Why Girls? The Importance of Developing Gender-Specific Health Promotion Programs for Adolescent Girls

Adolescence is a time when many girls begin to develop unhealthy behaviors that can affect myriad short- and long-term health outcomes across their lifespan.2There is evidence that smoking, physical activity, and diet are habituated during adolescence, and some physiologic processes of adolescence, such as peak bone mass development, have direct effects on future health.3-4 Establishing healthy practices, beliefs and knowledge among adolescent girls will decrease morbidity and mortality among adult women and potentially affect the health of men and children through women’s role as healthcare agents. This paper provides a brief review of lifestyle health behaviors among women and girls and argues for the importance of developing gender-specific health promotion programs. The paper focuses around three behaviors: substance use, diet and physical activity. We chose these behaviors because they are commonly targeted in school- and community-based programs and are most often implemented in the co-educational settings that de-emphasize gender. Many other health behaviors also affect morbidity and mortality, most notably those related to sexual behaviors as well as intentional and unintentional injury. Although some of our conclusions may be relevant to those behaviors as well, our primary focus is on the lifestyle behaviors described below

Providing reproductive health promotion in drug treatment clinics: A Formative Evaluation of a Pilot Program

Background and Purpose: Prenatal substance use continues to be a critical public health concern. Integrating reproductive health promotion with addiction treatment is a promising approach to addressing this issue. This study was designed to understand strengths and challenges of a pilot reproductive health program, consisting of preconception/interconception health classes, childbirth education classes, and access to free doula services, for people in addiction treatment. Methods: The study design was a qualitative formative evaluation. Observations of the program (n=9) were conducted along with interviews (n=12) with clients, counselors, and program facilitators. Results: Strengths included a good fit between the program and clients’ needs and commitment to further integrate the program. Challenges included inconsistent participation and issues of facilitator selection and training. Barriers were noted related to the complex and chaotic lives of the clientele. Techniques to address inconsistent participation through mandated attendance as well as rotating and reviewing content showed mixed success. Conclusion: The study found the program to be well-regarded by stakeholders, but several structural challenges were identified. Future programs should strive for greater integration between treatment providers and reproductive health facilitators. Research is also needed to assess the effectiveness of providing integrated reproductive health education to clients engaged in addiction treatment

Race, Age, and Neighborhood Socioeconomic Status in Low Birth Weight Disparities Among Adolescent Mothers: An Intersectional Inquiry

Introduction: Few studies examined socioeconomic contributors to racial disparities in low birth weight outcomes between African-American and Caucasian adolescent mothers. This cross-sectional study examined the intersections of maternal racial status, age, and neighborhood socioeconomic status in explaining these disparities in low birth weight outcomes across a statewide sample of adolescent mothers. Methods: Using data from the North Carolina State Center of Health Statistics for 2010-2011, birth cases for 16,472 adolescents were geocoded by street address and linked to census-tract information from the 2010 United States Census. Multilevel models with interaction terms were used to identify significant associations between maternal racial status, age, and neighborhood socioeconomic status (as defined by census-tract median household income) and low birth weight outcomes across census tracts. Results: Significant racial differences were identified in which African-American adolescents had greater odds of low birth weight outcomes than Caucasian adolescents (OR=1.88, 95% CI 1.64, 2.15). Although racial disparities in low birth weight outcomes remained significant in context of maternal age and neighborhood socioeconomic status, the greatest disparities were found between African-American and Caucasian adolescents that lived in areas of higher socioeconomic status (p Conclusion: These findings indicate that racial disparities in low birth weight outcomes among adolescent mothers can vary by neighborhood socioeconomic status. Further investigations using intersectional frameworks are needed for examining the relationships between neighborhood socioeconomic status and birth outcome disparities among infants born to adolescent mothers

Relationship Intentions, Race, and Gender: Student Differences in Condom Use During Hookups Involving Vaginal Sex

Objective: To examine the relationship between race, gender, and pre-hookup relationship intentions and college students’ participation in condomless vaginal sex. Participants: 3,315 Black and White college students who participated in the Online College Social Life Survey (OCSLS). Methods: Secondary data analysis of the OCSLS using Chi-square and multiple logistic regression analyses. Results: The model revealed that students who did not want a relationship with their hookup partners and students unsure of their relationship intentions were more likely to use condoms during their last vaginal hookup. Further, White and Female students were less likely to have used condoms during their last vaginal hookup. Conclusions: White and female students, as well as students desiring romantic relationships with hookup partners may be at risk for sexually transmitted infections (STIs) due to decreased condom use. However, more research is needed to explore the factors driving STI disparities facing Black students despite higher condom us

Using research poetics responsibly: Applications for health promotion research

Research poetics, a form of arts-based research methods, has been underutilized in the field of health promotion. Poetic methods have most commonly been used as a form of representation of the lived experience in qualitative research. For the community-engaged researcher, representing findings through poetry offers unique opportunities for engaging the reader and reaching diverse communities. However, this approach also has implications as an analytic method and allows the analyst to have a more meaningful and personal engagement with participants’ stories. Perhaps most importantly, this approach acknowledges and brings to the forefront the co-construction of qualitative findings and de-centers the authority of the researcher by preserving and promoting the participant’s voice. Using examples from the authors’ own research, this article describes opportunities for incorporating research poetics into health promotion research and argues for its applicability for community-engaged health promotion researchers

Sex differences in overt aggression and delinquency among urban minority middle school students

Given the recent debate over whether differential pathways to overt aggression and delinquency exist between boys and girls, this study examined sex differences in overt aggressive and delinquent acts along with potential differences in precursors (anger, self-control, family disruption) to antisocial behaviors among a sample of urban minority adolescents (N = 1559). Using a longitudinal design with data from 6th to 7th grade, results showed that girls had greater increases in rates of aggression relative to boys. Delinquency increased over time for both boys and girls, with boys consistently engaging in more delinquency. Girls and boys did not differ on the level of risk factors experienced except for a greater increase in anger over time for girls relative to boys. Across sex, anger and self-control predicted increases in both overt aggression and delinquency; family disruption also predicted increases in delinquency. Implications for subsequent studies on developmental process and preventive interventions are discussed

A Longitudinal Examination of Family, Friend, and Media Influences on Competent Versus Problem Behaviors Among Urban Minority Youth

This article examines family, friend, and media influences on competent and problem behaviors in a sample of 1,174 urban minority youth followed over 6th, 7th, and 8th grades. Students completed annual surveys at their schools. Each of the contextual factors investigated was significantly associated with concurrent aggression and delinquency as well as changes in these outcomes over time. In contrast, parental monitoring was most often significantly associated with indicators of competence both concurrently and over time (e.g., from 7th to 8th grade). In addition, engagement with violent media contributed to decreases in academic achievement. Overall, findings indicate that family factors, specifically parental monitoring, as a target of intervention, would not only offset risk trajectories but enhance positive development

Alcohol and Cigarette Free: Examining Social Influences on Substance Use Abstinence among Black Non-Latina and Latina Urban Adolescent Girls

Increases in substance use prevalence among girls, as well as a lack of research conducted with urban girls of color, highlight the importance of understanding both predictors and outcomes of substance use abstinence (SUA) within this population. This study addresses gaps in SUA research through a longitudinal investigation conducted with urban black non-Latina and Latina girls (N = 597) as they transitioned through junior high school. Multivariate logistic regressions found social influences (i.e., friend/family use, drug access) to be significantly associated with girls’ SUA, although differential associations were found by race/ethnicity. SUA was also associated with positive adjustment and wellness by ninth grade. Implications for gender-specific prevention programming are discussed

Comparison of Two School-Based Smoking Prevention Programs among South African High School Students: Results of a Randomized Trial

Background: Smoking rates are projected to increase substantially in developing countries such as South Africa.Purpose: The aim of this study was to test the efficacy of two contrasting approaches to school-based smoking prevention in South African youth compared to the standard health education program. One experimental program was based on a skills training/peer resistance model and the other on a harm minimization model.Method: Thirty-six public schools from two South African provinces, KwaZulu-Natal and the Western Cape, were stratified by socioeconomic status and randomized to one of three groups. Group 1 (comparison) schools (n?=?12) received usual tobacco use education. Group 2 schools (n?=?12) received a harm minimization curriculum in grades 8 and 9. Group 3 schools (n?=?12) received a life skills training curriculum in grades 8 and 9. The primary outcome was past month use of cigarettes based on a self-reported questionnaire.Result: Five thousand two hundred sixty-six students completed the baseline survey. Of these, 4,684 (89%) completed at least one follow-up assessment. The net change in 30-day smoking from baseline to 2-year follow-up in the control group was 6% compared to 3% in both harm minimization (HM) and life skills training (LST) schools. These differences were not statistically significant. Intervention response was significantly moderated by both gender and race. The HM intervention was more effective for males, whereas the life skills intervention was more effective for females. For black African students, the strongest effect was evident for the HM intervention, whereas the strongest intervention effect for “colored” students was evident for the LST group.Conclusion: The two experimental curricula both produced similar overall reductions in smoking prevalence that were not significantly different from each other or the control group. However, the impact differed by gender and race, suggesting a need to tailor tobacco and drug use prevention programs. More intensive intervention, in the classroom and beyond, may be needed to further impact smoking behavior