A Qualitative Study Exploring Reproductive Desires and Parenting Attitudes among Ethnically Diverse Teens at Risk of Unintended Pregnancy.

OBJECTIVES: There is minimal research eliciting teen reproductive desires and parenting attitudes. Behavioral, educational, and public health interventions to prevent teen pregnancy often highlight the negative consequences of teen pregnancy or benefits of delaying parenting. However, limited empirical information is available regarding what factors teens perceive to influence the desire to delay pregnancy. In this study, we sought to identify teen perspectives regarding factors that influence their desire to delay parenting. STUDY DESIGN: A consensual qualitative research approach was used to identify reproductive desires, parenting attitudes, and any factors that influence the desire to delay parenting expressed by at risk teens. Forty participants were randomly selected from a larger clinical trial testing the efficacy of a brief, motivational interviewing-based intervention. During the brief intervention, participants were asked about their parenting attitudes and reproductive desires and factors that influence decisions to avoid teen pregnancy. These recorded segments were extracted, transcribed, and thematically analyzed. RESULTS: The study collected qualitative data on overarching key themes regarding teen parenting attitudes and reproductive desires, as well as factors that influence the desire to delay pregnancy, including education, financial stability, partnership, maturity/responsibility, friendships, and family. Many participants indicated that they wanted to delay parenting due to wanting to pursue future goals and/or not feeling ready for the responsibility of children. CONCLUSION: Overall, teens have a variety of reasons for delaying parenting that may not be explicitly captured by the general gain/loss messaging of current interventions. Allowing teens to explore their own beliefs and values around factors that they perceive to influence their desire to delay parenting creates autonomy and places the focus on the teens themselves and not perceived future losses or gains. IMPLICATIONS: This study analyzed the parenting attitudes and reproductive desires of teens undergoing a parenting prevention motivational interviewing intervention. Through a qualitative assessment, this article identifies themes of teen perspectives regarding factors that influence their desire to delay parenting.

National Email Communication Platforms May Indicate or Contribute to Gender Disparities: Preliminary Analysis of an Academic Medicine Listserv.

Background: Gender disparities are well documented in the academic medicine literature and have been shown to impact representation, rank, and leadership opportunities for women. Social media platforms, including electronic mailing lists (listservs), may contribute to disparities by differentially highlighting or promoting individuals' work in academic and public health settings. Because of this, they provide a record by which to assess the presence of gender disparities; therefore, they become tools to identify gender differences in the frequency or pattern of representation. This study examines the representation of women in academic medicine electronic communications by analyzing weekly email listserv announcements of the American Association of Medical Colleges (AAMC). Materials and Methods: A mixed methods approach was used to analyze listserv communications during two time periods, 2012-2014 and 2018-2019. Each email contained multiple announcements. Individual achievement messages were selected, categorized by gender, and coded with one of three action categories: departures, appointments, and other mentions. Additionally, each notice was coded by professional setting (media, professional organizations, medical school/research, health care systems, public health, and government). Results: We analyzed a total of 5701 announcements in the AAMC communication listserv. Men represented 73.2% (N = 4171) and women 26.8% (N = 1530) of the total announcements. During 2012-2014, 24.0% of announcements were about women, while in the 2018-2019 sample, 35.7% of announcements were about women (p < 0.001). Overall, women were underrepresented in departure-focused messages compared to messages with an appointment or other focus in the sample. The prevalence of women in announcements from the 2012-2014 and 2018-2019 samples also varied based on setting. Conclusions: Findings support the presence of gender disparities in these sets of listserv communications. While social media overall is not considered to be a source of complete information, this study analyzed the same listserv communication by the same organization over the entire period, thereby providing a window into the frequency and type of representation of women's professional activity in academic medicine.

Integrative Health for Women.

Integrative Medicine is a model of health care that combines both conventional and unconventional therapies that serve the whole person and focus on prevention and whole health. Women are the highest utilizers of health care and Integrative Medicine for a variety of reasons. Integrative Medicine represents a more "female energy" in the field of medicine, which is needed even more today as health care moves toward value-based care and out of high-cost and high-harm care. Integrative Medicine can be incorporated into medical practice and into health workers' lives for wellness.

Development and differentiability of three brief interventions for risky alcohol use that include varying doses of motivational interviewing.

BACKGROUND: While brief intervention (BI) for risky alcohol use generally yields positive effects among those identified by screening, effect sizes are small and there is unexplained heterogeneity in outcome. The heterogeneity may be related to differences in intervention style and content, including elements of motivational interviewing (MI). To date, it has been difficult to interpret the role of MI in BI and these gaps in knowledge interfere with efforts to train, disseminate and implement BI that retains and maximizes efficacy. This study sought to develop BI protocols with varying doses of MI and test their differentiability. Differentiable BI protocols could allow for future studies that prospectively evaluate the role MI plays in affecting BI outcome. METHODS: We developed three intervention protocols: brief advice, standard BI (NIAAA Clinician's Guide), and MI-enhanced BI and administered them to 45 primary care patients who reported exceeding recommended drinking limits. We then rated the BI sessions for fidelity to the assigned protocol as well as MI consistency based on Motivational Interviewing Treatment Integrity (MITI) scale scores. The differentiability of BI protocols was determined by calculating fidelity to assigned protocols and comparing MITI scores using pairwise, Tukey-adjusted comparisons of least squares mean scores. RESULTS: High rates of fidelity to each protocol were achieved. The three BI protocols were also highly differentiable based on MITI scores. CONCLUSIONS: The three interventions can be used in future trials to prospectively examine the role MI has in determining BI outcome. Trial registration clinicaltrials.gov NCT02978027, retrospectively registered 11/28/16.

Missed Opportunities: Screening and Brief Intervention for Risky Alcohol Use in Women's Health Settings.

BACKGROUND: Although women's health settings could provide access to women for screening, brief intervention, and referral to treatment (SBIRT) for risky alcohol use, little is known about rates of alcohol use or associated risk for alcohol-exposed pregnancy (AEP) among women's health patients, receipt of SBIRT services in these settings, or patient attitudes towards SBIRT services. METHODS: This study reports the results of a self-administered survey to a convenience sample of women's health patients attending public clinics for family planning or sexually transmitted infection visits. RESULTS: Surveys were analyzed for 199 reproductive-aged women who had visited the clinic within the past year. The rate of risky drinking among the sample was (44%) and risk for AEP was (17%). Despite this, many patients did not receive SBIRT services, with more than half of risky drinking patients reporting that they were not advised about safe drinking limits (59%) and similar rates of patients at risk for AEP reporting that their medical provider did not discuss risk factors of AEP (53%). Patient attitudes towards receipt of SBIRT services were favorable; more than 90% of women agreed or strongly agreed that if their drinking was affecting their health, their women's health provider should advise them to cut down. CONCLUSIONS: Women's health clinics may be an ideal setting to implement SBIRT and future research should address treatment efficacy in these settings.

Determining navigability of terrain using point cloud data.

This paper presents an algorithm to identify features of the navigation surface in front of a wheeled robot. Recent advances in mobile robotics have brought about the development of smart wheelchairs to assist disabled people, allowing them to be more independent. These robots have a human occupant and operate in real environments where they must be able to detect hazards like holes, stairs, or obstacles. Furthermore, to ensure safe navigation, wheelchairs often need to locate and navigate on ramps. The algorithm is implemented on data from a Kinect and can effectively identify these features, increasing occupant safety and allowing for a smoother ride.