A Review of the Literature Regarding a History of Sexual Abuse as a Risk Factor for Risky Sexual Behavior in Females

Objective: This paper seeks to answer the questions: Does a history of sexual abuse predict risky sexual behavior for females? If so, by what mechanisms does this correlation occur? Method: A literature review was conducted to identify research articles that investigated the correlation between sexual abuse and sexual behavior. Cumulative Index of Nursing and Allied Health (CINAHL), Medline and PsychInfo databases were searched. Medline and CINAHL databases were searched using the terms sexual abuse and risky sexual behaviors. PsychInfo was searched using the terms sexual abuse, risky sexual behaviors, and risk taking behaviors. Studies examined multiple or single incidents of abuse and both childhood and adult victimization. Only abstracts published in English from 1997 and later were considered. Ultimately, 12 articles were reviewed and discussed. Results: There is a correlation between child and adolescent sexual abuse and risky sexual behaviors but the mechanisms by which this correlation exists are not fully understood. The mechanisms may be dependent on the interplay of pre-victimization, victimization, and post-victimization factors. Implications: This review indicates that it is important to conduct more prospective studies with various samples and sample sizes in order to clarify the mechanisms by which a victim of sexual abuse is at an increased risk for becoming involved in risky sexual behaviors

Youth\u27s Strategies for Staying Safe and Coping With the Stress of Living in Violent Communities.

Youth living in urban environments of pervasive violence are exposed to a variety of violence-related stressors. This qualitative descriptive study sought to ascertain how community-dwelling youth perceived exposure to violence and how these youth identified and used available resources. The intent of this community-based participatory research study was to help inform the design of a youth violence prevention center intervention. Semi-structured interviews were conducted with a purposive sample of 18 youth ages 10-16. Youth reported high levels of exposure to neighborhood violence. A theme of identifying and navigating safe and unsafe places emerged. Other stressors were more proximal and included interpersonal issues and conflicts. Youth used neighborhood and individual resources to cope with stressors. Youth maintained a high level of vigilance and developed clear strategies to safely navigate violent neighborhoods. Implications for youth due to the constant vigilance and exquisite sensitivity to stressors of chronic neighborhood violence are discussed

The health of women and girls determines the health and well-being of our modern world: A White Paper From the International Council on Women's Health Issues

The International Council on Women's Health Issues (ICOWHI) is an international nonprofit association dedicated to the goal of promoting health, health care, and well-being of women and girls throughout the world through participation, empowerment, advocacy, education, and research. We are a multidisciplinary network of women's health providers, planners, and advocates from all over the globe. We constitute an international professional and lay network of those committed to improving women and girl's health and quality of life. This document provides a description of our organization mission, vision, and commitment to improving the health and well-being of women and girls globally

Learning from girls: Family scripts, cultural context and sexual health.

Little is known about the context of social relationships in which girls construct their sexualities. The purpose of this study was to describe female adolescents' interpretations of family scripts about puberty and sexuality in order to better understand how economically and ethnically diverse families influence the developing sexuality of girls. This study explores girls' narratives about their experiences of first menses in the context of family relationships. It also explores girls' narratives about their experiences of learning about sex, sexuality and relationships through interactions with family members. In-depth individual interviews were conducted with 33 adolescent girls ages 14--18. The sample consisted of both African-American and European-American girls from higher and lower income families. Transcriptions of these recorded conversations were analyzed using an interpretive methodological approach. Findings from the narrative analysis indicate that many families were unable to achieve a balance between respecting teenage girls' need to make independent decisions about sexuality and relationships on the one hand and the girls' need for parental support and guidance on the other. In the other social spheres, outside of the family, (friends/peers, partners, school, media) information was often limited, guidance was minimal and pressures to adhere to narrow standards of behavior and appearance were strong. For all participants, in both higher and lower-income families, there was little discussion about how girls might be sexual in ways that allow them to feel in charge of their decisions. For lower income participants, family scripts were generally more accepting of girls' sexuality. However, this accepting attitude was often accompanied by greater scrutiny and control over girls' behavior. For higher-income teens, family scripts emphasized that girls' were in charge of their decisions generally. However, these families were less likely to treat sexuality as an active part of girls' lives. This study examined how teenage girls interpret their own experiences of their bodies and emerging sexuality in light of the prevailing public discourse, cultural scenarios and interpersonal scripts. The findings from this study suggest many girls have insufficient resources or support as they try to navigate decisions and interactions that involve their sexuality.Ph.D.Health and Environmental SciencesIndividual and family studiesNursingSocial SciencesWomen's studiesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/130688/2/3042181.pd

Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health: An integrative review

Scientific advances in health care have been disproportionately distributed across social strata. Disease burden is also disproportionately distributed, with marginalized groups having the highest risk of poor health outcomes. Social determinants are thought to influence health care delivery and the management of chronic diseases among marginalized groups, but the current conceptualization of social determinants lacks a critical focus on the experiences of people within their environment. The purpose of this article was to integrate the literature on marginalization and situate the concept in the framework of social determinants of health. We demonstrate that social position links marginalization and social determinants of health. This perspective provides a critical lens to assess the societal power dynamics that influence the construction of the socio‐environmental factors affecting health. Linking marginalization with social determinants of health can improve our understanding of the inequities in health care delivery and the disparities in chronic disease burden among vulnerable groups

Caregiver autonomy support : A systematic review of interventions for adults with chronic illness and their caregivers with narrative synthesis

Chronic illnesses cause significant mortality in adults. Caregivers (spouses, adult children, friends) support adults with chronic illness in multiple ways, for instance through support of their autonomous decisions about how and why to engage in self-care. Aim To examine interventions designed to improve the health and well-being of adults with chronic illness by enhancing the autonomy supportive behaviours of caregivers. Design Systematic review of randomized controlled trials with narrative synthesis. Data sources All available dates of publication through August 2020 conducted in PubMed, Medline, Ageline, PsychInfo, and CINAHL. Methods Randomized controlled interventions of adults with chronic illness and their caregivers with content to enhance caregiver autonomy support were included. Interventions involving healthcare personnel, adults without self-care capacity, or not published in English were excluded. Quality was appraised using Joanna Briggs Institute recommendations. Common themes in autonomy support and associated outcomes (e.g., self-care, social support) were synthesized. Results Search identified 1,426 studies with 16 included in review (N = 2,486 dyads). Methodological quality was moderate. Successful interventions were skills-based, targeted various communication styles, contained in-person elements, and involved nurses. Half of the interventions assessed autonomy support outcomes; 63% (5 of 8) of these improved autonomy support. Results were generally positive for social support, mixed for self-care, and null for caregiver burden. Heterogeneity and complexity of studies limited attribution of effects. Conclusion Behavioural interventions designed to enhance dyadic caregiver interpersonal communication to be autonomy supportive may positively influence caregiver skills and chronic illness outcomes. Future studies of autonomy support are needed to identify core intervention components. Impact This is the first systematic review examining interventions promoting caregiver to care-receiver autonomy support. Modifying interpersonal communication to be autonomy supportive has potential to improve chronic illness outcomes. Findings can inform how clinicians and investigators enlist caregiver autonomy support to encourage behaviour change

Implementation strategies to improve cervical cancer prevention in sub-Saharan Africa: a systematic review

Abstract Background Developed countries, such as the USA, have achieved significant decreases in cervical cancer burden since the introduction of Pap smear-based programs in the 1960s. Due to implementation barriers and limited resources, many countries in sub-Saharan Africa (SSA) have been unable to attain such reductions. The purpose of this review is to evaluate implementation strategies used to improve the uptake and sustainability of cervical cancer prevention programs in SSA. Methods A reviewer (LJ) independently searched PubMed, Ovid/MEDLINE, Scopus, and Web of Science databases for relevant articles with the following search limits: English language, peer reviewed, and published between 1996 and 2017. The 4575 search results were screened for eligibility (CJ, LJ) to identify original research that empirically evaluated or tested implementation strategies to improve cervical cancer prevention in SSA. Fifty-three articles met criteria for inclusion in the final review. AA, CJ, and LJ abstracted the included articles for implementation-related content and evaluated them for risk of bias according to study design with the National Heart, Lung, and Blood Institute’s (NHLBI) Quality Assessment Tools. Results were reported according to PRISMA guidelines. Results The 53 included studies are well represented among all sub-Saharan regions: South (n = 16, 30.2%), West (n = 16, 30.2%), East (n = 14, 26.4%), and Middle (n = 7, 13.2%). There are 34 cross-sectional studies (64.2%), 10 pre-posttests (18.9%), 8 randomized control trials (15.1%), and one nonrandomized control trial (1.9%). Most studies are “fair” quality (n = 22, 41.5%). Visual inspection with acetic acid (VIA) (n = 19, 35.8%) was used as the main prevention method more frequently than HPV DNA/mRNA testing (n = 15, 28.3%), Pap smear (n = 13, 24.5%), and HPV vaccine (n = 9, 17.0%). Effectiveness of strategies to improve program implementation was measured using implementation outcomes of penetration (n = 33, 62.3%), acceptability (n = 15, 28.3%), fidelity (n = 14, 26.4%), feasibility (n = 8, 15.1%), adoption (n = 6, 11.3%), sustainability (n = 2, 3.8%), and cost (n = 1, 1.9%). Education strategies (n = 38, 71.7%) were used most often but have shown limited effectiveness. Conclusion This systematic review highlights the need to diversify strategies that are used to improve implementation for cervical cancer prevention programs. While education is important, implementation science literature reveals that education is not as effective in generating change. There is a need for additional organizational support to further incentivize and sustain improvements in implementation