Community and health facility influences on contraceptive method choice in the Eastern Cape, South Africa

CONTEXT: Although a growing number of studies have examined how community factors influence contraceptive use, few have explored how such factors affect method choice. METHODS: Data from the 1998 South Africa Demographic and Health Survey and the 1998 Eastern Cape Facility Survey were used to examine community and health facility influences on the method choices of 1,165 women aged 15-49 who lived in the Eastern Cape. Relative risk ratios from multilevel multinomial models assessed how method choice varied between communities. RESULTS: The likelihood of using the pill or a more permanent method rather than the injection rose with the proportion of women in a community who controlled their earnings (risk ratios, 3.2 and 3.8, respectively). In communities with higher proportions of females with only a primary education, women were less likely to use the pill instead of the injection (0.1). Higher doctor staffing levels were associated with a greater likelihood of using the pill or a more permanent method (1.5 and 1.4), and having more expired methods in stock was associated with increased use of a more permanent method (2.1). Several facility factors were associated with a decreased likelihood of using the pill rather than the injection: higher numbers of community health workers in an area and higher numbers of facility nurses who had received training on HIV/AIDS in the last year (0.9 for each). Yet a substantial amount of variation in method choice was not accounted for by these variables. CONCLUSION: Future research should emphasize the collection of community-level data on structural, behavioral and cultural factors to help explain the variation in method choice between communities.     

Environmental influences on reading‐related outcomes: an adoption study

Evidence from intervention studies, quantitative genetic and molecular genetic studies suggests that genetic, and to a lesser extent, shared environmental influences are important to the development of reading and related cognitive skills. The Northeast‐Northwest Collaborative Adoption Projects (N2CAP) is a sample of 241 adoptive families, containing 354 children and their adoptive parents. Negative parent outcome × child age interactions significantly predicted child outcomes, suggesting that shared environmental influences related to parent–offspring resemblance, although modest, are most salient in younger children. Additional analyses suggested that identified measures of the family environment largely accounted for these parent–offspring correlations. Copyright © 2007 John Wiley & Sons, Ltd.     

Genetic and environmental influences on antisocial behavior: a meta-analysis of twin and adoption studies

A meta-analysis of 51 twin and adoption studies was conducted to estimate the magnitude of genetic and environmental influences on antisocial behavior. The best fitting model included moderate proportions of variance due to additive genetic influences (.32), nonadditive genetic influences (.09), shared environmental influences (.16), and nonshared environmental influences (.43). The magnitude of familial influences (i.e., both genetic and shared environmental influences) was lower in parent-offspring adoption studies than in both twin studies and sibling adoption studies. Operationalization, assessment method, zygosity determination method, and age were significant moderators of the magnitude of genetic and environmental influences on antisocial behavior, but there were no significant differences in the magnitude of genetic and environmental influences for males and females.     

Oral contraceptive use among African American adolescents: Individual and community influences

Side effects of oral contraceptives are a noteworthy problem, particularly among low-income young women who reside in inner-city communities. The problem may be compounded by inadequate family planning services, particularly when such services are provided by general medical practices with high volumes of clients. This study examined the prevalence and correlates of pill-related side effects, with particular attention to the role of clinic characteristics. Participants were 177 pregnant and parenting African American adolescents and young women (average age=18.34). The experience of a pill-related side effect was the most frequently cited barrier to birth control use, and it was significantly related to contraceptive behavior. Finally, although participants attending comprehensive clinics experienced more barriers to medical service use than those attending neighborhood clinics, they reported fewer problems with pill-related side effects and better psychological functioning. Implications for future research and policy are discussed. This study was completed with the assistance of grants from the Illinois Department of Alcoholism and Substance Abuse, the National Institute of Child Health and Human Development, and the Office of Research on Women's Health to Jean Rhodes. Portions of this paper were presented at the 1993 Biennial Meeting of the Society for Community Research and Action, Williamsburg, Virginia. The authors gratefully acknowledge the assistance of Julian Rappaport, Joel Meyers, Hope Landrine, Lori Ebert, the Reverend Annette Collins, Margaret Daniels, Khya Lawrence, and the professionals and participants at the service settings.     

Cultural and environmental influences on footedness: cross-sectional study in urban and semi-urban Malawi

The present study was designed to assess cultural and environmental pressure against left-foot preference in urban and semi-urban Malawi. The findings demonstrated that, when compared to handedness, footedness appeared to be less biased behavioral laterality in culturally restrictive communities. The percentage of responders with negative views on left-foot preference was lower than that on left-hand preference (57% vs. 75%) and a smaller proportion of volunteers suggested that left-footers should be forced to change the foot (63.5% vs. 87.6%). In total, mobilizing and stabilizing tasks scored similar proportions of negative responses. Expectation of inferior performance of the left foot than the right one was the major reason for negative views on left-foot preference. Gender and driving experience had significant but weak effect on the view on left-foot preference. Most of the responders (74%) suggested that left-footers should change the foot in early family environment.     

Cross-sequential analysis of genetic influences on cognitive ability in the swedish adoption/twin study of aging

Abstract

Cross-sequential methods of analysis were applied to cognitive data from the Swedish Adoption/Twin Study of Aging. Thirteen measures of cognitive ability assessing four major domains (verbal, spatial, memory, and perceptual speed) were collected at two times of measurement separated by a three-year interval. Data were available from 41 pairs of monozygotic twins reared apart (MZA), 54 pairs of monozygotic twins reared together (MZT), 86 pairs of dizygotic twins reared apart (DZA), and 73 pairs of dizygotic twins reared together (DZT) ranging in age from 41 to 84 years. Cross-sectional differences and longitudinal changes in total variance and sources of variance were examined. With a few exceptions, both cross-sectional and longitudinal stability were found for total variance. In addition, few cross-sectional differences and longitudinal changes were found for genetic and environmental components of variance.     

Positive mental imagery and mental health amongst university students in Pakistan

Mental health problems amongst university students pose a major public health challenge, and this is particularly the case in Pakistan. Alongside broader societal and cultural pressures, cognitive factors likely also play a role in the development of and resilience to mental health problems and may provide a feasible target for interventions. The current study built on previous research in primarily European samples investigating the relationship between one cognitive factor, positive future-oriented mental imagery, and mental health, extending this to a sample of university students in Pakistan (N = 1838). In a cross-sectional design, higher vividness of positive future-oriented mental imagery was associated with lower levels of depressive symptoms and higher levels of positive mental health amongst participants completing questionnaire measures on paper (N = 1430) or online (N = 408). In the sample completing the measures on paper, these relationships remained statistically significant even when controlling for socio-demographic and mental health-related variables. The results provide a foundation for further investigating positive mental imagery as a potential mechanism of mental health and intervention target amongst university students in Pakistan.     

Neurocognitive influences on health behavior in a community sample.

CONTEXT: Dominant models of individual health behavior omit biological variables entirely and are composed almost exclusively of social-cognitive and conative variables. Research from the neurosciences suggests a role for brain function in explaining behaviors that require active self-regulation for consistent performance. However, the association between brain function and health behavior is underexplored. OBJECTIVE: To examine the predictive power of executive function for 2 health risk behaviors and 2 health protective behaviors in healthy adults. DESIGN: A cross-sectional community sample (N = 216) of adults 20-100 years of age were administered a battery of neuropsychological tests and completed self-report questionnaires regarding their health practices. It was hypothesized that poor performance on neuropsychological tests tapping executive function would be associated with poor health behavior tendencies. RESULTS: Errors on the Stroop task were positively associated with health risk behavior and negatively associated with health protective behavior after controlling for demographics, education, and IQ. CONCLUSION: Executive function is associated with health behavior tendencies. If the association is causal, explanatory models of individual health behavior should be revised to account for individual differences in biologically imbued self-regulatory abilities.     

Early life influences on life-long patterns of behavior and health

The stability of a child's early life has profound effects on physical and mental health, and unstable parent-child relationships, as well as abuse, can lead to behavioral disorders and increased mortality and morbidity from a wide variety of common diseases later in life. One common consequence, namely, depressive illness, is associated with chemical imbalances in the brain and hormonal dysregulation, constituting a form of allostatic load that alters interpretations of stimuli and influences, behavioral, and hormonal responses to potentially stressful situations. The brain not only encodes information and controls the behavioral responses but it is also changed structurally by those experiences. Structural changes in the hippocampus and amygdala, which are important brain structures for cognition and emotion, are representative of what may be occurring throughout the brain as a result of allostatic load resulting from the chronic stress of a disorder such as depression. Such structural changes include dendritic debranching and hypertrophy, cell proliferation, and synaptic remodeling; they are produced by the combined overactivity of stress hormones and endogenous neurotransmitters. These mediators are normally involved in adaptation, but can also promote damage when they are dysregulated and over-active. They are very likely to be strongly biased by early life experiences. The findings from animal models thus provide a basis for understanding potential mechanisms of environmental and developmental determinants of individual differences in human stress reactivity, as well as anxiety, depression, and a host of related systemic disorders. There is an increasing amount of translational research that is beginning to tie the basic research to clinical outcomes of individuals exposed to abusive or inconsistent care-giving in early life. A major goal of studies on this important topic is to define times in development and strategies for intervening to prevent or reverse the effects of adverse early life experiences. Although prevention is clearly the preferable route, some degree of reversal of psychopathology and pathophysiology caused by early life adversity appears to be an achievable goal.     

Sexual activity and contraceptive use among low-income urban black adolescent females.

A modified form of Nathanson and Becker's (1983) Health Belief Model Questionnaire and other measures designed to assess cognitive processing were administered to low-income black adolescent female clients of an inner-city comprehensive health care clinic. The purpose of the study was to explore determinants of sexual activity and contraceptive use. Subjects were classified as not sexually active (n = 50), sexually active/noncontracepting (n = 20), or sexually active/contracepting (n = 72). Not sexually active subjects tended to be younger, more career motivated, to have a father at home, to be more influenced by family values, and to have more conservative attitudes regarding adolescent sexuality than did sexually active subjects. Sexually active/noncontracepting subjects tended to report fewer benefits and more barriers to the use of contraception. Level of cognitive processing did not differ among the three groups, but was at a lower-than-expected level for age. Finally, inconsistent contraceptive use was common to both sexually active groups.     

Women's mental health during pregnancy influences fetal and infant developmental and health outcomes

Women's mental health during pregnancy has important implications not only for the well-being of the mother, but also for the development, health, and well-being of her unborn child. A growing body of empirical evidence from population-based studies suggests that two indicators of women's mental health during pregnancy--psychosocial stress and social support--may exert a significant influence on fetal development and infant birth outcomes, such as birth weight and length of gestation, even after controlling for the effects of established sociodemographic, obstetric, and behavioral risk factors. This paper describes the role of three major biological systems involved in the physiology of pregnancy and stress physiology: neuroendocrine, immune/inflammatory, and cardiovascular systems. These systems have been hypothesized to mediate the effects of maternal mental health on fetal developmental and health outcomes, and a central role has been proposed for placental corticotropin-releasing hormone in this process. However, not all women reporting high prenatal stress and/or low social support proceed to develop adverse birth outcomes, raising the question of the determinants of susceptibility/vulnerability in the context of high stress and/or low social support. In this context, the role of race/ethnicity and genetic predisposition are discussed as two promising avenues of further investigation.     

Cognitive influences on health symptoms from acute chemical exposure.

Symptom reports, perceived adverse health effects, and public health concerns are increasingly precipitated by the perception of chemical odors. This study examined the interaction between health cognitions, odor perception, and symptom reports. A group of 180 healthy men and women were exposed to 1 of 3 ambient odors, normatively rated as healthful (methyl salicylate, or wintergreen), harmful (butanol or alcohol), and ambiguous (isobomyl acetate, or balsam), after receiving 1 of 3 odorant characterizations (harmful, healthful, and neutral). Individuals given a harmful bias reported significantly more health symptoms following exposure and more intense odor and irritation during exposure than did those given a neutral or healthful bias. The overall pattern of results suggests that many of the health-related effects of exposure to odorants are mediated not by a direct agency of odors but by cognitive variables, such as mental models of the relationship between environmental odors and health.     

Rural and urban elderly construe health differently.

Samples of people aged 65 or older (N = 396) living in the metropolitan Omaha area and in the rural Sandhills counties of central and western Nebraska completed an instrument to assess health satisfaction, health behaviors, and attitudes toward health care. Few intergroup differences were found that could be attributed to the area of residence. However, factor analysis and item analysis of the attitudes toward health items indicated that older respondents in rural areas may have very different perceptions of health in general and of health care services in particular than those of elderly urban residents.     

Feedback on health status and peer popularity influences social risk decision-making processes in adolescents and young adults

Cognitive and dual-processes models, involving cognitive and socio-emotional components, for adolescents’ risky behaviour have been proposed. This study tested their predictions by manipulating the presence or absence of feedback about gains and losses in health and peer popularity in a decision-making task with peers. Risky (e.g., taking or refusing a drug) and ambiguous decisions (e.g., eating hamburger or hotdog) were examined in 256 adolescents (aged 13–14; 15–16; 17–18) and young adults (aged 19–20). Participants made more risky choices and required less decision time when receiving feedback about the negative consequences on health and positive consequences on peer popularity. Decision times were comparatively larger for risky than for safe options in late adolescence and young adulthood. Results supported the dual-processes model showing that, though late cognitive changes were observed that could eventually lead to the selection of safe options, feedback gains in peer popularity outweighed unhealthy consequences leading to risky decisions.     

Upward intergenerational influences on parents' innovativeness and innovation adoption: A comparative study of single‐ and multiple‐child families

In the marketing and consumer behavior literature, there has been a growing attention on upward intergenerational influences, or reverse socialization, which is largely because of children's increasing influences on family decisions. This paper hypothesizes different patterns of upward intergenerational influences in single versus multiple‐child families, controlling for peer and spousal influences. We found that young adult single children had a direct positive influence on their parents' innovation adoption behavior, but not a significant influence on their parents' overall innovativeness, whereas young adult children with siblings had a different effect: Their innovativeness had a significant positive influence on their parents' overall innovativeness, but not a direct impact on their parents' innovation adoption.     

Moving beyond categorization to understand affective influences on real world health decisions

This paper provides an overview of affect and health decision‐making research, with a focus on identifying gaps, opportunities, and challenges to guide future research. We begin by defining common categorical distinctions of affective processes that influence health decisions: integral (i.e., related to the decision) and incidental (i.e., normatively unrelated to the decision) influences, and current (experienced in the moment) and anticipated (“cognitive representations” of future affect) affect. We then summarize key discoveries within the most common categories of affective influences on health decision making: current integral affect, current incidental affect, and anticipated integral affect. Finally, we highlight research gaps, challenges, and opportunities for future directions for research aimed at translating affective and decision science theory to improve our understanding of, and ability to intervene upon, health decision making.     

Professional and Provider Perspectives on Family Involvement in Therapeutic Foster Care

Therapeutic foster care (TFC) offers a promising community-based treatment option for children with serious emotional and behavioral disorders in the child welfare system. Family involvement is believed to contribute to achieving the goal of family reunification in TFC, but there has been little attention to family involvement in TFC. I present findings of a qualitative study of child welfare professionals' and TFC providers' perspectives on family involvement. Respondents' views of parent-child contact, parent-professional communication and information sharing, and family involvement in decision making were examined. Values and attitudes toward family involvement, practices related to family involvement, barriers to involvement, and strategies to promote involvement emerged as themes. Professionals in this study believed in the value of family involvement, but there were challenges at the organizational level and related to some TFC providers' lack of training to work with families.