Abstract available through the Journal of the American Pharmacists Association.

Background Maternal opioid use and neonatal abstinence syndrome (NAS) incidence have increased markedly in the US in recent years. Objectives (1) To assess prescribers’ and community pharmacists’ guideline-based NAS prevention behaviors; (2) to describe providers’ perceptions of contraceptive appropriateness in female patients of childbearing age. Method Cross-sectional study of 100 randomly selected primary care physicians, 100 prescribers authorized to engage in in-office treatment of opioid use disorders with buprenorphine, 100 pain management clinic directors, and 100 community pharmacists in Tennessee (N = 400 providers total) to evaluate self-reported engagement in 15 NAS prevention behaviors and perceived appropriateness of 8 contraceptive methods in opioid using women of childbearing age. Results An overall response rate of 17.5% was obtained. Pain clinic directors reported the most engagement in NAS prevention, engaging 80% or more of female patients of childbearing age prescribed an opioid in 11 prevention behaviors, followed by buprenorphine prescribers (8 behaviors), primary care physicians (5 behaviors), and community pharmacists (2 behaviors). Pain clinic directors, primary care physicians, and community pharmacists perceived oral contraceptive pills and patches to be as appropriate as long-acting, reversible forms of contraception (e.g., implants, injectable depots, intrauterine devices). Conclusion Provider engagement in behaviors that could prevent NAS is variable. Interventions should be implemented that equip providers to engage patients in conversations about long-acting, reversible contraception.

No description available.

Abstract available through Pharmacotherapy.

An increasing number of infants are diagnosed with neonatal abstinence syndrome (NAS) as a result of prenatal opioid exposure. Early intervention services are recommended for this population of children and families to mitigate developmental delays associated with NAS. The effectiveness of early intervention is dependent on the ability of interventionists who deliver these services. The purpose of this qualitative case study was to explore early interventionists' perspectives of self-efficacy when working with infants diagnosed with NAS and their families. Bandura's self-efficacy theory and Rotter's concept of locus of control provided the conceptual framework for this study. The study's guiding research questions focused on early interventionists' self-efficacy beliefs and factors that may affect those beliefs in their work with infants diagnosed with NAS and their families. Data were collected via semistructured interviews with 8 interventionists. Themes emerged from both in vivo and a priori coding pertaining to interventionists' self-efficacy beliefs working with the NAS population. Most interventionists in this study reported feeling highly efficacious in their work with infants with NAS and their families despite a lack of applicable educational and professional preparation. Interventionists attributed their professional efficacy to their own self-study, experience, and motivation to learn. Interventionists agreed that training specific to their work with NAS may improve their ability and self-efficacy in their work with infants with NAS and their families. Targeted training to increase interventionists' self-efficacy in their work with infants diagnosed with NAS and their families may result in increased effectiveness of intervention services and lead to lifelong positive outcomes for these vulnerable children.

The teen pregnancy rate in Henry County, Tennessee has increased over the years. The purpose of this project was to develop an evidence-based family life education policy for possible adoption by the board of education to address the persistent high teen pregnancy rate for girls aged 15-17 in the county. This present study resulted in a revised policy that was based on a comprehensive policy termed Abstinence-Centered Plus Contraception. An 18-member collaborative, organizational, and community project team, made up of community leaders, nurses, counselors, teachers, and students, assisted in the development and adoption of the policy, practice guidelines, and the development of implementation and evaluation plans for the newly adopted policy. The theoretical framework was based on the social, cognitive, and behavior change theories. The program logic model served as a framework to monitor its progress. Existing peer-reviewed literature, including research studies, state and national teen pregnancy prevention projects and curriculum, and publicly available statistics, were gathered and reviewed by the project team as background to be used for developing and changing policy at the institutional level. Project monitoring involved tracking processes surrounding policy and practice guideline development and adoption, as well as implementation and evaluation plan development for the adopted policy and whether these processes progressed as the empirically-derived teen pregnancy prevention projects should when changing sex education policy at the organizational level. This project resulted in policy adoption and developing a policy implementation and evaluation plan to be disseminated within a county school system that could decrease teen pregnancy rates and demonstrate positive outcomes.

The fieldwork for this study was conducted in the West Kimberley region of Western Australia between 1997 and 1999. Qualitative and quantitative information provided by 170 Aboriginal participants enabled an exploration of the context and patterns of Aboriginal alcohol use; Aboriginal perceptions of the alcohol issue, existing interventions, research findings, 'culture' and its role in prevention and intervention; and participants' incorporation of these perceptions into an Aboriginal model for alcohol misuse prevention, intervention and evaluation. Findings were based on the results of individual and focus group interviews, serial model-planning focus groups, documentary data and observation.Study findings generally suggest that in addition to self-determination and support components, 'cultural context' retains an important role for many remote area Aboriginal people. The findings from a small sub-sample tentatively suggest that 'cultural' disruption, in addition to the socio-economic consequences of colonisation and dispossession, may play an important role in alcohol misuse. Consequently, it appears that in combination with self-determination and support components, the strengthening of a locally-defined 'cultural' context may have an important role in alcohol misuse prevention and intervention - an approach frequently unrepresented in existing symptom-focused models and one inviting further investigation. The model developed by study participants expands significantly on existing symptom-focused approaches through a comprehensive life-enhancement focus on aspects of identity, opportunity and hope. This approach adds depth and meaning to understandings of cultural appropriateness and of culturally relevant models for substance misuse prevention and intervention.

La sexualité, pourtant base de la reproduction humaine, n’a intéressé les démographes que comme facteur ou déterminant indirect de la fécondité (principalement en Afrique Centrale). L’intérêt des chercheurs en sciences sociales pour des études sur la sexualité est né avec l’émergence du SIDA dans la perspective des comportements sexuels à risque d’IST/VIH/SIDA. Or, cette perspective restreint le champ d’investigation et limite la connaissance, car la sexualité va au-delà des comportements sexuels à risque. Pour nous rendre compte des évolutions ou changements intervenus dans le vécu de la sexualité des jeunes, nous avons mené une enquête par sondage auprès de 2000 jeunes célibataires, scolarisés et non scolarisés, âgés de 15-24 ans dans la ville de Kinshasa. Cette enquête quantitative a été complétée par 19 entretiens approfondis auprès des jeunes filles et garçons, 3 focus groups, des entretiens avec des responsables de différents services et, structures administratifs et de santé qui encadrent les jeunes, … L’étude a cherché à répondre à la question principale de savoir : Comment les jeunes célibataires de Kinshasa vivent-ils leur activité sexuelle et comment se protègent-ils contre les risques d’IST/VIH lors de cette sexualité ? Plus concrètement, l’étude a permis de caractériser cette sexualité de ces jeunes en termes d’intensité et de déterminants. Elle a également appréhendé les stratégies des jeunes en ce qui concerne la protection des rapports sexuels contre le risque d’IST/VIH auquel ils s’exposent. A cause de leur appartenance aux ethnies et religions dont les normes et valeurs interdisent l’activité sexuelle préconjugale, les jeunes kinois sont massivement opposés à la sexualité préconjugale. Cette opposition se révèle de façade, car non seulement la majorité est sexuellement active, mais surtout s’initie précocement. Près de 70 % des filles comme des garçons étaient déjà sexuellement actifs au moment de l’enquête et 1 jeune sur 2 s’était initié avant l’âge de 16,7 ans pour les filles et de 16,9 ans pour les garçons. Leurs croyances religieuses retardent l’initiation sexuelle, tandis que l’appartenance à un ménage aisé facilite l’adoption des comportements à moindres risques. Dès qu’ils commencent leur activité sexuelle, celle-ci devient, non seulement quasiment régulière (surtout chez les jeunes qui sont moins exposés aux informations sur la Santé de la Reproduction), mais aussi multipartenaire. Les jeunes kinois changent de temps en temps de partenaires qu’ils recrutent principalement dans le cercle de pairs. Du fait d’appartenir au même cercle, les jeunes considèrent leurs partenaires comme étant habituels et n’utilisent le condom qu’avec un partenaire « occasionnel » ou lors d’un rapport sexuel rémunéré, une façon pour eux d’appliquer le principe de la stratégie ABC de la lutte contre le sida qui conseille l’utilisation du préservatif avec des partenaires occasionnels. En plus, la plupart des jeunes observent presque toujours une période de continence d’au moins un mois avant d’avoir des rapports sexuels avec leurs nouveaux partenaires. En observant cette période, les jeunes se considèrent davantage comme des partenaires habituels et, même sans avoir procédé préalablement au test sérologique, ils passent à l’acte sans préservatif, s’estimant toujours moins exposés au risque d’IST/VIH. Malgré leur intense activité sexuelle, d’une part, et leur bonne mise en application des conseils pour une sexualité à moindres risques dans leurs pratiques, toutes les structures éducatives (famille, école, église) ne conseillent aux jeunes que l’abstinence sexuelle. Cette inadéquation entre les besoins des jeunes et l’éducation sexuelle offerte mérite d’être soulignée afin d’attirer l’attention des parents et des décideurs sur les dangers que courent les jeunes s’ils ne sont plus correctement accompagnés dans le vécu de leur sexualité.

Thesis (D. Min.)--Midwestern Baptist Theological Seminary, 2006. / Includes bibliographical references (leaves 229-237).

Thesis (D. Min.)--Midwestern Baptist Theological Seminary, 2006. / Includes bibliographical references (leaves 229-237).