Adolescents' Contributions to Family Communication Patterns

Early explications of family communication patterns (FCP) suggested that a family's communication pattern arises as a result of interactions in which parents and adolescents influence each other. In contrast, empirical research usually treats FCP as parent‐imposed norms that influence socialization outcomes in adolescents, without testing whether adolescents' socialization influences FCP. This study revisits the assumption that adolescents influence FCP, using data from a longitudinal quasi‐experimental evaluation of a school‐based civics curriculum intervention (N = 313 parent‐adolescent pairs). Results show that the intervention‐stimulated adolescents to initiate discussion of politics at home and that these adolescent‐initiated discussions influenced adolescents' and parents' perceptions of FCP 6 months later.     

Randomized controlled trial of an intervention to prevent adherence failure among HIV-infected patients initiating antiretroviral therapy.

OBJECTIVE: Compare the efficacy of a multicomponent social support intervention to standard-of-care counseling on medication adherence among HIV-infected patients initiating antiretroviral therapy. DESIGN: Randomized controlled trial. Generalized estimating equations tested for differences in the percentage of participants achieving 90% adherence. MAIN OUTCOME MEASURES: Pill-taking, electronically monitored over 6 consecutive months; plasma viral load (VL), assessed at 3 and 6 months following initiation of therapy. RESULTS: Of 226 participants who were randomized and began the trial, 87 (38%) were lost to the study by 6 months. The proportion of adherent participants declined steadily over time, with no time by group interaction. Sustained adherence was associated with increased odds of achieving an undetectable VL (OR=1.78; 95% CI=1.01, 3.13). In intention-to-treat analyses, a larger proportion of the intervention group than the control group was adherent (40.15% vs. 27.59%, p=.02) and achieved an undetectable VL p=.04). However, the majority of participants who remained on study experienced some reduction in VL (>or=1-log drop or undetectable), regardless of experimental condition. CONCLUSION: The multicomponent social support intervention significantly improved medication adherence over standard-of-care counseling; evidence for improved virologic outcomes was inconsistent. Early discontinuation of care and treatment may be a greater threat to the health of HIV patients than imperfect medication-taking.