But I Trust My Teen: Parents' Attitudes and Response to a Parental Monitoring Intervention

Parental knowledge gained from monitoring activities protects against adolescent risk involvement. Parental monitoring approaches are varied and may be modified with successful interventions but not all parents or adolescents respond to monitoring programs the same way. 339 parent-adolescent dyads randomized to receive a parental monitoring intervention and 169 parent-adolescent dyads in the control group were followed for one year over four measurement periods. Parent attitudes about the usefulness of monitoring, the importance of trust and respecting their teens' privacy, and the appropriateness of adolescent risk-taking behavior and experimentation were examined as predictors of longitudinal change in parental monitoring and open communication. Similar effects were found in both the intervention and control group models regarding open communication. Parental attitudes impacted longitudinal patterns of teen-reported parent monitoring, and these patterns differed across experimental groups. In the intervention group, parents' beliefs about the importance of trust and privacy were associated with a steeper decline in monitoring across time. Finally, parents' attitudes about the normative nature of teen experimentation were associated with a quadratic parental monitoring time trend in the intervention but not the control group. These findings suggest that parental attitudes may impact how families respond to an adolescent risk intervention

Cancer Screening Behaviors and Associations with Childhood Trauma, Resiliency, and Patient–Provider Relationships: Findings from an Exploratory Study of Appalachian Cervical Cancer Survivors

Introduction: Adverse childhood experiences (ACEs) are associated with increased cancer risk. ACEs may affect this risk in a variety of ways, including cancer screening compliance. ACEs can contribute to mistrust in the medical profession, inhibit patient­–provider relationships and cause at-risk individuals to miss critical access points to preventive services. Protective factors may play an important role in mitigating ACE-related consequences by supporting resiliency. Purpose: This study assesses the associations between ACEs, protective factors, patient–provider relationships, stage of cancer at diagnosis, and cancer screening behaviors for West Virginia (WV) cervical cancer survivors. Methods: WV cervical cancer survivors diagnosed between 2000 and 2020 were mailed a survey which included questions on demographic information and cancer screening behaviors, alongside three scales to measure depth of patient–provider relationships, ACEs, and protective factors. Results: Ninety participants completed the survey. ACEs were associated with weaker patient–provider relationships (p \u3c .01) and fewer protective factors (p \u3c .01). More protective factors were associated with stronger patient–provider relationships (p \u3c .01), earlier stage of cancer at diagnosis (p \u3c .05) and positive cancer screening behaviors. Positive cancer screening behaviors were associated with deeper patient–provider relationships (p \u3c .05). A statistically significant model (p = .004) using ACE and resilience scores was able to account for 13% of the explained variability in depth of patient–provider relationships. Implications: These findings suggest an important interplay between ACEs, protective factors, and patient–provider relationships on cancer screening behaviors. Future studies should consider these variables in different populations. In addition, interventions focused on enhancing patient–provider relationships and supporting acquisition of protective factors should be considered

Addressing Facilitators and Barriers Related to Early Childhood Obesity Prevention in Rural Appalachian Communities

Through a community-focused needs assessment conducted in rural Appalachia, we gauged perceptions of facilitators and barriers related to healthful eating and physical activity for young children and identified suggestions for improvement. Thirty-seven key informant interviews and three caregiver focus group sessions were coded and analyzed for key themes. Limited community resources emerged as a barrier to both healthful eating and physical activity. Suboptimal communication about existing opportunities was also identified. Community members reviewed the needs assessment data and implemented initiatives to address identified needs. The importance of Extension-facilitated needs assessments in rural settings to shape health initiatives to local contexts is highlighted

Examining smoking and cessation during pregnancy among an Appalachian sample: a preliminary view

Background Several transitions that a woman experiences prenatally may influence her desire or ability to discontinue smoking. This study explores the role of smoking for young, Appalachian, nulliparous pregnant women and their plans for smoking during their pregnancies. Results The reports of women and their male partners were taken from baseline interviews conducted during the first trimester of pregnancy. Cigarette smoking appeared to be more than an isolated addictive activity; rather, smoking was interwoven in women\u27s social and personal realms, often changing as their perceptions of self changed. Women and their partners who continued to smoke appeared to be depressed, reject authority, and perceived little control over issues related to being pregnant. Conclusion These findings support the argument that standard substance use treatments and polices based on stages-of-change theories may not be effective for all individuals particularly those experiencing significant developmental changes in their lives. Greater success might be obtained from treatment programs designed to recognize the impact of these transitions as it relates to the substance use. The changing experiences of pregnant women in terms of their identity development, views of others, and their relationships have not been adequately addressed in existing cessation programs. Empirically-based interventions targeting these lifestyle characteristics may lead to increased cessation success among pregnant women

Waking up every day in a body that is not yours: a qualitative research inquiry into the intersection between eating disorders and pregnancy

Background Women with eating disorders are more likely to negatively react to finding out they are pregnant, although this difference in attitudes between women with eating disorders and controls disappears at 18-weeks’ gestation. Those with anorexia also are twice as likely to have an unplanned pregnancy and those with bulimia have a 30-fold increased chance compared with healthy controls. Therefore, due to these considerations, pregnancy and the transition to motherhood can be an extremely challenging time for these women both psychologically and physically. The purpose of this qualitative descriptive study was to understand the intersection between eating disorders and pregnancy from the lived experience of women who have been pregnant or want to or do not want to become pregnant. Methods A total of 15 women with a current or past history of an eating disorder were recruited, including nine women who have had previous pregnancies as well as six nonparous women. Interviews were the primary unit of data collection, in addition to document analysis of diaries or blogs. Data analysis was based on verbatim transcripts from audio recordings. NVIVO 11© was used to manage the data from these interviews and thematic analysis was then conducted for emergence of major and sub themes. Results A total of six themes emerged from the iterative process of coding and categorizing. They were: Control, Disclosure to Others, Battle between Mothering & Eating Disorder, Fear of Intergenerational Transmission, Weight and Body Image Concerns, and Coping Strategies. One theme, Battle between Mothering & Eating Disorder also had three sub-themes: Decision to Have Child, Emotions Towards Pregnancy, and Focus on Child/Greater Good. Conclusions It is hoped that quotes and themes derived from this study will help inform both prenatal and postnatal care and interventions, as well as addressing intergenerational transmission concerns among mothers with eating disorders

Personal values and involvement in problem behaviors among Bahamian early adolescents: a cross-sectional study

Background Few studies, particularly in developing countries, have explored the relationship between adolescents and parental values with adolescent problem behaviors. The objectives of the study are to (1) describe adolescents\u27 personal values, their problem behaviors, and the relationships thereof according to gender and (2) examine the relationship between parental values, adolescent values, and adolescents\u27 problem behaviors among sixth-grade students and one of their parents. Methods The data used in these analyses were from the baseline assessment of a school-based HIV risk reduction intervention being conducted and evaluated among sixth grade students and one of their parents across 9 elementary schools in The Bahamas. Personal values were measured by the Portrait Values Questionnaire (PVQ). Seven reported problem behaviors were queried from the students, which included physical fight with a friend, drank alcohol, beer, or wine, smoked a cigarette, pushed or carried any drugs, carried a gun, knife, screwdriver or cutlass to use as a weapon, had sex and used marijuana or other illicit drugs over the past 6 months. Multilevel modeling for binary data was performed to estimate the associations between adolescent and parental values and adolescent problem behaviors. Results Among 785 students, 47% of the students reported at least one problem behavior. More boys (54%) reported having one or more problem behaviors than girls (41%, p \u3c 0.01). Boys compared to girls expressed a higher level of self-enhancement (means score: 36.5 vs. 35.1; p = 0.03), while girls expressed a higher level of self-transcendence (42.3 vs. 40.7; p = 0.03). The results of multilevel modeling indicates that boys with a higher level of self-enhancement and girls with a higher level of openness to change and a lower level of conservation were more likely to report engagement in problem behaviors. Only two parental values (self-transcendence and conservation) were low or modestly correlated with youth\u27 values (openness to change and self-enhancement). Parental-reported values documented limited association on adolescents\u27 reported values and behaviors. Conclusion In designing interventions for reducing adolescents\u27 problem behaviors, it may be important to understand the values associated with specific problem behaviors. Further exploration regarding lack of association between adolescent and parental values and problem behaviors is needed

Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis

Background Overweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease (CVD) risk factors during childhood and adolescence as well as premature mortality in adults. Despite the high prevalence of childhood and adolescent obesity as well as adult CVD, individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data meta-analytic approach to address this gap. Methods Studies were included if they met the following criteria: (1) longitudinal and cohort studies (including case-cohort), (2) childhood exposure and adult outcomes collected on the same individual over time, (3) childhood obesity, as defined by the original study authors, (4) English-language articles, (5) studies published up to June, 2015, (6) one or more of the following CVD risk factors [systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), non-high-density lipoprotein cholesterol (non-HDL), and triglycerides (TG)], (7) outcome(s) not self-reported, and (8) exposure measurements (child’s adiposity) assessed by health professionals, trained investigators, or self-reported. Studies were retrieved by searching three electronic databases as well as citation tracking. Fisher’s r to z score was calculated for each study for each outcome. Pooled effect sizes were calculated using random-effects models while risk of bias was assessed using the STROBE instrument. In order to try and identify sources of heterogeneity, random-effects meta-regression was also performed. Results Of the 4840 citations reviewed, a total of 23 studies were included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and positively associated with adult SBP (Zr = 0.11; 95% CI: 0.07, 0.14), DBP (Zr = 0.11; 95% CI: 0.07, 0.14), and TG (Zr =0.08; 95% CI: 0.03, 0.13), and significantly and inversely associated with adult HDL (Zr = −0.06; 95% CI: -0.10, −0.02). For those studies that adjusted for adult body mass index (BMI), associations were reversed, suggesting that adult BMI may be a potential mediator. Nine studies had more than 33% of items that placed them at an increased risk for bias. Conclusions The results of this study suggest that childhood obesity may be a risk factor for selected adult CVD risk factors. However, a need exists for additional, higher-quality studies that include, but are not limited to, both unadjusted and adjusted measures such as BMI before any definitive conclusions can be reached. Systematic review and meta-analysis PROSPERO 2015: CRD42015019763

The relationship between children's physical activity and family income in rural settings: A cross-sectional study

AbstractObjectiveTo examine potential differences in children's physical activity and parent support of their children's physical activity based on family income within the rural setting.MethodsA cross-sectional survey of 566 parents of children (5–15years-old; mean=7.7years; standard deviation=2.4) living in rural West Virginia from 2010 to 2011 was conducted. Children were recruited and had participated in a school-based health screening program.ResultsOverall, parents from a rural setting reported that their children engaged in an average of five days of physical activity for at least 60min. Upon closer examination, children from lower-income families engaged in more physical activity, on average, than children from higher income families per parent report (mean=6.6days, confidence interval 95%=4.9–6.0 vs. middle-income mean=5.0, confidence interval 95%=4.4–5.3 and highest-income mean=4.5, confidence interval 95%=4.1–4.7; p=.01). Rural parents supported their children's physical activity in numerous ways. Parents with the lowest incomes were more likely than parents from higher income families to encourage their children to be active and use their immediate environment for play and to be directly involved in physical activity with their children. More affluent parents were more likely to transport their children to other activity opportunities than parents from the lower income brackets.ConclusionsLower income families may utilize their immediate environment and encourage activity among their children whereas more affluent families focus on organized opportunity more often than lower income families. These findings emphasize the need to conceptualize the role family income plays in physical activity patterns and the potential benefit it provides to some families

Estimating substitution elasticities in household production models

Dynamic general equilibrium models that include explicit household production sectors provide a useful framework within which to analyze a variety of macroeconomic issues. However, some implications of these models depend critically on parameters, including the elasticity of substitution between market and home consumption goods, about which there is little information in the literature. Using the PSID, we estimate these parameters for single males, single females, and married couples. At least for single females and married couples, the results indicate a high enough substitution elasticity that including home production will make a significant difference in applied general equilibrium theory.Production (Economic theory)