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Missed opportunities for prevention: Chronically ill teens and risk taking
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RESEARCH PRESENTATIONS
JOURNAL OF ADOLESCENT HEALTH Vol. 18, No.2
MISSED OPPORTUNITIES FOR PREVENTION: CHRONICALLY ILL TEENS AND RlSK TAKING. Maria T Britto, MD, MPH, Thomas R Konrad, PhD, Joanne M Garrett, PhD, Malcolm AJ Douglas, as, Margaret W Leigh, MD, Gary R Jones, MD, Univ N Carolina, Chapel Hill NC; HR Daeschner, Jr., MD, East Carolina Univ, Greenville NC; J Marc Majure, MD, William Schultz, PAC, Duke Univ, Durham NC; Christine A Johnson, MD, Bowman Gray School of Med, Winston Salem NC. OBJECTIVE: To determine rates of health and risk behaviors, sources of health care, and receipt of anticipatory guidance among teens with chronic conditions. DESIGN: We conducted confidential structured interviews and administered a modified version of theCDC's Youth Risk Behavior Survey (YRBS) to 12-19 year olds with either Cystic Fibrosis (CF) or Sickle Cell Disease (SCD). Teens (N = 437) were identified through tertiary care center registries which represent an estimated 95% of patients with CF and 85% of those with SCD in a single southern state. Of those, 35 (8%) declined to participate, 3 (I%) were excluded, and 79 (I8%) could not be contacted, leaving 322 (74%) participants. Interviews were conducted in clinic or by phone. RESULTS: Participants had a mean age of 15.6 years and were 51% male; 64% had SCD. A history of smoking was reported by 26%, while 15% considered themselves current smokers. 40% had tried alcohol and 14% had consumed alcohol in the past 30 days. Of those who drank in the last 30 days, 25% reported binge drinking during that time. A history of sexual intercourse was reported by 42%. Among the sexually experienced, 51 % reported 3 or more partners; 5% reponed an STD; and 15% reported they or their partners had been pregnant, Less commonly reported were marijuana lise (14%), never or rarely wearing scat belts (12%), weapon carrying (10%), drunk driving (3%), and injection drug use (I %). Teens with SCD were more likely to report sexual activity and pregnancy experience, while teens with CF were more likely to carry weapons. The regular health provider was identified as a specialist (48%), a pediatrician (19%), or family physician (9%); 19% had no regular provider. Teens reported thattheir regular provider addressed each risk-taking behavior at an encounter occurring in the last year at the following rates: sexual activity (48%), weight and dieting (45%), tobacco use (25%), alcohol use (25%), drinking and driving (23%), illegal drugs (23%), seat belt or bike helmet use (20%), depression or suicidal thoughts (18%), and weapon carrying or violence (II %). Patients with SeD were significantly more likely to report having discussed drinking and driving, weapon carrying, alcohol use, other drug use and sexual activity. Patients with CF were more likely to have discussed weight and dieting. CONCLUSION: Teens with chronic conditions tak. more potentially darr...ging health risks than might be expected, although their rates are lower than those of their healthy peers. Physicians infrequently screened for behaviors other than sexual activity or weight and dieting.
THE IMPACT OF HOME-BASED SEX EDUCATION ON RURAL ADOLESCENTS SEXUAL BEHAVIOR AND ATTITUDES Redonna K. Chandler, Ph.D., Berea College, Berea, Kentucky; Janet G. Baker, M.A., University of Cincinnati, Cincinnati, Ohio; Marie Griffin, Berea College, Berea, Kentucky OBJECTIVE: The purpose of this study was to explore the relationship between parental sex education and sexual behaviors and attitudes among college students from an impoverished rural Appalachian region. METHODS: Participants were recruited from a college serving students from the Appalachian region who demonstrate financial need. A paper and pencil survey of 185 questions related to parental sexual education, and sexual attitudes and behaviors was administered during a health and wellness class. RESULTS: 175 college students with a mean age =18.4 years completed the surveys. There were 84 females and 91 males. There was no difference between genders in the relationship between sex education and attitudes and behaviors. The amount of sexual education received from the home is significantly related to attitudes regarding the use of birth control devices for both males and females (chi-square = 20.46. P < .01) but it was not related to the actual use of birth control devices. More parental sexual education was associated with delay in onset of sexual behaviors (chi-square = 42.12, P < .01). Level of sexual education within the home was not related to information or attitudes regarding AIDS. CONCLUSIONS: Although college students obtain sexual information from a variety of sources, this study examined the specific impact of parental education. The impact of parental education may be selective to issues such as attitudes and beliefs. Health care providers can assess the adolescent and parent attitudes toward birth control, and then make sure that adolescents can access birth control and arein relationships which support their use.
RESEARCH PRESENTATIONS
JOURNAL OF ADOLESCENT HEALTH Vol. 18, No.2
MISSED OPPORTUNITIES FOR PREVENTION: CHRONICALLY ILL TEENS AND RlSK TAKING. Maria T Britto, MD, MPH, Thomas R Konrad, PhD, Joanne M Garrett, PhD, Malcolm AJ Douglas, as, Margaret W Leigh, MD, Gary R Jones, MD, Univ N Carolina, Chapel Hill NC; HR Daeschner, Jr., MD, East Carolina Univ, Greenville NC; J Marc Majure, MD, William Schultz, PAC, Duke Univ, Durham NC; Christine A Johnson, MD, Bowman Gray School of Med, Winston Salem NC. OBJECTIVE: To determine rates of health and risk behaviors, sources of health care, and receipt of anticipatory guidance among teens with chronic conditions. DESIGN: We conducted confidential structured interviews and administered a modified version of theCDC's Youth Risk Behavior Survey (YRBS) to 12-19 year olds with either Cystic Fibrosis (CF) or Sickle Cell Disease (SCD). Teens (N = 437) were identified through tertiary care center registries which represent an estimated 95% of patients with CF and 85% of those with SCD in a single southern state. Of those, 35 (8%) declined to participate, 3 (I%) were excluded, and 79 (I8%) could not be contacted, leaving 322 (74%) participants. Interviews were conducted in clinic or by phone. RESULTS: Participants had a mean age of 15.6 years and were 51% male; 64% had SCD. A history of smoking was reported by 26%, while 15% considered themselves current smokers. 40% had tried alcohol and 14% had consumed alcohol in the past 30 days. Of those who drank in the last 30 days, 25% reported binge drinking during that time. A history of sexual intercourse was reported by 42%. Among the sexually experienced, 51 % reported 3 or more partners; 5% reponed an STD; and 15% reported they or their partners had been pregnant, Less commonly reported were marijuana lise (14%), never or rarely wearing scat belts (12%), weapon carrying (10%), drunk driving (3%), and injection drug use (I %). Teens with SCD were more likely to report sexual activity and pregnancy experience, while teens with CF were more likely to carry weapons. The regular health provider was identified as a specialist (48%), a pediatrician (19%), or family physician (9%); 19% had no regular provider. Teens reported thattheir regular provider addressed each risk-taking behavior at an encounter occurring in the last year at the following rates: sexual activity (48%), weight and dieting (45%), tobacco use (25%), alcohol use (25%), drinking and driving (23%), illegal drugs (23%), seat belt or bike helmet use (20%), depression or suicidal thoughts (18%), and weapon carrying or violence (II %). Patients with SeD were significantly more likely to report having discussed drinking and driving, weapon carrying, alcohol use, other drug use and sexual activity. Patients with CF were more likely to have discussed weight and dieting. CONCLUSION: Teens with chronic conditions tak. more potentially darr...ging health risks than might be expected, although their rates are lower than those of their healthy peers. Physicians infrequently screened for behaviors other than sexual activity or weight and dieting.
THE IMPACT OF HOME-BASED SEX EDUCATION ON RURAL ADOLESCENTS SEXUAL BEHAVIOR AND ATTITUDES Redonna K. Chandler, Ph.D., Berea College, Berea, Kentucky; Janet G. Baker, M.A., University of Cincinnati, Cincinnati, Ohio; Marie Griffin, Berea College, Berea, Kentucky OBJECTIVE: The purpose of this study was to explore the relationship between parental sex education and sexual behaviors and attitudes among college students from an impoverished rural Appalachian region. METHODS: Participants were recruited from a college serving students from the Appalachian region who demonstrate financial need. A paper and pencil survey of 185 questions related to parental sexual education, and sexual attitudes and behaviors was administered during a health and wellness class. RESULTS: 175 college students with a mean age =18.4 years completed the surveys. There were 84 females and 91 males. There was no difference between genders in the relationship between sex education and attitudes and behaviors. The amount of sexual education received from the home is significantly related to attitudes regarding the use of birth control devices for both males and females (chi-square = 20.46. P < .01) but it was not related to the actual use of birth control devices. More parental sexual education was associated with delay in onset of sexual behaviors (chi-square = 42.12, P < .01). Level of sexual education within the home was not related to information or attitudes regarding AIDS. CONCLUSIONS: Although college students obtain sexual information from a variety of sources, this study examined the specific impact of parental education. The impact of parental education may be selective to issues such as attitudes and beliefs. Health care providers can assess the adolescent and parent attitudes toward birth control, and then make sure that adolescents can access birth control and arein relationships which support their use.