Condom Negotiation in Heterosexually Active Men and Women: Development and Validation of a Condom Influence Strategy Questionnaire

The ability to negotiate condom use with a partner is a skill that sexually active men and women must have in order to avoid sexually transmitted diseases including HIV. Despite this fact, there is no psychometrically valid instrument in the literature to measure condom influence strategies. This investigation reports on the development and initial validation of the condom influence strategy questionnaire (CISQ). Exploratory and confirmatory analyses revealed and confirmed six influence strategies used by heterosexually active men and women to negotiate condom use. These CISQ subscales accounted for variance in safer sexual variables including sexual assertiveness, self-efficacy, and partner communication. Further, those who endorsed CISQ subscales were more likely to have intentions to use condoms consistently and to use condoms. Gender differences in subscales favoring women as the ones most likely to use influence strategies also emerged. Implications of these results as well as future directions for research are discussed.     

Developing a family-based depression prevention program in urban community mental health clinics: a qualitative investigation

Extensive research documents that children of depressed mothers are at a significantly higher risk for developing a variety of socioemotional difficulties than children of nondepressed mothers. Yet, little prevention research has been conducted for this population, and low-income, minority, and urban families are rarely included. To address this deficit, we are developing the Protecting Families Program (PFP), a family-based multicomponent depression prevention program for mothers in treatment at urban community mental health agencies and their school-aged children. To inform intervention development and begin relationship building with the agencies, patient and staff focus groups were conducted in the participating agencies. Eighteen mothers with depression participated, and eight major themes were identified: (1) depression symptoms, (2) generational legacy, (3) parenting difficulties, (4) child problems, (5) social support, (6) stressful life events, (7) therapy and other helpful activities, and (8) desired treatment. In the focus groups with 10 mental health providers, the five major themes identified were parenting difficulties, lack of social support, life stress, current mental health practices, and intervention development. The findings support the multicomponent design of PFP, which focuses on increasing knowledge of depression, enhancing social support, and improving parenting skills. The study helped clarify many of the challenges of conducting research in a community mental health system.     

医疗纠纷产生的原因与防范

医疗卫生工作关系到人民的生命与健康,当患者的生命权或健康权受侵害时,就会发生医疗纠纷。医疗纠纷的产生既有源性因素,也有非医源性因素,提高医务人员的法律素养,强化医疗纠纷的管理,合理利用纠纷处理的补偿手段是防范医疗纠纷的有效途径。     

Educational Success in High-Risk Settings: Contributions of the Chicago Longitudinal Study

I provide an overview of the Chicago Longitudinal Study. This prospective study traces the educational and social success of a large sample of low-income children (over 90% of whom are African American) from high-poverty neighborhoods in the Chicago Public Schools. In 1985–1986, the sample participated in the Child–Parent Centers and other early childhood programs. The four studies reported in this special issue highlight the contributions of school mobility, parent involvement, educational expectations, and other family and school experiences in preventing learning problems and promoting educational success.     

The EARLY ALLIANCE Prevention Trial: An Integrated Set of Interventions to Promote Competence and Reduce Risk for Conduct Disorder, Substance Abuse, and School Failure

Describes the EARLY ALLIANCE interventions, an integrated set of four programs designed to promote competence and reduce risk for early-onset conduct disorder, substance abuse, and school failure. These interventions are evaluated as part of a prevention trial that begins at school entry and targets child functioning and socializing practices across multiple contexts (school, peer group, family) and multiple domains (affective, social, and achievement coping-competence). The paper presents the conceptual foundation of the four interventions, including a synopsis of the risk and protective factors associated with conduct disorder and related outcomes, and of the coping-competence model driving EARLY ALLIANCE. The developmental rationale, intended impact, and procedures are described for each intervention: a universally administered classroom program and indicated, peer, reading-mentoring, and family programs. Interventions are currently being tested in a prevention trial, which is briefly summarized.     

Triple P-Positive Parenting Program: Towards an Empirically Validated Multilevel Parenting and Family Support Strategy for the Prevention of Behavior and Emotional Problems in Children

This paper outlines the theoretical and empirical foundations of a unique multilevel parenting and family support strategy designed to reduce the prevalence of behavioral and emotional problems in preadolescent children. The program known as Triple P-Positive Parenting Program is a multilevel system of family intervention, which provides five levels of intervention of increasing strength. These interventions include a universal population-level media information campaign targeting all parents, two levels of brief primary care consultations targeting mild behavior problems, and two more intensive parent training and family intervention programs for children at risk for more severe behavioral problems. The program aims to determine the minimally sufficient intervention a parent requires in order to deflect a child away from a trajectory towards more serious problems. The self-regulation of parental skill is a central construct in the program. The program uses flexible delivery modalities (including individual face-to-face, group, telephone assisted, and self-directed programs) to tailor the strength of the intervention to the requirements of individual families. Its multidisciplinary, preventive and community-wide focus gives the program wide reach, permitting the targeting of destigmatized access points through primary care services for families who are reluctant to participate in parenting skills programs. The available empirical evidence supporting the efficacy of the program is discussed and its implications for research on dissemination are discussed.     

Urban American Indian Community Perspectives on Resources and Challenges for Youth Suicide Prevention

American Indian (AI) youth have some of the highest rates of suicide of any group in the United States, and the majority of AI youth live in urban areas away from tribal communities. As such, understanding the resources available for suicide prevention among urban AI youth is critical, as is understanding the challenges involved in accessing such resources. Pre‐existing interview data from 15 self‐identified AI community members and staff from an Urban Indian Health Organization were examined to understand existing resources for urban AI youth suicide prevention, as well as related challenges. A thematic analysis was undertaken, resulting in three principal themes around suicide prevention: formal resources, informal resources, and community values and beliefs. Formal resources that meet the needs of AI youth were viewed as largely inaccessible or nonexistent, and youth were seen as more likely to seek help from informal sources. Community values of mutual support were thought to reinforce available informal supports. However, challenges arose in terms of the community's knowledge of and views on discussing suicide, as well as the perceived fit between community values and beliefs and formal prevention models.     

Sensation seeking, impulsive decision-making, and risky sex: implications for risk-taking and design of interventions

In an HIV prevention study, 2949 ninth-grade students in 17 high schools in two Midwestern U.S. cities were administered scales measuring sensation seeking and impulsive decision-making and their separate and combined relationships to a number of indicators of sexual risk-taking. Measures of sexual risk-taking included intentions to have sex, ever had sex, number of lifetime sexual partners, been pregnant or caused a pregnancy, used a condom, used marijuana, had unwanted sex when drunk, had unwanted sex under pressure, said no to sex, used alcohol or partner used alcohol before sex. Strong associations were observed between each of the measures and sexual risk-taking for most of the indicators. Strongest associations were found among sexually active students high on both sensation seeking and impulsive decision-making and weakest associations among students low on both measures. Implications for design of interventions in health campaigns are discussed.     

Child victims: Searching for opportunities to break the cycle of violence

In 1986 I began research to address the relationship between early child abuse and neglect and later deliquent and violent criminal behavior using a prospective cohort design. The relationship is not inevitable, suggesting an opportunity for long-range violence prevention through appropriate early intervention. Here, I briefly describe how childhood victimization and violent criminal behavior are related and illustrate a number of promising strategies and opportunities to intervene. Finally, I offer five principles to guide interventions: (1) the earlier the intervention, the better; (2) don't neglect neglected children; (3) one size does not fit all; (4) surveillance—a double-edged sword; and (5) accessibility to resources. Rather than focusing on responses to child abuse or neglect in court proceedings that “treat” offenders, primary prevention efforts should target childhood victims to reduce their risk of becoming offenders in the future.     

The Early Risers Preventive Intervention: Testing for Six-year Outcomes and Mediational Processes

We examined effects of the Early Risers “Skills for Success” early-age-targeted prevention program on serious conduct problems following 5 years of continuous intervention and one year of follow-up. We also examined if intervention effects on proximally-targeted variables found after 3 years mediated intervention effects on conduct problems found after 6 years. Participants included 151 at-risk children (106 males and 45 females) followed from first through sixth-grade, from 23 semi-rural schools in Minnesota. After 6 years, program children showed fewer oppositional defiant disorder (ODD) symptoms than control children. Program children did not significantly differ from controls on number of conduct disorder (CD) symptoms, DSM-IV diagnoses of ODD and CD, or drug use involvement. Results of the mediation analysis indicated that fewer ODD symptoms among program youth after 6 years were partially mediated by social skills and effective discipline. The study provides support for the early-starter model of conduct problems development that provides the framework for the Early Risers intervention. The study’s implications for prevention and limitations are discussed.