Polycystic Ovary Syndrome, Absent from National Surveillance and Present Online: Implications for Mental and Behavioral Health.

In the United States there is a need to increase awareness and management of polycystic ovary syndrome (PCOS), a metabolic, reproductive, and endocrine condition the National Institutes of Health has described as a major public health problem for women. PCOS is a highly prevalent chronic condition that can begin in adolescence and is associated with irregular or no menstrual periods, excessive body hair, acne, infertility, obesity, anxiety and depression, and poor health-related quality of life. This paper consists of two studies that aim to understand PCOS and women’s health in two contexts, the health care system and digital (online) spaces. The first paper examines the demographics and behavioral health care of patients seen for PCOS-related medical visits using national health care data. The findings point to potential disparities in PCOS-related health care access and utilization by age, race, insurance type, and percent poverty greater than 10% in the patient’s zip code. Limited information on behavioral health education and mental health including depression screening, depression diagnosis, and mental health care underscores the need to strengthen national surveillance to further understand behavioral health care services for PCOS. The second paper explores how teen and women’s digital magazines portray adolescents and women with PCOS to understand discourse and ideologies related to health, illness, and gender in these media. The results suggest these magazine articles contain dominant ideologies of beauty and gender and place considerable personal responsibility on women to improve their health through lifestyle changes. Women were also depicted as change agents that used their personal experiences with PCOS to advocate for women’s health. The results can inform the strategic use of digital women’s magazines to promote health and the development of health education programs that train women to be critical consumers of health media. Given that individuals look to the internet and magazines, in addition to health care providers, for health information, these studies highlight how the digital landscape and health care intersect and provide directions for future research to improve women’s health.PhDSocial Work and PsychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/113329/1/ninive_1.pd

Parental perceptions of neighborhood effects in Latino comunas: the script of "the delinquent" in understanding drug use, violence, and social disorganization

OBJECTIVES: To obtain rich information about how adult Latinos living in high-poverty/high-drug use neighborhoods perceive and negotiate their environment. METHODS: In 2008, thirteen adult caregivers in Santiago, Chile were interviewed with open-ended questions to ascertain beliefs about neighborhood effects and drug use. ANALYSIS: Inductive analysis was used to develop the codebook/identify trends. DISCUSSION: Residents externalized their understanding of drug use and misuse by invoking the concept of delinquent youth. A typology of their perceptions is offered. Learning more about residents’ circumstances may help focus on needs-based interventions. More research with Latino neighborhoods is needed for culturally-competent models of interventions.The present study received support from National Hispanic Science Network Fellows Summer grant awarded to the lead author. The study was also partially supported by the National Institutes of Health/National Institute on Drug Abuse (R01:DA021181) and the Vivian A. and James L. Curtis School of Social Work Research and Training Center, University of Michigan. (National Hispanic Science Network; R01:DA021181 - National Institutes of Health/National Institute on Drug Abuse; Vivian A. and James L. Curtis School of Social Work Research and Training Center, University of Michigan

Sexual intercourse among adolescents in Santiago, Chile: a study of individual and parenting factors

OBJECTIVE: To examine a range of individual, parenting, and family factors associated with sexual intercourse among a community sample of youth and their families in Santiago, Chile. METHODS: Data were taken from the first wave of the Santiago Longitudinal Study conducted in January 2008–November 2009. Participants were 766 youth (mean age = 14.03 years, 51% male) from municipalities of low-to mid-socioeconomic status. Variables included emotional and behavioral subscales from the Child Behavior Checklist’s Youth Self Report, parental monitoring, family involvement, parental control and autonomy, relationship with each parent, and sexual activity. Bivariate and multivariate logistic regression models were used to examine the odds of sexual intercourse initiation. RESULTS: Seventy (9.14%) youth reported having had sex in their lifetime; the average age of first sexual intercourse among this group was 13.5 years (Standard Deviation [SD] = 1.74) for males and 14.08 (SD = 1.40) for females. Having sex was inversely associated with withdrawn-depressed symptoms (Odds Ratio [OR] = 0.84, Confidence Interval [CI] = 0.72–0.97), but positively associated with somatic complaints (OR = 1.20, CI = 1.04–1.38) and rule breaking behavior (OR = 1.21, CI = 1.08–1.36), after adjusting for demographic and other individual and parenting variables. The majority (80%) of the youth who had had sex reported using protection at the time of last intercourse. CONCLUSIONS: Findings highlight the role that mental health problems—some of them not commonly associated with onset of sexual activity—may play in a youth’s decision to have sex. The potential protective effects of several parenting and family characteristics disappeared with youth age and youth behavioral problems.R01 HD033487 - NICHD NIH HHS; R01 DA021181 - NIDA NIH HHS; DA021181 - NIDA NIH HH

The association of at-risk, problem, and pathological gambling with substance use, depression, and arrest history

We examined at-risk, problem, or pathological gambling co-occurrence with frequency of past-year alcohol, tobacco, and marijuana use; depressive symptoms; and arrest history. Data included the responses of over 3,000 individuals who participated in a 2006 telephone survey designed to understand the extent of at-risk, problem, and pathological gambling; comorbidity levels with substance use; mental health; and social problems among Southwestern U.S. residents. Data were analyzed with multinomial and bivariate logistic regression. Respondents at risk for problem gambling were more likely to use alcohol, tobacco, and marijuana than those respondents not at risk. Pathological gamblers were no more or less likely to consume alcohol or tobacco than were non-gamblers or those not at risk. A dose-response relationship existed between degree of gambling problems and depressive symptoms and arrest history. Interventions for at-risk or problem gamblers need to include substance use treatment, and the phenomenon of low levels of substance use among pathological gamblers needs further exploration

Examining the quality of adolescent–parent relationships among Chilean families

The purpose of this study was to examine if adolescents reports of warm and harsh parenting practices by their mothers and fathers varied as a function of demographic, youth and their mothers or mother figures' individual and family characteristics. Data are from 707 community-dwelling adolescents (mean age=14, SD=1.4) and their mothers or mother figures in Santiago, Chile. Having a warmer relationship with both parents was inversely associated with the adolescents' age and positively associated with adolescents' family involvement and parental monitoring. Both mothers' and fathers' harsh parenting were positively associated with adolescent externalizing behaviors and being male and inversely associated with youth autonomy and family involvement. These findings suggest that net of adolescent developmental emancipation and adolescent behavioral problems, positive relationships with parents, especially fathers, may be nurtured through parental monitoring and creation of an interactive family environment, and can help to foster positive developmental outcomes.http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC3839673&blobtype=pdfAccepted manuscrip

Ecological factors and adolescent marijuana use: results of a prospective study in Santiago, Chile

PURPOSE: Despite the growing evidence that ecological factors contribute to substance use, the relationship of ecological factors and illicit drugs such as marijuana use is not well understood, particularly among adolescents in Latin America. Guided by social disorganization and social stress theories, we prospectively examined the association of disaggregated neighborhood characteristics with marijuana use among adolescents in Santiago, Chile, and tested if these relationships varied by sex. METHODS: Data for this study are from 725 community-dwelling adolescents participating in the Santiago Longitudinal Study, a study of substance using behaviors among urban adolescents in Santiago, Chile. Adolescents completed a two-hour interviewer administered questionnaire with questions about drug use and factors related to drug using behaviors. RESULTS: As the neighborhood levels of drug availability at baseline increased, but not crime or noxious environment, adolescents had higher odds of occasions of marijuana use at follow up, approximately 2 years later (odds ratio [OR] = 1.39; 95% CI = 1.16–1.66), even after controlling for the study’s covariates. No interactions by sex were significant. DISCUSSION: The findings suggest that “poverty”, “crime”, and “drug problems” may not be synonyms and thus can be understood discretely. As Latin American countries re-examine their drug policies, especially those concerning decriminalizing marijuana use, the findings suggest that attempts to reduce adolescent marijuana use in disadvantaged neighborhoods may do best if efforts are concentrated on specific features of the “substance abuse environment”.We are extremely grateful to the families in Chile for their participation in this study. This study received support from the U.S. National Institute on Drug Abuse (R01 DA021181; T32 DA007267) and the Vivian A. and James L. Curtis School of Social Work Research and Training Center. (R01 DA021181 - U.S. National Institute on Drug Abuse; T32 DA007267 - U.S. National Institute on Drug Abuse; Vivian A. and James L. Curtis School of Social Work Research and Training Center

Adult awareness of a youth-focused anti-tobacco campaign: does having children matter?

Data from a survey of tobacco use conducted in 2001 was used to examine if Florida’s youth-focused anti-tobacco media campaign, which focused on cigarette smoking, reached adults. The majority of the sample was white (87%), high school or college edu- cated (85%), and over half with children (56%). Differences in awareness and intentions to quit among adult smokers with and without children were examined. About 50% of adults were aware of the campaign and the awareness of the tobacco industry manipula- tion theme was associated with intentions to quit, independent of having children. These findings provide evidence that youth-targeted anti-tobacco media campaigns can reach adults; however, to change the behavior of adults who smoke, it may not be appropriate to have a “one-size-fits-all” program. The study’s limitations are noted.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78088/1/adultawareness.pd

Sexual intercourse among adolescents in Santiago, Chile: A study of individual and parenting factors

Objective. To examine a range of individual, parenting, and family factors associated with sexual intercourse among a community sample of youth and their families in Santiago, Chile. Methods. Data were taken from the Santiago Longitudinal Study conducted in January 2008-November 2009. Participants were 766 youth (mean age = 14.03 years, 51% male) from municipalities of low- to mid-socioeconomic status. Variables included emotional and behavioral subscales from the Child Behavior Checklist's Youth Self Report, parental monitoring, family involvement, parental control and autonomy, relationship with each parent, and sexual activity. Bivariate and multivariate logistic regression models were used to examine the odds of sexual intercourse initiation. Results. Seventy (9.14%) youth reported having had sex in their lifetime; the average age of first sexual intercourse among this group was 13.5 years (Standard Deviation [SD] = 1.74) for males and 14.08 (SD = 1.40) for females. Having sex wa

Sexual intercourse among adolescents in Santiago, Chile: a study of individual and parenting factors Relaciones sexuales entre adolescentes de Santiago, Chile: un estudio de factores individuales y de crianza

OBJECTIVE: To examine a range of individual, parenting, and family factors associated with sexual intercourse among a community sample of youth and their families in Santiago, Chile. METHODS: Data were taken from the Santiago Longitudinal Study conducted in January 2008-November 2009. Participants were 766 youth (mean age = 14.03 years, 51% male) from municipalities of low- to mid-socioeconomic status. Variables included emotional and behavioral subscales from the Child Behavior Checklist's Youth Self Report, parental monitoring, family involvement, parental control and autonomy, relationship with each parent, and sexual activity. Bivariate and multivariate logistic regression models were used to examine the odds of sexual intercourse initiation. RESULTS: Seventy (9.14%) youth reported having had sex in their lifetime; the average age of first sexual intercourse among this group was 13.5 years (Standard Deviation [SD] = 1.74) for males and 14.08 (SD = 1.40) for females. Having sex was inversely associated with withdrawn-depressed symptoms (Odds Ratio [OR] = 0.84, Confidence Interval [CI] = 0.72-0.97), but positively associated with somatic complaints (OR = 1.20, CI = 1.04-1.38) and rule breaking behavior (OR = 1.21, CI = 1.08-1.36), after adjusting for demographic and other individual and parenting variables. The majority (80%) of the youth who had had sex reported using protection at the time of last intercourse. CONCLUSIONS: Findings highlight the role that mental health problems-some of them not commonly associated with onset of sexual activity-may play in a youth's decision to have sex. The potential protective effects of several parenting and family characteristics disappeared with youth age and youth behavioral problems.<br>OBJETIVO: Examinar distintos factores relacionados con el inicio de la actividad sexual que presentan los jóvenes, sus padres y su familia en una muestra de jóvenes y su respectiva familia tomada de la ciudad de Santiago, Chile. MÉTODOS: Se tomaron los datos de la primera ronda del Estudio Longitudinal de Santiago, que se llevó a cabo de enero del 2008 a noviembre del 2009. La muestra estuvo integrada por 766 jóvenes (media de edad = 14,03 años; 51% del sexo masculino) de municipios de nivel socioeconómico bajo a medio. Las variables evaluadas fueron las subescalas emocionales y conductuales del instrumento de autonotificación sobre comportamiento juvenil (Youth Self-Report) que forma parte del inventario de comportamiento infantil (Child Behavior Checklist), la vigilancia de los padres, la participación familiar, el control y la autonomía de los padres, la relación con el padre y la madre, y la actividad sexual. Se emplearon modelos bifactoriales y multifactoriales de regresión logística para examinar las probabilidades de inicio de la actividad sexual. RESULTADOS: Setenta (9,14%) de los jóvenes informaron que ya habían tenido alguna relación sexual; en este grupo, la edad promedio de iniciación fue 13,5 años (desviación estándar [DE] = 1,74) en los hombres y 14,08 (DE = 1,40) en las mujeres. Se observó una relación inversa entre la actividad sexual y los síntomas de retraimiento y depresión (razón de posibilidades [OR] = 0,84; intervalo de confianza [IC] = 0,72-0,97), pero una relación positiva con los síntomas somáticos (OR = 1,20; IC = 1,04-1,38) y el comportamiento transgresor (OR = 1,21; IC = 1,08-1,36), después de ajustar los valores en función de las variables demográficas y otras variables personales, así como las relativas a la crianza. La mayoría de los jóvenes (80%) que habían tenido relaciones sexuales informaron que habían utilizado algún tipo de protección en su última relación. CONCLUSIONES: Estos resultados ponen de manifiesto la importancia que pueden tener para los jóvenes, a la hora de decidir el inicio de su vida sexual, los problemas de salud mental, algunos de los cuales no suelen estar asociados al inicio de la actividad sexual. El efecto protector que potencialmente pueden brindar algunas características de la crianza y de la familia desapareció durante la juventud y algunos problemas conductuales de esa etapa