Statistical power in nursing research.

A power analysis was performed on 62 articles that were published in Nursing Research and Research in Nursing and Health during 1989. The analysis revealed that when effects were small, the mean power of the statistical tests being performed to test research hypotheses was .26, indicating a very high risk of committing a Type II error. When effects were moderate, the mean power increased to .71, which is still below the conventionally acceptable power of .80. Only when a study involved large effects was the power adequate (mean of .95). Of the 583 power estimates calculated, 53% were for small effects. These analyses indicate that a substantial number of published nursing studies, and presumably even more of unpublished studies, have insufficient power to detect real effects, primarily because the samples used are too small.

Child sexual abuse and premarital intercourse among high-risk adolescents.

This study examined the extent to which child sexual abuse was associated with an increased likelihood of premarital sex among adolescents at high risk of sexual abuse. The sample consisted of 177 teenage girls who, because of evidence of family dysfunction, had become part of a public child welfare system. Half the sample had been placed in a foster home and the remainder were receiving protective services in their own home. About 40% of the teens in both groups had been sexually abused, although teens still living at home were less likely to have reported abuse. Victims of sexual abuse were found to be more likely to have engaged in voluntary sexual intercourse, even after background factors were controlled. Teens in foster home were somewhat less likely to be sexually active than the teens who remained at home.

PIP: This study examined the extent to which child sexual abuse was associated with an increased likelihood of premarital sex among adolescents at high risk of sexual abuse. The sample consisted of 177 US teenage girls between the ages of 13 and 18 years in a midwestern state, who, because of evidence of family dysfunction, had become part of a public child welfare system. Half the sample had been placed in a foster home and the remainder were receiving protective services in their own home. About 40% of the teens in both groups had been sexually abused, although teens still living at home were less likely to have reported abuse. Victims of sexual abuse were found to be more likely to have engaged in voluntary sexual intercourse, even after background factors were controlled. Teens in foster homes were somewhat less likely to be sexually active than the teens who remained at home.

Sex, contraception and pregnancy among adolescents in foster care.

Young women aged 13-18 who were surveyed in a 1986 study of child welfare clients were over 50 percent more likely to have had sexual intercourse than those in a comparison group drawn from a national sample of young women; they were also more than twice as likely to ever have been pregnant. The child welfare teenagers also scored significantly lower than their counterparts on a test of sexuality and birth control knowledge. Among the child welfare clients (half of whom were at home and half of whom were in foster care), the young women living in foster homes were less likely than those living with their own families to have ever had sex voluntarily (33 percent vs. 47 percent). However, the foster children were less likely to have used birth control at their most recent intercourse or to have obtained contraceptives from a family planning clinic. Nearly half of the foster care teenagers and 40 percent of the teenagers living at home reported having been sexually abused. Victims of sexual abuse were especially likely to be sexually active. Among blacks, the teenagers in foster care and their national counterparts were similar in the proportions who had had sexual intercourse, who had had voluntary intercourse and who had ever been pregnant. Among whites, however, the foster care teenagers were about four times as likely as their matched peers to have had intercourse and to have had voluntary sex, and they were almost eight times as likely to have been pregnant.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of a comprehensive program for teenage parents: five years after project redirection.

A fifth-year follow-up of teenage mothers who had enrolled in Project Redirection, a comprehensive program of services for pregnant and parenting teenagers, revealed many long-term benefits of the program. Administered when the young mothers were, on average, 22 years old, the follow-up found that program participants had better employment records, higher average earnings and lower rates of welfare dependency than a comparison group of similar young mothers who had not enrolled in Project Redirection. Moreover, participants had higher scores on a test of parenting, were more likely to have breastfed their infants and were more likely to have registered their children in Head Start. The children of the Project Redirection participants (whose average age was five and one-half) were better off than their comparison-group counterparts in terms of cognitive, social and emotional development. The two groups of young mothers were similar in terms of their educational attainment after five years, but differences in fertility were observed. Although the two groups had experienced similar numbers of pregnancies, Project Redirection participants were less likely to have terminated a pregnancy by means of induced abortion, and as a result had had a higher average number of live births. The economic status of women who were able to limit their child-bearing was generally more favorable than for those who were not able to do so, but participation in Project Redirection was associated with improved employment outcomes and greater self-sufficiency among all of the women, regardless of the size of their family.

Sex education and family planning services for adolescents in foster care.

Representatives of public child-welfare agencies in 48 states were surveyed to determine their states' policies for meeting the sexual development and family planning needs of teenagers served by the agencies. Only nine states have a formal written policy dealing with this area of child welfare, and just two of the states have a comprehensive policy. A handful of states have deliberately avoided addressing the issue. Officials in other states believe that a formal policy would be counterproductive, arguing that a low-key approach is the best way to deal with the needs of the teenagers they serve. Finally, some state child-welfare officials admit that they have not given the issue much thought. Twenty-nine states offer foster parents special training in adolescent sexuality, and 19 offer such training to caseworkers; however, only five states mandate such training for foster parents and only four do so for caseworkers. Southern states are the most likely to have written policies, while western states are the least likely; western states also are the least likely to offer or mandate special training for caseworkers in contact with teenagers. The officials surveyed also identified a number of institutional barriers that prevent their agencies from developing and implementing policies to deal with the sexual development needs of children in state care.

Early subsequent pregnancy among economically disadvantaged teenage mothers.

This study investigated the antecedents and short-term consequences of an early subsequent pregnancy in a sample of economically disadvantaged teenage mothers. Data were gathered over a two-year period from a sample of 675 young mothers living in eight United States cities. Within two years of the initial interview, when half the sample was still pregnant with the index pregnancy, nearly half of the sample experienced a second- or higher-order pregnancy. Characteristics of the young women at entry into the study were relatively poor predictors of which teenagers would conceive again by the final interview. An early repeat pregnancy was associated with a number of negative short-term consequences in the areas of education, employment, and welfare dependency, even after background characteristics were statistically controlled.

Project Redirection: evaluation of a comprehensive program for disadvantaged teenage mothers.

An evaluation of Project Redirection, a two-year demonstration program designed to help pregnant teenagers and teenage mothers, shows that teenagers from a comparison group, who were not enrolled in the demonstration program, were significantly more likely than project participants to experience a repeat pregnancy after one year, but that after two years the difference was small and nonsignificant. Likewise, at 12 months into the program, the project participants proved more likely to be using contraceptives, but by 24 months the comparison group had caught up. After one year of participation, the project teenagers were more likely than the others either to be in school or to have graduated (56 and 49 percent, respectively). However, this differential also disappeared by 24 months. Nonetheless, even at that point, project teenagers who had dropped out prior to joining the program and those who had had a repeat pregnancy were more likely to be in school or to have completed school than were similar comparison teens. Project teenagers also were somewhat more likely to have held a job during the two-year period than were teenagers not enrolled in the program. All in all, the evaluation demonstrated that teenagers who participated in the project and remained in it for more than a year had consistently better outcomes in education, employment and repeat pregnancy than any other group had. Comparison teenagers who had never participated in any special program for pregnant teenagers, on the other hand, demonstrated consistently poorer outcomes than any other group.

PIP: An evaluation of Project Redirection, a 2-year demonstration program designed to help economically disadvantaged teenage mothers, shows short-term gains but few long-term results in effecting significant changes' in repeat pregnancies, use of contraceptives and schooling. Conducted from mid-1980 to 1983 under the sponsorship of the Ford Foundation and US Department of Labor, Project Redirection coordinated a wide range of services by developing relationships with other service providers in 4 communities--Boston, Mass., New York City (Harlem), Phoenix, Ariz., and Riverside, Calif. Based on a series of interviews with some 675 teenagers (305 from the experimental group and 370 from a comparison group), it was found that, 12 months after the program began, a significantly higher proportion of the comparison than of the project teenagers had a repeat pregnancy (22% and 14%, respectively). However, 12 months later, or a year after the average teenager had completed the program, 49% of the comparison group and 45% of the project teenagers had experienced repeat pregnancies. Similarly, 45% of the comparison group and 54% of the project participants had used some form of contraceptive at last intercourse when the teenagers were interviewed after 12 months. But a year later, the use of a contraceptive at the last intercourse was the same for both groups--54%. In addition, while project teenagers were more likely than the comparison group to have been enrolled in school (87% and 71%, respectively) after 2 years, the difference between the groups was similar to the difference that existed after 1 year. The study indicates the need to extend family planning program services for teenagers for a longer period. This can be accomplished by removing mandatory exit criteria based on the length of time spent in the program, the use of incentives to reward teenagers for longevity or the attainment of major goals, and as an alternative to continuous enrollment, offering teenagers the option of returning periodically for short-term targeted services perhaps every 6 months, or at times of crisis.

Family size and child development.

PIP: For some time now there has been a multidisciplinary interest in the effects of family size on children's development and on their overall life outcomes. In general, available evidence indicates that children from small families tend to accrue advantages in many developmental areas, while children from larger families are, as a group, relatively disadvantaged. Care needs to be taken when drawing conclusions from correlational research, yet there is growing evidence that even when the social class of families is accounted for, children from smaller families fare better on many measures of development than those from large families. 1 of the best documented research findings is that children from smaller families perform better on tests of intellectual ability than children from large families. Efforts to understand why family size should affect intellectual performance have intensified in recent years. Many explanations have been offered, but the explanation termed the "confluence model" has attracted the most interest and controversy. According to this model, a child's intellectual development is a function of the intellectual environment provided by the family. That environment is conceptualized as the average of absolute intelligence of all family members. A child is born with an absolute intelligence of zero. The arrival of each additional child has the effect of lowering the family's intellectual environment. Thus, children from larger families grow up in a less enriched environment and tend to perform less well on measures of ability. A 2nd component of the confluence model is necessary to explain the phenomenon that "only" children fail to perform as well as might be expected on intelligence tests. According to the confluence model, the only child discontinuity results from the absence of an opportunity to tutor younger siblings. Available evidence indicates that family size exerts an effect on educational and occupational achievement over and above its effect on ability. A multidisciplinary explanation for the findings on family size suggests that family resources become "diluted" as family size increases and the result is the various developmental deficits reported by researchers. In sum, there is substantial documentation indicating that children from small families have a better developmental prognosis than children with many siblings. In the aggregate, these effects could have a substantial impact on the quality of a country's citizenry.^ieng

Social and psychological correlates of menopausal symptoms.

The present study explored the effects of various demographic and personality variables on the nature and intensity of subjectively menopausal symptoms. Data were collected by means of a mailed questionnaire from 135 menopausal and postmenopausal women from a general urban population. It was found that women who reported a higher number of menopausal symptoms tended to be less well-educated, were less likely to be working, and viewed themselves in poorer health than women with fewer or no symptoms. Psychosomatic and psychologic symptoms such as nervousness, depression, headaches, and irritability were found to be signififantly related to such personality attributes as self-confidence, personal adjustment, nurturance, and aggression.

Women's knowledge about the menopause.

This study sought to determine women's knowledge concerning the menopause and to investigate the relationship between a woman's level of knowledge and her background characteristics. Data were collected from 167 forty- to 60-year-old women from a general urban population by means of a mailed questionnaire. On the average, the women responded correctly to 59 percent of the questions. Younger women, those who were employed, and women with higher levels of education performed better than older, unemployed, and less well-educated women. Questions on which the women showed the weakest knowledge suggest that old wives' tales concerning the menopause have not totally disappeared.