Preventing Intimate Partner Violence Among Teen Mothers: A Pilot Study.

Despite high rates of intimate partner violence (IPV) among teens who are pregnant or parenting, the field is lacking evidence-based prevention programs designed for this population. The purpose of this study was to comprehensively adapt the evidence-based Safe Dates IPV prevention program and conduct a pilot study of the adapted program with female teens who were pregnant or parenting. We completed formative research including a literature review, focus groups, and pre-testing of adapted content to inform the revised curriculum. We then conducted a randomized controlled trial with 32 teens (average age = 17) to compare the adapted program to the original program on implementation characteristics and outcomes, including IPV perpetration and victimization. Directions of effect favored the adapted program over the original program for 18 out of 21 implementation outcomes for which models could be estimated and for 11 of 12 participant outcomes. The strongest effects, all favoring the adapted program, were found for observer-reported adherence to the curriculum, participant ratings of the relevance of characters and scenarios, participant knowledge of ways to get help for abuse, and attitudes toward IPV. These findings demonstrate the feasibility and acceptability of the adapted program for this target population and suggest that the program may be efficacious when evaluated in a larger study.

Young Mothers' and Fathers' Perceptions of Relationship Violence: A Focus Group Study.

Teens and young adults who are pregnant or parenting are important targets for efforts to prevent intimate partner violence (IPV). To intervene appropriately and effectively, we need to fully understand the unique issues and contexts for IPV in this population. This focus group study examined young parents' ( N = 28) perceptions of their relationships, stressors and sources of conflict, forms of IPV, and help-seeking behaviors. We examined data using template, content, thematic, and framework analyses. Findings about relationships and violence between young parents provide valuable insights for future intervention programs designed to prevent or address IPV among teen parents.

Assessing the effectiveness of Wise Guys: A mixed-methods approach.

Previous research with teens raised questions on the validity of survey studies with this population. As one response, our team implemented a mixed-methods study to evaluate an evidence-based, interactive curriculum, Wise Guys, that is designed to promote healthy relationships and sexual behavior in young men 14-17 years of age. The current study included a Youth Advisory Group, focus groups, and a video-journaling project to delineate teens' thoughts on the most salient aspects of Wise Guys and we used these to develop a stakeholder-informed survey instrument. The survey was administered via REDCap, a computer-based medium via phones and mobile devices. Quantitative survey analyses revealed significant positive changes in study constructs. Qualitative interpretations provided rich data that validated the survey findings. Community engagement in the research process and mixed methods may provide the infrastructure for future research and evaluation efforts related to teens.

Teen Perceptions of Sexual Activity: Influences, consequences, realities, and thoughts on safe sexual health practices.

Teens' engagement in sexual activity and safe sexual practices is an important public health issue in the US today. This descriptive survey study explored teens' thoughts about the influences, consequences, and realities associated with teen sexual activity and pregnancy and their perceptions of access to sexual health education and contraception. Surveys were administered to 856 Delaware youth in 39 high school health classes from 16 schools. Of the 31 survey items, 25 offered significantly different responses; participants agreed with 16 and disagreed with 9 items (p < .005), revealing important findings concerning teen perceptions as the basis for meaningful interventions.

Intimate partner violence and pregnant and parenting adolescents in out-of-home care: reflections on a data set and implications for intervention.

AIMS AND OBJECTIVES: To present the findings from a data set reflecting intimate partner violence among adolescents who are pregnant and parenting and living in out-of-home care and to analyse these findings in order to generate potential interventions to address this significant issue. BACKGROUND: Because of their developmental stage, coupled with the stress of pregnancy and new parenthood, adolescent women who are pregnant or postpartum are often at a high risk of abuse. Violence may include physical, emotional/psychological, verbal and sexual abuse, along with birth control sabotage and pregnancy coercion. Adolescent mothers in out-of-home care such as foster care, juvenile detention facilities, kinship care or living in complex family circumstances may be at an even higher risk of intimate partner violence related to the increase in stress, conflict and tenuous situations. DESIGN: This descriptive study was designed, using baseline self-report and demographic data, to examine the relationship of pregnancy or parenting among adolescents with a fear of or reported involvement in intimate partner violence. METHODS: A total of 151 sexually active, urban, system-involved youths in out-of-home care were assessed between 2012-2015 with a survey questionnaire assessment of sexual reproductive health behaviours, areas of risk and protective factors. RESULTS: The findings indicated a significant association between ever having been pregnant and fear of intimate partner violence. CONCLUSIONS: In this population, fear of intimate partner violence was prevalent among adolescent mothers, adding to the complexity of an already difficult family situation. Due to the small sample size and the potential correlation between intimate partner violence and adolescent motherhood, future longitudinal studies with larger samples of adolescents residing in out-of-home care are needed to better understand how this relationship impacts adolescent mothers, their children and families.

Focus on Teen Men: Evaluating the Effectiveness of the Wise Guys Program.

PROBLEM: Many interventions designed to promote safe sexual behaviors in teens focus on young women. Wise Guys is one curricular intervention designed to foster safe sexual practices in young men. This study assessed knowledge, attitude, and behavioral changes as the result of Wise Guys. METHODS: This pre/posttest descriptive study measured changes in knowledge, attitudes, and sexual behaviors in 159 young men. FINDINGS: This study detected limited knowledge and attitude changes but yielded statistically significant differences in safe sexual behaviors and likelihood to talk with parents or guardians about sexuality and dating. CONCLUSIONS: This study revealed important benefits of Wise Guys and proposed future mixed methods research to ensure that authentic teen voices inform programming. Nurses working with adolescents may find this information valuable as they address sexual health issues in their work.

Stakeholder Perceptions of the Provision of Reproductive Health Services by School-Based Health Centers as They May Inform Public Policy.

The provision of reproductive health services (RHS) by school-based health centers (SBHCs) is the subject of much controversy. Ideological differences about the role of schools in health care and the sexual activity of youth frame this debate. The purpose of this study was to determine the perspectives of key stakeholders related to access to RHS in SBHCs. Individual, semistructured interviews were conducted with 50 adult stakeholders. Template analysis yielded rich answers to the interview questions. Nine overarching themes emerged during thematic analysis. Subthemes and exemplar quotes revealed important insights into public opinion about RHS at SBHCs. Findings reflect strong stakeholder support for the inclusion of RHS in SBHCs as a way to promote teen sexual health. Nurses have an important role in influencing policies related to teen reproductive health such as those addressed in this study.

Preparedness for clinical: evaluation of the core elements of the Clinical Immersion curriculum model.

The Clinical Immersion Model is an innovative baccalaureate nursing curriculum that has demonstrated successful outcomes over the past 10 years. For those intending to adopt the model, individual components in isolation may prove ineffective. This article describes three core components of the curriculum that form the foundation of preparation for the senior-year clinical immersion. Detailed student-centered outcomes evaluation of these critical components is shared. Results of a mixed-methods evaluation, including surveys and focus groups, are presented. Implications of this curricular evaluation and future directions are explored.

A feasibility study to assess the effectiveness of safe dates for teen mothers.

OBJECTIVE: To determine the effectiveness of the adapted Safe Dates curriculum as an intervention for pregnant and/or parenting teens to prevent teen dating violence (TDV). DESIGN: This pre-/posttest, single-sample study provided a means to assess the effectiveness of an adapted Safe Dates curriculum for teen mothers. SETTING: The adapted Safe Dates curriculum was implemented in three schools designed for the unique needs of teens who are pregnant and/or parenting. PARTICIPANTS: The final sample of 41 teen participants, with a mean age of 16.27, completed 80% of the curriculum and two of the three assessments. Most of the teens were pregnant during participation in the curriculum, and six had infants between age 1 and 3 months. METHODS: The teen mothers completed the pretest, participated in the 10-session adapted Safe Dates curriculum, and completed the posttest at the end of the program and 1 month after program completion. The pre/posttest was adapted from the Safe Dates curriculum-specific evaluation instrument. Senior, undergraduate nursing students were trained in and implemented the curriculum. RESULTS: Participation in the adapted Safe Dates program yielded significant differences in the areas of responses to anger, gender stereotyping, awareness of resources for perpetrators and victims, and psychological violence perpetration. CONCLUSIONS: This adapted program may be effective in changing selected outcomes. The implementation of a larger scale, experimental/control group study may demonstrate the program's efficacy at reducing the incidence of TDV among teen mothers.

How teen mothers describe dating violence.

OBJECTIVE: To present voices of young women who were pregnant or new parents as they shared their thoughts on the risks, behaviors, and prevention of teen dating violence (TDV). DESIGN: Descriptive, qualitative analysis. SETTING: Focus groups in schools designed expressly for the needs of young women who are pregnant and parenting. PARTICIPANTS: Twenty-six young mothers participated in one of three focus groups. METHODS: Focus groups explored perceptions of several dimensions of intimate partner violence within the context of pregnancy and parenting. A semi-structured interview guide provided the medium to delve into young mothers' thoughts and perspectives about TDV. RESULTS: Data were organized in four major typologies: describing TDV, increasing the risk, why violence, and prevention of TDV. CONCLUSIONS: This analysis provides important insights into young mothers' lives when teen parenting and violence intersect. Rich data provide the foundation to expand awareness and inform programs and policies designed to address TDV in young women who are pregnant and parenting. Findings may be used by nurses to assess risk, identify teens in violent relationships, and provide for understanding of TDV from the perspectives of young women who are pregnant and parenting.

Using the thoughts on teen parenting survey to determine the impact of Wise Guys.

PURPOSE: The purpose of this project was to determine if the Wise Guys program influences young men's perceptions of the impact a teen birth would have on their lives in the areas of relationships, vocation, and personal life. DESIGN AND METHODS: The Wise Guys program was implemented with 70 adolescent males. The Thoughts on Teen Parenting Survey was used to determine participants' perceptions of the costs and rewards associated with teen parenting. RESULTS: Data, analyzed using paired t-tests, demonstrated that Wise Guys was effective in reinforcing less positive perceptions of teen parenting. PRACTICE IMPLICATIONS: Wise Guys offers an important strategy to impact young men's perceptions about the teen parenting experience and provides one means to promote responsible sexual behavior in teen men.

A pilot program to address healthy sexual behaviors among girls in juvenile detention.

PURPOSE: This pilot study was designed to determine the effectiveness of an intervention on sexual behavior among girls in juvenile detention. METHODS: The pre/posttest model assessed for changes in knowledge, attitudes, and reported behaviors. This program merged three curricula to create the unique Young Women Get Real Program with nursing student program facilitators. FINDINGS: Despite high levels of satisfaction with the program, the data related to the final sample (n = 35) failed to reveal significant changes in measured variables. CONCLUSIONS: The results may inform nurses as they pursue interventions to promote responsible sexual behavior in selected populations.

Development of a survey to assess adolescent perceptions of teen parenting.

Initiatives designed to prevent teen pregnancy are often based on adult perceptions of the negative aspects of a teen birth. Qualitative research has revealed that teens may perceive positive rewards associated with teen parenting. These perceptions have not yet been examined through survey research. The theory of reasoned action proposes that individuals assess the costs and rewards prior to engaging in a behavior and provides a framework for the development of a survey instrument designed to measure adolescent thoughts about the costs and rewards of the teen parenting experience. This manuscript describes the development and testing of a quantitative survey instrument designed to measure adolescents' perceptions. Pretesting, piloting, exploratory factor analysis, and a variety of reliability and validity measures were used to determine the value of the measure. The thoughts on teen parenting survey (TTPS) demonstrates an alpha level of .90. The TTPS yields a cumulative score of teen perceptions about the impact of a teen birth during the adolescent years that may be used to assess youth beliefs, correlated with demographic data, used to identify teens at risk for pregnancy/parenting, or provide a pretest/posttest to assess the effectiveness of interventions designed to foster realistic attitudes toward teen parenting.

Girls and violence: a review of the literature.

Violence and its prevention are key issues in community health nursing. Significant concern and controversy surrounds the current involvement of girls as witnesses, offenders, and victims of violence. This article provides a review of the literature about girls and violence, including the girls' roles as offenders, victims, and witnesses, predictors of violence, consequences associated with violence, and potential ideas for violence prevention. This information paves the way for a subsequent manuscript presenting a review of the literature about girls' perceptions of violence and its prevention and the results of a focus group study designed to determine girls' thoughts about community violence and prevention.

Girls' perceptions of violence and prevention.

This research examines girls' perceptions of violence and its prevention. A purposive sample of 32 young women ages 12-18 who were incarcerated, affiliated with the juvenile justice system, or self-identified as living in disadvantaged neighborhoods participated in 1 of 4 focus groups. Recursive, iterative analysis yielded seven themes, including: violence is learned, violence is contagious, violence is unstoppable, violence is necessary to manage stress and conflict, violence is belonging, violence is connected to other crime, and maybe it can be stopped. These themes provide important insights into young women's thoughts on violence and may inform policies and programs as prevention strategies.

Women's perceptions of centeringpregnancy: a focus group study.

OBJECTIVES: CenteringPregnancy, a model of group prenatal care, provides healthcare assessment, education, and support to women. The current study was designed to determine women's perceptions of the CenteringPregnancy program. METHODS: Twenty-one women participating in CenteringPregnancy, as part of a larger study, shared their thoughts related to the strengths and weaknesses of their healthcare, thoughts on improvement, and how the care impacted their health and health behaviors. A thematic and iterative analysis process, assisted by Ethnograph 6.0, allowed for the emersion of important themes that were validated in a member check process. RESULTS: The focus group participants provided rich insights into their prenatal experiences in CenteringPregnancy. Four substantive themes emerged from the data: It's about respect, Knowledge is Power, I'm a better mother, and Supporting each other. CONCLUSIONS: CenteringPregnancy was well-received by urban, low-income women during their pregnancy and may have value with select populations. Themes, exemplar quotes, and participant observations may assist others interested in implementing the CenteringPregnancy model of care.

Student-centered outcomes evaluation of the Clinical Immersion Program: five years later.

Curricular innovation is an ever-present element of nursing education. It is incumbent for nurse educators to evaluate their curricula and its outcomes to ensure quality nursing education. This article describes a comprehensive student-centered outcome evaluation of the Clinical Immersion Model. This model and the foundational components unique to the curricular design and the senior clinical immersion are described. Several methods of evaluation, including National Council Licensure Examination for Registered Nurses pass rates, exit surveys, alumni surveys, and a senior nursing student focus group, are presented. Implications of this evaluation and future directions are explored to inform potential implementation and adaptation of this effective curriculum by other schools of nursing.

Keeping their attention: innovative strategies for nursing education.

Providing nursing education in clinical and other educational settings presents several challenges. Changes in learners, vast amounts of material to be taught, and decreasing educational resources require increased effectiveness of nurse educators and each educational experience. Current teaching strategies may be enhanced to meet learners' expectations and address the reduced attention spans characteristic of today's learners. This article provides 20 strategies and additional helpful hints to increase learner engagement, improve retention of material, and make nursing education more enjoyable for instructors and learners.