The results of logistic regression analyses indicated (after controlling for the demographic and behavoral variables mentioned above (OR = 2.3, p<0.01) that men who smoked marijuana before sex had an increased risk of having STD infections. No increased risk was found in women who smoked marijuana before sex. Because of the high prevalence of marijuana smoking among men, it is important that their increased risk for STDs be considered by health authorities in the planning of STD/AIDS control programmes (AU)

Patterns of mental development among young, middle-class Jamaican children

This study looked at the performance on the Griffiths Mental Development Scales of middle-class children, aged 6-60 months, from three suburban neighborhoods in Kingston, Jamaica. Their mean DQs were higher than the English standardisation sample. The high scores below 2 years were similar to those reported from black children elsewhere. After 2 years the scores fell into the general range reported for middle-class children from other countries. The children had relatively high hearing and speech scores and low performance scores. Girls scored higher than boys, but birth order and maternal age were not associated with DQs (AU)

The developmental levels of middle class Jamaican children and associated background factors - abstract

There is little information available on young Jamaican children's performance on tests of mental development. The few studies reported, have focussed on deprived children, and there is a need to compare these children with more advantaged ones living in the same society. In addition there are no published tests standardised for young Jamaicans, and clinical psychologist frequently have to evaluate abnormal children on tests standardised elsewhere, not knowing how normal Jamaicans perform on these tests. In this study we assessed the developmental quoteints (DQs) of middle class children on the Griffiths Mental Development Scales. The sample comprised children living in 3 suburban areas who were between 6 and 60 months of age. Certain social background information was also collected from a questionnaire given in their homes. The mean DQ of the total sample was 113 (SD ñ 15). the scores showed marked variation with age; there was a non-significant tendency to decline from 6 to 36 months followed by a significant increase from 36 to 60 months (r=0.42 p<0.0005). We examined certain background factors to determine if they were associated with DQ scores. Girls had significantly higher scores than boys. Parental educational level and occupational status was consistently associated with children's DQ scores. The association was statistically significant for maternal education. Children attedning preschool facilities had higher DQ scores. Birth order and housing were not associated with DQs. These results were compared with those from a previously reported study of children living in a nearby poor neighbourhood. They were aged between 6 and 36 months and were also tested with the Griffiths Test. The children had scores similar to the middle class children between 6 and 12 months, but gradually dropped behind them and were 14 points behind by 36 months of age. Other studies of three and four-year-old-poor Jamaican children suggest that the gap between them and middle class children widens after 36 months to around 20 points. It is concluded that young children's development is related to their environment in a complex way, and that middle class children's SQs reflect their relatively advantaged environment, whereas poor children are at a devlopmental disadvantage at a very early age (AU)