Challenges of Pre- and Post-Test Counseling for Orthodox Jewish Individuals in the Premarital Phase.

PubMed

Rose, E; Schreiber-Agus, N; Bajaj, K; Klugman, S; Goldwaser, T

2016-02-01

The Jewish community has traditionally taken ownership of its health, and has taken great strides to raise awareness about genetic issues that affect the community, such as Tay-Sachs disease and Hereditary Breast and Ovarian Cancer syndrome. Thanks in part to these heightened awareness efforts, many Orthodox Jewish individuals are now using genetics services as they begin to plan their families. Due to unique cultural and religious beliefs and perceptions, the Orthodox Jewish patients who seek genetic counseling face many barriers to a successful counseling session, and often seek the guidance of programs such as the Program for Jewish Genetic Health (PJGH). In this article, we present clinical vignettes from the PJGH's clinical affiliate, the Reproductive Genetics practice at the Montefiore Medical Center. These cases highlight unique features of contemporary premarital counseling and screening within the Orthodox Jewish Community, including concerns surrounding stigma, disclosure, "marriageability," the use of reproductive technologies, and the desire to include a third party in decision making. Our vignettes demonstrate the importance of culturally-sensitive counseling. We provide strategies and points to consider when addressing the challenges of pre- and post-test counseling as it relates to genetic testing in this population.

The Viewpoints of Sexually Active Single Women About Premarital Sexual Relationships: A Qualitative Study in the Iranian Context

PubMed Central

Rahmani, Azam; Merghati-Khoei, Effat; Moghaddam-Banaem, Lida; Hajizadeh, Ebrahim; Montazeri, Ali

2016-01-01

Background: Premarital sexual relationships could harm youth’s health in terms of sexually transmitted infections or increased risk of unprotected sexual behaviors. Sexual abstinence has been recommended to prevent young adolescents from adverse outcomes of premarital sexual relationships. Objectives: The aim of this study was to explore the viewpoints of sexually active single women about premarital sexual relationships in the Iranian context. Patients and Methods: In this qualitative study, we recruited 41 young women aged 18 to 35 years. Data were collected using focus group discussions and individual interviews. We employed conventional content analysis to analyze the data. Multiple data collection methods, maximum variation sampling, and peer checks were applied to enhance the reliability of the findings. Results: Eight themes emerged from the data analysis: ‘acceptance of sexual contact in the context of opposite-sex relationships, ‘sexual activity as a guarantee for keeping the boyfriend in the relationship’, ‘premarital sexual relationship as an undeniable personal right’, ‘having successful marriage in spite of premarital sexual relationships’, ‘virginity as an old fashioned phenomenon’, ‘love as a license for premarital sexual behaviors’, ‘goal-oriented relationship as a license for premarital sexual behaviors’, and ‘experiencing premarital sexual relationships in order to gain perfection’. Conclusions: Results of this study could be applied to designing interventions, such as promotion of preventive beliefs or educational programs regarding premarital sexual relationships in conservative societies. These interventions could start within families and continue at schools and universities. PMID:27162757

Sexual attitudes, pattern of communication, and sexual behavior among unmarried out-of-school youth in China.

PubMed

Wang, Bo; Li, Xiaoming; Stanton, Bonita; Kamali, Vafa; Naar-King, Sylvie; Shah, Iqbal; Thomas, Ronald

2007-07-31

In recent years, more adolescents are engaging in premarital sex in China. However, only a limited number of studies have explored out-of-school youth's sexual attitudes and behaviors, critical for prevention intervention development. Using data from the baseline survey of a comprehensive sex education program that was conducted in a suburb of Shanghai in 2000-2002, this study describes sexual attitudes, patterns of communication on sexual matters, and premarital sexual behavior among 1,304 out-of-school youth. Multivariate logistic regression analysis was conducted to examine the factors associated with youth's premarital sexual intercourse. The majority (60%) of out-of-school youth held favorable attitudes towards premarital sex. Males were more likely to have favorable attitudes compared with females. Male youth generally did not communicate with either parent about sex, while one-third of female youth talked to their mothers about sexual matters. Both males and females chose their friends as the person with whom they were most likely to talk about sexual matters. About 18% of the youth reported having engaged in sexual intercourse. One-fifth of sexually active youth had always used a contraceptive method, and one-quarter had been pregnant (or had impregnated a partner). There were no gender differences in rate of premarital sex or frequency of contraceptive use. Multivariate analysis revealed that age, education, family structure, parent's discipline, attitudes towards premarital sex, pattern of communication and dating were significantly associated with youth premarital sex. A substantial proportion of out-of-school youth engage in risky sexual behaviors. Prevention programs that empower communication and sexual negotiation skills, and promote condom use should be implemented for this vulnerable group.

Sexual attitudes, pattern of communication, and sexual behavior among unmarried out-of-school youth in China

PubMed Central

Wang, Bo; Li, Xiaoming; Stanton, Bonita; Kamali, Vafa; Naar-King, Sylvie; Shah, Iqbal; Thomas, Ronald

2007-01-01

Background In recent years, more adolescents are engaging in premarital sex in China. However, only a limited number of studies have explored out-of-school youth's sexual attitudes and behaviors, critical for prevention intervention development. Methods Using data from the baseline survey of a comprehensive sex education program that was conducted in a suburb of Shanghai in 2000–2002, this study describes sexual attitudes, patterns of communication on sexual matters, and premarital sexual behavior among 1,304 out-of-school youth. Multivariate logistic regression analysis was conducted to examine the factors associated with youth's premarital sexual intercourse. Results The majority (60%) of out-of-school youth held favorable attitudes towards premarital sex. Males were more likely to have favorable attitudes compared with females. Male youth generally did not communicate with either parent about sex, while one-third of female youth talked to their mothers about sexual matters. Both males and females chose their friends as the person with whom they were most likely to talk about sexual matters. About 18% of the youth reported having engaged in sexual intercourse. One-fifth of sexually active youth had always used a contraceptive method, and one-quarter had been pregnant (or had impregnated a partner). There were no gender differences in rate of premarital sex or frequency of contraceptive use. Multivariate analysis revealed that age, education, family structure, parent's discipline, attitudes towards premarital sex, pattern of communication and dating were significantly associated with youth premarital sex. Conclusion A substantial proportion of out-of-school youth engage in risky sexual behaviors. Prevention programs that empower communication and sexual negotiation skills, and promote condom use should be implemented for this vulnerable group. PMID:17672903

'Main' girlfriends, girlfriends, marriage, and money: the social context of HIV risk behaviour in sub-Saharan Africa.

PubMed

Meekers, D; Calvès, A E

1997-01-01

Research on African societies documents the magnitude of the AIDS epidemic, and shows that at younger ages women are more likely to be affected than men. Young African women are particularly vulnerable to HIV infection because sexual relations with men are an important means to achieve social and economic status, and for some women they are necessary for survival. Many African adolescents and young adults engage in premarital sexual relationships, either sequentially or simultaneously. Unmarried African males commonly have a 'main' girlfriend whom they expect to marry, and one or more other girlfriends, for whom there are no such expectations; some females have similar strategies. This study uses focus-group data from Cameroun to describe popular types of premarital sexual relationships, and to examine gender differentials in the motivations for engaging in such relationships and in perceptions of the factors that affect the marriage prospects of these premarital relationships. Economic need leads many young women to use premarital sexual relations for economic support, despite high levels of HIV infection. These findings help inform policy-makers and program managers in Africa about gender differentials in the motivations for engaging in premarital sexual unions, which in turn can help improve the design and implementation of social and health policies and programs.

Avoid falling for a jerk(ette): Effectiveness of the Premarital Interpersonal Choices and Knowledge Program among Emerging Adults.

PubMed

Bradford, Kay; Stewart, J Wade; Pfister, Roxane; Higginbotham, Brian J

2016-10-01

Premarital education may help emerging adults form healthy relationships, but evaluation research is needed, particularly with community samples. We studied emerging adults in the Premarital Interpersonal Choices and Knowledge (PICK) program, using a pre- to post- and a posttest-then-retrospective-pretest design to examine change in perceived relationship skills, partner selection, relational patterns, and relationship behaviors and attitudes. Mixed models analyses showed that scores for the treatment group (n = 682) increased from pre to post on all four outcomes. Changes in scores for the nonequivalent comparison group (n = 462) were nonsignificant. In addition, significant differences between pre- and retrospective prescores demonstrated evidence for response shift bias. The results suggest that the PICK program helps participants increase their knowledge regarding the components of healthy relationship formation. © 2016 American Association for Marriage and Family Therapy.

Reasons for Divorce and Recollections of Premarital Intervention: Implications for Improving Relationship Education

PubMed Central

Scott, Shelby B.; Rhoades, Galena K.; Stanley, Scott M.; Allen, Elizabeth S.; Markman, Howard J.

2014-01-01

The study presents findings from interviews of 52 divorced individuals who received the Prevention and Relationship Enhancement Program (PREP) while engaged to be married. Using both quantitative and qualitative methods, the study sought to understand participant reasons for divorce (including identification of the “final straw”) in order to understand if the program covered these topics effectively. Participants also provided suggestions based on their premarital education experiences so as to improve future relationship education efforts. The most commonly reported major contributors to divorce were lack of commitment, infidelity, and conflict/arguing. The most common “final straw” reasons were infidelity, domestic violence, and substance use. More participants blamed their partners than blamed themselves for the divorce. Recommendations from participants for the improvement of premarital education included receiving relationship education before making a commitment to marry (when it would be easier to break-up), having support for implementing skills outside of the educational setting, and increasing content about the stages of typical marital development. These results provide new insights into the timing and content of premarital and relationship education. PMID:24818068

Reasons for Divorce and Recollections of Premarital Intervention: Implications for Improving Relationship Education.

PubMed

Scott, Shelby B; Rhoades, Galena K; Stanley, Scott M; Allen, Elizabeth S; Markman, Howard J

2013-06-01

The study presents findings from interviews of 52 divorced individuals who received the Prevention and Relationship Enhancement Program (PREP) while engaged to be married. Using both quantitative and qualitative methods, the study sought to understand participant reasons for divorce (including identification of the "final straw") in order to understand if the program covered these topics effectively. Participants also provided suggestions based on their premarital education experiences so as to improve future relationship education efforts. The most commonly reported major contributors to divorce were lack of commitment, infidelity, and conflict/arguing. The most common "final straw" reasons were infidelity, domestic violence, and substance use. More participants blamed their partners than blamed themselves for the divorce. Recommendations from participants for the improvement of premarital education included receiving relationship education before making a commitment to marry (when it would be easier to break-up), having support for implementing skills outside of the educational setting, and increasing content about the stages of typical marital development. These results provide new insights into the timing and content of premarital and relationship education.

A randomized clinical trial of the effectiveness of premarital intervention: moderators of divorce outcomes.

PubMed

Markman, Howard J; Rhoades, Galena K; Stanley, Scott M; Peterson, Kristina M

2013-02-01

This study examined the effects of premarital relationship intervention on divorce during the first 8 years of first marriage. Religious organizations were randomly assigned to have couples marrying through them complete the Prevention and Relationship Education Program (PREP) or their naturally occurring premarital services. Results indicated no differences in overall divorce rates between naturally occurring services (n = 44), PREP delivered by clergy at religious organizations (n = 66), or PREP delivered by professionals at a university (n = 83). Three moderators were also tested. Measured premaritally and before intervention, the level of negativity of couples' interactions moderated effects. Specifically, couples observed to have higher levels of negative communication in a video task were more likely to divorce if they received PREP than if they received naturally occurring services; couples with lower levels of premarital negative communication were more likely to remain married if they received PREP. A history of physical aggression in the current relationship before marriage and before intervention showed a similar pattern as a moderator, but the effect was only marginally significant. Family-of-origin background (parental divorce and/or aggression) was not a significant moderator of prevention effects across the two kinds of services. Implications for defining risk, considering divorce as a positive versus negative outcome, the practice of premarital relationship education, and social policy are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Sexual and Reproductive Health among Unmarried Rural-Urban Female Migrants in Shanghai China: A Comparative Analysis

PubMed Central

Wang, Ying; Yao, Wen; Shang,  Meili; Cai, Yong; Shi, Rong; Ma, Jin; Wang, Jin; Song, Huijiang

2013-01-01

We compared sexual and reproductive health (SRH)-related knowledge, attitude and behavior among unmarried rural-urban female migrants in Shanghai coming from different regions of China. A total of 944 unmarried rural-urban female migrants were recruited from three districts of Shanghai. We used an interviewer-administered structured questionnaire to collect information from each participant and a multivariate logistic regression to examine the association between premarital sex and risk factors. We found the rates of premarital sex, pregnancy and abortion among unmarried rural-urban female migrants were 28.2%, 5.2% and 5.0%, respectively. Participants from the east of China were more likely to engage in premarital sex than those from the mid-west (p < 0.001). The analysis showed premarital sex was associated with age, hometown, education, current residential type, knowledge of sexual physiology and safe sex, attitude to SRH and safe sex, and permissive attitude to sex. Unmarried rural-urban female migrants lack SRH related knowledge and the data suggests high levels of occurrence of premarital sex. The results indicate that programs to promote safe sex, especially to those migrants coming from eastern China, should be a priority. PMID:23939391

Siblings' premarital childbearing and the timing of first sex in three major cities of Cote d'Ivoire.

PubMed

Diop-Sidibe, Nafissatou

2005-06-01

The association between youths' sexual and reproductive attitudes and behaviors and those of their peers and parents has been documented; however, information on siblings' influence is scarce, especially for developing countries. Data on 1,395 female and 1,242 male survey respondents aged 15-24 from three cities in Côte d'Ivoire were analyzed. Life-table analysis was conducted to examine respondents' probability of remaining sexually inexperienced according to siblings' history of premarital childbearing. Cox multivariate regressions were used to estimate respondents' relative risks of sexual debut by age 17 and by age 24. At any age between 15 and 24 years, the life-table probability of remaining sexually inexperienced was typically lower among persons who had at least one sibling with a premarital birth than among those who had no such sibling. In general, among those with at least one sibling who had had a premarital birth, the probability was lower if the sibling or siblings and the respondent were of the same gender rather than opposite genders, and the probability was lowest among those who had a brother and a sister with a history of premarital childbearing. In the multivariate analysis for males, having one or more brothers only, or having at least one brother and at least one sister, with a history of premarital childbearing was associated with increased relative risks of being sexually experienced by ages 17 and 24. No such association was found for females. Programs that seek to reduce premarital sexual activity among young people should develop strategies that take into account the potential influence of siblings.

Cohort Trends in Premarital First Births: What Role for the Retreat From Marriage?

PubMed Central

Wu, Lawrence L.; Shafer, Emily Fitzgibbons

2015-01-01

We examine cohort trends in premarital first births for U.S. women born between 1920 and 1964. The rise in premarital first births is often argued to be a consequence of the retreat from marriage, with later ages at first marriage resulting in more years of exposure to the risk of a premarital first birth. However, cohort trends in premarital first births may also reflect trends in premarital sexual activity, premarital conceptions, and how premarital conceptions are resolved. We decompose observed cohort trends in premarital first births into components reflecting cohort trends in (1) the age-specific risk of a premarital conception taken to term; (2) the age-specific risk of first marriages not preceded by such a conception, which will influence women’s years of exposure to the risk of a premarital conception; and (3) whether a premarital conception is resolved by entering a first marriage before the resulting first birth (a “shotgun marriage”). For women born between 1920–1924 and 1945–1949, increases in premarital first births were primarily attributable to increases in premarital conceptions. For women born between 1945–1949 and 1960–1964, increases in premarital first births were primarily attributable to declines in responding to premarital conceptions by marrying before the birth. Trends in premarital first births were affected only modestly by the retreat from marriages not preceded by conceptions—a finding that holds for both whites and blacks. These results cast doubt on hypotheses concerning “marriageable” men and instead suggest that increases in premarital first births resulted initially from increases in premarital sex and then later from decreases in responding to a conception by marrying before a first birth. PMID:24072609

The Premarital Communication Roots of Marital Distress and Divorce: The First Five Years of Marriage

PubMed Central

Markman, Howard J.; Rhoades, Galena K.; Stanley, Scott M.; Ragan, Erica P.; Whitton, Sarah W.

2011-01-01

Using data from 210 couples who provided data across the first five years of marriage, we examined how premarital communication quality was related to divorce and later distress. The results showed that premarital observed negative and positive communication nearly reached significance as predictors of divorce, while self-reported negative communication was significantly associated with divorce. In terms of marital adjustment, we found that both premarital observed and self-reported negative premarital communication (but not observed positive communication) were associated with lower adjustment during the first five years of marriage. The most important questions addressed in this study pertain to how positive and negative dimensions of communication change over time and how these changes are related to being distressed or nondistressed after five years of marriage. This is the first study, to our knowledge, to examine the changes in communication over time that are so central to theories of the development of marital distress and for research based interventions. We found that all couples showed decreases in negative communication over time, but the non-distressed group declined significantly more than the distressed group in negative communication, suggesting they are handling negative emotions better. Implications for future research on the development of relationship distress and for enhancing research-based couples intervention programs are provided. PMID:20545402

Effectiveness of premarital sexual counselling program on sexual satisfaction of recently married couples.

PubMed

Vural, Bilgin Kiray; Temel, Ayla Bayik

2009-09-01

Through its ability to address and remove fear and misunderstanding and the resulting sexual reluctance and related problems, pre-marital sexual education and counselling can contribute to sexual satisfaction. This quasi-experimental research conducted in a pre-test-post-test control group design aimed to examine the effectiveness of nursing interventions on a premarital counselling program and its impacts on the sexual satisfaction of couples (36 couples in the experimental group and 35 couples in the control group). Although no difference was detected between the experimental and control groups in terms of the level of knowledge on pre-test point averages, the difference between them in terms of post-test knowledge gain averages was statistically significant. Approval rates for sexual myths in the pre-test were 27.87% in the experimental group and 37.03% in the control group; in the post-test they were 23.51% and 36.66% respectively. In the experimental group, 80.6% of the women and 63.9% of the men, and in the control group, 77.1% of the women and 71.4% of the men were established as having a problem-free sexual life. It was also discovered that levels of sexual satisfaction were shown to be higher among women and men in the experimental group who had attended premarital sexual counselling education than the women and men in the control group. A recommendation to encourage engaged couples to attend premarital sexual counselling is made based on the findings. It is thought that an intervention plan prepared within the framework of the Information, Motivation, Behavioural Skills theoretical model will help nurses guide recently-married couples to greater sexual satisfaction.

The Correlation between Current Marital Satisfaction and Premarital Counseling

DTIC Science & Technology

1985-05-04

Family , 3, 9 41-955. Ridley, C. A., Avery, A. W., Harrell, J. E., Leslie, L. A., & Dent, J. (1981). Conflict management : A premarital training program in...00 THE CORRELATION BETWEEN CURRENT MRITAL SATISFACTION AND PRE MARITAL COUNSELING California Family Study Center Burbank, CA Contract NOO228-8O-A-425...1 ! A Project submitted to the Faculty of California Family Study Center, in partial fulfillment of the requirements for the degree of Master of Arts

[Relationship between gender, experience of migration and premarital sex among out-of-school youths in rural Hainan, China].

PubMed

Cao, Yuan; Wang, Yu; He, Qi-ya; Wang, Zhao-qian; Feng, Wei-ping; Ji, Jin-hua; Liao, Su-su

2011-11-01

To assess pre-marital sex behavior and its relationship with gender and experience of migration among 16 - 24 years-old out-of-school youths in rural Hainan province, China. 160 eligible youths from each of the 2 townships in County A and 80 from each of the 6 townships in County B were recruited, under equal proportion on gender, age distribution and experience of migration. An interviewer-administered, standardized questionnaire was used. 760 eligible participants (with each gender of 380) were interviewed. There were no significant differences in the proportions of reporting as sexually active (56.8% and 57.9%) or having premarital sex (54.5% and 50.0%) between male and female youths. However, among those sexually active participants, the average age at first sexual intercourse was (18.2 ± 1.9 years or 19.2 ± 1.8 years, P < 0.01), the average age of first-time leaving hometown for work (18.0 ± 2.3 years or 16.5 ± 1.9 years P < 0.01) and the percentage of having first sexual intercourse before 18 years old (59.3% vs. 35.5%, P < 0.01) were different between males and females. 31.2% of the male youths reported that their sexual debut happened before they left their hometown for work and 45.9% of the sex debut appeared within 1 year after they left hometown. However, 78.5% of the sexually active female youths reported their sexual debut happened 1 year after leaving their hometown. Data from the multivariate analysis showed that being away from hometown for more than 3 months and having more friends who presumably had presumably pre-marital sex experiences were more likely to report pre-marital sex behavior. Older men were more likely to report pre-marital sex behavior than the younger ones. Married women were more likely to report pre-marital sex behavior than the unmarried ones. Through multivariate analysis on unmarried men, data showed that those having had experience on migration and at older age were associated with experiencing premarital sex. Gender difference was identified on the pattern of migration and its relationship with premarital sex among out-of-school rural youths in Hainan province. When prevention program is developed for rural youth, these differences should be taken into account.

The premarital communication roots of marital distress and divorce: the first five years of marriage.

PubMed

Markman, Howard J; Rhoades, Galena K; Stanley, Scott M; Ragan, Erica P; Whitton, Sarah W

2010-06-01

Using data from 210 couples who provided data across the first 5 years of marriage, we examined how premarital communication quality was related to divorce and later distress. The results showed that premarital observed negative and positive communication nearly reached significance as predictors of divorce, while self-reported negative communication was significantly associated with divorce. In terms of marital adjustment, we found that both premarital observed and self-reported negative premarital communication (but not observed positive communication) were associated with lower adjustment during the first 5 years of marriage. The most important questions addressed in this study pertain to how positive and negative dimensions of communication change over time and how these changes are related to being distressed or nondistressed after 5 years of marriage. This is the first study, to our knowledge, to examine the changes in communication over time that are so central to theories of the development of marital distress and for research-based interventions. We found that all couples showed decreases in negative communication over time, but the nondistressed group declined significantly more than the distressed group in negative communication, suggesting they are handling negative emotions better. Implications for future research on the development of relationship distress and for enhancing research-based couples' intervention programs are provided. (c) 2010 APA, all rights reserved.

Gender norms affect adolescents.

PubMed

Barnett, B

1997-01-01

Gender roles of men and women are determined by the society they live in. Many organizations that work with adolescents and young adults are incorporating a gender perspective into sex education, service delivery, and provider training programs in order to improve the reproductive health of their target groups. Many societies place a higher value on males than females. In sub-Saharan African countries girls are expelled from school if they become pregnant. In Egypt 86% of 2300 women interviewed believed the beatings by husband are justified under some circumstances, and 31% reported being beaten during pregnancy. A study of 128 adolescents in Peru and 108 in Columbia found that 60% of them had been sexually abused within the previous year. Female circumcision jeopardizes reproductive health, yet some 2 million girls undergo the procedure annually. In Thailand, among more than 100 factory workers 15-24 years old, the majority of men said premarital intercourse was accepted, while young women said premarital intercourse was unacceptable. Many programs that incorporate gender have begun projects that empower girls. Better Life Options administered by the Center for Development and Population Activities (CEDPA) provides information about sexuality, reproductive health, family planning and communication skills. The Young Men's Clinic, located in New York, aims to provide reproductive health services for men while also doing screening for tuberculosis or sickle-cell anemia. A report from the United Nations Population Fund states that men's services can be provided by minor adaptations to existing facilities. In Argentina the Foundation for Study and Research on Women offers education sessions on family planning and STDs to 50-100 secondary school students. In Gujarat, India, the Center for Health Education, Training and Nutrition Awareness incorporates gender into its health education workshops for young people ages 11-18. In these programs more equality in gender roles is needed in the future.

The natural history and the national pre-marital screening program in Saudi Arabia.

PubMed

El-Hazmi, Mohsen A F

2004-11-01

The genetic disorders are chronic in nature and, therefore, require continuous support and health care. Consequently, the genetic diseases cause formidable economic and psychosocial burdens on the family with negative reflection on the community at large. The genetic diseases are a heterogeneous group that result in varieties of chronic health ailment as a result of defects in the genetic material. The congenital malformations and some genetic defects may result from exposure to radiation, pharmaceutical drugs, the exposure of the mother during pregnancy to certain infectious diseases, such as rubella, toxoplasma or viruses. It may also result as a side effect of chronic diseases, including diabetes, hypertension or varieties of environmental factors, or both. The other group of genetic diseases are transmitted from parents to the offspring through a specific pattern of inheritance exemplified by recessive genetic disorders. This group includes the sickle cell gene, the thalassemias, the hemophilias, inborn errors of metabolism and red cell enzymopathies. The main etiological factors of genetic diseases and congenital malformations are 1) Genetic defects which are transmitted to offspring through carriers of affected parents. 2) Mutations in the genetic materials due to spontaneous mutations, exposure of the mother during pregnancy to infectious diseases, such as rubella and toxoplasma, receiving certain teratogenic drugs during pregnancy, exposure of the mother to ionizing radiation during pregnancy such as x-ray and chronic diseases of the mother, such as diabetes mellitus. 3) Others such as difficult labor or injury to the baby, during or after labor. This paper reviews the natural history of common blood genetic disorders and the means of prevention and control, focusing on pre-marital screening as a means of prevention.

Four perspectives of women's health. Workshop participants talk about women's health issues in four countries. [Malaysia].

PubMed

Kaur, P

1994-01-01

The program officer of the SIEC Project of the Federation of Family Planning Associations, Malaysia (FFPA,M) granted an interview to JOICFP News during JOICFP's IEC Workshop for the Production of Video Script for Women's Health in Tokyo, Japan. FFPA,M provides comprehensive reproductive health services, including family planning services, pap smear screenings, breast examination, annual medical checkups, and premarital and marital counseling for women. Around 50% of married women use family planning. More than 90% of contraceptive users are familiar with at least one family planning method. FFPA,M is focusing on marginalized women. As Malaysia industrializes, rural-urban migration occurs. Young women comprise many of the new factory workers. FFPA,M provides family life education for these women and strives to help them achieve reproductive health and rights. The enthusiasm for women's issues exhibited at the workshop by both male and female participants pleased FFPA,M's program officer.

Gender Differences in Adolescent Premarital Sexual Permissiveness in Three Asian Cities: Effects of Gender-Role Attitudes

PubMed Central

Xiayun, Zuo; Chaohua, Lou; Ersheng, Gao; Yan, Cheng; Hongfeng, Niu; Zabin, Laurie S.

2014-01-01

Purpose Gender is an important factor in understanding premarital sexual attitudes and behaviors. Many studies indicate that males are more likely to initiate sexual intercourse and have more permissive perceptions about sex than females. Yet few studies have explored possible reasons for these gender differences. With samples of unmarried adolescents in three Asian cities influenced by Confucian cultures, this paper investigates the relationship between underlying gender norms and these differences in adolescents’ premarital sexual permissiveness. Methods 16,554 unmarried participants aged 15–24 were recruited in the Three-City Asian Study of Adolescents and Youth, a collaborative survey conducted in 2006–2007 in urban and rural areas of Hanoi, Shanghai and Taipei, with 6204, 6023 and 4327 from each city respectively. All of the adolescents were administered face-to-face interviews, coupled with Computer Assisted Self Interview (CASI) for sensitive questions. Scales on gender-role attitudes and on premarital sexual permissiveness for both male and female respondents were developed and applied to our analysis of the data. Multi-linear regression was used to analyze the relationship between gender-role attitudes and sexual permissiveness. Results Male respondents in each city held more permissive attitudes towards premarital sex than did females with both boys and girls expressing greater permissiveness to male premarital sexual behaviors. Boys also expressed more traditional attitudes to gender roles (condoning greater inequality) than did girls in each city. Adolescents’ gender-role attitudes and permissiveness to premarital sex varied considerably across the three cities, with the Vietnamese the most traditional, the Taiwanese the least traditional, and the adolescents in Shanghai in the middle. A negative association between traditional gender roles and premarital sexual permissiveness was only found among girls in Shanghai and Taipei. In Shanghai, female respondents who held more traditional gender role attitudes were more likely to exercise a double standard with respect to male as opposed to female premarital sex (OR=1.18). This relationship also applied to attitudes of both girls and boys in Taipei (OR=1.20 and OR=1.22, respectively). Conclusions Although with variation across sites, gender differences in premarital sexual permissiveness and attitudes to gender roles among adolescents were very significant in each of the three Asian cities influenced by Confucian-based values. Traditional gender norms may still be deeply rooted in the three cities, especially among females, while it is important to advocate gender equity in adolescent reproductive health programs, the pathway of traditional gender norms in influencing adolescent reproductive health outcomes must be understood, as must differences and similarities across regions. PMID:22340852

Chinese adolescents' attitudes toward sexual relationships and premarital sex: implications for promoting sexual health.

PubMed

Chang, Yu-Ting; Hayter, Mark; Lin, Mei-Ling

2014-12-01

This study was designed to explore Taiwanese school students' attitudes toward sexual relationships and premarital sex. This was an exploratory descriptive, qualitative study. Focus groups (N = 8) were conducted with 47 adolescents from three high schools in Taiwan. Transcripts were transcribed and thematically analyzed using Atlas V 5.0. Adolescent attitudes toward sexual relationships and premarital sexual behavior comprise the following three dimensions: (1) external incentives, (2) the developmental process, and (3) internal control. External incentives include the normalization of sexual behavior between peers, the desire to feel included in a group, parental influence, and media influence. The developmental process includes imagining the sexual experience and onset of sexual activity. Internal control includes the fear of pregnancy, the fear of parental rejection, and the fear of being judged. These findings can provide a reference for designing future sex education curricula and counseling programs for adolescents. © The Author(s) 2014.

Surface plasmon resonance-based molecular detection of Hb S [beta6(A3)Glu-->Val, GAG-->GTG] at the gene level.

PubMed

Atalay, Erol O; Ustel, Emre; Yildiz, Sanem; Atalay, Ayfer

2006-01-01

The surface plasmon resonance (SPR) approach, being a relatively novel biophysical method, is used to detect many different targets by biomolecular interaction. The SPR system uses optical and evanescent wave phenomenon. This approach does not need any labels, such as enzymes or isotopes, and the monitored interactions are in real time. In DNA-DNA interaction, the SPR approach is Tm-independent. Here we report our preliminary results for the molecular detection of the Hb S (GAG -->GTG) mutation at codon 6 of the human beta-globin gene. Our preliminary results show that the SPR approach could be applied as an inexpensive and fast routine test system for the molecular diagnosis of abnormal hemoglobins (Hbs), especially in premarital screening programs.

Premarital first births: The influence of the timing of sexual onset versus post-onset risks in the United States.

PubMed

Wu, Lawrence L; Martin, Steven P

2015-01-01

Motivated by long-standing debates between abstinence proponents and sceptics, we examine how socio-economic factors influence premarital first births via: (i) age at first sexual intercourse and (ii) the risk of a premarital first birth following the onset of sexual activity. Factors associated with an earlier age at first intercourse will imply more premarital first births owing to increased exposure to risk, but many of these same factors will also be associated with higher risks of a premarital first birth following onset. Our analyses confirm previous findings that women from disadvantaged backgrounds are younger at first intercourse and have higher premarital first-birth risks than women from more advantaged backgrounds. However, differences in onset timing have a strikingly smaller influence on premarital first-birth probabilities than do differences in post-onset risks. Our findings thus suggest that premarital first births result primarily from differences in post-onset risk behaviours as opposed to differences in onset timing.

Premarital first births: The influence of the timing of sexual onset versus post-onset risks in the United States

PubMed Central

Wu, Lawrence L.; Martin, Steven P.

2015-01-01

Motivated by long-standing debates between abstinence proponents and skeptics, we examine how socioeconomic factors influence premarital first births via: (1) age at first sexual intercourse and (2) the risk of a premarital first birth following onset. Factors associated with an earlier age at first intercourse will imply more premarital first births due to increased exposure to risk, but many of these same factors will also be associated with higher risks of a premarital first birth following onset. Our analyses confirm previous findings that women from disadvantaged backgrounds are younger at first intercourse and have higher premarital first birth risks relative to those from more advantaged backgrounds. However, differences in onset timing have a strikingly smaller influence on premarital first birth probabilities than do differences in post-onset risks. Our findings thus suggest that premarital first births result primarily from differences in post-onset risk behaviors as opposed to differences in onset timing. PMID:26585183

Sex education sources and attitudes about premarital sex of Seventh Day Adventist youth.

PubMed

Ali, H K; Naidoo, A

1999-02-01

37 Seventh Day Adventist youth were surveyed about their sex education and attitudes towards premarital sex. Analysis indicated differences between their attitudes and actual sexual behaviour. While 70% endorsed the church's prohibition on premarital sex, 54% had engaged in premarital sex.

Premarital romantic partnerships: attitudes and sexual experiences of youth in Delhi, India.

PubMed

Jaya, Jaya; Hindin, Michelle J

2009-06-01

Despite restrictive social norms, there is increasing evidence that youth in India engage in premarital romantic and sexual partnerships. However, information on how they initiate and build these relationships is scarce, even though it is vital for addressing the needs of young people. Attitudes toward and behavior within romantic partnerships were examined using data collected in 2004 from unmarried youth (583 males and 475 females, aged 15-19) living in economically disadvantaged neighborhoods in Delhi, India. Associations between specific attitudes or behaviors and age, gender and sexual experience were determined using Fisher's exact tests. Sixty-two percent of males and 53% of females reported that someone of the opposite sex had expressed an interest in them; 86% of males and 63% of females reported feeling good about it. In addition, 67% of males and 47% of females reported that they liked someone from the opposite sex. Compared with females, males were more likely to seek information about the person they were interested in (76% vs. 61%), and to engage in heterosexual premarital sex (32% vs. 6%). Females were less likely than males to report that it is okay to engage in premarital sex if the male and female love one another (14% vs. 33%). For both males and females, television and films were the most popular source of information on issues related to sexual health. Gender disparities in premarital romantic partnership formation and the experience of sexual relations make a strong case for sexuality education programs tailored to the different experiences and circumstances of young men and women.

Exploring the Effectiveness of Mandatory Premarital Screening and Genetic Counselling Programmes for β-Thalassaemia in the Middle East: A Scoping Review.

PubMed

Saffi, Marwa; Howard, Natasha

2015-01-01

β-Thalassaemia is a common genetic blood disorder in the Middle Eastern region. Mandatory premarital screening and genetic counselling (PMSGC) programmes are implemented in 8 Middle East countries to reduce at-risk marriages and thus disease prevalence. A scoping review was conducted to explore the effectiveness of these programmes. The 6-stage scoping framework of Arksey and O'Malley [Int J Soc Res Methodol 2005;8:19-32] was used. Reported outcomes were analysed per country, with success defined as achieving a 65% reduction in at-risk marriages and/or thalassaemia-affected births. Emergent enablers and barriers were analysed thematically. Twenty-one sources were included from the 1,348 identified, discussing 7 country programmes, with 95% (20/21) published during 2003-2013. Five publications each were included for Iran and Saudi Arabia, 3 for Turkey, 2 each for Bahrain and Iraq (Kurdistan), and 1 for the United Arab Emirates, plus 2 multi-country evaluations. No programme achieved a 65% at-risk marriage cancellation rate. Though data on thalassaemia-affected birth reductions were minimal, programmes in Iran, Turkey and Iraq reported at least 65% reductions. A thematic analysis found that screening timing, access to prenatal detection and abortion, socio-religious issues, awareness and counselling affected decisions. This review found that PMSGC programmes were unsuccessful in discouraging at-risk marriages but successful in reducing the prevalence of affected births in countries providing prenatal detection and therapeutic abortion. A life cycle approach to prevention, incorporation of school screening, awareness campaigns, reconsideration of therapeutic abortion, and screening and counselling of couples married prior to programme inception are likely to improve the effectiveness of such programmes in the Middle Eastern region. © 2015 S. Karger AG, Basel.

Social context of premarital fertility in rural South-Africa.

PubMed

Zwang, Julien; Garenne, Michel

2008-08-01

A qualitative study was conducted in Agincourt, a rural area of South Africa, to document the perceptions and attitudes towards premarital fertility and late marriage among young adults of both sexes. Two focus groups and 35 individual interviews were conducted among 17-30 year olds, randomly selected. Most interviewees perceived premarital fertility as undesirable, and a new phenomenon in a context of major social changes, in particular loss of authority of parents and increasing freedom of the youth. In contrast, late marriage was perceived as positive, by both sexes, primarily for economic reasons. Much stigma was associated with premarital fertility, from friends, institutions and families who occasionally apply mild or severe sanctions. Consequences of premarital fertility were numerous: school abandonment, economic adversity, health risks, stigmatization. In extreme cases, premarital fertility might lead to exclusion and deviant behavior. Premarital fertility was ultimately due to a lack of contraception among young women, and to refusal of abortion for religious reasons, and is associated with the risk of contracting STD's.

Timing of first sex before marriage and its correlates: evidence from India.

PubMed

Santhya, K G; Acharya, Rajib; Jejeebhoy, Shireen J; Ram, Usha

2011-03-01

While several studies have documented the extent of pre-marital sexual experience among young people in India, little work has been done to explore the factors that are correlated with the timing of pre-marital sexual initiation. This paper examines age at initiation of pre-marital sex, circumstances in which first sex was experienced, nature of first sexual experience and correlates of age at initiation of pre-marital sex. Life table estimates suggest that pre-marital sexual initiation occurred in adolescence for 1 in 20 young women and 1 in 10 young men. For the majority of these young people, their first sex was with an opposite-sex romantic partner. First sex, moreover, was unprotected for the majority and forced for sizeable proportion of young women. A number of individual, family-, peer- and community-level factors were correlated with age at first pre-marital sex. Moreover, considerable gender differences were apparent in the correlates of age at first pre-marital sex, with peer- and parent-level factors found more often to be significant for young women than men.

Premarital sexual behavior among male college students of Kathmandu, Nepal.

PubMed

Adhikari, Ramesh; Tamang, Jyotsna

2009-07-15

In Nepal, as in other Asian countries, the issue of sexuality still remains a taboo. Despite this fact, an increasing number of sexual activities is being reported by Nepalese students. This trend warrants serious and timely attention. Due to the sensitivity of the topic of premarital sexuality, youth receive inadequate education, guidance and services on reproductive health. The main objectives of this paper are to explore the sexual behavior especially focusing on prevalence of premarital sex among college men and to investigate the factors surrounding premarital sexual behavior. A cross-sectional survey of college students was conducted in April-May 2006. A self-administered questionnaire was completed by 573 male students. Association between premarital sex and the explanatory variables was assessed in bivariate analysis using Chi-square tests. The associations were further explored using multivariate logistic analysis. Despite the religious and cultural restrictions, about two-fifths of survey respondents (39%) reported that they have had premarital sex. The study has also shown that substantial proportions of students indulge in sexual activities as well as risky sexual behavior. Sex with commercial sex workers, multiple sex partners, and inconsistence use of condom with non-regular partner was common among the students. Less than two in five male students (57%) had used condom at the first sexual intercourse.The prevalence of premarital sex varied on different settings. Older students aged 20 and above were more likely to have premarital sex compared with younger students aged 15-19. Men who had liberal attitude towards male virginity at marriage were almost two times more likely to have engaged in premarital sex compared to their counterparts who have conservative attitude towards male virginity at marriage. Moreover, those students who believe in Hindu religion were more than two times (OR = 2.5) more likely to have premarital sex compared with those who follow other religions. Furthermore, those men who have close unmarried friends who have experienced premarital sexual intercourse were eight times (OR = 8.4) more likely to be sexually active compared to those who did not have such sexually active friends. Prevalence of premarital sexual intercourse and risky sexual behavior are not uncommon in Nepal. Young people are exposed to health hazards due to their sexual behavior; hence sex education should be provided. School or college based sexuality education could benefit even out-of-school youths, because their partners often are students.

True Love Waits: Do Southern Baptists? Premarital Sexual Behavior Among Newly Married Southern Baptist Sunday School Students

PubMed Central

Weathersbee, Byron

2011-01-01

This study measures premarital sex prevalence, sources of sex education, and support for secular sex education among 151 newly married young adults surveyed at 9 Texas Southern Baptist churches. More than 70% of respondents reported having had premarital vaginal or oral sex, but more than 80% regretted premarital sex. The proportion of premarital sex exceeded 80% in 6 of 9 churches, among men and women married after age 25 and women married before age 21. School sex education was the only source of information about sexually transmitted infections for 57% of respondents, and 65% supported secular sex education despite church opposition. PMID:21274632

Premarital fertility in Namibia: trends, factors and consequences.

PubMed

Garenne, Michel; Zwang, Julien

2006-03-01

Premarital fertility, defined as fertility before first marriage, was found to be highly prevalent in Namibia. According to data from the 1992 and 2000 DHS surveys, the proportion of premarital births was 43% for all births, and 60% for the first birth. This seemed to be primarily due to a late mean age at first marriage (26.4 years) and low levels of contraception before first marriage. Data were analysed using a variety of demographic methods, including multiple decrement life table and multivariate logistic models. Major variations were found by ethno-linguistic groups: Herero and Nama/Damara had the highest levels of premarital fertility (above 60%); Ovambo and Lozi had intermediate levels of premarital fertility (around 40%); Kavongo and San appeared to have kept a more traditional behaviour of early marriage and low levels of premarital fertility (around 20%). The largest ethno-linguistic group, the Ovambo, were in a special situation, with fast increasing age at marriage and average level of premarital fertility. Whites and mixed races also differed, with Afrikaans-speaking groups having a behaviour closer to the average, whereas other Europeans had less premarital fertility despite an average age at marriage. Ethnic differences remained stable after controlling for various socioeconomic factors, such as urbanization, level of education, wealth, access to mass media, and religion. Results are discussed in light of the population dynamics and political history of Namibia in the 20th century.

Young Syrian adults' knowledge, perceptions and attitudes to premarital testing.

PubMed

Gharaibeh, H; Mater, F K

2009-12-01

The issue of premarital testing is a controversial and complex issue. Syria is an Islamic country that is moving towards modernization that involves changes in social structures and urbanization of attitudes, beliefs, views and values. The purpose of this study was to identify young Syrian adults' knowledge, perceptions and attitudes about premarital testing. Descriptive, cross-sectional design was utilized. The study was conducted at a mid-sized university in Syria. A stratified simple random sampling was used to recruit the university students in the last 2 years of their graduation. A total of 942 students participated in the study using a questionnaire developed to measure the participants' knowledge, attitudes and perception of premarital testing. Although university students had a considerable knowledge of premarital testing, they had a limited knowledge about certain aspects. Moreover, although they had some positive attitudes, they still had negative attitudes and perceptions towards other aspects of premarital testing. The study results could assist in the development of health education programmes in Syria and other Arab countries to increase their awareness and influence their attitudes towards premarital testing. The study limitation was that the sample was chosen from one part of Syria.

Premarital Childbearing Decision Making.

ERIC Educational Resources Information Center

Oakley, Deborah

1985-01-01

Investigated premarital decision-making among community college students. Results concluded that premarital decisions about the number of children to have is associated with certain characteristics of the rational-comprehensive thinker, but is also associated with non-normative childbearing expectations, whether they are above or below the popular…

Solution-focused premarital counseling: helping couples build a vision for their marriage.

PubMed

Murray, Christine E; Murray, Thomas L

2004-07-01

This article outlines a solution-focused approach to premarital counseling. Solution-focused premarital counseling is a strength-based approach that focuses on a couple's resources to develop a shared vision for the marriage. Background information about premarital counseling and solution-focused therapy provide the framework for the development of intervention strategies that are grounded in the solution-focused approach. Solution-oriented interventions include solution-oriented questions, providing feedback, and the Couple's Resource Map, an original intervention that is described in this article.

Community-level intimate partner violence and the circumstances of first sex among young women from five African countries.

PubMed

Gómez, Anu Manchikanti; Speizer, Ilene S

2010-06-19

Gender-based violence is an important risk factor for adverse reproductive health (RH). Community-level violence may inhibit young women's ability to engage in safer sexual behaviors due to a lack of control over sexual encounters. Few studies examine violence as a contextual risk factor. Using nationally representative data from five African countries, the association between community-level physical or sexual intimate partner violence (IPV) and the circumstances of first sex (premarital or marital) among young women (ages 20-29) was examined. In Mali, and Kenya bivariate analyses showed that young women who had premarital first sex were from communities where a significantly higher percentage of women reported IPV experience compared to young women who had marital first sex. Multivariate analyses confirmed the findings for these two countries; young women from communities with higher IPV were significantly more likely to have had premarital first sex compared to first sex in union. In Liberia, community-level IPV was associated with a lower risk of premarital sex as compared to first sex in union at a marginal significance level. There was no significant relationship between community-level IPV and the circumstances of first sex in the Democratic Republic of Congo or Zimbabwe. These findings indicate that context matters for RH. Individualized efforts to improve RH may be limited in their effectiveness if they do not acknowledge the context of young women's lives. Programs should target prevention of violence to improve RH outcomes of youth.

Factors associated with pre-marital sexual debut among unmarried high school female students in bahir Dar town, Ethiopia: cross- sectional study.

PubMed

Mulugeta, Yeshalem; Berhane, Yemane

2014-05-31

Pre-marital sexual debut increase the risk of sexually transmitted infections (STIs) including HIV/AIDS and unwanted pregnancy. It may also affect their school performance and completion rate. In spite of this fact, number of unmarried female students who started sexual debut is increasing from time to time. However, information on the extent of pre-marital sexual debut and associated factors were not well studied and documented in the study area where pre-marital sexual debut is largely condemned. Therefore this study was conducted to assess the magnitude and associated factors of pre-marital sexual debut. School based cross-sectional survey was conducted from May 10-13/2012. A total of 1123 unmarried high school female students were selected by multi- stage sampling technique. Data were collected using structured, self administered questionnaire. Descriptive statistics, binary and multivariable logistic regression analyses were used to identify factors associated with pre-marital sexual debut. Among unmarried high school female students 30.8% reported pre-marital sexual debut. The major associated factors were frequent watching of pornographic video [AOR = 10.15, 95% CI: (6.63, 15.53)], peer pressure [AOR = 2.98, 95% CI: (1.57, 5.67)] and chewing khat [AOR = 8.99, 95% CI: (3.84, 21.06)]. Significant proportion of unmarried high school female students have started pre-marital sexual debut. The finding suggests the need for communicating and supporting school students to help them make informed and safer decisions on their sexual behavior. Therefore, Bahir dar city administration health and education bureau should design persistent and effective health education to decrease pre-marital sexual debut in unmarried female students.

Factors associated with pre-marital sexual debut among unmarried high school female students in bahir Dar town, Ethiopia: cross- sectional study

PubMed Central

2014-01-01

Background Pre-marital sexual debut increase the risk of sexually transmitted infections (STIs) including HIV/AIDS and unwanted pregnancy. It may also affect their school performance and completion rate. In spite of this fact, number of unmarried female students who started sexual debut is increasing from time to time. However, information on the extent of pre-marital sexual debut and associated factors were not well studied and documented in the study area where pre-marital sexual debut is largely condemned. Therefore this study was conducted to assess the magnitude and associated factors of pre-marital sexual debut. Methods School based cross-sectional survey was conducted from May 10-13/2012. A total of 1123 unmarried high school female students were selected by multi- stage sampling technique. Data were collected using structured, self administered questionnaire. Descriptive statistics, binary and multivariable logistic regression analyses were used to identify factors associated with pre-marital sexual debut. Results Among unmarried high school female students 30.8% reported pre-marital sexual debut. The major associated factors were frequent watching of pornographic video [AOR = 10.15, 95% CI: (6.63, 15.53)], peer pressure [AOR = 2.98, 95% CI: (1.57, 5.67)] and chewing khat [AOR = 8.99, 95% CI: (3.84, 21.06)]. Conclusion Significant proportion of unmarried high school female students have started pre-marital sexual debut. The finding suggests the need for communicating and supporting school students to help them make informed and safer decisions on their sexual behavior. Therefore, Bahir dar city administration health and education bureau should design persistent and effective health education to decrease pre-marital sexual debut in unmarried female students. PMID:24885739

Development of three new scales for assessing clients' perspectives on premarital counseling.

PubMed

Schumm, W R; West, D R

2001-06-01

Within a subsample of 73 men and 179 women from a larger study of current and former members of the Christian Church (Disciples of Christ), three new scales were developed to assess the value attributed to premarital counseling, quality of premarital counseling received, and a pastor's competence at premarital counseling. Although internal consistency reliability as measured by Cronbach alpha was marginally acceptable (.61) for the latter three-item scale, it was adequate for the three-item value (.84) and the seven-item quality (.87) scales. Evidence for construct validity was limited with respect to demographic variables for social class, sex, and religiosity. Those who attended church more frequently and women reported lower quality of premarital counseling.

Knowledge, attitude and practice of premarital counseling for sickle cell disease among youth in Yaba, Nigeria.

PubMed

Oludarei, Gabriel O; Ogili, Matthew C

2013-12-01

Nigeria accounts for 50% of sickle cell disease (SCD) births worldwide and about 2.3% of her population suffers from SCD with 25% of Nigerians being healthy carriers. This study determined the knowledge, attitude and practice of youths in Yaba, Nigeria towards pre-marital genetic counseling. Data was collected using a questionnaire containing both open ended and closed ended questions. The questionnaires (n= 280) were analyzed by frequency counts, percentages and chi-square. The study shows that 80% of youths had knowledge, 86% had positive attitude and 65% had practiced things related to SCD and premarital counseling. There was a significant association between respondents' educational qualification and knowledge, attitude and practices related to SCD and SCD premarital counseling, and between age and attitude and practices related to SCD premarital counseling. In conclusion, public education on the role of premarital genetic counseling should continue and avenues to allow individuals carry out genotype test should still be encouraged.

The Teen STAR Program.

ERIC Educational Resources Information Center

Klaus, Hanna

Since neither the provision of contraception, nor exhortations to preserve premarital chastity serve the adolescent's need to integrate their now-present biological capacity to procreate into their operational self concept, this study utilized experiential learning about fertility to facilitate the integration of biologic maturity with adolescent…

How Does Premarital Cohabitation Affect Trajectories of Marital Quality?

ERIC Educational Resources Information Center

Tach, Laura; Halpern-Meekin, Sarah

2009-01-01

We investigate the link between premarital cohabitation and trajectories of subsequent marital quality using random effects growth curve models and repeated measures of marital quality from married women in the NLSY-79 (N = 3,598). We find that premarital cohabitors experience lower quality marital relationships on average, but this is driven by…

Parent and Peer Influence on Sexual Behavior, Contraceptive Use, and Pregnancy Experience of Young Women.

ERIC Educational Resources Information Center

Shah, Farida; Zelnik, Melvin

1981-01-01

Analyzed data from a national probability sample of 15 through 19-year-old women to determine the influence of parents and peers on premarital sexual behavior, contraceptive use, and premarital pregnancy. Results show women with views resembling those of parents have low levels of premarital experience. (Author)

Making a Case for Premarital Education.

ERIC Educational Resources Information Center

Stanley, Scott M.

2001-01-01

Proposes that premarital education efforts can reduce marital distress and divorce. Using a combination of rational argument and empirical findings, four key benefits of premarital education are discussed: (a) it fosters deliberation; (b) it sends the message that marriage matters; (c) it make seeking help an option; and (d) it may lower risk for…

A Literature Review of the Strengths and Limitations of Premarital Preparation: Implications for a Canadian Context

ERIC Educational Resources Information Center

Green, Amy R.; Miller, Lynn D.

2013-01-01

The adverse effects of marital dissolution and dissatisfaction point to a need for interventions, such as premarital preparation, to improve marital quality. Although several studies support the potential for premarital preparation to improve couples' marital satisfaction and interpersonal skills, results from other studies are mixed. Moreover,…

Premarital sexual attitudes of unmarried university students: 1968 vs. 1972.

PubMed

Bauman, K E; Wilson, R R

1976-01-01

Information on premarital sexual attitudes of unmarried undergraduates was obtained from random samples on the same campus in 1968 and 1972. Students in 1972, compared with those in 1968, reported (1) more permissive attitudes toward premarital sexual behavior (both men and women), (2) fewer differences in attitudes between men and women, and (3) less adherence to the "double standard." In contrast to earlier research on premarital sexual attitudes, these differences need not be due to the markedly different populations compared, or generalizable only to sociology and psychology students, or indicative of only those who chose to volunteer for study (volunteer bias).

What You Don't Know May Kill You: The Importance of Including Sexual Health in Premarital Counseling

ERIC Educational Resources Information Center

Slater, LaTrina M.; Cummings Aholou, Tiffiany M.

2009-01-01

Sexual health is a widespread concern for intimate partners. As couples transition to marriage, it is vitally important to explore issues related to sexual health. Moreover, premarital counselors are encouraged to facilitate a sexual health discussion with premarital couples. This article presents the importance of raising the topic of sexual…

Remarried Couples in Premarital Education: Does Our Content Match Participant Needs?

ERIC Educational Resources Information Center

Fox, Winifred Ellen

2013-01-01

Premarital education has been found to be an effective way to reduce risk factors of divorce, yet limited research existed on the use of premarital education with individuals who divorced and later remarried. Thus, remarrying couples, already at a higher risk of divorce than couples entering their first marriage, may be entering remarriage…

The Inventory of Pre-Marital Conflict: Clinical and Educational Applications.

ERIC Educational Resources Information Center

Fournier, David G.; And Others

The Inventory of Pre-Marital Conflict (IPMC) is a systematic procedure for the diagnosis and assessment of pre-marital conflict and related issues. The self-report component of the IPMC involves a series of 18 hypothetical conflict situations. The individual responds to each of these by evaluating who is primarily responsible for the problem, and…

Gender differences in adolescent premarital sexual permissiveness in three Asian cities: effects of gender-role attitudes.

PubMed

Zuo, Xiayun; Lou, Chaohua; Gao, Ersheng; Cheng, Yan; Niu, Hongfeng; Zabin, Laurie S

2012-03-01

Gender is an important factor in understanding premarital sexual attitudes and behaviors. Many studies indicate that males are more likely to initiate sexual intercourse and have more permissive perceptions about sex than females. Yet few studies have explored possible reasons for these gender differences. With samples of unmarried adolescents in three Asian cities influenced by Confucian cultures, this article investigates the relationship between underlying gender norms and these differences in adolescents' premarital sexual permissiveness (PSP). In a collaborative survey conducted in 2006-2007 in urban and rural areas of Hanoi, Shanghai, and Taipei, 16,554 unmarried participants aged 15-24 years were recruited in the three-City Asian Study of Adolescents and Youth, with 6,204, 6,023, and 4,327 respondents from each city, respectively. All the adolescents were administered face-to-face interviews, coupled with computer-assisted self-interview for sensitive questions. Scales on gender-role attitudes and on PSP for both male and female respondents were developed and applied to our analysis of the data. Multilinear regression was used to analyze the relationship between gender-role attitudes and sexual permissiveness. Male respondents in each city held more permissive attitudes toward premarital sex than did females, with both boys and girls expressing greater permissiveness to male premarital sexual behaviors. Boys also expressed more traditional attitudes to gender roles (condoning greater inequality) than did girls in each city. Adolescents' gender-role attitudes and permissiveness to premarital sex varied considerably across the three cities, with the Vietnamese the most traditional, the Taiwanese the least traditional, and the adolescents in Shanghai in the middle. A negative association between traditional gender roles and PSP was only found among girls in Shanghai and Taipei. In Shanghai, female respondents who held more traditional gender-role attitudes were more likely to exercise a double standard with respect to male as opposed to female premarital sex (odds ratio [OR] = 1.18). This relationship also applied to attitudes of both girls and boys in Taipei (OR = 1.20 and OR = 1.22, respectively). Although with variation across sites, gender differences in PSP and attitudes to gender roles among adolescents were very significant in each of the three Asian cities influenced by Confucian-based values. Traditional gender norms may still be deeply rooted in the three cities, especially among females; while it is important to advocate gender equity in adolescent reproductive health programs, the pathway of traditional gender norms in influencing adolescent reproductive health outcomes must be understood, as must differences and similarities across regions. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Do Cold Feet Warn of Trouble Ahead? Premarital Uncertainty and Four-Year Marital Outcomes

PubMed Central

Lavner, Justin A.; Karney, Benjamin R.; Bradbury, Thomas N.

2012-01-01

Are the doubts that people feel prior to marriage signs of impending difficulties or normative experiences that can be safely ignored? To test these opposing views, we asked 464 recently-married spouses whether they had ever been uncertain about getting married and then compared four-year divorce rates and marital satisfaction trajectories among those partners with and without premarital doubts. Doubts were reported by at least one partner in two-thirds of couples. Women with premarital doubts had significantly higher four-year divorce rates, even when controlling for concurrent marital satisfaction, the difficulty of their engagement, history of parental divorce, premarital cohabitation, and neuroticism. Among intact couples, men’s and women’s doubts predicted less satisfied marital trajectories. Premarital doubts appear to be common but not benign, suggesting that valid precursors of marital distress are evident during couples’ engagements. PMID:22946462

The effect of comprehensive sexual education program on sexual health knowledge and sexual attitude among college students in Southwest China.

PubMed

Chi, Xinli; Hawk, Skyler T; Winter, Sam; Meeus, Wim

2015-03-01

The purpose of this study was to evaluate whether a comprehensive sexual education program for college students in Southwest China (a) improved sexual health knowledge in reproduction, contraception, condom use, sexually transmitted diseases, and HIV; (b) increased accepting attitudes toward lesbian, gay, bisexual, and transsexual individuals; and (c) altered participants' attitudes toward premarital sex and monogamy. The program used diverse teaching methods, providing 6 sessions over a period of 9 weeks about sexual health knowledge and sexual attitudes to college students (age 18-26 years) in Southwest China. Sexual health knowledge and sexual attitudes of 80 comprehensive sexual education class students (education group) and 92 general mental health education class students (control group) were measured at baseline, the end of course (posttest), and 3 weeks after the end of course (follow-up). There were significant effects of the program on (a) sexual health knowledge, including reproductive health, contraception, condom use, and HIV/AIDS and (b) positive attitudes toward sexual minorities, although these changes may require further reinforcement. In contrast, the program did not alter students' attitudes about premarital sex or monogamy. The results are discussed in terms of recommendations of sex education in China and future directions for research. © 2013 APJPH.

Regulation and Resistance: Negotiation of Premarital Sexuality in the Context of Migrant and Refugee Women.

PubMed

Hawkey, Alexandra J; Ussher, Jane M; Perz, Janette

2017-07-06

Constructions of normative sexuality shape the sexual scripts that women are permitted to adopt and the manner in which such sexuality can be expressed. We explored experiences and constructions of premarital sexuality among migrant and refugee women recently resettled in Sydney, Australia, and Vancouver, Canada. A total of 78 semistructured individual interviews and 15 focus groups composed of 82 participants were undertaken with women who had migrated from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, and South America. We analyzed the data using thematic decomposition. Across all cultural groups, women's premarital sexuality was regulated through cultural and religious discourse and material practice. Such regulation occurred across three main facets of women's lives, shaping the themes presented in this article: (1) regulating premarital sex-the virginity imperative; (2) regulation of relationships with men; and (3) regulation of the sexual body. These themes capture women's reproduction of dominant discourses of premarital sexuality, as well as women's resistance and negotiation of such discourses, both prior to and following migration. Identifying migrant and refugee women's experiences and constructions of premarital sexuality is essential for culturally safe sexual health practice, health promotion, and health education.

Development of the Dyadic Relationship Scale

ERIC Educational Resources Information Center

Haskan Avci, Özlem

2014-01-01

Problem Statement: The rise of premarital studies raises questions about the effectiveness of educational programs developed to prepare young couples for marriage and family life. Purpose of Study: The purpose of this study is to describe and introduce the Dyadic Relationship Scale (DRS) for use with university students. The author developed the…

Sex Education and Premarital Sexual Behavior among American College Students.

ERIC Educational Resources Information Center

Spanier, Graham B.

1978-01-01

Interviews with 1177 male and female college students revealed no significant differences in sexual behavior between those who took public school sex education courses and those who did not, nor between those taught about birth control or about coitus. Implications for successful sex education programs are discussed. (SJL)

Non-consensual sex within pre-marital relationships: experiences of young women in India.

PubMed

Santhya, K G; Francis Zavier, A J

2014-01-01

In India, little is known about the prevalence of non-consensual sex within pre-marital relationships and factors correlated with such experience, although a sizeable proportion of young people engage in pre-marital relationships. Drawing on qualitative and quantitative data from a representative study of youth in six Indian states, this paper examines the extent to which young women who had had pre-marital sex had experienced non-consensual sex, that is, sex by persuasion or force, and factors associated with it. Analysis is restricted to 821 young women who reported pre-marital sex. Of those who had had pre-marital sex, 33% reported that they were either persuaded (14%) or forced (19%) to engage in sex. Young women residing in urban areas and in communities reportedly characterised by physical fights among youth were more likely than their respective counterparts to have experienced sex by persuasion. Young women who had delayed sexual initiation and those who displayed self-efficacy were less likely than others to experience forced sex. Young women who had experienced geographic mobility in adolescence and who had witnessed parental violence were more likely than others to report forced sex. Finally, those in southern states were less likely than their northern counterparts to experience forced sex.

An exploration of knowledge, attitudes and behaviours of young multiethnic Muslim-majority society in Malaysia in relation to reproductive and premarital sexual practices

PubMed Central

2012-01-01

Background The increasing trend of premarital sexual experience and unintended pregnancies in Malaysia warrants sustained and serious attention. The sensitivities of sex-related issues in a Muslim-majority country create various types of barriers to sexual and reproductive health information, support and practices. This study aims to gain understanding of knowledge, attitudes and behaviours of young women in Malaysia concerning reproductive, contraception and premarital sexual practices. Methods A cross-sectional study was performed, using an anonymous self-administered questionnaire carried out among 1695 female university students in a public university in Malaysia. Results Respondents had low scores for knowledge of reproduction and pregnancy (median=4, of maximum score 10), contraceptive uses (median=6, of maximum score 16) and contraceptive availability (median=3, of maximum score 13). The majority of women surveyed do not have liberal values in relation to premarital sexual behaviour (median=37, of maximum 40); higher scores on this scale corresponded to opposing premarital sex. The multivariate analyses showed that ethnic group was the strongest correlate of knowledge and attitude scores; being of Malay Muslim ethnicity was associated significantly with lower knowledge scores and premarital sex permissiveness. Other significant correlates were year of study, maternal occupational groups, level of religious faith, dating status and urban–rural localities. Level of premarital sex permissiveness was inversely correlated with reproduction and pregnancy knowledge score, and contraceptive knowledge scores. Conclusion Reproductive health knowledge and attitudes were intricately linked to religious values and cultural norms differences surrounding sexual issues. PMID:23057505

An exploration of knowledge, attitudes and behaviours of young multiethnic Muslim-majority society in Malaysia in relation to reproductive and premarital sexual practices.

PubMed

Wong, Li Ping

2012-10-11

The increasing trend of premarital sexual experience and unintended pregnancies in Malaysia warrants sustained and serious attention. The sensitivities of sex-related issues in a Muslim-majority country create various types of barriers to sexual and reproductive health information, support and practices. This study aims to gain understanding of knowledge, attitudes and behaviours of young women in Malaysia concerning reproductive, contraception and premarital sexual practices. A cross-sectional study was performed, using an anonymous self-administered questionnaire carried out among 1695 female university students in a public university in Malaysia. Respondents had low scores for knowledge of reproduction and pregnancy (median=4, of maximum score 10), contraceptive uses (median=6, of maximum score 16) and contraceptive availability (median=3, of maximum score 13). The majority of women surveyed do not have liberal values in relation to premarital sexual behaviour (median=37, of maximum 40); higher scores on this scale corresponded to opposing premarital sex. The multivariate analyses showed that ethnic group was the strongest correlate of knowledge and attitude scores; being of Malay Muslim ethnicity was associated significantly with lower knowledge scores and premarital sex permissiveness. Other significant correlates were year of study, maternal occupational groups, level of religious faith, dating status and urban-rural localities. Level of premarital sex permissiveness was inversely correlated with reproduction and pregnancy knowledge score, and contraceptive knowledge scores. Reproductive health knowledge and attitudes were intricately linked to religious values and cultural norms differences surrounding sexual issues.

Sexual behavior among unmarried business process outsourcing employees in Chennai: gender differences and correlates associated with it.

PubMed

Charles, Bimal; Rastogi, Saumya; Sam, Asirvatham Edwin; Williams, Joseph D; Kandasamy, Aarthi

2013-01-01

Premarital sex is often associated with high risk sexual behavior such as early age of initiation, multiple partners and inconsistent condom use. Evidence shows that such sexual behavior pre-disposes to sexually transmitted diseases including HIV. This paper tried to investigate the correlates of premarital sexual behavior among male and female business process outsourcing (BPO) employees to highlight the gender differences that exist in relation to it. Data were collected from 526 unmarried BPO employees during behavioral surveillance survey in Chennai, in the year 2009. The results showed that about one-third of respondents (males - 39.6%, females - 26.1%) had experienced premarital sex. Men reported having had their first sexual intercourse at 12 years and women at 16 years of age. While the prevalence of premarital sex was found to be high, the percentage using a condom during last sex was also high, especially, among the female employees (82.4%). Logistic regression showed that monthly individual income, work in shifts, migration, peer influence and friends with previous sexual experience were significant predictors of premarital sex among the male BPO employees. Visit to night clubs was significantly associated with a higher prevalence of premarital sex among the female employees. The study concludes that there is a significant gender dimension in the premarital sexual behavior among the BPO employees and that even as the sexual behavior of the young people is transitioning; their ability to negotiate safe sex behavior is also increasing. It is recommended to enhance efforts to advocate safe sex behavior among young adults employed in the BPO industry.

Associations between family factors and premarital heterosexual relationships among female college students in Tehran.

PubMed

Farahani, Farideh Khalaj Abadi; Cleland, John; Mehryar, Amir Hooshang

2011-03-01

Although premarital heterosexual relationships, especially those involving sexual contact, are discouraged in Iran, particularly for females, a considerable minority of young people are involved in such relationships. However, the determinants of such relationships have not been identified, especially those pertaining to family. In 2005-2006, a random sample of 1,378 unmarried female college students from four universities in Tehran completed anonymous, self-administered surveys that asked whether the respondent had ever had a premarital heterosexual relationship. Bivariate and multivariate regression analyses were conducted to examine associations between such relationships and family factors, including socioeconomic measures, parent-child communication and closeness, family values and atmosphere, and parental control. Having had a boyfriend was positively associated with paternal income (odds ratio, 1.3), maternal educational attainment (1.3) and more liberal family values (1.3), and negatively associated with parent-child closeness (0.6). Very strict and very relaxed parental control during adolescence were both associated with having had a boyfriend, but only the former was associated with having had premarital sex. In addition, respondents were more likely to have had premarital intercourse if they did not live with both parents (2.0) or if their family had more liberal values (1.3); they had reduced odds of having had sex if they had a closer relationship with their parents (0.7). Good family relationships may reduce the likelihood that youth will engage in premarital sex, possibly by fostering parent-child closeness. Moderate parental control may discourage premarital relationships more effectively than lesser or greater degrees of control.

Premarital sexual practices and its predictors among in-school youths of shendi town, west Gojjam zone, North Western Ethiopia

PubMed Central

2014-01-01

Background Youth who begin early pre-marital sexual activity are more likely to be engaged in unsafe sex. Early sexual debut puts them at increased risk for acquiring or transmitting sexually transmitted infections, including HIV; and makes them highly vulnerable to unwanted pregnancy and its consequences. This study was conducted to assess premarital sexual practices and its predictors among in-school youths in North West Ethiopia. Methods A cross-sectional study was carried among 826 in school youths from December; 2011 to January; 2012 in Shendi town. A multistage sampling technique was used to select the study participants. Binary and multiple logistic regression analyses were performed to examine the relationship between premarital sexual practices and selected exposure variables. Results Nearly one fifth 157 (19%) of the participants reported having had premarital sexual intercourse, of which 91 (22.7%) were males and 66 (15.5%) were females. The mean (SD) age at first sexual intercourse was 16 .48 (1.59) for males and 15.89 (1.68) for females. More than three - fourth of sexually active in-school youths engaged in premarital sexual relationship before celebrating their 18th birthday. Being greater than 20 years (AOR = 3.67; 95% CI = 1.98, 6.82), living with friends or relatives (AOR = 2.47; 95% CI = 1.46, 4.16), living alone (without parental control (AOR = 2.51; 95% CI = 1.38, 4.55) and watching pornographic movies (AOR = 1.73; 95% CI = 1.18, 2.53) were found to be significantly associated with premarital sexual practices. Conclusion A significant number of in-school youths had started premarital sexual activity that might predispose them to different sexual and reproductive health risks. Therefore, various efforts need to be initiated through school-based information, education, and behavioral change communication, interventions, such as life skills education and negotiation. PMID:24961239

Premarital sexual practices and its predictors among in-school youths of Shendi town, west Gojjam zone, North Western Ethiopia.

PubMed

Bogale, Alemayehu; Seme, Assefa

2014-06-25

Youth who begin early pre-marital sexual activity are more likely to be engaged in unsafe sex. Early sexual debut puts them at increased risk for acquiring or transmitting sexually transmitted infections, including HIV; and makes them highly vulnerable to unwanted pregnancy and its consequences. This study was conducted to assess premarital sexual practices and its predictors among in-school youths in North West Ethiopia. A cross-sectional study was carried among 826 in school youths from December; 2011 to January; 2012 in Shendi town. A multistage sampling technique was used to select the study participants. Binary and multiple logistic regression analyses were performed to examine the relationship between premarital sexual practices and selected exposure variables. Nearly one fifth 157 (19%) of the participants reported having had premarital sexual intercourse, of which 91 (22.7%) were males and 66 (15.5%) were females. The mean (SD) age at first sexual intercourse was 16 .48 (1.59) for males and 15.89 (1.68) for females. More than three - fourth of sexually active in-school youths engaged in premarital sexual relationship before celebrating their 18th birthday. Being greater than 20 years (AOR = 3.67; 95% CI = 1.98, 6.82), living with friends or relatives (AOR = 2.47; 95% CI = 1.46, 4.16), living alone (without parental control (AOR = 2.51; 95% CI = 1.38, 4.55) and watching pornographic movies (AOR = 1.73; 95% CI = 1.18, 2.53) were found to be significantly associated with premarital sexual practices. A significant number of in-school youths had started premarital sexual activity that might predispose them to different sexual and reproductive health risks. Therefore, various efforts need to be initiated through school-based information, education, and behavioral change communication, interventions, such as life skills education and negotiation.

Thalassemia: a prevalent disease yet unknown term among college students in Saudi Arabia.

PubMed

Olwi, Duaa Ibrahim; Merdad, Leena Adnan; Ramadan, Eman Kamal

2017-12-14

Thalassemia is a life-threatening blood disorder that has a high prevalence in Saudi Arabia despite the implementation of mandatory premarital testing and the availability of genetic counseling. This study aimed to assess college students' knowledge of thalassemia. A cross-sectional survey of a random sample of 920 senior students enrolled at King Abdulaziz University was conducted. A self-administered questionnaire was used to collect information about thalassemia and socio-demographic characteristics. Of the 920 students, 445 (48%) had ever heard of thalassemia. Despite the mandatory premarital testing for thalassemia, only 50% of married students stated having heard of the disease. The mean thalassemia knowledge score was 4.4 ± 2.2 out of a maximum of 12. Knowledge was significantly influenced by university faculty, gender, and education outside of Saudi Arabia. Those who had heard of thalassemia had misconceptions about the disease characteristics and pattern of inheritance such as associating thalassemia with low iron levels. A substantial proportion of the participants had a low knowledge of thalassemia. This lack of awareness requires a reassessment of the goals and success of the premarital testing program, including the genetic counseling services, and also indicates the importance of emphasizing thalassemia in school curricula and promoting and scaling up existing thalassemia campaigns in the region.

Adolescent males and young females in tehran: differing perspectives, behaviors and needs for reproductive health and implications for gender sensitive interventions.

PubMed

Farahani, Farideh Khalaj Abadi; Shah, Iqbal; Cleland, John; Mohammadi, Mohammad Reza

2012-04-01

Despite cultural and religious prohibitions against premarital heterosexual relationships and intimacy, some recent evidence suggests some rise in premarital heterosexual interactions and relationships among young people. On the other hand, although HIV in Iran is a concentrated epidemic and mainly reported among high risk groups such as injecting drug users (IDUs), but there are evidences that the mode of transmission is shifting towards sexual contacts. This trend has caused concern among health policy makers in terms of prevention of STDs and HIV/AIDS particularly, among young people. This paper was prepared with the aim of highlighting how gender contributes to variation in reproductive health needs and conduct of young people in Iran. This paper is based on a secondary analysis and compares comparable reproductive beliefs and conducts of women and men based on the data of two surveys conducted in Tehran in 2002 and 2005. A survey among 1385 adolescent males and another survey among 1743 female undergraduate students in four multidisciplinary universities in Tehran. Both surveys used anonymous self-administered questionnaires. To make the two samples comparable, the data of unmarried female university undergraduate students who resided in Tehran were merged with the data of adolescent male students who intended to pursue higher education. Common variables of the two surveys were identified, homogenized, merged and analysed. Reproductive health knowledge among male adolescents was poor compared to that of their female peers. Although premarital friendships were moderately acceptable from view points of both males and females, the majority were against premarital sex, particularly among female participants. There were evidences of gender-based double standards in perceptions of premarital sexuality among both males and females; particularly, it was stronger among males than females. Male adolescents reported earlier and greater experiences of premarital heterosexual intimacy and sexual contact than females. Multiple partners were also more common among males than females. Females had a tendency to regret first sexual contact more than males, which reflects that first sex is more likely to be unplanned and unwanted among females compared to males. Significant gender-based double standards prevailed current sexual attitudes and conduct of young people in Iran. Gender norms which encourage unmarried men to practice premarital sex lead to an earlier transition of men to sexual relations and multiple sexual partners. Due to poor knowledge and various misconceptions about sexual health and lack of consistent contraceptive and condom use among adolescents and young people in Iran, both young men and women are susceptible to sexual and reproductive health hazards such as sexually transmitted infections (STIs), HIV/AIDS, pregnancy and unsafe abortion. Changing gender norms associated with sexuality may lead to promotion of safer sexual behaviors particularly among young people. Current reproductive health and HIV prevention programs should take into account gender-based double standards among young people and their unmet reproductive health needs.

Adolescent Males and Young Females in Tehran: Differing Perspectives, Behaviors and Needs for Reproductive Health and Implications for Gender Sensitive Interventions

PubMed Central

Farahani, Farideh Khalaj Abadi; Shah, Iqbal; Cleland, John; Mohammadi, Mohammad Reza

2012-01-01

Background Despite cultural and religious prohibitions against premarital heterosexual relationships and intimacy, some recent evidence suggests some rise in premarital heterosexual interactions and relationships among young people. On the other hand, although HIV in Iran is a concentrated epidemic and mainly reported among high risk groups such as injecting drug users (IDUs), but there are evidences that the mode of transmission is shifting towards sexual contacts. This trend has caused concern among health policy makers in terms of prevention of STDs and HIV/AIDS particularly, among young people. This paper was prepared with the aim of highlighting how gender contributes to variation in reproductive health needs and conduct of young people in Iran. Method This paper is based on a secondary analysis and compares comparable reproductive beliefs and conducts of women and men based on the data of two surveys conducted in Tehran in 2002 and 2005. A survey among 1385 adolescent males and another survey among 1743 female undergraduate students in four multidisciplinary universities in Tehran. Both surveys used anonymous self-administered questionnaires. To make the two samples comparable, the data of unmarried female university undergraduate students who resided in Tehran were merged with the data of adolescent male students who intended to pursue higher education. Common variables of the two surveys were identified, homogenized, merged and analysed. Results Reproductive health knowledge among male adolescents was poor compared to that of their female peers. Although premarital friendships were moderately acceptable from view points of both males and females, the majority were against premarital sex, particularly among female participants. There were evidences of gender-based double standards in perceptions of premarital sexuality among both males and females; particularly, it was stronger among males than females. Male adolescents reported earlier and greater experiences of premarital heterosexual intimacy and sexual contact than females. Multiple partners were also more common among males than females. Females had a tendency to regret first sexual contact more than males, which reflects that first sex is more likely to be unplanned and unwanted among females compared to males. Conclusion Significant gender–based double standards prevailed current sexual attitudes and conduct of young people in Iran. Gender norms which encourage unmarried men to practice premarital sex lead to an earlier transition of men to sexual relations and multiple sexual partners. Due to poor knowledge and various misconceptions about sexual health and lack of consistent contraceptive and condom use among adolescents and young people in Iran, both young men and women are susceptible to sexual and reproductive health hazards such as sexually transmitted infections (STIs), HIV/AIDS, pregnancy and unsafe abortion. Changing gender norms associated with sexuality may lead to promotion of safer sexual behaviors particularly among young people. Current reproductive health and HIV prevention programs should take into account gender-based double standards among young people and their unmet reproductive health needs. PMID:23926532

Development and psychometric evaluation of the Premarital Sexual Behavior Assessment Scale for Young Women (PSAS-YW): an exploratory mixed method study.

PubMed

Rahmani, Azam; Merghati-Khoei, Effat; Moghadam-Banaem, Lida; Hajizadeh, Ebrahim; Hamdieh, Mostafa; Montazeri, Ali

2014-06-13

Premarital sexual behaviors are important issue for women's health. The present study was designed to develop and examine the psychometric properties of a scale in order to identify young women who are at greater risk of premarital sexual behavior. This was an exploratory mixed method investigation. Indeed, the study was conducted in two phases. In the first phase, qualitative methods (focus group discussion and individual interview) were applied to generate items and develop the questionnaire. In the second phase, psychometric properties (validity and reliability) of the questionnaire were assessed. In the first phase an item pool containing 53 statements related to premarital sexual behavior was generated. In the second phase item reduction was applied and the final version of the questionnaire containing 26 items was developed. The psychometric properties of this final version were assessed and the results showed that the instrument has a good structure, and reliability. The results from exploratory factory analysis indicated a 5-factor solution for the instrument that jointly accounted for the 57.4% of variance observed. The Cronbach's alpha coefficient for the instrument was found to be 0.87. This study provided a valid and reliable scale to identify premarital sexual behavior in young women. Assessment of premarital sexual behavior might help to improve women's sexual abstinence.

Predictors of premarital sexual activity among unmarried youth in Vientiane, Lao PDR: the role of parent-youth interactions and peer influence.

PubMed

Sychareun, Vanphanom; Phengsavanh, Alongkone; Hansana, Visanou; Chaleunvong, Kongmany; Kounnavong, Sengchan; Sawhney, Monika; Durham, Jo

2013-01-01

Research indicates that adolescents in low-income countries have an early sexual debut and engage in risky sexual behaviours. Few studies in low-income countries however, have explored the factors that influence young people's sexual behaviours. This study examined individual, family and peer-level factors associated with premarital sexual behaviours in the Lao People's Democratic Republic (PDR). A cross-sectional survey was undertaken with unmarried youth aged 18 to 24 years (N = 1200) in Vientiane Capital City. Logistic regression models, controlling for confounding variables, were employed to test for the contribution of factors influencing premarital sexual activity. Most respondents held positive attitudes towards premarital sex, with males having more liberal attitudes than females (mean score of 2.68 vs. 2.32, p < 0.001). Prevalence of premarital sexual activity was higher among males than females (44.7% and 19.2%, respectively). Predictors of premarital sex for males were age, sexual attitudes, perceived parental expectations regarding sex, dating and peer influence. For females, predictors were father's level of education, parent-youth sexual communication, peer influence and liberal sexual attitudes. The results highlight the role of parent-youth interaction and peer influence. The results suggest the need for a range of strategies at the individual, peer and family level, as well as a gender-specific focus.

Development and psychometric evaluation of the Premarital Sexual Behavior Assessment Scale for Young Women (PSAS-YW): an exploratory mixed method study

PubMed Central

2014-01-01

Background Premarital sexual behaviors are important issue for women’s health. The present study was designed to develop and examine the psychometric properties of a scale in order to identify young women who are at greater risk of premarital sexual behavior. Method This was an exploratory mixed method investigation. Indeed, the study was conducted in two phases. In the first phase, qualitative methods (focus group discussion and individual interview) were applied to generate items and develop the questionnaire. In the second phase, psychometric properties (validity and reliability) of the questionnaire were assessed. Results In the first phase an item pool containing 53 statements related to premarital sexual behavior was generated. In the second phase item reduction was applied and the final version of the questionnaire containing 26 items was developed. The psychometric properties of this final version were assessed and the results showed that the instrument has a good structure, and reliability. The results from exploratory factory analysis indicated a 5-factor solution for the instrument that jointly accounted for the 57.4% of variance observed. The Cronbach’s alpha coefficient for the instrument was found to be 0.87. Conclusion This study provided a valid and reliable scale to identify premarital sexual behavior in young women. Assessment of premarital sexual behavior might help to improve women’s sexual abstinence. PMID:24924696

Survey sheds new light on marriage and sexuality in the Philippines.

PubMed

Xenos, P

1997-07-01

The Young Adults Fertility and Sexuality Study (YAFS-II) was conducted in 1994 by interviewing 10,879 men and women aged 15-24 years in households on dating, marriage, and onset of sexual activity in the Philippines. In addition, screening data were collected on all households visited and on the 959 sampled local communities. Direct questions on premarital sex revealed that at least 52% of married women had sex before marriage. Among married respondents, 57% of men and 51% of women reported having had sex with their spouse before they were married. Only 3% of the women had additional premarital partners vs. 37% of the men. Questions on premarital sex and social patterns showed that about 20% of the single women and 28% of the single men had been in a serious relationship by the time they were 17. By age 20, 44% of the single women and 63% of the single men had been in a serious relationship, while the respective figures by age 24 were 60% and 68%. Altogether 24% of the women and 10% of the men described themselves as married. 34% of all women who either eloped or lived with their spouses had been married in church by the time of the survey, 23% had had civil ceremonies, and 41% designated their marital status as cohabitation. With regard to the risk of HIV/AIDS and other sexually transmitted diseases, 25% of the 24-year old men who never had a girlfriend reported sexual experience and 22% of those still single at age 24 reported that they had visited a commercial sex worker. Marital status was not the best basis for providing family planning services, and the provision of reproductive health services to young people living in consensual union would reduce accidental pregnancy.

Premarital sexual activity and contraceptive use in Santiago, Chile.

PubMed

Herold, J M; Valenzuela, M S; Morris, L

1992-01-01

The Santiago Young Adult Reproductive Health Survey was conducted in 1988 to examine the sexual behavior of and contraceptive use among young adults in Chile. The survey was based on multistage household probability samples of 865 women and 800 men aged 15-24 who were living in Santiago in 1988. Findings show that 35 percent of females and 65 percent of males had had premarital intercourse. Among those who had done so, the median age at first experience was 18.4 years for women and 16.4 years for men. Only 20 percent of females and 19 percent of males used contraceptives at first premarital intercourse. Use of contraceptives increased with age at the time of that event. Fertility data reveal that 70 percent of first births were premaritally conceived, and more than one-third of these were born prior to union. The high rates of premarital and unintended pregnancy among young women and the low prevalence of effective contraceptive use indicate a need for greater emphasis on sex education and family planning services directed at adolescents and unmarried young adults in Santiago.

First premarital cohabitation in the United States: 2006-2010 National Survey of Family Growth.

PubMed

Copen, Casey E; Daniels, Kimberly; Mosher, William D

2013-04-04

This report provides an updated description of trends and patterns in first premarital cohabitations among women aged 15-44 in the United States using the National Survey of Family Growth (NSFG). Trends in pregnancies within first premarital cohabiting unions and differences by Hispanic origin and race, and education are also presented. Data for 2006-2010 were collected through in-person interviews with 22,682 women and men aged 15-44 in the household population of the United States. This report is based primarily on the sample of 12,279 women interviewed in 2006-2010, and is supplemented by data from the 1995 and 2002 NSFGs. Forty-eight percent of women interviewed in 2006-2010 cohabited with a partner as a first union, compared with 34% of women in 1995. Between 1995 and 2006-2010, the percentage of women who cohabited as a first union increased for all Hispanic origin and race groups, except for Asian women. In 2006-2010, 70% of women with less than a high school diploma cohabited as a first union, compared with 47% of women with a bachelor's degree or higher. First premarital cohabitations were longest for foreign-born Hispanic women (33 months) and shortest for white women (19 months). In 2006-2010, 40% of first premarital cohabitations among women transitioned to marriage by 3 years, 32% remained intact, and 27% dissolved. Nearly 20% of women experienced a pregnancy in the first year of their first premarital cohabitation.

Relationship Education for Modern Orthodox Jewish Adolescents as a Factor of Marital Satisfaction: A Quantitative Study

ERIC Educational Resources Information Center

Maybruch, Chana

2012-01-01

Research on the influence of relationship education on marital satisfaction over the last decade has demonstrated positive outcomes for both high school and premarital programs within the general American population. Yet few studies have examined relationship education as a factor of marital satisfaction specifically within the North American…

Formal and informal sex education as determinants of premarital sexual behavior.

PubMed

Spanier, G B

1976-01-01

Controversies exist regarding the effects of sex education in the schools and informal sex education obtained from parents, peers, the mass media, and other sources. Similarly, there is widespread interest in premarital sexual behavior, especially its determinants. This study presents several issues reflecting these concerns which have been the subject of much speculation but which have received little attention by researchers. The purpose of this study was to investigate--through the use of respondent reports--how formal and informal sex education influences premarital sexual behavior during college. A national probability sample of 1177 college students was studied using face-to-face interviews with approximately equal numbers of males and females. These interviews, which were conducted for the Institute for Sex Research, included questions about past and present sexual involvement and other attitudinal, behavioral and background variables. Accordingly, the data about sexual behavior and attitudes are based on the interviewees' self-reports. Indices were created which operationalized independent variables such as familial sexual conservatism, exposure to eroticism, perceived sex knowledge, and sexual exposure and assault during childhood and adolescence. Individual items reflecting childhood sex play, masturbation, current religiosity, religiosity while growing up, social class, sources of sex information, sex education in classrooms, and high school and college dating were used. The dependent variable, premarital sociosexual involvement, is a composite measure of incidence and prevalence of premarital heterosexual involvement which meets Guttman scaling criteria. An Automatic Interaction Detector analysis was used to determine the relative influences of reported sexualization variables on premarital sexual behavior. Major findings can be summarized as follows: Heterosexual behavior progresses in stepwise fashion from elementary to advanced levels of involvement, with each level representing a threshold. Reports of current influences and pressures explain more variance in premarital sexual behavior than reports of past informal sexualization influences, which, in turn, explain more variance than reported formal sex-education experiences. Limited success was reported with the use of a four-stage AID analysis which attempted to ascertain whether variables represented in later stages of the sexualization process "mask" the effects of variables in earlier stages and whether a development process can be identified. It may be concluded that these data do not support the belief that exposure to sexuality through formal sex education influences premarital sexual behavior. Informal sex education has significantly more impact on premarital sexual behavior, but there are indications that pressures and experiences confronting young people in a given dating or peer group situation take precedence over all past sexual socialization influences.

Pre-marital and Marital Counselling: Implications for the School Guidance Counsellor

ERIC Educational Resources Information Center

Schlesinger, Benjamin

1978-01-01

One of the foremost tasks of young people contemplating marriage is the discovery of their basic selfhood and their continued growth as people; this is the first goal in pre-marital counseliling. (Author)

Premarital sexual activities among students in a university in Beijing, China.

PubMed

Zhang, Liying; Gao, Xiang; Dong, Zhaowen; Tan, Yongping; Wu, Zhenglai

2002-04-01

Sexually transmitted diseases are becoming a serious public health problem in China. College students are recognized as one of the age groups most affected. The goal was to investigate premarital sexual activities and condom use among college students in Beijing in order to collect the information necessary for research on interventions. A cross-sectional survey was conducted in June 1999 among students at a university in Beijing. A self-administered, anonymous, structured questionnaire was used. Among those interviewed, 41% reported premarital sexual activities: 28% had kissed partners of the opposite sex, 19% had masturbated, and 12% had engaged in sexual intercourse. Among those who had sexual intercourse, 69% had used condoms. Today, more students are engaging in premarital sexual intercourse. Thus, it is necessary to reinforce reproductive health education among college students and provide convenient and optional services that are easily accessed.

Dimensions of Rural-to-Urban Migration and Premarital Pregnancy in Kenya

PubMed Central

Xu, Hongwei; Mberu, Blessing U.; Goldberg, Rachel E.

2013-01-01

Rural-to urban migration is increasingly common among youth and could affect sexual activities. We use life history calendar data collected in Kisumu, Kenya, to investigate how the timing and number of rural-to-urban moves are associated with premarital pregnancy. Among sexually experienced young women aged 18-24 (N=226), 39 percent have experienced a premarital pregnancy and 60 percent experienced a move in the last 10 years. Results of the event history analysis show that those who experienced one or two moves or whose most recent move occurred in the last seven to 12 months are at increased risk of premarital pregnancy compared to nonmovers. Those whose last move occurred at age 13 or younger were also at an elevated risk. Migration brings about specific needs for youth, including the need for sexual and reproductive health education and services, which should be made available and accessible to new urban residents. PMID:24443586

Models of Preconception Care Implementation in Selected Countries

PubMed Central

Lo, Sue Seen-Tsing; Zhuo, Jiatong; Han, Jung-Yeol; Delvoye, Pierre; Zhu, Li

2006-01-01

Globally, maternal and child health faces diverse challenges depending on the status of the development of the country. Some countries have introduced or explored preconception care for various reasons. Falling birth rates and increasing knowledge about risk factors for adverse pregnancy outcomes led to the introduction of preconception care in Hong Kong in 1998, and South Korea in 2004. In Hong Kong, comprehensive preconception care including laboratory tests are provided to over 4000 women each year at a cost of $75 per person. In Korea, about 60% of the women served have known medical risk history, and the challenge is to expand the program capacity to all women who plan pregnancy, and conducting social marketing. Belgium has established an ad hoc-committee to develop a comprehensive social marketing and professional training strategy for pilot testing preconception care models in the French speaking part of Belgium, an area that represents 5 million people and 50,000 births per year using prenatal care and pediatric clinics, gynecological departments, and the genetic centers. In China, Guangxi province piloted preconceptional HIV testing and counseling among couples who sought the then mandatory premarital medical examination as a component of the three-pronged approach to reduce mother to child transmission of HIV. HIV testing rates among couples increased from 38% to 62% over one year period. In October 2003, China changed the legal requirement of premarital medical examination from mandatory to “voluntary.” This change was interpreted by most women that the premarital health examination was “unnecessary” and overall premarital health examination rates dropped. Social marketing efforts piloted in 2004 indicated that 95% of women were willing to pay up to RMB 100 (US$12) for preconception health care services. These case studies illustrate programmatic feasibility of preconception care services to address maternal and child health and other public health challenges in developed and emerging economies. PMID:16763771

Ethics of mandatory premarital HIV testing in Africa: the case of Goma, Democratic Republic of Congo.

PubMed

Rennie, Stuart; Mupenda, Bavon

2008-08-01

Despite decades of prevention efforts, millions of persons worldwide continue to become infected by the human immunodeficiency virus (HIV) every year. This urgent problem of global epidemic control has recently lead to significant changes in HIV testing policies. Provider-initiated approaches to HIV testing have been embraced by the Centers for Disease Control and Prevention and the World Health Organization, such as those that routinely inform persons that they will be tested for HIV unless they explicitly refuse ('opt out'). While these policies appear to increase uptake of testing, they raise a number of ethical concerns that have been debated in journals and at international AIDS conferences. However, one special form of 'provider-initiated' testing is being practiced and promoted in various parts of the world, and has advocates within international health agencies, but has received little attention in the bioethical literature: mandatory premarital HIV testing. This article analyses some of the key ethical issues related to mandatory premarital HIV testing in resource-poor settings with generalized HIV epidemics. We will first briefly mention some mandatory HIV premarital testing proposals, policies and practices worldwide, and offer a number of conceptual and factual distinctions to help distinguish different types of mandatory testing policies. Using premarital testing in Goma (Democratic Republic of Congo) as a point of departure, we will use influential public health ethics principles to evaluate different forms of mandatory testing. We conclude by making concrete recommendations concerning the place of mandatory premarital testing in the struggle against HIV/AIDS.

ETHICS OF MANDATORY PREMARITAL HIV TESTING IN AFRICA: THE CASE OF GOMA, DEMOCRATIC REPUBLIC OF CONGO

PubMed Central

RENNIE, STUART; MUPENDA, BAVON

2015-01-01

Despite decades of prevention efforts, millions of persons worldwide continue to become infected by the human immunodeficiency virus (HIV) every year. This urgent problem of global epidemic control has recently lead to significant changes in HIV testing policies. Provider-initiated approaches to HIV testing have been embraced by the Centers for Disease Control and Prevention and the World Health Organization, such as those that routinely inform persons that they will be tested for HIV unless they explicitly refuse (‘opt out’). While these policies appear to increase uptake of testing, they raise a number of ethical concerns that have been debated in journals and at international AIDS conferences. However, one special form of ‘provider-initiated’ testing is being practiced and promoted in various parts of the world, and has advocates within international health agencies, but has received little attention in the bioethical literature: mandatory premarital HIV testing. This article analyses some of the key ethical issues related to mandatory premarital HIV testing in resource-poor settings with generalized HIV epidemics. We will first briefly mention some mandatory HIV premarital testing proposals, policies and practices worldwide, and offer a number of conceptual and factual distinctions to help distinguish different types of mandatory testing policies. Using premarital testing in Goma (Democratic Republic of Congo) as a point of departure, we will use influential public health ethics principles to evaluate different forms of mandatory testing. We conclude by making concrete recommendations concerning the place of mandatory premarital testing in the struggle against HIV/AIDS. PMID:19143089

Attitudes and beliefs among high- and low-risk population groups towards β-thalassemia prevention: a cross-sectional descriptive study from India.

PubMed

Chawla, Swati; Singh, Rajnish Kumar; Lakkakula, Bhaskar V K S; Vadlamudi, Raghavendra Rao

2017-07-01

β-thalassemia is an autosomal recessive blood disorder caused by gene mutations that affect all aspects of β-globin production. In majority of Asian countries including India, the frequency of β-thalassemia is closely intertwined with social, cultural, and religious issues of the respective country. Several national level screening programs imparted education regarding β-thalassemia, but follow-up evaluation revealed that education was not effective. It has been hypothesized that the beliefs and attitudes, carrier screening, and education among "high risk communities" will have far-reaching implications towards β-thalassemia prevention in the country. The present study is aimed to investigate attitudes, intention, and behavior of β-thalassemia high- and low-risk ethnic groups towards carrier screening and education. A structured questionnaire on knowledge, attitude, and practice regarding β-thalassemia was administered on 926 individuals belong to Arora, a high-risk ethnic group for β-thalassemia (347 rural (AR) and 202 urban (AU)) and 377 cosmopolitan commoners (CC) aged above 18 years of both sexes. To understand the relationship between various questions, Pearson's correlation test and factor analysis was performed. The responses were further categorized into the theory of planned behavior (TPB) constructs with the measures of the main constructs reported as a mean. Various dimensions of knowledge, attitude, and practice reveal that the urban groups (AU and CC) are better aware of the disease "β-thalassemia" than the rural group (AR) who witness suffering at close quarters. The AR group is more positive for preventive measures than the urban groups. Significant correlations and factor analysis show "intentions" for premarital and prenatal screening highly loaded as outcome behaviors. The Ajzen's "Theory of planned behavior" support that the "intention" and "perceived behavior control" are better predictors of "outcome behavior" compared to "attitude" and "subjective norm." As this study is cross-sectional and descriptive in nature, the constructs of the theory should be considered as perceptions. However, we believe the patterns observed are indicative of "predicting behavior" that has far-reaching implications on health planners and administrators in designing β-thalassemia screening and prevention program.

The U.S. Marine Corps Combined Action Program (CAP): A Proposed Alternative Strategy for the Vietnam War

DTIC Science & Technology

2002-05-01

Vietnamese men abstained from premarital sex, they openly practiced mutual masturbation . 62 In western culture, a man’s business was a man’s business, but... practice of integrating Marine with native forces marked the beginning of a nearly six year endeavor entitled the Combined Action Program or CAP. Embraced...chain of command. While the CAP platoons drew from infantry battalions primarily, their ties to them remained administrative and informal in practice

A comprehensive review of the prevalence of beta globin gene variations and the co-inheritance of related gene variants in Saudi Arabians with beta-thalassemia

PubMed Central

Alaithan, Mousa A.; AbdulAzeez, Sayed; Borgio, J. Francis

2018-01-01

Beta-thalassemia is a genetic disorder that is caused by variations in the beta-hemoglobin (HBB) gene. Saudi Arabia is among the countries most affected by beta-thalassemia, and this is particularly problematic in the Eastern regions. This review article is an attempt to compile all the reported mutations to facilitate further national-level studies to prepare a Saudi repository of HBB gene variations. In Saudi Arabians, IVSI-5 (G>C) and Cd 39 (C>T) are the most prevalent HBB gene variations out of 42 variations. The coinheritance of HBB gene variations with ATRX, HBA1, HBA2, HBA12, AHSP, and KLF1 gene variations were observed to be common in the Saudi population. National surveys on the molecular nature of hemoglobinopathies should be set up through collaborations between research centers from various regions to create a well-documented molecular data bank. This data bank can be used to develop a premarital screening program and lead to the best treatment and prevention strategies for beta-thalassemia. PMID:29619482

Genetic counselling in tribals in India

PubMed Central

Mohanty, Dipika; Das, Kishalaya

2011-01-01

Genetic counselling in tribals unlike general population residing in cities and near villages is a difficult task due of their lower literacy and poor socio-economic status. However, sustained effort is essential with a close interaction in the local language, certain misbeliefs need to be removed gradually taking into account their socio-cultural background. The present communication deals with our experience in counselling for haemoglobinopathies during Neonatal Screening Programme undertaken for sickle cell disease in Kalahandi district of Orissa and Community Screening Programmes in primitive tribes of India in four States viz. Orissa, Gujarat, Tamil Nadu and Maharashtra. Counselling during neonatal screening programme was very well accepted demonstrating the benefit to the small babies as regards the morbidity. Premarital marriage counselling was also accepted by them. The success rate as followed up for 5 years is almost 50 per cent, the limitation being long follow up. Genetic counselling in these areas has to be continuous to achieve success and therefore the need for setting up of permanent centres in the tribal areas in India. PMID:22089621

Premarital Predictors of Marital Quality and Stability.

ERIC Educational Resources Information Center

Larson, Jeffry H.; Holman, Thomas B.

1994-01-01

Reviews research on premarital factors associated with later marital quality and stability in first marriages. Three major categories of factors are described, including background and context, individual traits and behaviors, and couple interactional processes. Both cross-sectional and longitudinal research are summarized. Recommendations for…

Deciphering Community and Race Effects on Adolescent Premarital Childbearing.

ERIC Educational Resources Information Center

South, Scott J.; Baumer, Eric P.

2000-01-01

Racial differences in adolescent premarital childbearing were largely explained by racial differences in neighborhood quality. These neighborhood effects were attributed to peer attitudes and behaviors, adolescents' more tolerant attitudes toward unmarried parenthood, and greater residential mobility in distressed communities. Neighborhood effects…

Correlates of Condom-use Self-efficacy on the EPPM-based Integrated Model among Chinese College Students.

PubMed

Jin, Shan Shan; Bu, Kai; Chen, Fang Fang; Xu, Hui Fang; Li, Yi; Zhao, Dong Hui; Xu, Fang; Li, Jing Yan; Han, Meng Jie; Wang, Ning; Wang, Lu

2017-02-01

To explore the predictors of condom-use self-efficacy in Chinese college students according to the extended parallel process model (EPPM)-based integrated model. A total of 3,081 college students were anonymously surveyed through self-administered questionnaires in Guangzhou and Harbin, China. A structural equation model was applied to assess the integrated model. Among the participants, 1,387 (46.7%) were male, 1,586 (53.3%) were female, and the average age was 18.6 years. The final integrated model was acceptable. Apart from the direct effect (r = 0.23), perceived severity had two indirect effects on condom-use self-efficacy through the attitude to HIV education (r = 0.40) and intention to engage in premarital sex (r = -0.16), respectively. However, the perceived susceptibility mediated through the intention to engage in premarital sex (intent-to-premarital-sex) had a poor indirect impact on condom-use self-efficacy (total effect was -0.06). Furthermore, attitude toward HIV health education (r = 0.49) and intent-to-premarital-sex (r = -0.31) had a strong direct effect on condom-use self-efficacy. In addition, male students perceived higher susceptibility, stronger intent-to-premarital-sex, and lower condom-use self-efficacy than female students. The integrated model may be used to assess the determinants of condom-use self-efficacy among Chinese college students. Future research should focus on raising the severity perception, HIV-risk-reduction motivation, and the premarital abstinence intention among college students. Furthermore, considering the gender differences observed in the present survey, single-sex HIV education is required in school-based HIV/sex intervention. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Factors associated with continuing emergence of β-thalassemia major despite prenatal testing: a cross-sectional survey.

PubMed

Al Sabbah, Haleama; Khan, Sarah; Hamadna, Abdallah; Abu Ghazaleh, Lamia; Dudin, Anwar; Karmi, Bashar Adnan

2017-01-01

Health care initiatives focusing on prenatal testing and premarital genetic screening aiming to reduce the incidence of β-thalassemia have emerged during the last decade. In Palestine, 4% of the population are known thalassemia carriers with new cases continuing to appear despite the availability of prenatal testing. This study aims to identify factors that influence the decision to retain or abort fetuses affected by β-thalassemia in Palestine. Convenience sampling was used to select 32 women (72 fetuses) who were at risk of having a baby with β-thalassemia. A questionnaire on prenatal testing, test results, pregnancy outcomes, and factors influencing the decision to terminate the pregnancy were used for this cross-sectional study. The data were analyzed using SPSS version 17. Among the fetuses screened, 36 (50%) were thalassemia carriers and 20 (28%) had β-thalassemia; 17 (85%) affected fetuses were aborted. Religious beliefs were the most cited reason for opposing abortion while prior experience with β-thalassemia patients and awareness programs promoted abortions. Mothers who opted to retain an affected fetus had modest educational attainment. Higher educational level was significantly associated with the decision to abort an affected fetus ( p <0.05). A religious consensus is needed on the abortion of fetuses affected by β-thalassemia. Improving female education and increasing awareness on thalassemia could help reduce the incidence of β-thalassemia in Palestine and around the world.

Impact of 226C>T MSH2 gene mutation on cancer phenotypes in two HNPCC-associated highly-consanguineous families from Kuwait: emphasis on premarital genetic testing.

PubMed

Marafie, Makia J; Al-Awadi, Sadiqa; Al-Mosawi, Fatemah; Elshafey, Alaa; Al-Ali, Waleed; Al-Mulla, Fahd

2009-01-01

Lynch syndrome or hereditary nonpolyposis colorectal cancer (HNPCC) is one of the commonest cancer susceptibility syndromes. It is characterized by early onset colon cancer and a variety of extracolonic tumours. Germline mutations in the DNA mismatch repair genes (MLH1, MSH2, MSH6, PMS1, and PMS2) are responsible for this disorder. Identifying an affected individual depends on the tumour histopathology, family history that fulfils the Amsterdam and/or Bethesda criteria, tumour immunohistochemistry, microsatellite instability, and finally molecular analysis of an affected member. It is a laborious, time consuming and expensive procedure, which needs the effort of a multi-disciplinary team. However, once the diagnosis is established and germline defect is identified, other high risk pre-symptomatic carriers could be offered intensive surveillance and management as a preventive measure against cancer development. Here, we present two large highly consanguineous HNPCC-families from Kuwait in whom a founder MSH2 mutation was identified. The relationship between this mutation and cancer expressivity in two large consanguineous families harbouring other genetic defects is discussed. Moreover, we shed light on the challenges pertaining to diagnosis, screening, premarital counselling of couples and prenatal diagnosis of offspring with biallelic MSH2 gene mutation.

Premarital Sexual Guilt and Contraceptive Attitudes and Behavior.

ERIC Educational Resources Information Center

Herold, Edward S.; Goodwin, Marilyn Shirley

1981-01-01

Studied the relationship between premarital sexual guilt and contraceptive attitudes and behavior among young single women. High-guilt subjects were significantly more embarrassed about coming to the birth control clinics and were more likely to believe that it was difficult to obtain birth control. (Author)

Attitudes about Male-Female Relations among Black Adolescents.

ERIC Educational Resources Information Center

Rubin, Roger H.

1981-01-01

Examines the relationship of family structure, peer group affiliation, social class, and sex with five dependent variables concerned with attitudes toward dating values, marriage, romanticism, premarital pregnancy, and premarital sexual permissiveness among 85 rural, Black adolescent males and females. Findings suggest general community norms and…

Prevalence and sex-related risk factors of premarital pregnancy and reproductive tract infections among female undergraduates in Wuhan, China.

PubMed

Cao, Yue; Xiao, Han; Yan, Hong; Li, Jingjing; Li, Shiyue

2015-03-01

In China, more and more female college students engage in premarital sex. Few seek reproductive health services, increasing their risk for unintended pregnancy and reproductive tract infections (RTIs). The present study aims to explore the prevalence and sex-related risk factors of premarital pregnancy and RTIs among female undergraduates in China. A total of 4769 females were recruited using randomized cluster sampling and anonymously completed questionnaires. Of the 4,769 females, 863 (18.1%) reported ever having sexual intercourse, 17.5% of which had become pregnant, and 22.7% had contracted RTIs. Younger age or not using a condom at first sex and having multiple sex partners contributed to premarital pregnancy. Majoring in arts, being from less-developed regions of China, having multiple partners, and self-reported pregnancy contributed to RTIs. Findings suggest importance of sexual health education among undergraduates, especially women from less-developed regions of China and/or majoring in arts. © 2015 APJPH.

Public perceptions and attitudes toward thalassaemia: Influencing factors in a multi-racial population.

PubMed

Wong, Li Ping; George, Elizabeth; Tan, Jin-Ai Mary Anne

2011-03-30

Thalassaemia is a common public health problem in Malaysia and about 4.5 to 6% of the Malays and Chinese are carriers of this genetic disorder. The major forms of thalassaemia result in death in utero of affected foetuses (α-thalassaemia) or life-long blood transfusions for survival in β-thalassaemia. This study, the first nationwide population based survey of thalassaemia in Malaysia, aimed to determine differences in public awareness, perceptions and attitudes toward thalassaemia in the multi-racial population in Malaysia. A cross-sectional computer-assisted telephone interview survey of a representative sample of multi-racial Malaysians aged 18 years and above was conducted between July and December 2009. Of a total of 3723 responding households, 2846 (76.4%) have heard of thalassaemia. Mean knowledge score was 11.85 (SD ± 4.03), out of a maximum of 21, with higher scores indicating better knowledge. Statistically significant differences (P < 0.05) in total knowledge score by age groups, education attainment, employment status, and average household income were observed. Although the majority expressed very positive attitudes toward screening for thalassaemia, only 13.6% of married participants interviewed have been screened for thalassaemia. The majority (63.4%) were unsupportive of selective termination of foetuses diagnosed with thalassaemia major. Study shows that carrier and premarital screening programs for thalassaemia may be more effective and culturally acceptable in the reduction of pregnancies with thalassaemia major. The findings provide insights into culturally congruent educational interventions to reach out diverse socio-demographic and ethnic communities to increase knowledge and cultivate positive attitudes toward prevention of thalassaemia.

The Role of Day Care in Serving the Needs of School-Age Parents and Their Children: A Review of the Literature. Working Paper No. 174.

ERIC Educational Resources Information Center

Marx, Fern

The recent rise in premarital sexual experience and in pregnancy and births among unmarried teenage women from all socioeconomic groups has focused public, professional, and governmental attention on the immediate and long-term implications of teenage pregnancy. The assumption underlying the need for adolescent parent programs in general is that…

Premarital Contraceptive Use: A Test of Two Models

ERIC Educational Resources Information Center

Delamater, John; Maccorquodale, Patricia

1978-01-01

Tests the utility of two models for explaining contraceptive use by sexually active women (N=391). Significant relationships were found between use and permissive premarital standards and standard-behavior consistency. Neither model is particularly applicable to the contraceptive reports of sexually active males (N=354). (Author)

Gender Comparisons of College Students' Attitudes toward Sexual Behavior.

ERIC Educational Resources Information Center

Wilson, Stephan M.; Medora, Nilufer P.

1990-01-01

Found significant differences between male and female college students' (n=641) attitudes toward premarital sex among casual acquaintances and attitudes toward extramarital, oral-genital, and anal sex, with males expressing more liberal attitudes. Found no significant differences between males' and females' attitudes toward premarital sex when…

Parental Communication and Perceived Parental Attitudes about Sexuality among Turkish College Students

ERIC Educational Resources Information Center

Topkaya, Nursel

2012-01-01

This current study was conducted to examine parental communication and perceived parental attitudes about sexuality with respect to gender among Turkish college students. Moreover, attitudes toward premarital sexuality with respect to gender were explored. A demographic data form, premarital sexual permissiveness scale, parental communication…

The Psychophysiology of Adult Attachment Relationships: Autonomic Reactivity in Marital and Premarital Interactions

ERIC Educational Resources Information Center

Roisman, Glenn I.

2007-01-01

To better understand the origins of autonomic reactivity during marital interactions, this study examined the psychophysiological profiles of prototypically secure (vs. insecure) and deactivating (vs. hyperactivating) adults while they talked about areas of disagreement with their (pre)marital partners. Adults who idealized their caregivers…

Some Determinants of Commitment Levels in Premarital Relationships.

ERIC Educational Resources Information Center

Kramer, Robert M.; And Others

Premarital dating couples (N=61) were asked to answer questions concerning their perceived commitment to their relationship, the amount of time they spend with their partner, the amount of time they spend arguing, their partner's attractiveness, the length of their relationship, and their desire to continue the relationship. Time spent together…

Behavioral surveillance of premarital sex among never married young adults in a high HIV prevalence district in India.

PubMed

Kumar, G Anil; Dandona, Rakhi; Kumar, S G Prem; Dandona, Lalit

2011-01-01

In a population-based representative sample of 2,475 never married persons aged 15-24 years from Guntur district of Andhra Pradesh state in India, 21.7% (95% CI 18.7-24.7) males and 4.6% (95% CI 2.2-7.0) females reported having had sex. Only 22.3% males and 6.3% females reported consistent condom use for premarital sex in the last 6 months. The strongest associations with premarital sex for males were current use of alcohol and tobacco, and for females were not living with parents currently and being an income earner. These findings can inform HIV prevention efforts among young adults in India.

Premarital Sex, Social Support, Submissive Behaviors, and Loneliness among Turkish University Students

ERIC Educational Resources Information Center

Yalcin, Ilhan; Aricioglu, Ahu; Malkoc, Asude

2012-01-01

The purpose of this study was to investigate whether differences in social support, submissive behaviors, and loneliness existed among Turkish university students who had had premarital sexual intercourse and those who had not. Using self-reported questionnaires, students who had experienced sexual intercourse were contrasted with those who had…

Better Child Support Enforcement: Can It Reduce Teenage Premarital Childbearing?

ERIC Educational Resources Information Center

Plotnick, Robert D.; Garfinkel, Irwin; McLanahan, Sara S.; Ku, Inhoe

2004-01-01

Stricter child support enforcement may reduce unwed childbearing by raising the costs of fatherhood. The authors investigate this hypothesis using a sample of young women from the National Longitudinal Survey of Youth, to which they add information on state child support enforcement. Models of the probability of a teenage premarital birth and of…

A Test and Reformulation of Reference Group and Role Correlates of Premarital Sexual Permissiveness Theory

ERIC Educational Resources Information Center

Libby, Roger W.; And Others

1978-01-01

Propositions concerned with reference group and role correlates of Ira Reiss' premarital sexual permissiveness theory were tested. Reiss' basic propositions are only partially supported. Closeness to mother's sexual standards is considerably more predictive of self-permissiveness than was obvious in Reiss' theory. Closeness to friends' and peers'…

Race, Liberalism-Conservatism and Premarital Sexual Permissiveness: A Bi-Racial Comparison.

ERIC Educational Resources Information Center

Staples, Robert

1978-01-01

Data were gathered by means of questionnaires administered to 429 Black and White, male and female college students in Florida and California. The purpose of this investigation was to test Ira Reiss' proposition that a liberal or conservative attitude differentially affects groups that are traditionally high or low on premarital sexual…

Social Exchange and Sexual Behavior in Young Women's Premarital Relationships in Kenya

ERIC Educational Resources Information Center

Luke, Nancy; Goldberg, Rachel E.; Mberu, Blessing U.; Zulu, Eliya M.

2011-01-01

Transactional sex, or the exchange of money and gifts for sexual activities within nonmarital relationships, has been widely considered a contributing factor to the disproportionate prevalence of HIV/AIDS among young women in sub-Saharan Africa. This study applied social exchange theory to premarital relationships in order to investigate the…

Family Adult Awareness of Adolescents' Premarital Romantic and Sexual Relationships in Ghana

ERIC Educational Resources Information Center

Bingenheimer, Jeffrey B.; Roche, Kathleen M.; Blake, Susan M.

2017-01-01

This study examined the circumstances under which family adults in Ghana were aware of their adolescent children's involvement in premarital relationships. It was hypothesized that factors related to the seriousness and social acceptability of the relationship would influence the likelihood of family adults' awareness in gender-specific ways. Data…

Is Your Love in Vain? Another Look at Premarital Cohabitation and Divorce

ERIC Educational Resources Information Center

Svarer, Michael

2004-01-01

In this paper we provide an empirical investigation of the association between premarital cohabitation and subsequent risk of divorce. Theoretically couples who cohabit before marriage should have a lower subsequent risk of divorce since cohabitation enables you to gather information about the match quality, and only good matches evolve into…

Sex, love and gender norms: sexual life and experience of a group of young people in Ho Chi Minh City, Vietnam.

PubMed

Nguyen, Hoa Ngan; Liamputtong, Pranee

2007-03-01

This paper discusses the impacts of gender norms on the sexual life and experience of a group of young Vietnamese people. It is based on a qualitative study on sexuality and abortion among young people in Ho Chi Minh City, Vietnam. There were two general attitudes towards premarital sex. One view supported young people in a serious, loving relationship engaging in sex before marriage; the other opposed premarital sex because it affected the reputation of girls and their families. These general attitudes were similar to the views on virginity: one group believed strongly in girls maintaining their virginity and the other group emphasised love, emotion and trust, not virginity, as the most important criteria for marriage. Among women there were more supporters than opponents of the traditional view of premarital sex and virginity. Premarital sex was more acceptable for young people in a serious, loving relationship with certain commitment to marriage. Young men considered sex a way to express their love and to become more intimate. Women's view was that premarital sex only occurred within a serious, loving relationship or when there was a serious commitment to marriage. It is clear that young people's sexual life is shaped and constrained by gender norms through political interventions, sexual education and moral judgements. Under the pressure of these norms, young people face many difficulties in order to fulfill a safe and satisfying sexual life.

Risk behaviours and associated factors among medical students and community youths in Myanmar.

PubMed

Htay, San San; Oo, Myo; Yoshida, Yoshitoku; Harun-Or-Rashid, Md; Sakamoto, Junichi

2010-02-01

We conducted a cross-sectional study of the risk behaviours inherent in tobacco smoking, alcohol consumption and premarital sex, among 400 medical students (186 males) from a medical university, Yangon, and 410 community youths (244 males) 15 to 24 years of age from selected townships in Myanmar. As a result, we found that 12.8% smoked, 34.5% consumed alcohol and 10.1% engaged in premarital sex, among medical students, whereas among community youths, the corresponding rates were 28.8%, 32.1% and 11.9%. There was a significant difference in the prevalence of all risk behaviours between male and female respondents. Such risk behaviours were more dominant among males, while being very low among females. Among male respondents, the smoking rate was significantly higher among community youths (46.7%) than among medical students (26.9%); however, student alcohol consumption (58.5%) was greater than that of community youths (47.1%). Premarital sexual experience did not differ significantly between the two groups. These risk behaviours were correlated with one another. Having close friends who engaged in similar behaviours was found to be the major contributing factor for those kinds of risk among both groups. Our results highlighted the fact that, despite their relatively sophisticated knowledge of risks, the prevalence of risky behaviour among the medical students was no less frequent than among community youths. To diminish those risks, evaluations of actual conditions, behaviour modifications and specific preventive measures compatible with existing culture and changing lifestyles should be undertaken. Effective adolescent health programs at schools, colleges and universities should be revised and emphasized.

The pros and cons of the fourth revision of thalassaemia screening programme in Iran.

PubMed

Moafi, Alireza; Vallian, Reihaneh; Vallian, Sadeq; Rahgozar, Soheila; Torfenajad, Mohammad; Moafi, Hadi

2017-03-01

Objective To evaluate the repercussions of recent changes to the cut-offs used in the first screening step of the pre-marital screening programme for thalassaemia prevention in Iran. Methods The profiles of 984 subjects referred to a genetic laboratory, and the tests of 242 parents of children with thalassaemia major were assessed for red blood cell (RBC) indices, haemoglobin (Hb) A2 levels and results of Hb electrophoresis. Results Of 407 suspected thalassaemia minor (STM) cases, 18 proved positive for thalassaemia minor on molecular analysis (18/407, confidence interval 2.6-6.9%). If the revised screening cut-offs had been used to determine who would undergo molecular analysis, two of these cases would not have been identified. Only 4.4% of suspected cases with lower than normal RBC indices (mean corpuscular volume <80 fl and mean corpuscular Hb <27 pg) and HbA2 (<3.5%) were diagnosed with thalassaemia minor. Conclusion The thalassaemia major prevention programme is performed in two separate steps. One step involves the screening of subjects and identification of β-thalassaemia minor, suspected cases for thalassaemia minor (STM), and normal subject groups. The other step concerns the identification of thalassaemia minor in the STM group. Changing the cut-offs at the first screening step does not result in significant improvement from an economic view, and is associated with significant risk at the second screening step.

Prevalence and molecular characterization of Glucose-6-Phosphate dehydrogenase deficient variants among the Kurdish population of Northern Iraq

PubMed Central

2010-01-01

Background Glucose-6-Phosphate dehydrogenase (G6PD) is a key enzyme of the pentose monophosphate pathway, and its deficiency is the most common inherited enzymopathy worldwide. G6PD deficiency is common among Iraqis, including those of the Kurdish ethnic group, however no study of significance has ever addressed the molecular basis of this disorder in this population. The aim of this study is to determine the prevalence of this enzymopathy and its molecular basis among Iraqi Kurds. Methods A total of 580 healthy male Kurdish Iraqis randomly selected from a main regional premarital screening center in Northern Iraq were screened for G6PD deficiency using methemoglobin reduction test. The results were confirmed by quantitative enzyme assay for the cases that showed G6PD deficiency. DNA analysis was performed on 115 G6PD deficient subjects, 50 from the premarital screening group and 65 unrelated Kurdish male patients with documented acute hemolytic episodes due to G6PD deficiency. Analysis was performed using polymerase chain reaction/restriction fragment length polymorphism for five deficient molecular variants, namely G6PD Mediterranean (563 C→T), G6PD Chatham (1003 G→A), G6PD A- (202 G→A), G6PD Aures (143 T→C) and G6PD Cosenza (1376 G→C), as well as the silent 1311 (C→T) mutation. Results Among 580 random Iraqi male Kurds, 63 (10.9%) had documented G6PD deficiency. Molecular studies performed on a total of 115 G6PD deficient males revealed that 101 (87.8%) had the G6PD Mediterranean variant and 10 (8.7%) had the G6PD Chatham variant. No cases of G6PD A-, G6PD Aures or G6PD Cosenza were identified, leaving 4 cases (3.5%) uncharacterized. Further molecular screening revealed that the silent mutation 1311 was present in 93/95 of the Mediterranean and 1/10 of the Chatham cases. Conclusions The current study revealed a high prevalence of G6PD deficiency among Iraqi Kurdish population of Northern Iraq with most cases being due to the G6PD Mediterranean and Chatham variants. These results are similar to those reported from neighboring Iran and Turkey and to lesser extent other Mediterranean countries. PMID:20602793

Prevalence and molecular characterization of Glucose-6-Phosphate dehydrogenase deficient variants among the Kurdish population of Northern Iraq.

PubMed

Al-Allawi, Nasir; Eissa, Adil A; Jubrael, Jaladet Ms; Jamal, Shakir Ar; Hamamy, Hanan

2010-07-05

Glucose-6-Phosphate dehydrogenase (G6PD) is a key enzyme of the pentose monophosphate pathway, and its deficiency is the most common inherited enzymopathy worldwide. G6PD deficiency is common among Iraqis, including those of the Kurdish ethnic group, however no study of significance has ever addressed the molecular basis of this disorder in this population. The aim of this study is to determine the prevalence of this enzymopathy and its molecular basis among Iraqi Kurds. A total of 580 healthy male Kurdish Iraqis randomly selected from a main regional premarital screening center in Northern Iraq were screened for G6PD deficiency using methemoglobin reduction test. The results were confirmed by quantitative enzyme assay for the cases that showed G6PD deficiency. DNA analysis was performed on 115 G6PD deficient subjects, 50 from the premarital screening group and 65 unrelated Kurdish male patients with documented acute hemolytic episodes due to G6PD deficiency. Analysis was performed using polymerase chain reaction/restriction fragment length polymorphism for five deficient molecular variants, namely G6PD Mediterranean (563 C-->T), G6PD Chatham (1003 G-->A), G6PD A- (202 G-->A), G6PD Aures (143 T-->C) and G6PD Cosenza (1376 G-->C), as well as the silent 1311 (C-->T) mutation. Among 580 random Iraqi male Kurds, 63 (10.9%) had documented G6PD deficiency. Molecular studies performed on a total of 115 G6PD deficient males revealed that 101 (87.8%) had the G6PD Mediterranean variant and 10 (8.7%) had the G6PD Chatham variant. No cases of G6PD A-, G6PD Aures or G6PD Cosenza were identified, leaving 4 cases (3.5%) uncharacterized. Further molecular screening revealed that the silent mutation 1311 was present in 93/95 of the Mediterranean and 1/10 of the Chatham cases. The current study revealed a high prevalence of G6PD deficiency among Iraqi Kurdish population of Northern Iraq with most cases being due to the G6PD Mediterranean and Chatham variants. These results are similar to those reported from neighboring Iran and Turkey and to lesser extent other Mediterranean countries.

Parents' Attitudes about Adolescents' Premarital Sexual Activity: The Role of Inter-Parent Consistency/Inconsistency in Sexual Outcomes

ERIC Educational Resources Information Center

Somers, Cheryl L.; Anagurthi, Claudia

2014-01-01

Objective: Parents' values about sexuality and about premarital sex play unique roles in the development of adolescents' sexual attitudes and behaviours. However, research is scarce on the role of consistent versus inconsistent values transmission. The purpose of the present study was to examine the association between parental…

Chinese Adolescents' Attitudes toward Sexual Relationships and Premarital Sex: Implications for Promoting Sexual Health

ERIC Educational Resources Information Center

Chang, Yu-Ting; Hayter, Mark; Lin, Mei-Ling

2014-01-01

This study was designed to explore Taiwanese school students' attitudes toward sexual relationships and premarital sex. This was an exploratory descriptive, qualitative study. Focus groups (N = 8) were conducted with 47 adolescents from three high schools in Taiwan. Transcripts were transcribed and thematically analyzed using Atlas V 5.0.…

Marital Quality and Divorce Decisions: How Do Premarital Cohabitation and Nonmarital Childbearing Matter?

ERIC Educational Resources Information Center

Tach, Laura M.; Halpern-Meekin, Sarah

2012-01-01

This study used the 1979 cohort of the National Longitudinal Survey of Youth (N = 3,481) to test whether the association between marital quality and divorce is moderated by premarital cohabitation or nonmarital childbearing status. Prior research identified lower marital quality as a key explanation for why couples who cohabit or have children…

Public perceptions and attitudes toward thalassaemia: Influencing factors in a multi-racial population

PubMed Central

2011-01-01

Background Thalassaemia is a common public health problem in Malaysia and about 4.5 to 6% of the Malays and Chinese are carriers of this genetic disorder. The major forms of thalassaemia result in death in utero of affected foetuses (α-thalassaemia) or life-long blood transfusions for survival in β-thalassaemia. This study, the first nationwide population based survey of thalassaemia in Malaysia, aimed to determine differences in public awareness, perceptions and attitudes toward thalassaemia in the multi-racial population in Malaysia. Methods A cross-sectional computer-assisted telephone interview survey of a representative sample of multi-racial Malaysians aged 18 years and above was conducted between July and December 2009. Results Of a total of 3723 responding households, 2846 (76.4%) have heard of thalassaemia. Mean knowledge score was 11.85 (SD ± 4.03), out of a maximum of 21, with higher scores indicating better knowledge. Statistically significant differences (P < 0.05) in total knowledge score by age groups, education attainment, employment status, and average household income were observed. Although the majority expressed very positive attitudes toward screening for thalassaemia, only 13.6% of married participants interviewed have been screened for thalassaemia. The majority (63.4%) were unsupportive of selective termination of foetuses diagnosed with thalassaemia major. Conclusion Study shows that carrier and premarital screening programs for thalassaemia may be more effective and culturally acceptable in the reduction of pregnancies with thalassaemia major. The findings provide insights into culturally congruent educational interventions to reach out diverse socio-demographic and ethnic communities to increase knowledge and cultivate positive attitudes toward prevention of thalassaemia. PMID:21447191

Factors associated with continuing emergence of β-thalassemia major despite prenatal testing: a cross-sectional survey

PubMed Central

Al Sabbah, Haleama; Khan, Sarah; Hamadna, Abdallah; Abu Ghazaleh, Lamia; Dudin, Anwar; Karmi, Bashar Adnan

2017-01-01

Purpose Health care initiatives focusing on prenatal testing and premarital genetic screening aiming to reduce the incidence of β-thalassemia have emerged during the last decade. In Palestine, 4% of the population are known thalassemia carriers with new cases continuing to appear despite the availability of prenatal testing. This study aims to identify factors that influence the decision to retain or abort fetuses affected by β-thalassemia in Palestine. Methods Convenience sampling was used to select 32 women (72 fetuses) who were at risk of having a baby with β-thalassemia. A questionnaire on prenatal testing, test results, pregnancy outcomes, and factors influencing the decision to terminate the pregnancy were used for this cross-sectional study. The data were analyzed using SPSS version 17. Results Among the fetuses screened, 36 (50%) were thalassemia carriers and 20 (28%) had β-thalassemia; 17 (85%) affected fetuses were aborted. Religious beliefs were the most cited reason for opposing abortion while prior experience with β-thalassemia patients and awareness programs promoted abortions. Mothers who opted to retain an affected fetus had modest educational attainment. Higher educational level was significantly associated with the decision to abort an affected fetus (p<0.05). Conclusion A religious consensus is needed on the abortion of fetuses affected by β-thalassemia. Improving female education and increasing awareness on thalassemia could help reduce the incidence of β-thalassemia in Palestine and around the world. PMID:29026336

The Effect of School Status and Academic Skills on the Reporting of Premarital Sexual Behavior: Evidence from a Longitudinal Study in Rural Malawi

PubMed Central

Soler-Hampejsek, Erica; Grant, Monica J.; Mensch, Barbara S.; Hewett, Paul C.; Rankin, Johanna

2013-01-01

Purpose Reliable data on sexual behavior are needed to identify adolescents at risk of acquiring HIV or other sexually transmitted diseases, as well as unintended pregnancies. This study aims to investigate whether schooling status and literacy and numeracy skills affect adolescents’ reports of premarital sex collected using audio computer-assisted self-interviews (ACASI). Methods Data on 2320 participants in the first three rounds of the Malawi Schooling and Adolescent Study were analyzed to estimate the level of inconsistency in reporting premarital sex among rural Malawian adolescents. Multivariate logistic regressions were used to examine the relationships between school status and academic skills and premarital sexual behavior reports. Results Males were more likely than females to report premarital sex at baseline while females were more likely than males to report sex inconsistently within and across rounds. School-going females and males were more likely to report never having had sex at baseline and to “retract” reports of ever having sex across rounds than their peers who had recently left school. School-going females were also more likely to report sex inconsistently at baseline. Literate and numerate respondents were less likely to report sex inconsistently at baseline; however, they were more likely to retract sex reports across rounds. Conclusions The level of inconsistency both within a survey round and across rounds reflects the difficulties in collecting reliable sexual behavior data from young people in settings such as rural Malawi, where education levels are low, and sex among school-going females is not socially accepted. PMID:23688856

Marriage, Abortion, or Unwed Motherhood? How Women Evaluate Alternative Solutions to Premarital Pregnancies in Japan and the United States

ERIC Educational Resources Information Center

Hertog, Ekaterina; Iwasawa, Miho

2011-01-01

In this article, the authors argue that to understand the very low incidence of outside-of-marriage childbearing in contemporary Japan one needs to take into account perceptions of all possible solutions to a premarital pregnancy: marriage, abortion, and childbearing outside wedlock. To demonstrate the particular impact of these perceptions in…

Premarital and Postmarital Conception and the Risk of Fetal and Infant Death. PHSB Studies, No. 10.

ERIC Educational Resources Information Center

North Carolina State Dept. of Human Resources, Raleigh. Div. of Health Services.

This report indicates relationships between the marital status of pregnant North Carolina women and mothers and the risk of fetal and infant death in the year 1974. No significant difference in the fetal mortality of the two legitimate groups (postmarital and premarital or pregnant brides) was found, although the illegitimate group had by far the…

Pre-marital genetic counselling to consanguineous couples: attitudes, beliefs and decisions among counselled, noncounselled and unrelated couples in Israel.

PubMed

Shiloh, S; Reznik, H; Bat-Miriam-Katznelson, M; Goldman, B

1995-11-01

Semi-structured interviews were conducted with 65 Israeli subjects who received genetic counselling while considering marriage to a close relative, 40 subjects married to a close relative who did not receive pre-marital genetic counselling, and 125 controls married to a nonrelative and never having considered marrying a relative. It was found that 72% of the consanguineous couples who received pre-marital genetic counselling proceeded with their plans and married their relative; 86% of them reported that the counselling influenced their final decision to some degree. Counsellees' appraisals of genetic counselling revealed unfulfilled expectations to obtain more definitive answers, and mixed reactions to the nondirective approach applied by the counsellors. Comparisons between consanguineous and control couples revealed different views about consanguinity in general, and genetic risks in particular. Consanguineous couples, unlike controls, perceived consanguinity as an ordinary form of marriage, and had more favorable attitudes towards it. Compared to the noncounselled consanguineous group, consanguineous couples who received pre-marital genetic counselling had fewer children, estimated their genetic risk as lower but its subjective significance as higher, and perceived genetic disorders as more severe. The implications of these results are discussed from both theoretical and practical standpoints.

Cousin marriage and premarital carrier matching in a Bedouin community in Israel: attitudes, service development and educational intervention.

PubMed

Raz, Aviad E; Atar, Marcela

2004-01-01

Premarital carrier matching is a form of genetic counselling in which two individuals are told, if both are carriers, that they have a 25% risk at each pregnancy of having a child affected by the disease for which they were tested. If only one individual is a carrier this information is not disclosed. This scheme is offered to a consanguineous Bedouin community characterised by high prevalence of genetic diseases and a religious ban on abortion. To elicit attitudes of community members concerning cousin marriage and genetic counselling. Semi-structured interviews were conducted with Bedouin respondents (n = 49). Interviews revealed that a majority of Bedouin respondents confirmed the traditional and social role of cousin marriage. The main reasons given in this context were clan solidarity, interpersonal compatibility, preservation of family property, parental authority and social protection for women. A majority of the respondents also associated cousin marriage with genetic diseases. Regarding genetic testing, the majority of respondents preferred the option of premarital carrier matching, which was supposed to reduce stigmatisation, especially of women. Prenatal genetic testing was rejected on religious grounds. The result of this community-based and culture-sensitive process was a focus on premarital carrier matching.

Exome Sequencing Identifies Potential Risk Variants for Mendelian Disorders at High Prevalence in Qatar

PubMed Central

Rodriguez-Flores, Juan L.; Fakhro, Khalid; Hackett, Neil R.; Salit, Jacqueline; Fuller, Jennifer; Agosto-Perez, Francisco; Gharbiah, Maey; Malek, Joel A.; Zirie, Mahmoud; Jayyousi, Amin; Badii, Ramin; Al-Marri, Ajayeb Al-Nabet; Chouchane, Lotfi; Stadler, Dora J.; Hunter-Zinck, Haley; Mezey, Jason G.; Crystal, Ronald G.

2013-01-01

Exome sequencing of families of related individuals has been highly successful in identifying genetic polymorphisms responsible for Mendelian disorders. Here, we demonstrate the value of the reverse approach, where we use exome sequencing of a sample of unrelated individuals to analyze allele frequencies of known causal mutations for Mendelian diseases. We sequenced the exomes of 100 individuals representing the three major genetic subgroups of the Qatari population (Q1 Bedouin, Q2 Persian-South Asian, Q3 African) and identified 37 variants in 33 genes with effects on 36 clinically significant Mendelian diseases. These include variants not present in 1000 Genomes and variants at high frequency when compared to 1000 Genomes populations. Several of these Mendelian variants were only segregating in one Qatari subpopulation, where the observed subpopulation specificity trends were confirmed in an independent population of 386 Qataris. Pre-marital genetic screening in Qatar tests for only 4 out of the 37, such that this study provides a set of Mendelian disease variants with potential impact on the epidemiological profile of the population that could be incorporated into the testing program if further experimental and clinical characterization confirms high penetrance. PMID:24123366

Timing and circumstances of first sex among female and male youth from select urban areas of Nigeria, Kenya, and Senegal.

PubMed

Speizer, Ilene S; Fotso, Jean Christophe; Davis, Joshua T; Saad, Abdulmumin; Otai, Jane

2013-11-01

To examine the timing and circumstances of first sex among urban female and male youth in Kenya, Nigeria, and Senegal. Recently collected data are used to examine youth sexual behaviors in Kenya, Nigeria, and Senegal. In each country, a large, representative sample of women (ages 15-49) and men (ages 15-59) was collected from multiple cities. Data from youth (ages 15-24) are used for the analyses of age at sexual initiation, whether first sex was premarital, and modern family planning use at first sex. Cox proportional hazard models and logistic regression analyses are performed to determine factors associated with these outcomes. Across all three countries, a greater percentage of male youth than female youth report initiating sex with a nonmarital partner. More educated youth are less likely to have initiated sex at each age. In Nigeria and Senegal, poor female youth report earlier first sex than wealthier female youth. In Kenya, richer female youth are more likely to have premarital first sex and to use contraception/condom at first sex than their poorer counterparts. Older age at first sex and youth who report that first sex was premarital are significantly more likely to use a method of contraception (including condom) at first sex. City-specific distinctions are found and discussed for each outcome. Programs seeking to reduce HIV and unintended pregnancy risk among urban youth need to undertake needs assessments to understand the local context that influences the timing and circumstances of first sex in each city/country-specific context. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Gender-Based Power and Couples' HIV Risk in Uttar Pradesh and Uttarakhand, North India

PubMed Central

Agrawal, Alpna; Bloom, Shelah S.; Suchindran, Chirayath; Curtis, Sian; Angeles, Gustavo

2015-01-01

Context Gender inequality is a long-recognized driver of the HIV epidemic. However, few studies have investigated the association between gender-based power and HIV risk in India, which has the world's third largest HIV epidemic. Methods Population-based data collected in 2003 from 3,385 couples residing in Uttar Pradesh and Uttarakhand, North India, were used to examine associations between gender-based power (wife's autonomy and husband's inequitable gender attitudes) and indicators of couples' HIV risk (whether the husband had had premarital sex with someone other than his eventual spouse, extramarital sex in the past year or STI symptoms in the past year). Structural equation modeling was used to create composite variables for the gender-based power measures and test their associations with HIV risk measures. Results Twenty-four percent of husbands had had premarital sex, 7% had had extramarital sex in the past year and 6% had had STI symptoms in the past year. Structural equation models indicated that wives who reported higher levels of autonomy were less likely than other wives to have husbands who had had extramarital sex in the past year (direct association) and STI symptoms in the past year (indirect association). Moreover, husbands who endorsed more inequitable gender attitudes were more likely than others to report having had premarital sex with someone other than their spouse, which in turn was associated with having had extramarital sex and STI symptoms in the past year. Conclusions If the associations identified in this study reflect a causal relationship between gender-based power and HIV risk behavior, then HIV prevention programs that successfully address inequitable gender roles may reduce HIV risks in North India. PMID:25565347

Gender-based power and couples' HIV risk in Uttar Pradesh and Uttarakhand, north India.

PubMed

Agrawal, Alpna; Bloom, Shelah S; Suchindran, Chirayath; Curtis, Siân; Angeles, Gustavo

2014-12-01

Gender inequality is a long-recognized driver of the HIV epidemic. However, few studies have investigated the association between gender-based power and HIV risk in India, which has the world's third largest HIV epidemic. Population-based data collected in 2003 from 3,385 couples residing in Uttar Pradesh and Uttarakhand, North India, were used to examine associations between gender-based power (wife's autonomy and husband's inequitable gender attitudes) and indicators of couples' HIV risk (whether the husband had had premarital sex with someone other than his eventual spouse, extramarital sex in the past year or STI symptoms in the past year). Structural equation modeling was used to create composite variables for the gender-based power measures and test their associations with HIV risk measures. Twenty-four percent of husbands had had premarital sex, 7% had had extramarital sex in the past year and 6% had had STI symptoms in the past year. Structural equation models indicated that wives who reported higher levels of autonomy were less likely than other wives to have husbands who had had extramarital sex in the past year (direct association) or STI symptoms in the past year (indirect association). Moreover, husbands who endorsed more inequitable gender attitudes were more likely than others to report having had premarital sex with someone other than their spouse, which in turn was associated with having had extramarital sex and STI symptoms in the past year. If the associations identified in this study reflect a causal relationship between gender-based power and HIV risk behavior, then HIV prevention programs that successfully address inequitable gender roles may reduce HIV risks in North India.

'Disrespectful men, disrespectable women': men's perceptions on heterosexual relationships and premarital sex in a Sri Lankan Free Trade Zone - a qualitative interview study.

PubMed

Jordal, Malin; Wijewardena, Kumudu; Öhman, Ann; Essén, Birgitta; Olsson, Pia

2015-02-07

Gender norms have been challenged by unmarried rural women's migration for employment to urban Sri Lankan Free Trade Zones (FTZ). Men are described as looking for sexual experiences among the women workers, who are then accused of engaging in premarital sex, something seen as taboo in this context. Increased sexual and reproductive health and rights (SRHR) risks for women workers are reported. To improve SRHR it is important to understand the existing gender ideals that shape these behaviours. This qualitative study explores men's perspectives on gender relations in an urban Sri Lankan FTZ, with a focus on heterosexual relationships and premarital sex. Further, possible implications for SRHR of women workers in FTZs are discussed. Eighteen qualitative semi-structured interviews were conducted with men living or working in an urban Sri Lankan FTZ and were analysed using thematic analysis. Two conflicting constructions of masculinity; the 'disrespectful womaniser' and the 'respectful partner', were discerned. The 'disrespectful womaniser' was perceived to be predominant and was considered immoral while the 'respectful partner' was considered to be less prevalent, but was seen as morally upright. The migrant women workers' moral values upon arrival to the FTZ were perceived to deteriorate with time spent in the FTZ. Heterosexual relationships and premarital sex were seen as common, however, ideals of female respectability and secrecy around premarital sex were perceived to jeopardize contraceptive use and thus counteract SRHR. The 'disrespectful' masculinity revealed in the FTZ is reflective of the patriarchal Sri Lankan society that enables men's entitlement and sexual domination over women. Deterioration of men's economic power and increase of women's economic and social independence may also be important aspects contributing to men's antagonistic attitudes towards women. The promotion of negative attitudes towards women is normalized through masculine peer pressure. This and ambivalence towards women's premarital sex are undermining the SRHR and well-being of women, but also men, in the FTZ. Awareness and counteraction of destructive gender power relations are essential for the improvement of the SRHR of women and men in the FTZ and the surrounding society.

The effect of school status and academic skills on the reporting of premarital sexual behavior: evidence from a longitudinal study in rural Malawi.

PubMed

Soler-Hampejsek, Erica; Grant, Monica J; Mensch, Barbara S; Hewett, Paul C; Rankin, Johanna

2013-08-01

Reliable data on sexual behavior are needed to identify adolescents at risk of acquiring human immunodeficiency virus or other sexually transmitted diseases, as well as unintended pregnancies. This study aimed to investigate whether schooling status and literacy and numeracy skills affect adolescents' reports of premarital sex, collected using audio computer-assisted self-interviews. We analyzed data on 2,320 participants in the first three rounds of the Malawi Schooling and Adolescent Study to estimate the level of inconsistency in reporting premarital sex among rural Malawian adolescents. We used multivariate logistic regressions to examine the relationships between school status and academic skills and premarital sexual behavior reports. Males were more likely than females to report premarital sex at baseline, whereas females were more likely than males to report sex inconsistently within and across rounds. School-going females and males were more likely to report never having had sex at baseline and to retract reports of ever having sex across rounds than were their peers who had recently left school. School-going females were also more likely to report sex inconsistently at baseline. Literate and numerate respondents were less likely to report sex inconsistently at baseline; however, they were more likely to retract sex reports across rounds. The level of inconsistency both within a survey round and across rounds reflects the difficulties in collecting reliable sexual behavior data from young people in settings such as rural Malawi, where education levels are low and sex among school-going females is not socially accepted. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Premarital relationships and livelihoods in Ghana.

PubMed

Ankomah, A

1996-10-01

This study is based on interviews with a sample of 400 single women aged 18-25 years from the Fante ethnic group in Cape Coast, Ghana, in 1991, and on focus groups. This case study illustrates the importance of economic and living arrangement support expected from partners in premarital relationships. Support may be for living and maintenance ('chopmoney', provisions, household items, and rent); for financial security (provision of capital); and for clothing and hairdressing. Women did not always require economic support in premarital relationships. Women expect boyfriends to provide 'chopmoney' (money for food and general upkeep) and contribute some money for the rent. Only 36% of sexually active women expected their boyfriends to supply food provisions. Premarital sexual relationships are used to obtain start-up capital. The author refers to evidence that senior government officials engaged in sexual transactions with clients before loans and credit facilities were offered. 87% of sexually experienced women expected their partners to pay for at least part of clothing expenses. The study revealed that there was considerable disparity between women's expectations and actual receipt of economic support. 56% desired, but only 36% received, 'chopmoney' in full. 40% expected their partners to pay for household furnishings in full, while only 10% did so. 55% expected capital, but only 15% received it. The three most frequently received benefits in full were hair dressing, shoes, and dresses. Men provided most non-negotiable items as a means of "boosting their egos." Many young women rely on the support of men in order to improve their status. Ghanaian men control financial resources and economic power. Mothers of adolescent daughters encourage premarital sexual behavior. Prostitution is considered different from sexual exchange relationships. It is argued that gender inequalities and domestic abuse are perpetuated through sexual exchange relationships.

The influence of parents' marital quality on adult children's attitudes toward marriage and its alternatives: main and moderating effects.

PubMed

Cunningham, Mick; Thornton, Arland

2006-11-01

Drawing on a panel study of parents and children, we investigate linkages between parents' marital quality and adult children's attitudes toward a range of family issues, including premarital sex, cohabitation, lifelong singlehood, and divorce. We hypothesize that parents' marital quality will be negatively related to children's support for these behaviors in adulthood and that parents' marital quality will condition the intergenerational transmission of attitudes toward these issues. We find some evidence that parents' marital quality influences children's support for divorce and premarital sex. More important, our analyses show that parents' marital quality facilitates the intergenerational transmission of attitudes. Parents' attitudes toward premarital sex, cohabitation, and being single are more strongly linked to those same attitudes among their young adult children when parents' marital quality is high than when it is low.

Reassessing the Link Between Premarital Cohabitation and Marital Instability

PubMed Central

REINHOLD, STEFFEN

2010-01-01

Premarital cohabitation has been found to be positively correlated with the likelihood of marital dissolution in the United States. To reassess this link, I estimate proportional hazard models of marital dissolution for first marriages by using pooled data from the 1988, 1995, and 2002 surveys of the National Survey of Family Growth (NSFG). These results suggest that the positive relationship between premarital cohabitation and marital instability has weakened for more recent birth and marriage cohorts. Using multiple marital outcomes for a person to account for one source of unobserved heterogeneity, panel models suggest that cohabitation is not selective of individuals with higher risk of marital dissolution and may be a stabilizing factor for higher-order marriages. Further research with more recent data is needed to assess whether these results are statistical artifacts caused by data weaknesses in the NSFG. PMID:20879685

Knowledge, Attitude and Practice of Carrier Thalassemia Marriage Volunteer in Prevention of Major Thalassemia.

PubMed

Karimzaei, Tahmineh; Masoudi, Qolamreza; Shahrakipour, Mahnaz; Navidiyan, Ali; Jamalzae, Abd Al-Qaffar; Zoraqi Bamri, Ahmad

2015-06-09

Thalassemia is the most common genetic disorder and rising in the world as a health problem. Due to the criticality of this disease, in our country thalassemia prevention programs are more importance. The aim of this study was investigation of knowledge, attitude and behavior of marrying partners who were thalassemia genetic carriers in prevention of the birth of the children with major thalassemia. This study was a descriptive-analytic study. Data collection tool was a self-administered questionnaire that included 43 items. The content validity of questionnaire was investigated under the supervision of physicians, experts of health education and promotion. Its reliability was confirmed by Cronbach's Alpha test. The subjects in the study consisted of 100 marrying partners who were genetic carriers of thalassemia who referred to Premarital Counseling Center in Iranshahr City. Iranshahr is a a large city of Sistan and Balouchestan Province that located in southeast of Iran. The subjects were selected by convenience non-probability sampling method. Data analyzed using descriptive and analytic statistical tests in SPSS 16.00 and level of significance considered on α<0.05. The average age of men and women that participated in this study was 21.92 and 24 years respectively. 88% of the partners had familial relationships. The educational level of most of the men (34%) was diploma and of women (44%) was pre-diploma. The research findings showed that 7% and 62% of the subjects had poor and mediocre levels of knowledge respectively. Also results showed that only 13% of them had a satisfactory behavior and educational status had a positive correlation with knowledge, behavior, perceived susceptibility and perceived severity (P<0.05). As well there was a significant statistical relationship between gender and familial relationship, and the perceived barriers of participants. (p=0.01). The survey viewpoint of participants showed that they believed knowledge increasing (40%), genetic counseling (33%) and premarital screening (27%) were the most important strategies for prevention of thalassemia. The perceived barriers were the strongest predictors for preventive behaviors of incidence of major thalassemia in marrying partners, therefor educational interventions should focused on perceived barriers removing in Volunteer marrying partners.

Television and adolescent sexuality.

PubMed

Brown, J D; Childers, K W; Waszak, C S

1990-01-01

Existing studies of the sexual content of television programming and advertising and the effects of this content on adolescent viewers are reviewed. Content studies show that the frequency of sexual references have increased in the past decade and are increasingly explicit. Studies of the effects of this content, while scarce, suggest that adolescents who rely heavily on television for information about sexuality will have high standards of female beauty and will believe that premarital and extramarital intercourse with multiple partners is acceptable. They are unlikely to learn about the need for contraceptives as a form of protection against pregnancy or disease. Suggestions for future research and trends in television programming policies are explored.

Arranging marriage; negotiating risk: genetics and society in Qatar.

PubMed

Kilshaw, Susie; Al Raisi, Tasneem; Alshaban, Fouad

2015-01-01

This paper considers how the globalized discourse of genetic risk in cousin marriage is shaped, informed and taken up in local moral worlds within the context of Qatar. This paper investigates the way Qataris are negotiating the discourse on genetics and risk. It is based on data from ongoing ethnographic research in Qatar and contributes to anthropological knowledge about this understudied country. Participants were ambivalent about genetic risks and often pointed to other theories of causation in relation to illness and disability. The discourse on genetic risk associated with marrying in the family was familiar, but for some participants the benefits of close marriage outweighed potential risks. Furthermore, the introduction of mandatory pre-marital screening gave participants confidence that risks were monitored and minimized.

The Relationship Context of Premarital Serial Cohabitation

PubMed Central

Cohen, Jessica; Manning, Wendy

2011-01-01

Even though serial cohabitation is on the rise, it has not been integrated into recent family research. We analyze the National Survey of Family Growth (NSFG) cycle 6 to explore the relationship context of serial cohabitation for women throughout emerging adulthood (N=3,397). We provide a relationship context for serial cohabitation by examining the age at first cohabitation, duration of cohabiting unions, marital expectations and transitions, as well as premarital sexual histories. Furthermore, we examine the change in these relationship indicators across women’s birth cohorts. We find that serial cohabitors’ co-residential unions are about the same duration as single-instance cohabiting unions. Serial cohabitors start cohabiting younger, report lower marital expectations than single-instance cohabitors and a smaller proportion marry before age 30. Women who have more premarital sex partners have significantly greater odds of serial cohabiting. These findings indicate that women face increasingly complex relationship trajectories during emerging adulthood. PMID:24381370

Old Ideals and New Realities: The Changing Context of Adolescent Partnerships in Cebu, Philippines

PubMed Central

Gultiano, Socorro A.; Avila, Josephine L.; Hindin, Michelle J.

2014-01-01

The Philippines has experienced rapid sociodemographic changes in recent years, with implications for adolescents. This study combines quantitative and qualitative data from Metro Cebu to assess the timing and predictors of adolescent partnerships, as well as the context in which these partnerships are occurring. The majority of adolescents (54%) had premarital sex, though this pattern varied by gender. Wealthier, urban men, and women with less education and lower reported religiosity, were more likely to have premarital sex. Engagement in risk behaviors was predictive of premarital sex for both males and females. The qualitative data contextualize the circumstances under which adolescents engage in sex and form partnerships, and illustrate how sociocultural norms contribute to gender differences in partnership patterns. Given the ‘new’ realities of young Filipinos’ lives, targeted efforts to support adolescents’ transition to adulthood are needed to avert potentially adverse lifeevents. PMID:22587636

Social Exchange and Sexual Behavior in Young Women's Premarital Relationships in Kenya.

PubMed

Luke, Nancy; Goldberg, Rachel E; Mberu, Blessing U; Zulu, Eliya M

2011-10-01

Transactional sex, or the exchange of money and gifts for sexual activities within nonmarital relationships, has been widely considered a contributing factor to the disproportionate prevalence of HIV/AIDS among young women in sub-Saharan Africa. This study applied social exchange theory to premarital relationships in order to investigate the linkages between a variety of young women's resources-including employment and material transfers from male partners-and sexual behaviors. Data on the first month of premarital relationships (N=551 relationships) were collected from a random sample of young adult women ages 18-24 in Kisumu, Kenya, using a retrospective life history calendar. Consistent with the hypotheses, results showed that young women's income increases the likelihood of safer sexual activities, including delaying sex and using condoms consistently. Material transfers from the male partner displayed the opposite effect, supporting the view that resources obtained from within the relationship decrease young women's negotiating power.

Can Marriage Education Mitigate the Risks Associated with Premarital Cohabitation?

PubMed Central

Rhoades, Galena K.; Stanley, Scott M.; Markman, Howard J.; Allen, Elizabeth S.

2015-01-01

This study tested whether relationship education (i.e., the Prevention and Relationship Education Program; PREP) can mitigate the risk of having cohabited before making a mutual commitment to marry (i.e., “pre-commitment cohabitation”) for marital distress and divorce. Using data from a study of PREP for married couples in the U.S. Army (N = 662 couples), we found that there was a significant association between pre-commitment cohabitation and lower marital satisfaction and dedication before random-assignment to intervention. After intervention, this pre-commitment cohabitation effect was only apparent in the control group. Specifically, significant interactions between intervention condition and cohabitation history indicated that for the control group, but not the PREP group, pre-commitment cohabitation was associated with lower dedication as well as declines in marital satisfaction and increases in negative communication over time. Further, those with pre-commitment cohabitation were more likely to divorce by the two-year follow up only in the control group; there were no differences in divorce based on premarital cohabitation history in the PREP group. These findings are discussed in light of current research on cohabitation and relationship education; potential implications are also considered. PMID:25938709

A Knowledge, Attitudes and Practices Survey regarding Sex, Contraception and Sexually Transmitted Diseases among Commerce College Students in Mumbai.

PubMed

Mutha, Amit S; Mutha, Sonali A; Baghel, Paritosh J; Patil, Ramanand J; Bhagat, Sagar B; Patel, Sadiq B; Watsa, Mahinder C

2014-08-01

One in four Indians is a juvenile. Sexual crimes, pre marital sex, sexually transmitted diseases and unwanted pregnancies are on the rise. It has been shown that lack of sexuality education can significantly contribute to the above. We conducted this study to determine the knowledge and awareness of college students regarding sex and related matters and the factors affecting the prevalent outlook and practices of youth towards the same. A prospective cross-sectional survey was conducted amongst 500 students of the K.P.B. Hinduja College of Commerce from December 2012 to March 2013 as per the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. 1. Sex knowledge scores of males and females regarding contraception, sexually transmitted diseases and HIV/AIDS. 2. Percentage response of males and females to questions depicting attitudes and perceptions regarding premarital sex and promiscuity, sexual fantasy and masturbation, unwanted pregnancies and contraception. 3. Responses depicting participant's premarital and high risk sexual activities. The mean age was 18.6 ±1.6 years, 46% of participants were female. The total sex related knowledge scores of males and females were 8.2±1.2 and 6.2±2.4 (p<0.0001), respectively. 84% males and 72% females disagree that virginity should be preserved till marriage. Premarital sex was reported by 48% males and 18% females. Out of those who had premarital sex, 68% males and none of the females had more than one sex partner and 21% males and 12% females had used a contraceptive during their sexual encounter. 87% males and 82% females disagree that sex education in secondary schools will cause a rise in premarital intercourse. 40% males and 13% females are of the view that birth control is primarily a female's responsibility. 14% of males and 21% of females (p = 0.2) reported being forced to have sex. Participants, especially females, lacked basic information about sexuality and related concepts. Male participants had a very casual attitude towards having sex with multiple partners. Premarital sex is more common than once believed. In the light of our finds and the current scenario, sexuality education is indispensable in order to guide the youth to develop and adopt healthy and appropriate sexual practices.

A Knowledge, Attitudes and Practices Survey regarding Sex, Contraception and Sexually Transmitted Diseases among Commerce College Students in Mumbai

PubMed Central

Mutha, Sonali A; Baghel, Paritosh J; Patil, Ramanand J; Bhagat, Sagar B; Patel, Sadiq B; Watsa, Mahinder C

2014-01-01

Introduction: One in four Indians is a juvenile. Sexual crimes, pre marital sex, sexually transmitted diseases and unwanted pregnancies are on the rise. It has been shown that lack of sexuality education can significantly contribute to the above. Aim: We conducted this study to determine the knowledge and awareness of college students regarding sex and related matters and the factors affecting the prevalent outlook and practices of youth towards the same. Methodology: A prospective cross-sectional survey was conducted amongst 500 students of the K.P.B. Hinduja College of Commerce from December 2012 to March 2013 as per the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Main Outcome Measures: 1. Sex knowledge scores of males and females regarding contraception, sexually transmitted diseases and HIV/AIDS. 2. Percentage response of males and females to questions depicting attitudes and perceptions regarding premarital sex and promiscuity, sexual fantasy and masturbation, unwanted pregnancies and contraception. 3. Responses depicting participant’s premarital and high risk sexual activities. Results: The mean age was 18.6 ±1.6 years, 46% of participants were female. The total sex related knowledge scores of males and females were 8.2±1.2 and 6.2±2.4 (p<0.0001), respectively. 84% males and 72% females disagree that virginity should be preserved till marriage. Premarital sex was reported by 48% males and 18% females. Out of those who had premarital sex, 68% males and none of the females had more than one sex partner and 21% males and 12% females had used a contraceptive during their sexual encounter. 87% males and 82% females disagree that sex education in secondary schools will cause a rise in premarital intercourse. 40% males and 13% females are of the view that birth control is primarily a female’s responsibility. 14% of males and 21% of females (p = 0.2) reported being forced to have sex. Conclusion: Participants, especially females, lacked basic information about sexuality and related concepts. Male participants had a very casual attitude towards having sex with multiple partners. Premarital sex is more common than once believed. In the light of our finds and the current scenario, sexuality education is indispensable in order to guide the youth to develop and adopt healthy and appropriate sexual practices. PMID:25302214

Contextual influence of Taiwanese adolescents' sexual attitudes and behavioral intent.

PubMed

Chen, Angela Chia-Chen; Neilands, Torsten B; Chan, Shu-Min; Lightfoot, Marguerita

2016-09-01

This study examined parental, peer, and media influences on Taiwanese adolescents' attitudes toward premarital sex and intent to engage in sexual behavior. Participants included a convenience sample of 186 adolescents aged 13-15 recruited from two middle schools in Taiwan. Parental influence was indicated by perceived parental disapproval toward premarital sex and perceived peer sexual behavior was used to measure peer influence. Media influence was measured by the adolescents' perception of whether the media promotes premarital sex. We conducted structural equation modeling to test a hypothesized model. The findings suggested that the perceived sexual behavior of peers had the strongest effect on Taiwanese adolescents' sexual attitudes and behavioral intent, while parental disapproval and media influence also significantly contributed to adolescents' sexual attitudes and intent to engage in sex. School nurses are in an ideal position to coordinate essential resources and implement evidence-based sexually transmitted infection and HIV/AIDS prevention interventions that address issues associated with the influence of parents, peers, and media. © 2016 John Wiley & Sons Australia, Ltd.

Factors associated with attitude toward premarital sexual activities among school-going adolescents in Kelantan, Malaysia.

PubMed

Rahman, Azriani Abdul; Rahman, Razlina Abdul; Ismail, Shaiful Bahari; Ibrahim, Mohd Ismail; Ali, Siti Hawa; Salleh, Halim; Wan Muda, Wan Abdul Manan

2015-03-01

The objective of this cross-sectional study was to determine the factors associated with the attitudes toward premarital sexual activities among school-going adolescents in Kelantan, Malaysia. It was conducted among 1032 secondary school students using a self-administered validated questionnaire. Multiple logistic regression revealed that the risk factors for having permissive attitudes toward practice of premarital sexual activities were male students (odds ratio [OR] = 1.83; 95% confidence interval [CI] = 1.34-2.48), being less religious (OR = 2.02; 95% CI = 1.49-2.73), and younger age group of students (13 to 14 years old; OR = 1.42; 95% CI = 1.05-1.92). Having good knowledge on sexual and reproductive health was a protective factor against permissive sexual attitude (OR = 0.27; 95% CI = 0.20-0.36). In conclusion, male and young adolescents were at risk of having permissive attitudes toward sexual behaviors, but good knowledge on sexual and reproductive health and being more religious may protect them from it. © 2012 APJPH.

Premarital mental disorders and physical violence in marriage: cross-national study of married couples

PubMed Central

Miller, Elizabeth; Breslau, Joshua; Petukhova, Maria; Fayyad, John; Green, Jennifer Greif; Kola, Lola; Seedat, Soraya; Stein, Dan J.; Tsang, Adley; Viana, Maria Carmen; Andrade, Laura Helena; Demyttenaere, Koen; de Girolamo, Giovanni; Haro, Josep Maria; Hu, Chiyi; Karam, Elie G.; Kovess-Masfety, Viviane; Tomov, Toma; Kessler, Ronald C.

2011-01-01

Background Mental disorders may increase the risk of physical violence among married couples. Aims To estimate associations between premarital mental disorders and marital violence in a cross-national sample of married couples. Method A total of 1821 married couples (3642 individuals) from 11 countries were interviewed as part of the World Health Organization's World Mental Health Survey Initiative. Sixteen mental disorders with onset prior to marriage were examined as predictors of marital violence reported by either spouse. Results Any physical violence was reported by one or both spouses in 20% of couples, and was associated with husbands' externalising disorders (OR = 1.7, 95% CI 1.2-2.3). Overall, the population attributable risk for marital violence related to premarital mental disorders was estimated to be 17.2%. Conclusions Husbands' externalising disorders had a modest but consistent association with marital violence across diverse countries. This finding has implications for the development of targeted interventions to reduce risk of marital violence. PMID:21778172

Social Exchange and Sexual Behavior in Young Women’s Premarital Relationships in Kenya

PubMed Central

Luke, Nancy; Goldberg, Rachel E.; Mberu, Blessing U.; Zulu, Eliya M.

2011-01-01

Transactional sex, or the exchange of money and gifts for sexual activities within nonmarital relationships, has been widely considered a contributing factor to the disproportionate prevalence of HIV/AIDS among young women in sub-Saharan Africa. This study applied social exchange theory to premarital relationships in order to investigate the linkages between a variety of young women’s resources—including employment and material transfers from male partners—and sexual behaviors. Data on the first month of premarital relationships (N=551 relationships) were collected from a random sample of young adult women ages 18–24 in Kisumu, Kenya, using a retrospective life history calendar. Consistent with the hypotheses, results showed that young women’s income increases the likelihood of safer sexual activities, including delaying sex and using condoms consistently. Material transfers from the male partner displayed the opposite effect, supporting the view that resources obtained from within the relationship decrease young women’s negotiating power. PMID:22180665

Nonmarital Childbearing, Union History, and Women's Health at Midlife*

PubMed Central

Williams, Kristi; Sassler, Sharon; Frech, Adrianne; Addo, Fenaba; Cooksey, Elizabeth

2011-01-01

Despite high rates of nonmarital childbearing in the U.S., little is known about the health of women who have nonmarital births. We use data from the NLSY79 to examine differences in age 40 self-assessed health between women who had a premarital birth and those whose first birth occurred within marriage. We then differentiate women with a premarital first birth according to their subsequent union histories and estimate the effect of marrying or cohabiting versus remaining never-married on midlife self-assessed health, paying particular attention to the paternity status of the mother's partner and the stability of marital unions. To partially address selection bias, we employ multivariate propensity score techniques. Results suggest that premarital childbearing is negatively associated with midlife health for white and black (but not Hispanic) women. We find no evidence that these negative health consequences of nonmarital childbearing are mitigated by either marriage or cohabitation for black women. For other women, only enduring marriage to the biological father is associated with better health than remaining unpartnered. PMID:22199398

Acceptance of premarital health counseling in riyadh city, 1417h.

PubMed

Al-Kahtani, N H

2000-05-01

Health counseling before marriage can be a most worthwhile and satisfying aspect of preventive medicine. It is important in genetic diagnosis and the prevention of hereditary, sexually transmitted and other infectious diseases. To determine the acceptance of the concept of Premarital Health Counseling (PMHC), and to identify some factors, which may efect this acceptance among Saudis who attend Primary Health Care Center in Riyadh, Kingdom of Saudi Arabia (KSA), 1417H. The present study is a cross-sectional one with a selected sample of Saudis who attended the Primary Health Care Centers in Riyadh during the year 1417H. A multistage sampling and equal allocation stratified sampling within was used to select 484 persons comprising an equal number of males and females, married and single above the age of 18 years. A pre-designed pre-tested questionnaire sheet was used to collect the required data, which were then tabulated and statistically analyzed. The study indicated that 364 (75.2%) of the study population accepted the concept of Premarital Health Counseling. PMHC was positively affected by the advancing age, experience of marriage, educational level and well-understood Islamic-health related issues. Out f those who accepted the concept, 273 (75%) agreed on the exchange of PMHC certificates between couples to be married and 152 (42%) agreed on the implementation of legislation on PMHC. Also, 298 (82%) of them wanted PMHC to be confidential and 168 (46%) agreed to the concept despite its cost. As regards the location of PMHC, most of participants who agreed to PMHC would prefer it to be given at governmental establishments. The study recommended the implementation of PMHC in Saudi Arabia, since it was accepted by the study population. However, further studies should be carried out to determine the details to be incorporated in the PMHC, their implementation and legislation on demographic basis of the Saudi community. Also, a community health education program for PMHC has to be devised in collaboration with Islamic leaders.

Incidence and molecular characterization of Glucose-6-Phosphate Dehydrogenase deficiency among neonates for newborn screening in Chaozhou, China.

PubMed

Yang, H; Wang, Q; Zheng, L; Zhan, X-F; Lin, M; Lin, F; Tong, X; Luo, Z-Y; Huang, Y; Yang, L-Y

2015-06-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is highly prevalent in southern China. The aim of this study is to assess the extent of this disease in Chinese neonates and determine its molecular characteristics using a novel molecular screening method. A total of 2500 neonates were routinely screened for G6PD deficiency using a modified fluorescent spot test (FST). PCR-high-resolution melting (HRM) analysis was then used for the molecular assay. The overall incidence of G6PD deficiency was 2.68% in our study cohort. Frequency in male population was 3.22% (44 neonates of 1365 male neonates), and in female population was 2.03% (23 neonates of 1135 female neonates). Of the 67 newborns suspected to be G6PD deficient based on FST (44 males, 23 females), 58 of 67 (87%) were detected with gene alterations. Seven kinds of mutations [c.95A>G, c.392G>T, c.493A>G, c.871G>A, c.1360C>T, c.1376G>T, and c.1388G>A] were identified by HRM analysis. Routine newborn screening in Chaozhou, China with a relatively high prevalence of G6PD deficiency is justified and meets the World Health Organization recommendation. The usage of molecular diagnosis can favor the detection of heterozygotes which can be a supplement to regular newborn screening and useful for premarital and prenatal diagnosis for G6PD deficiency. © 2014 John Wiley & Sons Ltd.

Premarital sexual experience and preferred sources of reproductive health information among young men in Kumbotso, northern Nigeria.

PubMed

Iliyasu, Z; Zubairu, I; Abubakar, I S; Isa, S A; Galadanci, H S; Hadiza, S G; Babam Maryam, A; Babam-Maryam, A; Aliyu, M H; Muktar, H A

2012-01-01

Despite well known risks associated with unprotected premarital sex, this phenomenon has not been well explored among young men in rural northern Nigeria. We studied the predictors of premarital sex and preferred sources of sexual and reproductive health information among young unmarried men in Kumbotso, northern Nigeria. A cross section of 400 young men were interviewed using structured questionnaires with mostly closed ended questions. Of the 385 respondents, 39 (10.1%) were sexually experienced. Less than half of respondents (48.7%) used a condom at sexual debut, and an equal proportion reported having multiple sex partners. Only 41.0% of sexually experienced respondents reported subsequent consistent condom use Age (adjusted odds ratio [AOR] = 4.12; 95% confidence interval (CI): 2.24-5.20 and educational attainment [AOR = 3.57; 95% CI (1.49-9.10)] were significant predictors of sexual experience. The current versus preferred sources of sexual and reproductive health information included friends (51.3% vs. 93.3%), Islamic school teachers (41.0% vs. 72.7%) and school teachers (8.8% vs. 15.1%). Although the prevalence of premarital sex among young men in this community in northern Nigeria as low, those that did engage in such activity were likely to not use condoms and to have multiple partners. Preferred and trusted sources of information included peers and religious leaders. The findings in this study could be used to develop innovative strategies for reaching young men with accurate sexual and reproductive health information.

Sexual behavior among university students in Nigera.

PubMed

Soyinka, F

1979-01-01

Sexual behavior patterns among Nigerian university students and factors influencing them were studied. While permarital cohabitation is common, a large percentage (48%) had their first coital experience between the ages of 22 and 27. Religion does not appear to have a strong inhibiting influence on premarital sex, although it does affect the frequency of changing partners. Contraceptives, although known to almost all the respondents, are not widely used. The use of contraceptives had little influence on premarital cohabitation. Oral-genital, male-male, and female-female sexual practices are very uncommon.

Acceptability of HIV/AIDS testing among pre-marital couples in Iran (2012)

PubMed Central

Ayatollahi, Jamshid; Nasab Sarab, Mohammad Ali Bagheri; Sharifi, Mohammad Reza; Shahcheraghi, Seyed Hossein

2014-01-01

Background: Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) is a lifestyle-related disease. This disease is transmitted through unprotected sex, contaminated needles, infected blood transfusion and from mother to child during pregnancy and delivery. Prevention of infection with HIV, mainly through safe sex and needle exchange programmes is a solution to prevent the spread of the disease. Knowledge about HIV state helps to prevent and subsequently reduce the harm to the later generation. The purpose of this study was to assess the willingness rate of couples referred to the family regulation pre-marital counselling centre for performing HIV test before marriage in Yazd. Patients and Methods: In this descriptive study, a simple random sampling was done among people referred to Akbari clinic. The couples were 1000 men and 1000 women referred to the premarital counselling centre for pre-marital HIV testing in Yazd in the year 2012. They were in situations of pregnancy, delivery or nursing and milking. The data were analyzed using Statistical Package for the Social Sciences (SPSS) software and chi-square statistical test. Results: There was a significant statistical difference between the age groups about willingness for HIV testing before marriage (P < 0.001) and also positive comments about HIV testing in asymptomatic individuals (P < 0.001). This study also proved a significant statistical difference between the two gender groups about willingness to marry after HIV positive test of their wives. Conclusion: The willingness rate of couples to undergo HIV testing before marriage was significant. Therefore, HIV testing before marriage as a routine test was suggested. PMID:25114363

Acceptability of HIV/AIDS testing among pre-marital couples in Iran (2012).

PubMed

Ayatollahi, Jamshid; Nasab Sarab, Mohammad Ali Bagheri; Sharifi, Mohammad Reza; Shahcheraghi, Seyed Hossein

2014-07-01

Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) is a lifestyle-related disease. This disease is transmitted through unprotected sex, contaminated needles, infected blood transfusion and from mother to child during pregnancy and delivery. Prevention of infection with HIV, mainly through safe sex and needle exchange programmes is a solution to prevent the spread of the disease. Knowledge about HIV state helps to prevent and subsequently reduce the harm to the later generation. The purpose of this study was to assess the willingness rate of couples referred to the family regulation pre-marital counselling centre for performing HIV test before marriage in Yazd. In this descriptive study, a simple random sampling was done among people referred to Akbari clinic. The couples were 1000 men and 1000 women referred to the premarital counselling centre for pre-marital HIV testing in Yazd in the year 2012. They were in situations of pregnancy, delivery or nursing and milking. The data were analyzed using Statistical Package for the Social Sciences (SPSS) software and chi-square statistical test. There was a significant statistical difference between the age groups about willingness for HIV testing before marriage (P < 0.001) and also positive comments about HIV testing in asymptomatic individuals (P < 0.001). This study also proved a significant statistical difference between the two gender groups about willingness to marry after HIV positive test of their wives. The willingness rate of couples to undergo HIV testing before marriage was significant. Therefore, HIV testing before marriage as a routine test was suggested.

Risky sexual behavior among rural female adolescents in Malaysia: a limited role of protective factors.

PubMed

Ahmadian, Maryam; Hamsan, Hanina H; Abdullah, Haslinda; Samah, Asnarulkhadi Abu; Noor, Amna Md

2014-03-23

This paper presents the findings of a cross-sectional survey on the risk and protective factors of premarital sexual behavior among rural female adolescents in Peninsular Malaysia. We investigated data on 770 female respondents aged 13-17 years in rural areas to identify predictive factors for premarital sexual intercourse. Data were analyzed using bivariate and multivariate regression. Specific socio-demographic factors, psychological and family domains, peer delinquency, and knowledge and attitudes about sexuality were considered in risky sexual behaviors in rural Malay girls. The effects of other covariates for premarital sexual intercourse were controlled by logistic regression model. Of the 770 rural female students, about 3.2% of respondents reported experience of sexual intercourse in the past three months. Out of those sexually active girls, 36% were 17 years old and 20% stated having sexual intercourse with more than one partner, and 72% did not use contraception during the most recent sexual intercourse. Midnight activities, peer-sexual disorder, self-evaluation, and attitude toward sexual health were significant predictors of sexual intercourse in rural girls in Malaysia. The finding highlights the impact of psychological factors and peer group influences on the challenges of premarital sexual behavior among rural girls and the notion of school-based sexual health education for adolescents. This study triggers other researchers take into account a comprehensive view of protective factors operating in adolescents' risky sexual behaviors in Asian culture seeing that family domain variables, unexpectedly, exerted no predicting influence on sexually active female teens in rural areas in Malaysia.

Parent-adolescent communication about premarital pregnancy.

PubMed

Jaccard, J; Dittus, P

1993-06-01

Studies conducted in the 1970s and 1980s on the impact of parent-teen communication on adolescent sexual behavior and contraceptive use generally failed to reveal any significant association. Although 30-60% of adolescents report some communication about sexuality with at least one parent, peers and printed material are identified as more valuable sources of information for decision making. No consistent relationship has been recorded between parental attitudes toward premarital sex (liberal or conservative) and their child's sexual behavior. The literature is limited, however, by serious gaps and methodological problems. Typically, researchers ask teenagers if they have engaged in discussions about sex or birth control with their parents and then correlate the finding with a measure of sexual or contraceptive behavior. Few studies have attempted to identify the content of these discussions (e.g., a mechanistic presentation of facts about reproduction versus an interactive exchange on the pros and cons of premarital intercourse) or acknowledge the complexity of the communication process. Also neglected has been the impact of the family context (e.g., the degree of cohesion or the structure of power relations) on the way in which information is presented and absorbed. Also absent has been any effort to elucidate why a given source of information is perceived, by the teenager, as useful. Finally, an emphasis on the teenager's perspective has led to a neglect of the impact of parental discomfort with discussions about sexuality and the identification of strategies to facilitate parent-child communication. Needed are multivariate research models that recognize the complex interplay among variables that shape premarital sexual behavior.

Risky Sexual Behavior among Rural Female Adolescents in Malaysia: A Limited Role of Protective Factors

PubMed Central

Ahmadian, Maryam; Hamsan, Hanina H.; Abdullah, Haslinda; Samah, Asnarulkhadi Abu; Noor, Amna Md

2014-01-01

Purpose: This paper presents the findings of a cross-sectional survey on the risk and protective factors of premarital sexual behavior among rural female adolescents in Peninsular Malaysia. Methods: We investigated data on 770 female respondents aged 13-17 years in rural areas to identify predictive factors for premarital sexual intercourse. Data were analyzed using bivariate and multivariate regression. Specific socio-demographic factors, psychological and family domains, peer delinquency, and knowledge and attitudes about sexuality were considered in risky sexual behaviors in rural Malay girls. The effects of other covariates for premarital sexual intercourse were controlled by logistic regression model. Results: Of the 770 rural female students, about 3.2% of respondents reported experience of sexual intercourse in the past three months. Out of those sexually active girls, 36% were 17 years old and 20% stated having sexual intercourse with more than one partner, and 72% did not use contraception during the most recent sexual intercourse. Midnight activities, peer-sexual disorder, self-evaluation, and attitude toward sexual health were significant predictors of sexual intercourse in rural girls in Malaysia. Conclusion: The finding highlights the impact of psychological factors and peer group influences on the challenges of premarital sexual behavior among rural girls and the notion of school-based sexual health education for adolescents. This study triggers other researchers take into account a comprehensive view of protective factors operating in adolescents’ risky sexual behaviors in Asian culture seeing that family domain variables, unexpectedly, exerted no predicting influence on sexually active female teens in rural areas in Malaysia. PMID:24762359

Global burden, distribution and prevention of β-thalassemias and hemoglobin E disorders.

PubMed

Colah, Roshan; Gorakshakar, Ajit; Nadkarni, Anita

2010-02-01

The β-thalassemias, including the hemoglobin E disorders, are not only common in the Mediterranean region, South-East Asia, the Indian subcontinent and the Middle East but have now become a global problem, spreading to much of Europe, the Americas and Australia owing to migration of people from these regions. Approximately 1.5% of the global population are heterozygotes or carriers of the β-thalassemias. While the overall frequencies of carriers of these disorders are known in most countries, there have been few attempts at micromapping and wherever this has been done, significant variations are seen even within small geographic regions. Thus, the figures for the estimated numbers of births each year of homozygous β-thalassemia and the severe compound states involving other hemoglobin disorders may be an underestimate. Screening strategies have varied from premarital to antenatal in different countries depending on socio-cultural and religious customs in different populations. Prenatal diagnosis programs are ongoing in many countries and the knowledge of the distribution of mutations has facilitated the establishment of successful control programs. Many of these were through North-South partnerships and networking. Yet, there are many countries in Asia where they are lacking, and South-South partnerships are now being developed in South-East Asia and the Indian subcontinent to link centers with expertise to centers where expertise needs to be developed. Although the carrier frequencies will remain unaltered, this will eventually help to bring down the burden of the birth of affected children with β-thalassemias and hemoglobin E disorders in Asia.

Abstinence education for urban youth.

PubMed

Carter-Jessop, L; Franklin, L N; Heath, J W; Jimenez-Irizarry, G; Peace, M D

2000-08-01

Teen sexual problems in the U.S. are reaching enormous proportions. Attempts to prevent common problems, pregnancy and sexually transmitted diseases, are underway through the persistent efforts of community, health, academic and government organizations. Abstinence education is one of the current attempts. However, the lack of well defined theoretical frameworks and analyses of outcomes have limited progress in the study of abstinence education. This article describes a pilot program in abstinence-only education provided to six groups of young teens within an urban middle school. The framework for the program, cognitive social learning theory, is described and operationalized. Student pretest-posttest attitudes, open-ended written comments about the program and the researchers' anecdotes about behavioral changes in the students are the outcome measures. Positive attitudes about premarital abstinence increased for all six groups; for four of the six groups the increase was statistically significant.

A new family programme in Zhejiang province.

PubMed

Xu, B

1994-04-01

Zhejiang Province in China has promoted a new family planning program since April 1993. The program stresses delayed marriage and childbearing, fewer and healthier births, modernization of family life, and prosperity through hard work. The people are receptive to the new program out of a desire for an improved standard of living. The objective is to build small, modern families who 1) practice deferred marriage and childbearing; 2) voluntarily practice family planning and have no unplanned births; 3) practice avoidance of consanguineous marriage, become sterilized if a carrier of a hereditary disease of chromosomal abnormality, and use premarital education and counseling and proper prenatal care; 4) uphold the laws and maintain discipline in action to avoid criminal behavior; 5) establish families that respect the old, care for children, and help their neighbors; 6) complete 9 years of compulsory education; and 7) create well being through hard work. The program is compatible with the strategy of the "three stresses" and an integrated approach. IEC and service provision are important components in program implementation. The target population are the masses and grassroots cadres, particularly those in the childbearing ages. IEC will be directed in different ways to different groups. Those aged 18-35 years will receive education. Face to face interaction with family planning workers and lectures will be directed to grassroots cadres. The mass media will be employed to reach the masses. The messages will include information and persuasion to adopt new families, accept family planning regulations, and learn about contraceptive use, healthy births and childrearing, education, health care, sex education, and income generation skills. Classes will be conducted for groups, such as teenagers, unmarried youth, pregnant women, and lactating women. Priority will be given to couples that accept the certificates for one child; favoritism will be granted for allocation of housing; acceptance in kindergartens and schools, employment, and military positions; and receipt of business licenses and poverty aide. Sterilization will be rewarded with longer paid leave and subsidies. Services will include contraceptive provision and follow-up, infertility treatment, gynecological check-ups, sex education, old age pensions, premarital counseling, and other quality services.

Promiscuous Girls, Good Wives, and Cheating Husbands: Gender Inequality, Transitions to Marriage, and Infidelity in Southeastern Nigeria

PubMed Central

Smith, Daniel Jordan

2013-01-01

The transition from premarital sexual relationships and courtship to marriage and parenthood in southeastern Nigeria involves particularly dramatic adjustments for young women who have absorbed changing ideas about sexuality, marriage, and gender equality, and who have had active premarital sexual lives. In the eyes of society, these women must transform from being promiscuous girls to good wives. This paper examines these adjustments and, specifically, how young married women’s lives are affected by the reality of male infidelity and a persistent gendered double standard regarding the acceptability of extramarital sex. PMID:24259752

First intercourse, contraception and first pregnancy in Flanders: changes during the past 30 years.

PubMed

Lodewijckx, E

1987-10-01

The investigation of women in Flanders born between 1931 and 1962 shows that premarital sexual intercourse has become almost general and that the age at the onset of sexual intercourse is steadily declining. Until the 1970s in spite of the improving contraceptive behavior of youngsters, the number of women experiencing premarital pregnancy increased and 1st conceptions occurred at an increasingly younger age. The 1970s marked a turning point: fewer women became pregnant before marriage or in adolescnece. From that time, the contraceptive revolution kept pace with the sexual revolution.

Promiscuous Girls, Good Wives, and Cheating Husbands: Gender Inequality, Transitions to Marriage, and Infidelity in Southeastern Nigeria.

PubMed

Smith, Daniel Jordan

2010-01-01

The transition from premarital sexual relationships and courtship to marriage and parenthood in southeastern Nigeria involves particularly dramatic adjustments for young women who have absorbed changing ideas about sexuality, marriage, and gender equality, and who have had active premarital sexual lives. In the eyes of society, these women must transform from being promiscuous girls to good wives. This paper examines these adjustments and, specifically, how young married women's lives are affected by the reality of male infidelity and a persistent gendered double standard regarding the acceptability of extramarital sex.

Prevalence and mutations of β-thalassemia trait and abnormal hemoglobins in premarital screening in Çanakkale province, Turkey

PubMed Central

Uludağ, A; Uludağ, A; Ertekin, YH; Tekin, M; Kütük, B; Silan, F; Özdemir, Ö

2016-01-01

Abstract The prevalence of β-thalassemia (β-thal) carriers in Turkey varies according to region but in general it is 2.0%. Çanakkale is a city in the Aegean region of Turkey but no study about β-thal frequency in Çanakkale has been published to date. In this study, we aimed to investigate the frequency of β-thal mutations in this province. A total of 4452 couples (8904 individuals) applied for premarital thalassemia scans at the Çanakkale State Health Directorate Laboratory between January 2008 and June 2012 and scanning was done with high performance liquid chromatography (HPLC). Of 125 β-thal carriers seen at the Medical Genetics Clinic, Çanakkale Onsekiz Mart University, Çanakkale, Turkey, for genetic counseling, 46 participated in the study. The remaining 79 patients could not be reached. The prevalence for β-thal carriers in Çanakkale was identified as 1.4% (125/8904). One couple were both β-thal carriers. β-Globin gene analysis of 46 carriers found the total frequency of the three most common mutations was 45.6%. These mutations were found to be HBB: c.93-21G>A [IVS-I-110 (G>A)], 26.08% (12/46); HBB: c.17_ 18delCT [codon 5 (‒CT)], 10.85% (5/46); HBB: c.20delA [codon 6 (‒A)] 8.69% (4/46). This is the first report on the frequency and mutation profiles of β-thal for Çanakkale. The incidence of β-thal carriers in Çanakkale is below the average for Turkey. The most frequently observed mutation profile and rate of β-thal in our region is different from the other regions of Turkey. PMID:27785405

Paradoxical attitudes toward premarital dating and sexual encounters in Tehran, Iran: a cross-sectional study.

PubMed

Motamedi, Mahnaz; Merghati-Khoei, Effat; Shahbazi, Mohammad; Rahimi-Naghani, Shahrzad; Salehi, Mehrdad; Karimi, Mehrdad; Hajebi, Ahmad; Khalajabadi-Farahani, Farideh

2016-08-30

The purpose of this study is to assess attitudes toward premarital dating and sexual encounters in individuals aged 15-49 years in Tehran. Utilizing the attitudes section of an original cross-sectional study (n = 755) aimed at assessing sexual health needs of adults, this paper examined personal attitudes towards premarital dating, non-sexual relationships and sexual encounters in both male and female adults aged between 15-49 years. Multi-stage cluster random sampling and a validated/reliable questionnaire were used. Descriptive, bivariate and multivariate analyses were conducted using statistical software. The results indicated that the majority of the participants were supportive of dating. Almost three-fourths of the males were more positively inclined towards non-sexual, yet tactile, affectionate interactions between unmarried males and females as opposed to only half of the females (70 % vs. 50.5 %). Also, males held significantly more liberal attitudes than females in their acceptance of premarital sex. On preserving virginity prior to marriage, 43 % of the males felt that it was important for a female to be a virgin, whereas only 26 % felt it was important for males to remain a virgin. Interestingly, more females (61 %) supported the importance of a female's virginity compared with the importance of males' virginity (48 %). This study showed that, being a male, of a younger age, single, and being less religious or being secular were important determinants of a liberal sexual attitude. These results might reflect a socio-cultural transition in the sexual attitudes of different age groups of participants - a phenomenon that will need empirical studies to unpack in the Iranian socio-cultural context.

Impact of Family Planning Health Education on the Knowledge and Attitude among Yasoujian Women

PubMed Central

Mahamed, Fariba; Parhizkar, Saadat; Shirazi, Alireza Raygan

2012-01-01

The aim of this study was to determine the effect of health education on the knowledge and attitude regarding family planning and contraception’s method among the women who obligatory attended the Premarital Counseling Center in Yasouj city, Iran. An experimental study was carried out and a total of 200 women were selected for the study using convenience sampling method among women who attended in the health centre in order to utilize the necessary premarital actions. Respondents were divided by two experimental and control groups randomly. A pre-evaluation was done on the knowledge and attitude on family planning using a structured questionnaire. After which, the health education for experimental group was done within four educational sessions during 4 consecutive weeks and control group underwent traditional education method. Post evaluation was utilized for any changes regarding their knowledge and attitude among the respondents immediately after the intervention. Independent and paired t-test was used to evaluate the mean knowledge and attitude scores differences among both groups. Results showed that there was a significant improvement in respondents’ knowledge and attitude after educational program in experimental group (p<0.001), while no significant difference was observed in knowledge and attitude of control group. The finding also indicated that age was significantly associated with the level of respondents’ knowledge. These results deal the effectiveness of the educational method. In conclusion, the educational method is effective in increasing the knowledge and improving the attitude of women regarding family planning in Yasouj compared to current used educational method. Future educational programs need to incorporate the features that have been associated with successful interventions in the past, as well as including their own evaluation procedures. PMID:22980158

Decreasing nonmarital births and strengthening marriage to reduce poverty.

PubMed

Amato, Paul R; Maynard, Rebecca A

2007-01-01

Since the 1970s, the share of U.S. children growing up in single-parent families has doubled, a trend that has disproportionately affected disadvantaged families. Paul Amato and Rebecca Maynard argue that reversing that trend would reduce poverty in the short-term and, perhaps more important, improve children's growth and development over the long term, thus reducing the likelihood that they would be poor when they grew up. The authors propose school and community programs to help prevent nonmarital births. They also propose to lower divorce rates by offering more educational programs to couples before and during marriage. Amato and Maynard recommend that all school systems offer health and sex education whose primary message is that parenthood is highly problematic for unmarried youth. They also recommend educating young people about methods to prevent unintended pregnancies. Ideally, the federal government would provide tested curriculum models that emphasize both abstinence and use of contraception. All youth should understand that unintended pregnancies are preventable and have enormous costs for the mother, the father, the child, and society. Strengthening marriage, argue the authors, is also potentially an effective strategy for fighting poverty. Researchers consistently find that premarital education improves marital quality and lowers the risk of divorce. About 40 percent of couples about to marry now participate in premarital education. Amato and Maynard recommend doubling that figure to 80 percent and making similar programs available for married couples. Increasing the number of couples receiving services could mean roughly 72,000 fewer divorces each year, or around 65,000 fewer children entering a single-parent family every year because of marital dissolution. After seven or eight years, half a million fewer children would have entered single-parent families through divorce. Efforts to decrease the share of children in single-parent households, say the authors, would almost certainly be cost effective in the long run and could reduce child poverty by 20 to 29 percent.

Judaism, genetic screening and genetic therapy.

PubMed

Rosner, F

1998-01-01

Genetic screening, gene therapy and other applications of genetic engineering are permissible in Judaism when used for the treatment, cure, or prevention of disease. Such genetic manipulation is not considered to be a violation of God's natural law, but a legitimate implementation of the biblical mandate to heal. If Tay-Sachs disease, diabetes, hemophilia, cystic fibrosis, Huntington's disease or other genetic diseases can be cured or prevented by "gene surgery," then it is certainly permitted in Jewish law. Genetic premarital screening is encouraged in Judaism for the purpose of discouraging at-risk marriages for a fatal illness such as Tay-Sachs disease. Neonatal screening for treatable conditions such as phenylketonuria is certainly desirable and perhaps required in Jewish law. Preimplantation screening and the implantation of only "healthy" zygotes into the mother's womb to prevent the birth of an affected child are probably sanctioned in Jewish law. Whether or not these assisted reproduction techniques may be used to choose the sex of one's offspring, to prevent the birth of a child with a sex-linked disease such as hemophilia, has not yet been ruled on by modern rabbinic decisions. Prenatal screening with the specific intent of aborting an affected fetus is not allowed according to most rabbinic authorities, although a minority view permits it "for great need." Not to have children if both parents are carriers of genetic diseases such as Tay-Sachs is not a Jewish option. Preimplantation screening is preferable. All screening test results must remain confidential. Judaism does not permit the alteration or manipulation of physical traits and characteristics such as height, eye and hair color, facial features and the like, when such change provides no useful benefit to mankind. On the other hand, it is permissible to clone organisms and microorganisms to facilitate the production of insulin, growth hormone, and other agents intended to benefit mankind and to cure and treat diseases.

Acceptability and Correlates of Primary and Secondary Prevention of Cervical Cancer among Medical Students in Southwest China: Implications for Cancer Education

PubMed Central

Pan, Xiong-Fei; Zhao, Zhi-Mei; Sun, Jing; Chen, Feng; Wen, Qing-Lian; Liu, Kang; Song, Gui-Qin; Zhang, Jing-Jing; Wen, Ying; Fu, Chun-Jing; Yang, Chun-Xia

2014-01-01

Objectives To understand knowledge about, and acceptability of, cervical cancer screening and HPV vaccines among medical students; and to explore potential factors that influence their acceptability in China. Methods We conducted a survey among medical students at six universities across southwest China using a 58-item questionnaire regarding knowledge and perceptions of HPV, cervical cancer, and HPV vaccines. Results We surveyed 1878 medical students with a mean age of 20.8 years (standard deviation: 1.3 years). Of these, 48.8% and 80.1% believed cervical cancer can be prevented by HPV vaccines and screening respectively, while 60.2% and 71.2% would like to receive or recommend HPV vaccines and screening. 35.4% thought HPV vaccines ought to be given to adolescents aged 13–18 years. 32% stated that women should start to undergo screening from the age of 25. 49.2% felt that women should receive screening every year. Concern about side effects (38.3% and 39.8%), and inadequate information (42.4% and 35.0%) were the most cited barriers to receiving or recommending HPV vaccination and cervical cancer screening. Females were more likely to accept HPV vaccines (OR, 1.86; 95% CI: 1.47–2.35) or cervical cancer screening (OR, 3.69; 95% CI: 2.88–4.74). Students with a higher level of related knowledge were much more willing to receive or recommend vaccines (P<0.001) or screening (P<0.001). Students who showed negative or uncertain attitudes towards premarital sex were less likely to accept either HPV vaccines (OR, 0.67; 95% CI: 0.47–0.96), or screening (OR, 0.68; 0.47–0.10). Non-clinical students showed lower acceptability of cervical screening compared to students in clinical medicine (OR, 0.74; 95% CI: 0.56–0.96). Conclusions The acceptability of HPV vaccines and cervical cancer screening is relatively low among medical students in southwest China. Measures should be taken to improve knowledge about cervical cancer and awareness of HPV vaccines and screening among medical students at university. PMID:25360743

Acceptability and correlates of primary and secondary prevention of cervical cancer among medical students in southwest China: implications for cancer education.

PubMed

Pan, Xiong-Fei; Zhao, Zhi-Mei; Sun, Jing; Chen, Feng; Wen, Qing-Lian; Liu, Kang; Song, Gui-Qin; Zhang, Jing-Jing; Wen, Ying; Fu, Chun-Jing; Yang, Chun-Xia

2014-01-01

To understand knowledge about, and acceptability of, cervical cancer screening and HPV vaccines among medical students; and to explore potential factors that influence their acceptability in China. We conducted a survey among medical students at six universities across southwest China using a 58-item questionnaire regarding knowledge and perceptions of HPV, cervical cancer, and HPV vaccines. We surveyed 1878 medical students with a mean age of 20.8 years (standard deviation: 1.3 years). Of these, 48.8% and 80.1% believed cervical cancer can be prevented by HPV vaccines and screening respectively, while 60.2% and 71.2% would like to receive or recommend HPV vaccines and screening. 35.4% thought HPV vaccines ought to be given to adolescents aged 13-18 years. 32% stated that women should start to undergo screening from the age of 25. 49.2% felt that women should receive screening every year. Concern about side effects (38.3% and 39.8%), and inadequate information (42.4% and 35.0%) were the most cited barriers to receiving or recommending HPV vaccination and cervical cancer screening. Females were more likely to accept HPV vaccines (OR, 1.86; 95% CI: 1.47-2.35) or cervical cancer screening (OR, 3.69; 95% CI: 2.88-4.74). Students with a higher level of related knowledge were much more willing to receive or recommend vaccines (P<0.001) or screening (P<0.001). Students who showed negative or uncertain attitudes towards premarital sex were less likely to accept either HPV vaccines (OR, 0.67; 95% CI: 0.47-0.96), or screening (OR, 0.68; 0.47-0.10). Non-clinical students showed lower acceptability of cervical screening compared to students in clinical medicine (OR, 0.74; 95% CI: 0.56-0.96). The acceptability of HPV vaccines and cervical cancer screening is relatively low among medical students in southwest China. Measures should be taken to improve knowledge about cervical cancer and awareness of HPV vaccines and screening among medical students at university.

Sexuality and 'silence' among Khasi youth of Meghalaya, Northeast India.

PubMed

War, Ryntihlin Jennifer; Albert, Sandra

2013-01-01

The importance of sex education has been well documented in the literature, but there exists a lack of research involving indigenous youth in India. This paper describes perceptions, knowledge and attitudes towards sex education, sexuality, pre-marital sex, rape and homosexuality among indigenous students from the matrilineal Khasi tribe attending a university in Meghalaya in northeast India. Qualitative and quantitative data were collected during and after reproductive health, sexuality and life skills courses. Despite the impression of sexual permissiveness of indigenous peoples that exists in India, students reported a societal silence on issues related to sexuality. Lack of appropriate words in the indigenous language potentially contributes to this silence. Although co-habitation is common and culturally acceptable, students disapproved of pre-marital sex. The influence of Christianisation was also perceived in the frequent reference to sin and guilt associated with masturbation, homosexuality, pre-marital sex and abortion. Students reported that the sex education received in school was 'childish' and inadequate for their adult needs. Many had unrealistic images of what constituted 'normal' sex and also blamed women for rape. The majority of indigenous students expressed the need for non-judgmental fora for discussions on sexual health and for sexuality education.

A blind area of family planning services in China: unintended pregnancy among unmarried graduate students.

PubMed

Zhou, Yuanzhong; Xiong, Chengliang; Xiong, Jinwen; Shang, Xuejun; Liu, Guohui; Zhang, Meimei; Yin, Pin

2013-03-06

Status of premarital sex, unintended pregnancy and associated factors among Chinese graduate students remain unclear. And unmarried graduate students' needs of family planning services seem to be ignored. In the present study, we ascertained the prevalence rate of premarital sex and unintended pregnancy, as well as estimated the possible factors associated with unintended pregnancy among unmarried Chinese graduate students, and evaluated their reproductive health needs. We obtained the representative sample of graduate students using a multistage, stratified, cluster design, and collected data using a questionnaire. We obtained 11936 responders. Premarital sexual intercourse was acknowledged by 24.2% of responders; unintended pregnancy was acknowledged by 4.8% of responders (19.8% of students active in premarital sex); and abortion was acknowledged by 4.6% of responders (96.7% of pregnant students). In multivariate analysis, the identified risk factors for unintended pregnancy among both genders that were active in premarital sex were: (1) having no steady lover [for males: odds ratio (OR), 1.96, 95% confidence interval (CI), 1.41-2.70; for females: OR, 2.65; 95%CI, 1.56-4.84]; (2) younger age at the first sexual intercourse (for males: OR, 1.62, 95% CI, 1.22-2.15; for females: OR, 2.57; 95% CI, 1.64-4.02); (3) lack of condom use at the first sex (for males: OR, 1.13, 95% CI, 1.09-1.37; for females: OR, 2.81; 95% CI, 1.81-4.39); (4) unaware of the conditions of conception (for males: OR, 1.69, 95% CI, 1.31-2.19; for females: OR, 1.75; 95% CI, 1.16-2.65); and (5) unaware that abortion endangers women's future pregnancy (for males: OR, 2.98, 95% CI, 2.15-4.14; for females: OR, 2.34; 95% CI, 1.23-4.46). Medical graduates were not less likely to have unintended pregnancy than nonmedical graduates for both genders. The avoidable risk of being unintended pregnancy among graduate students in China indicates that an urgent need to take action on how to delay the age of first sex, promote condom use at first sex, and acquire accurate contraceptive information, as well as improve skills to use reliable contraception among graduate students.

A blind area of family planning services in China: unintended pregnancy among unmarried graduate students

PubMed Central

2013-01-01

Background Status of premarital sex, unintended pregnancy and associated factors among Chinese graduate students remain unclear. And unmarried graduate students’ needs of family planning services seem to be ignored. In the present study, we ascertained the prevalence rate of premarital sex and unintended pregnancy, as well as estimated the possible factors associated with unintended pregnancy among unmarried Chinese graduate students, and evaluated their reproductive health needs. Methods We obtained the representative sample of graduate students using a multistage, stratified, cluster design, and collected data using a questionnaire. Results We obtained 11936 responders. Premarital sexual intercourse was acknowledged by 24.2% of responders; unintended pregnancy was acknowledged by 4.8% of responders (19.8% of students active in premarital sex); and abortion was acknowledged by 4.6% of responders (96.7% of pregnant students). In multivariate analysis, the identified risk factors for unintended pregnancy among both genders that were active in premarital sex were: (1) having no steady lover [for males: odds ratio (OR), 1.96, 95% confidence interval (CI), 1.41-2.70; for females: OR, 2.65; 95%CI, 1.56-4.84]; (2) younger age at the first sexual intercourse (for males: OR, 1.62, 95% CI, 1.22-2.15; for females: OR, 2.57; 95% CI, 1.64-4.02); (3) lack of condom use at the first sex (for males: OR, 1.13, 95% CI, 1.09-1.37; for females: OR, 2.81; 95% CI, 1.81-4.39); (4) unaware of the conditions of conception (for males: OR, 1.69, 95% CI, 1.31-2.19; for females: OR, 1.75; 95% CI, 1.16-2.65); and (5) unaware that abortion endangers women's future pregnancy (for males: OR, 2.98, 95% CI, 2.15-4.14; for females: OR, 2.34; 95% CI, 1.23-4.46). Medical graduates were not less likely to have unintended pregnancy than nonmedical graduates for both genders. Conclusions The avoidable risk of being unintended pregnancy among graduate students in China indicates that an urgent need to take action on how to delay the age of first sex, promote condom use at first sex, and acquire accurate contraceptive information, as well as improve skills to use reliable contraception among graduate students. PMID:23497130

Sexual practices of young educated men: implications for further research and health education in Kingdom of Saudi Arabia (KSA).

PubMed

Raheel, Hafsa; Mahmood, Muhammad Afzal; BinSaeed, Abdulaziz

2013-03-01

Considering the high prevalence of sexually transmitted infections (STIs) and other associated health problems among young people globally, it is important to identify sexual practices that could potentially compromise health. This study explored the sexual practices of young men in Riyadh city, the Kingdom of Saudi Arabia (KSA). Materials and methodology A cross-sectional study among young, male students was conducted using a pre-tested, structured, self-administered questionnaire. Descriptive analysis and adjusted odds ratio (OR) were calculated. Among 225 study participants, 31% had engaged in premarital sexual activity at least once and 61% viewed pornographic movies/materials. Only 51% knew that condom use could prevent STIs, 20% were not aware that HIV could be transmitted through both homosexual and heterosexual contacts. Premarital sexual activity was associated with the use of illegal drugs (OR: 2.51), viewing of pornographic movies (OR: 6.79) and traveling alone abroad (OR: 3.10). and recommendations Our study was the first to report the existence of premarital sexual practices among young educated men in KSA. There is a need to identify in detail the risks and the knowledge gaps, and base sexual health awareness among youth on such knowledge in order to prevent the spread of STIs and HIV.

CDC Kerala 1: Organization of clinical child development services (1987-2013).

PubMed

Nair, M K C; George, Babu; Nair, G S Harikumaran; Bhaskaran, Deepa; Leena, M L; Russell, Paul Swamidhas Sudhakar

2014-12-01

The main objective of establishing the Child Development Centre (CDC), Kerala for piloting comprehensive child adolescent development program in India, has been to understand the conceptualization, design and scaling up of a pro-active positive child development initiative, easily replicable all over India. The process of establishing the Child Development Centre (CDC) Kerala for research, clinical services, training and community extension services over the last 25 y, has been as follows; Step 1: Conceptualization--The life cycle approach to child development; Step 2: Research basis--CDC model early stimulation is effective; Step 3: Development and validation of seven simple developmental screening tools; Step 4: CDC Diagnostic services--Ultrasonology and genetic, and metabolic laboratory; Step 5: Developing seven intervention packages; Step 6: Training--Post graduate diploma in clinical child development; Step 7: CDC Clinic Services--seven major ones; Step 8: CDC Community Services--Child development referral units; Step 9: Community service delivery models--Childhood disability and for adolescent care counselling projects; Step 10: National capacity building--Four child development related courses. CDC Kerala follow-up and clinic services are offered till 18 y of age and premarital counselling till 24 y of age as shown in "CDC Kerala Clinic Services Flow Chart" and 74,291 children have availed CDC clinic services in the last 10 y. CDC Kerala is the first model for comprehensive child adolescent development services using a lifecycle approach in the Government sector and hence declared as the collaborative centre for Rashtriya Bal Swasthya Karyakram (RBSK), in Kerala.

Latino Youths’ Sexual Values and Condom Negotiation Strategies

PubMed Central

Deardorff, Julianna; Tschann, Jeanne M.; Flores, Elena; de Groat, Cynthia L.; Steinberg, Julia R.; Ozer, Emily J.

2013-01-01

CONTEXT Young Latinos in the United States are at high risk for STDs and are less likely than other youth to use condoms. To our knowledge, no studies have examined the relationship between sexual values and condom negotiation strategies among young Latinos. METHODS Cross-sectional data collected in 2003–2006 from 571 Latino women and men aged 16–22 in the San Francisco Bay Area were used to examine associations between sexual values (e.g., considering sexual talk disrespectful or female virginity important) and use of strategies to engender or avoid condom use. Linear regression analyses were used to identify such associations while adjusting for potential covariates and gender interactions. RESULTS Among women, sexual comfort and comfort with sexual communication were positively associated with frequency of direct communication to foster condom use; the importance of premarital virginity and levels of sexual self-acceptance was positively associated with expressing dislike of condoms to avoid using them; and levels of sexual self-acceptance were negatively associated with expressing dislike of condoms to avoid using them. Moreover, the degrees to which women considered sexual talk disrespectful and female virginity important were positively associated with the frequency with which they shared risk information as a condom use strategy. Among both sexes, the importance that respondents placed on premarital female virginity was negatively associated with use of direct communication strategies. CONCLUSION Researchers designing interventions to influence Latino youths’ sexual decision making and behaviors should consider including program components that address sexual values. PMID:24165307

Latino youths' sexual values and condom negotiation strategies.

PubMed

Deardorff, Julianna; Tschann, Jeanne M; Flores, Elena; de Groat, Cynthia L; Steinberg, Julia R; Ozer, Emily J

2013-12-01

Young Latinos in the United States are at high risk for STDs and are less likely than other youth to use condoms. To our knowledge, no studies have examined the relationship between sexual values and condom negotiation strategies among young Latinos. Cross-sectional data collected in 2003-2006 from 571 Latino women and men aged 16-22 in the San Francisco Bay Area were used to examine associations between sexual values (e.g., considering sexual talk disrespectful or female virginity important) and use of strategies to engender or avoid condom use. Linear regression analyses were used to identify such associations while adjusting for potential covariates and gender interactions. Among women, sexual comfort and comfort with sexual communication were positively associated with frequency of direct communication to foster condom use; the importance of female premarital virginity and levels of sexual self-acceptance were positively associated with expressing dislike of condoms to avoid using them; and levels of sexual self-acceptance were negatively associated with expressing dislike of condoms to avoid using them. Moreover, the degrees to which women considered sexual talk disrespectful and female virginity important were positively associated with the frequency with which they shared risk information as a condom use strategy. Among both sexes, the importance that respondents placed on premarital female virginity was negatively associated with use of direct communication strategies. Researchers designing interventions to influence Latino youths' sexual decision making and behaviors should consider including program components that address sexual values. Copyright © 2013 by the Guttmacher Institute.

Correlates and Determinants of Reproductive Behavior among Female University Students in Tehran

PubMed Central

Farahani, Farideh Khalaj Abadi; Cleland, John; Mehryar, Amir Hooshang

2012-01-01

Background This paper aims to examine the reproductive health and behaviors which might expose young people at risks of STIs/HIV and potential correlates of such behaviors among female college students in Tehran. Methods This paper focuses on the study conducted on a sample of 1743 female undergraduate students in four multidisciplinary universities in Tehran during 2005− 2006 using a two-stage stratified cluster sampling. The main focus was to determine the predictors of premarital heterosexual reproductive behavior among female students. Results The mean age of the unmarried students was 21.4 years. Low self-efficacy (OR=7.87, p <0.001), perceived peers’ liberal attitude on virginity (OR= 4.33), perception of parents’ liberal attitude towards relationship with the opposite sex and poor family atmosphere (OR=3.04 and 2.20, p <0.001, respectively) were predictors of ever having any type of sexual experience after controlling for other factors. The only predictors of penetrative sex remained in the logistic model were older age (OR=5.95), low self-efficacy (OR=10.86), poor family atmosphere (OR= 2.96), liberal parental attitude (OR=4.29) and liberal peer norms on virginity (OR= 4.90). Conclusion Interventional programs need to be designed at various levels such as enhancing self-efficacy, informing families of the protective role of a balanced control and monitoring over adolescents’ behavior and choices of peer network against premarital sexual activity. PMID:23926523

[Attitudes and opinions of Palestinian decision-makers about premarital examination law].

PubMed

El Sharif, Nuha; Rifai, Ayshea; Assi, Sana'a; Al Hmidat, Amjad

2006-11-01

We explored the attitudes and opinions of 90 Palestinian decision-makers about the draft law on premarital examination. The findings revealed that decision-makers were aware of the spread of genetic diseases but not infectious diseases. The majority agreed on the draft law; however, they differed on the mode of its application. Half believed that the law is not ready yet for application due to insufficient financial support to establish the needed infrastructure. The most significant recommendations made by the decision-makers were to: enhance community awareness of the law, ensure proper coordination among the concerned ministries and institutions, and establish a national organization to work on endorsement of the tests and issuance of the appropriate application strategies and regulations.

Primary hyperoxaluria type 1 in 18 children: genotyping and outcome.

PubMed

Al Riyami, Mohamed S; Al Ghaithi, Badria; Al Hashmi, Nadia; Al Kalbani, Naifain

2015-01-01

Background. Primary hyperoxaluria belongs to a group of rare metabolic disorders with autosomal recessive inheritance. It results from genetic mutations of the AGXT gene, which is more common due to higher consanguinity rates in the developing countries. Clinical features at presentation are heterogeneous even in children from the same family; this study was conducted to determine the clinical characteristics, type of AGXT mutation, and outcome in children diagnosed with PH1 at a tertiary referral center in Oman. Method. Retrospective review of children diagnosed with PH1 at a tertiary hospital in Oman from 2000 to 2013. Result. Total of 18 children were identified. Females composed 61% of the children with median presentation age of 7 months. Severe renal failure was initial presentation in 39% and 22% presented with nephrocalcinosis and/or renal calculi. Family screening diagnosed 39% of patients. Fifty percent of the children underwent hemodialysis. 28% of children underwent organ transplantation. The most common mutation found in Omani children was c.33-34insC mutation in the AGXT gene. Conclusion. Due to consanguinity, PH1 is a common cause of ESRD in Omani children. Genetic testing is recommended to help in family counseling and helps in decreasing the incidence and disease burden; it also could be utilized for premarital screening.

Primary Hyperoxaluria Type 1 in 18 Children: Genotyping and Outcome

PubMed Central

Al Riyami, Mohamed S.; Al Ghaithi, Badria; Al Hashmi, Nadia; Al Kalbani, Naifain

2015-01-01

Background. Primary hyperoxaluria belongs to a group of rare metabolic disorders with autosomal recessive inheritance. It results from genetic mutations of the AGXT gene, which is more common due to higher consanguinity rates in the developing countries. Clinical features at presentation are heterogeneous even in children from the same family; this study was conducted to determine the clinical characteristics, type of AGXT mutation, and outcome in children diagnosed with PH1 at a tertiary referral center in Oman. Method. Retrospective review of children diagnosed with PH1 at a tertiary hospital in Oman from 2000 to 2013. Result. Total of 18 children were identified. Females composed 61% of the children with median presentation age of 7 months. Severe renal failure was initial presentation in 39% and 22% presented with nephrocalcinosis and/or renal calculi. Family screening diagnosed 39% of patients. Fifty percent of the children underwent hemodialysis. 28% of children underwent organ transplantation. The most common mutation found in Omani children was c.33-34insC mutation in the AGXT gene. Conclusion. Due to consanguinity, PH1 is a common cause of ESRD in Omani children. Genetic testing is recommended to help in family counseling and helps in decreasing the incidence and disease burden; it also could be utilized for premarital screening. PMID:25918646

Prevalence of Sickle Cell Trait in the Southern Suburb of Beirut, Lebanon.

PubMed

El Ariss, Abdel Badih; Younes, Mohamad; Matar, Jad; Berjaoui, Zeina

2016-01-01

The objective of this study was to assess the prevalence, gender differences, and time trends of Sickle Cell Trait in the Southern Suburb of Beirut, Lebanon, as well as to highlight the importance of screening for Sickle Cell Trait carriers in this population. Another objective was to describe a new screening technique for Sickle Cell Trait carriers. This was a retrospective cohort study carried out at a private laboratory in the Southern Suburb of Beirut, Lebanon between 2002 and 2014. The sickling test was carried out for each patient using two methods: the classical "sodium metabisulfite sickling test", and the new "sickling test method" used in the private lab. As a confirmatory test, hemoglobin electrophoresis was run on a random sample of 223 cases which were found to be positive using the two sickling tests. A total of 899 cases were found to be positive for the sickle cell trait out of 184,105 subjects screened during the 12-year period, prevalence = 0.49% (95% CI: 0.46 - 0.52). Among the total sample, females were found to have higher prevalence, where no time trend over the studied period was noted. The haemoglobin electrophoresis method confirmed the results of this new sickling test technique among the random sample of the 223 cases. We found that the prevalence of sickle cell trait is lower as compared to other Arab countries, higher in females, with no significant time trend. The sickle cell test was found to be an accurate, simple and cheap test that could be easily added as a requirement for the pre-marital testing to screen for Sickle Cell Trait carriers.

Prevalence of Sickle Cell Trait in the Southern Suburb of Beirut, Lebanon

PubMed Central

El Ariss, Abdel Badih; Younes, Mohamad; Matar, Jad; Berjaoui, Zeina

2016-01-01

Objective The objective of this study was to assess the prevalence, gender differences, and time trends of Sickle Cell Trait in the Southern Suburb of Beirut, Lebanon, as well as to highlight the importance of screening for Sickle Cell Trait carriers in this population. Another objective was to describe a new screening technique for Sickle Cell Trait carriers. Methods This was a retrospective cohort study carried out at a private laboratory in the Southern Suburb of Beirut, Lebanon between 2002 and 2014. The sickling test was carried out for each patient using two methods: the classical “sodium metabisulfite sickling test”, and the new “sickling test method” used in the private lab. As a confirmatory test, hemoglobin electrophoresis was run on a random sample of 223 cases which were found to be positive using the two sickling tests. Results A total of 899 cases were found to be positive for the sickle cell trait out of 184,105 subjects screened during the 12-year period, prevalence = 0.49% (95% CI: 0.46 – 0.52). Among the total sample, females were found to have higher prevalence, where no time trend over the studied period was noted. The haemoglobin electrophoresis method confirmed the results of this new sickling test technique among the random sample of the 223 cases. Conclusion We found that the prevalence of sickle cell trait is lower as compared to other Arab countries, higher in females, with no significant time trend. The sickle cell test was found to be an accurate, simple and cheap test that could be easily added as a requirement for the pre-marital testing to screen for Sickle Cell Trait carriers. PMID:26977274

Sex, religion, and the single woman c.1950-75: the importance of a 'short' sexual revolution to the English religious crisis of the sixties.

PubMed

Brown, Callum G

2011-01-01

The English 'sexual revolution' has recently become increasingly conceived as 'long', lasting many decades, and by some historians as a gradual phenomenon, but reaching a peak with the introduction of the oral contraceptive pill in the 1960s. At the same time, the 'religious crisis' of the same decade has been attributed by some recent scholarship to liberal Christian revolt within the churches, and largely unconnected with sex. This article offers different views. First, based on the illegitimacy rate, it argues that, after a period of decline, restraint, and only minor change in the period 1946-59, the 1960s witnessed a sudden growth in pre-marital heterosexual intercourse before the pill's availability to single women, implying a cultural rather than a technological cause. Second, based on contemporary social surveys, it argues that there is clear evidence of a strong inverse correlation between levels of religious activity and levels of pre-marital sexual intercourse. Third, it argues that in the 1950s the dominant conservative Christian culture restrained single women from pre-marital sexual intercourse, but that from the early 1960s changing attitudes led to rising levels of sexual activity, led by single women, which reduced religious attitudes and Christian churchgoing, thus constituting a significant instigator of the religious crisis.

A message to school girls.

PubMed

Akinwande, A

1993-06-01

Information, education, and communication (IEC) programs need to be strengthened to appeal to adolescents, who are increasingly contributing to unwanted pregnancy and are using abortion as a means of birth control. Successful IEC programs have the following characteristics: 1) established communication theories that guide development of materials; 2) a multimedia and a mass media approach to information dissemination, and 3) emphasis on visual displays. The primary emphasis should be on presentation of a concise, clear message with the appropriate visual medium. Many communication specialists in developing countries, however, lack the training to design and use effective IEC software. Designing effective messages involves a process of integrating scientific ideas with artistic appeal. The aim is to stimulate the target audience to change its behavior of life style. The message must be convincing and contain practical and useful information. The IEC Software Design Cycle focuses on analysis and diagnosis, design production, pretesting and modification, and distribution and evaluation. Each of these processes are described. Necessary before any attempt is made is obtaining data on historical, sociocultural, and demographic characteristics, economic activities, health and social services, communication infrastructure, marriage and family life patterns, and decision making systems. Focus group discussions may be used to collect information about the target group. An example is given of the process of development, in a course through the Center or African Family Studies, of a poster about premarital sex directed to 11-16 year olds. On the basis of focus group discussions, it was decided that the message would be to encourage girls to talk with their mothers about family life and premarital sex. The poster was produced with 2 school girls talking in front of the school. The evaluation yielded modifications such as including a school building that resembled actual classrooms better, students playing ball, a caption at the top of the poster and more feminine and younger faces. The changes were made and the project completed.

Changes in the timing of sexual initiation among young Muslim and Christian women in Nigeria.

PubMed

Agha, Sohail

2009-12-01

Sexual initiation during adolescence has important demographic and health consequences for a population, yet no systematic analysis of changes in the timing of sexual initiation has been conducted in Nigeria. Two rounds of national surveys conducted in 1990 and 2003 were used to examine changes in the timing of sexual initiation among female adolescents in Nigeria. Multivariate survival analysis using Cox proportional hazards models was used to assess changes in the risk of sexual initiation and to identify the correlates of first sex. Contrary to what has been reported in several Nigerian studies, there was no decline in age at first sex among Christian adolescents. Age at first sex did not change significantly for Christian adolescents, although premarital sex appears to have increased-primarily due to an increase in the age at marriage. Age at first sex did increase among Muslim women. Premarital sex remained low among Muslim women. A number of socioeconomic variables were associated with the timing of sexual initiation. Weekly exposure to the mass media was associated with earlier sexual initiation. The degree to which an environment was liberal or restrictive was a key determinant of the timing of sexual initiation in Nigeria. The findings also illustrate the important role of socioeconomic factors in determining the timing of sexual initiation in Nigeria. As secondary education increases in Northern Nigeria, additional increases in the age at sexual debut are likely among Muslim women. The study raises concerns about the influence of the mass media on the timing of first sex in Nigeria. The evidence of an absence of changes in the timing of sexual initiation among Christian women in more than a decade implies that programs which aim to delay the timing of sexual initiation in Southern Nigeria may have limited success. With age at marriage already high among Christian women, programs that focus on abstinence until marriage may also be pursuing an approach with limited chances of success.

The molecular spectrum and distribution of haemoglobinopathies in Cyprus: a 20-year retrospective study

PubMed Central

Kountouris, Petros; Kousiappa, Ioanna; Papasavva, Thessalia; Christopoulos, George; Pavlou, Eleni; Petrou, Miranda; Feleki, Xenia; Karitzie, Eleni; Phylactides, Marios; Fanis, Pavlos; Lederer, Carsten W.; Kyrri, Andreani R.; Kalogerou, Eleni; Makariou, Christiana; Ioannou, Christiana; Kythreotis, Loukas; Hadjilambi, Georgia; Andreou, Nicoletta; Pangalou, Evangelia; Savvidou, Irene; Angastiniotis, Michael; Hadjigavriel, Michael; Sitarou, Maria; Kolnagou, Annita; Kleanthous, Marina; Christou, Soteroula

2016-01-01

Haemoglobinopathies are the most common monogenic diseases, posing a major public health challenge worldwide. Cyprus has one the highest prevalences of thalassaemia in the world and has been the first country to introduce a successful population-wide prevention programme, based on premarital screening. In this study, we report the most significant and comprehensive update on the status of haemoglobinopathies in Cyprus for at least two decades. First, we identified and analysed all known 592 β-thalassaemia patients and 595 Hb H disease patients in Cyprus. Moreover, we report the molecular spectrum of α-, β- and δ-globin gene mutations in the population and their geographic distribution, using a set of 13824 carriers genotyped from 1995 to 2015, and estimate relative allele frequencies in carriers of β- and δ-globin gene mutations. Notably, several mutations are reported for the first time in the Cypriot population, whereas important differences are observed in the distribution of mutations across different districts of the island. PMID:27199182

African American Mother–Daughter Communication About Sex and Daughters’ Sexual Behavior: Does College Racial Composition Make a Difference?

PubMed Central

Bynum, Mia Smith

2014-01-01

This study examined the influence of African American mothers’ communication about sexual topics on the sexual attitudes and behavior of their college-enrolled daughters. Daughters were enrolled at a historically Black college/university (HBCU) or a predominantly White institution (PWI) to assess whether and how college racial context might affect daughters’ sexual attitudes and behavior. Findings indicated that daughters at the HBCU had less permissive attitudes about premarital sex than their counterparts at the PWI. This result was especially true for daughters of mothers with more conservative attitudes about premarital sex and who discussed such topics infrequently. Last, the combination of positive mother–daughter communication and fewer discussions about sexual topics resulted in lower levels of sexual experience among the daughters. PMID:17500604

African American mother-daughter communication about sex and daughters' sexual behavior: does college racial composition make a difference?

PubMed

Bynum, Mia Smith

2007-04-01

This study examined the influence of African American mothers' communication about sexual topics on the sexual attitudes and behavior of their college-enrolled daughters. Daughters were enrolled at a historically Black college/university (HBCU) or a predominantly White institution (PWI) to assess whether and how college racial context might affect daughters' sexual attitudes and behavior. Findings indicated that daughters at the HBCU had less permissive attitudes about premarital sex than their counterparts at the PWI. This result was especially true for daughters of mothers with more conservative attitudes about premarital sex and who discussed such topics infrequently. Last, the combination of positive mother-daughter communication and fewer discussions about sexual topics resulted in lower levels of sexual experience among the daughters. (c) 2007 APA, all rights reserved.

Ethical guidelines in genetics and genomics. An Islamic perspective.

PubMed

Al-Aqeel, Aida I

2005-12-01

We are at a time of unprecedented increase in knowledge of rapidly changing technology. Such biotechnology especially when it involves human subjects raises complex ethical, legal, social and religious issues. A World Health Organization expert consultation concluded that "genetics advances will only be acceptable if their application is carried out ethically, with due regard to autonomy, justice, education and the beliefs and resources of each nation and community." Public health authorities are increasingly concerned by the high rate of births with genetic disorders especially in developing countries where Muslims are a majority. Therefore, it is imperative to scrutinize the available methods of prevention and management of genetic disorders. A minimum level of cultural awareness is a necessary prerequisite for the delivery of care that is culturally sensitive, especially in Islamic countries. Islam presents a complete moral, ethical, and medical framework, it is a religion which encompasses the secular with the spiritual, the mundane with the celestial and hence forms the basis of the ethical, moral and even juridical attitudes and laws towards any problem or situation. Islamic teachings carry a great deal of instructions for health promotion and disease prevention including hereditary and genetic disorders, therefore, we will discuss how these teachings play an important role in the diagnostic, management and preventive measures including: genomic research; population genetic screening pre-marital screening, pre-implantation genetic diagnosis; assisted reproduction technology; stem cell therapy; genetic counseling and others.

Family life and human development (sex education): the Prince George's County Public Schools experience.

PubMed

Schaffer, M J

1981-04-01

The Family Life and Human Development (Sex Education) program is now fully implemented in 99.5% of Prince George's County Public Schools. The program is credited with better than 98% parental acceptance and student participation. The administrative guidelines and program supervision are crucial to the program's success. The program was developed to be in compliance with the Maryland State Board of Education Bylaw 13.03.03.01 that requires that sex education be offered. Prior to program implementation, the guidelines were written, parents were involved, and teachers and administrators were trained. All instruction is organized around 3 areas of focus: interpersonal relationships; physiological and personality changes of puberty; and advanced physiology and psychology of human sexual behavior. The major limitation of the program is that in grades 9-12 when such subjects as contraception, abortion, homosexuality and premarital intercourse can be discussed, only a small percentage of the student population are able to enroll each year. The reason for the low percentage include lack of funds to hire additional teachers, limited time due to 1/2 day work/study teachers, and the elective classification of the program. Before a teacher is permitted to teach any aspect of the program that deals with the reproductive system or any potentially sensitive area of sexuality, he/she must 1st meet certain established criteria.

Media’s Contribution to Sexual Knowledge, Attitudes and Behaviors for Adolescents and Young Adults in Three Asian Cities

PubMed Central

Lou, Chaohua; Cheng, Yan; Gao, Ersheng; Zuo, Xiayun; Emerson, Mark R.; Zabin, Laurie S.

2014-01-01

Background Evidence in western countries indicates that the media have associations with adolescents’ and young people’ sexual behavior that may be as important as family, school and peers. In this new study of Asian adolescents and young adults in the three cities of Hanoi, Shanghai and Taipei, the associations between exposure to sexual content in the media and adolescents’ and young adults’ sex-related knowledge, attitudes and behaviors are explored in societies with traditional Confucian culture, but at different stages in the process of modernization. Method The data are from a questionnaire-based cross-sectional study conducted from 2006 to 2007 where a sample of 17,016 adolescents and young adults aged 15–24 years from Shanghai, Hanoi and Taipei completed face-to-face interviews coupled with computer-assisted self-interviews (CASI) for sensitive questions. For the objectives of this paper, analysis was restricted to the 16,554 unmarried respondents. Exposure to sexual content in the mass media (including the Internet and traditional media), pornographic videos, and a preference for western/Asian movies/videos were the main media influence measures. Sex-related knowledge, premarital sexual permissiveness, and sex-related behaviors were the main outcome measures. The impact of each of four contexts including family, peer, school and media on sex-related knowledge, attitudes and behaviors were assessed using multiple linear regression stratified by gender and city, controlling for age, urban/rural residence, education and economic status. The change in adjusted R2 from the multiple linear regression analysis was adopted to indicate the contribution of family, peer, school and media variables to respondents’ sex-related knowledge, attitudes and behaviors. Results The contextual factors, including family, peer, school and media, explained 30–50% of the variance in sex-related knowledge, 8–22% of the variance in premarital sexual permissiveness and 32–41% of the variance in sex-related behaviors. Media variables explained 13–24% of the variance in sexual knowledge, 3–13% in premarital sexual permissiveness and 3–13% in sex-related behaviors, which was comparable to that of family, peer and school variables. These associations differed by city and gender. Conclusion Access to and use of mass media and the messages it presents are influential factors on sex-related knowledge, attitudes and behaviors of unmarried Asian adolescents and young adults, and should be considered in future research and intervention programs attempting to improve reproductive health outcomes. PMID:22340853

Developmental Patterns in Marital Satisfaction: Another Look at Covenant Marriage

PubMed Central

DeMaris, Alfred; Sanchez, Laura A.; Krivickas, Kristi

2012-01-01

This study investigated differences in the trajectory of marital satisfaction in the first seven years between couples in covenant vs. standard marriages. Data on 707 Louisiana marriages from the Marriage Matters Panel Survey of Newlywed Couples, 1998 – 2004, were analyzed using multivariate longitudinal growth modeling. Restricting the sample to couples who remained married over the duration of the study, a marginal benefit of covenant status was found for husbands. This effect was largely accounted for by covenant husbands’ more extensive exposure to premarital counseling. The linear decline in marital satisfaction over time that obtained for both husbands and wives was not, however, any different for covenants vs. standards. Couples characterized by more traditional attitudes toward gender roles were significantly less satisfied than others. High premarital risk factors, initial uncertainty about marrying the spouse, and the presence of preschool children in the household were all corrosive of marital satisfaction at any given time. PMID:23144502

Culture and acculturation influences on Palestinian perceptions of prenatal genetic counseling.

PubMed

Awwad, Rawan; Veach, Patricia McCarthy; Bartels, Dianne M; LeRoy, Bonnie S

2008-02-01

Patient cultural backgrounds strongly influence decision-making processes and outcomes in genetic counseling. The present study investigated influences of culture and acculturation on prenatal decision making processes of native Palestinians and Palestinian Americans. Seventeen native Palestinians and 14 first-generation, Palestinian Americans were interviewed and asked to imagine themselves as patients in hypothetical premarital and prenatal situations. Five major issues were investigated: 1) Influence of family history of an inherited condition on pre-marital decisions; 2) Perceptions of non-directive genetic counselor statements regarding options; 3) Role of gender in prenatal decisions; 4) Gender differences in emotional expression; and 5) Role of family and society in prenatal decisions. Several similarities and differences in native Palestinian and Palestinian American responses were obtained. Similarities appear to be due to common cultural roots, while differences may be due to acculturation. Practice and research recommendations are provided.

Unconsummated marriage in sub-Saharan Africa: case reports.

PubMed

Lema, Valentino M

2014-09-01

Unconsummated marriage is a condition where newly married couples are unable to achieve penile-vaginal intercourse for variable periods despite desire and several attempts to do so. Its exact cause(s) is/are unknown, but performance anxiety resulting from or leading to other conditions is reportedly the major etiological factor. It is thought to be more prevalent in traditional and conservative religious communities where premarital sexual exposure is strictly prohibited. Most publications on unconsummated marriage have originated from North America, European and Middle Eastern countries. There have not been any such reports from sub-Saharan Africa, which is home to diverse cultures and traditions regarding premarital sex and marriage. This paper presents a sample of four cases with unconsummated marriage managed by the author in his private clinic based in the city of Nairobi Kenya, over the past five years. Possible etiological factors and management approaches are discussed, with a review of relevant literature.

Developmental Patterns in Marital Satisfaction: Another Look at Covenant Marriage.

PubMed

Demaris, Alfred; Sanchez, Laura A; Krivickas, Kristi

2012-10-01

This study investigated differences in the trajectory of marital satisfaction in the first seven years between couples in covenant vs. standard marriages. Data on 707 Louisiana marriages from the Marriage Matters Panel Survey of Newlywed Couples, 1998 - 2004, were analyzed using multivariate longitudinal growth modeling. Restricting the sample to couples who remained married over the duration of the study, a marginal benefit of covenant status was found for husbands. This effect was largely accounted for by covenant husbands' more extensive exposure to premarital counseling. The linear decline in marital satisfaction over time that obtained for both husbands and wives was not, however, any different for covenants vs. standards. Couples characterized by more traditional attitudes toward gender roles were significantly less satisfied than others. High premarital risk factors, initial uncertainty about marrying the spouse, and the presence of preschool children in the household were all corrosive of marital satisfaction at any given time.

Trends in reproductive behavior among young single women in Colombia and Peru: 1985-1999.

PubMed

Ali, Mohamed M; Cleland, John; Shah, Iqbal H

2003-11-01

Using "calendar" data for single women aged 15-24 from successive Demographic and Health Surveys (DHS) conducted in Colombia and Peru during the 1990s, we document trends, year by year, in sexual activity, the use of contraceptives, and subsequent reproductive outcomes. We provide evidence of the important and hitherto largely untapped potential of DHS calendar data to draw complete sexual and reproductive profiles when data from various surveys are integrated. Over the period 1985-1999, young single women in both Colombia and Peru became sexually active at younger ages. The use of contraceptives, especially the use of condoms, increased but did not fully offset the rise in sexual activity, and thus the incidence of premarital conceptions rose among young single women. In both countries, sharp declines occurred in the proportion of premaritally conceived births that were reported as being wanted.

Attitudes of Lebanese university students towards surgical hymen reconstruction.

PubMed

Awwad, Johnny; Nassar, Anwar; Usta, Ihab; Shaya, Monique; Younes, Zeina; Ghazeeri, Ghina

2013-11-01

Many cultural and religious beliefs place virginity at a high level of social significance, in that women who lose their virginity before marriage may face humiliation, ostracism, divorce, and extreme violence. This led to an increase in the demand for virginity restoration through surgical hymen reconstruction among these cultures. However, data regarding the acceptance of hymenoplasty in societies that consider sexuality a taboo are scarce. In this cross-sectional study, we investigated the effects of gender and religion on sexual attitudes towards hymenoplasty, premarital sex, and virginity in a sample of 600 Lebanese university students. Our findings showed that approval of hymenoplasty was low among participants regardless of gender (25.7 % men vs. 19.1 % women) and religious affiliations (22.5 % Muslims vs. 22.3 % Christians). Arguments for rejection were rooted in moral ethics and personal convictions: "form of deceiving and cheating" (80.7 %) and "betrayal of honesty in the relationship" (80.4 %). Reasons for acceptance included: personal belief in "women's rights, autonomy, and freedom" (72.2 %) and "physical harm and death" (63.5 %).Male participants were more likely to approve premarital coital sex than females (61.0 vs. 27.3 %). Muslims were also more likely to reject marrying a non-virgin than Christians (39.9 vs. 18.0 %). Female participants expressed more tolerance towards marrying a non-virgin male partner (78.3 vs. 57.3 %). Low acceptance of hymenoplasty among Lebanese university students was found to be related to moral ethics and personal convictions independently from gender and religious affiliation. Differences in sexual attitudes towards premarital coital sex and virginity, however, were more significantly influenced by culture and religion.

Impact of health education program about reproductive health on knowledge and attitude of female Alexandria University students.

PubMed

Mounir, Gehan M; Mahdy, Nehad H; Fatohy, Ibtsam M

2003-01-01

In Egypt, adolescents don't have enough and/or correct knowledge regarding reproductive health. Health education interventions are widely seen as the most appropriate strategy for promoting young people's sexual health. The aim of the present work was to assess the impact of a short-term health education program about reproductive health on knowledge and attitude of female Alexandria university students. Quasi-experimental study (pre-post testing control group) was carried out among 682 female university students living in the university hostels, 354 students represented the intervention group (Ezbet-Saad hostel) who received the program and 328 students constituted the control group (El-Shatby hostel). The study revealed that no one had satisfactory knowledge level while 61.7 % and 38.3% respectively had fair and poor levels. The low knowledge level was more evident regarding the questions about: the meaning of the term 'reproductive health' (only 5.1% gave correct complete answer), the benefits of premarital examination (only 37.9% reported complete answer), the investigations done for the pregnant woman (only 28.3% gave complete answer) the benefits of breast feeding (only 8.2% reported complete answer), methods of family planning (only 36.4% gave complete answer), side effects of female genital mutilation (only 4% reported complete answer), sexually transmitted diseases and methods of protection (only 11.9% and 3.9% reported complete answer). It was evident that 32.6% had an overall positive attitude level, 46.3% were in the neutral level and 21.1% had a negative level. It was also found that students of highly or moderately educated mothers and of high social class reported significantly higher knowledge score about premarital examination, age of marriage and breast-feeding than those of non-educated mothers and of low social class. After the intervention program there was a significant improvement in the majority of knowledge questions from pre to post test in the intervention group and no absolute changes were detected in the control group. The highest percentage of gain scores (33.3%) was detected for knowledge about the term 'reproductive health' and female genital mutilation. A significant gain score of 25% was observed for the knowledge about sexually transmitted diseases. Also there was a gain of 20% in the median score concerning the knowledge about breast feeding and family planning. A significant shift towards a positive attitude was found among the intervention group.

β-Globin chain abnormalities with coexisting α-thalassemia mutations

PubMed Central

Canataroglu, Abdullah; Unsal, Cagatay; Yildiz, Sule Menziletoglu; Turhan, Ferda Tekin; Bozdogan, Sevcan Tug; Dincer, Suleyman; Erkman, Hakan

2012-01-01

Introduction The frequency of hemoglobinopathies is still high in Adana, the biggest city of the Cukurova Region that is located in the southern part of Turkey. Our aim was to identify the concomitant mutations in α- and β-globin genes which lead to complex hemoglobinopathies and to establish an appropriate plan of action for each subject, particularly when prenatal diagnosis is necessary. Material and methods We studied the association between the β-globin gene and α-thalassemia genotypes. The reverse hybridization technique was employed to perform molecular analysis, and the results were confirmed by amplification refractory mutation system (ARMS) or restriction fragment length polymorphism (RFLP) technique. Results We evaluated 36 adult subjects (28 female and 8 male; age range: 18-52 years) with concomitant mutations in their α- and β-globin genes. The –α3.7/αα deletion was the commonest defect in the α-chain as expected, followed by α3.7/–α3.7 deletion. Twenty-five of 36 cases were sickle cell trait with coexisting α-thalassemia, while seven Hb S/S patients had concurrent mutations in their α-genes. The coexistence of αPolyA-2α/αα with Hb A/D and with Hb S/D, which is very uncommon, was also detected. There was a subject with compound heterozygosity for β-globin chain (–α3.7/αα with IVSI.110/S), and also a case who had –α3.7/αα deletion with IVSI.110/A. Conclusions Although limited, our data suggest that it would be valuable to study coexisting α-globin mutations in subjects with sickle cell disease or β-thalassemia trait during the screening programs for premarital couples, especially in populations with a high frequency of hemoglobinopathies. PMID:23056075

Contraceptive Embarrassment and Contraceptive Behavior among Young Single Women.

ERIC Educational Resources Information Center

Herold, Edward S.

1981-01-01

This paper determined factors predictive of contraceptive embarrassment, and the relationship of contraceptive embarrassment to contraceptive use among young unmarried females. The most important predictors found were parental attitude to premarital intercourse and sexual guilt. The embarrassment scale had significant correlations with…

Family Planning Handbook for Doctors.

ERIC Educational Resources Information Center

Kleinman, Ronald L., Ed.

The International Planned Parenthood Federation (IPPF) believes that all people have the right to family planning information, including premarital and marital counseling, contraception information, and sex education. This physician's handbook is designed to provide all doctors with the necessary instructions on the latest family planning methods…

A survey of graduate students' knowledge, views, and behavior with respect to reproductive health.

PubMed

Zheng, X

1997-01-01

This study examines knowledge, attitude, and reproductive health behavior among unmarried and married graduate students from 18 universities and colleges in eight Chinese cities (Beijing, Shanghai, Tianjin, Dalian, Changchun, Suzhou, Wuhan, and Nanjing). Data were obtained from a 1994 survey conducted among 2730 graduate students, who account for about 2.56% of the graduate students nationwide. Most married graduate students were aged 25-30 years, but only 60.6% of unmarried graduate students were similarly aged. 50% of students had parents who were intellectuals or professionals. The next highest proportion were students who had parents who were farmers. Single students tended to live in dormitories. 16.4% of married students lived at home with their parents or independently. 45.3% of married students had at least one child. Graduate students are not allowed to marry while in school. Romantic involvement of any kind is discouraged. Most graduate students valued chastity as a Chinese cultural virtue, but 25% did not respond to this question. Chastity was not as favored among unmarried students. Male students were more likely to favor premarital sex under all circumstances. Both genders similarly accepted premarital sex based on love and commitment. Over 50% (more women than men) were aware of safe abortion within the first 2 months of pregnancy; only 25% of unmarried students were aware of the safe abortion period. 16.5% of married students and 50% of unmarried students did not know the impregnation-prone period. Few students learned about reproductive health from their parents. Married students were more likely to read about reproductive health. 72.9% of married student used contraception, usually obtained from pharmacies. 38.6% of married students had an abortion. 10.9% of unmarried students had premarital sex. Most favored college courses in reproductive health.

[Religion and fertility among adolescents in Brazil].

PubMed

Verona, Ana Paula de Andrade; Dias Júnior, Cláudio Santiago

2012-01-01

The objective of this study was to examine the association between the age of having one's first child in adolescence and before marriage and religious involvement in Brazil, measured by religious affiliation and frequency of attendance at religious services or masses. The objective of this study was to examine the association between the age of having one's first child in adolescence and before marriage and religious involvement in Brazil, measured by religious affiliation and frequency of attendance at religious services or masses. Transverse data obtained from the National Survey of Demographics and Health of 1996 and the National Survey of Demographics and Health of Women and Children of 2006 were utilized. Cox proportional risks models were employed to estimate the association between religion and age of having one's first child premaritally and during adolescence. The results indicate a strong association between premarital fertility in adolescence and religious involvement in both 1996 and 2006. In 1996, frequency of attendance at religious service s or masses was more important than religious affiliation in explaining the age at which one had her first child. In 2006, belonging to a Pentecostal church comes to predominate. The results presented in this study are encouraging insofar as they show that Protestant adolescents, particularly Pentecostals, have a reduced risk of adolescent premarital motherhood. This result was not expected, given that Pentecostalism predominates in the less advantaged population groups, with lower incomes and levels of education and residence in urban areas, where adolescent fertility is also concentrated in Brazil. Future studies must be undertaken with the purpose of understanding how the various mechanisms of religious influence operate in the life and behavior of adolescents in Brazil.

Sexual and reproductive behaviour among single women aged 15-24 in eight Latin American countries: a comparative analysis.

PubMed

Ali, Mohamed M; Cleland, John

2005-03-01

A comparative analysis of exposure to sexual activity, contraceptive use, conceptions, and pregnancy resolutions among single women aged 15-24 in eight Latin American countries is presented. Using data from Demographic and Health Surveys complete contraceptive and reproductive histories are constructed for single women aged 15-24 during the 5 year period preceding each survey. Pre-marital conception rates and overall and cause-specific life-table probabilities of contraceptive discontinuation are estimated. Pregnancy outcome and intention status of births are summarized. Trends in virginity, contraceptive protection, and conception rates for five sites are documented. In all eight countries, virginity accounts for over half of all single woman-years of exposure between age 15 and 24. The percentage of sexually active time protected by contraception is less than 20% in five countries, is about 30% in Peru and 50% in Brazil and Colombia. The contribution of condoms to contraceptive protection ranges from one-tenth to one-fifth. Pre-marital conception rates among sexually active single women range from 14.1 per 100 woman-years in Nicaragua to 25.8 in Bolivia. Most pre-marital conceptions ended in live birth, and births that are legitimized by marriage or cohabitation are more likely to be wanted. In five settings, virginity has fallen over time, especially in Northeast Brazil and Colombia, and uptake of condoms has increased faster than use of other methods. Because of pervasive declines in the protective effect of virginity, conception rates among single women in Latin America are rising. Contraceptive uptake, particularly of condoms, is increasing but not sufficiently to offset the decline in virginity.

Ethical issues in psychiatric genetics.

PubMed

Appelbaum, Paul S

2004-11-01

As knowledge grows regarding the genetic bases of psychiatric disorders, a variety of ethical issues will need to be confronted. Current evidence suggests that the etiology of most psychiatric disorders rests on a combination of multiple genes and environmental factors. As tests for the genes involved become more easily available, pressures will arise to use them for prenatal testing, screening of children and adults, selection of potential adoptees, and pre-marital screening. Common problems that will need to be addressed include popular misunderstanding of the consequences of possessing an affected allele, impact of knowledge of one's genetic make-up on one's sense of self, and the discriminatory use of genetic information to deny persons access to insurance and employment. Although most states have some legislation aimed at preventing discrimination, the laws' coverage is spotty and federal rules are lacking. Physicians may find that newly available genetic information creates new duties for them, including warning third parties who may share the patient's genetic endowment. And genetics research itself has raised questions about when to disclose information to subjects and their family members about the genes that are being studied, and how to define the subjects of the research when information is collected about family members other than the proband. Knowledge of these dilemmas is a first step to resolving them, something that the medical profession will need to attend to in the near-term. Neglect will lead others to set the rules that will control medical practice, including the practice of psychiatry, in the new world of genetic medicine.

Factors influencing contraceptive behavior of single college students.

PubMed

Maxwell, J W; Sack, A R; Frary, R B; Keller, J F

1977-01-01

This study investigated the premarital contraceptive behavior of 222 male and female college students. Contraceptive practice was examined in relation to dating patterns, level of emotional involvement with the sex partner was heightened, the intercourse was planned, and the individual and prior sexual experience.

Sex Attitudes of Physicians and Marriage Counselors

ERIC Educational Resources Information Center

Coombs, Robert H.

1971-01-01

Psychiatrists, obstetrician/gynecologists and marriage counselors were surveyed about controversial sexual topics. Considerable consensus was found among all professionals about sex education in the public schools and about the role of parents as sex educators; but there was little agreement concerning premarital sexual standards. (Author)

Professional Women and Marriage.

ERIC Educational Resources Information Center

Allen, Suzanne M.; Kalish, Richard A.

1984-01-01

Explored the phenomenon of late marriage in 41 highly educated professional women. Compared with normative marriers, the late-marrying women had higher career goals, a more egalitarian role structure in marriage, and were more accepting of premarital sex and cohabitation. Factors associated with family backgrounds were identified. (JAC)

SIECUS Study Guides. NOS 1-8.

ERIC Educational Resources Information Center

Sex Information and Education Council of the United States, Inc., New York, NY.

A series of eight booklets, entitled Sex Education, Characteristics of Male and Female Sexual Responses, Premarital Sexual Standards, Sexual Relations During Pregnancy and the Post-Delivery Period, Homosexuality, Masturbation, Sexuality and the Life Cycle, and Film Resources for Sex Education were written by medical doctors, sociologists, a…

COHORT CHANGES IN THE SOCIAL DISTRIBUTION OF TOLERANT SEXUAL ATTITUDES

PubMed Central

Pampel, Fred C.

2017-01-01

Though many studies have described societal-wide changes in tolerance for sexual behaviors outside marriage, few have examined how the social distribution of tolerant attitudes has changed. A diffusion-of-innovations approach predicts nonlinear change in the distribution: high SES groups adopt the attitudes first, which produces a positive relationship, but diffusion to other SES groups subsequently weakens the association with SES. I test this argument using the General Social Survey from 1973 to 2014 to compare the SES determinants of attitudes toward premarital sex, extramarital sex, same-gender sex, and teenage sex across 86 cohorts born from around 1900 to 1985. Multilevel age, period, and cohort models support diffusion arguments concerning tolerance of premarital sex by demonstrating that the effects of indicators of SES first strengthen and then weaken across cohorts. Little support emerges for diffusion arguments concerning tolerance of extramarital sex and teenage sex, and preliminary but suggestive support emerges concerning tolerance of same-gender sex. PMID:28533566

Effectiveness of Abstinence-Based Sex Education Curricula: A Review.

ERIC Educational Resources Information Center

Toups, Melanie L.; Holmes, William R.

2002-01-01

Many attempts have been made to address the problem of teenage premarital sexual activity in order to reduce the number of pregnancies and sexually transmitted diseases. The authors review some of those efforts and attempt to identify effective approaches. Implications for research are also presented. (Author)

Factors Influencing Contraceptive Behavior of Single College Students

ERIC Educational Resources Information Center

Maxwell, Joseph W.; And Others

1977-01-01

This study investigates the premarital contraceptive behavior of 222 male and female college students. Contraceptive practice was examined in relation to dating patterns, level of emotional involvement with sex partners, types of birth control used, number of different sex partners, and reasons for failure to use birth control. (Author)

Premarital Contraceptives Usage among Male and Female Adolescents.

ERIC Educational Resources Information Center

Hornick, Joesph P.; And Others

1979-01-01

Variables important in predicting female contraception usage were found to be those which involved dyadic commitment, conditions of love, self-esteem, and father's occupation (social class). The best predictors of male contraception usage involved experience in dating and internalization of role models via mother's and father's permissiveness.…

Neighborhood, Family, and Work: Influences on the Premarital Behaviors of Adolescent Males.

ERIC Educational Resources Information Center

Ku, Leighton; And Others

1993-01-01

Analysis of national survey data suggests that level of sexual activity and likelihood of paternity among adolescent males are related to personal financial resources and employment but also to neighborhood unemployment. Discusses associations of sexual activity, contraceptive use, and paternity with personal and neighborhood race/ethnicity,…

Perceived Causes of Marriage Breakdown and Conditions of Life.

ERIC Educational Resources Information Center

Burns, Ailsa

1984-01-01

Compared reasons given by divorced men and women (N=335) for the failure of their marriages. Structural and demographic variables, including sex, socioeconomic status, religion, age at marriage, parental approval, duration, number of children, and premarital acquaintance were mentioned. Results suggested that different types of marriage breakdown…

Sexual Behavior and Correlates among College Students.

ERIC Educational Resources Information Center

Murstein, Bernard I.; Holden, Cynthia Caravatt

1979-01-01

A representative sample of 347 college men and women were queried on their experience with premarital sex. Responses were correlated to subjects' self-reported philosophy of sex, relationship with parents, physical attractiveness, religious feelings, drug use, commitment to last sexual partner, and attitudes toward marriage and women's liberation.…

African American Daughter-Mother Relations and Teenage Pregnancy: Two Faces of Premarital Teenage Pregnancy.

ERIC Educational Resources Information Center

Scott, Joseph W.

1993-01-01

Examines mother-daughter relationships and teenage pregnancy prevention in 153 school-aged mothers. The consistent finding is that negative daughter-mother relationships foster earlier first pregnancies, whereas positive relationships resulted in later-age pregnancies. Consistently positive relationships are second in potency for delaying or…

Parent-Teen Communication about Premarital Sex: Factors Associated with the Extent of Communication.

ERIC Educational Resources Information Center

Jaccard, James; Dittus, Patricia J.; Gordon, Vivian V.

2000-01-01

This study explored topic-specific reservations about discussing sex and birth control among inner-city African American mothers and their 14- to 17-year-olds. Findings showed that reservations predicted communication behavior beyond that predicted by general family environment variables. Interaction effects suggested differential impact of…

Perceptions of Adolescent Pregnancy Among Teenage Girls in Rakai, Uganda

PubMed Central

Maly, Christina; McClendon, Katherine A.; Baumgartner, Joy Noel; Nakyanjo, Neema; Ddaaki, William George; Serwadda, David; Nalugoda, Fred Kakaire; Wawer, Maria J.; Bonnevie, Erika; Wagman, Jennifer A.

2017-01-01

The leading causes of death and disability among Ugandan female adolescents aged 15 to 19 years are pregnancy complications, unsafe abortions, and childbirth. Despite these statistics, our understanding of how girls perceive adolescent pregnancy is limited. This qualitative study explored the social and contextual factors shaping the perceptions of adolescent pregnancy and childbirth among a sample of 12 currently pregnant and 14 never pregnant girls living in the rural Rakai District of Uganda. Interviews were conducted to elicit perceived risk factors for pregnancy, associated community attitudes, and personal opinions on adolescent pregnancy. Findings indicate that notions of adolescent pregnancy are primarily influenced by perceptions of control over getting pregnant and readiness for childbearing. Premarital pregnancy was perceived as negative whereas postmarital pregnancy was regarded as positive. Greater understanding of the individual and contextual factors influencing perceptions can aid in development of salient, culturally appropriate policies and programs to mitigate unintended adolescent pregnancies. PMID:28835911

Beliefs About Sex and Parent-Child-Church Sex Communication Among Church-Based African American Youth.

PubMed

Moore, Erin; Berkley-Patton, Jannette; Bohn, Alexandria; Hawes, Starlyn; Bowe-Thompson, Carole

2015-10-01

Parent-child sex communication has been shown to be protective against sexual risk among African American youth. The current study sought to use the theory of planned behavior as a framework for focus group discussions (N = 54 youth participants aged 12-19 years) to explore church youths' (a) sex beliefs and values (attitudes), (b) sources and evaluation of sex communication and education (subjective norms), (c) facilitator/barriers to adolescent sexual risk reduction and communication behaviors (perceived behavioral control), and (d) intentions to engage in these behaviors. Additionally, participants identified strategies for consideration in developing tailored parent-child-church sex communication education programs for use in African American churches. Themes suggested both positive and negative attitudes toward premarital sex and parents and churches as key sources of sex education and communication. Strategies to enhance parent-child-church sex communication are discussed in the context of these findings.

High-risk behaviour in young men attending sexually transmitted disease clinics in Pune, India

PubMed Central

BRAHME, R. G.; SAHAY, S.; MALHOTRA-KOHLI, R.; DIVEKAR, A. D.; GANGAKHEDKAR, R. R.; PARKHE, A. P.; KHARAT, M. P.; RISBUD, A. R.; BOLLINGER, R. C.; MEHENDALE, S. M.; PARANJAPE, R. S.

2012-01-01

The present study reports sexual risk factors associated with HIV infection among men attending two sexually transmitted disease (STD) clinics in Pune, India and compares these behaviours between young and older men. Between April 1998 and May 2000, 1,872 STD patients were screened for HIV infection. Data on demographics, medical history and sexual behaviour were collected at baseline. The overall HIV prevalence was 22.2%. HIV risk was associated with being divorced or widowed, less educated, living away from the family, having multiple sexual partners and initiation of sex at an early age. The risk behaviours in younger men were different to older men. Younger men were more likely to report early age of initiation of sex, having friends, acquaintances or commercial sex workers as their regular partners, having premarital sex and bisexual orientation. Young men were more educated and reported condom use more frequently compared with the older men. Similar high HIV prevalence among younger and older men highlights the need for focused targeted interventions aimed at adolescents and young men and also appropriate interventions for older men to reduce the risk of HIV and STD acquisition. PMID:15832886

Alcohol intoxication and sexual risk behaviors among rural-to-urban migrants in China

PubMed Central

Lin, Danhua; Li, Xiaoming; Yang, Hongmei; Fang, Xiaoyi; Stanton, Bonita; Chen, Xinguang; Abbey, Antonia; Liu, Hongjie

2007-01-01

Background The migrant population in China is at high risk for sexual risk behavior and alcohol intoxication. Information about the prevalence of alcohol intoxication and its association with sexual risk behavior among migrants is needed for designing effective intervention prevention programs for reduction in alcohol abuse and HIV infection. Methods Cross-sectional data were collected from 2153 sexually experienced young rural-to-urban migrants in Beijing and Nanjing, China, in 2002. Results Approximately one-third of the participants had been intoxicated with alcohol at least once during the previous month, with more males than females reporting intoxication (40.2% versus 23.7%, p < 0.001). Compared to non-intoxicated participants, respondents with alcohol intoxication in previous 30 days reported more psychological problems, including higher depression scores, lower levels of satisfaction with life and work, and higher perception of peer involvement in risk behavior. Intoxicated respondents were more likely to engage in premarital sex than non-intoxicated respondents (76% versus 60.2%, p < 0.001), have multiple sexual partners (13.4% versus 5.2%, p < 0.001), purchase sex (12.6% versus 4.9%, p < 0.001), and sell sex (10.1% versus 3.7%, p < 0.001). However, there was no association between alcohol intoxication and inconsistent/non-use of condoms. Multivariate analysis controlling for depression, peer risk involvement, age, gender, and other socio-demographic variables indicated that alcohol intoxication was independently correlated with premarital sex, multiple sexual partners, and buying and selling sex. Conclusions Compared to the general Chinese population, levels of intoxication were elevated among Chinese rural-to-urban migrants. Alcohol intoxication was associated with sexual risk behaviors. HIV/AIDS prevention and intervention efforts should include components of alcohol use/abuse prevention for an effective reduction of sexual risk among young rural-to-urban migrants in China. PMID:15943949

A National Registry of Thalassemia in Turkey: Demographic and Disease Characteristics of Patients, Achievements, and Challenges in Prevention

PubMed Central

Aydınok, Yeşim; Oymak, Yeşim; Atabay, Berna; Aydoğan, Gönül; Yeşilipek, Akif; Ünal, Selma; Kılınç, Yurdanur; Oflaz, Banu; Akın, Mehmet; Vergin, Canan; Sezgin Evim, Melike; Çalışkan, Ümran; Ünal, Şule; Bay, Ali; Kazancı, Elif; İleri, Talia; Atay, Didem; Patıroğlu, Türkan; Kahraman, Selda; Söker, Murat; Akcan, Mediha; Akdeniz, Aydan; Büyükavcı, Mustafa; Alanoğlu, Güçhan; Bör, Özcan; Soyer, Nur; Özdemir Karadaş, Nihal; Uysalol, Ezgi; Türker, Meral; Akçay, Arzu; Ocak, Süheyla; Güneş, Adalet Meral; Tokgöz, Hüseyin; Ünal, Elif; Tiftik, Naci; Karakaş, Zeynep

2018-01-01

Objective: The Turkish Society of Pediatric Hematology set up a National Hemoglobinopathy Registry to demonstrate the demographic and disease characteristics of patients and assess the efficacy of a hemoglobinopathy control program (HCP) over 10 years in Turkey. Materials and Methods: A total of 2046 patients from 27 thalassemia centers were registered, of which 1988 were eligible for analysis. This cohort mainly comprised patients with β-thalassemia major (n=1658, 83.4%) and intermedia (n=215, 10.8%). Results: The majority of patients were from the coastal areas of Turkey. The high number of patients in Southeastern Anatolia was due to that area having the highest rates of consanguineous marriage and fertility. The most common 11 mutations represented 90% of all β-thalassemia alleles and 47% of those were IVS1-110(G->A) mutations. The probability of undergoing splenectomy within the first 10 years of life was 20%, a rate unchanged since the 1980s. Iron chelators were administered as monotherapy regimens in 95% of patients and deferasirox was prescribed in 81.3% of those cases. Deferasirox administration was the highest (93.6%) in patients aged <10 years. Of the thalassemia major patients, 5.8% had match-related hemopoietic stem cell transplantation with a success rate of 77%. Cardiac disease was detected as a major cause of death and did not show a decreasing trend in 5-year cohorts since 1999. Conclusion: While the HCP has been implemented since 2003, the affected births have shown a consistent decrease only after 2009, being at lowest 34 cases per year. This program failure resulted from a lack of premarital screening in the majority of cases. Additional problems were unawareness of the risk and misinformation of the at-risk couples. In addition, prenatal diagnosis was either not offered to or was not accepted by the at-risk families. This study indicated that a continuous effort is needed for optimizing the management of thalassemia and the development of strategies is essential for further achievements in the HCP in Turkey. PMID:28404539

A National Registry of Thalassemia in Turkey: Demographic and Disease Characteristics of Patients, Achievements, and Challenges in Prevention.

PubMed

Aydınok, Yeşim; Oymak, Yeşim; Atabay, Berna; Aydoğan, Gönül; Yeşilipek, Akif; Ünal, Selma; Kılınç, Yurdanur; Oflaz, Banu; Akın, Mehmet; Vergin, Canan; Sezgin Evim, Melike; Çalışkan, Ümran; Ünal, Şule; Bay, Ali; Kazancı, Elif; İleri, Talia; Atay, Didem; Patıroğlu, Türkan; Kahraman, Selda; Söker, Murat; Akcan, Mediha; Akdeniz, Aydan; Büyükavcı, Mustafa; Alanoğlu, Güçhan; Bör, Özcan; Soyer, Nur; Özdemir Karadaş, Nihal; Uysalol, Ezgi; Türker, Meral; Akçay, Arzu; Ocak, Süheyla; Güneş, Adalet Meral; Tokgöz, Hüseyin; Ünal, Elif; Tiftik, Naci; Karakaş, Zeynep

2018-03-01

The Turkish Society of Pediatric Hematology set up a National Hemoglobinopathy Registry to demonstrate the demographic and disease characteristics of patients and assess the efficacy of a hemoglobinopathy control program (HCP) over 10 years in Turkey. A total of 2046 patients from 27 thalassemia centers were registered, of which 1988 were eligible for analysis. This cohort mainly comprised patients with β-thalassemia major (n=1658, 83.4%) and intermedia (n=215, 10.8%). The majority of patients were from the coastal areas of Turkey. The high number of patients in Southeastern Anatolia was due to that area having the highest rates of consanguineous marriage and fertility. The most common 11 mutations represented 90% of all β-thalassemia alleles and 47% of those were IVS1-110(G->A) mutations. The probability of undergoing splenectomy within the first 10 years of life was 20%, a rate unchanged since the 1980s. Iron chelators were administered as monotherapy regimens in 95% of patients and deferasirox was prescribed in 81.3% of those cases. Deferasirox administration was the highest (93.6%) in patients aged <10 years. Of the thalassemia major patients, 5.8% had match-related hemopoietic stem cell transplantation with a success rate of 77%. Cardiac disease was detected as a major cause of death and did not show a decreasing trend in 5-year cohorts since 1999. While the HCP has been implemented since 2003, the affected births have shown a consistent decrease only after 2009, being at lowest 34 cases per year. This program failure resulted from a lack of premarital screening in the majority of cases. Additional problems were unawareness of the risk and misinformation of the at-risk couples. In addition, prenatal diagnosis was either not offered to or was not accepted by the at-risk families. This study indicated that a continuous effort is needed for optimizing the management of thalassemia and the development of strategies is essential for further achievements in the HCP in Turkey.

The Pregnant Teen-Ager: A Medical, Educational, and Social Analysis.

ERIC Educational Resources Information Center

Osofsky, Howard J.

Concerned with teen-aged pregnancy, the text includes discussions of premarital pregnancy, the pregnant teen as a member of the poor, as nonwhite, and as a teen-ager, obstetrical concepts, pregnancy results, factors which influence medical prognosis, and solutions to minimize medical risk. Additional areas of concern are a research review and a…

Sexuality Education Beliefs among Sexually Experienced Youth: Differences by Gender and Birth Control Use

ERIC Educational Resources Information Center

Tolma, Eleni L.; Vesely, Sara K.; Oman, Roy F.; Aspy, Cheryl B.; Rodine, Sharon

2006-01-01

Purpose: To examine whether gender and birth control use are associated with premarital sexual attitudes, beliefs about peers, family communication about sexual relationships, and sexuality education among sexually experienced youth. Methods: Data were collected from a randomly selected ethnically diverse youth sample (N = 1,253). Only the…

Reasoning about Family Honour among Two Generations of Hindu Indian-Americans

ERIC Educational Resources Information Center

Kay, Adam

2012-01-01

To investigate reasoning about family honour, 128 first generation (mean age = 27.2 years) and second generation Hindu Indian-American adults (mean age = 24.7 years) were presented hypothetical scenarios in which male or female protagonists defied common Hindu customs (e.g., arranged marriage, intra-religion marriage and premarital sexual…

Use of Standardized Assessment Instruments by Marital and Family Therapists: A Survey.

ERIC Educational Resources Information Center

Boughner, Shelly R.; And Others

1994-01-01

Surveyed 598 marriage/family practitioners to examine use of standardized assessment instruments in practice. Responses from 188 clinicians who reported use of tests revealed that 147 different standardized tests were used in marriage and family therapy practice. Test use was most frequent for treatment planning purposes, except in premarital area…

Sexual Attitudes and Behavior at Four Universities: Do Region, Race, and/or Religion Matter?

ERIC Educational Resources Information Center

Davidson, J. Kenneth, Sr.; Moore, Nelwyn B.; Earle, John R.; Davis, Robert

2008-01-01

This study sought to ascertain any differences in sexual attitudes, levels of premarital sexual involvement, and risk-taking sexual practices of college students at four distinctly different universities: a historic Black public university; a predominately white, Southern private university with a religious heritage; a Southwestern public…

Understanding the Effects of Personal and School Religiosity on the Decision to Abort a Premarital Pregnancy

ERIC Educational Resources Information Center

Adamczyk, Amy

2009-01-01

Although much research has examined the relationship between religion and abortion attitudes, few studies have examined whether religion influences abortion behavior. This study looks at whether individual and school religiosity influence reported abortion behavior among women who become pregnant while unmarried. Hierarchical Logistic Models are…

Some Research and Clinical Perspectives on Adolescent Sexuality.

ERIC Educational Resources Information Center

Chilman, Catherine S.

This paper selects and emphasizes some of the concepts and findings to be found in the author's book, Adolescent Sexuality in a Changing Society. This paper limits itself to various aspects of premarital intercourse among adolescents, including the personality traits of virgins and non-virgins, and the effects of education upon sexual attitudes.…

Parental Sexual Attitudes, Family Sexual Communication, and Adolescent Sexual Behavior.

ERIC Educational Resources Information Center

Fisher, Terri D.

Some researchers have reported that when parents are the main source of sex education, their adolescent children are less likely to engage in premarital sexual activity and are more likely to use effective contraception. This study used the variables of gender and parental sexual attitudes (liberal or conservative) to categorize 349 college…

Parental Divorce and Premarital Couples: Commitment and Other Relationship Characteristics.

ERIC Educational Resources Information Center

Jacquet, E.; Surra Catherine A.

2001-01-01

Parental divorce is thought to affect romantic relationships of young adults, especially with respect to certainty about relationships and perceptions of problems in relationships. This study examined these connections with a random sample of 464 coupled partners. Young adults who were casually dating showed the strongest effects of divorce,…

Premarital Cohabitation and Marital Dissolution: An Examination of Recent Marriages

ERIC Educational Resources Information Center

Manning, Wendy D.; Cohen, Jessica A.

2012-01-01

An ongoing question remains for family researchers: Why does a positive association between cohabitation and marital dissolution exist when one of the primary reasons to cohabit is to test relationship compatibility? Drawing on recently collected data from the 2006-2008 National Survey of Family Growth, the authors examined whether premarital…

Neighborhood Poverty and Nonmarital Fertility: Spatial and Temporal Dimensions

ERIC Educational Resources Information Center

South, Scott J.; Crowder, Kyle

2010-01-01

Data from 4,855 respondents to the Panel Study of Income Dynamics were used to examine spatial and temporal dimensions of the effect of neighborhood poverty on teenage premarital childbearing. Although high poverty in the immediate neighborhood increased the risk of becoming an unmarried parent, high poverty in surrounding neighborhoods reduced…

Residential Mobility and the Onset of Adolescent Sexual Activity

ERIC Educational Resources Information Center

South, Scott J.; Haynie, Dana L.; Bose, Sunita

2005-01-01

Data from almost 5,000 adolescent respondents to the National Longitudinal Study of Adolescent Health (Add Health) are used to examine the mechanisms that transmit the facilitative effect of residential mobility on the timing of the transition to first premarital sexual intercourse. Adolescents who have recently moved are approximately one third…

A Comparison of Unwed Pregnant Teenagers and Nulligravid Sexually Active Adolescents Seeking Contraception.

ERIC Educational Resources Information Center

DeAmicis, Lyn A.; And Others

1981-01-01

Pregnant adolescent students were less likely than nulligravid students to employ or plan to use contraceptives. They more often expressed a desire for a pregnancy and described their boyfriends as happy about the pregnancy. Nulligravid youngsters described their parents as more disapproving of their premarital sexual activity. (Author/RH)

Childhood and Adolescent Sexuality, Islam, and Problematics of Sex Education: A Call for Re-Examination

ERIC Educational Resources Information Center

Tabatabaie, Alireza

2015-01-01

This paper offers a critical examination of the problematics of childhood and adolescent sexuality and sex education in an Islamic context. By exploring conceptions of (pre-marital) sexuality, childhood, and maturity/adulthood, it is suggested that: (i) "childhood" and "sexuality" do not coexist harmoniously in Islamic…

Individual and Family Correlates of Adolescents' Sexual Behavior: Multiethnic Findings

ERIC Educational Resources Information Center

Anagurthi, Claudia; Johnson, Ashley Cahill; Somers, Cheryl L.

2011-01-01

The purpose of this study was to examine correlates of adolescent sexual activity, including age of first date, family composition, clarity of long term goals, and maternal and paternal views about premarital sex. There were 672 males and females, three races/ethnicities, both urban and suburban settings, and socioeconomic diversity. Sexual…

Moving Out and Marriage: What Do Young Adults Expect?

ERIC Educational Resources Information Center

Goldscheider, Calvin; Goldscheider, Frances K.

Living independently before marriage is part of a broader pattern of family and demographic change characterizing modern societies since World War II. This study examined expectations about premarital residential independence among young adults. Data were obtained from 28,240 high school seniors who participated in the High School and Beyond study…

Adolescent Sexuality Related Beliefs and Differences by Sexual Experience Status

ERIC Educational Resources Information Center

Tolma, Eleni L.; Oman, Roy F.; Vesely, Sara K.; Aspy, Cheryl B.; Rodine, Sharon; Marshall, LaDonna; Fluhr, Janene

2007-01-01

Purpose: To examine if attitudes toward premarital sex, beliefs about peer influence, and family communication about sexual relationships differ by sexual experience status. Methods: Data were collected from a randomly selected ethnically diverse youth sample (N = 1,318) residing in two Midwestern cities. The primary method used in data analysis…

Premarital Sexual Behavior and Attitudes Toward Marriage and Divorce among Young Women as a Function of Their Mothers' Marital Status.

ERIC Educational Resources Information Center

Kinnaird, Keri L.; Gerrard, Meg

1986-01-01

Investigated attitudes and sexual activity of young unmarried women from different family structures. Intact family respondents reported most positive attitudes toward marriage; reconstituted family respondents reported most accepting attitudes toward divorce. Divorced and reconstituted family subjects reported significantly more sexual experience…

The social consequences of teenage parenthood.

PubMed

Furstenberg, F F

1976-01-01

The adolescent mothers consistently experienced great difficulty in realizing their life plans, when compared with their classmates who did not become pregnant premaritally in their early teens. Marital instability, school disruption, economic problems, and difficulty in family size regulation and child-rearing were some of the complications brought on by their premature, unscheduled childbearing.

Reassessing Differences in Work and Income in Cohabitation and Marriage

ERIC Educational Resources Information Center

Kuperberg, Arielle

2012-01-01

Are cohabiters different than married couples who cohabited before marriage? This study used the 2002 wave of the National Survey of Families and Households to determine how work behavior might differ for 4 relationship types: (a) cohabiters with uncertain marriage plans, (b) cohabiters with definite marriage plans, (c) premarital cohabiters who…

A Comparison of Sexual Attitudes and Practices of Black Junior College Students.

ERIC Educational Resources Information Center

Christ, Susann

The attitudes of community college students toward premarital sexual relationships were investigated. Subjects were 83 Black college men and women. A 30-item questionnaire was administered to each subject. Results indicated that: (1) females reported less frequent occurrence of sexual relations than males; (2) neither sex reported a high incidence…

New laws on population urged.

PubMed

1976-12-03

A workshop on ''Population and the Law'' sponsored by the Family Planning Organization of the Philippines and the International Planned Parenthood Federation recommended the following changes in Philippine law to implement family planning: legalization of abortion for women whose life or health are endangered by pregnancy and those who become pregnant despite contraceptives; delaying age of marriage to 18; extension of family planning incentives and maternity leave to women in government service; allow trained nurses and midwives to dispense contractives; legalize sterilization; include sterilization in medicare benefits; specify by law which contraceptive drugs may be dispensed by nonphysicians and nonpharmacists in rural areas; legalize premarital family planning counseling; declare family planning materials tax exempt; encourage reluctant doctors to practice sterilization through professional regulatory agencies; extend industrial family planning services to women living near the plant; launch massive information drives to advise young people of the hazards of premarital sex; strict enforcement of abortion laws in areas where illegal abortion still exists; grant women equal rights in area of consent for sterilization; and eliminate the stigma of illegitimacy for those born out of wedlock.

The attitudes of Kenyan in-school adolescents toward sexual autonomy.

PubMed

Adaji, Sunday E; Warenius, Linnea U; Ong'any, Antony A; Faxelid, Elisabeth A

2010-03-01

This was a cross-sectional study to examine the attitudes of Kenyan in-school adolescents towards premarital sex, unwanted pregnancies/abortions and contraception. Data collection was undertaken using a structured questionnaire. Kenyan in-school adolescents have conservative attitudes toward premarital sex, disagreeing that adolescent boy and girls should be left alone to satisfy their sexual needs. The girls had the view that boys have uncontrollable sexual appetites. With regards to unwanted pregnancies, the majority of the respondents disagreed with allowing abortions for pregnant school girls while they agreed that a pregnant school girl should be allowed to return to school. However, the majority of the girls held the view that a school boy who had impregnated a school girl should be expelled from school. The attitudes of the respondents to contraception were also largely conservative. The conservative attitudes of the respondents conflicts with the findings of high levels of unsafe sex and reproductive ill-health among Kenyan adolescents. There is need to help Kenyan in-school adolescents to develop more realistic attitudes toward sexuality in order to improve their reproductive health.

Virginity dilemma: Re-creating virginity through hymenoplasty in Iran.

PubMed

Kaivanara, Marzieh

2016-01-01

Bridal virginity retains undeniable value in Iran's contemporary cultural landscape. Widely regarded as a sign of chastity and purity for unmarried girls, failure to prove virginity on the wedding night may have serious consequences for a girl. In this context, there has been a recent growth in the rate of hymen restoration surgery (hymenoplasty) due to an increase in the number of girls who engage in premarital sexual relationships. The present study attempts to elucidate the processes through which particular physical features come to be considered culturally meaningful, and explores the phenomenon of hymen-reconstructing surgery from the perspective of young Tehrani girls and boys. Applying anthropological insights into gender roles, I explore how so-called 'rebellious' Iranian girls find - through the surgical reconstruction of their hymen - a means to negotiate between dominant models of gender and their own subjective experiences. While their actions challenge the premarital sex taboo, Iranian girls who participate in hymen restoration surgery also conform to the values that require them to be a virgin at the time of marriage, thus reinforcing existing power relations.

Telemedicine and Diabetic Retinopathy: Review of Published Screening Programs

PubMed Central

Tozer, Kevin; Woodward, Maria A.; Newman-Casey, Paula A.

2016-01-01

Background Diabetic Retinopathy (DR) is a leading cause of blindness worldwide even though successful treatments exist. Improving screening and treatment could avoid many cases of vision loss. However, due to an increasing prevalence of diabetes, traditional in-person screening for DR for every diabetic patient is not feasible. Telemedicine is one viable solution to provide high-quality and efficient screening to large number of diabetic patients. Purpose To provide a narrative review of large DR telemedicine screening programs. Methods Articles were identified through a comprehensive search of the English-language literature published between 2000 and 2014. Telemedicine screening programs were included for review if they had published data on at least 150 patients and had available validation studies supporting their model. Screening programs were then categorized according to their American Telemedicine Association Validation Level. Results Seven programs from the US and abroad were identified and included in the review. Three programs were Category 1 programs (Ophdiat, EyePacs, and Digiscope), two were Category 2 programs (Eye Check, NHS Diabetic Eye Screening Program), and two were Category 3 programs (Joslin Vision Network, Alberta Screening Program). No program was identified that claimed category 4 status. Programs ranged from community or city level programs to large nationwide programs including millions of individuals. The programs demonstrated a high level of clinical accuracy in screening for DR. There was no consensus amongst the programs regarding the need for dilation, need for stereoscopic images, or the level of training for approved image graders. Conclusion Telemedicine programs have been clinically validated and successfully implemented across the globe. They can provide a high-level of clinical accuracy for screening for DR while improving patient access in a cost-effective and scalable manner. PMID:27430019

Influence of a screening navigation program on social inequalities in health beliefs about colorectal cancer screening.

PubMed

Vallet, Fanny; Guillaume, Elodie; Dejardin, Olivier; Guittet, Lydia; Bouvier, Véronique; Mignon, Astrid; Berchi, Célia; Salinas, Agnès; Launoy, Guy; Christophe, Véronique

2016-08-01

The aim of the study was to test whether a screening navigation program leads to more favorable health beliefs and decreases social inequalities in them. The selected 261 noncompliant participants in a screening navigation versus a usual screening program arm had to respond to health belief measures inspired by the Protection Motivation Theory. Regression analyses showed that social inequalities in perceived efficacy of screening, favorable attitude, and perceived facility were reduced in the screening navigation compared to the usual screening program. These results highlight the importance of health beliefs to understand the mechanism of screening navigation programs in reducing social inequalities. © The Author(s) 2014.

Trends in Attitudes About Marriage, Childbearing, and Sexual Behavior: United States, 2002, 2006-2010, and 2011-2013.

PubMed

Daugherty, Jill; Copen, Casey

2016-03-17

This report describes attitudes about marriage, childbearing, and sexual behavior among men and women aged 15-44 in the United States based on the 2002, 2006-2010, and 2011-2013 National Survey of Family Growth (NSFG). Data for all three survey periods were collected through in-person interviews with nationally representative, independent samples of men and women in the household population of the United States. The overall response rate for NSFG was 79% in 2002, 77% in 2006-2010, and 73% in 2011-2013. Attitudinal items examined in this report include those related to marriage, divorce, cohabitation, parenthood, and sexual behavior. Where data from all three survey periods were available, differences were tested using trend analysis. Data from the 2002 survey were not available for some attitude items, and in these cases, comparisons were made only between the 2006-2010 and 2011-2013 surveys. Attitudinal differences by age group were analyzed using 2011-2013 data. All results are shown separately for women and men. From 2002 to 2011-2013, there was an increase in the percentages of men and women who agreed with premarital cohabitation, nonmarital childbearing, the right for gay and lesbian adults to adopt children, same-sex sexual relations, and premarital sex for those aged 18. There was a decrease in the percentages of men and women who agreed with divorce. There was no change in the percentages of men and women who agreed with premarital sex for those aged 16. There was no change from 2006-2010 to 2011-2013 in attitudes regarding marriage, cohabitation and the risk of divorce, the necessity of having children for one's happiness, and raising children in a cohabiting union. Several of the attitudinal items varied significantly by age group for both men and women. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

A review of interventions to prevent pregnancy.

PubMed

Dryfoos, J G

1990-01-01

Of more developed nations, the US is unique in its problem with high rates of teen pregnancy. At the heart of our failure to check teen pregnancy may lie the country's poor sexual climate, a lack of government commitment, poor health system performance, local barriers to the provision of quality sex education, and/or lack of access to contraception. Potential solutions to reduce teen pregnancy are equally wide-ranging. Programs may aim to provide better and more health and sex education, improve decision making skills, improve access to contraception and abortion, improve life opportunities as alternatives to pregnancies, restructure welfare, and/or encourage youths to refrain from premarital sex. This essay presents and discusses major prevention efforts which seem to have the highest probability of reducing pregnancy rates, and especially childbearing rates among young, unmarried teens. Literature on program successes, agency reports, and program observations are reviewed, and include programs of sex education and skills enhancement, those helping sexually active youths become better contraceptors, and those which offer life option alternatives. In the area of improving access to contraception, school-based clinics, condom distribution, and other male-oriented programs are covered. Major social structural change is, however, called for with a view to promoting equity in education, housing, and jobs. Short of such change, interventions may target school-based populations, as well as community centers to reach dropouts. Early intervention and collaboration to bolster health, social, and recreational services for children and adolescents is urged.

Beliefs versus Lived Experience: Gender Differences in Catholic College Students' Attitudes Concerning Premarital Sex and Contraception

ERIC Educational Resources Information Center

Maher, Michael J.; Sever, Linda M.; Pichler, Shaun

2008-01-01

In April 2003, the researchers conducted a survey of undergraduate students living in residence halls at Loyola University Chicago. The survey contained twenty statements on issues currently discussed in the religious circles, especially the Catholic Church. The majority of both Catholic males and Catholic females disagreed with the statements,…

Religiosity and Premarital Sexual Permissiveness: A Response to the Reiss-Heltsley and Broderick Debate

ERIC Educational Resources Information Center

Ruppel, Howard J., Jr.

1970-01-01

When religiosity among college students was measured by Faulkner and DeJong's 5-D Scale of Religiosity" and the Reiss scale was used to measure permissiveness, the expected stronger relationship between religiosity and permissiveness in groups with traditions of low sexual permissiveness than in groups with traditions of high sexual…

A Longitudinal Study of Premarital Couples: A Social Exchange Perspective.

ERIC Educational Resources Information Center

Markman, Howard J.

The attributes of couples planning to marry can affect their future relationship satisfaction. To study this phenomenon, a social exchange model was applied to a sample of couples planning to marry to assess the predictive validity of a measure of positive exchange. The longitudinal design of the two-and-a-half year investigation provided direct…

Knowledge and Attitude of Nigerian Adolescents to Premarital Genotying.

ERIC Educational Resources Information Center

Egbochuku, E. O.; Imogie, A. O.

Sickle cell disease (SCD) refers to a group of hereditary disorders of the structure of hemoglobin of red blood cells. This disorder involves the inheritance of two abnormal genes, which are related to the hemoglobin promotion, at least, one of which is the sickle cell gene. Nigeria, by virtue of her large population, has the greatest number of…

The Effects of Premarital Heterosexual and Homosexual Experience on Dating and Marriage Desirability.

ERIC Educational Resources Information Center

Williams, John D.; Jacoby, Arthur P.

1989-01-01

Surveyed 365 college students to investigate their attitudes toward the effects of past sexual behavior, both heterosexual and homosexual, on one's acceptability as a dating or marriage partner. Results showed that both men and women prefer partners without previous coital or oral heterosexual experience, and both strongly rejected those with any…

Sexual Behavior among Employed Male Rural Migrants in Shanghai, China

ERIC Educational Resources Information Center

He, Na; Detels, Roger; Chen, Zheng; Jiang, Qingwu; Zhu, Jinde; Dai, Yiqun; Wu, Min; Zhong, Xing; Fu, Chaowei; Gui, Dexin

2006-01-01

A study of sexual behavior in migrant men was conducted in construction sites, markets, and factories in Shanghai, the largest city in China. An anonymous, self-administered questionnaire was completed by the migrants. Among 986 sexually active men, 14% had had more than one sexual partner in their lifetime, 31% premarital sex, 3.3% oral sex, and…

The Timing of Cohabitation and Engagement: Impact on First and Second Marriages

ERIC Educational Resources Information Center

Stanley, Scott M.; Rhoades, Galena K.; Amato, Paul R.; Markman, Howard J.; Johnson, Christine A.

2010-01-01

Using a multistate sample of marriages that took place in the 1990s, this study examined associations between premarital cohabitation history and marital quality in first (N = 437) and second marriages (N = 200) and marital instability in first marriages (intact N = 521, divorced N = 124). For first marriages, cohabiting with the spouse without…

Between acculturation and ambivalence: knowledge of genetics and attitudes towards genetic testing in a consanguineous bedouin community.

PubMed

Raz, Aviad E; Atar, Marcela; Rodnay, Maya; Shoham-Vardi, Ilana; Carmi, Rivka

2003-01-01

The Bedouins of the Negev (Southern part of Israel) are a community at increased risk for genetic diseases and congenital anomalies as a result of frequent consanguinity (particularly patrilateral parallel-cousin marriage) and underutilization of prenatal genetic tests due to a Muslim ban on abortion. To assess the knowledge and attitudes of Bedouin schoolchildren and their teachers towards a community-based, premarital carrier-matching program aimed at reducing the prevalence at birth of genetic diseases. A questionnaire was presented to 61 teachers and 40 schoolchildren as part of guided interaction in small groups, conducted in Bedouin schools between 1999 and 2001. Susceptibility as well as knowledge of genetics were found to correlate with a positive attitude towards the genetics program among both teachers and pupils. However, pupils had a lower knowledge index as compared to teachers, and their attitudes were slightly less positive. The difference between teachers and pupils is discussed in the context of the latter's acculturation, which contradicts tradition and parental authority and can generate ambivalence. Attitudes are further discussed in the context of the Health Belief Model and the complex interplay of tradition, Islam, cousin marriage and biomedicine. Copyright 2003 S. Karger AG, Basel

Planning and Implementing Health Screening Programs.

ERIC Educational Resources Information Center

Webster, Katherine P.

1980-01-01

School health screening programs, which include screening, education of children and parents, and follow-up in the form of appropriate treatment, are described. A scoliosis screening program is described as an example of the model presented. Suggestions for planners, participants, and evaluators of any school health screening are summarized. (JMF)

Impact of the National Breast and Cervical Cancer Early Detection Program on cervical cancer mortality among uninsured low-income women in the U.S., 1991-2007.

PubMed

Ekwueme, Donatus U; Uzunangelov, Vladislav J; Hoerger, Thomas J; Miller, Jacqueline W; Saraiya, Mona; Benard, Vicki B; Hall, Ingrid J; Royalty, Janet; Li, Chunyu; Myers, Evan R

2014-09-01

The benefits of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) on cervical cancer screening for participating uninsured low-income women have never been measured. To estimate the benefits in life-years (LYs) gained; quality-adjusted life-years (QALYs) gained; and deaths averted. A cervical cancer simulation model was constructed based on an existing cohort model. The model was applied to NBCCEDP participants aged 18-64 years. Screening habits for uninsured low-income women were estimated using National Health Interview Survey data from 1990 to 2005 and NBCCEDP data from 1991 to 2007. The study was conducted during 2011-2012 and covered all 68 NBCCEDP grantees in 50 states, the District of Columbia, five U.S. territories, and 12 tribal organizations. Separate simulations were performed for the following three scenarios: (1) women who received NBCCEDP (Program) screening; (2) women who received screening without the program (No Program); and (3) women who received no screening (No Screening). Among 1.8 million women screened in 1991-2007, the Program added 10,369 LYs gained compared to No Program, and 101,509 LYs gained compared to No Screening. The Program prevented 325 women from dying of cervical cancer relative to No Program, and 3,829 relative to No Screening. During this time period, the Program accounted for 15,589 QALYs gained when compared with No Program, and 121,529 QALYs gained when compared with No Screening. These estimates suggest that NBCCEDP cervical cancer screening has reduced mortality among medically underserved low-income women who participated in the program. Published by Elsevier Inc.

[New guidelines in regard to cervical cancer screening].

PubMed

Vargas-Hernández, Víctor Manuel; Acosta-Altamirano, Gustavo; Moreno-Eutimio, Mario Adán; Vargas-Aguilar, Víctor Manuel

2014-01-01

Cancer screening programs have been successful in reducing the incidence and mortality due to cervical cancer. For more than a decade, the human papillomavirus test has been recommended as part of these programs, however, Pap tests is not currently recommended for women 65 years of age who participated adequately in screening programs, continuing with these screening programs is not needed. Screening programs will be different in special populations at greatest risk where tests are frequently needed or use of alternative methods.

Evaluation of a workplace hemochromatosis screening program.

PubMed

Stave, G M; Mignogna, J J; Powell, G S; Hunt, C M

1999-05-01

Hemochromatosis is a common inherited disorder of iron metabolism with significant health consequences for the employed population. Although screening for hemochromatosis has been recommended, workplace screening programs remain uncommon. In the first year of a newly initiated corporate screening program, 1968 employees were tested. The screening algorithm included measurement of serum iron and transferrin and subsequent ferritin levels in those employees with elevated iron/transferrin ratios. Thirteen percent of men and 21% of women had elevated iron/transferrin ratios. Of these, 14 men and 2 women had elevated ferritin levels. Of these 16, three had liver biopsies and all three have hemochromatosis. The cost of the screening program was $27,850. The cost per diagnosis was $9283 and the cost per year of life saved was $928. These costs compare very favorably with other common workplace screening programs. Several barriers to obtaining definitive diagnoses on all patients with a positive screening result were identified; strategies to overcome these barriers would further enhance the cost effectiveness of the program. We conclude that workplace hemochromatosis screening is highly cost effective and should be incorporated into health promotion/disease prevention programs.

Cervical cancer screening programs in Latin America and the Caribbean.

PubMed

Murillo, Raul; Almonte, Maribel; Pereira, Ana; Ferrer, Elena; Gamboa, Oscar A; Jerónimo, José; Lazcano-Ponce, Eduardo

2008-08-19

Latin America and the Caribbean (LAC) have a significant burden of cervical cancer. Prophylactic human papillomavirus (HPV) vaccines are an opportunity for primary prevention and new screening methods, such as new HPV DNA testing, are promising alternatives to cytology screening that should be analyzed in the context of regional preventive programs. Cytology-based screening programs have not fulfilled their expectations and coverage does not sufficiently explain the lack of impact on screening in LAC. While improved evaluation of screening programs is necessary to increase the impact of screening on the reduction of incidence and mortality, other programmatic aspects will need to be addressed such as follow-up of positive tests and quality control. The implementation of new technologies might enhance screening performance and reduce mortality in the region. The characteristics, performance and impact of cervical cancer screening programs in LAC are reviewed in this article.

Enhancement of the cervical cancer screening program in Malaysia: a qualitative study.

PubMed

Abdullah, Fauziah; Su, Tin Tin

2010-01-01

Cervical cancer has long been known as a preventable disease. Yet it still is a prime women's health issue globally. In Malaysia, the current cervical cancer screening program, introduced in the 1960s, has been found to be unsuccessful in terms of Pap smear coverage. The aim of this study is to determine providers perceptives on the program and the feasibility of practicing an organized cervical screening program in Malaysia. 11 key informant interviews were conducted with policy makers and health care providers from the Ministry of Health in Malaysia from October 2009 to May 2010. Interviewees' perceptions were explored on current and organized cervical screening program based on their expertise and experience. The results highlighted that the existing cervical screening program in Malaysia faced flaws at all levels that failed to reduce cervical cancer morbidity and mortality. The identified weaknesses were poor acceptance by women, lack of commitment by health care providers, nature of the program, an improper follow-up system, limited resources and other competing needs. Complementarily, all interviewees perceived an organized cervical screening program as an alternative approach both feasible and acceptable by women and government to practice in Malaysia. Better screening coverage depends on an effective screening program that incorporates a behaviour-based strategy. A new program should be focused in the policy-making context to improve screening coverage and to effectively combat cervical cancer.

"A Diploma and a Descendant!" Premarital Sexuality, Education and Politics among Dani University Students in North Sulawesi, Indonesia

ERIC Educational Resources Information Center

Munro, Jenny

2012-01-01

In Indonesia, the notion of "study first" ("kuliah dulu") pressures young adults to refrain from sex and delay marriage until they finish tertiary education. Recent scholarship has viewed choices to abstain from sex as evidence of the potency of values of modernisation, Islamic culture and the contemporary importance of moral…

Premarital Sex and Family Planning Attitudes: A Report of a Pilot Study in a Rural Georgia County.

ERIC Educational Resources Information Center

Johnson, Clara L.

Adolescent pregnancy, especially among low income non-white groups, is becoming a matter of increasing concern. Data indicated that pregnancy in the adolescent, especially under age 16, is associated with high incidences of toxemia, anemia, contracted pelvis, prolonged labor, and a high maternal death rate. It is also the largest single reason why…

Social Implications of Music Videos for Youth: An Analysis of the Content and Effects of MTV.

ERIC Educational Resources Information Center

Greeson, Larry E.; Williams, Rose Ann

1986-01-01

Seventh- and tenth-grade students were shown segments of Music Television (MTV), then asked to respond to a brief attitude survey on parental influence, premarital sex, violence, drug use, and the influence of MTV. Results suggest the potentially powerful influence of popular music and MTV, especially on attitudes towards violence and premarital…

Parenting Education Classes: Promise and Paradox.

ERIC Educational Resources Information Center

Seiferth, Berniece B.; Tyree, Carolyn L.

There are many reasons for implementing a course in parenting education in the schools. Among them are: (1) In the past decade, premarital sex among teenage girls has risen from 30 to 50 percent; (2) One child of every five is born to teenage parents and 94 percent of these teenagers keep their babies; and (3) 90 percent of teenage mothers drop…

Marital status and abortion among young women in Rupandehi, Nepal.

PubMed

Andersen, Kathryn L; Khanal, Ram Chandra; Teixeira, Alexandra; Neupane, Shailes; Sharma, Sharad; Acre, Valerie N; Gallo, Maria F

2015-01-01

Despite liberalization of the Nepal abortion law, young women continue to experience barriers to safe abortion services. We hypothesize that marital status may differentially impact such barriers, given the societal context of Nepal. We evaluated differences in reproductive knowledge and attitudes by marital status with a probability-based, cross-sectional survey of young women in Rupandehi district, Nepal. Participants (N = 600) were surveyed in 2012 on demographics, romantic experiences, media habits, reproductive information, and abortion knowledge and attitudes. We used logistic regression to assess differences by marital status, controlling for age. Participants, who comprised never-married (54%) and ever-married women (45%), reported good access to basic reproductive health and abortion information. Social desirability bias might have prevented reporting of premarital romantic and sexual activity given that participants reported more premarital activities for their friends than for themselves. Only 45% knew that abortion was legal, and fewer ever-married women were aware of abortion legality. Never-married women expected more negative responses from having an abortion than ever-married women. Findings highlight the need for providing sexual and reproductive health care information and services to young women regardless of marital status.

Sex Ideologies in China: Examining Interprovince Differences.

PubMed

Hu, Yang

2016-01-01

In recent decades, premarital sex, extramarital sex, and homosexuality have become increasingly visible in China, leading scholars to claim that a national "sex revolution" is under way. However, China's internal sociocultural diversity calls this nation-level generalization into question. How do sex ideologies vary across China's distinct provinces? To what extent are interprovince variations in sex ideologies associated with distinct macrolevel social factors in China? In this research, data from the 2010 China General Social Survey and the 2011 Chinese Statistics Yearbook were analyzed using multilevel models to test four contending theories of interprovince differences in sex ideologies in China: modernization, Westernization, deindustrialization, and the "rice theory." The modernization theory was unsupported by the results, as socioeconomic development is not significantly associated with sex ideologies. Higher levels of deindustrialization and Westernization were associated with less traditional sex ideologies, but the strength of association varied across the domains of premarital sex, extramarital sex, and homosexuality. The rice theory was consistently supported, as the distinction between rice and wheat agriculture explained up to 30% of the province-level variance in sex ideologies. The findings underline the roles of both long-standing geographic differences and recent social changes in shaping China's ideational landscape of sex.

Detraditionalisation and attitudes to sex outside marriage in China.

PubMed

Zheng, Weijun; Zhou, Xudong; Zhou, Chi; Liu, Wei; Li, Lu; Hesketh, Therese

2011-05-01

China has undergone massive socio-economic change over the past 30 years. In parallel, there have been huge changes in social and sexual mores. Until the end of the Mao era strict norms prevailed, with sex outside marriage widely regarded as immoral and unacceptable. Detraditionalisation theory describes the abandonment or reconfiguration of the socio-cultural traditions and has been explored widely in Western settings. This study aimed to explore its relevance for China through exploring attitudes towards premarital sex, extramarital sex, same-sex relations and sex work. We conducted semi-structured interviews with 212 men and women aged 18 to 39 in urban and rural areas of three provinces: Zhejiang, Guizhou and Yunnan. Analysis identified emerging themes. Results show varying degrees of acceptance of the four sexual behaviours, with premarital sex seen as common, homosexuality still regarded as unacceptable by the majority but considerable acceptance of commercial sex work as part of male business transactions and social life. China appears to be on a pathway of detraditionalisation with specific Chinese features. This study suggests that the concept of detraditionalisation applies well to non-Western contexts, but the path it takes is culture-specific and relatively unpredictable. © 2011 Taylor & Francis

Measuring the childbearing motivation of couples referred to the Shiraz Health Center for premarital examinations.

PubMed

Pezeshki, Mohammad Z; Zeighami, Bahram; Miller, Warren B

2005-01-01

Millions of children who were born during the first decade after the Islamic revolution in Iran are now reaching the age of marriage and childbearing. Short spacing between marriage and the birth of the first child has the potential to cause an excessive and costly increase in the growth of population in Iran. Research into the motivations for the birth of first child among newly married couples can create a knowledge base that will enable health centres to help these couples make better decisions about the timing of their first pregnancy. Using a consecutive sampling technique and administering Miller's Childbearing Questionnaire, data were gathered regarding the childbearing motivations and desires of 300 couples who had been referred to the Shiraz Health Center for premarital counselling. The Childbearing Questionnaire, with some minor modifications, was found to be a valid and reliable instrument for measuring the childbearing motivations of newly married couples of Shiraz County, Fars Province, Iran. The utility of these findings for counselling in health centres is discussed. Based on the results, a longitudinal study is being designed that will allow the development of models for predicting the time of first pregnancy after marriage.

Sex, Money, and Premarital Relationships in Southern Malawi

PubMed Central

Poulin, Miss Michelle J.

2009-01-01

In this paper, I argue two main points: (1), the purpose of money exchange in premarital, sexual partnerships in rural Malawi extends beyond the alleviation of female partners’ economic constraints, and (2), by elucidating this broader purpose, it becomes possible to recognize where women exert control over their own sexual selves. These findings come from field observations and a rich set of in-depth interviews (N=54), bolstered on occasion by survey data, conducted with young women and men, aged 15 to 24 years, in the Balaka district in the southern region of the country. My research demonstrates that, contrary to typical expectations, money and gift transfers in sexual partnerships are part and parcel of the courting practices of young Malawian women and men. Transfers are as much about the expression of love and commitment as they are about meeting the financial “needs” of women or the acquisition of sex for men. Using narrative information to shed light on the semiotics of the sex-money link, these findings from Malawi offer a new perspective that broadens usual interpretations of “transactional” sex, the understanding of which is critical in fighting AIDS. PMID:17764797

The psychosocial effects of the Li-Fraumeni Education and Early Detection (LEAD) program on individuals with Li-Fraumeni syndrome.

PubMed

Ross, Jessica; Bojadzieva, Jasmina; Peterson, Susan; Noblin, Sarah Jane; Yzquierdo, Rebecca; Askins, Martha; Strong, Louise

2017-09-01

In the past 5 years, new screening protocols have been developed that provide improved cancer screening options for individuals with Li-Fraumeni syndrome (LFS). Very little has been published on the psychosocial impact of these screening protocols. The goals of this study were to determine how participation in screening impacts individuals psychosocially, to examine the benefits and drawbacks of screening, and to evaluate possible barriers to continued screening. We performed a qualitative study consisting of semistructured phone interviews conducted from December 2015 to February 2016 with 20 individuals attending the LFS screening program at MD Anderson Cancer Center. Data analysis showed that benefits of screening include early detection, peace of mind, centralized screening, knowledge providing power, and screening making LFS seem more livable. Perceived drawbacks included logistical issues, difficulty navigating the system, screening being draining, and significant negative emotional reactions such as anxiety, fear, and skepticism. Regardless of the emotions that were present, 100% of participants planned on continuing screening in the program. Our data indicate that the perceived benefits of screening outweigh the drawbacks of screening. Individuals in this screening program appeared to have improved psychosocial well-being because of their access to the screening program.Genet Med advance online publication 16 March 2017.

Past, present & future scenario of thalassaemic care & control in India

PubMed Central

Verma, Ishwar C.; Saxena, Renu; Kohli, Sudha

2011-01-01

The first case of thalassaemia, described in a non-Mediterranean person, was from India. Subsequently, cases of thalassaemia were documented in all parts of India. Centres for care of thalassaemics were started in the mid-1970s in Mumbai and Delhi, and then in other cities. The parent's associations, with the help of International Thalassemia Federation, greatly helped in improving the care of thalassaemics. Obtaining blood for transfusion was difficult, but the Indian Red Cross Society and the parent's associations played a crucial role in arranging voluntary donations of blood. Chelation with deferoxamine was used sparingly due to the high cost. The Indian physicians conducted trials with deferiprone, and the drug was first approved and marketed in India. Deferasirox is also now being administered. Studies of physical and pubertal growth documented significant retardation, suggesting that generally patients receive inadequate chelation and transfusions. Bone marrow transplantation is available at a number of centres, and cord blood stem cell storage facilities have been established. Information about mutations in different parts of India is available, and ThalInd, an Indian database has been set up. There is a need to set up preimplantation genetic diagnosis and non-invasive prenatal diagnosis. It is argued that too much emphasis should not be placed on premarital screening. The focus should be on screening pregnant women to yield immediate results in reducing the burden of this disorder. Care of thalassaemia has been included in the 12th 5-year Plan of the Government of India. Many States now provide blood transfusions and chelation free of cost. Although inadequacies in care of thalassaemia remain, but the outlook is bright, and the stage is set for initiating a control programme in the high risk States. PMID:22089615

[Economic evaluation of the new national breast cancer screening programme in France: application to the Bouche-du-Rhone district].

PubMed

Giorgi, Roch; Reynaud, Julie; Wait, Suzanne; Seradour, Brigitte

2005-11-01

The purpose is to measure the costs of the new national breast cancer screening programme in France and to compare these with those of the previous programme in the Bouches-du-Rhône district. Direct screening costs and costs related to diagnosis and assessment were collected. Costs are presented by screening period, by organisms involved in the screening program and by corresponding phase within the screening process. The total cost of the screening program total cost has increased from 5587487 euros to 9345469 euros between the two campaigns. The main reasons are the investment costs in the new screening program, the increase in the target population and the increased fee for programs. This study presents a first estimate of the costs related to the new national breast cancer screening program. Results of this study may help to guide future decisions on the further development of breast cancer screening in France.

Disseminating perinatal depression screening as a public health initiative: a train-the-trainer approach.

PubMed

Segre, Lisa S; Brock, Rebecca L; O'Hara, Michael W; Gorman, Laura L; Engeldinger, Jane

2011-08-01

This case report describes the development and implementation of the Train-the-Trainer: Maternal Depression Screening Program (TTT), a novel approach to disseminating perinatal depression screening. We trained screeners according to a standard pyramid scheme of train-the-trainer programs: three experts trained representatives from health care agencies (the TTT trainers), who in turn trained their staff and implemented depression screening at their home agencies. The TTT trainers had little or no prior mental health experience so "enhanced" components were added to ensure thorough instruction. Although TTT was implemented primarily as a services project, we evaluated both the statewide dissemination and the screening rates achieved by TTT programs. Thirty-two social service or health agencies implemented maternal depression screening in 20 counties throughout Iowa; this reached 58.2% of the Iowa population. For the 16 agencies that provided screening data, the average screening rate (number of women screened/number eligible to be screened) for the first 3 months of screening was 73.2%, 80.5% and 79.0%. We compared screening rates of our TTT programs with those of Healthy Start, a program in which screening was established via an intensive consultation model. We found the screening rates in 62.5% of TTT agencies were comparable to those in Healthy Start. Our "enhanced" train-the-trainer method is a promising approach for broadly implementing depression-screening programs in agencies serving pregnant and postpartum women.

DESIGN: a program to create data entry programs

Treesearch

J. Michael Wuerth; David R. Weise

1994-01-01

Scientific data entry can be an exacting process. The specific information needs change from investigation to investigation. A computer program to design custom data screens is described. The program, DESIGN, generates the necessary C programming language source code to create a basic data entry program. Data entry screens can contain multiple nested screens. Users can...

Clinical, Endocrine, and Molecular Genetic Analysis of a Large Cohort of Saudi Arabian Patients with Laron Syndrome.

PubMed

Al-Ashwal, Abdullah A; Al-Sagheir, Afaf; Ramzan, Khushnooda; Al-Owain, Mohammed; Allam, Rabab; Qari, Alya; Al-Numair, Nouf S; Imtiaz, Faiqa

2017-01-01

Laron syndrome (LS) is an autosomal recessive disease characterized by marked short stature and very low serum IGF-1 and IGFBP-3 levels. This study assessed the clinical and endocrine features alongside determining the growth hormone receptor gene (GHR) mutation in Saudi Arabian patients with LS in order to establish whether or not a genotype/phenotype correlation is evident in this large cohort. A total of 40 Saudi Arabian patients with a suspected diagnosis of LS were recruited and subjected to a full clinical and endocrine investigation together with direct sequencing of the coding regions of the GHR gene. GHR mutations were identified in 34 patients from 22 separate nuclear families. All 34 molecularly confirmed patients had the typical clinical and endocrinological manifestations of LS. Eleven different mutations (9 previously unreported) were detected in this cohort of patients, all inherited in an autosomal recessive homozygous form. No genotype/phenotype correlation was apparent. The identification of pathogenic mutations causing LS will be of tremendous use for the molecular diagnosis of patients in Saudi Arabia and the region in general, with respect to prevention of this disease in the forms of future carrier testing, prenatal testing, premarital screening and preimplantation genetic diagnosis. © 2017 S. Karger AG, Basel.

‘It means there is doubt in the house’: perceptions and experiences of HIV testing in rural Malawi

PubMed Central

Conroy, Amy A.

2014-01-01

Research on HIV testing decision-making overlooks a complex array of interpersonal factors that go beyond HIV risk and extend into the realms of intimacy, love and marriage. The current study draws upon two sets of qualitative data, semi-structured interviews and focus-group discussions, to investigate how romantic relationships shape HIV testing perceptions and experiences in rural Malawi. It invokes the classical works of symbolic interactionism to frame how people create meaning around the act of HIV testing that fits with their everyday lives. Pre-marital HIV testing was considered an acceptable method to confirm a partner’s trustworthiness and commitment to the relationship. However, during marriage, a spontaneous discussion of HIV testing signified a breach of fidelity or that a partner could not be trusted. This belief was transposed such that an HIV test could also be used to confirm a person’s moral character in the face of infidelity accusations and gossip. Thus, HIV testing during marriage was labelled as an unusual event, one reserved for special or problematic circumstances, rather than for regular screening of disease. A discussion of how these findings can inform HIV testing programmes and policy in sub-Saharan Africa is provided. PMID:24580127

Prenatal molecular diagnosis of oculocutaneous albinism (OCA) in a large cohort of Israeli families.

PubMed

Rosenmann, Ada; Bejarano-Achache, Idit; Eli, Dalia; Maftsir, Genia; Mizrahi-Meissonnier, Liliana; Blumenfeld, Anat

2009-10-01

To present our accumulated data on prenatal molecular diagnosis of oculocutaneous albinism (OCA) in a large cohort of Israeli albino families. Albinism consists of variable phenotypes, but only families with predicted severely handicapped albino offspring, who declared their wish to terminate a pregnancy of such a fetus, are eligible for prenatal testing. Prenatal testing is not offered otherwise. Following detailed genetic investigation and counseling, molecular prenatal testing was performed using the combination of mutation screening, direct sequencing, and haplotype analysis. A total of 55 prenatal tests were performed in 37 families; in 26 families the propositus was the child, and in 11, a parent or a close relative. In 32 families tyrosinase (TYR) mutations were diagnosed. In 5 families a P gene mutation was detected. Twelve albino fetuses were diagnosed. Following further genetic counseling, all couples elected to terminate the pregnancy. Three additional pregnancies were terminated for other reasons. Families with increased risk for an albino child with severe visual handicap, seek premarital and prenatal genetic counseling and testing, for the prevention of affected offspring. Our combined methods of molecular genetic testing enable a nationwide approach for prevention of albinism. The same paradigm can be applied to other populations affected with albinism.

Exclusive purpose: abstinence-only proponents create federal entitlement in welfare reform.

PubMed

Daley, D

1997-01-01

Since 1981, the US government has funded a program promoting sexual abstinence among young people through its Office of Population's Adolescent Family Life Demonstration Grants program (AFLA). A 1983 court challenge which held that AFLA violated the separation of church and state by endorsing a particular religious viewpoint was settled out of court in 1993 with stipulations that AFLA-funded sexuality education must not include religious references, must be medically accurate, must respect the principle of self-determination of teenagers regarding contraceptive referrals, and must not be implemented on church property. Critics continue to charge that AFLA's abstinence-only programs have failed to receive proper evaluation. While AFLA has no broad-based support, it is backed by the same small group of Congressional proponents who are attempting to promote broad-scale, federally-funded abstinence-only programs. Thus, the August 1996 welfare reform legislation represents the broadest attack on the provision of comprehensive sexuality education in the US. While opponents of sexuality education could not restrict the content of education programs, they could restrict programs through health policy and funding mechanisms. Congress, thus, mandated $50 million a year for 1998-2002 to a matching grant with entitlement status, which was tagged on to final versions of the larger welfare reform bill. The intent of this action was to use federal law to change the social norm of premarital sexual activity. Funds will not go to programs which discuss contraception. Additional problems with the statute include misinformation, ambiguity, and a lack of evaluation requirements. It remains for states to decide whether to accept the restricted funds and for parties on both sides of the issue to continue to lobby for their positions.

Survey of Speech-Language Pathology Graduate Program Training in Outer and Middle Ear Screening.

PubMed

Serpanos, Yula C; Senzer, Deborah

2015-08-01

The purpose of this study was to determine the national training practices of speech-language pathology graduate programs in outer and middle ear screening. Directors of all American Speech-Language-Hearing Association-accredited speech-language pathology graduate programs (N = 254; Council on Academic Accreditation in Audiology and Speech-Language Pathology, 2013) were surveyed on instructional formats in outer and middle ear screening. The graduate speech-language pathology program survey yielded 84 (33.1%) responses. Results indicated that some programs do not provide any training in the areas of conventional screening otoscopy using a handheld otoscope (15.5%; n = 13) or screening tympanometry (11.9%; n = 10), whereas close to one half (46.4%; n = 39) reported no training in screening video otoscopy. Outcomes revealed that approximately one third or more of speech-language pathology graduate programs do not provide experiential opportunities in screening handheld otoscopy (36.9%) or tympanometry (32.1%), and most (78.6%) do not provide experiential opportunities in video otoscopy. The implication from the graduate speech-language pathology program survey findings is that some speech-language pathologists will graduate from academic programs without the acquired knowledge or experiential learning required to establish skill in 1 or more areas of screening otoscopy and tympanometry. Graduate speech-language pathology programs should consider appropriate training opportunities for students to acquire and demonstrate skill in outer and middle ear screening.

Dockres: a computer program that analyzes the output of virtual screening of small molecules

PubMed Central

2010-01-01

Background This paper describes a computer program named Dockres that is designed to analyze and summarize results of virtual screening of small molecules. The program is supplemented with utilities that support the screening process. Foremost among these utilities are scripts that run the virtual screening of a chemical library on a large number of processors in parallel. Methods Dockres and some of its supporting utilities are written Fortran-77; other utilities are written as C-shell scripts. They support the parallel execution of the screening. The current implementation of the program handles virtual screening with Autodock-3 and Autodock-4, but can be extended to work with the output of other programs. Results Analysis of virtual screening by Dockres led to both active and selective lead compounds. Conclusions Analysis of virtual screening was facilitated and enhanced by Dockres in both the authors' laboratories as well as laboratories elsewhere. PMID:20205801

Addressing consumer grievances in medicine: policies and practices of newborn screening programs in the United States.

PubMed

Natowicz, Marvin R; Hiller, Elaine H

2002-01-01

Newborn screening programs collectively administer the largest genetic testing initiative in the United States. The redress of grievances is an important mechanism for consumers to provide input into clinical and public health programs. In this study, we evaluated mechanisms for addressing consumer grievances in newborn screening programs. To do this, we surveyed all 50 state plus the District of Columbia newborn screening programs by questionnaire regarding protocols for receipt and redress of problems reported by parents of newborns and ascertained the existence and nature of complaints and how complaints were documented and addressed. Pertinent state and federal legislation and regulation were also reviewed. Six of 49 newborn screening programs reported having formal policies for handling consumer grievances. Four states reported having pertinent legislation or regulation. Thirty-eight of 49 states reported having received complaints from 1993 to 1995. Thirteen of 49 newborn screening programs reported that they actively seek feedback from consumers. Consumer grievances ranged from minor complaints to potentially life-threatening concerns. In general, complaints are managed on an ad hoc basis; formal policies are typically lacking. As newborn screening programs affect a vast number of Americans, a proactive and comprehensive approach, including solicitation of consumer feedback, could benefit both newborn screening programs and the public served by them.

A multimedia patient education program on colorectal cancer screening increases knowledge and willingness to consider screening among Hispanic/Latino patients.

PubMed

Makoul, Gregory; Cameron, Kenzie A; Baker, David W; Francis, Lee; Scholtens, Denise; Wolf, Michael S

2009-08-01

To test a multimedia patient education program on colorectal cancer (CRC) screening that was designed specifically for the Hispanic/Latino community, and developed with input from community members. A total of 270 Hispanic/Latino adults, age 50-80 years, participated in Spanish for all phases of this pretest-posttest design. Patients were randomly assigned to a version of the multimedia program that opened with either a positive or negative introductory appeal. Structured interviews assessed screening relevant knowledge (anatomy and key terms, screening options, and risk information), past screening behavior, willingness to consider screening options, intention to discuss CRC screening with the doctor, and reactions to the multimedia patient education program. The multimedia program significantly increased knowledge of anatomy and key terms (e.g., polyp), primary screening options (FOBT, flexible sigmoidoscopy, colonoscopy), and risk information as well as willingness to consider screening (p<.001 for all). No significant differences emerged between positive and negative introductory appeals on these measures, intention to discuss CRC screening with their doctor, or rating the multimedia program. Multimedia tools developed with community input that are designed to present important health messages using graphics and audio can reach Hispanic/Latino adults across literacy levels and ethnic backgrounds. Additional research is needed to determine effects on actual screening behavior. Despite promising results for engaging a difficult-to-reach audience, the multimedia program should not be considered a stand-alone intervention or a substitute for communication with physicians. Rather, it is a priming mechanism intended to prepare patients for productive discussions of CRC screening.

Detection of critical congenital heart defects: Review of contributions from prenatal and newborn screening

PubMed Central

Olney, Richard S.; Ailes, Elizabeth C.; Sontag, Marci K.

2015-01-01

In 2011, statewide newborn screening programs for critical congenital heart defects began in the United States, and subsequently screening has been implemented widely. In this review, we focus on data reports and collection efforts related to both prenatal diagnosis and newborn screening. Defect-specific, maternal, and geographic factors are associated with variations in prenatal detection, so newborn screening provides a population-wide safety net for early diagnosis. A new web-based repository is collecting information on newborn screening program policies, quality indicators related to screening programs, and specific case-level data on infants with these defects. Birth defects surveillance programs also collect data about critical congenital heart defects, particularly related to diagnostic timing, mortality, and services. Individuals from state programs, federal agencies, and national organizations will be interested in these data to further refine algorithms for screening in normal newborn nurseries, neonatal intensive care settings, and other special populations; and ultimately to evaluate the impact of screening on outcomes. PMID:25979782

Detection of critical congenital heart defects: Review of contributions from prenatal and newborn screening.

PubMed

Olney, Richard S; Ailes, Elizabeth C; Sontag, Marci K

2015-04-01

In 2011, statewide newborn screening programs for critical congenital heart defects began in the United States, and subsequently screening has been implemented widely. In this review, we focus on data reports and collection efforts related to both prenatal diagnosis and newborn screening. Defect-specific, maternal, and geographic factors are associated with variations in prenatal detection, so newborn screening provides a population-wide safety net for early diagnosis. A new web-based repository is collecting information on newborn screening program policies, quality indicators related to screening programs, and specific case-level data on infants with these defects. Birth defects surveillance programs also collect data about critical congenital heart defects, particularly related to diagnostic timing, mortality, and services. Individuals from state programs, federal agencies, and national organizations will be interested in these data to further refine algorithms for screening in normal newborn nurseries, neonatal intensive care settings, and other special populations; and ultimately to evaluate the impact of screening on outcomes. Published by Elsevier Inc.

A workplace breast cancer screening program. Costs and components.

PubMed

Schrammel, P; Griffiths, R I; Griffiths, C B

1998-11-01

Screening for breast cancer can result in early detection of malignancies and lives saved. Many employers now offer periodic screening as an employee health benefit, and some have established screening programs in the workplace. This study was performed to identify the employer costs of breast cancer screening in the workplace, referrals for suspicious findings, and initial treatment of malignant disease. Additionally, the costs for these same services, had they been obtained outside of a workplace screening program, were estimated. Data on program components and associated costs for an established employer based breast cancer screening program were obtained. These costs were compared to those among a hypothetical cohort of women not enrolled in the workplace screening program. From 1989 through 1995, 1,416 women participated in the program. Nearly 2,500 screening mammograms and approximately 2,773 clinical breast examinations were performed, resulting in 292 referrals to physicians outside of the program for additional diagnostic procedures and treatment as needed. These referrals resulted in the detection of 12 malignancies: 8 Stage I; 3 Stage II; and 1 Stage III. Mammographic and clinical breast examination screening cost $249,041; referrals resulting in benign disease or no detectable disease cost $185,002; and referrals resulting in malignant disease, followed by initial treatment, cost $148,530. Therefore, the total cost was $582,573. Approximately 47% of the cost of referrals and initial treatment were due to employee lost productivity. Total cost in the hypothetical cohort was $1,067,948 under the assumptions that all women received screening outside of the workplace, and that the same number of malignancies were detected at the same stage as in the workplace program. These findings indicate referrals resulting in detection of benign disease or no disease accounted for a substantial proportion of the total cost of the program. In addition, employee lost productivity accounted for almost 50% of the cost of all referrals and initial treatment. Workplace screening is a relatively efficient approach for early detection of breast cancer when compared to off site screening or no screening. The efficiency could be improved with a reduction in the number and cost of unnecessary referrals.

A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates

PubMed Central

2011-01-01

Background Tuberculosis (TB) in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. Methods Descriptive study of immigration TB screening programs Results 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. Conclusions In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas outlined in this study should facilitate the development of improved screening programs. PMID:21205318

Outcomes of an International Workshop on Preconception Expanded Carrier Screening: Some Considerations for Governments.

PubMed

Molster, Caron M; Lister, Karla; Metternick-Jones, Selina; Baynam, Gareth; Clarke, Angus John; Straub, Volker; Dawkins, Hugh J S; Laing, Nigel

2017-01-01

Consideration of expanded carrier screening has become an emerging issue for governments. However, traditional criteria for decision-making regarding screening programs do not incorporate all the issues relevant to expanded carrier screening. Further, there is a lack of consistent guidance in the literature regarding the development of appropriate criteria for government assessment of expanded carrier screening. Given this, a workshop was held to identify key public policy issues related to preconception expanded carrier screening, which governments should consider when deciding whether to publicly fund such programs. In June 2015, a satellite workshop was held at the European Society of Human Genetics Conference. It was structured around two design features: (1) the provision of information from a range of perspectives and (2) small group deliberations on the key issues that governments need to consider and the benefits, risks, and challenges of implementing publicly funded whole-population preconception carrier screening. Forty-one international experts attended the workshop. The deliberations centered primarily on the conditions to be tested and the elements of the screening program itself. Participants expected only severe conditions to be screened but were concerned about the lack of a consensus definition of "severe." Issues raised regarding the screening program included the purpose, benefits, harms, target population, program acceptability, components of a program, and economic evaluation. Participants also made arguments for consideration of the accuracy of screening tests. A wide range of issues require careful consideration by governments that want to assess expanded carrier screening. Traditional criteria for government decision-making regarding screening programs are not a "best fit" for expanded carrier screening and new models of decision-making with appropriate criteria are required. There is a need to define what a "severe" condition is, to build evidence regarding the reliability and accuracy of screening tests, to consider the equitable availability and downstream effects on and costs of follow-up interventions for those identified as carriers, and to explore the ways in which the components of a screening program would be impacted by unique features of expanded carrier screening.

Possible Factors Associated with High Rates of Out-of-Marriage Births Among Adolescents.

ERIC Educational Resources Information Center

Chilman, Catherine S.

An exhaustive analytic review of large bodies of research indicates that rates of premarital intercourse among teenagers have risen sharply since 1966. This is particularly true for white females, for whom the rate is probably about three times that of the 1920's thru the mid-1960's; for white males the rate seems to have risen about 50%. By age…

Revisiting Risk in the 21st Century. Forum Focus. Volume 3, Issue 1, January-February 2005

ERIC Educational Resources Information Center

Forum for Youth Investment, 2005

2005-01-01

Over the past year, dozens of articles have been published about excessive youth borrowing and spending (leading to high amounts of debt), new reactions to negative body image (such as plastic surgery), as well as more familiar risks like premarital sex and smoking. In Forum Focus: Revisiting Risk in the 21st Century, we explore these challenges…

Survey on sexual experiences among unmarried women in Shanghai and solutions.

PubMed

Gao, E; Wu, Z; Gu, X

1993-01-01

In Shanghai, China, the Institute of Family Planning surveyed 2409 unmarried women who had a premarital medical examination during September-October 1988 to determine the prevalence of premarital sexual experience (PSE). It also compared data on 394 women who had PSE with data on 126 women who had not had PSE to learn PSE determinants. Overall 73.1% of the women surveyed had had PSE (80.7% in rural suburbs vs. 64.3% in urban areas; p .01). Youngest age at 1st intercourse was 16 in urban areas and 17 in rural suburbs, yet rural suburban women tended to be younger at 1st intercourse than urban women (20.5 years vs. 22.5 years; p .01). Age at 1st intercourse increased with education level (20.6 years for no junior high school vs. 23.2 for college graduates; p .01). The period between 1st date and 1st intercourse was 17.5 months. This period was shorter in rural suburbs than in urban areas (16.4 months vs. 20.4 months; p .01) and for less educated women than for most educated women (15 months vs. 25 months; p .01). Mean number of intercourse acts in the month before the examination was 1.4. 50.3% had sexual intercourse less than once during that month. The multivariate logistic regression analysis found that age (odds ratio [OR] = 0.82), educational level (OR = 0.52), partner's occupation (OR = 0.69, i.e., PSE less likely if partners have high ranking occupation), family relationships (OR - 1.81, i.e., PSE lower if relationships were harmonious), number of years dating (OR = 1.2), means of acquaintance (OR = 0.57 i.e., met partner through others decreased the likelihood of PSE), loneliness before dating (OR = 2.11), and conservative attitudes towards sex (OR = 2.98) had a significant effect on having PSE (p .01). Based on these findings, the Institute recommends that sex education, disseminated through the media, schools, work units, and families, should focus on a responsible attitude towards sexual intercourse, reproduction, consequences of premarital pregnancy, and family planning.

Components Necessary for High-Quality Lung Cancer Screening

PubMed Central

Powell, Charles A.; Arenberg, Douglas; Detterbeck, Frank; Gould, Michael K.; Jaklitsch, Michael T.; Jett, James; Naidich, David; Vachani, Anil; Wiener, Renda Soylemez; Silvestri, Gerard

2015-01-01

Lung cancer screening with a low-dose chest CT scan can result in more benefit than harm when performed in settings committed to developing and maintaining high-quality programs. This project aimed to identify the components of screening that should be a part of all lung cancer screening programs. To do so, committees with expertise in lung cancer screening were assembled by the Thoracic Oncology Network of the American College of Chest Physicians (CHEST) and the Thoracic Oncology Assembly of the American Thoracic Society (ATS). Lung cancer program components were derived from evidence-based reviews of lung cancer screening and supplemented by expert opinion. This statement was developed and modified based on iterative feedback of the committees. Nine essential components of a lung cancer screening program were identified. Within these components 21 Policy Statements were developed and translated into criteria that could be used to assess the qualification of a program as a screening facility. Two additional Policy Statements related to the need for multisociety governance of lung cancer screening were developed. High-quality lung cancer screening programs can be developed within the presented framework of nine essential program components outlined by our committees. The statement was developed, reviewed, and formally approved by the leadership of CHEST and the ATS. It was subsequently endorsed by the American Association of Throacic Surgery, American Cancer Society, and the American Society of Preventive Oncology. PMID:25356819

Impact of a public cholesterol screening program.

PubMed

Fischer, P M; Guinan, K H; Burke, J J; Karp, W B; Richards, J W

1990-12-01

The National Cholesterol Education Program (NCEP) has endorsed physician case finding as the primary method to detect individuals with elevated cholesterol levels. Despite this recommendation, promotional and for-profit public screening programs have flourished. We surveyed participants of a mall-based cholesterol screening program 1 year after their screening. Sixty-four percent of those screened had not previously known their cholesterol levels. Those who were newly screened were less likely to benefit from this testing than the general public, since they were older (mean age, 55.3 years), more likely to be female (67.4%), and nonsmokers (88%). Screenees had excellent recall of their cholesterol level (mean absolute reporting error, 0.24 mmol/L [9 mg/dL]) and a good understanding of cholesterol as a coronary heart disease risk. Those with elevated cholesterol levels reported high distress from screening but no reduction in overall psychosocial well-being and an actual decrease in absenteeism. Only 53.7% of all who were advised to seek follow-up because of an elevated screening value had done so within the year following the screening program. However, of those with values greater than 6.2 mmol/L (240 mg/dL), 68% had sought follow-up. Many of those who participate in public screening programs have been previously tested, fall into low-benefit groups, or fail to comply with recommended follow-up. We therefore conclude that cholesterol screening programs of the type now commonly offered are unlikely to contribute greatly to the national efforts to further reduce coronary heart disease.

Recommendations From the International Colorectal Cancer Screening Network on the Evaluation of the Cost of Screening Programs.

PubMed

Subramanian, Sujha; Tangka, Florence K L; Hoover, Sonja; Nadel, Marion; Smith, Robert; Atkin, Wendy; Patnick, Julietta

2016-01-01

Worldwide, colorectal cancer is the fourth leading cause of death from cancer and the incidence is projected to increase. Many countries are exploring the introduction of organized screening programs, but there is limited information on the resources required and guidance for cost-effective implementation. To facilitate the generating of the economics evidence base for program implementation, we collected and analyzed detailed program cost data from 5 European members of the International Colorectal Cancer Screening Network. The cost per person screened estimates, often used to compare across programs as an overall measure, varied significantly across the programs. In addition, there were substantial differences in the programmatic and clinical cost incurred, even when the same type of screening test was used. Based on these findings, several recommendations are provided to enhance the underlying methodology and validity of the comparative economic assessments. The recommendations include the need for detailed activity-based cost information, the use of a comprehensive set of effectiveness measures to adequately capture differences between programs, and the incorporation of data from multiple programs in cost-effectiveness models to increase generalizability. Economic evaluation of real-world colorectal cancer-screening programs is essential to derive valuable insights to improve program operations and ensure optimal use of available resources.

Regional colorectal cancer screening program using colonoscopy on an island: a prospective Nii-jima study.

PubMed

Hotta, Kinichi; Matsuda, Takahisa; Kakugawa, Yasuo; Ikematsu, Hiroaki; Kobayashi, Nozomu; Kushima, Ryoji; Hozawa, Atsushi; Nakajima, Takeshi; Sakamoto, Taku; Mori, Mika; Fujii, Takahiro; Saito, Yutaka

2017-02-13

Colorectal cancer screening program using fecal immunochemical test had been conducted on an isolated island named Nii-jima. However, the participation rate of the program had been approximately 12%, which was lower than average level of Japan. This study aimed to evaluate the participation rate, safety and efficacy of a colorectal cancer screening program using colonoscopy on the island. Educational campaigns were actively conducted every month using information bulletins and special propaganda pamphlets. The primary recommended modality was colonoscopy, followed by fecal immunochemical test. The participants of this program were 1671 individuals aged 40–79 years (men, 819; women, 852). A total of 789 (47.2%) individuals provided consent for this screening program, and 89.2% (704/789) of participants chose colonoscopy as the primary screening procedure. The completion rate of total colonoscopy was 99.7%, and there was no complication during this program. Detection rates of invasive cancer, intramucosal cancer, advanced neoplasia and any adenoma were 0.9% (n = 6), 2.4% (n = 17), 11.8% (n = 83) and 50.0% (n = 352), respectively. The adenoma detection rate and incidence of advanced neoplasia were significantly higher in men than in women in all age groups. The colorectal cancer screening program using colonoscopy that was conducted on an island achieved considerably higher participation rate than the conventional screening program using fecal immunochemical test. Completion rate and safety of screening colonoscopy were excellent during this program.

Addressing multilevel barriers to cervical cancer screening in Korean American women: A randomized trial of a community-based intervention.

PubMed

Fang, Carolyn Y; Ma, Grace X; Handorf, Elizabeth A; Feng, Ziding; Tan, Yin; Rhee, Joanne; Miller, Suzanne M; Kim, Charles; Koh, Han Seung

2017-05-15

Korean American women have among the lowest rates of cervical cancer screening in the United States. The authors evaluated a multicomponent intervention combining community education with navigation services to reduce access barriers and increase screening rates in this underserved population. It was hypothesized that cervical cancer screening rates would be higher among women who received the intervention program compared with those in the control program. Korean American women (N = 705) were recruited from 22 churches. In this matched-pair, group-randomized design, 347 women received the intervention, which consisted of a culturally relevant cancer education program combined with provision of navigation services. The control group (N = 358) received general health education, including information about cervical cancer risk and screening and where to obtain low-cost or no-cost screening. Screening behavior was assessed 12 months after the program. Screening behavior data were obtained from 588 women 12 months after the program. In both site-level and participant-level analyses, the intervention program contributed to significantly higher screening rates compared with the control program (odds ratio [OR], 25.9; 95% confidence interval [CI], 10.1-66.1; P < .001). In sensitivity analysis, the treatment effect remained highly significant (OR, 16.7; 95% CI, 8.1-34.4; P < .001). A multicomponent intervention combining community cancer education with navigation services yielded significant increases in cervical cancer screening rates among underscreened Korean American women. Community-accessible programs that incorporate cancer education with the delivery of key navigation services can be highly effective in increasing cervical cancer screening rates in this underserved population. Cancer 2017;123:1018-26. © 2016 American Cancer Society. © 2016 American Cancer Society.

Smoking cessation results in a clinical lung cancer screening program.

PubMed

Borondy Kitts, Andrea K; McKee, Andrea B; Regis, Shawn M; Wald, Christoph; Flacke, Sebastian; McKee, Brady J

2016-07-01

Lung cancer screening may provide a "teachable moment" for promoting smoking cessation. This study assessed smoking cessation and relapse rates among individuals undergoing follow-up low-dose chest computed tomography (CT) in a clinical CT lung screening program and assessed the influence of initial screening results on smoking behavior. Self-reported smoking status for individuals enrolled in a clinical CT lung screening program undergoing a follow-up CT lung screening exam between 1st February, 2014 and 31st March, 2015 was retrospectively reviewed and compared to self-reported smoking status using a standardized questionnaire at program entry. Point prevalence smoking cessation and relapse rates were calculated across the entire population and compared with exam results. All individuals undergoing screening fulfilled the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Lung Cancer Screening v1.2012(®) high-risk criteria and had an order for CT lung screening. A total of 1,483 individuals underwent a follow-up CT lung screening exam during the study interval. Smoking status at time of follow-up exam was available for 1,461/1,483 (98.5%). A total of 46% (678/1,461) were active smokers at program entry. The overall point prevalence smoking cessation and relapse rates were 20.8% and 9.3%, respectively. Prior positive screening exam results were not predictive of smoking cessation (OR 1.092; 95% CI, 0.715-1.693) but were predictive of reduced relapse among former smokers who had stopped smoking for 2 years or less (OR 0.330; 95% CI, 0.143-0.710). Duration of program enrollment was predictive of smoking cessation (OR 0.647; 95% CI, 0.477-0.877). Smoking cessation and relapse rates in a clinical CT lung screening program rates are more favorable than those observed in the general population. Duration of participation in the screening program correlated with increased smoking cessation rates. A positive exam result correlated with reduced relapse rates among smokers recently quit smoking.

Psychological screening program overview.

PubMed

Wright, Kathleen M; Huffman, Ann H; Adler, Amy B; Castro, Carl A

2002-10-01

This article reviews the literature on health surveillance conducted during military deployments, focusing on models for assessing the impact of operational deployments on peacekeepers. A discussion of the stressors and potential mental health consequences of peacekeeping operations follows with relevant examples of findings from U.S. and international military forces. Psychological screening in different peacekeeping operations conducted in U.S. Army-Europe is reviewed. The review begins with the redeployment screening of military personnel deployed to Bosnia mandated under the Joint Medical Surveillance Program, and continues through the present screening of units deployed to Kosovo. The detailed description of the screening program includes a discussion of procedures and measures and demonstrates the evolution of the program. A summary of key findings from the screening program and a discussion of future research directions are provided.

A Guide to Screening for the Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT) Under Medicaid.

ERIC Educational Resources Information Center

Frankenburg, William K.; North, A. Frederick, Jr.

The manual was designed to help public officials, physicians, nurses, and others to plan and implement an Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program under Medicaid. Procedures for carrying out components of an EPSDT program are recommended. Part 1 discusses organization and administration of screening, diagnosis, and…

Modifications to the Current EPA Endocrine Disruptor Screening Program's Tier 1 Female Pubertal Protocol: A Study on the Effects of the Chlorotriazine Simazine

EPA Science Inventory

Currently the US EPA is implementing a screening program for environmental endocrine disruptors. One of the in vivo assays in the Tier 1 Screen of the Endocrine Disruptors Screening Program (EDSP) is a female pubertal assay. In this study we examined the chlorotriazine simazine, ...

Implementation and process evaluation of a workplace colorectal cancer screening program in eastern Washington.

PubMed

Hannon, Peggy A; Vu, Thuy; Ogdon, Sara; Fleury, Emily M; Yette, Emily; Wittenberg, Reva; Celedonia, Megan; Bowen, Deborah J

2013-03-01

Colorectal cancer screening is a life-saving intervention, but screening rates are low. The authors implemented and evaluated the Spokane Colorectal Cancer Screening Program-a novel worksite intervention to promote colorectal cancer screening that used a combination of evidence-based strategies recommended by the Guide to Community Preventive Services, as well as additional strategies. Over a period of approximately 3 months, participating worksites held one or more physician-led seminars about colorectal cancer screening for employees. They also distributed free fecal immunochemical tests at the worksite to employees 50 years and older, and they provided test results to employees and their primary care physician. The authors measured attendance at seminars, test kits taken and returned, employee awareness of the program, and colorectal cancer screening rates in participating and comparison worksites. It is estimated that 9% of eligible employees received kits at the worksite, and 4% were screened with these kits. The Spokane Colorectal Cancer Screening Program was a promising pilot test of an innovative worksite screening program that successfully translated evidence-based strategies into practical use in a brief period of time, and it merits a larger study to be able to test its effects more rigorously.

An economic evaluation of a genetic screening program for Tay-Sachs disease.

PubMed Central

Nelson, W B; Swint, J M; Caskey, C T

1978-01-01

The resolution of policy questions relating to medical genetic screening programs will not be without considerable difficulty. Examples include such issues as the optimal degree of screening program expansion, the relative values of screening for different genetic diseases, the appropriate sources of program funding (public vs. private), and the relative value of funding expanded genetic screening programs vs. research directed toward elimination of genetic traits themselves. Information on the net impact of the relevant alternatives is greatly needed, and this need will increase if the National Genetics Act receives funding approval. We have provided what is hopefully a contribution toward this end. While our analysis pertains to a specific disease and a specific screening program for that disease, the methodology is readily generalizable to other genetic diseases, as well as programs of any size or structure. Hopefully, this will serve to stimulate further research efforts that we believe are needed for the objective consideration of resource allocation alternatives. PMID:418675

An economic evaluation of a genetic screening program for Tay-Sachs disease.

PubMed

Nelson, W B; Swint, J M; Caskey, C T

1978-03-01

The resolution of policy questions relating to medical genetic screening programs will not be without considerable difficulty. Examples include such issues as the optimal degree of screening program expansion, the relative values of screening for different genetic diseases, the appropriate sources of program funding (public vs. private), and the relative value of funding expanded genetic screening programs vs. research directed toward elimination of genetic traits themselves. Information on the net impact of the relevant alternatives is greatly needed, and this need will increase if the National Genetics Act receives funding approval. We have provided what is hopefully a contribution toward this end. While our analysis pertains to a specific disease and a specific screening program for that disease, the methodology is readily generalizable to other genetic diseases, as well as programs of any size or structure. Hopefully, this will serve to stimulate further research efforts that we believe are needed for the objective consideration of resource allocation alternatives.

Chlamydia screening strategies and outcomes in educational settings: a systematic review.

PubMed

Jamil, Muhammad Shahid; Bauer, Heidi M; Hocking, Jane S; Ali, Hammad; Wand, Handan; Walker, Jennifer; Douglas, Laura; Donovan, Basil; Kaldor, John M; Guy, Rebecca J

2014-03-01

Chlamydia trachomatis (CT) screening programs have been established in educational settings in many countries during the past 2 decades. However, recent evidence suggests that high uptake of screening and management (treatment, partner notification, and retesting for reinfection) improves program effectiveness. We conducted a systematic review to understand the screening strategies, the extent of screening conducted, and uptake of management strategies in educational settings. Screening studies in educational settings were identified through a systematic search of published literature from 2005 to 2011. We identified 27 studies describing 30 screening programs in the United States/Canada (n = 10), Europe (n = 8), Australia/New Zealand (n = 5), and Asia (n = 4). Most studies targeted both male and female students (74%). Classroom-based strategies resulted in 21,117 testes overall (4 programs), followed by opportunistic screening during routine health examination (n = 13,470; 5 programs) and opportunistic screening at school-based health centers (n = 13,006; 5 programs). The overall median CT positivity was 4.7% (range, 1.3%-18.1%). Only 5 programs reported treatment rates (median, 100%; range, 86%-100%), 1 partner notification rate (71%), 1 retesting rate within a year of an initial CT diagnosis (47%), and 2 reported repeat positivity rates (21.1% and 26.3%). In conclusion, this systematic review shows that a variety of strategies have been used to screen large numbers of students in educational settings; however, only a few studies have reported CT management outcomes.

Young people in Bogota, Colombia develop their own strategies to prevent risky sexual behavior.

PubMed

Saavedra, M

1996-01-01

Although the government of Colombia moved in 1993 to mandate sexuality education in primary and secondary schools, nongovernmental organizations have worked in this area for more than two decades. Notable has been the work of one such organization, the Colombian Human and Social Development Foundation, among youth from a marginal, underserved area of Bogota that houses approximately 27,000 adolescents. The project uses a peer approach to relate the values of responsibility, tolerance, and self-determination to the prevention of risky sexual behaviors. At the onset, 15 youth leaders from the local school identified strategies for raising the topic of sexuality to their peers: suggestion boxes, school radio programs, educational materials such as murals and pamphlets, workshops, board games with sexuality-related themes, and community involvement. Suggestion box submissions revealed that sixth and seventh graders wanted to know about puberty-related events, while older students were interested in the effects of masturbation on health and appearance and the association between premarital sexual activity and one's reputation. In an 18-month period, close to 9000 community residents were reached with program materials and 1798 adolescents participated in group meetings. Among the gains observed have been correction of misinformation, a broader view of sexuality, the capacity for independent thought, and self-pride.

Colorectal Cancer Screening Initiation After Age 50 Years in an Organized Program.

PubMed

Fedewa, Stacey A; Corley, Douglas A; Jensen, Christopher D; Zhao, Wei; Goodman, Michael; Jemal, Ahmedin; Ward, Kevin C; Levin, Theodore R; Doubeni, Chyke A

2017-09-01

Recent studies report racial disparities among individuals in organized colorectal cancer (CRC) programs; however, there is a paucity of information on CRC screening utilization by race/ethnicity among newly age-eligible adults in such programs. This was a retrospective cohort study among Kaiser Permanente Northern California enrollees who turned age 50 years between 2007 and 2012 (N=138,799) and were served by a systemwide outreach and facilitated in-reach screening program based primarily on mailed fecal immunochemical tests to screening-eligible people. Kaplan-Meier and Cox model analyses were used to estimate differences in receipt of CRC screening in 2015-2016. Cumulative probabilities of CRC screening within 1 and 2 years of subjects' 50th birthday were 51% and 73%, respectively. Relative to non-Hispanic whites, the likelihood of completing any CRC screening was similar in blacks (hazard ratio, 0.98; 95% CI=0.96, 1.00); 5% lower in Hispanics (hazard ratio, 0.95; 95% CI=0.93, 0.96); and 13% higher in Asians (hazard ratio, 1.13; 95% CI=1.11, 1.15) in adjusted analyses. Fecal immunochemical testing was the most common screening modality, representing 86% of all screening initiations. Blacks and Hispanics had lower receipt of fecal immunochemical testing in adjusted analyses. CRC screening uptake was high among newly screening-eligible adults in an organized CRC screening program, but Hispanics were less likely to initiate screening near age 50 years than non-Hispanic whites, suggesting that cultural and other individual-level barriers not addressed within the program likely contribute. Future studies examining the influences of culturally appropriate and targeted efforts for screening initiation are needed. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Race/Ethnicity and Adoption of a Population Health Management Approach to Colorectal Cancer Screening in a Community-Based Healthcare System.

PubMed

Mehta, Shivan J; Jensen, Christopher D; Quinn, Virginia P; Schottinger, Joanne E; Zauber, Ann G; Meester, Reinier; Laiyemo, Adeyinka O; Fedewa, Stacey; Goodman, Michael; Fletcher, Robert H; Levin, Theodore R; Corley, Douglas A; Doubeni, Chyke A

2016-11-01

Screening outreach programs using population health management principles offer services uniformly to all eligible persons, but racial/ethnic colorectal cancer (CRC) screening patterns in such programs are not well known. To examine the association between race/ethnicity and the receipt of CRC screening and timely follow-up of positive results before and after implementation of a screening program. Retrospective cohort study of screen-eligible individuals at the Kaiser Permanente Northern California community-based integrated healthcare delivery system (2004-2013). A total of 868,934 screen-eligible individuals 51-74 years of age at cohort entry, which included 662,872 persons in the period before program implementation (2004-2006), 654,633 during the first 3 years after implementation (2007-2009), and 665,268 in the period from 4 to 7 years (2010-2013) after program implementation. A comprehensive system-wide long-term effort to increase CRC that included leadership alignment, goal-setting, and quality assurance through a PHM approach, using mailed fecal immunochemical testing (FIT) along with offering screening at office visits. Differences over time and by race/ethnicity in up-to-date CRC screening (overall and by test type) and timely follow-up of a positive screen. Race/ethnicity categories included non-Hispanic white, non-Hispanic black, Hispanic/Latino, Asian/Pacific Islander, Native American, and multiple races. From 2004 to 2013, age/sex-adjusted CRC screening rates increased in all groups, including 35.2 to 81.1 % among whites and 35.6 to 78.0 % among blacks. Screening rates among Hispanics (33.1 to 78.3 %) and Native Americans (29.4 to 74.5 %) remained lower than those for whites both before and after program implementation. Blacks, who had slightly higher rates before program implementation (adjusted rate ratio [RR] = 1.04, 99 % CI: 1.02-1.05), had lower rates after program implementation (RR for period from 4 to 7 years = 0.97, 99 % CI: 0.96-0.97). There were also substantial improvements in timely follow-up of positive screening results. In this screening program using core PHM principles, CRC screening increased markedly in all racial/ethnic groups, but disparities persisted for some groups and developed in others, which correlated with levels of adoption of mailed FIT.

Evaluation of a seven state criminal history screening pilot program for long-term care workers.

PubMed

Radcliff, Tiffany A; White, Alan; West, David R; Hurd, Donna; Côté, Murray J

2013-01-01

This article summarizes results from an evaluation of a federally sponsored criminal history screening (CHS) pilot program to improve screening for workers in long-term care settings. The evaluation addressed eight key issues specified through enabling legislation, including efficiency, costs, and outcomes of screening procedures. Of the 204,339 completed screenings, 3.7% were disqualified due to criminal history, and 18.8% were withdrawn prior to completion for reasons that may include relevant criminal history. Lessons learned from the pilot program experiences may inform a new national background check demonstration program.

What Disorders Are Newborns Screened for in the United States?

MedlinePlus

... of newborn screening successes? Many conditions included in today's U.S. newborn screening programs no longer cause serious ... and developmental disabilities (IDD) in the United States. Today, as a result of newborn screening programs that ...

Implementation of a fall screening program in a high risk of fracture population.

PubMed

Ritchey, Katherine; Olney, Amanda; Shofer, Jane; Phelan, Elizabeth A; Matsumoto, Alvin M

2017-10-31

Fall prevention is an important way to prevent fractures in person with osteoporosis. We developed and implemented a fall screening program in the context of routine osteoporosis care. This program was found to be feasible and showed that a significant proportion of persons with osteoporosis are at risk of falling. Falls are the most common cause of fracture in persons with osteoporosis. However, osteoporosis care rarely includes assessment and prevention of falling. We thus sought to assess the feasibility of a fall screening and management program integrated into routine osteoporosis care. The program was developed and offered to patients with osteoporosis or osteopenia seen at an outpatient clinic between May 2015 and May 2016. Feasibility was measured by physical therapist time required to conduct screening and ease of integrating the screening program into the usual clinic workflow. Self-report responses and mobility testing were conducted to describe the fall and fracture risk profile of osteoporosis patients screened. Effects on fall-related care processes were assessed via chart abstraction of patient participation in fall prevention exercise. Of the 154 clinic patients who presented for a clinic visit, 68% met screening criteria and completed in two thirds of persons. Screening was completed in a third of the time typically allotted for traditional PT evaluations and did not interfere with clinic workflow. Forty percent of those screened reported falling in the last year, and over half had two or more falls in the past year. Over half reported a balance or lower extremity impairment, and over 40% were below norms on one or more performance tests. Most patients who selected a group exercise fall prevention program completed all sessions while only a quarter completed either supervised or independent home-based programs. Implementation of a fall risk screening program in an outpatient osteoporosis clinic appears feasible. A substantial proportion of people with osteoporosis screened positive for being at risk of falling, justifying integration of fall prevention into routine osteoporosis care.

Age at first marriage and its determinants in Bangladesh.

PubMed

Islam, M N; Ahmed, A U

1998-06-01

The authors investigate marriage patterns and their determinants in Bangladesh, using data from the 1989 Bangladesh Fertility Survey. "It is believed that, whatever is the impact of the differentials that could be discerned from the analysis, a lower age at marriage (a) among rural women, (b) among those who are Muslims and (c) among those without pre-marital exposure to work is associated with a low level of education." excerpt

Double standard for traditional value of virginity and premarital sexuality in Turkey: a university students case.

PubMed

Eşsizoğlu, Altan; Yasan, Aziz; Yildirim, Ejder Akgun; Gurgen, Faruk; Ozkan, Mustafa

2011-03-01

This study investigates the prevalence of myths regarding virginity and the hymen and their associations with sexuality prior to marriage. This study was conducted with 534 single, heterosexual male and female students from various faculties of Dicle University in Turkey. The findings demonstrated that the rates of masturbation (11.1%) and premarital sexual intercourse (4.3%) were much lower in women than in men (87.7% and 44.2% respectively) who were traditionally expected to maintain their virginity until marriage. A higher degree of commitment to religious faith was associated with a lower rate of masturbation and sexual contact experience. Also, the myth that the hymen symbolized virginity was slightly more prevalent among male students (74.2% vs. 72.1%). Female virginity was significantly more important among male students (76.7%) than females (11.1%), and male students more frequently (30.1% vs. 11.1%) stated that "the blood-stained bed sheet" should be displayed to the family on the day of marriage. Although some myths about virginity were frequently reported by females, less significance was attributed to virginity by females than by males. In conclusion, the traditional social structure that incites sexual double standards still prevails over the sexual attitudes and behaviors of university students in Turkey.

A multinational study of mental disorders, marriage, and divorce.

PubMed

Breslau, J; Miller, E; Jin, R; Sampson, N A; Alonso, J; Andrade, L H; Bromet, E J; de Girolamo, G; Demyttenaere, K; Fayyad, J; Fukao, A; Gălăon, M; Gureje, O; He, Y; Hinkov, H R; Hu, C; Kovess-Masfety, V; Matschinger, H; Medina-Mora, M E; Ormel, J; Posada-Villa, J; Sagar, R; Scott, K M; Kessler, R C

2011-12-01

Estimate predictive associations of mental disorders with marriage and divorce in a cross-national sample. Population surveys of mental disorders included assessment of age at first marriage in 19 countries (n = 46,128) and age at first divorce in a subset of 12 countries (n = 30,729). Associations between mental disorders and subsequent marriage and divorce were estimated in discrete time survival models. Fourteen of 18 premarital mental disorders are associated with lower likelihood of ever marrying (odds ratios ranging from 0.6 to 0.9), but these associations vary across ages of marriage. Associations between premarital mental disorders and marriage are generally null for early marriage (age 17 or younger), but negative associations come to predominate at later ages. All 18 mental disorders are positively associated with divorce (odds ratios ranging from 1.2 to 1.8). Three disorders, specific phobia, major depression, and alcohol abuse, are associated with the largest population attributable risk proportions for both marriage and divorce. This evidence adds to research demonstrating adverse effects of mental disorders on life course altering events across a diverse range of socioeconomic and cultural settings. These effects should be included in considerations of public health investments in preventing and treating mental disorders. © 2011 John Wiley & Sons A/S.

A multinational study of mental disorders, marriage, and divorce

PubMed Central

Breslau, J.; Miller, E.; Jin, R.; Sampson, N. A.; Alonso, J.; Andrade, L. H.; Bromet, E. J.; de Girolamo, G.; Demyttenaere, K.; Fayyad, J.; Fukao, A.; Gălăon, M.; Gureje, O.; He, Y.; Hinkov, H. R.; Hu, C.; Kovess-Masfety, V.; Matschinger, H.; Medina-Mora, M. E.; Ormel, J.; Posada-Villa, J.; Sagar, R.; Scott, K. M.; Kessler, R. C.

2014-01-01

Objective Estimate predictive associations of mental disorders with marriage and divorce in a cross-national sample. Method Population surveys of mental disorders included assessment of age at first marriage in 19 countries (n = 46 128) and age at first divorce in a subset of 12 countries (n = 30 729). Associations between mental disorders and subsequent marriage and divorce were estimated in discrete time survival models. Results Fourteen of 18 premarital mental disorders are associated with lower likelihood of ever marrying (odds ratios ranging from 0.6 to 0.9), but these associations vary across ages of marriage. Associations between premarital mental disorders and marriage are generally null for early marriage (age 17 or younger), but negative associations come to predominate at later ages. All 18 mental disorders are positively associated with divorce (odds ratios ranging from 1.2 to 1.8). Three disorders, specific phobia, major depression, and alcohol abuse, are associated with the largest population attributable risk proportions for both marriage and divorce. Conclusion This evidence adds to research demonstrating adverse effects of mental disorders on life course altering events across a diverse range of socioeconomic and cultural settings. These effects should be included in considerations of public health investments in preventing and treating mental disorders. PMID:21534936

A comparison of the fertility of Dominican, Puerto Rican and mainland Puerto Rican adolescents.

PubMed

Fennelly, K; Cornwell, G; Casper, L

1992-01-01

Data from three fertility surveys are used to examined the probabilities and determinants of adolescent births among Dominican and Puerto Rican women. Young women in the Dominican Republic are the most likely to have had a child by each year of age from 14 through 24, followed by young women on the Island of Puerto Rico; the probability of an early birth is lowest for Puerto Rican women on the U.S. mainland. Eighteen percent of Dominican women have had a child before their 18th birthday, compared with 13% of women living in Puerto Rico, and 10% of Puerto Rican women in metropolitan New York. The cumulative probabilities that Puerto Rican women will have borne a child before their 20th birthday are almost identical, whether the women live on the island or the U.S. mainland, but the difference between Puerto Rican and Dominican women widens. The order is reversed, however, in the analysis of premarital births: The probability of a premarital birth during adolescence is highest for Puerto Rican women in New York, and lowest for Dominican women. In a separate logistic regression analysis, education and age at first sexual intercourse are shown to be important determinants of adolescent fertility in all three populations.

78 FR 35903 - Information Collection Request Submitted to OMB for Review and Approval; Comment Request; ICR...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

...; Tier 1 Screening of Certain Chemicals Under the Endocrine Disruptor Screening Program AGENCY... Chemicals; Tier 1 Screening of Certain Chemicals Under the Endocrine Disruptor Screening Program (EDSP... effects. The EDSP consists of a two-tiered approach to screen chemicals for potential endocrine disrupting...

[Preference on screening frequency and willingness-to-pay for multiple-cancer packaging screening programs in urban populations in China].

PubMed

Zhu, J; Huang, H Y; Mao, A Y; Sun, Z X; Qiu, W Q; Lei, H K; Dong, P; Huang, J W; Bai, Y N; Sun, X J; Liu, G X; Wang, D B; Liao, X Z; Ren, J S; Guo, L W; Lan, L; Zhou, Q; Song, B B; Liu, Y Q; Du, L B; Zhu, L; Cao, R; Wang, J L; Mai, L; Ren, Y; Zhou, J Y; Sun, X H; Wu, S L; Qi, X; Lou, P A; Cai, B; Li, N; Zhang, K; He, J; Dai, M; Shi, J F

2018-02-10

Objective: From an actual cancer screening service demanders' perspective, we tried to understand the preference on screening frequency and willingness-to-pay for the packaging screening program on common cancers and to evaluate its long-term sustainability in urban populations in China. Methods: From 2012 to 2014, a multi-center cross-sectional survey was conducted among the actual screening participants from 13 provinces covered by the Cancer Screening Program in Urban China (CanSPUC). By face-to-face interview, information regarding to preference to screening frequency, willingness-to-pay for packaging screening program, maximum amount on payment and related reasons for unwillingness were investigated. Results: A total of 31 029 participants were included in this survey, with an average age as (55.2±7.5) years and median annual income per family as 25 000 Chinese Yuan. People's preference to screening frequency varied under different assumptions ( " totally free" and "self-paid" ). When the packaging screening was assumed totally free, 93.9% of residents would prefer to take the screening program every 1 to 3 years. However, the corresponding proportion dropped to 67.3% when assuming a self-paid pattern. 76.7% of the participants had the willingness-to-pay for the packaging screening, but only 11.2% of them would like to pay more than 500 Chinese Yuan (the expenditure of the particular packaging screening were about 1 500 Chinese Yuan). The remaining 23.3% of residents showed no willingness-to-pay, and the main reasons were unaffordable expenditure (71.7%) and feeling'no need'(40.4%). Conclusions: People who participated in the CanSPUC program generally tended to choose high-frequency packaging screening program, indicating the high potential acceptance for scale-up packaging screening, while it needs cautious assessments and rational guidance to the public. Although about seven in ten of the residents were willing to pay, the payment amount was limited, revealing the necessity of strengthening individual's awareness of his or her key role in health self-management, and a reasonable payment proportion should be considered when establishing co-compensation mechanism.

Models of Community-Based Hepatitis B Surface Antigen Screening Programs in the U.S. and Their Estimated Outcomes and Costs

PubMed Central

Rein, David B.; Lesesne, Sarah B.; Smith, Bryce D.; Weinbaum, Cindy M.

2011-01-01

Objectives Information on the process and method of service delivery is sparse for hepatitis B surface antigen (HBsAg) testing, and no systematic study has evaluated the relative effectiveness or cost-effectiveness of different HBsAg screening models. To address this need, we compared five specific community-based screening programs. Methods We funded five HBsAg screening programs to collect information on their design, costs, and outcomes of participants during a six-month observation period. We categorized programs into four types of models. For each model, we calculated the number screened, the number screened as per Centers for Disease Control and Prevention (CDC) recommendations, and the cost per screening. Results The models varied by cost per person screened and total number of people screened, but they did not differ meaningfully in the proportion of people screened following CDC recommendations, the proportion of those screened who tested positive, or the proportion of those who newly tested positive. Conclusions Integrating screening into outpatient service settings is the most cost-effective method but may not reach all people needing to be screened. Future research should examine cost-effective methods that expand the reach of screening into communities in outpatient settings. PMID:21800750

Expenditure and resource utilisation for cervical screening in Australia

PubMed Central

2012-01-01

Background The National Cervical Screening Program in Australia currently recommends that women aged 18–69 years are screened with conventional cytology every 2 years. Publicly funded HPV vaccination was introduced in 2007, and partly as a consequence, a renewal of the screening program that includes a review of screening recommendations has recently been announced. This study aimed to provide a baseline for such a review by quantifying screening program resource utilisation and costs in 2010. Methods A detailed model of current cervical screening practice in Australia was constructed and we used data from the Victorian Cervical Cytology Registry to model age-specific compliance with screening and follow-up. We applied model-derived rate estimates to the 2010 Australian female population to calculate costs and numbers of colposcopies, biopsies, treatments for precancer and cervical cancers in that year, assuming that the numbers of these procedures were not yet substantially impacted by vaccination. Results The total cost of the screening program in 2010 (excluding administrative program overheads) was estimated to be A$194.8M. We estimated that a total of 1.7 million primary screening smears costing $96.7M were conducted, a further 188,900 smears costing $10.9M were conducted to follow-up low grade abnormalities, 70,900 colposcopy and 34,100 histological evaluations together costing $21.2M were conducted, and about 18,900 treatments for precancerous lesions were performed (including retreatments), associated with a cost of $45.5M for treatment and post-treatment follow-up. We also estimated that $20.5M was spent on work-up and treatment for approximately 761 women diagnosed with invasive cervical cancer. Overall, an estimated $23 was spent in 2010 for each adult woman in Australia on cervical screening program-related activities. Conclusions Approximately half of the total cost of the screening program is spent on delivery of primary screening tests; but the introduction of HPV vaccination, new technologies, increasing the interval and changing the age range of screening is expected to have a substantial impact on this expenditure, as well as having some impact on follow-up and management costs. These estimates provide a benchmark for future assessment of the impact of changes to screening program recommendations to the costs of cervical screening in Australia. PMID:23216968

Screening Students for Scoliosis Spares Them Pain and Saves You Money.

ERIC Educational Resources Information Center

Seward, Kim

1983-01-01

A screening program for scoliosis, or curvature of the spine, is now required in public schools in 13 states. The history of the Massachusetts program suggests ideas for starting a program in school systems. Screening kits are included. (MLF)

Cost-Effectiveness of Breast Cancer Screening in Turkey, a Developing Country: Results from Bahçeşehir Mammography Screening Project.

PubMed

Özmen, Vahit; Gürdal, Sibel Ö; Cabioğlu, Neslihan; Özcinar, Beyza; Özaydın, A Nilüfer; Kayhan, Arda; Arıbal, Erkin; Sahin, Cennet; Saip, Pınar; Alagöz, Oğuzhan

2017-07-01

We used the results from the first three screening rounds of Bahcesehir Mammography Screening Project (BMSP), a 10-year (2009-2019) and the first organized population-based screening program implemented in a county of Istanbul, Turkey, to assess the potential cost-effectiveness of a population-based mammography screening program in Turkey. Two screening strategies were compared: BMSP (includes three biennial screens for women between 40-69) and Turkish National Breast Cancer Registry Program (TNBCRP) which includes no organized population-based screening. Costs were estimated using direct data from the BMSP project and the reimbursement rates of Turkish Social Security Administration. The life-years saved by BMSP were estimated using the stage distribution observed with BMSP and TNBCRP. A total of 67 women (out of 7234 screened women) were diagnosed with breast cancer in BMSP. The stage distribution for AJCC stages O, I, II, III, IV was 19.4%, 50.8%, 20.9%, 7.5%, 1.5% and 4.9%, 26.6%, 44.9%, 20.8%, 2.8% with BMSP and TNBCRP, respectively. The BMSP program is expected to save 279.46 life years over TNBCRP with an additional cost of $677.171, which implies an incremental cost-effectiveness ratio (ICER) of $2.423 per saved life year. Since the ICER is smaller than the Gross Demostic Product (GDP) per capita in Turkey ($10.515 in 2014), BMSP program is highly cost-effective and remains cost-effective in the sensitivity analysis. Mammography screening may change the stage distribution of breast cancer in Turkey. Furthermore, an organized population-based screening program may be cost-effective in Turkey and in other developing countries. More research is needed to better estimate life-years saved with screening and further validate the findings of our study.

Newborn screening education on the internet: a content analysis of North American newborn screening program websites.

PubMed

Araia, Makda H; Potter, Beth K

2011-09-01

The Internet is a potentially important medium for communication about public health programs including newborn screening. This study explores whether the information available on official newborn screening program websites is consistent with existing guidelines regarding educational content for parents. We conducted a systematic search of the public websites of newborn screening programs in the US and Canada, identifying web pages and downloadable brochures that contained educational information. Two researchers independently reviewed all documents to determine the extent to which they included 14 key recommended educational messages. We identified 85 documents containing educational information on 46 US and 6 Canadian newborn screening program websites. The documents contained from 1 to 14 of the recommended messages. The majority of identified materials emphasized the importance and benefits of screening. The differences between US and Canadian materials were related to the importance of parental involvement in follow-up and issues of consent and storage of blood spots. Our findings are consistent with studies of non-web-based newborn screening education materials. The results emphasize the need for further evaluation of newborn screening education, including internet-based resources, particularly in terms of the impact of particular messages on parental attitudes and behaviors.

HPV vaccination impact on a cervical cancer screening program: methods of the FASTER-Tlalpan Study in Mexico.

PubMed

Salmerón, Jorge; Torres-Ibarra, Leticia; Bosch, F Xavier; Cuzick, Jack; Lörincz, Attila; Wheeler, Cosette M; Castle, Philip E; Robles, Claudia; Lazcano-Ponce, Eduardo

2016-04-01

To outline the design of a clinical trial to evaluate the impact of HPV vaccination as part of a hrHPV-based primary screening program to extend screening intervals. A total of 18,000 women aged 25-45 years, attending the regular cervical cancer-screening program in primary health care services in Tlalpan, Mexico City, will be invited to the study. Eligible participants will be assigned to one of three comparison groups: 1) HPV16/18 vaccine and hrHPV-based screening; 2) HPV6/11/16/18 vaccine and hrHPV-based screening; 3) Control group who will receive only hrHPV-based screening. Strict surveillance of hrHPV persistent infection and occurrence of precancerous lesions will be conducted to estimate safety profiles at different screening intervals; participants will undergo diagnosis confirmation and treatment as necessary. The FASTER-Tlalpan Study will provide insights into new approaches of cervical cancer prevention programs. It will offer valuable information on potential benefits of combining HPV vaccination and hrHPV-based screening to safety extend screening intervals.

Developmental milestones across the programmatic life cycle: implementing the CDC's Colorectal Cancer Screening Demonstration Program.

PubMed

Glover-Kudon, Rebecca; DeGroff, Amy; Rohan, Elizabeth A; Preissle, Judith; Boehm, Jennifer E

2013-08-01

In 2005 through 2009, the Centers for Disease Control and Prevention (CDC) funded 5 sites to implement a colorectal cancer screening program for uninsured, low-income populations. These 5 sites composed a demonstration project intended to explore the feasibility of establishing a national colorectal cancer screening program through various service delivery models. A longitudinal, multiple case study was conducted to understand and document program implementation processes. Using metaphor as a qualitative analytic technique, evaluators identified stages of maturation across the programmatic life cycle. Analysis rendered a working theory of program development during screening implementation. In early stages, program staff built relationships with CDC and local partners around screening readiness, faced real-world challenges putting program policies into practice, revised initial program designs, and developed new professional skills. Midterm implementation was defined by establishing program cohesiveness and expanding programmatic reach. In later stages of implementation, staff focused on sustainability and formal program closeout, which prompted reflection about personal and programmatic accomplishments. Demonstration sites evolved through common developmental stages during screening implementation. Findings elucidate ways to target technical assistance to more efficiently move programs along their maturation trajectory. In practical terms, the time and cost associated with guiding a program to maturity may be potentially shortened to maximize return on investment for both organizations and clients receiving service benefits. © 2013 American Cancer Society.

Smoking cessation results in a clinical lung cancer screening program

PubMed Central

McKee, Andrea B.; Regis, Shawn M.; Wald, Christoph; Flacke, Sebastian; McKee, Brady J.

2016-01-01

Background Lung cancer screening may provide a “teachable moment” for promoting smoking cessation. This study assessed smoking cessation and relapse rates among individuals undergoing follow-up low-dose chest computed tomography (CT) in a clinical CT lung screening program and assessed the influence of initial screening results on smoking behavior. Methods Self-reported smoking status for individuals enrolled in a clinical CT lung screening program undergoing a follow-up CT lung screening exam between 1st February, 2014 and 31st March, 2015 was retrospectively reviewed and compared to self-reported smoking status using a standardized questionnaire at program entry. Point prevalence smoking cessation and relapse rates were calculated across the entire population and compared with exam results. All individuals undergoing screening fulfilled the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Lung Cancer Screening v1.2012® high-risk criteria and had an order for CT lung screening. Results A total of 1,483 individuals underwent a follow-up CT lung screening exam during the study interval. Smoking status at time of follow-up exam was available for 1,461/1,483 (98.5%). A total of 46% (678/1,461) were active smokers at program entry. The overall point prevalence smoking cessation and relapse rates were 20.8% and 9.3%, respectively. Prior positive screening exam results were not predictive of smoking cessation (OR 1.092; 95% CI, 0.715–1.693) but were predictive of reduced relapse among former smokers who had stopped smoking for 2 years or less (OR 0.330; 95% CI, 0.143–0.710). Duration of program enrollment was predictive of smoking cessation (OR 0.647; 95% CI, 0.477–0.877). Conclusions Smoking cessation and relapse rates in a clinical CT lung screening program rates are more favorable than those observed in the general population. Duration of participation in the screening program correlated with increased smoking cessation rates. A positive exam result correlated with reduced relapse rates among smokers recently quit smoking. PMID:27606076

Predictors of participation in prostate cancer screening at worksites.

PubMed

Weinrich, S P; Greiner, E; Reis-Starr, C; Yoon, S; Weinrich, M

1998-01-01

Unfortunately, African American men have a higher incidence of and a higher mortality rate for prostate cancer than White men but are less likely to participate in prostate cancer screening. This correlational survey research identifies predictors for participation in a free prostate cancer screening in 179 men, 64% of whom are African American. Each man was invited to see his personal physician for a free prostate cancer screening following a prostate cancer educational program given at his worksite. Forty-seven percent of the African American men went to their personal physician following the educational program and received a digital rectal examination (DRE) and a prostate specific antigen (PSA) screening. In the original cohort of educational program attendees, only 16% of the African Americans had obtained a DRE in the previous 12 months. However, 44% subsequently did participate in free DRE screening. Similarly, only 6% of the African American men had received a PSA screening in the previous 12 months, yet 42% obtained a PSA screening after the educational program, a sevenfold increase. Implications for allocating limited resources for education and screening to the high-risk group of African American men are discussed. This study's model of a prostate cancer educational program at worksites followed by attendees visiting their personal physician for screening could be replicated throughout the United States to increase African American men's participation in prostate cancer screening.

Data integration and warehousing: coordination between newborn screening and related public health programs.

PubMed

Therrell, Bradford L

2003-01-01

At birth, patient demographic and health information begin to accumulate in varied databases. There are often multiple sources of the same or similar data. New public health programs are often created without considering data linkages. Recently, newborn hearing screening (NHS) programs and immunization programs have virtually ignored the existence of newborn dried blood spot (DBS) newborn screening databases containing similar demographic data, creating data duplication in their 'new' systems. Some progressive public health departments are developing data warehouses of basic, recurrent patient information, and linking these databases to other health program databases where programs and services can benefit from such linkages. Demographic data warehousing saves time (and money) by eliminating duplicative data entry and reducing the chances of data errors. While newborn screening data are usually the first data available, they should not be the only data source considered for early data linkage or for populating a data warehouse. Birth certificate information should also be considered along with other data sources for infants that may not have received newborn screening or who may have been born outside of the jurisdiction and not have birth certificate information locally available. This newborn screening serial number provides a convenient identification number for use in the DBS program and for linking with other systems. As a minimum, data linkages should exist between newborn dried blood spot screening, newborn hearing screening, immunizations, birth certificates and birth defect registries.

Implementing the CDC’s Colorectal Cancer Screening Demonstration Program: Wisdom From the Field

PubMed Central

Rohan, Elizabeth A.; Boehm, Jennifer E.; DeGroff, Amy; Glover-Kudon, Rebecca; Preissle, Judith

2017-01-01

BACKGROUND Colorectal cancer, as the second leading cause of cancer-related deaths among men and women in the United States, represents an important area for public health intervention. Although colorectal cancer screening can prevent cancer and detect disease early when treatment is most effective, few organized public health screening programs have been implemented and evaluated. From 2005 to 2009, the Centers for Disease Control and Prevention funded 5 sites to participate in the Colorectal Cancer Screening Demonstration Program (CRCSDP), which was designed to reach medically underserved populations. METHODS The authors conducted a longitudinal, multiple case study to analyze program implementation processes. Qualitative methods included interviews with 100 stakeholders, 125 observations, and review of 19 documents. Data were analyzed within and across cases. RESULTS Several themes related to CRCSDP implementation emerged from the cross-case analysis: the complexity of colorectal cancer screening, the need for teamwork and collaboration, integration of the program into existing systems, the ability of programs to use wisdom at the local level, and the influence of social norms. Although these themes were explored independently from 1 another, interaction across themes was evident. CONCLUSIONS Colorectal cancer screening is clinically complex, and its screening methods are not well accepted by the general public; both of these circumstances have implications for program implementation. Using patient navigation, engaging in transdisciplinary teamwork, assimilating new programs into existing clinical settings, and deferring to local-level wisdom together helped to address complexity and enhance program implementation. In addition, public health efforts must confront negative social norms around colorectal cancer screening. PMID:23868482

Developmental Screening in Community Health Care Centers and Pediatric Practices: An Evaluation of the Baby Steps Program

ERIC Educational Resources Information Center

Shannon, Patrick; Anderson, Patti Rawding

2008-01-01

The Baby Steps Program (Easter Seals of New Hampshire, 2003) is a child-find program that introduces developmental specialists into health care settings to conduct developmental screenings with children during well-child visits. This article presents the Baby Steps Program model, summaries of screening and referral data, and the results of 3 focus…

Feasibility and acceptability of a novel, computerized screening and brief intervention (SBI) for alcohol and sweetened beverage use in pregnancy.

PubMed

Nayak, Madhabika B; Korcha, Rachael A; Kaskutas, Lee A; Kaskustas, Lee A; Avalos, Lyndsay A

2014-11-25

Recommended screening and brief intervention (SBI) for alcohol use during pregnancy is impeded by high patient loads and limited resources in public health settings. We evaluated the feasibility, acceptability and validity of a new self-administered, single-session, bilingual, computerized Screening and Brief Intervention (SBI) program for alcohol and sugar sweetened beverage (SSB) use in pregnancy. We developed and tested the computerized SBI program at a public health clinic with 290 pregnant women. Feasibility, acceptability, and validity measures were included in the program which had several modules, including those on demographics, health and beverage use. Time to complete the program and user experience items were used to determine program feasibility and acceptability. Validity analyses compared proportions of prenatal alcohol use identified by the program versus in-person screening by clinic staff. Most program users (87%, n = 251) completed the entire program; 91% (n = 263) completed the key screening and brief intervention modules. Most users also completed the program in ten to fifteen minutes. Program users reported that the program was easy to use (97%), they learned something new (88%), and that they would share what they learned with others (83%) and with their doctors or clinic staff (76%). Program acceptability did not differ by age, education, or type of beverage intervention received. The program identified alcohol use in pregnancy among 21% of users, a higher rate than the 13% (p < .01) found via screening by clinic staff. Computerized Screening and Brief Intervention for alcohol and SSB use in public health clinics is feasible and acceptable to English and Spanish speaking pregnant women and can efficiently identify prenatal alcohol use.

Trends in cancer screening among Hispanic and white non-Hispanic women, 2000-2005.

PubMed

Zhou, Jing; Enewold, Lindsey; Peoples, George E; Clifton, Guy T; Potter, John F; Stojadinovic, Alexander; Zhu, Kangmin

2010-12-01

Hispanics are the largest and fastest growing ethnic group in the United States. Compared with white non-Hispanic women, however, Hispanic women have significantly lower cancer screening rates. Programs designed to increase cancer screening rates, including the national Screen for Life campaign, which specifically promoted colorectal cancer (CRC) screening, regional educational/research programs, and state cancer control programs, have been launched. Screen for Life and some of these other intervention programs have targeted Hispanic populations by providing educational materials in Spanish in addition to English. The objective of this study was to compare changes in colorectal, breast, and cervical cancer screening rates from 2000 to 2005 among Hispanic and white non-Hispanic women, using data from the National Health Interview Survey (NHIS). The age ranges of study subjects and the definitions of cancer screening were site specific and based on the American Cancer Society (ACS) screening recommendations. Although overall screening rates were found to be lower among Hispanic women, CRC screening increased about 1.5-fold among both Hispanic and white non-Hispanic women, mainly driven by endoscopic screening, which increased 2.1-fold and 2.9-fold, respectively, from 2000 to 2005 (p < 0.01). Fecal occult blood testing (FOBT) for CRC declined among white non-Hispanic women and remained stable among Hispanic women during the same period. Mammogram and Pap smear screening tended to decline during the study period for both ethnic groups, especially white non-Hispanic women. Although cancer screening rates may be affected by multiple factors, culturally sensitive and linguistically appropriate national educational programs may have contributed to the increase in endoscopic CRC screening compliance.

Sickle Cell Screening: Emphasis on Education

ERIC Educational Resources Information Center

Valente, Carmine; Frank, William

1972-01-01

This article relates the sickle cell education program, the personnel training and the screening procedures of a pilot sickle cell screening program by the Prince George's County Health Department. (JA)

32 CFR 720.46 - Overseas screening programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Overseas screening programs. 720.46 Section 720... Department of the Navy Members, Employees, and Family Members Outside the United States § 720.46 Overseas screening programs. The Chief of Naval Operations (CNO) and the CMC shall incorporate procedures requiring...

College Student Sexual Morality Revisited: A Consideration of Pre-Marital Sex, Extra-Marital Sex and Childlessness between 1940 and 2000-2005

ERIC Educational Resources Information Center

Lance, Larry M.

2007-01-01

Much attention has been given to the new "sexual morality" of college students today. Indeed, some maintain that the American family is doomed because of the attitudes of young people today toward sex and the family. How does the sexual morality of college students today compare with the sexual morality of college students over half a century ago?…

A pan-Canadian web-based education program to support screening for distress: evaluation of outcomes.

PubMed

McLeod, Deborah L; Morck, Angela C; Curran, Janet A

2014-02-01

Cancer-related distress has been endorsed as the sixth vital sign by many international cancer organizations, and some countries such as Canada have implemented national screening for distress programs. The completion of a screening tool is an important first step in improving responsiveness to cancer-related distress, but screening must be followed with skilled supportive care to make a difference in patient-reported outcomes. Our objective was to create a web-based education program to support nurses and other frontline staff in providing an initial response to screening results. To address screening and supportive care learning needs, the Canadian Association of Psychosocial Oncology (CAPO), with support from the Canadian Partnership Against Cancer, created a web-based education program as one component of the national screening for distress agenda. The program provides clinically grounded and interactive learning through the use of PowerPoint presentations, video clips of clinical interactions with patients and family members, and test questions. Presentation topics include, for example, strategies for dealing with screening results, managing referrals, and supportive counseling. We employed a matched pairs, pre-post survey design to assess the effect of the education program on confidence in screening and in providing initial supportive care. Our analysis of the first 147 matched pairs to complete the course suggests that satisfaction with the course was high. Statistically significant increases in confidence in relation to screening for distress and assessing distress, and in providing initial supportive care, were evident. Our ongoing experience with CAPO's Interprofessional Psychosocial Oncology Distance Education (IPODE) project (www.ipode.ca) project suggests that healthcare professionals value web-based learning for its accessibility and convenience. Such programs appear to offer excellent opportunities for cost-effective education that supports practice change.

Endocrine Disruptor Screening Program Reports to Congress

EPA Pesticide Factsheets

This page includes EPA reports to congress on pesticide licensing and endocrine disruptor screening activities, Endocrine Disruptor Methods Validation Subcomittee (EDMVS) progress, and Endocrine Disruptor Screening Program (EDSP) implementation progress.

Message Design Guidelines For Screen-Based Programs.

ERIC Educational Resources Information Center

Rimar, G. I.

1996-01-01

Effective message design for screen-based computer or video instructional programs requires knowledge from many disciplines. Evaluates current conventions and suggests a new set of guidelines for screen-based designers. Discusses screen layout, highlighting and cueing, text font and style, text positioning, color, and graphical user interfaces for…

75 FR 77869 - Endocrine Disruptor Screening Program; Second List of Chemicals for Tier 1 Screening; Extension...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-14

... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPPT-2009-0477; FRL-8856-5] Endocrine Disruptor Screening... Federal Register issue of November 17, 2010, concerning the Endocrine Disruptor Screening Program's (EDSP... CONTACT. List of Subjects Environmental protection, Chemicals, Drinking water, Endocrine disruptors...

ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS CONSANGUINEOUS MARRIAGES AMONG A COHORT OF MULTIETHNIC HEALTH CARE PROVIDERS IN SAUDI ARABIA.

PubMed

Alnaqeb, Dhekra; Hamamy, Hanan; Youssef, Amira M; Al-Rubeaan, Khalid

2018-01-01

This study aimed to assess knowledge, attitude and practice related to consanguinity among multiethnic health care providers in the Kingdom of Saudi Arabia. Using a cross-sectional study design, a validated, self-administered close-ended questionnaire was randomly distributed to health care providers in different health institutions in the country between 1st August 2012 and 31st July 2013. A total of 1235 health care providers completed the study questionnaire. Of the 892 married participants (72.23% of total), 11.43% were married to a first cousin, and were predominantly Arabs, younger than 40 years and male. Only 17.80% of the patients seen by the health care providers requested consanguinity related counselling. A knowledge barrier was expressed by 27.49% of the participants, and 85.67% indicated their willingness to have more training in basic genetic counselling. A language barrier was expressed as a limiting factor to counselling for consanguinity among non-Arabs. The health care providers had a major dearth of knowledge that was reflected in their attitude and practice towards consanguinity counselling. This finding indicates the need for more undergraduate and postgraduate medical and nursing education and training in the counselling of consanguineous couples. It is recommended that consanguinity counselling is included in the current premarital screening and counselling programmes in the Kingdom.

WE-D-207-01: Background and Clinical Implementation of a Screening Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Aberle, D.

2015-06-15

In the United States, Lung Cancer is responsible for more cancer deaths than the next four cancers combined. In addition, the 5 year survival rate for lung cancer patients has not improved over the past 40 to 50 years. To combat this deadly disease, in 2002 the National Cancer Institute launched a very large Randomized Control Trial called the National Lung Screening Trial (NLST). This trial would randomize subjects who had substantial risk of lung cancer (due to age and smoking history) into either a Chest X-ray arm or a low dose CT arm. In November 2010, the National Cancermore » Institute announced that the NLST had demonstrated 20% fewer lung cancer deaths among those who were screened with low-dose CT than with chest X-ray. In December 2013, the US Preventive Services Task Force recommended the use of Lung Cancer Screening using low dose CT and a little over a year later (Feb. 2015), CMS announced that Medicare would also cover Lung Cancer Screening using low dose CT. Thus private and public insurers are required to provide Lung Cancer Screening programs using CT to the appropriate population(s). The purpose of this Symposium is to inform medical physicists and prepare them to support the implementation of Lung Screening programs. This Symposium will focus on the clinical aspects of lung cancer screening, requirements of a screening registry for systematically capturing and tracking screening patients and results (such as required Medicare data elements) as well as the role of the medical physicist in screening programs, including the development of low dose CT screening protocols. Learning Objectives: To understand the clinical basis and clinical components of a lung cancer screening program, including eligibility criteria and other requirements. To understand the data collection requirements, workflow, and informatics infrastructure needed to support the tracking and reporting components of a screening program. To understand the role of the medical physicist in implementing Lung Cancer Screening protocols for CT, including utilizing resources such as the AAPM Protocols and the ACR Designated Lung Screening Center program. UCLA Department of Radiology has an Institutional research agreement with Siemens Healthcare; Dr. McNitt-Gray has been a recipient of Research Support from Siemens Healthcare in the past. Dr. Aberle has been a Member of Advisory Boards for the LUNGevity Foundation (2011-present) and Siemens Medical Solutions. (2013)« less

Evaluation of the effect of an audit and feedback reporting tool on screening participation: The Primary Care Screening Activity Report (PCSAR).

PubMed

Jonah, Leigh; Pefoyo, Anna Kone; Lee, Alex; Hader, Joanne; Strasberg, Suzanne; Kupets, Rachel; Chiarelli, Anna M; Tinmouth, Jill

2017-03-01

Participation in cancer screening is critical to its effectiveness in reducing the burden of cancer. The Primary Care Screening Activity Report (PCSAR), an electronic report, was developed as an innovative audit and feedback tool to increase screening participation in Ontario's cancer screening programs. This study aims to assess its impact on patient screening participation. This study used a retrospective cohort design to evaluate the effectiveness of the 2014 PCSAR on screening participation in Ontario's three screening programs (breast, cervix and colorectal). The 3 cohorts comprised all participants eligible for each of the programs enrolled with a primary care physician in Ontario. Two exposures were evaluated for each cohort: enrollment with a physician who was registered to receive the PCSAR and enrollment with a registered physician who also logged into the PCSAR. Logistic regression modelling was used to assess the magnitude of the effect of PCSAR on participation, adjusting for participant and physician characteristics. Across all three screening programs, 63% of eligible physicians registered to receive the PCSAR and 38% of those registered logged-in to view it. Patients of physicians who registered were significantly more likely to participate in screening, with odds ratios ranging from 1.06 [1.04;1.09] to 1.15 [1.12;1.19]. The adjusted odds ratios associated with PCSAR log-in were 1.07 [1.03;1.12] to 1.18 [1.14;1.22] across all screening programs. Implementation of the PCSAR was associated with a small increase in screening participation. The PCSAR appears to be modestly effective in assisting primary care physicians in optimizing cancer screening participation among their patients. Copyright © 2017 Elsevier Inc. All rights reserved.

The Next Step Trial: impact of a worksite colorectal cancer screening promotion program.

PubMed

Tilley, B C; Vernon, S W; Myers, R; Glanz, K; Lu, M; Hirst, K; Kristal, A R

1999-03-01

The Next Step Trial was a randomized trial of worksite colorectal cancer screening promotion and nutrition interventions for automobile industry employees at increased risk of colorectal cancer. Interventions were tested at 28 worksites with 5,042 employees. This report describes results of the screening promotion intervention. Worksites randomized to the control group received a standard program including rectal examination, fecal occult blood testing, and flexible sigmoidoscopy. Intervention worksites received an enhanced program (i.e., standard program plus an educational booklet/telephone call). Compliance (i.e., completion of all recommended screening examinations) and coverage (i.e., completion of at least one screening examination), the primary and secondary outcomes, were measured over 2 years. In the 2 years prior to baseline, 61% of employees had been screened. After random assignment, baseline differences in several employee characteristics and worksite screening procedures were detected, including more past history of screening in control worksites. After adjusting for differences, we found modest, but higher, compliance and coverage in intervention compared with control worksites (odds ratio [95% confidence limits] = 1.46 [1.1-2.0] and 1.33 [1.1, 1.6], respectively). Adding a personally tailored behavioral intervention to a standard colorectal cancer screening program can promote continued employee participation in screening as measured by compliance. Further research is needed to assess intervention effects in other populations. Copyright 1999 American Health Foundation and Academic Press.

Screening Jews and genes: a consideration of the ethics of genetic screening within the Jewish community: challenges and responses.

PubMed

Levin, M

1999-01-01

Screening for genetic disorders, particularly Tay-Sachs Disease, has been traditionally welcome by the Jewish community. I review the history of genetic screening among Jews and the views from the Jewish tradition on the subject, and then discuss ethical challenges of screening and the impact of historical memories upon future acceptance of screening programs. Some rational principles to guide future design of genetic screening programs among Jews are proposed.

Endocrine Disruptor Screening Program (EDSP) 1998 Federal Register Notices

EPA Pesticide Factsheets

EPA outlined the Endocrine Disruptor Screening Program (EDSP), which incorporated many of the Endocrine Disruptor Screening and Testing Advisory Committee's (EDSTAC) recommendations, in two Federal Register Notices published in 1998.

Challenges faced by cervical cancer prevention programs in developing countries: a situational analysis of program organization in Argentina.

PubMed

Arrossi, Silvina; Paolino, Melisa; Sankaranarayanan, Rengaswamy

2010-10-01

to carry out a situational analysis of cervical cancer prevention activities in Argentina, specifically regarding (a) the organizational framework of cervical cancer prevention activities; (b) Pap-smear coverage; (c) cytology laboratory organization; and (d) follow-up/treatment of women with abnormal lesions. a situational analysis of provincial cervical cancer programs using data from an ad-hoc questionnaire sent to the leaders of cervical cancer prevention programs in Argentina's 24 provinces. In addition, the provinces' program guidelines, statistical reports, laws, and program regulations were reviewed and certain key leaders were personally interviewed. data were obtained for 19 of Argentina's 24 provinces. Four of the 19 provinces had no formal program framework. Conventional cytology was the most commonly used screening test. Screening was mainly opportunistic. The recommended interval between normal tests was 3 years in most provinces. The eligible age for screening ranged from 10-70 years of age; however, annual or biannual screening was the usual practice after becoming sexually active. None of the provincial programs had data available regarding Pap-smear coverage. Most of the cytology laboratories did not have a quality control policy. The number of smears read varied greatly by laboratory (650-24 000 per year). A log of events related to screening and treatment did not exist in most provinces. screening in Argentina is mainly opportunistic, characterized by an estimated low coverage, coexisting with over-screening of women with access to health services, and an absence of quality control procedures. Policies for cervical cancer screening in the provinces vary and, most often, deviate from the national recommendation of one Pap smear every 3 years for women 35-64 years of age. Ensuring compliance with national program guidelines is an essential step toward significantly reducing the burden of cervical cancer.

A controversial endorser for RH ad.

PubMed

In the Philippines, a celebrity actress has been chosen to star in three public service commercials promoting the reproductive health program of the Department of Health (DOH). One of the commercials will influence adult men to take care of their own health and to support the reproductive health decisions of their wives, while the other two will raise women's consciousness about reproductive health rights and services. The Roman Catholic Church objected to the choice of the actress and charged that she would only encourage people to engage in illicit sex. The Church also objects to the use of celebrities to promote family planning because it believes this will encourage couples to engage in premarital sex as long as they use contraceptives. However, the DOH advertisements do not mention condoms or sex, and they reveal only the face of the famous actress. A comment on this article notes that the choice of this actress imposes responsibility on the sponsors of the advertisements to educate her on gender issues so that her comments in other arenas will not interfere with her effective endorsement of reproductive health.

Pitfalls in the biological diagnosis of common hemoglobin disorders.

PubMed

Wajcman, Henri; Moradkhani, Kamran

2015-01-01

In West-European countries, hemoglobin disorders are no more rare diseases. Programs for diagnosis of heterozygous carriers have been established to prevent cases with major sickle cell disease or thalassemias. These studies have been done essentially by high performance liquid chromatography on cation-exchange columns and electrophoresis (mostly capillary electrophoresis). They have been done through systematic population studies or premarital diagnosis. We describe in this work the frequent or rare pitfalls encountered, which led to false negative or positive diagnosis both in the field of sickle cell disease and thalassemias. In the absence of a well identified hemoglobin disorder in the proband's family, it is a rule that the use of a single test is insufficient to identify formally HbS. The presence of HbS could also be masked by another hemoglobin abnormality. The sole measurement of HbA2 level is insufficient to characterize a thalassemic trait: this level needs always to be interpreted considering RBC parameters and iron metabolic status. In difficult cases, the definitive answer may require a family study and/or a molecular genetic characterization.

A pre-breeding screening program for transgenic boars based on fluorescence in situ hybridization assay.

PubMed

Bou, Gerelchimeg; Sun, Mingju; Lv, Ming; Zhu, Jiang; Li, Hui; Wang, Juan; Li, Lu; Liu, Zhongfeng; Zheng, Zhong; He, Wenteng; Kong, Qingran; Liu, Zhonghua

2014-08-01

For efficient transgenic herd expansion, only the transgenic animals that possess the ability to transmit transgene into next generation are considered for breeding. However, for transgenic pig, practically lacking a pre-breeding screening program, time, labor and money is always wasted to maintain non-transgenic pigs, low or null transgenic transmission pigs and the related fruitless gestations. Developing a pre-breeding screening program would make the transgenic herd expansion more economical and efficient. In this technical report, we proposed a three-step pre-breeding screening program for transgenic boars simply through combining the fluorescence in situ hybridization (FISH) assay with the common pre-breeding screening workflow. In the first step of screening, combined with general transgenic phenotype analysis, FISH is used to identify transgenic boars. In the second step of screening, combined with conventional semen test, FISH is used to detect transgenic sperm, thus to identify the individuals producing high quality semen and transgenic sperm. In the third step of screening, FISH is used to assess the in vitro fertilization embryos, thus finally to identify the individuals with the ability to produce transgenic embryos. By this three-step screening, the non-transgenic boars and boars with no ability to produce transgenic sperm or transgenic embryos would be eliminated; therefore only those boars could produce transgenic offspring are maintained and used for breeding and herd expansion. It is the first time a systematic pre-breeding screening program is proposed for transgenic pigs. This program might also be applied in other transgenic large animals, and provide an economical and efficient strategy for herd expansion.

76 FR 49473 - Petition to Maximize Practical Utility of List 1 Chemicals Screened Through EPA's Endocrine...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-10

... Utility of List 1 Chemicals Screened Through EPA's Endocrine Disruptor Screening Program; Notice of... to the test orders issued under the Endocrine Disruptor Screening Program. DATES: Comments must be... testing of chemical substances for potential endocrine effects. Potentially affected entities, identified...

77 FR 65682 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-30

... Under the Endocrine Disruptor Screening Program (EDSP) (Renewal) AGENCY: Environmental Protection Agency....regulations.gov . Title: Tier 1 Screening of Certain Chemicals Under the Endocrine Disruptor Screening Program... of a two-tiered approach to screen chemicals for potential endocrine disrupting effects. The purpose...

ToxCast Workflow: High-throughput screening assay data processing, analysis and management (SOT)

EPA Science Inventory

US EPA’s ToxCast program is generating data in high-throughput screening (HTS) and high-content screening (HCS) assays for thousands of environmental chemicals, for use in developing predictive toxicity models. Currently the ToxCast screening program includes over 1800 unique c...

Reaching Graduate Students at Risk for Suicidal Behavior through the Interactive Screening Program

ERIC Educational Resources Information Center

Moffitt, Lauren B.; Garcia-Williams, Amanda; Berg, John P.; Calderon, Michelle E.; Haas, Ann P.; Kaslow, Nadine J.

2014-01-01

Suicidal behavior is a significant concern among graduate students. Because many suicidal graduate students do not access mental health services, programs to connect them to resources are essential. This article describes the Interactive Screening Program (ISP), an anonymous, Web-based tool for screening and engaging at-risk graduate school…

Results of a neonatal hearing screening program in Maceió.

PubMed

Dantas, Margareth Barbosa de Souza; Anjos, César Antônio Lira Dos; Camboim, Elizângela Dias; Pimentel, Marcella de Carvalho Ramos

2009-01-01

Since 1998, after we started the support group for neonatal hearing screening, many other hearing screening programs were held in Brazil. In Alagoas, the first program started in 2003, but none of its results were published. Hearing is paramount for human communication; therefore, childhood hearing loss can impair speech acquisition, emotional, educational and social development. to present the results achieved in a neonatal hearing screening program in Maceió. a retrospective analytical study was carried out in order to study the results from tests carried out from September 2003 to December 2006 in a private hospital of Maceió. from a total of 2002 newborns, 1,626 fitted the inclusion criteria, 835 (51.4%) males. The hearing screening was considered appropriate in 1416 cases (87.1%), and the most frequently found age was between 16 and 30 days. Finally, 163 (10.0%) children presented risk indicators for hearing loss, and hyperbilirubinemia was the most common indicator. statistical results obtained from this hearing screening program show the importance of holding such programs. This study is important because it contributes to further regional or multinational studies.

Colon Cancer Screening Programs: Impact of an Organized Screening Strategy Assessed by the EDIFICE Surveys.

PubMed

Viguier, Jérôme; Morère, Jean-François; Brignoli-Guibaudet, Lysel; Lhomel, Christine; Couraud, Sébastien; Eisinger, François

2018-03-05

The aim of EDIFICE surveys is to improve insight into the behavior of the French population with regard to cancer prevention and participation in screening programs. Via the colorectal cancer screening program, all average-risk individuals in the 50-74-year age group are invited every 2 years to do a guaiac-based or, since April 2015, an immunochemical fecal occult blood test. The fifth edition of the nationwide observational survey was conducted by phone interviews using the quota method. A representative sample of 1299 individuals with no history of cancer (age, 50-74 years) was interviewed between 22 November and 7 December 2016. The present analysis focuses on minimum lifetime uptake of screening tests, compliance to recommended repeat-screening intervals, and reasons for non-participation. In 2016, 64% survey participants had been screened at least once and 38% had been screened in the previous 2 years, suggesting a trend towards increasing participation rates, particularly in the younger age categories and among men. The 2016 data also suggest that the newly implemented FIT-based screening program has been well perceived by the population. Up to one in four individuals cited "no risk factors" as the reason for not undergoing screening. This reveals ignorance of the fact that the colorectal cancer screening program actually targets all average-risk individuals in a given age group, without individual risk factors. We suggest the next step should be dedicated to educational approaches to explain exactly what screening involves and to persuasive messages targeting those who to date have remained unreceptive to information campaigns.

Factors predicting health practitioners' awareness of UNHS program in Malaysian non-public hospitals.

PubMed

Ismail, Abdussalaam Iyanda; Abdul Majid, Abdul Halim; Zakaria, Mohd Normani; Abdullah, Nor Azimah Chew; Hamzah, Sulaiman; Mukari, Siti Zamratol-Mai Sarah

2018-06-01

The current study aims to examine the effects of human resource (measured with the perception of health workers' perception towards UNHS), screening equipment, program layout and screening techniques on healthcare practitioners' awareness (measured with knowledge) of universal newborn hearing screening (UNHS) in Malaysian non-public hospitals. Via cross sectional approach, the current study collected data using a validated questionnaire to obtain information on the awareness of UNHS program among the health practitioners and to test the formulated hypotheses. 51, representing 81% response rate, out of 63 questionnaires distributed to the health professionals were returned and usable for statistical analysis. The survey instruments involving healthcare practitioners' awareness, human resource, program layout, screening instrument, and screening techniques instruments were adapted and scaled with 7-point Likert scale ranging from 1 (little) to 7 (many). Partial Least Squares (PLS) algorithm and bootstrapping techniques were employed to test the hypotheses of the study. With the result involving beta values, t-values and p-values (i.e. β=0.478, t=1.904, p<0.10; β=0.809, t=3.921, p<0.01; β= -0.436, t=1.870, p<0.10), human resource, measured with training, functional equipment and program layout, are held to be significant predictors of enhanced knowledge of health practitioners. Likewise, program layout, human resource, screening technique and screening instrument explain 71% variance in health practitioners' awareness. Health practitioners' awareness is explained by program layout, human resource, and screening instrument with effect size (f2) of 0.065, 0.621, and 0.211 respectively, indicating that program layout, human resource, and screening instrument have small, large and medium effect size on health practitioners' awareness respectively. However, screening technique has zero effect on health practitioners' awareness, indicating the reason why T-statistics is not significant. Having started the UNHS program in 2003, non-public hospitals have more experienced and well-trained employees dealing with the screening tools and instrument, and the program layout is well structured in the hospitals. Yet, the issue of homogeneity exists. Non-public hospitals charge for the service they render, and, in turn, they would ensure quality service, given that they are profit-driven and/or profit-making establishments, and that they would have no option other than provision of value-added and innovative services. The employees in the non-public hospitals have less screening to carry out, given the low number of babies delivered in the private hospitals. In addition, non-significant relationship between screening techniques and healthcare practitioners' awareness of UNHS program is connected with the fact that the techniques that are practiced among public and non-public hospital are similar and standardized. Limitations and suggestions were discussed. Copyright © 2018 Elsevier B.V. All rights reserved.

[Validation of the Spanish parent satisfaction questionnaire with neonatal hearing screening programs].

PubMed

Núñez-Batalla, Faustino; Antuña-León, Eva; González-Trelles, Teresa; Carro-Fernández, Pilar

2009-01-01

Although measuring parent satisfaction has been recommended as one of the important outcome measures in assessing the effectiveness of neonatal hearing screening programs, there are few published studies investigating this issue. To validate the Spanish version of the Parent Satisfaction Questionnaire with Neonatal Hearing Screening Program (PSQ-NHSP). 112 parents whose children had received hearing screening participated in this study. High levels of satisfaction were reported with more than 90% of parents satisfied with all aspects of the program. The psychometric properties of the Spanish version of the PSQ-NHSP were analyzed and demonstrated good internal consistency (alpha=0.75). Construct validity was indicated by a significant positive relationship between overall satisfaction and the three specific dimensions in the questionnaire. The development of a valid and reliable parent satisfaction questionnaire is important for improving hearing screening programs.

Budget impact analysis of switching to digital mammography in a population-based breast cancer screening program: a discrete event simulation model.

PubMed

Comas, Mercè; Arrospide, Arantzazu; Mar, Javier; Sala, Maria; Vilaprinyó, Ester; Hernández, Cristina; Cots, Francesc; Martínez, Juan; Castells, Xavier

2014-01-01

To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term. Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs.

Budget Impact Analysis of Switching to Digital Mammography in a Population-Based Breast Cancer Screening Program: A Discrete Event Simulation Model

PubMed Central

Comas, Mercè; Arrospide, Arantzazu; Mar, Javier; Sala, Maria; Vilaprinyó, Ester; Hernández, Cristina; Cots, Francesc; Martínez, Juan; Castells, Xavier

2014-01-01

Objective To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. Methods A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. Results Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term. Conclusions Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs. PMID:24832200

Longitudinal Rates of Colon Cancer Screening Use in Winnipeg, Canada: The Experience of a Universal Health-Care System with an Organized Colon Screening Program.

PubMed

Decker, Kathleen M; Demers, Alain A; Nugent, Zoann; Biswanger, Natalie; Singh, Harminder

2015-12-01

We examined trends in colorectal cancer (CRC) screening (fecal occult blood test (FOBT), colonoscopy, and flexible sigmoidoscopy (FS)) and differences in CRC screening by income in a population with an organized CRC screening program and universal health-care coverage. Individuals who had an FOBT, colonoscopy, or FS were identified from the provincial Physician Claims database and the population-based colon cancer screening registry. Trends in age-standardized rates were determined. Logistic regression was performed to explore the association between CRC screening and income quintiles by year. Up-to-date CRC screening (FOBT, colonoscopy, or FS) increased over time for men and women, all age groups, and all income quintiles. Up-to-date CRC screening was very high among 65- to 69- and 70- to 74-year-olds (70% and 73%, respectively). There was a shift toward the use of an FOBT for CRC screening for individuals in the lower income quintiles. The disparity in colonoscopy/FS coverage by income quintile was greater in 2012 than in 1995. Overall, there was no reduction in disparities by income in up-to-date CRC screening nor did the rate of increase in up-to-date CRC screening or FOBT use change after the introduction of the organized provincial CRC screening program. CRC screening is increasing over time for both men and women and all age groups. However, a disparity in up-to-date CRC screening by income persisted even with an organized CRC screening program in a universal health-care setting.

A Comparative Study on Willingness to Pay for Breast Cancer and Osteoporosis Screening in Kerman, Southeastern Iran.

PubMed

Sabermahani, Asma; Mohammad Taghizade, Sedighe; Goodarzi, Reza

2017-05-01

One of the economic evaluation techniques involves calculation of willingness to pay (WTP) for a service to find out the value of that service from the clients' perspective. This study estimated WTP for both breast cancer and osteoporosis screening and comparatively examined the contributing factors. In fact, the comparisons served to provide an exact analysis of individual attitudes and behaviors in relation to screening programs for cancers and other diseases. This study was first designed in six scenarios several questionnaires concerning individual breast cancer and osteoporosis screening cases, and determined the WTP median in each scenario between people in Kerman Province of Iran in 2016. Then, the demand function for breast cancer and osteoporosis screening was formulated. Moreover, the factors contributing to WTP were examined through various scenarios in Stata and econometric techniques. The median and mean values of WTP in all the above scenarios were greater for breast cancer screening than for osteoporosis screening. Theoretically, the price assumed a minus sign whereas risk assumed a plus sign within the demand function formulated for both screening programs. Regarding the evaluated factors, age in breast cancer screening and risk of disease in osteoporosis screening were the major factors contributing to WTP. Breast cancer screening was more valuable than osteoporosis screening program from the perspective of the subjects. The programs can be successfully designed by concentrating on patients' age groups in breast cancer screening and high-risk patients in osteoporosis screening.

Changes in sexual behaviour and practice and HIV prevalence indicators among young people aged 15–24 years in Zambia: An in-depth analysis of the 2001–2002 and 2007 Zambia Demographic and Health Surveys

PubMed Central

Kembo, Joshua

2014-01-01

HIV and AIDS still pose a major public health problem to most countries in sub-Saharan Africa, Zambia included. The objective of the paper is to determine changes in selected sexual behaviour and practice and HIV prevalence indicators between 2001–2002 and 2007. We used the Demographic and Health Survey Indicators Database for the computation of the selected indicators. We further used STATA 10.0 to compute significance tests to test for statistical difference in the indicators. The results indicate some changes in sexual behaviour, as indicated by an increase in abstinence, use of condoms and the decrease in multiple partnerships. The overall percentage of abstinence among never-married young men and women aged 15–24 years in Zambia increased significantly by 15.2% (p = .000) and 5.9% (p = .001) respectively, between 2001–2002 and 2007. A statistically significant increase of 6.6% (p = .029) was observed in the percentage of young women who reported having used a condom during the last time they had had premarital sex. A statistically significant decrease of 11.0% (p = .000) and 1.4% (p = .000) was observed among young men and women, respectively, who reported having multiple partners in the preceding 12 months. The factorial decomposition using multivariate analysis reveals that the indicators which contributed to the statistically significant 2.6% decline in HIV prevalence among young women aged 15–24 years in Zambia include proportion reporting condom use during premarital sex (+6.6%), abstinence (+5.9%), sex before age 15 (– 4.5%), premarital sex (– 2.6%), sex before age 18 (– 2.4%) and proportion reporting multiple partnerships (– 1.4%). Remarkable strides have been achieved towards promoting responsible sexual behaviour and practice among young people in Zambia. Further research focusing on factors that predispose young women in Zambia to higher risk of infection from HIV is required. The results from this paper should be useful in the design of programmes to control the spread of HIV and AIDS, particularly among young people in Zambia and other sub-Saharan countries. PMID:24702245

WE-D-207-03: CT Protocols for Screening and the ACR Designated Lung Screening Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

McNitt-Gray, M.

2015-06-15

In the United States, Lung Cancer is responsible for more cancer deaths than the next four cancers combined. In addition, the 5 year survival rate for lung cancer patients has not improved over the past 40 to 50 years. To combat this deadly disease, in 2002 the National Cancer Institute launched a very large Randomized Control Trial called the National Lung Screening Trial (NLST). This trial would randomize subjects who had substantial risk of lung cancer (due to age and smoking history) into either a Chest X-ray arm or a low dose CT arm. In November 2010, the National Cancermore » Institute announced that the NLST had demonstrated 20% fewer lung cancer deaths among those who were screened with low-dose CT than with chest X-ray. In December 2013, the US Preventive Services Task Force recommended the use of Lung Cancer Screening using low dose CT and a little over a year later (Feb. 2015), CMS announced that Medicare would also cover Lung Cancer Screening using low dose CT. Thus private and public insurers are required to provide Lung Cancer Screening programs using CT to the appropriate population(s). The purpose of this Symposium is to inform medical physicists and prepare them to support the implementation of Lung Screening programs. This Symposium will focus on the clinical aspects of lung cancer screening, requirements of a screening registry for systematically capturing and tracking screening patients and results (such as required Medicare data elements) as well as the role of the medical physicist in screening programs, including the development of low dose CT screening protocols. Learning Objectives: To understand the clinical basis and clinical components of a lung cancer screening program, including eligibility criteria and other requirements. To understand the data collection requirements, workflow, and informatics infrastructure needed to support the tracking and reporting components of a screening program. To understand the role of the medical physicist in implementing Lung Cancer Screening protocols for CT, including utilizing resources such as the AAPM Protocols and the ACR Designated Lung Screening Center program. UCLA Department of Radiology has an Institutional research agreement with Siemens Healthcare; Dr. McNitt-Gray has been a recipient of Research Support from Siemens Healthcare in the past. Dr. Aberle has been a Member of Advisory Boards for the LUNGevity Foundation (2011-present) and Siemens Medical Solutions. (2013)« less

Moving forward: using the experience of the CDCs' Colorectal Cancer Screening Demonstration Program to guide future colorectal cancer programming efforts.

PubMed

Seeff, Laura C; DeGroff, Amy; Joseph, Djenaba A; Royalty, Janet; Tangka, Florence K L; Nadel, Marion R; Plescia, Marcus

2013-08-01

The Centers for Disease Control and Prevention (CDC) established and supported a 4-year Colorectal Cancer Screening Demonstration Program (CRCSDP) from 2005 to 2009 for low-income, under- or uninsured men and women aged 50-64 at 5 sites in the United States. A multiple methods evaluation was conducted including 1) a longitudinal, comparative case study of program implementation, 2) the collection and analysis of client-level screening and diagnostic services outcome data, and 3) the collection and analysis of program- and patient-level cost data. Several themes emerged from the results reported in the series of articles in this Supplement. These included the benefit of building on an existing infrastructure, strengths and weakness of both the 2 most frequently used screening tests (colonoscopy and fecal occult blood tests), variability in costs of maintaining this screening program, and the importance of measuring the quality of screening tests. Population-level evaluation questions could not be answered because of the small size of the participating population and the limited time frame of the evaluation. The comprehensive evaluation of the program determined overall feasibility of this effort. Critical lessons learned through the implementation and evaluation of the CDC's CRCSDP led to the development of a larger population-based program, the CDC's Colorectal Cancer Control Program (CRCCP). © 2013 American Cancer Society.

Association Between Socioeconomic Status and Participation in Colonoscopy Screening Program in First Degree Relatives of Colorectal Cancer Patients.

PubMed

Chouhdari, Arezoo; Yavari, Parvin; Pourhoseingholi, Mohammad Amin; Sohrabi, Mohammad-Reza

2016-04-01

Approximately 15% to 25% of colorectal cancer (CRC) cases have positive family history for disease. Colonoscopy screening test is the best way for prevention and early diagnosis. Studies have found that first degree relatives (FDRs) with low socioeconomic status are less likely to participate in colonoscopy screening program. The aim of this study is to determine the association between socioeconomic status and participation in colonoscopy screening program in FDRs. This descriptive cross-sectional, study has been conducted on 200 FDRs who were consulted for undergoing colonoscopy screening program between 2007 and 2013 in research institute for gastroenterology and liver disease of Shahid Beheshti University of Medical Sciences, Tehran, Iran. They were interviewed via phone by a valid questionnaire about socioeconomic status. For data analysis, chi-square, exact fisher and multiple logistic regression were executed by SPSS 19. The results indicated 58.5% participants underwent colonoscopy screening test at least once to the time of the interview. There was not an association between participation in colonoscopy screening program and socioeconomic status to the time of the interview in binomial analysis. But statistical significance between intention to participate and educational and income level were found. We found, in logistic regression analysis, that high educational level (Diploma and University degree in this survey) was a predictor to participate in colonoscopy screening program in FDRs. According to this survey low socioeconomic status is an important factor to hinder participation of FDRs in colonoscopy screening program. Therefore, planned interventions for elevation knowledge and attitude in FDRs with low educational level are necessary. Also, reducing colonoscopy test costs should be a major priority for policy makers.

See, Test & Treat: A 5-Year Experience of Pathologists Driving Cervical and Breast Cancer Screening to Underserved and Underinsured Populations.

PubMed

Magnani, Barbarajean; Harubin, Beth; Katz, Judith F; Zuckerman, Andrea L; Strohsnitter, William C

2016-12-01

- See, Test & Treat is a pathologist-driven program to provide cervical and breast cancer screening to underserved and underinsured patient populations. This program is largely funded by the CAP Foundation (College of American Pathologists, Northfield, Illinois) and is a collaborative effort among several medical specialties united to address gaps in the current health care system. - To provide an outline for administering a See, Test & Treat program, using an academic medical center as a model for providing care and collating the results of 5 years of data on the See, Test & Treat program's findings. - Sources include data from patients seen at Tufts Medical Center (Boston, Massachusetts) who presented to the See, Test & Treat program and institutional data between 2010 and 2014 detailing the outline of how to organize and operationalize a volunteer cancer-screening program. - During the 5-year course of the program, 203 women were provided free cervical and breast cancer screening. Of the 169 patients who obtained Papanicolaou screening, 36 (21.3%) had abnormal Papanicolaou tests. In addition, 16 of 130 patients (12.3%) who underwent mammography had abnormal findings. - In general, women from ethnic populations have barriers that prevent them from participating in cancer screening. However, the CAP Foundation's See, Test & Treat program is designed to reduce those barriers for these women by providing care that addresses cultural, financial, and practical issues. Although screening programs are helpful in identifying those who need further treatment, obtaining further treatment for these patients continues to be a challenge.

The balance sheet of benefits and harms of breast cancer population-based screening in Europe: outcome research, practice and future challenges.

PubMed

Broeders, Mireille; Paci, Eugenio

2015-11-01

Breast cancer screening programs are still object of harsh debate. In 2012, the Independent UK Panel reviewed the benefits and harms of mammography screening based on randomized trials and the EUROSCREEN Working Group reviewed European observational outcome studies. The conclusion was that screening programs should continue, while acknowledging that harms, such as the occurrence of false-positive results and overdiagnosis, can have a negative impact on a woman's life. Information on the balance sheet of the benefits and harms of breast cancer screening should help women and their physicians to make an informed choice. The future challenge for breast screening programs is to assess the feasibility, acceptability, effectiveness and impact of risk-based screening in order to maximize benefit-to-harm ratios.

Cost-Effectiveness of Three Rounds of Mammography Breast Cancer Screening in Iranian Women

PubMed Central

Haghighat, Shahpar; Akbari, Mohammad Esmaeil; Yavari, Parvin; Javanbakht, Mehdi; Ghaffari, Shahram

2016-01-01

Background Breast cancer is the most common cancer in Iranian women as is worldwide. Mammography screening has been introduced as a beneficial method for reducing mortality and morbidity of this disease. Objectives We developed an analytical model to assess the cost effectiveness of an organized mammography screening program in Iran for early detection of the breast cancer. Patients and Methods This study is an economic evaluation of mammography screening program among Iranian woman aged 40 - 70 years. A decision tree and Markov model were applied to estimate total quality adjusted life years (QALY) and lifetime costs. Results The results revealed that the incremental cost effectiveness ratio (ICER) of mammography screening in Iranian women in the first round was Int. $ 37,350 per QALY gained. The model showed that the ICER in the second and third rounds of screening program were Int. $ 141,641 and Int. $ 389,148 respectively. Conclusions Study results identified that mammography screening program was cost-effective in 53% of the cases, but incremental cost per QALY in the second and third rounds of screening are much higher than the accepted payment threshold of Iranian health system. Thus, evaluation of other screening strategies would be useful to identify more cost-effective program. Future studies with new national data can improve the accuracy of our finding and provide better information for health policy makers for decision making. PMID:27366315

Impact of age cutoffs on a lynch syndrome screening program.

PubMed

Gudgeon, James M; Belnap, Thomas W; Williams, Janet L; Williams, Marc S

2013-07-01

To determine the impact of applying an age cutoff to tumor-based Lynch syndrome (LS) screening, specifically focusing on changes in relative effectiveness, efficiency, and cost. The project was undertaken to answer questions about implementation of the LS screening program in an integrated health care delivery system. Clinical data extracted from an internal cancer registry, previous modeling efforts, published literature, and gray data were used to populate decision models designed to answer questions about the impact of age cutoffs in LS screening. Patients with colorectal cancer (CRC) were stratified at 10-year intervals from ages 50 to 80 years and compared with no age cutoff. Outcomes are reported for a cohort of 325 patients screened and includes total cost to screen, LS cases present in the cutoff category, number of LS cases expected to be identified by screening, cost per LS case detected, and total number and percentage of LS cases missed. Applying an age cutoff to an LS screening program has considerable potential for decreasing total screening costs and increasing efficiency, but at a loss of effectiveness. Imposing an age cutoff of 50 years reduces the cost of the screening program to 16% of a program with no age cutoff, but at the expense of missing more than half of the cases. Failure to identify LS cases is magnified by a cascade effect in family members. The results of this analysis influenced the final policy in our system.

Women as Symbols and Swords in Boko Haram’s Terror

DTIC Science & Technology

2016-03-01

kid - napped women and telling them that, “these are your teachers from Chibok.” During raids “people were tied and laid down and the girls took it...discourages premarital sex and extols vir- tue. The women’s experiences have justifiably instilled a fear and loathing of Boko Haram among a diverse...boko-haram-offers-to-swap-detainees-for- kid - napped-girls/312497711/>. 48 “Shekau Denies Ceasefire, Says Chibok Girls have Converted to Islam

Qualitative Inquiry into Premarital Sexual Behaviours and Contraceptive Use among Multiethnic Young Women: Implications for Education and Future Research

PubMed Central

Wong, Li Ping

2012-01-01

Background This study was a qualitative investigation into sexual attitudes and behaviours, and contraceptive use among Malaysian youth, based on constructs from the health belief model, theory of reasoned action, and problem behaviour theory. Methods A total of 34 focus group discussions with 185 participants were conducted among the Malay (35%), Chinese (34%), and Indian (31%) young females between November, 2010 and April, 2011. The participants were secondary school students and university undergraduates from Selangor and the Federal Territory of Kuala Lumpur. Results The study found a lack of knowledge about sexual issues and contraception among the participants. Many engaged in unprotected sexual intercourse and relied on periodic abstinence, natural methods, and traditional folk pregnancy preventive practices. The findings also revealed numerous categories of factors influencing sexual attitudes and behaviours: ethnic group and religion, level of religiosity, peer pressure and norms, and parental monitoring. With regard to condom use, factors such as embarrassment about condom acquisition, low perceived susceptibility to sexually transmitted infections (STIs), and perceived efficacy of traditional and folk methods of contraception, were uncovered from the discussions. Conclusion This study underscores the importance of development of culturally specific interventions that address the identified promoting factors of premarital sex. Behavioral interventions to promote condom use should increase awareness about condom effectiveness against not only unwanted pregnancies but also STIs. PMID:23272156

[An epidemiological study on sexual transmission of human immunodeficiency virus among pre-marital group in Yining city, Xinjiang].

PubMed

Mao, Yu-rong; Zheng, Xi-wen; Re, Zi-yan; Pan, Cheng-dong; Guli, Rou-zi; Song, Jun-qing; Yang, Li-min; Zhang, Gui-yun

2004-04-01

To study the human immunodeficiency virus (HIV) status through heterosexual transmission in Yining city and to provide information on effective intervention measures. Cohort of HIV sero-discordant couples identified from 1997 to 2000 was formed. Proportional risk model was used to analyze the time of HIV sero-conversion and the related factors. All the recruiters were under informed consent. Through following on 22 sero-discordant couples, we found that the incidence density (ID) of HIV sero-conversion was 32.49/100 person-year (PY) with 33.74/100 PY for women. In the proportional hazard model, the course of sero-conversion was only 2.43 years and the frequency of sexual contact was statistically significant (>or= 3 times/week vs. < 3 time/week: RR = 1.984, 95% CI: 1.045 - 3.767), indicating this factor was related to the hazard of HIV sero-conversion. However, the viral load of HIV infections has no such effect on HIV sero-conversion of their spouses. In addition, the ratio of CD4(+)/CD8(+) was lower in spouses of HIV sero-conversion than that in spouses of HIV non-sero conversion (t test: t = 4.77, P < 0.01). In order to control HIV transmission among general population, we suggested that HIV/AIDS counseling and testing be developed for pre-marital people in the region with high HIV prevalence.

Qualitative inquiry into premarital sexual behaviours and contraceptive use among multiethnic young women: implications for education and future research.

PubMed

Wong, Li Ping

2012-01-01

This study was a qualitative investigation into sexual attitudes and behaviours, and contraceptive use among Malaysian youth, based on constructs from the health belief model, theory of reasoned action, and problem behaviour theory. A total of 34 focus group discussions with 185 participants were conducted among the Malay (35%), Chinese (34%), and Indian (31%) young females between November, 2010 and April, 2011. The participants were secondary school students and university undergraduates from Selangor and the Federal Territory of Kuala Lumpur. The study found a lack of knowledge about sexual issues and contraception among the participants. Many engaged in unprotected sexual intercourse and relied on periodic abstinence, natural methods, and traditional folk pregnancy preventive practices. The findings also revealed numerous categories of factors influencing sexual attitudes and behaviours: ethnic group and religion, level of religiosity, peer pressure and norms, and parental monitoring. With regard to condom use, factors such as embarrassment about condom acquisition, low perceived susceptibility to sexually transmitted infections (STIs), and perceived efficacy of traditional and folk methods of contraception, were uncovered from the discussions. This study underscores the importance of development of culturally specific interventions that address the identified promoting factors of premarital sex. Behavioral interventions to promote condom use should increase awareness about condom effectiveness against not only unwanted pregnancies but also STIs.

Newborn screening policy in the United Kingdom & the United States: two different communities of practice.

PubMed

Patch, Christine

2006-01-01

Newborn screening is a rapidly developing area driven by both technological advances and public pressure. If they are not yet, all nurses working with mothers and children will soon be involved with implementing newborn-screening programs, and it is therefore important that they appreciate both the benefits and potential harms of such programs. In the United Kingdom, policy regarding the implementation of newborn-screening programs is developed at national level, and consideration of the introduction of new tests is subject to a formalized evaluation framework. In the United States, by contrast, each state develops its own screening program. Knowledge of developments in newborn screening in different countries that have diverse types of healthcare systems helps to inform nurses about the totality of healthcare for newborns, and assists them in becoming more knowledgeable about how international standards differ from those in the United States.

Sustaining SBIRT in the wild: simulating revenues and costs for Screening, Brief Intervention and Referral to Treatment programs.

PubMed

Cowell, Alexander J; Dowd, William N; Mills, Michael J; Hinde, Jesse M; Bray, Jeremy W

2017-02-01

To examine the conditions under which Screening, Brief Intervention and Referral to Treatment (SBIRT) programs can be sustained by health insurance payments. A mathematical model was used to estimate the number of patients needed for revenues to exceed costs. Three medical settings in the United States were examined: in-patient, out-patient and emergency department. Components of SBIRT were delivered by combinations of health-care practitioners (generalists) and behavioral health specialists. Practitioners in seven SBIRT programs who received grants from the US Substance Abuse and Mental Health Services Administration (SAMHSA). Program costs and revenues were measured using data from grantees. Patient flows were measured from administrative data and adjusted with prevalence and screening estimates from the literature. SBIRT can be sustained through health insurance reimbursement in out-patient and emergency department settings in most staffing mixes. To sustain SBIRT in in-patient programs, a patient flow larger than the national average may be needed; if that flow is achieved, the range of screens required to maintain a surplus is narrow. Sensitivity analyses suggest that the results are very sensitive to changes in the proportion of insured patients. Screening, Brief Intervention and Referral to Treatment programs in the United States can be sustained by health insurance payments under a variety of staffing models. Screening, Brief Intervention and Referral to Treatment programs can be sustained only in an in-patient setting with above-average patient flow (more than 2500 screens). Screening, Brief Intervention and Referral to Treatment programs in out-patient and emergency department settings can be sustained with below-average patient flows (fewer than 125 000 out-patient visits and fewer than 27 000 emergency department visits). © 2017 Society for the Study of Addiction.

Eliciting population preferences for mass colorectal cancer screening organization.

PubMed

Nayaradou, Maximilien; Berchi, Célia; Dejardin, Olivier; Launoy, Guy

2010-01-01

The implementation of mass colorectal cancer (CRC) screening is a public health priority. Population participation is fundamental for the success of CRC screening as for any cancer screening program. The preferences of the population may influence their likelihood of participation. The authors sought to elicit population preferences for CRC screening test characteristics to improve the design of CRC screening campaigns. A discrete choice experiment was used. Questionnaires were compiled with a set of pairs of hypothetical CRC screening scenarios. The survey was conducted by mail from June 2006 to October 2006 on a representative sample of 2000 inhabitants, aged 50 to 74 years from the northwest of France, who were randomly selected from electoral lists. Questionnaires were sent to 2000 individuals, each of whom made 3 or 4 discrete choices between hypothetical tests that differed in 7 attributes: how screening is offered, process, sensitivity, rate of unnecessary colonoscopy, expected mortality reduction, method of screening test result transmission, and cost. Complete responses were received from 656 individuals (32.8%). The attributes that influenced population preferences included expected mortality reduction, sensitivity, cost, and process. Participants from high social classes were particularly influenced by sensitivity. The results demonstrate that the discrete choice experiment provides information on patient preferences for CRC screening: improving screening program effectiveness, for instance, by improving test sensitivity (the most valued attribute) would increase satisfaction among the general population with regard to CRC screening programs. Additional studies are required to study how patient preferences actually affect adherence to regular screening programs.

Student and community outcomes in service-learning: part 2--community outcomes.

PubMed

Reising, Deanna L; Allen, Patricia N; Hall, Susan G

2006-12-01

This article is the second of a two-part series reporting outcomes from a service-learning program implemented in a bachelor of science in nursing program. Part 1 (on pages 512-515) described students' perceptions of outcomes realized from the program, and Part 2 describes the community outcomes. The purposes of the program were to provide students with history-taking, blood pressure, and heart rate assessment skills, and beginning counseling skills, as well as to provide the university community with blood pressure screening and counseling in a convenient and accessible location. Data on community outcomes were collected on a continual basis during the hypertension screening and counseling program implementation. Clients were anonymously surveyed on health behavior actions taken after their screening and on the screening process. More than 700 client screenings were performed over 2 years, with positive health behavior changes being reported by clients.

Stigmatization of carrier status: social implications of heterozygote genetic screening programs.

PubMed Central

Kenen, R H; Schmidt, R M

1978-01-01

Possible latent psychological and social consequences ensuing from genetic screening programs need to be investigated during the planning phase of national genetic screening programs. The relatively few studies which have been performed to determine psychological, social, and economic consequences resulting from a genetic screening program are reviewed. Stigmatization of carrier-status, having major psychosocial implications in heterozygote genetic screening programs, is discussed and related to Erving Goffman's work in the area of stigmatization. Questions are raised regarding the relationship between such variables as religiosity and sex of the individual and acceptance of the status of newly identified carrier of a mutant gene. Severity of the deleterious gene and visibility of the carrier status are two important factors to consider in an estimation of potential stigma. Specific implications are discussed for four genetic diseases: Tay-Sachs, Sickle-Cell Anemia, Huntington's disease and Hemophilia. PMID:152585

Virtual Screening with AutoDock: Theory and Practice

PubMed Central

Cosconati, Sandro; Forli, Stefano; Perryman, Alex L.; Harris, Rodney; Goodsell, David S.; Olson, Arthur J.

2011-01-01

Importance to the field Virtual screening is a computer-based technique for identifying promising compounds to bind to a target molecule of known structure. Given the rapidly increasing number of protein and nucleic acid structures, virtual screening continues to grow as an effective method for the discovery of new inhibitors and drug molecules. Areas covered in this review We describe virtual screening methods that are available in the AutoDock suite of programs, and several of our successes in using AutoDock virtual screening in pharmaceutical lead discovery. What the reader will gain A general overview of the challenges of virtual screening is presented, along with the tools available in the AutoDock suite of programs for addressing these challenges. Take home message Virtual screening is an effective tool for the discovery of compounds for use as leads in drug discovery, and the free, open source program AutoDock is an effective tool for virtual screening. PMID:21532931

Effects of a health education and telephone counseling program on patients with a positive fecal occult blood test result for colorectal cancer screening: A randomized controlled trial.

PubMed

Chiu, Hui-Chuan; Hung, Hsin-Yuan; Lin, Hsiu-Chen; Chen, Shu-Ching

2017-10-01

Our purpose was to evaluate the effects of a health education and telephone counseling program on knowledge and attitudes about colorectal cancer and screening and the psychological impact of positive screening results. A randomized controlled trial was conducted with 2 groups using a pretest and posttest measures design. Patients with positive colorectal cancer screening results were selected and randomly assigned to an experimental (n = 51) or control (n = 51) group. Subjects in the experimental group received a health education and telephone counseling program, while the control group received routine care only. Patients were assessed pretest before intervention (first visit to the outpatient) and posttest at 4 weeks after intervention (4 weeks after first visit to the outpatient). Patients in the experimental group had a significantly better level of knowledge about colorectal cancer and the psychological impact of a positive screening result than did the control group. Analysis of covariance revealed that the health education and telephone counseling program had a significant main effect on colorectal cancer knowledge. A health education and telephone counseling program can improve knowledge about colorectal cancer and about the psychological impact in patients with positive colorectal cancer screening results. The health education and telephone counseling program is an easy, simple, and convenient method of improving knowledge, improving attitudes, and alleviating psychological distress in patients with positive colorectal cancer screening results, and this program can be expanded to other types of cancer screening. Copyright © 2016 John Wiley & Sons, Ltd.

Integrative review of cervical cancer screening in Western Asian and Middle Eastern Arab countries.

PubMed

Ali, Suhailah; Skirton, Heather; Clark, Maria T; Donaldson, Craig

2017-12-01

Population-based screening programs have resulted in minimizing mortality and morbidity from cervical cancer. The aim of this integrative review was to explore the factors influencing access of women from Western Asian and Middle Eastern Arab countries to cervical cancer screening. A systematic search for studies conducted in Arab countries in those regions, and published in English between January 2002 and January 2017, was undertaken. Thirteen papers were selected and subjected to quality appraisal. A three step analysis was used, which involved a summary of the evidence, analysis of both quantitative and qualitative data, and integration of the results in narrative form. Few population-based cervical cancer screening programs had been implemented in the relevant countries, with low knowledge of, and perceptions about, cervical screening among Arab women, the majority of whom are Muslim. Factors affecting the uptake of cervical cancer screening practices were the absence of organized, systematic programs, low screening knowledge among women, healthcare professionals' attitudes toward screening, pain and embarrassment, stigma, and sociocultural beliefs. Policy changes are urgently needed to promote population-based screening programs. Future research should address the promotion of culturally-sensitive strategies to enable better access of Arab Muslim women to cervical cancer screening. © 2017 John Wiley & Sons Australia, Ltd.

Cancer Screening Practices Among Physicians in the National Breast and Cervical Cancer Early Detection Program

PubMed Central

Saraiya, Mona S.; Soman, Ashwini; Roland, Katherine B.; Yabroff, K. Robin; Miller, Jackie

2011-01-01

Abstract Background The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides low-income, uninsured women with screening and diagnostic services for breast and cervical cancer. Our study was conducted to describe the demographic and practice characteristics of participating and nonparticipating physicians, as well as their beliefs, adoption of new screening technologies, and recommendations for breast and cervical cancer screening. Methods From a 2006–2007 nationally representative survey, we identified 1,111 practicing primary care physicians who provide breast and cervical cancer screenings and assessed their recommendations using clinical vignettes related to screening initiation, frequency, and cessation. Responses of physicians participating in the NBCCEDP were compared with those from nonparticipating physicians. Results Of the physicians surveyed, 15% reported participation in the NBCCEDP, 65% were not participants, and 20% were not sure or did not respond to this question. Program physicians were significantly more likely to practice in multispecialty settings, in a rural location, and in a hospital or clinic setting and had more patients who were female and insured by Medicaid or uninsured compared with nonprogram physicians. Beliefs about the effectiveness of screening tools or procedures in reducing breast or cervical cancer mortality were similar by program participation. Adoption of new technologies, including digital mammography and human papillomavirus (HPV) testing, and making guideline-consistent recommendations for screening initiation, frequency, and cessation did not differ significantly by program participation. Conclusions Although there may be differences in physician characteristics and practice settings, the beliefs and screening practices for both breast and cervical cancer are similar between program and nonprogram providers. PMID:21774673

Endocrine Disruptor Screening Program Tier 1 Assessments

EPA Pesticide Factsheets

EPA has completed weight-of-evidence (WoE) assessments under the Endocrine Distruptor Screening Program (EDSP) for 52 pesticides included in the final list of chemicals for Tier 1 screening. See weight of evidence reports and data evaluation records.

Cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in four US-Affiliated Pacific Islands between 2007 and 2015.

PubMed

Senkomago, Virginia; Royalty, Janet; Miller, Jacqueline W; Buenconsejo-Lum, Lee E; Benard, Vicki B; Saraiya, Mona

2017-10-01

Cervical cancer incidence in the US-Affiliated Pacific Islands (USAPIs) is double that of the US mainland. American Samoa, Commonwealth of Northern Mariana Islands (CNMI), Guam and the Republic of Palau receive funding from the Centers for Disease Control (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to implement cervical cancer screening to low-income, uninsured or under insured women. The USAPI grantees report data on screening and follow-up activities to the CDC. We examined cervical cancer screening and follow-up data from the NBCCEDP programs in the four USAPIs from 2007 to 2015. We summarized screening done by Papanicolaou (Pap) and oncogenic human papillomavirus (HPV) tests, follow-up and diagnostic tests provided, and histology results observed. A total of 22,249 Pap tests were conducted in 14,206 women in the four USAPIs programs from 2007-2015. The overall percentages of abnormal Pap results (low-grade squamous intraepithelial lesions or worse) was 2.4% for first program screens and 1.8% for subsequent program screens. Histology results showed a high proportion of cervical intraepithelial neoplasia grade 2 or worse (57%) among women with precancers and cancers. Roughly one-third (32%) of Pap test results warranting follow-up had no data recorded on diagnostic tests or follow-up done. This is the first report of cervical cancer screening and outcomes of women served in the USAPI through the NBCCEDP with similar results for abnormal Pap tests, but higher proportion of precancers and cancers, when compared to national NBCCEDP data. The USAPI face significant challenges in implementing cervical cancer screening, particularly in providing and recording data on diagnostic tests and follow-up. The screening programs in the USAPI should further examine specific barriers to follow-up of women with abnormal Pap results and possible solutions to address them. Published by Elsevier Ltd.

When public health intervention is not successful: Cost sharing, crowd-out, and selection in Korea's National Cancer Screening Program.

PubMed

Kim, Hyuncheol Bryant; Lee, Sun-Mi

2017-05-01

This study investigates the impact of and behavioral responses to cost sharing in Korea's National Cancer Screening Program, which provides free stomach and breast cancer screenings to those with an income below a certain cutoff. Free cancer screening substantially increases the screening take up rate, yielding more cancer detections. However, the increase in cancer detection is quickly crowded out by cancer detection through other channels such as diagnostic testing and private cancer screening. Further, compliers are much less likely to have cancer than never takers. Crowd-out and selection help explain why the program has been unable to reduce cancer mortality. Copyright © 2017 Elsevier B.V. All rights reserved.

The Relationship of Eye Anomalies and Reading Ability, and an Analysis of Vision-Screening Programs. (Volumes I and II).

ERIC Educational Resources Information Center

Francis, Leslie John

The purpose of this study was to provide an in-depth analysis of vision-screening programs in relation to their efficacy, appropriateness, and feasibility for public school use. Twenty-two vision-screening programs were analyzed for reliability, validity, efficiency of identification and referral cost, and required testing time. Findings are that…

Suicide Prevention among High School Students: Evaluation of a Nonrandomized Trial of a Multi-Stage Suicide Screening Program

ERIC Educational Resources Information Center

Torcasso, Gina; Hilt, Lori M.

2017-01-01

Background: Suicide is a leading cause of death among youth. Suicide screening programs aim to identify mental health issues and prevent death by suicide. Objective: The present study evaluated outcomes of a multi-stage screening program implemented over 3 school years in a moderately-sized Midwestern high school. Methods: One hundred ninety-three…

Cancer screening education: can it change knowledge and attitudes among culturally and linguistically diverse communities in Queensland, Australia?

PubMed

Cullerton, Katherine; Gallegos, Danielle; Ashley, Ella; Do, Hong; Voloschenko, Anna; Fleming, MaryLou; Ramsey, Rebecca; Gould, Trish

2016-06-29

Issue addressed: Screening for cancer of the cervix, breast and bowel can reduce morbidity and mortality. Low participation rates in cancer screening have been identified among migrant communities internationally. Attempting to improve low rates of cancer screening, the Ethnic Communities Council of Queensland developed a pilot Cancer Screening Education Program for breast, bowel and cervical cancer. This study determines the impact of education sessions on knowledge, attitudes and intentions to participate in screening for culturally and linguistically diverse (CALD) communities living in Brisbane, Queensland. Methods: Seven CALD groups (Arabic-speaking, Bosnian, South Asian (including Indian and Bhutanese), Samoan and Pacific Island, Spanish-speaking, Sudanese and Vietnamese) participated in a culturally-tailored cancer screening education pilot program that was developed using the Health Belief Model. A pre- and post-education evaluation session measured changes in knowledge, attitudes and intention related to breast, bowel and cervical cancer and screening. The evaluation focussed on perceived susceptibility, perceived seriousness and the target population's beliefs about reducing risk by cancer screening. Results: There were 159 participants in the three cancer screening education sessions. Overall participants' knowledge increased, some attitudes toward participation in cancer screening became more positive and intent to participate in future screening increased (n=146). Conclusion: These results indicate the importance of developing screening approaches that address the barriers to participation among CALD communities and that a culturally-tailored education program is effective in improving knowledge, attitudes about and intentions to participate in cancer screening. So what?: It is important that culturally-tailored programs are developed in conjunction with communities to improve health outcomes.

CT Lung Cancer Screening Program Development: Part 2.

PubMed

Yates, Teri

2015-01-01

Radiology administrators must use innovative strategies around clinical collaboration and marketing to ensure that patients access the service in sufficient numbers. Radiology Associates of South Florida in collaboration with Baptist Health South Florida have developed a successful lung cancer screening program. The biggest factors in their success have been the affordability of their service and the quality of the program. Like mammography, lung cancer screening programs serve as an entry point to other services that generate revenue for the hospital. Patients may require further evaluation in the form of more imaging or surgical services for biopsy. Part 1 provided background and laid out fundamentals for starting a program. Part 2 focuses on building patient volume, marketing, and issues related to patient management after the screen is performed.

Early Detection and Mass Screening For Cancer

PubMed Central

Miller, A. B.

1972-01-01

The author reviews the evidence for the efficacy of early detection and mass screening programs in reducing morbidity and mortality from cancer. In cancer of the cervix, although screening reduces morbidity, we still do not have evidence for reduction in mortality. In cancer of the breast, one study suggests a reduction in mortality in the 50-59 year age group following screening by clinical examination and mammography. In other sites, especially lung, there is no evidence at present to support the adoption of mass screening programs. It is important that such programs should be carefully evaluated in the population, preferably in controlled studies. PMID:20468806

Development of a community cancer education program: the Forsyth County, NC cervical cancer prevention project.

PubMed

Michielutte, R; Dignan, M B; Wells, H B; Young, L D; Jackson, D S; Sharp, P C

1989-01-01

The authors outline the development and implementation of a public health education program for cervical cancer screening among black women in Forsyth County, NC. The educational program includes distributing electronic and printed information media messages, a program of direct education for women, and providing information on current issues in cervical screening to primary-care physicians. Program development was based on social marketing principles, the PRECEDE model, and the communication-behavior change (CBC) model. Since a true experimental design was not feasible, program evaluation is based on several complementary quasi-experimental designs. Analysis of baseline data indicate that the county where the intervention is taking place, and the control county, are similar with respect to both demographic characteristics and the current level of screening activity. Preliminary results indicate that the program has been successful in raising women's level of awareness of cervical cancer and cervical screening.

Financing state newborn screening programs: sources and uses of funds.

PubMed

Johnson, Kay; Lloyd-Puryear, Michele A; Mann, Marie Y; Ramos, Lauren Raskin; Therrell, Bradford L

2006-05-01

Financing for newborn screening is different from virtually all other public health programs. All except 5 screening programs collect fees as the primary source of program funding. A fee-based approach to financing newborn screening has been adopted by most states, to ensure consistent funding for this critical public health activity. Two types of data are reported here, ie, primary data from a survey of 37 state public health agencies and findings from exploratory case studies from 7 states. Most of the programs that participated in this survey (73%) reported that their newborn screening funding increased between 2002 and 2005, typically through increased fees and to a lesser extent through Medicaid, Title V Maternal and Child Health Services Block Grant, and state general revenue funding. All of the responding states that collect fees (n = 31) use such funds to support laboratory expenses, and most (70%) finance short-term follow-up services and program management. Nearly one half (47%) finance longer-term follow-up services, case management, or family support beyond diagnosis. Other states (43%) finance genetic or nutritional counseling and formula foods or treatment. Regardless of the source of funds, the available evidence indicates that states are committed to maintaining their programs and securing the necessary financing for the initial screening through diagnosis. Use of federal funding is currently limited; however, pressure to provide dedicated federal funding would likely increase if national recommendations for a uniform newborn screening panel were issued.

Economies of scale in federally-funded state-organized public health programs: results from the National Breast and Cervical Cancer Early Detection Programs

PubMed Central

Trogdon, Justin G.; Subramanian, Sujha; Crouse, Wesley

2018-01-01

This study investigates the existence of economies of scale in the provision of breast and cervical cancer screening and diagnostic services by state National Breast and Cervical Cancer Early Detection Program (NBCCEDP) grantees. A translog cost function is estimated as a system with input factor share equations. The estimated cost function is then used to determine output levels for which average costs are decreasing (i.e., economies of scale exist). Data were collected from all state NBCCEDP programs and District of Columbia for program years 2006–2007, 2008–2009 and 2009–2010 (N =147). Costs included all programmatic and in-kind contributions from federal and non-federal sources, allocated to breast and cervical cancer screening activities. Output was measured by women served, women screened and cancers detected, separately by breast and cervical services for each measure. Inputs included labor, rent and utilities, clinical services, and quasi-fixed factors (e.g., percent of women eligible for screening by the NBCCEDP). 144 out of 147 program-years demonstrated significant economies of scale for women served and women screened; 136 out of 145 program-years displayed significant economies of scale for cancers detected. The cost data were self-reported by the NBCCEDP State programs. Quasi-fixed inputs were allowed to affect costs but not economies of scale or the share equations. The main analysis accounted for clustering of observations within State programs, but it did not make full use of the panel data. The average cost of providing breast and cervical cancer screening services decreases as the number of women screened and served increases. PMID:24326873

Photo screening around the world: Lions Club International Foundation experience.

PubMed

Donahue, Sean P; Lorenz, Sylvia; Johnson, Tammy

2008-01-01

To describe the use of photoscreening for preschool vision screening in several diverse locations throughout the world. The MTI photo screener was used to screen pre-verbal children; photographs were interpreted using standard criteria. The Tennessee vision screening program remains successful, screening over 200,000 children during the past 8 years. Similar programs modeled across the United States have screened an additional 500,000 children. A pilot demonstration project in Hong Kong, Beijing, and Brazil screened over 5000 additional children with good success and appropriately low referral rates. Photoscreening can be an appropriate technique for widespread vision screening of preschool children throughout the world.

[Reasearch progress in health economic evaluation of colorectal cancer screening in China].

PubMed

Huang, Huiyao; Shi, Jufang; Dai, Min

2015-08-01

Burden of colorectal cancer is rising in China. More attention and financial input have been paid to it by central government that colorectal cancer screening program has been carried out recently in many areas in China. Diversity of screening strategies and limited health resources render selecting the best strategy in a population-wide program a challenging task that economy was also required to be considered except safety and efficacy. To provide a reference for the subsequent further economic evaluation, here we reviewed the evidence available on the economic evaluation of colorectal cancer screening in China. Meanwhile, information related to screening strategies, participation and mid-term efficacy of screening, information and results on economic evaluation were extracted and summarized. Three of the four studies finally included evaluated strategies combining immunochemical fecel occult blood test (iFOBT) with high-risk factor questionnaire as initial screening, colonoscopy as diagnostic screening. There was a consensus regarding the efficacy and effectiveness of screening compared to no screening. Whereas the lack and poor comparability between studies, multi-perspective and multi-phase economic evaluation of colorectal cancer screening is needed, relying on current population-based screening program to conduct a comprehensive cost accounting.

[Willingness and preferences of actual service suppliers regarding cancer screening programs: a multi-center survey in urban China].

PubMed

Shi, J F; Mao, A Y; Sun, Z X; Lei, H K; Qiu, W Q; Huang, H Y; Dong, P; Huang, J W; Zhu, J; Li, J; Liu, G X; Wang, D B; Bai, Y N; Sun, X J; Liao, X Z; Ren, J S; Guo, L W; Lan, L; Zhou, Q; Yang, L; Song, B B; Du, L B; Zhu, L; Wang, J L; Liu, Y Q; Ren, Y; Mai, L; Qin, M F; Zhang, Y Z; Zhou, J Y; Sun, X H; Wu, S L; Qi, X; Lou, P A; Cai, B; Li, N; Zhang, K; He, J; Dai, M

2018-02-10

Objective: From the perspective of actual service suppliers regarding cancer screening, this study aimed to assess the long-term sustainability of cancer screening programs in China. Methods: Based on a Cancer Screening Program in Urban China (CanSPUC), our survey focused on all the hospitals, centers for disease control and prevention (CDC) and community service centers across 16 provinces in China which participated in the programs between 2013 and 2015. All the managers (institutional/department level) and professional staff involved in the program were interviewed using either paper-based questionnaire or online approach. Results: A total of 4 626 participants completed the interview. It showed that the main gains from providing screening service emphasized promotion in social value (63.6%), local reputation (35.9%), and professional skills (30.6%), whereas difficulties encountered included inadequate compensation (30.9%) and discordance among information systems (28.3%). When the service remuneration amounts to about 50 Chinese Yuan per screening item, those professional staff self-reported that they would like to work overtime. More than half (63.7%) of the staff expressed willingness to provide routine screening service, the main expectations were to promote their reputation to the local residents (48.7%) and to promote professional skills (43.1%). Those who were not willing to provide screening services were worried about the potential heavy workload (59.8%) or being interfered with their routine work (49.8%). Further detailed results regarding the different organization types and program roles were presented in the following detailed report. Conclusions: Findings of gains and difficulties showed that if cancer screening is expected to become a long-term running, incentive mechanism from the program, external promotion and advocacy as well as capacity building should be strengthened; furthermore, rewards to staff's screening services should be raised according to the local situations. Results regarding the "willingness to provide service" showed that management of the program should also be strengthened, including information system building and inter-agency and inter-department coordination at the government levels.

The Potential Cost-Effectiveness of Amblyopia Screening Programs

PubMed Central

Rein, David B.; Wittenborn, John S.; Zhang, Xinzhi; Song, Michael; Saaddine, Jinan B.

2013-01-01

Background To estimate the incremental cost-effectiveness of amblyopia screening at preschool and kindergarten, we compared the costs and benefits of 3 amblyopia screening scenarios to no screening and to each other: (1) acuity/stereopsis (A/S) screening at kindergarten, (2) A/S screening at preschool and kindergarten, and (3) photoscreening at preschool and A/S screening at kindergarten. Methods We programmed a probabilistic microsimulation model of amblyopia natural history and response to treatment with screening costs and outcomes estimated from 2 state programs. We calculated the probability that no screening and each of the 3 interventions were most cost-effective per incremental quality-adjusted life year (QALY) gained and case avoided. Results Assuming a minimal 0.01 utility loss from monocular vision loss, no screening was most cost-effective with a willingness to pay (WTP) of less than $16,000 per QALY gained. A/S screening at kindergarten alone was most cost-effective between a WTP of $17,000 and $21,000. A/S screening at preschool and kindergarten was most cost-effective between a WTP of $22,000 and $75,000, and photoscreening at preschool and A/S screening at kindergarten was most cost-effective at a WTP greater than $75,000. Cost-effectiveness substantially improved when assuming a greater utility loss. All scenarios were cost-effective when assuming a WTP of $10,500 per case of amblyopia cured. Conclusions All 3 screening interventions evaluated are likely to be considered cost-effective relative to many other potential public health programs. The choice of screening option depends on budgetary resources and the value placed on monocular vision loss prevention by funding agencies. PMID:21877675

Evaluation of a Public-sector, Provider-initiated Cryptococcal Antigen Screening and Treatment Program, Western Cape, South Africa

PubMed Central

Smith, Mariette; Smith, Rachel; Osler, Meg; Kelly, Nicola; Cross, Anna; Boulle, Andrew; Meintjes, Graeme; Govender, Nelesh P.

2016-01-01

Background Screening for serum cryptococcal antigen (CrAg) may identify those at risk for disseminated cryptococcal disease (DCD), and pre-emptive fluconazole treatment may prevent progression to DCD. In August 2012, the Western Cape Province (WC), South Africa, adopted provider-initiated CrAg screening. We evaluated the implementation and effectiveness of this large-scale public-sector program during its first year, September 1, 2012—August 31, 2013. Methods We used data from the South African National Health Laboratory Service, WC provincial HIV program, and nationwide surveillance data for DCD. We assessed the proportion of eligible patients screened for CrAg (CrAg test done within 30 days of CD4 date) and the prevalence of CrAg positivity. Incidence of DCD among those screened was compared with those not screened. Results Of 4,395 eligible patients, 26.6% (n=1170) were screened. The proportion of patients screened increased from 15.9% in September 2012 to 36.6% in August 2013. The prevalence of positive serum CrAg was 2.1%. Treatment data were available for 13 of 24 CrAg-positive patients; nine of 13 were treated with fluconazole. Nine (0.8%) incident cases of DCD occurred among the 1170 patients who were screened for CrAg vs. 49 (1.5%) incident cases among the 3225 patients not screened (p=0.07). Conclusions Relatively few eligible patients were screened under the WC provider-initiated CrAg screening program. Unscreened patients were nearly twice as likely to develop DCD. CrAg screening can reduce the burden of DCD, but needs to be implemented well. To improve screening rates, countries should consider laboratory-based reflexive screening when possible. PMID:26926942

Pack-Year Cigarette Smoking History for Determination of Lung Cancer Screening Eligibility. Comparison of the Electronic Medical Record versus a Shared Decision-making Conversation.

PubMed

Modin, Hannah E; Fathi, Joelle T; Gilbert, Christopher R; Wilshire, Candice L; Wilson, Andrew K; Aye, Ralph W; Farivar, Alexander S; Louie, Brian E; Vallières, Eric; Gorden, Jed A

2017-08-01

Implementation of lung cancer screening programs is occurring across the United States. Programs vary in approaches to patient identification and shared decision-making. The eligibility of persons referred to screening programs, the outcomes of eligibility determination during shared decision-making, and the potential for the electronic medical record (EMR) to identify eligible individuals have not been well described. Our objectives were to assess the eligibility of individuals referred for lung cancer screening and compare information extracted from the EMR to information derived from a shared decision-making conversation for the determination of eligibility for lung cancer screening. We performed a retrospective analysis of individuals referred to a centralized lung cancer screening program serving a five-hospital health services system in Seattle, Washington between October 2014 and January 2016. Demographics, referral, and outcomes data were collected. A pack-year smoking history derived from the EMR was compared with the pack-year history obtained during a shared decision-making conversation performed by a licensed nurse professional representing the lung cancer screening program. A total of 423 individuals were referred to the program, of whom 59.6% (252 of 423) were eligible. Of those, 88.9% (224 of 252) elected screening. There was 96.2% (230 of 239) discordance in pack-year smoking history between the EMR and the shared decision-making conversation. The EMR underreported pack-years of smoking for 85.2% (196 of 230) of the participants, with a median difference of 29.2 pack-years. If identification of eligible individuals relied solely on the accuracy of the pack-year smoking history recorded in the EMR, 53.6% (128 of 239) would have failed to meet the 30-pack-year threshold for screening. Many individuals referred for lung cancer screening may be ineligible. Overreliance on the EMR for identification of individuals at risk may lead to missed opportunities for appropriate lung cancer screening.

Does patient time spent viewing computer-tailored colorectal cancer screening materials predict patient-reported discussion of screening with providers?

PubMed

Sanders, Mechelle; Fiscella, Kevin; Veazie, Peter; Dolan, James G; Jerant, Anthony

2016-08-01

The main aim is to examine whether patients' viewing time on information about colorectal cancer (CRC) screening before a primary care physician (PCP) visit is associated with discussion of screening options during the visit. We analyzed data from a multi-center randomized controlled trial of a tailored interactive multimedia computer program (IMCP) to activate patients to undergo CRC screening, deployed in primary care offices immediately before a visit. We employed usage time information stored in the IMCP to examine the association of patient time spent using the program with patient-reported discussion of screening during the visit, adjusting for previous CRC screening recommendation and reading speed.On average, patients spent 33 minutes on the program. In adjusted analyses, 30 minutes spent using the program was associated with a 41% increase in the odds of the patient having a discussion with their PCP (1.04, 1.59, 95% CI). In a separate analysis of the tailoring modules; the modules encouraging adherence to the tailored screening recommendation and discussion with the patient's PCP yielded significant results. Other predictors of screening discussion included better self-reported physical health and increased patient activation. Time spent on the program predicted greater patient-physician discussion of screening during a linked visit.Usage time information gathered automatically by IMCPs offers promise for objectively assessing patient engagement around a topic and predicting likelihood of discussion between patients and their clinician. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Gastric cancer screening of a high-risk population in Japan using serum pepsinogen and barium digital radiography.

PubMed

Ohata, Hiroshi; Oka, Masashi; Yanaoka, Kimihiko; Shimizu, Yasuhito; Mukoubayashi, Chizu; Mugitani, Kouichi; Iwane, Masataka; Nakamura, Hideya; Tamai, Hideyuki; Arii, Kenji; Nakata, Hiroya; Yoshimura, Noriko; Takeshita, Tetsuya; Miki, Kazumasa; Mohara, Osamu; Ichinose, Masao

2005-10-01

With the aim of developing more efficient gastric cancer screening programs for use in Japan, we studied a new screening program that combines serum pepsinogen (PG) testing and barium digital radiography (DR). A total of 17 647 middle-aged male subjects underwent workplace screening over a 7-year period using a combination of PG testing and DR. This program's effectiveness, as well as other characteristics of the program, was analyzed. Forty-nine cases of gastric cancer were detected (comprising 88% early cancer cases). The detection rate was 0.28%, and the positive predictive value was 0.85%. The PG test detected 63.3% of cases, DR detected 69.4% of cases, and both tests were positive in 32.7% of cancer cases. The two methods were almost equally effective, and were considerably more effective than conventional screening using photofluorography. Each screening method detected a distinct gastric cancer subgroup; the PG test efficiently detected asymptomatic small early cancer with intestinal type histology, while DR was efficient at detecting cancers with depressed or ulcerated morphology and diffuse type histology. The cost for the detection of a single cancer was much less than that for conventional screening. In fact, it is possible to further reduce the cost of detecting a single cancer to a cost comparable to that of surgically resecting a single gastric cancer. Thus, it is probable that a highly efficient gastric cancer screening system can be implemented by combining the two screening methods. Such a screening program would be beneficial in a population at high risk for gastric cancer.

Implementation of a food insecurity screening and referral program in student-run free clinics in San Diego, California.

PubMed

Smith, Sunny; Malinak, David; Chang, Jinnie; Perez, Maria; Perez, Sandra; Settlecowski, Erica; Rodriggs, Timothy; Hsu, Ming; Abrew, Alexandra; Aedo, Sofia

2017-03-01

Food insecurity is associated with many poor health outcomes yet is not routinely addressed in clinical settings. The purpose of this study was to implement a food insecurity screening and referral program in Student-run Free Clinics (SRFC) and to document the prevalence of food insecurity screening in this low-income patient population. All patients seen in three SRFC sites affiliated with one institution in San Diego, California were screened for food insecurity using the 6-item United States Department of Agriculture (USDA) Food Security Survey between January and July 2015 and referred to appropriate resources. The percentage of patients who were food insecure was calculated. The screening rate was 92.5% (430/463 patients), 74.0% (318/430) were food insecure, including 30.7% (132/430) with very low food security. A food insecurity registry and referral tracking system revealed that by January 2016, 201 participants were receiving monthly boxes of food onsite, 66 used an off-site food pantry, and 64 were enrolled in the Supplemental Nutrition Assistance Program (SNAP). It is possible to implement a food insecurity screening and referral program into SRFCs. The prevalence of food insecurity in this population was remarkably high yet remained largely unknown until this program was implemented. Other health care settings, particularly those with underserved patient populations, should consider implementing food insecurity screening and referral programs.

The need for supplemental breast cancer screening modalities: a perspective of population-based breast cancer screening programs in Japan.

PubMed

Uematsu, Takayoshi

2017-01-01

This article discusses possible supplemental breast cancer screening modalities for younger women with dense breasts from a perspective of population-based breast cancer screening program in Japan. Supplemental breast cancer screening modalities have been proposed to increase the sensitivity and detection rates of early stage breast cancer in women with dense breasts; however, there are no global guidelines that recommend the use of supplemental breast cancer screening modalities in such women. Also, no criterion standard exists for breast density assessment. Based on the current situation of breast imaging in Japan, the possible supplemental breast cancer screening modalities are ultrasonography, digital breast tomosynthesis, and breast magnetic resonance imaging. An appropriate population-based breast cancer screening program based on the balance between cost and benefit should be a high priority. Further research based on evidence-based medicine is encouraged. It is very important that the ethnicity, workforce, workflow, and resources for breast cancer screening in each country should be considered when considering supplemental breast cancer screening modalities for women with dense breasts.

The Shock and Vibration Digest, Volume 13, Number 1

DTIC Science & Technology

1981-01-01

Transfer matrices of different elements constituting expansion chamber mufflers have been used to develop a computer program for designing a... developed general computer programs using 10 ^=3 m^ Figure 4. Suppression of Flow-Acoustic Coupling by a Bridge Perforate [57] Figure 5. A Generally...the paper sessions are: • Environmental Stress Screening Theory • Screening Program Development /Implementa- tion • Screening Case Histories

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

In the United States, Lung Cancer is responsible for more cancer deaths than the next four cancers combined. In addition, the 5 year survival rate for lung cancer patients has not improved over the past 40 to 50 years. To combat this deadly disease, in 2002 the National Cancer Institute launched a very large Randomized Control Trial called the National Lung Screening Trial (NLST). This trial would randomize subjects who had substantial risk of lung cancer (due to age and smoking history) into either a Chest X-ray arm or a low dose CT arm. In November 2010, the National Cancermore » Institute announced that the NLST had demonstrated 20% fewer lung cancer deaths among those who were screened with low-dose CT than with chest X-ray. In December 2013, the US Preventive Services Task Force recommended the use of Lung Cancer Screening using low dose CT and a little over a year later (Feb. 2015), CMS announced that Medicare would also cover Lung Cancer Screening using low dose CT. Thus private and public insurers are required to provide Lung Cancer Screening programs using CT to the appropriate population(s). The purpose of this Symposium is to inform medical physicists and prepare them to support the implementation of Lung Screening programs. This Symposium will focus on the clinical aspects of lung cancer screening, requirements of a screening registry for systematically capturing and tracking screening patients and results (such as required Medicare data elements) as well as the role of the medical physicist in screening programs, including the development of low dose CT screening protocols. Learning Objectives: To understand the clinical basis and clinical components of a lung cancer screening program, including eligibility criteria and other requirements. To understand the data collection requirements, workflow, and informatics infrastructure needed to support the tracking and reporting components of a screening program. To understand the role of the medical physicist in implementing Lung Cancer Screening protocols for CT, including utilizing resources such as the AAPM Protocols and the ACR Designated Lung Screening Center program. UCLA Department of Radiology has an Institutional research agreement with Siemens Healthcare; Dr. McNitt-Gray has been a recipient of Research Support from Siemens Healthcare in the past. Dr. Aberle has been a Member of Advisory Boards for the LUNGevity Foundation (2011-present) and Siemens Medical Solutions. (2013)« less

Evaluation of preventive technologies in Germany: case studies of mammography, prostate cancer screening, and fetal ultrasound.

PubMed

Perleth, M; Busse, R; Gibis, B; Brand, A

2001-01-01

In this article, three preventive strategies-mammography screening for breast cancer, PSA screening for prostate cancer, and routine ultrasound in normal pregnancy-are discussed in the context of German health care. Epidemiologic data and German studies evaluating different aspects of these preventive measures were identified and analyzed. Only a few studies could be identified that investigate these preventive measures. Despite sufficient evidence, in part derived from a German study, there is not yet a mammography screening program. In contrast, ultrasound in pregnancy is offered routinely, although there are controversies regarding the benefit of this practice. PSA screening is not offered as part of the screening program for prostate cancer. However, PSA tests as well as mammographies are done in large numbers in German ambulatory care-a practice that could be considered wild or opportunistic screening. These case studies show that preventive programs and practices in Germany are not sufficiently based on sound evidence. The paucity of evaluation activities related to prevention in Germany is probably due to the low threshold to introduce new preventive programs into the German healthcare system in the past.

Cost-effectiveness and budget impact analysis of a population-based screening program for colorectal cancer.

PubMed

Pil, L; Fobelets, M; Putman, K; Trybou, J; Annemans, L

2016-07-01

Colorectal cancer (CRC) is one of the leading causes of cancer mortality in Belgium. In Flanders (Belgium), a population-based screening program with a biennial immunochemical faecal occult blood test (iFOBT) in women and men aged 56-74 has been organised since 2013. This study assessed the cost-effectiveness and budget impact of the colorectal population-based screening program in Flanders (Belgium). A health economic model was conducted, consisting of a decision tree simulating the screening process and a Markov model, with a time horizon of 20years, simulating natural progression. Predicted mortality and incidence, total costs, and quality-adjusted life-years (QALYs) with and without the screening program were calculated in order to determine the incremental cost-effectiveness ratio of CRC screening. Deterministic and probabilistic sensitivity analyses were conducted, taking into account uncertainty of the model parameters. Mortality and incidence were predicted to decrease over 20years. The colorectal screening program in Flanders is found to be cost-effective with an ICER of 1681/QALY (95% CI -1317 to 6601) in males and €4,484/QALY (95% CI -3254 to 18,163). The probability of being cost-effective given a threshold of €35,000/QALY was 100% and 97.3%, respectively. The budget impact analysis showed the extra cost for the health care payer to be limited. This health economic analysis has shown that despite the possible adverse effects of screening and the extra costs for the health care payer and the patient, the population-based screening program for CRC in Flanders is cost-effective and should therefore be maintained. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Effectiveness of gastric cancer screening programs in South Korea: Organized vs opportunistic models

PubMed Central

Kim, Beom Jin; Heo, Chae; Kim, Byoung Kwon; Kim, Jae Yeol; Kim, Jae Gyu

2013-01-01

AIM: To investigate the outcome and effectiveness of two screening programs, National Cancer Screening Program (NCSP) and opportunistic screening (OS), for the detection of gastric cancer. METHODS: A total of 45  654 subjects underwent upper endoscopy as part of the NCSP or OS at the Chung-Ang University Healthcare System in Korea between January 2007 and December 2010. The study population was comprised of subjects over the age of 40 years. More specifically, subjects who took part in the NCSP were Medicaid recipients and beneficiaries of the National Health Insurance Corporation. Still photographs from the endoscopies diagnosed as gastric cancer were reviewed by two experienced endoscopists. RESULTS: The mean age of the screened subjects was 55 years for men and 54 years for women. A total of 126 cases (0.28%) of gastric cancer were detected from both screening programs; 100 cases (0.3%) from NCSP and in 26 cases (0.2%) from OS. The proportion of early gastric cancer (EGC) detected in NCSP was higher than that in OS (74.0% vs 53.8%, P = 0.046). Among the 34  416 screenees in NCSP, 6585 (19.1%) underwent upper endoscopy every other year as scheduled. Among the 11  238 screenees in OS, 3050 (27.1%) underwent upper endoscopy at least once every two years during the study period. The detection rate of gastric cancer was found to be significantly higher during irregular follow-up than during regular follow-up in both screening programs (0.3% vs 0.2%, P = 0.036). A higher incidence of EGC than advanced gastric cancer was observed during regular follow-up compared with irregular follow-up. CONCLUSION: Compliance to the screening program is more important than the type of screening system used. PMID:23430471

Decreasing disparities in breast cancer screening in refugee women using culturally tailored patient navigation.

PubMed

Percac-Lima, Sanja; Ashburner, Jeffrey M; Bond, Barbara; Oo, Sarah A; Atlas, Steven J

2013-11-01

Patient navigator (PN) programs can improve breast cancer screening in low income, ethnic/racial minorities. Refugee women have low breast cancer screening rates, but it has not been shown that PN is similarly effective. Evaluate whether a PN program for refugee women decreases disparities in breast cancer screening. Retrospective program evaluation of an implemented intervention. Women who self-identified as speaking Somali, Arabic, or Serbo-Croatian (Bosnian) and were eligible for breast cancer screening at an urban community health center (HC). Comparison groups were English-speaking and Spanish-speaking women eligible for breast cancer screening in the same HC. Patient navigators educated women about breast cancer screening, explored barriers to screening, and tailored interventions individually to help complete screening. Adjusted 2-year mammography rates from logistic regression models for each calendar year accounting for clustering by primary care physician. Rates in refugee women were compared to English-speaking and Spanish-speaking women in the year before implementation of the PN program and over its first 3 years. There were 188 refugee (36 Somali, 48 Arabic, 104 Serbo-Croatian speaking), 2,072 English-speaking, and 2,014 Spanish-speaking women eligible for breast cancer screening over the 4-year study period. In the year prior to implementation of the program, adjusted mammography rates were lower among refugee women (64.1 %, 95 % CI: 49-77 %) compared to English-speaking (76.5 %, 95 % CI: 69 %-83 %) and Spanish-speaking (85.2 %, 95 % CI: 79 %-90 %) women. By the end of 2011, screening rates increased in refugee women (81.2 %, 95 % CI: 72 %-88 %), and were similar to the rates in English-speaking (80.0 %, 95 % CI: 73 %-86 %) and Spanish-speaking (87.6 %, 95 % CI: 82 %-91 %) women. PN increased screening rates in both younger and older refugee women. Linguistically and culturally tailored PN decreased disparities over time in breast cancer screening among female refugees from Somalia, the Middle East and Bosnia.

Contributions and Limitations of National Cervical Cancer Screening Program in Korea: A Retrospective Observational Study.

PubMed

Lee, Jung Hyun; Kim, Hyeongsu; Choi, Heejung; Jeong, Hyoseon; Ko, Young; Shim, Seung-Hyuk; Lee, Eunjoo; Chae, Su Hyun

2018-03-01

The purpose of this study was to evaluate the contributions and limitations of the cervical cancer screening test with accuracy in Korea. This was a retrospective observational study. The study population consisted of all participants who underwent cervical cancer screening test from 2009 to 2014. The data were obtained from National Health Information Database (NHID) which represents medical use records of most Koreans. As the indices for contributions and limitations of the screening test, crude detection rate, incidence rate of interval cancer, sensitivity, specificity, and positive predictive value were used. The crude detection rate of screening test per 100,000 participants increased from 100.7 in 2009 to 102.1 in 2014. The incidence rate of interval cancer per 100,000 negatives decreased from 13.0 in 2009 to 10.2 in 2014. The sensitivities of screening test were 88.7% in 2009 and 91.2% in 2014, and the specificities were 98.5% in 2009 and 97.7% in 2014. The positive predictive value of screening decreased from 6.2% in 2009 to 4.3% in 2014. The Korean national cervical cancer screening program has improved in accuracy and has contributed to detection of early stage of cervical cancer over the years. Along with efforts to promote participation in cancer screening programs, quality control over the screening program should be enhanced. Copyright © 2018. Published by Elsevier B.V.

[Organized breast cancer screening].

PubMed

Rouëssé, Jacques; Sancho-Garnier, Hélèn

2014-02-01

Breast screening programs are increasingly controversial, especially regarding two points: the number of breast cancer deaths they avoid, and the problem of over-diagnosis and over-treatment. The French national breast cancer screening program was extended to cover the whole country in 2004. Ten years later it is time to examine the risk/benefit ratio of this program and to discuss the need for change. Like all forms of cancer management, screening must be regularly updated, taking into account the state of the art, new evidence, and uncertainties. All screening providers should keep themselves informed of the latest findings. In the French program, women aged 50-74 with no major individual or familial risk factors for breast cancer are offered screening mammography and clinical breast examination every two years. Images considered non suspicious of malignancy by a first reader are re-examined by a second reader. The devices and procedures are subjected to quality controls. Participating radiologists (both public and private) are required to read at least 500 mammographies per year. The program's national participation rate was 52.7 % in 2012. When individual screening outside of the national program is taken into account (nearly 15 % of women), coverage appears close to the European recommendation of 65 %. Breast cancer mortality has been falling in France by 0.6 % per year for over 30 years, starting before mass screening was implemented, and by 1.5 % since 2005. This decline can be attributed in part to earlier diagnosis and better treatment, so that the specific impact of screening cannot easily be measured. Over-treatment, defined as the detection and treatment of low-malignancy tumors that would otherwise not have been detected in a person's lifetime, is a major negative effect of screening, but its frequency is not precisely known (reported to range from 1 % to 30 %). In view of these uncertainties, it would be advisable to modify the program in order to increase its efficiency, by targeting populations at a higher risk than the women currently included, and to reduce the number of mammograms done outside the program, as they are not subject to the same quality controls. Risks could be reduced by increasing the sensitivity of mammography and the specificity of the readings. Moreover, it is mandatory to inform women of both the benefits and risks of screening, in compliance with the principle of enabling patients to make a free and informed choice.

Population screening for genetic disorders in the 21st century: evidence, economics, and ethics.

PubMed

Grosse, S D; Rogowski, W H; Ross, L F; Cornel, M C; Dondorp, W J; Khoury, M J

2010-01-01

Proposals for population screening for genetic diseases require careful scrutiny by decision makers because of the potential for harms and the need to demonstrate benefits commensurate with the opportunity cost of resources expended. We review current evidence-based processes used in the United States, the United Kingdom, and the Netherlands to assess genetic screening programs, including newborn screening programs, carrier screening, and organized cascade testing of relatives of patients with genetic syndromes. In particular, we address critical evidentiary, economic, and ethical issues that arise in the appraisal of screening tests offered to the population. Specific case studies include newborn screening for congenital adrenal hyperplasia and cystic fibrosis and adult screening for hereditary hemochromatosis. Organizations and countries often reach different conclusions about the suitability of screening tests for implementation on a population basis. Deciding when and how to introduce pilot screening programs is challenging. In certain cases, e.g., hereditary hemochromatosis, a consensus does not support general screening although cascade screening may be cost-effective. Genetic screening policies have often been determined by technological capability, advocacy, and medical opinion rather than through a rigorous evidence-based review process. Decision making should take into account principles of ethics and opportunity costs. Copyright 2009 S. Karger AG, Basel.

Readiness for Implementation of Lung Cancer Screening. A National Survey of Veterans Affairs Pulmonologists.

PubMed

Tukey, Melissa H; Clark, Jack A; Bolton, Rendelle; Kelley, Michael J; Slatore, Christopher G; Au, David H; Wiener, Renda Soylemez

2016-10-01

To mitigate the potential harms of screening, professional societies recommend that lung cancer screening be conducted in multidisciplinary programs with the capacity to provide comprehensive care, from screening through pulmonary nodule evaluation to treatment of screen-detected cancers. The degree to which this standard can be met at the national level is unknown. To assess the readiness of clinical facilities in a national healthcare system for implementation of comprehensive lung cancer screening programs, as compared with the ideal described in policy recommendations. This was a cross-sectional, self-administered survey of staff pulmonologists in pulmonary outpatient clinics in Veterans Health Administration facilities. The facility-level response rate was 84.1% (106 of 126 facilities with pulmonary clinics); 88.7% of facilities showed favorable provider perceptions of the evidence for lung cancer screening, and 73.6% of facilities had a favorable provider-perceived local context for screening implementation. All elements of the policy-recommended infrastructure for comprehensive screening programs were present in 36 of 106 facilities (34.0%); the most common deficiencies were the lack of on-site positron emission tomography scanners or radiation oncology services. Overall, 26.5% of Veterans Health Administration facilities were ideally prepared for lung cancer screening implementation (44.1% if the policy recommendations for on-site positron emission tomography scanners and radiation oncology services were waived). Many facilities may be less than ideally positioned for the implementation of comprehensive lung cancer screening programs. To ensure safe, effective screening, hospitals may need to invest resources or coordinate care with facilities that can offer comprehensive care for screening through downstream evaluation and treatment of screen-detected cancers.

49 CFR 1549.101 - Acceptance, screening, and transfer of cargo.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY CERTIFIED CARGO SCREENING PROGRAM Operations § 1549.101 Acceptance, screening, and transfer of cargo. (a) Preventing or... facilities, equipment, and procedures described in its security program to prevent or deter the carriage...

48 CFR 719.271-6 - Small business screening procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Small business screening... DEVELOPMENT SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Policies 719.271-6 Small business screening...) Preparation of Form USAID 1410-14 (the Small Business/Minority Business Enterprise Procurement Review Form...

Las mujeres saludables: reaching Latinas for breast, cervical and colorectal cancer prevention and screening.

PubMed

Larkey, Linda

2006-02-01

Community health advisors have effectively promoted breast and cervical cancer prevention and screening among low-income Latina women. Specific elements of such programs, such as enhanced social support, may explain successes. Promotion of colorectal cancer screening has been less studied. Promotoras de Salud (i.e., Latina health advisors) implemented a 12-week program among women recruited from community-based organizations. The program educated 366 Latinas in breast, cervical and colorectal cancer prevention and screening and emphasized social support among class members. Pre- and post-intervention assessments demonstrated significant increases for fruit and vegetable consumption (3.05 to 3.60 servings/day), and physical activity (65.15 to 122.40 minutes/week). Of women previously non-compliant, 39 percent, 31 percent and 4 percent received Pap tests, mammography, and fecal occult blood test (FOBT), respectively. A culturally aligned education program using community health advisors and emphasizing social support among participants may improve prevention and selected screening behaviors, but more intensive interventions may be required for colorectal cancer screening compliance.

Pediatric Provider Insight Into Newborn Screening for Glucose-6-Phosphate Dehydrogenase Deficiency.

PubMed

Bernardo, Janine; Nock, Mary

2015-06-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a major contributor to neonatal hyperbilirubinemia, yet newborn screening for this disorder in the United States is not standard practice. We surveyed pediatric providers regarding a novel newborn G6PD screening program successfully implemented in 2007 at a US urban women's hospital newborn nursery. An electronic survey was distributed to 472 pediatric providers addressing extent to which they were influenced by the screening program. Ninety-two (20%) providers responded, of whom 74 (80%) had taken care of G6PD-deficient patients diagnosed by the screening program. A majority found the diagnosis helpful for patient management and influential in their management. Most common changes in management included more counseling on jaundice and follow-up and avoidance of hemolytic crisis triggers. General pediatric providers support newborn G6PD screening and appreciate the current program. Knowing the G6PD deficiency status of newborns informed and influenced pediatric providers' care. © The Author(s) 2014.

Promoting colorectal cancer screening through group education in community-based settings.

PubMed

Crookes, Danielle M; Njoku, Ogo; Rodriguez, Maria Carina; Mendez, Elsa Iris; Jandorf, Lina

2014-06-01

National colonoscopy adherence rates near 65% and New York City (NYC) colonoscopy rates approach 69%. Despite an overall increase in national colorectal cancer (CRC) screening rates, rates of CRC screening among Blacks and Latinos are lower than non-Latino Whites. We developed two group level, culturally targeted educational programs about CRC for Blacks and Latinos. One hour programs included education about screening, peer testimony given by a colonoscopy-adherent person, and pre- and post-knowledge assessment. From 2010 to 2012, we conducted 66 education programs in NYC, reaching 1,065 participants, 62.7% of whom were 50 years of age or older identified as Black or Latino and provided information about colonoscopy history (N = 668). Colonoscopy adherence in the sample was 69.3%. There was a significant increase in mean knowledge score about CRC and CRC screening from pretest to posttest. Sixty-eight percent of attendees without prior colonoscopy reported intent to schedule a colonoscopy as a result of attending the program. Culturally targeted education programs with peer testimony are a valuable way to raise awareness about CRC and colonoscopy and can influence intent to screen among nonadherent persons. Additional research is needed to establish group level education as an effective means of promoting CRC screening.

Prevention. How much harm? How much benefit? 3. Physical, psychological and social harm.

PubMed Central

Marshall, K G

1996-01-01

Harm caused by preventive programs may be physical, psychological, social or, if informed consent has not been obtained, ethical. Adverse effects of preventive screening programs may occur at any of the three levels of the "screening cascade", the screening procedure itself, the investigation of abnormal results of screening tests or the treatment of detected abnormalities or diseases. The greatest harm occurs at the second and third levels. Examples of procedures that may cause physical harm are venipuncture, mammography, colonoscopy, breast biopsy, transrectal ultrasonography, prostate biopsy, weight-reducing and cholesterol-lowering diets and radical prostatectomy. The psychological and social harm of preventive programs involves anticipated discomfort or perception of adverse effects of preventive interventions; unpleasant interactions with health care workers, time required for preventive programs, excessive overall awareness of health, anxiety over the results of a screening test implications of a positive screening test, consequences of being labelled as "sick" or "at risk," psychopathologic effects induced directly by preventive programs and, in the case of a false-negative test result, false assurance of disease-free status. Since the positive predictive value of screening tests in the general population is always low, most abnormal test results are "false-positive," these engender a great deal of psychological discuss among patients. PMID:8800074

Survey of departments of health about PKU screening programs.

PubMed Central

Steiner, K C; Smith, H A

1975-01-01

Mailed questionnaires were used to examine the success of PKU (phenylketonuria) screening programs that were operated by departments of health and to examine differences between these programs. Of 55 departments, 44 were returned and 42 departments reported they had a PKU detection program. Thirty-eight respondents considered the PKU detection program to be effective, and 31 respondents indicated that the entire program cost $60,000 or less per year. The answers and comments on the questionnaires showed a generally positive view of the effectiveness about the value of the treatment program in general were also positive. However, a few departments indicated that more clinical evidence and experience were needed to fully evaluate the overall merits of PKU detection and screening programs. PMID:803697

Workforce Characteristics and Attitudes Regarding Participation in Worksite Wellness Programs.

PubMed

Hall, Jennifer L; Kelly, Kevin M; Burmeister, Leon F; Merchant, James A

2017-09-01

To estimate workforce participation characteristics and employees' attitudes regarding participation in workplace wellness programs. Data from a statewide stratified random sample were used to compare small (<50 employees) and larger (50+ employees) workplaces to estimate participation in screening programs and likelihood of participation in workplace wellness programs. A telephone survey of employed Iowans registered to vote. Surveyed were 1171 employed Iowans registered to vote, ages 18 to 65. Among questionnaire survey modules were items from the Wellness Council of America Employee Needs and Interest Survey, the U.S. Census Bureau for employment documentation, and the World Health Organization Health and Work Performance Questionnaire for assessment of sickness absenteeism and presenteeism. Prevalence of participation in screening and wellness programs was analyzed by employment size and levels of likeliness to participate, and multivariable analyses of employee baseline characteristics regarding participation in screening programs and likelihood of participation in wellness programs was presented as top and bottom quartiles. Those employed in smaller workplaces participated less often in screening programs. Multivariable models identified male gender and those with an abnormal body mass index were associated with nonparticipation, while having a primary care physician was associated with participation. Very few items showed significant statistical difference in willingness to participate. Workforce characteristics and access to health care may influence participation in screening and wellness programs. Employment size is not a determining factor for willingness to participate in wellness programs.

Implementation and Evaluation of a Large-Scale Teleretinal Diabetic Retinopathy Screening Program in the Los Angeles County Department of Health Services

PubMed Central

Vasquez, Carolina; Martinez, Carlos; Tseng, Chi-Hong; Mangione, Carol M.

2017-01-01

Importance Diabetic retinopathy (DR) is the leading cause of blindness in adults of working age in the United States. In the Los Angeles County safety net, a nonvertically integrated system serving underinsured and uninsured patients, the prevalence of DR is approximately 50%, and owing to limited specialty care resources, the average wait times for screening for DR have been 8 months or more. Objective To determine whether a primary care–based teleretinal DR screening (TDRS) program reduces wait times for screening and improves timeliness of needed care in the Los Angeles County safety net. Design, Setting, and Participants Quasi-experimental, pretest-posttest evaluation of exposure to primary care–based TDRS at 5 of 15 Los Angeles County Department of Health Services safety net clinics from September 1, 2013, to December 31, 2015, with a subgroup analysis of random samples of 600 patients before and after the intervention (1200 total). Exposure Primary care clinic–based teleretinal screening for DR. Main Outcomes and Measures Annual rates of screening for DR before and after implementation of the TDRS program across the 5 clinics, time to screening for DR in a random sample of patients from these clinics, and a description of the larger framework of program implementation. Results Among the 21 222 patients who underwent the screening (12 790 female, 8084 male, and 348 other gender or not specified; mean [SD] age, 57.4 [9.6] years), the median time to screening for DR decreased from 158 days (interquartile range, 68-324 days) before the intervention to 17 days (interquartile range, 8-50 days) after initiation of the program (P < .001). Overall annual screening rates for DR increased from 5942 of 14 633 patients (40.6%) before implementation to 7470 of 13 133 patients (56.9%) after initiation of the program at all 15 targeted clinics (odds ratio, 1.9; 95% CI, 1.3-2.9; P = .002). Of the 21 222 patients who were screened, 14 595 (68.8%) did not require referral to an eye care professional, 4160 (19.6%) were referred for treatment or monitoring of DR, and 2461 (11.6%) were referred for other ophthalmologic conditions. Conclusions and Relevance A digital TDRS program was successfully implemented for the largest publicly operated county safety net population in the United States, resulting in the elimination of the need for more than 14 000 visits to specialty care professionals, a 16.3% increase in annual rates of screening for DR, and an 89.2% reduction in wait times for screening. Teleretinal DR screening programs have the potential to maximize access and efficiency in the safety net, where the need for such programs is most critical. PMID:28346590

Evolving the EPA Endocrine Disruptor Screening Program: The case for and against using high-throughput screening assays in EDSP Tier 1

EPA Science Inventory

Testing has begun as part of the EPA Endocrine Disruptor Screening Program (EDSP) Tier 1 battery of 11 in vitro and in vivo tests. A recognized issue with the EDSP is that the current Tier 1 screening battery is highly resource intensive in terms of cost, time and animal usage fo...

Colorectal cancer screening: Estimated future colonoscopy need and current volume and capacity.

PubMed

Joseph, Djenaba A; Meester, Reinier G S; Zauber, Ann G; Manninen, Diane L; Winges, Linda; Dong, Fred B; Peaker, Brandy; van Ballegooijen, Marjolein

2016-08-15

In 2014, a national campaign was launched to increase colorectal cancer (CRC) screening rates in the United States to 80% by 2018; it is unknown whether there is sufficient colonoscopy capacity to reach this goal. This study estimated the number of colonoscopies needed to screen 80% of the eligible population with fecal immunochemical testing (FIT) or colonoscopy and determined whether there was sufficient colonoscopy capacity to meet the need. The Microsimulation Screening Analysis-Colon model was used to simulate CRC screening test use in the United States (2014-2040); the implementation of a national screening program in 2014 with FIT or colonoscopy with 80% participation was assumed. The 2012 Survey of Endoscopic Capacity (SECAP) estimated the number of colonoscopies that were performed and the number that could be performed. If a national screening program started in 2014, by 2024, approximately 47 million FIT procedures and 5.1 million colonoscopies would be needed annually to screen the eligible population with a program using FIT as the primary screening test; approximately 11 to 13 million colonoscopies would be needed annually to screen the eligible population with a colonoscopy-only screening program. According to the SECAP survey, an estimated 15 million colonoscopies were performed in 2012, and an additional 10.5 million colonoscopies could be performed. The estimated colonoscopy capacity is sufficient to screen 80% of the eligible US population with FIT, colonoscopy, or a mix of tests. Future analyses should take into account the geographic distribution of colonoscopy capacity. Cancer 2016;122:2479-86. © 2016 American Cancer Society. © 2016 American Cancer Society.

Residency application screening tools: A survey of academic medical centers.

PubMed

Hillebrand, Kristen; Leinum, Corey J; Desai, Sonya; Pettit, Natasha N; Fuller, Patrick D

2015-06-01

The current use and content of screening tools utilized by ASHP-accredited pharmacy residency programs were assessed. A survey consisting of 19 questions assessing residency programs and the screening of pharmacy residency program applicants was e-mailed to residency directors of 362 pharmacy residency programs at 105 University HealthSystem Consortium (UHC)-member institutions. Questions gathered general program demographic information, data related to applicant growth from residency years 2010-11 to 2011-12, and information about the residency screening processes currently used. Responses were received from 73 residency program sites (69.5%) of the 105 UHC-member institutions to whom the e-mail was sent. Many sites used screening tools to calculate applicants' scores and then determined which candidates to invite for an onsite interview based on applicants' scores and group discussion. Seventy-eight percent (n = 57) of the 73 responding institutions reported the use of a screening tool or rubric to select applicants to invite for onsite interviews. The most common method of evaluation was individual applicant review before meeting as a group to discuss candidate selection. The most important factor for determining which residency candidate to interview was the overall impression based on the candidate's curriculum vitae (CV) and letters of recommendation. Most residency programs in UHC-member hospitals used a screening tool to determine which applicants to invite for an onsite interview. The most important factor for determining which residency candidate to interview was the overall impression based on the candidate's CV and letters of recommendation. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

SCIENTIFIC AND TECHNOLOGICAL SUPPORT ON IN VITRO ASSAYS FOR THE AGENCY'S ENDOCRINE DISRUPTOR SCREENING PROGRAM

EPA Science Inventory

In response to the 1996 legislative mandate for an endocrine screening and testing program, we are helping develop, standardize and validate relatively sensitive, robust and relatively simple methods for in vitro screening of chemicals that affect estrogen, and androgen function ...

77 FR 12297 - Petition To Demonstrate Paperwork Reduction Act Compliance of the Endocrine Disruptor Screening...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-29

... Paperwork Reduction Act Compliance of the Endocrine Disruptor Screening Program; Notice of Availability... chemicals to receive orders under the Endocrine Disruptor Screening Program by demonstrating the information... potential endocrine effects. Potentially affected entities identified by the North American Industrial...

Feasibility of community-based screening for cardiovascular disease risk in an ethnic community: the South Asian Cardiovascular Health Assessment and Management Program (SA-CHAMP).

PubMed

Jones, Charlotte A; Nanji, Alykhan; Mawani, Shefina; Davachi, Shahnaz; Ross, Leanne; Vollman, Ardene; Aggarwal, Sandeep; King-Shier, Kathryn; Campbell, Norman

2013-02-21

South Asian Canadians experience disproportionately high rates of cardiovascular disease (CVD). The goal of this qualitative study was to determine the feasibility of implementing a sustainable, culturally adapted, community-based CVD risk factor screening program for this population. South Asians (≥ 45 years) in Calgary, Alberta underwent opportunistic cardiovascular risk factor screening by lay trained volunteers at local religious facilities. Those with elevated blood pressure (BP) or ≥ 1 risk factor underwent point of care cholesterol testing, 10-year CVD risk calculation, counseling, and referral to family physicians and local culturally tailored chronic disease management (CDM) programs. Participants were invited for re-screening and were surveyed about health system follow-up, satisfaction with the program and suggestions for improvement. Changes in risk factors from baseline were estimated using McNemar's test (proportions) and paired t-tests (continuous measures). Baseline assessment was completed for 238 participants (median age 64 years, 51% female). Mean TC, HDL and TC/HDL were 5.41 mmol/L, 1.12 mmol/L and 4.7, respectively. Mean systolic and diastolic blood pressures (mmHg) were 129 and 75 respectively. Blood pressure and TC/HDL ratios exceeded recommended targets in 36% and 58%, respectively, and 76% were at high risk for CVD. Ninety-nine participants (47% female) attended re-screening. 82% had accessed health care providers, 22% reported medication changes and 3.5% had attended the CDM programs. While BP remained unchanged, TC and TC/HDL decreased and HDL increased significantly (mean differences: -0.52 mmol/L, -1.04 and +0.07 mmol/L, respectively). Participants were very satisfied (80%) or satisfied (20%) with the project. Participants suggested screening sessions and CDM programs be more accessible by: delivering evening or weekends programs at more sites, providing transportation, offering multilingual programs/translation assistance, reducing screening wait times and increasing numbers of project staff. SA-CHAMP demonstrated the feasibility and value of implementing a lay volunteer-led, culturally adapted, sustainable community-based CVD risk factor screening program in South Asian places of worship in Calgary, Alberta, Canada. Subsequent screening and CDM programs were refined based on the learnings from this study. Further research is needed to determine physician and patient factors associated with uptake of and adherence to risk reduction strategies.

A review of screening mammography participation and utilization in Canada.

PubMed

Doyle, G P; Major, D; Chu, C; Stankiewicz, A; Harrison, M L; Pogany, L; Mai, V M; Onysko, J

2011-09-01

Participation rate is an important indicator for a screening program's effectiveness; however, the current approach to measuring participation rate in Canada is not comparable with other countries. The objective of this study is to review the measurement of screening mammography participation in Canada, make international comparisons, and propose alternative methods. Canadian breast cancer screening program data for women aged 50 to 69 years screened between 2004 and 2006 were extracted from the Canadian Breast Cancer Screening Database (CBCSD). The fee-for-services (FSS) mammography data (opportunistic screening mammography) were obtained from the provincial ministries of health. Both screening mammography program participation and utilization were examined over 24 and 30 months. Canada's screening participation rate increases from 39.4% for a 24-month cut-off to 43.6% for a 30-month cut-off. The 24-month mammography utilization rate is 63.1% in Canada, and the 30-month utilization rate is 70.4%. Due to the differences in health service delivery among Canadian provinces, both programmatic participation and overall utilization of mammography at 24 months and 30 months should be monitored.

The Impact of a Population-Based Screening Program on Income- and Immigration-Related Disparities in Colorectal Cancer Screening.

PubMed

Kiran, Tara; Glazier, Richard H; Moineddin, Rahim; Gu, Sumei; Wilton, Andrew S; Paszat, Lawrence

2017-09-01

Background: A population-based program promoting the Fecal Occult Blood Test (FOBT) for colorectal cancer screening was introduced in 2008 in Ontario, Canada, where opportunistic screening with colonoscopy had been increasing in frequency. We evaluated the impact of the program on income and immigration-related disparities in screening. Methods: We used linked administrative data to calculate colorectal cancer screening rates for eligible Ontarians in each year between 2001/02 ( n = 2,852,619) and 2013/14 ( n = 4,139,304). We quantified disparities using an "inequality ratio" of screening rates in the most disadvantaged group relative to the most advantaged group. We performed segmented logistic regression analyses stratified by screening modality and adjusted for age, sex, rurality, comorbidity, and morbidity. Results: Between 2001/02 and 2013/14, the income and immigration inequality ratios narrowed from 0.74 to 0.80 and 0.55 to 0.69, respectively. Before the screening program, the income inequality ratio was widening by 1% per year (95% CI 1% to 1%); in the year it was introduced, it narrowed by 4% (95% CI 2% to 7%) and in the years following, it remained stable [0% decrease (95% CI 1% decrease to 0% decrease) per year]. Results were similar for immigration-related disparities. After program introduction, disparities in receiving FOBT were narrowing at a faster rate while disparities in receiving colonoscopy were widening at a slower rate. Conclusions: Introduction of a population-based screening program promoting FOBT for colorectal cancer was associated with only modest improvements in immigration and income-related disparities. Impact: Reducing immigration and income-related disparities should be a focus for future research and policy work. Disparities in Ontario seem to be driven by a higher uptake of colonoscopy among more advantaged groups. Cancer Epidemiol Biomarkers Prev; 26(9); 1401-10. ©2017 AACR . ©2017 American Association for Cancer Research.

Newborn Screening

MedlinePlus

... Laboratory Sciences Office of Public Health Genomics Publications & Articles Newborn Screening Lab Bulletin Laboratory Partners Multimedia Tools Newborn Screening Program – Role of Laboratories Meet the Scientist Newborn Screening: Family Stories Newborn Screening: Public Health ...

Using lessons from breast, cervical, and colorectal cancer screening to inform the development of lung cancer screening programs.

PubMed

Armstrong, Katrina; Kim, Jane J; Halm, Ethan A; Ballard, Rachel M; Schnall, Mitchell D

2016-05-01

Multiple advisory groups now recommend that high-risk smokers be screened for lung cancer by low-dose computed tomography. Given that the development of lung cancer screening programs will face many of the same issues that have challenged other cancer screening programs, the National Cancer Institute-funded Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium was used to identify lessons learned from the implementation of breast, cervical, and colorectal cancer screening that should inform the introduction of lung cancer screening. These lessons include the importance of developing systems for identifying and recruiting eligible individuals in primary care, ensuring that screening centers are qualified and performance is monitored, creating clear communication standards for reporting screening results to referring physicians and patients, ensuring follow-up is available for individuals with abnormal test results, avoiding overscreening, remembering primary prevention, and leveraging advances in cancer genetics and immunology. Overall, this experience emphasizes that effective cancer screening is a multistep activity that requires robust strategies to initiate, report, follow up, and track each step as well as a dynamic and ongoing oversight process to revise current screening practices as new evidence regarding screening is created, new screening technologies are developed, new biological markers are identified, and new approaches to health care delivery are disseminated. Cancer 2016;122:1338-1342. © 2016 American Cancer Society. © 2016 American Cancer Society.

Mortality audit of the Finnish cervical cancer screening program.

PubMed

Lönnberg, Stefan; Nieminen, Pekka; Luostarinen, Tapio; Anttila, Ahti

2013-05-01

Incidence-based evaluations of cervical cancer screening programs have suggested age-specific impacts and there is uncertainty regarding the effectiveness of screening outside the ages of 30-60 years. We audited the screening histories of cervical cancer deaths and conducted a case-control evaluation of the effectiveness of organized screening in different ages with mortality as outcome. We included all 506 cervical cancer deaths in Finland in 2000-2009 due to cancers diagnosed in 1990 or later, and 3,036 controls matched by age at diagnosis to the cases. Squamous cell carcinoma constituted 59% of the cases, adenocarcinomas 29%, and the remaining 12% were other specified and unspecified cervical malignancies. Most deaths (54%) were due to cancers diagnosed more than 5 years after last screening invitation, 24% were diagnosed among nonattenders and only 14% of deaths occurred among women who had attended invitational screening. The risk reduction associated with attending a single program screen at an age below 40 was nonsignificant (OR 0.70; 95% CI 0.33-1.48), while clear risk reductions were observed after screening at the age of 40-54 (OR 0.33; CI 0.20-0.56) and 55-69 (OR 0.29; CI 0.16-0.54). This study also provides some indication of a long-lasting additional effect of screening at the age of 65. Possible avenues for improving the effectiveness of the Finnish screening program include efforts to increase attendance and an extension of the target ages to include 65-to 69-year-old women. The potential benefit of increasing the sensitivity of the screening test or shortening the screening interval is smaller. Copyright © 2012 UICC.

From Cancer Screening to Treatment: Service Delivery and Referral in the National Breast and Cervical Cancer Early Detection Program

PubMed Central

Miller, Jacqueline W.; Hanson, Vivien; Johnson, Gale D.; Royalty, Janet E.; Richardson, Lisa C.

2015-01-01

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screening and diagnostic services to low-income and underserved women through a network of providers and health care organizations. Although the program serves women 40-64 years old for breast cancer screening and 21-64 years old for cervical cancer screening, the priority populations are women 50-64 years old for breast cancer and women who have never or rarely been screened for cervical cancer. From 1991 through 2011, the NBCCEDP provided screening and diagnostic services to more than 4.3 million women, diagnosing 54,276 breast cancers, 2554 cervical cancers, and 123,563 precancerous cervical lesions. A critical component of providing screening services is to ensure that all women with abnormal screening results receive appropriate and timely diagnostic evaluations. Case management is provided to assist women with overcoming barriers that would delay or prevent follow-up care. Women diagnosed with cancer receive treatment through the states' Breast and Cervical Cancer Treatment Programs (a special waiver for Medicaid) if they are eligible. The NBCCEDP has performance measures that serve as benchmarks to monitor the completeness and timeliness of care. More than 90% of the women receive complete diagnostic care and initiate treatment less than 30 days from the time of their diagnosis. Provision of effective screening and diagnostic services depends on effective program management, networks of providers throughout the community, and the use of evidence-based knowledge, procedures, and technologies. PMID:25099897

Screening and treatment of asymptomatic bacteriuria in pregnancy prevent pyelonephritis.

PubMed

Gratacós, E; Torres, P J; Vila, J; Alonso, P L; Cararach, V

1994-06-01

Although asymptomatic bacteriuria during pregnancy is associated with an increased risk of developing pyelonephritis, the effectiveness of screening programs to reduce this risk is controversial. A sharp reduction in the annual incidence of pyelonephritis (1.8% to 0.6%, P < .001) occurred after the introduction of a program to screen and treat asymptomatic bacteriuria among pregnant women followed at a large teaching hospital. The data provide retrospective and prospective evidence that screening and treatment programs for asymptomatic bacteriuria during pregnancy reduce the risk of pyelonephritis in a population with a moderate to high prevalence of bacteriuria.

The Role of Effective Communication to Enhance Participation in Screening Mammography: A New Zealand Case

PubMed Central

Brunton, Margaret A

2009-01-01

Changes in the organisation of health care have dominated policy initiatives over the past two decades in many countries. An increasing reliance on public health initiatives to prevent or detect disease early has resulted in an increase in programs that screen for cancer in the community. In turn, this accentuates the need to persuasively communicate the value of such initiatives to encourage continued participation. Merely placing screening programs into a community setting is not sufficient to ensure that adequate numbers will voluntarily participate regularly to achieve anticipated cost and mortality savings in the population. In this research the influence of managing communication in a public screening mammography program was investigated. The results revealed that significant opportunities were overlooked for reassurance and information during the physical mammography process. In turn, this highlights the influence of constraints imposed by the structure of the screening program and the resources allocated to the process. This research suggests that it is important to address multiple influences, including ethnic differences, when asking questions about the effectiveness of public health policy, particularly when considering the choices women make about ongoing participation in breast screening programs. PMID:19440417

The role of effective communication to enhance participation in screening mammography: a New Zealand case.

PubMed

Brunton, Margaret A

2009-02-01

Changes in the organisation of health care have dominated policy initiatives over the past two decades in many countries. An increasing reliance on public health initiatives to prevent or detect disease early has resulted in an increase in programs that screen for cancer in the community. In turn, this accentuates the need to persuasively communicate the value of such initiatives to encourage continued participation. Merely placing screening programs into a community setting is not sufficient to ensure that adequate numbers will voluntarily participate regularly to achieve anticipated cost and mortality savings in the population. In this research the influence of managing communication in a public screening mammography program was investigated. The results revealed that significant opportunities were overlooked for reassurance and information during the physical mammography process. In turn, this highlights the influence of constraints imposed by the structure of the screening program and the resources allocated to the process. This research suggests that it is important to address multiple influences, including ethnic differences, when asking questions about the effectiveness of public health policy, particularly when considering the choices women make about ongoing participation in breast screening programs.

Which BRCA genetic testing programs are ready for implementation in health care? A systematic review of economic evaluations.

PubMed

D'Andrea, Elvira; Marzuillo, Carolina; De Vito, Corrado; Di Marco, Marco; Pitini, Erica; Vacchio, Maria Rosaria; Villari, Paolo

2016-12-01

There is considerable evidence regarding the efficacy and effectiveness of BRCA genetic testing programs, but whether they represent good use of financial resources is not clear. Therefore, we aimed to identify the main health-care programs for BRCA testing and to evaluate their cost-effectiveness. We performed a systematic review of full economic evaluations of health-care programs involving BRCA testing. Nine economic evaluations were included, and four main categories of BRCA testing programs were identified: (i) population-based genetic screening of individuals without cancer, either comprehensive or targeted based on ancestry; (ii) family history (FH)-based genetic screening, i.e., testing individuals without cancer but with FH suggestive of BRCA mutation; (iii) familial mutation (FM)-based genetic screening, i.e., testing individuals without cancer but with known familial BRCA mutation; and (iv) cancer-based genetic screening, i.e., testing individuals with BRCA-related cancers. Currently BRCA1/2 population-based screening represents good value for the money among Ashkenazi Jews only. FH-based screening is potentially very cost-effective, although further studies that include costs of identifying high-risk women are needed. There is no evidence of cost-effectiveness for BRCA screening of all newly diagnosed cases of breast/ovarian cancers followed by cascade testing of relatives, but programs that include tools for identifying affected women at higher risk for inherited forms are promising. Cost-effectiveness is highly sensitive to the cost of BRCA1/2 testing.Genet Med 18 12, 1171-1180.

Screening for cervical cancer in low-resource settings in 2011.

PubMed

Tambouret, Rosemary

2013-06-01

Cervical cancer remains the most common malignancy in women living in low- and middle-income countries, despite the decline of the disease in countries where cervical cytology screening programs have been implemented. To review the current incidence of cervical cancer in low-resource countries, the availability and types of screening programs, and the treatment options. Literature review through PubMed, Internet search, and personal communication. Although data are incomplete, available figures confirm that the rate of cervical cancer deaths and the availability of cervical cancer screening programs are inversely proportional and vary, in general, by the wealth of the nation. Despite the success of cervical cytology screening, many major health care organizations have abandoned screening by cytology in favor of direct visualization methods with immediate treatment of lesions by cryotherapy provided by trained, nonmedical personnel.

Integrating Oral and General Health Screening at Senior Centers for Minority Elders

PubMed Central

Cheng, Bin; Northridge, Mary E.; Kunzel, Carol; Huang, Catherine; Lamster, Ira B.

2013-01-01

Racial/ethnic and socioeconomic disparities regarding untreated oral disease exist for older adults, and poor oral health diminishes quality of life. The ElderSmile program integrated screening for diabetes and hypertension into its community-based oral health activities at senior centers in northern Manhattan. The program found a willingness among minority seniors (aged ≥ 50 years) to be screened for primary care sensitive conditions by dental professionals and a high level of unrecognized disease (7.8% and 24.6% of ElderSmile participants had positive screening results for previously undiagnosed diabetes and hypertension, respectively). Dental professionals may screen for primary care–sensitive conditions and refer patients to health care providers for definitive diagnosis and treatment. The ElderSmile program is a replicable model for community-based oral and general health screening. PMID:23597378

Using a discrete choice experiment to inform the design of programs to promote colon cancer screening for vulnerable populations in North Carolina.

PubMed

Pignone, Michael P; Crutchfield, Trisha M; Brown, Paul M; Hawley, Sarah T; Laping, Jane L; Lewis, Carmen L; Lich, Kristen Hassmiller; Richardson, Lisa C; Tangka, Florence Kl; Wheeler, Stephanie B

2014-11-30

Screening for colorectal cancer (CRC) is suboptimal, particularly for vulnerable populations. Effective intervention programs are needed to increase screening rates. We used a discrete choice experiment (DCE) to learn about how vulnerable individuals in North Carolina value different aspects of CRC screening programs. We enrolled English-speaking adults ages 50-75 at average risk of CRC from rural North Carolina communities with low rates of CRC screening, targeting those with public or no insurance and low incomes. Participants received basic information about CRC screening and potential program features, then completed a 16 task DCE and survey questions that examined preferences for four attributes of screening programs: testing options available; travel time required; money paid for screening or rewards for completing screening; and the portion of the cost of follow-up care paid out of pocket. We used Hierarchical Bayesian methods to calculate individual-level utilities for the 4 attributes' levels and individual-level attribute importance scores. For each individual, the attribute with the highest importance score was considered the most important attribute. Individual utilities were then aggregated to produce mean utilities for each attribute. We also compared DCE-based results with those from direct questions in a post-DCE survey. We enrolled 150 adults. Mean age was 57.8 (range 50-74); 55% were women; 76% White and 19% African-American; 87% annual household income under $30,000; and 51% were uninsured. Individuals preferred shorter travel; rewards or small copayments compared with large copayments; programs that included stool testing as an option; and greater coverage of follow-up costs. Follow-up cost coverage was most frequently found to be the most important attribute from the DCE (47%); followed by test reward/copayment (33%). From the survey, proportion of follow-up costs paid was most frequently cited as most important (42% of participants), followed by testing options (32%). There was moderate agreement (45%) in attribute importance between the DCE and the single question in the post-DCE survey. Screening test copayments and follow-up care coverage costs are important program characteristics in this vulnerable, rural population.

The U.S. EPA's ToxCast Chemical Screening Program and Predictive Modeling of Toxicity

EPA Science Inventory

The ToxCast program was developed by the U.S. EPA's National Center for Computational Toxicology to provide cost-effective high-throughput screening for the potential toxicity of thousands of chemicals. Phase I screened 309 compounds in over 500 assays to evaluate concentration-...

Report of a Health Screening Project in Pre-School Programs.

ERIC Educational Resources Information Center

Grever, Elizabeth

This paper describes a preschool health screening service in which nurses, contracted through the Visiting Nurse Association, are assigned to day care centers receiving Title XX funds. The program focuses on health, safety and nutrition education. Screening includes history and physical assessment, developmental assessment, assessment or updating…

75 FR 81605 - Endocrine Disruptor Screening Program (EDSP); Announcing the Availability of a Draft for Weight...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPPT-2010-0877; FRL-8858-9] Endocrine Disruptor Screening Program (EDSP); Announcing the Availability of a Draft for Weight-of-Evidence Guidance Document..., Endocrine disruptors, Screening assays, Weight-of-evidence. Dated: December 20, 2010. Stephen A. Owens...

A High-Throughput Screening Assay to Detect Thyroperoxidase Inhibitors (Teratology Society)

EPA Science Inventory

In support of the Endocrine Disruption Screening Program (EDSP21), the US EPA ToxCast program is developing assays to enable screening for chemicals that may disrupt thyroid hormone synthesis. Thyroperoxidase (TPO) is critical for TH synthesis and is a known target of thyroid-dis...

Applying Public Health Screening Criteria: How Does Universal Newborn Screening Compare to Universal Tumor Screening for Lynch Syndrome in Adults with Colorectal Cancer?

PubMed Central

Cragun, Deborah; DeBate, Rita D.; Pal, Tuya

2014-01-01

Institutions have increasingly begun to adopt universal tumor screening (UTS) programs whereby tumors from all newly diagnosed patients with colorectal cancer (CRC) are screened to identify who should be offered germline testing for Lynch syndrome (the most common cause of hereditary CRC). Given limited information about the impact of universal screening programs to detect hereditary disease in adults, we apply criteria used to evaluate public health screening programs and compares and contrasts UTS with universal newborn screening (NBS) for the purpose of examining ethical implications and anticipating potential outcomes of UTS. Both UTS and a core set of NBS conditions clearly meet most of the Wilson and Jungner screening criteria. However, many state NBS panels include additional conditions that do not meet several of these criteria, and there is currently insufficient data to confirm that UTS meets some of these criteria. Comparing UTS and NBS with regard to newer screening criteria raises additional issues that require attention for both UTS and NBS. Comparisons also highlight the importance of evaluating the implementation of genomic tests to ensure or improve their effectiveness at reducing morbidity and mortality while minimizing potential harms. PMID:25323653

Design and evaluation of a theory-based, culturally relevant outreach model for breast and cervical cancer screening for Latina immigrants.

PubMed

White, Kari; Garces, Isabel C; Bandura, Lisa; McGuire, Allison A; Scarinci, Isabel C

2012-01-01

Breast and cervical cancer are common among Latinas, but screening rates among foreign-born Latinas are relatively low. In this article we describe the design and implementation of a theory-based (PEN-3) outreach program to promote breast and cervical cancer screening to Latina immigrants, and evaluate the program's effectiveness. We used data from self-administered questionnaires completed at six annual outreach events to examine the sociodemographic characteristics of attendees and evaluate whether the program reached the priority population - foreign-born Latina immigrants with limited access to health care and screening services. To evaluate the program's effectiveness in connecting women to screening, we examined the proportion and characteristics of women who scheduled and attended Pap smear and mammography appointments. Among the 782 Latinas who attended the outreach program, 60% and 83% had not had a Pap smear or mammogram, respectively, in at least a year. Overall, 80% scheduled a Pap smear and 78% scheduled a mammogram. Women without insurance, who did not know where to get screening and had not been screened in the last year were more likely to schedule appointments (P < .05). Among women who scheduled appointments, 65% attended their Pap smear and 79% attended the mammogram. We did not identify significant differences in sociodemographic characteristics associated with appointment attendance. Using a theoretical approach to outreach design and implementation, it is possible to reach a substantial number of Latina immigrants and connect them to cancer screening services.

A brief nursing intervention reduces anxiety before breast cancer screening mammography.

PubMed

Fernández-Feito, Ana; Lana, Alberto; Baldonedo-Cernuda, Ricardo; Mosteiro-Díaz, María Pilar

2015-01-01

Anxiety experienced by women during their participation in breast cancer screening programs can condition their adherence to the program. The aim was to determine whether a brief nursing intervention could reduce anxiety before screening mammography. A randomized controlled trial carried out with 436 Spanish women aged between 50-69 years, who attended a population breast cancer screening program. The experimental group received an ad-hoc tailored intervention, which consisted of offering information about the screening program and the mammography exam, as well as of providing personal emotional support. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI). Fear of screening outcome and fear of breast cancer were also assessed. Women of the experimental group had 60% less probability of having a high anxiety state (OR = 0.40; 95%: CI [0.25, 0.65]), after adjusting for sociodemographic and clinical variables. Regarding trait anxiety, no differences were observed between groups. The stratified analysis showed that this positive impact was greater in women who did not fear the screening outcome (OR = 0.24; 95% CI [0.11, 0.52]) or breast cancer (OR = 0.07; 95% CI [0.01, 0.41]). A protocolized nursing intervention reduced the probability of being anxious when undergoing a screening mammography.

Expanded Newborn Screening Program in Saudi Arabia: Incidence of screened disorders.

PubMed

Alfadhel, Majid; Al Othaim, Ali; Al Saif, Saif; Al Mutairi, Fuad; Alsayed, Moeenaldeen; Rahbeeni, Zuhair; Alzaidan, Hamad; Alowain, Mohammed; Al-Hassnan, Zuhair; Saeedi, Mohamad; Aljohery, Saeed; Alasmari, Ali; Faqeih, Eissa; Alwakeel, Mansour; AlMashary, Maher; Almohameed, Sulaiman; Alzahrani, Mohammed; Migdad, Abeer; Al-Dirbashi, Osama Y; Rashed, Mohamed; Alamoudi, Mohamed; Jacob, Minnie; Alahaidib, Lujane; El-Badaoui, Fahd; Saadallah, Amal; Alsulaiman, Ayman; Eyaid, Wafaa; Al-Odaib, Ali

2017-06-01

To address the implementation of the National Newborn Screening Program (NBS) in Saudi Arabia and stratify the incidence of the screened disorders. A retrospective study conducted between 1 August 2005 and 31 December 2012, total of 775 000 newborns were screened from 139 hospitals distributed among all regions of Saudi Arabia. The NBS Program screens for 16 disorders from a selective list of inborn errors of metabolism (IEM) and endocrine disorders. Heel prick dry blood spot samples were obtained from all newborns for biochemical and immunoassay testing. Recall screening testing was performed for Initial positive results and confirmed by specific biochemical assays. A total of 743 cases were identified giving an overall incidence of 1:1043. Frequently detected disorders nationwide were congenital hypothyroidism and congenital adrenal hyperplasia with an incidence of 1:7175 and 1:7908 correspondingly. The highest incidence among the IEM was propionic acidaemia with an incidence rate of 1:14 000. The article highlights the experience of the NBS Program in Saudi Arabia and providing data on specific regional incidences of all the screened disorders included in the programme; and showed that the incidence of these disorders is one of the highest reported so far world-wide. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Model driver screening and evaluation program. Volume 1, Project summary and model program recommendations

DOT National Transportation Integrated Search

2003-05-01

This research project studied the feasibility as well as the scientific validity and utility of performing functional capacity screening with older drivers. A Model Program was described encompassing procedures to detect functionally impaired drivers...

Clinical Costs of Colorectal Cancer Screening in 5 Federally Funded Demonstration Programs

PubMed Central

Tangka, Florence K. L.; Subramanian, Sujha; Beebe, Maggie C.; Hoover, Sonja; Royalty, Janet; Seeff, Laura C.

2016-01-01

BACKGROUND The Centers for Disease Control and Prevention initiated the Colorectal Cancer Screening Demonstration Program (CRCSDP) to explore the feasibility of establishing a large-scale colorectal cancer (CRC) screening program for underserved populations in the United States. The authors of this report assessed the clinical costs incurred at each of the 5 participating sites during the demonstration period. METHODS By using data on payments to providers by each of the 5 CRCSDP sites, the authors estimated costs for specific clinical services and overall clinical costs for each of the 2 CRC screening methods used by the sites: colonoscopy and fecal occult blood test (FOBT). RESULTS Among CRCSDP clients who were at average risk for CRC and for whom complete cost data were available, 2131 were screened by FOBT, and 1888 were screened by colonoscopy. The total average clinical cost per individual screened by FOBT (including costs for screening, diagnosis, initial surveillance, office visits, and associated clinical services averaged across all individuals who received screening FOBT) ranged from $48 in Nebraska to $149 in Greater Seattle. This compared with an average clinical cost per individual for all services related to the colonoscopy screening ranging from $654 in St. Louis to $1600 in Baltimore City. CONCLUSIONS Variations in how sites contracted with providers and in the services provided through CRCSDP affected the cost of clinical services and the complexity of collecting cost data. Health officials may find these data useful in program planning and budgeting. PMID:23868481

Evaluation of a patient navigation program to promote colorectal cancer screening in rural Georgia, USA.

PubMed

Honeycutt, Sally; Green, Rhonda; Ballard, Denise; Hermstad, April; Brueder, Alex; Haardörfer, Regine; Yam, Jennifer; Arriola, Kimberly J

2013-08-15

Colorectal cancer (CRC) is a leading cause of cancer death in the United States. Early detection through recommended screening has been shown to have favorable treatment outcomes, yet screening rates among the medically underserved and uninsured are low, particularly for rural and minority populations. This study evaluated the effectiveness of a patient navigation program that addresses individual and systemic barriers to CRC screening for patients at rural, federally qualified community health centers. This quasi-experimental evaluation compared low-income patients at average risk for CRC (n = 809) from 4 intervention clinics and 9 comparison clinics. We abstracted medical chart data on patient demographics, CRC history and risk factors, and CRC screening referrals and examinations. Outcomes of interest were colonoscopy referral and examination during the study period and being compliant with recommended screening guidelines at the end of the study period. We conducted multilevel logistic analyses to evaluate the program's effectiveness. Patients at intervention clinics were significantly more likely than patients at comparison clinics to undergo colonoscopy screening (35% versus 7%, odds ratio = 7.9, P < .01) and be guideline-compliant on at least one CRC screening test (43% versus 11%, odds ratio = 5.9, P < .001). Patient navigation, delivered through the Community Cancer Screening Program, can be an effective approach to ensure that lifesaving, preventive health screenings are provided to low-income adults in a rural setting. Copyright © 2013 American Cancer Society.

Alcohol Screening among Opioid Agonist Patients in a Primary Care Clinic and an Opioid Treatment Program.

PubMed

Klimas, Jan; Muench, John; Wiest, Katharina; Croff, Raina; Rieckman, Traci; McCarty, Dennis

2015-01-01

Problem alcohol use is associated with adverse health and economic outcomes, especially among people in opioid agonist treatment. Screening, brief intervention, and referral to treatment (SBIRT) are effective in reducing alcohol use; however, issues involved in SBIRT implementation among opioid agonist patients are unknown. To assess identification and treatment of alcohol use disorders, we reviewed clinical records of opioid agonist patients screened for an alcohol use disorder in a primary care clinic (n = 208) and in an opioid treatment program (n = 204) over a two-year period. In the primary care clinic, 193 (93%) buprenorphine patients completed an annual alcohol screening and six (3%) had elevated AUDIT scores. In the opioid treatment program, an alcohol abuse or dependence diagnosis was recorded for 54 (27%) methadone patients. Practitioner focus groups were completed in the primary care (n = 4 physicians) and the opioid treatment program (n = 11 counselors) to assess experience with and attitudes towards screening opioid agonist patients for alcohol use disorders. Focus groups suggested that organizational, structural, provider, patient, and community variables hindered or fostered alcohol screening. Alcohol screening is feasible among opioid agonist patients. Effective implementation, however, requires physician training and systematic changes in workflow.

Evaluation of two-year Jewish genetic disease screening program in Atlanta: insight into community genetic screening approaches.

PubMed

Shao, Yunru; Liu, Shuling; Grinzaid, Karen

2015-04-01

Improvements in genetic testing technologies have led to the development of expanded carrier screening panels for the Ashkenazi Jewish population; however, there are major inconsistencies in current screening practices. A 2-year pilot program was launched in Atlanta in 2010 to promote and facilitate screening for 19 Jewish genetic diseases. We analyzed data from this program, including participant demographics and outreach efforts. This retrospective analysis is based on a de-identified dataset of 724 screenees. Data were obtained through medical chart review and questionnaires and included demographic information, screening results, response to outreach efforts, and follow-up behavior and preferences. We applied descriptive analysis, chi-square tests, and logistic regression to analyze the data and compare findings with published literature. The majority of participants indicated that they were not pregnant or did not have a partner who was pregnant were affiliated with Jewish organizations and reported 100 % AJ ancestry. Overall, carrier frequency was 1 in 3.9. Friends, rabbis, and family members were the most common influencers of the decision to receive screening. People who were older, had a history of pregnancy, and had been previously screened were more likely to educate others (all p < 0.05). Analysis of this 2-year program indicated that people who are ready to have children or expand their families are more likely to get screened and encourage others to be screened. The most effective outreach efforts targeted influencers who then encouraged screening in the target population. Educating influencers and increasing overall awareness were the most effective outreach strategies.

Implications of newborn screening for nurses.

PubMed

DeLuca, Jane; Zanni, Karen L; Bonhomme, Natasha; Kemper, Alex R

2013-03-01

Newborn screening has dramatically decreased the morbidity and mortality associated with a wide range of heritable conditions. Continuing advances in screening technology and improvements in the effectiveness of treatment are driving the rapid expansion of newborn screening programs. In this article, we review issues in newborn screening care and opportunities for nurses and nursing faculty to provide education and conduct research to improve the impact of newborn screening. This article provides (a) an overview of current newborn screening activities, including how conditions are added to newborn screening panels and how implementation occurs at state and national levels; (b) a description of current controversies and ethical considerations; (c) a description of the roles of nurses in the newborn screening process; (d) suggestions for nursing education and research; and (e) a summary of expected future developments in newborn screening, including genome sequencing. Nurses are uniquely well suited to address the educational needs and future research in newborn screening because of the role that nurses play in the provision of direct clinical care and in population-based healthcare delivery. Newborn screening is a public health approach to the identification of rare but treatable conditions in early infancy. In the United States, as in other industrialized countries, newborn screening is rapidly expanding. Nurses, nurse educators, and nurse researchers are positioned to contribute to the field of newborn screening by assuring programs are implemented safely and effectively, by facilitating education of the nursing work force, and by developing and contributing to research programs in newborn screening. © 2013 Sigma Theta Tau International.

A visit to the village of Saye.

PubMed

1992-01-01

This brief article describes the changes in the village of Saye, Burkina Faso which were recognizable after 20 years absence. Rainfall was plentiful and it was the best season for agriculture in 20 years; the sorghum swayed in the breezes ready for harvest. There are 28 women and village elders who still recognized their visitor, Ramata. The changes in family planning attitudes and sexuality were evident in the way men and women freely joke and laugh about sexual issues in a good humored but not superficial way. The respected El Hadj (meaning that he had visited Mecca) Sawadogo, president of the local Naam group, was the one who cracked jokes which brought laughter to the audience. The taboos are still there, but everyone agrees that family planning is a good idea because it reduces suffering and the people do not still have enough food to eat. Birth spacing is generally accepted, but there is resistance to stopping births. There is growing tolerance toward premarital pregnancies, and polygamy among younger women, which leads to fractious polygamous wives. 20 years ago it was a radical act to show a film on sex education, where pen and ink outlines gave shape to a naked teenaged boy and girl next to each other on the screen. The audience response was a roar of disbelief and the author feared that the local prefet would put him in jail for disturbing public order and violating a taboo.

Impact assessment of a pay-for-performance program on breast cancer screening in France using micro data.

PubMed

Sicsic, Jonathan; Franc, Carine

2017-06-01

A voluntary-based pay-for-performance (P4P) program (the CAPI) aimed at general practitioners (GPs) was implemented in France in 2009. The program targeted prevention practices, including breast cancer screening, by offering a maximal amount of €245 for achieving a target screening rate among eligible women enrolled with the GP. Our objective was to evaluate the impact of the French P4P program (CAPI) on the early detection of breast cancer among women between 50 and 74 years old. Based on an administrative database of 50,752 women aged 50-74 years followed between 2007 and 2011, we estimated a difference-in-difference model of breast cancer screening uptake as a function of visit to a CAPI signatory referral GP, while controlling for both supply-side and demand-side determinants (e.g., sociodemographics, health and healthcare use). Breast cancer screening rates have not changed significantly since the P4P program implementation. Overall, visiting a CAPI signatory referral GP at least once in the pre-CAPI period increased the probability of undergoing breast cancer screening by 1.38 % [95 % CI (0.41-2.35 %)], but the effect was not significantly different following the implementation of the contract. The French P4P program had a nonsignificant impact on breast cancer screening uptake. This result may reflect the fact that the low-powered incentives implemented in France through the CAPI might not provide sufficient leverage to generate better practices, thus inviting regulators to seek additional tools beyond P4P in the field of prevention and screening.

Performance of a quantitative fecal immunochemical test in a colorectal cancer screening pilot program: a prospective cohort study.

PubMed

Telford, Jennifer; Gentile, Laura; Gondara, Lovedeep; McGahan, Colleen; Coldman, Andrew

2016-01-01

British Columbia undertook a colorectal cancer screening pilot program in 3 communities. Our objective was to assess the performance of 2-specimen fecal immunochemical testing in the detection of colorectal neoplasms in this population-based screening program. A prospective cohort of asymptomatic, average-risk people aged 50 to 74 years completed 2 quantitative fecal immunochemical tests every 2 years, with follow-up colonoscopy if the result of either test was positive. Participant demographics, fecal immunochemical test results, colonoscopy quality indicators and pathology results were recorded. Non-screen-detected colorectal cancer that developed in program participants was identified through review of data from the BC Cancer Registry. A total of 16 234 people completed a first round of fecal immunochemical testing, with a positivity rate of 8.6%; 5378 (86.0% of eligible participants) completed a second round before the end of the pilot program, with a positivity rate of 6.7%. Of the 1756 who had a positive test result, 1555 (88.6%) underwent colonoscopy. The detection rate of colorectal cancer was 3.5 per 1000 participants. The positive predictive value of the fecal immunochemical test was 4.9% (95% confidence interval [CI] 3.8%-6.0%) for colorectal cancer, 35.0% (95% CI 32.5%-37.2%) for high-risk polyps and 62.0% (95% CI 59.6%-64.4%) for all neoplasms. The number needed to screen was 283 to detect 1 cancer, 40 to detect 1 high-risk polyp and 22 to detect any neoplasm. Screening every 2 years with a 2-specimen fecal immunochemical test surpassed the current benchmark for colorectal cancer detection in population-based screening. This study has implications for other jurisdictions planning colorectal cancer screening programs.

Changes in American Adults' Sexual Behavior and Attitudes, 1972-2012.

PubMed

Twenge, Jean M; Sherman, Ryne A; Wells, Brooke E

2015-11-01

In the nationally representative General Social Survey, U.S. Adults (N = 33,380) in 2000-2012 (vs. the 1970s and 1980s) had more sexual partners, were more likely to have had sex with a casual date or pickup or an acquaintance, and were more accepting of most non-marital sex (premarital sex, teen sex, and same-sex sexual activity, but not extramarital sex). The percentage who believed premarital sex among adults was "not wrong at all" was 29 % in the early 1970s, 42 % in the 1980s and 1990s, 49 % in the 2000s, and 58 % between 2010 and 2012. Mixed effects (hierarchical linear modeling) analyses separating time period, generation/birth cohort, and age showed that the trend toward greater sexual permissiveness was primarily due to generation. Acceptance of non-marital sex rose steadily between the G.I. generation (born 1901-1924) and Boomers (born 1946-1964), dipped slightly among early Generation X'ers (born 1965-1981), and then rose so that Millennials (also known as Gen Y or Generation Me, born 1982-1999) were the most accepting of non-marital sex. Number of sexual partners increased steadily between the G.I.s and 1960s-born GenX'ers and then dipped among Millennials to return to Boomer levels. The largest changes appeared among White men, with few changes among Black Americans. The results were discussed in the context of growing cultural individualism and rejection of traditional social rules in the U.S.

Unintended pregnancy and induced abortion among unmarried women in China: a systematic review

PubMed Central

Qian, Xu; Tang, Shenglan; Garner, Paul

2004-01-01

Background Until recently, premarital examination for both men and women was a legal requirement before marriage in China. Researchers have carried out surveys of attendees' sexual activity, pregnancy and abortion before their marriages, trying to map out reproductive health needs in China, according to this unique population-based data. To systematically identify, appraise and summarise all available studies documenting pregnancy and induced abortion among unmarried Chinese women attending premarital examinations. Methods We searched the Chinese Biomedical Literature Index from 1978 to 2002; PUBMED; and EMBASE. Trials were assessed and data extracted by two people independently. Results Nine studies, of which seven were conducted in the urban areas, one in the rural areas, and one in both urban and rural areas, met the inclusion criteria. In the seven studies in urban areas, the majority of unmarried women had experienced sexual intercourse, with estimates ranging from 54% to 82% in five studies. Estimates of a previous pregnancy ranged from 12% to 32%. Abortion rates were high, ranging between 11 to 55% in 8 studies reporting this, which exclude the one rural study. In the three studies reporting both pregnancy and abortion, most women who had become pregnant had an induced abortion (range 86% to 96%). One large rural study documented a lower low pregnancy rate (20%) and induced abortion rate (0.8%). Conclusions There is a large unmet need for temporary methods of contraception in urban areas of China. PMID:14736336

Knowledge of sexual and reproductive health among adolescents attending school in Kelantan, Malaysia.

PubMed

Ab Rahman, Azriani; Ab Rahman, Razlina; Ibrahim, Mohd Ismail; Salleh, Halim; Ismail, Shaiful Bahri; Ali, Siti Hawa; Muda, Wan Manan Wan; Ishak, Maizun; Ahmad, Amaluddin

2011-05-01

The objectives of this study were to describe the knowledge of sexual and reproductive health among adolescents attending school and to compare the levels of knowledge between males and females and between older and younger groups of adolescents. Across-sectional study was conducted among 1,034 secondary school students using a self administered validated questionnaire. The items with the fewest correct responses included: whether one can get pregnant after a single act of sexual intercourse (30.4%), whether sexual intercourse causes sexually transmitted diseases (STDs) (12.4%) and whether washing the vagina after sexual intercourse prevents pregnancy (17.0%). Their main source of sexual information was friends (64.4%). An independent t-test revealed the mean knowledge score was significantly higher among females than males on items assessing whether the genitalia may be touched freely by family members, females having attained menarche may become pregnant if having sex, whether pregnancy will occur if there is penetration of the penis into the vagina, whether premarital sexual intercourse causes pregnancy and if there is a relationship between abandoned babies and premarital pregnancies. The mean knowledge score assessing whether pregnancy can be prevented using condoms was higher among males than females. The mean knowledge scores were significantly higher among form four and form five students than forms one, two and three students. Lack of knowledge regarding important aspects of sexual and reproductive health warrant the need to strengthen sexual and reproductive health education.

Relationship between Migration and HIV Risky Behavior: a Comparative Study of Returning Migrants and Non Migrants Based on Rural Out-of-school Youth in Jilin, China.

PubMed

Zhu, Guang Rong; Ji, Cheng Ye; Yang, Xing Hua

2015-06-01

To estimate the relationship between migration and HIV risky behavior when controlling for gender, age, and educational levels and to evaluate the gender differences in migration, HIV knowledge, and HIV risky behaviors among rural youth in China. A cross-sectional, anonymous, investigative questionnaire for 1710 unmarried, out-of-school rural youth, aged between 15 and 24 years, was handed out in Gongzhuling county of Jilin province, China. 58.5% of participants had a history of migration, irrespective of gender. There were gender differences observed in other factors such as drug abuse (4.3% for males and 5.5% for females, P<0.01), multiple sexual partners (24.1% for males and 44.1% for females, P<0.01), and HIV knowledge rate (35.2% for males and 25.5% for females, P<0.001). While controlling for gender, age, and educational levels, the relationships between migration and drug abuse, selling sex, and non usage of condoms during last instance of sexual activity were found to be significant. The cases of premarital sex and multiple sexual partners were both not found to be related to migration. Among rural youth, the HIV risky behavior such as drug abuse, selling sex, and lack of condom use, is significantly related to migration, while premarital sex and multiple sexual partners seem unrelated to migration. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Economic Evaluation of Screening Strategies Combined with HPV Vaccination of Preadolescent Girls for the Prevention of Cervical Cancer in Vientiane, Lao PDR

PubMed Central

2016-01-01

Background Several approaches to reduce the incidence of invasive cervical cancers exist. The approach adopted should take into account contextual factors that influence the cost-effectiveness of the available options. Objective To determine the cost-effectiveness of screening strategies combined with a vaccination program for 10-year old girls for cervical cancer prevention in Vientiane, Lao PDR. Methods A population-based dynamic compartment model was constructed. The interventions consisted of a 10-year old girl vaccination program only, or this program combined with screening strategies, i.e., visual inspection with acetic acid (VIA), cytology-based screening, rapid human papillomavirus (HPV) DNA testing, or combined VIA and cytology testing. Simulations were run over 100 years. In base-case scenario analyses, we assumed a 70% vaccination coverage with lifelong protection and a 50% screening coverage. The outcome of interest was the incremental cost per Disability-Adjusted Life Year (DALY) averted. Results In base-case scenarios, compared to the next best strategy, the model predicted that VIA screening of women aged 30–65 years old every three years, combined with vaccination, was the most attractive option, costing 2 544 international dollars (I$) per DALY averted. Meanwhile, rapid HPV DNA testing was predicted to be more attractive than cytology-based screening or its combination with VIA. Among cytology-based screening options, combined VIA with conventional cytology testing was predicted to be the most attractive option. Multi-way sensitivity analyses did not change the results. Compared to rapid HPV DNA testing, VIA had a probability of cost-effectiveness of 73%. Compared to the vaccination only option, the probability that a program consisting of screening women every five years would be cost-effective was around 60% and 80% if the willingness-to-pay threshold is fixed at one and three GDP per capita, respectively. Conclusions A VIA screening program in addition to a girl vaccination program was predicted to be the most attractive option in the health care context of Lao PDR. When compared with other screening methods, VIA was the primary recommended method for combination with vaccination in Lao PDR. PMID:27631732

Economic Evaluation of Screening Strategies Combined with HPV Vaccination of Preadolescent Girls for the Prevention of Cervical Cancer in Vientiane, Lao PDR.

PubMed

Chanthavilay, Phetsavanh; Reinharz, Daniel; Mayxay, Mayfong; Phongsavan, Keokedthong; Marsden, Donald E; Moore, Lynne; White, Lisa J

2016-01-01

Several approaches to reduce the incidence of invasive cervical cancers exist. The approach adopted should take into account contextual factors that influence the cost-effectiveness of the available options. To determine the cost-effectiveness of screening strategies combined with a vaccination program for 10-year old girls for cervical cancer prevention in Vientiane, Lao PDR. A population-based dynamic compartment model was constructed. The interventions consisted of a 10-year old girl vaccination program only, or this program combined with screening strategies, i.e., visual inspection with acetic acid (VIA), cytology-based screening, rapid human papillomavirus (HPV) DNA testing, or combined VIA and cytology testing. Simulations were run over 100 years. In base-case scenario analyses, we assumed a 70% vaccination coverage with lifelong protection and a 50% screening coverage. The outcome of interest was the incremental cost per Disability-Adjusted Life Year (DALY) averted. In base-case scenarios, compared to the next best strategy, the model predicted that VIA screening of women aged 30-65 years old every three years, combined with vaccination, was the most attractive option, costing 2 544 international dollars (I$) per DALY averted. Meanwhile, rapid HPV DNA testing was predicted to be more attractive than cytology-based screening or its combination with VIA. Among cytology-based screening options, combined VIA with conventional cytology testing was predicted to be the most attractive option. Multi-way sensitivity analyses did not change the results. Compared to rapid HPV DNA testing, VIA had a probability of cost-effectiveness of 73%. Compared to the vaccination only option, the probability that a program consisting of screening women every five years would be cost-effective was around 60% and 80% if the willingness-to-pay threshold is fixed at one and three GDP per capita, respectively. A VIA screening program in addition to a girl vaccination program was predicted to be the most attractive option in the health care context of Lao PDR. When compared with other screening methods, VIA was the primary recommended method for combination with vaccination in Lao PDR.

Evaluation of staff performance and interpretation of the screening program for prevention of thalassemia.

PubMed

Prommetta, Simaporn; Sanchaisuriya, Kanokwan; Fucharoen, Goonnapa; Yamsri, Supawadee; Chaiboonroeng, Attawut; Fucharoen, Supan

2017-06-15

Thalassemia screening program has been implemented for years in Southeast Asia, but no external quality assessment program has been established. We have developed and initiated the proficiency testing (PT) program for the first time in Thailand with the aim to assess the screening performance of laboratory staff and their competency in interpretation of the screening results. Three PT cycles per year were organized. From the first to the third cycle of the PT scheme, a total number of participant laboratories increased from 59 to 67. In each cycle, 2 PT items (assigned as blood samples of the couple) were provided. Performance evaluation was based on the accuracy of screening results, i.e . mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and the dichlorophenolindophenol (DCIP) test for haemoglobin E, including the competency in interpretation of screening results and assessment of foetal risk. Performance was assessed by comparing the participants' result against the assigned value. Of all 3 cycles, most laboratories reported acceptable MCV and MCH values. From the first to the third cycle, incorrect DCIP test and misinterpretation rates were decreased while incorrect risk assessment varied by cycle to cycle. Combining the accuracy of thalassemia screening and the competency in interpretation and risk assessment, approximately half of participants showed excellent performance. Improved performance observed in many laboratories reflects the achievement and benefit of the PT program which should be regularly provided.

Male Oncology Research and Education program for men at high risk for prostate cancer.

PubMed

Lorentz, J; Liu, S K; Vesprini, D

2018-04-01

Three groups of men are at high risk of developing prostate cancer: men with a strong family history of prostate cancer, men of West African or Caribbean ancestry, and men with a germline pathogenic variant in a prostate cancer-associated gene. Despite the fact that those men constitute a significant portion of the male population in North America, few recommendations for prostate cancer screening specific to them have been developed. For men at general population risk for prostate cancer, screening based on prostate-specific antigen (psa) has remained controversial despite the abundance of literature on the topic. As a result, recommendations made by major screening authorities are inconsistent (ranging from no psa screening to baseline psa screening at age 45), allowing physicians to pick and choose how to screen their patients. The Male Oncology Research and Education (more) program is an observational research program that serves as an academic platform for multiple research foci. For its participants, serum and dna are biobanked, medical information is collected, and contact for relevant research-related opportunities is maintained. This research program is paired with a specialized clinic called the more clinic, where men at high risk are regularly screened for prostate cancer in a standard approach that includes physical examination and serum psa measurement. In this article, we describe the goals, participant accrual to date, and projects specific to this unique program.

The provision of information and informed decision-making on prenatal screening for Down syndrome: a questionnaire- and register-based survey in a non-selected population.

PubMed

Schoonen, Marleen; Wildschut, Hajo; Essink-Bot, Marie-Louise; Peters, Ingrid; Steegers, Eric; de Koning, Harry

2012-06-01

Evaluating the information provision procedure about prenatal screening for Down syndrome, using informed decision-making as a quality-indicator. Questionnaire- and register-based surveys. Midwives associated with 59 midwifery practices completed process data for 6435 pregnancies. Pregnant women (n=510) completed questionnaires on informed decision-making. Midwives offered information to 98.5% of women; 62.6% of them wished to receive information, of these, 81.9% actually received information. Decision-relevant knowledge was adequate in 89.0% of responding women. Knowledge about Down syndrome was less adequate than knowledge about the screening program. Participants in the screening program had higher knowledge scores on Down syndrome and on the screening program than non-participants. Of the women who intended to participate (35.8%), 3.1% had inadequate knowledge. A total of 75.5% of women made an informed decision; 94.3% of women participating in the screening program, and 64.9% of women not participating. This quality assurance study showed high levels of informed decision-making and a relatively low participation rate in the national screening program for Down syndrome in the Netherlands. Knowledge of the Down syndrome condition needs to be improved. This evaluation may serve as a pilot study for quality monitoring studies at a national level. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Cost-Effectiveness of Screening and Treating Foreign-Born Students for Tuberculosis before Entering the United States

PubMed Central

Wingate, La’Marcus T.; Posey, Drew L.; Zhou, Weigong; Olson, Christine K.; Maskery, Brian

2015-01-01

Introduction The Centers for Disease Control and Prevention is considering implementation of overseas medical screening of student-visa applicants to reduce the numbers of active tuberculosis cases entering the United States. Objective To evaluate the costs, cases averted, and cost-effectiveness of screening for, and treating, tuberculosis in United States-bound students from countries with varying tuberculosis prevalence. Methods Costs and benefits were evaluated from two perspectives, combined and United States only. The combined perspective totaled overseas and United States costs and benefits from a societal perspective. The United States only perspective was a domestic measure of costs and benefits. A decision tree was developed to determine the cost-effectiveness of tuberculosis screening and treatment from the combined perspective. Results From the United States only perspective, overseas screening programs of Chinese and Indian students would prevent the importation of 157 tuberculosis cases annually, and result in $2.7 million in savings. From the combined perspective, screening programs for Chinese students would cost more than $2.8 million annually and screening programs for Indian students nearly $440,000 annually. From the combined perspective, the incremental cost for each tuberculosis case averted by screening Chinese and Indian students was $22,187 and $15,063, respectively. Implementing screening programs for German students would prevent no cases in most years, and would result in increased costs both overseas and in the United States. The domestic costs would occur because public health departments would need to follow up on students identified overseas as having an elevated risk of tuberculosis. Conclusions Tuberculosis screening and treatment programs for students seeking long term visas to attend United States schools would reduce the number of tuberculosis cases imported. Implementing screening in high-incidence countries could save the United States millions of dollars annually; however there would be increased costs incurred overseas for students and their families. PMID:25924009

77 FR 35745 - Highway Safety Programs; Conforming Products List of Screening Devices To Measure Alcohol in...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-14

..., battery powered device with a semiconductor sensor. (2) Alcohol Countermeasure Systems Corp., submitted...-0062] Highway Safety Programs; Conforming Products List of Screening Devices To Measure Alcohol in... Screening Devices to Measure Alcohol in Bodily Fluids dated, March 31, 2008 (73 FR 16956). DATES: Effective...

Universal Newborn Screening and Adverse Medical Outcomes: A Historical Note

ERIC Educational Resources Information Center

Brosco, Jeffrey P.; Seider, Michael I.; Dunn, Angela C.

2006-01-01

Universal newborn screening programs for metabolic disorders are typically described as a triumph of medicine and public policy in the US over the last 50 years. Advances in science and technology, including the Human Genome Project, offer the opportunity to expand universal newborn screening programs to include many additional metabolic and…

75 FR 70557 - Endocrine Disruptor Screening Program; Draft Policies and Procedures for Screening Safe Drinking...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

... intends to post the status of the test orders, including recipients' responses, on the EPA Web site so... screening program using appropriate validated test systems and other scientifically relevant information to... chemicals. Scientific research and development services (NAICS code 5417), e.g., persons who conduct testing...

The US EPA's Endocrine Disruptor Screening Program: In VItro and In Vivo Mammalian Tier 1 Screening Assays

EPA Science Inventory

In response to emerging concerns that environmental chemicals may have adverse effects on human health by altering the function of the endocrine system, the Food Quality Protection Act mandated that the U.S. EPA develop and implement an endocrine disruptor screening program (EDSP...

"Pepsi": A Screening and Programming Tool for Understanding the Whole Child.

ERIC Educational Resources Information Center

Ellsworth, J'Anne

1996-01-01

This article discusses using "PEPSI", a screening and programming method that evaluates the physical, emotional, philosophical, social, and intellectual levels of development in children with disabilities. The steps in the PEPSI screening process are described and a case study is provided. A chart depicting indicators in teaching respect for self…

Parent Reactions to a School-Based Body Mass Index Screening Program

ERIC Educational Resources Information Center

Johnson, Suzanne Bennett; Pilkington, Lorri L.; Lamp, Camilla; He, Jianghua; Deeb, Larry C.

2009-01-01

Background: This study assessed parent reactions to school-based body mass index (BMI) screening. Methods: After a K-8 BMI screening program, parents were sent a letter detailing their child's BMI results. Approximately 50 parents were randomly selected for interview from each of 4 child weight-classification groups (overweight, at risk of…

Evaluation of a program to train nurses to screen for breast and cervical cancer among Native American women.

PubMed

Sellers, Thomas A; Trapp, Mary Alice; Vierkant, Robert A; Petersen, Wesley; Kottke, Thomas E; Jensen, Ann; Kaur, Judith S

2002-01-01

Routine screening for breast and cervical cancers lowers mortality from these diseases, but the benefit has not permeated to Native American women, for whom the five-year survival rate is the lowest of any population group in the United States. To help address this problem, an educational/training program was designed to enhance the skills of nurses and other health service providers and develop clinic support systems to better recruit, screen, and follow clients for breast and cervical cancer screening services. A total of 131 nurses participated in the training program at 33 different sites between 1995 and 2000. Prior to and following training, each participant was given a questionnaire to determine knowledge of breast and cervical cancer screening techniques and recommendations, cancer survival and risk factors, and situational scenarios. The average score for the pretest was 54% correct. The posttest average was 89% correct. The percent correct increased 35% from pre- to posttest (p < 0.001). The knowledge to implement a successful screening program can be acquired through the current curriculum.

A Peer Health Educator Program for Breast Cancer Screening Promotion: Arabic, Chinese, South Asian, and Vietnamese Immigrant Women's Perspectives

PubMed Central

Parascandalo, Faye

2015-01-01

This study explored Arabic, Chinese, South Asian, and Vietnamese immigrant women's experiences with a peer health educator program, a public health program that facilitated access to breast health information and mammography screening. Framed within critical social theory, this participatory action research project took place from July 2009 to January 2011. Ten focus groups and 14 individual interviews were conducted with 82 immigrant women 40 years of age and older. Qualitative methods were utilized. Thematic content analysis derived from grounded theory and other qualitative literature was employed to analyze data. Four dominant themes emerged: Breast Cancer Prevention focused on learning within the program, Social Support provided by the peer health educator and other women, Screening Services Access for Women centered on service provision, and Program Enhancements related to specific modifications required to meet the needs of immigrant women accessing the program. The findings provide insights into strategies used to promote breast health, mammography screening, and the improvement of public health programming. Perceived barriers that continue to persist are structural barriers, such as the provision of information on breast cancer and screening by family physicians. A future goal is to improve collaborations between public health and primary care to minimize this barrier. PMID:25810922

A Peer Health Educator Program for Breast Cancer Screening Promotion: Arabic, Chinese, South Asian, and Vietnamese Immigrant Women's Perspectives.

PubMed

Crawford, Joanne; Frisina, Angela; Hack, Tricia; Parascandalo, Faye

2015-01-01

This study explored Arabic, Chinese, South Asian, and Vietnamese immigrant women's experiences with a peer health educator program, a public health program that facilitated access to breast health information and mammography screening. Framed within critical social theory, this participatory action research project took place from July 2009 to January 2011. Ten focus groups and 14 individual interviews were conducted with 82 immigrant women 40 years of age and older. Qualitative methods were utilized. Thematic content analysis derived from grounded theory and other qualitative literature was employed to analyze data. Four dominant themes emerged: Breast Cancer Prevention focused on learning within the program, Social Support provided by the peer health educator and other women, Screening Services Access for Women centered on service provision, and Program Enhancements related to specific modifications required to meet the needs of immigrant women accessing the program. The findings provide insights into strategies used to promote breast health, mammography screening, and the improvement of public health programming. Perceived barriers that continue to persist are structural barriers, such as the provision of information on breast cancer and screening by family physicians. A future goal is to improve collaborations between public health and primary care to minimize this barrier.

Outcomes of Screening Mammography in Elderly Women

DTIC Science & Technology

2004-10-01

program run by the National Health Service (NHS) provides virtually all mammographic screening for women aged 50 or older . 2,3 There are differences also...government-funded National Health Service Breast Screening Program provides free breast cancer screening in the U.K. for women 50 or older . 3, 10 Women aged ...for Public Release; Distribution Unlimited 13. ABSTRACT (Maximum 200 Words) There is uncertainty about whether women older than age 65 should undergo