Effect of Peer Counselors on Adolescent Compliance in Use of Oral Contraceptives

PEDIATRICS ◽  
1984 ◽  
Vol 73 (2) ◽  
pp. 126-131
Author(s):  
M. Susan Jay ◽  
Robert H. DuRant ◽  
Tamsen Shoffitt ◽  
Charles W. Linder ◽  
Iris F. Litt
Keyword(s):  
Adolescent Pregnancy ◽  
Oral Contraceptives ◽  
Health Care Team ◽  
Socioeconomic Background ◽  
Counseling Program ◽  
Guttman Scale ◽  
Appointment Adherence ◽  
Peer Counselors ◽  
Lower Socioeconomic

Poor compliance with contraceptive regimens has been shown to be an important antecedent of adolescent pregnancy. The purpose of this study was to test prospectively the effect of a peer v nurse counseling program on adolescent compliance with the use of oral contraceptives. Fifty-seven females aged 14 to 19 years from a lower socioeconomic background were randomly assigned to a peer (n = 26) or nurse (n = 31) group. At the initial visit and at 1-, 2-, and 4-month follow-up visits, subjects received Ortho-Novum 1/35 combined with a tablet marker and were counseled by a nurse or peer. Noncompliance was measured using a Guttman scale consisting of: (1) avoidance of pregnancy, (2) appointment adherence, (3) pill count, and (4) urinary fluorescence for riboflavin. At the first and second follow-ups, the adolescents counseled by a peer had a significantly (P ≤.038) lower noncompliance level than the nurse-counseled group. Adolescents with more frequent sexual activity (P ≤.027), with one sexual partner (P <.04), and who worried that they might become pregnant (P ≤.01) had significantly lower levels of noncompliance when counseled by a peer than by a nurse. At the fourth month follow-up, adolescents who expressed feelings of hopelessness about the future had significantly (P ≤.036) higher levels of noncompliance when counseled by a nurse than when counseled by a peer. These results suggest that incorporating a peer counselor into the health care team may be an effective method of increasing adolescent compliance.

scholarly journals Association of oral contraceptives and tubal ligation with risk of early natural menopause

2021 ◽  
Author(s):  
C R Langton ◽  
B W Whitcomb ◽  
A C Purdue-Smithe ◽  
L L Sievert ◽  
S E Hankinson ◽  
...  
Keyword(s):  
Oral Contraceptives ◽  
Proportional Hazards ◽  
Reproductive Factors ◽  
Cox Proportional Hazards ◽  
Tubal Ligation ◽  
Health Study ◽  
Early Menopause ◽  
Natural Menopause ◽  
Increased Risk

Abstract STUDY QUESTION What is the association of oral contraceptives (OCs) and tubal ligation (TL) with early natural menopause? SUMMARY ANSWER We did not observe an association of OC use with risk of early natural menopause; however, TL was associated with a modestly higher risk. WHAT IS KNOWN ALREADY OCs manipulate hormone levels, prevent ovulation, and may modify the rate of follicular atresia, while TL may disrupt the blood supply to the ovaries. These mechanisms may be associated with risk of early menopause, a condition associated with increased risk of cardiovascular disease and other adverse health outcomes. STUDY DESIGN, SIZE, DURATION We examined the association of OC use and TL with natural menopause before the age of 45 years in a population-based study within the prospective Nurses’ Health Study II (NHSII) cohort. Participants were followed from 1989 to 2017 and response rates were 85-90% for each cycle. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants included 106 633 NHSII members who were premenopausal and aged 25-42 years at baseline. Use, duration and type of OC, and TL were measured at baseline and every 2 years. Menopause status and age were assessed every 2 years. Follow-up continued until early menopause, age 45 years, hysterectomy, oophorectomy, death, cancer diagnosis, or loss to follow-up. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% CIs adjusted for lifestyle, dietary, and reproductive factors. MAIN RESULTS AND THE ROLE OF CHANCE Over 1.6 million person-years, 2579 members of the analytic cohort experienced early natural menopause. In multivariable models, the duration, timing, and type of OC use were not associated with risk of early menopause. For example, compared with women who never used OCs, those reporting 120+ months of OC use had an HR for early menopause of 1.01 (95% CI, 0.87-1.17; P for trend=0.71). TL was associated with increased risk of early menopause (HR = 1.17, 95% CI, 1.06-1.28). LIMITATIONS, REASONS FOR CAUTION Our study population is homogenous with respect to race and ethnicity. Additional evaluation of these relations in more diverse populations is important. WIDER IMPLICATIONS OF THE FINDINGS To our knowledge, this is the largest study examining the association of OC use and TL with early natural menopause to date. While TL was associated with a modest higher risk of early menopause, our findings do not support any material hazard or benefit for the use of OCs. STUDY FUNDING/COMPETING INTEREST(S) The study was sponsored by UO1CA176726 and R01HD078517 from the National Institutes of Health and Department of Health and Human Services. The work was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The authors have no competing interests to report. TRIAL REGISTRATION NUMBER N/A

A phenomenological exploration of change towards healthier food purchasing behaviour in women from a lower socioeconomic background using a health app

Appetite ◽  
2020 ◽  
Vol 147 ◽  
pp. 104566
Author(s):  
Sarah Jane Flaherty ◽  
Mary B. McCarthy ◽  
Alan M. Collins ◽  
Claire McCafferty ◽  
Fionnuala M. McAuliffe
Keyword(s):  
Socioeconomic Background ◽  
Food Purchasing ◽  
Lower Socioeconomic ◽  
Purchasing Behaviour ◽  
Phenomenological Exploration

Some Psychological Correlates of Civil Rights Activity

1970 ◽  
Vol 26 (3) ◽  
pp. 899-906 ◽  
Author(s):  
Dorothy A. Evans ◽  
Sheldon Alexander
Keyword(s):  
Civil Rights ◽  
Geographic Location ◽  
Demographic Variables ◽  
Activity Level ◽  
Socioeconomic Background ◽  
External Control ◽  
Ego Strength ◽  
Psychological Correlates ◽  
Lower Socioeconomic ◽  
Group Memberships

Northern Negroes and whites at varying levels of participation in college student civil rights groups were compared with selected groups of northern, Negro non-members of civil rights groups on a number of personality and demographic variables (race, geographic location). Negro Actives showed more repression and ego strength than Negto non-actives. White Actives showed less social approval motivation and less repression than Negro Actives. In contrast to studies of southern Negroes, in this study, Negro Actives came from a lower socioeconomic background than Negro non-actives; internal vs external control of reinforcement and number of non-civil rights group memberships were unrelated to civil rights activity level. Factors other than activity level are important in predicting personality and demographic differences among civil rights activists and non-activists. The importance of additonal empirical research is also discussed.

Risk factors for incidence of trachomatous scarring in a cohort of women in low endemic district

2018 ◽  
Vol 102 (4) ◽  
pp. 419-423 ◽  
Author(s):  
Rabia Karani ◽  
Meraf Wolle ◽  
Harran Mkocha ◽  
Beatriz Muñoz ◽  
Sheila K West
Keyword(s):  
Socioeconomic Status ◽  
Logistic Regression ◽  
Demographic Factors ◽  
Bivariate Analysis ◽  
Fire Exposure ◽  
Lower Socioeconomic Status ◽  
Multivariable Logistic Regression Model ◽  
Lower Socioeconomic ◽  
Endemic District

Background/aimsTo determine the incidence of scarring in women in a trachoma low endemic district of rural Tanzania and to determine the effects of lifetime cooking fire exposure and markers of lower socioeconomic status on incidence of scarring in these women.MethodsA prospective cohort study was conducted over a 3.5-year period from 2013 to 2016 in 48 villages in Kongwa, Tanzania where trachoma at baseline was 5.2% in children. A random sample of 2966 women aged 15 and older who were at risk for incident scarring were eligible for follow-up. Data on demographic factors, cooking fire exposure and trachomatous scarring were gathered at baseline and follow-up. An index of lifetime exposure to cooking fire exposure was created and bivariate analysis, age-adjusted logistic regression and multivariable logistic models were used to look for associations of demographic factors and cooking fire exposure with incident trachomatous scarring.ResultsThe cumulative incidence of scarring was 7.1% or 2.0% per year. Incidence of scarring increased with age and exposure to markers of lower socioeconomic status. A multivariable logistic regression model adjusting for confounding factors did not find an association between lifetime cooking fire exposure and incidence of scarring (OR=0.92; 95% CI 0.68 to 1.24, P=0.58).ConclusionsThere was still incident scarring in women in Tanzania despite low rates of active trachoma. There was no association between exposure to cooking fires and incident scarring. More research is needed to understand the factors that contribute to new scarring in these women.

scholarly journals Money is Brain: Financial Barriers and Consequences for Canadian Stroke Patients

2016 ◽  
Vol 44 (2) ◽  
pp. 146-151 ◽  
Author(s):  
Aravind Ganesh ◽  
Kathryn King-Shier ◽  
Braden J. Manns ◽  
Michael D. Hill ◽  
David J.T. Campbell
Keyword(s):  
Health Resources ◽  
Health Care Team ◽  
Professional Services ◽  
Stroke Patients ◽  
Financial Barriers ◽  
Lower Socioeconomic ◽  
Inadequate Knowledge ◽  
History Of ◽  
Qualitative Descriptive

AbstractBackground: Stroke patients of lower socioeconomic status have worse outcomes. It remains poorly understood whether this is due to illness severity or personal or health system barriers. We explored the experiences of stroke patients with financial barriers in a qualitative descriptive pilot study, seeking to capture perceived challenges that interfere with their poststroke health and recovery. Methods: We interviewed six adults with a history of stroke and financial barriers in Alberta, Canada, inquiring about their: (1) experiences after stroke; (2) experience of financial barriers; (3) perceived reasons for financial barriers; (4) health consequences of financial barriers; and (5) mechanisms for coping with financial barriers. Two reviewers analyzed data using inductive thematic analysis. Results: The participants developed new or worsened financial circumstances as a consequence of stroke-related disability. Poststroke impairments and financial barriers took a toll on their mental health. They struggled to access several aspects of long-term poststroke care, including allied health professional services, medications, and proper nutrition. They described opportunity costs and tradeoffs when accessing health services. In several cases, they were unaware of health resources available to them and were hesitant to disclose their struggles to their physicians and even their families. Conclusion: Some patients with financial barriers perceive challenges to accessing various aspects of poststroke care. They may have inadequate knowledge of resources available to them and may not disclose their concerns to their health care team. This suggests that providers themselves might consider asking stroke patients about financial barriers to optimize their long-term poststroke care.

Barriers to survivorship care in the Consortium for New England Childhood Cancer Survivors (CONNECCS).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10035-10035
Author(s):  
Cindy L. Schwartz ◽  
Priay Hirway ◽  
Jeremy Ader ◽  
Heather Appleton Bradeen ◽  
Satkiran S. Grewal ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Lymphoblastic Leukemia ◽  
Private Insurance ◽  
Healthcare Access ◽  
Socioeconomic Background ◽  
Survivorship Care ◽  
Cns Disease ◽  
Long Term Follow Up

10035 Background: Although long-term adverse consequences of childhood cancer treatment may be mitigated by screening, prevention, and interventions, many survivors do not take advantage of survivorship care. We hypothesized that patients who are at risk for poor compliance with long-term follow-up are identifiable at diagnosis. Methods: To identify factors associated with poor follow-up compliance, 7 CONNECCS institutions evaluated a childhood acute lymphoblastic leukemia (ALL) survivor cohort diagnosed 1996-99. Data collected included: diagnosis year, age, race, ethnicity, gender, insurance, distance from center, CNS disease, and risk classification. Primary endpoints were compliance with 5 and 10-year follow-up. Differences in compliance were tested using chi-squared or t-tests. Logistic regression (including institution as a clustering variable) was used to calculate adjusted odds ratios (OR). Results: At diagnosis, the 358 ALL patients were: female (47%), age= 6.5 + 4.6 years, white/non-Hispanic (84%), black non-Hispanic (7%), high-risk (52%), CNS involvement (10%), privately insured (68%). Private insurance (OR 4.0; 95% CI 2.1-7.8) significantly increased the odds of 5-year compliance. Compliance with 10-year follow-up increased with private insurance (OR 3.3; 95% CI 1.4-8.1) but decreased with CNS disease (OR 0.36; 95% CI 0.31- 0.42) and with years of age (OR 0.93; 95% CI 0.88- 0.96). Conclusions: We evaluated predictors of long-term follow-up based on disease/demographic characteristics at diagnosis to identify cohorts in need of early interventions. In this regional cohort, patients from lower socioeconomic background (without private insurance) at diagnosis were less likely to participate in long-term follow-up care at 5 and 10 years from diagnosis. Older survivors and those with CNS disease were less likely to be in follow-up at 10 years. Future studies should investigate reasons why follow-up compliance is affected by 1) private insurance at diagnosis, 2) older age, and 3) CNS disease. Remediable causes might include: understanding of risk, adolescence/young adult transitions, and healthcare access.

Current Practices for Withdrawal of Life Support in Intensive Care Units

2010 ◽  
Vol 19 (6) ◽  
pp. 532-541 ◽  
Author(s):  
Karin T. Kirchhoff ◽  
Jennifer A. Kowalkowski
Keyword(s):  
Intensive Care ◽  
Nursing Education ◽  
Intensive Care Units ◽  
Life Support ◽  
Quality Care ◽  
The United States ◽  
Health Care Team ◽  
Intensive Care Nurses ◽  
Care Plans

BackgroundNurses are present at the bedside of patients undergoing withdrawal of life support more often than any other member of the health care team, yet most publications on this topic are directed at physicians.ObjectivesTo describe the training, guidance, and support related to withdrawal of life support received by nurses in intensive care units in the United States, how the nurses participated, and how the withdrawal of life support occurred.MethodsA questionnaire about withdrawal of life support was sent to 1000 randomly selected members of the American Association of Critical-Care Nurses, with 2 follow-up mailings.ResultsResponses were received from 48.4% of the nurses surveyed. Content on withdrawal of life support was required in only 15.5% of respondents’ basic nursing education and was absent from work site orientations for 63.1% of respondents. Nurses’ actions during withdrawal were most often guided by individual physician’s orders (63.8%), followed by standardized care plans (20%) and standing orders (11.8%). Nurses rated the importance of emotional support during and after the withdrawal of life support very highly, but they did not believe they were receiving that level of support. Most respondents (87.5%) participated in family conferences where withdrawal of life support was discussed. After physicians, nurses were most influential concerning administration of palliative medications. Patients’ families were present during withdrawal procedures between 32.3% and 58.4% of the time.ConclusionsTo improve their practice, intensive care nurses should receive formal training on withdrawal of life support, and institutions should develop best practices that support nurses in providing the highest quality care for patients undergoing this procedure.

Risk of recurrent venous thromboembolism after a first oestrogen-associated episode

2010 ◽  
Vol 104 (09) ◽  
pp. 498-503 ◽  
Author(s):  
Grégoire Le Gal ◽  
Michael Kovacs ◽  
Marc Carrier ◽  
Kimberley Do ◽  
Susan Kahn ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Oral Contraceptives ◽  
Hormone Replacement ◽  
Anticoagulant Treatment ◽  
Exogenous Oestrogen ◽  
Recurrent Venous Thromboembolism ◽  
Recurrent Vte ◽  
Post Menopausal ◽  
Age Range

SummaryThe use of exogenous oestrogen in women with otherwise unprovoked venous thromboembolism (VTE) could be considered sufficient explanation to classify VTE as provoked if the risk of recurrent VTE after 3–6 months of anticoagulant treatment is similar to the risk of recurrent VTE observed after a surgery or prolonged immobilisation. Our objective was to assess the risk of recurrent VTE in women after a first unprovoked episode on oestrogen. The REVERSE study is a cohort study of patients with a first unprovoked VTE treated with anticoagulant treatment for 5–7 months. The risk of recurrent VTE during follow-up was compared between women users and non users of oestrogen at the time of index VTE. Among the 646 patients included, 314 were women, of them 67 were current users of oestrogen at the time of their VTE: 49 were on oral contraceptives and 18 on post-menopausal hormone replacement therapy (HRT). No significant association was found between oestrogen exposure, either oral contraceptives or HRT, and a lower risk of recurrent VTE after adjustment for age, or analysis restricted to women in the same age range as oestrogen contraceptives and HRT users, respectively. The risk of recurrent VTE is low in women after a first otherwise unprovoked oestrogen-associated VTE. However, this risk is not significantly lower than in women whose VTE was not related to oestrogen use.

Long-term follow-up of children whose mothers used oral contraceptives prior to conception

Contraception ◽  
1984 ◽  
Vol 29 (3) ◽  
pp. 203-214 ◽  
Author(s):  
S. Magidor ◽  
H. Palti ◽  
S. Harlap ◽  
M. Baras
Keyword(s):  
Oral Contraceptives ◽  
Long Term Follow Up
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