Biomedical subjects

Janna Lesser

Publications and source records attributed to Janna Lesser.

8 recordsLinked to original sources

PubMed2005

Respecting and protecting our relationships: a community research HIV prevention program for teen fathers and mothers.

This article describes a two-phase community and academic collaboration funded by the California Collaborative Research Initiative to develop and test the feasibility of an innovative HIV prevention program relevant to the needs of the population of inner-city Latino teen parenting couples and realistic for implementation in community settings. The article describes (a) the identification of special issues that needed to be addressed before formation of a productive academic-community-based organization research partnership, including integrating a dominant theoretical model used in health education with principles of practice derived from clinical experience; (b) the first phase of the project that helped to inform the development of the HIV prevention program for couples; (c) examples from the intervention pilot study (Phase 2) that illustrate both the intervention strategies and the young participants' responses to the curriculum; and (d) the feasibility of program implementation and evaluation in a community setting.

Adolescent↗

PubMed2003

Teen pregnancy, motherhood, and unprotected sexual activity.

The sexual behaviors and attitudes toward condom use of adolescent mothers (N = 572) from ethnic minority groups were examined. Constructs from social cognitive theory (SCT), the theory of reasoned action (TRA), and the theory of planned behavior (TPB; e.g., intentions to use condoms, self-efficacy, outcome expectancies) were measured with questionnaires. Measures of AIDS and condom-use knowledge and selected psychosocial, behavioral, and demographic variables were included. Many adolescents reported early onset of sexual activity, multiple lifetime sexual partners, substance use, and childhood sexual or physical abuse. Only 18% stated a condom was used at last intercourse. Using hierarchical regression analysis, 13% of the variance for factors associated with unprotected sex was accounted for by TRA constructs. Other variables contributed an additional 17% of the variance. Unprotected sex was associated with behavioral intentions to use condoms, pregnancy, having a steady partner, more frequent church service attendance, and ever having anal sex. Findings support the urgent need for broad-based HIV prevention efforts for adolescent mothers that build on theoretical concepts and address the realities of their lives.

Adolescent↗

PubMed2003

Vulnerable adolescent mothers' perceptions of maternal role and HIV risk.

Pregnant adolescents and young mothers living in Los Angeles County are vulnerable to acquiring HIV/AIDS through sexual transmission because they lack the resources, social status, and power to protect themselves. In this article we describe adolescent mothers' (n = 76) responses to an HIV prevention program. The design of the study was based in ethnography, the anthropological tradition of qualitative research. Many of the pregnant teens and young mothers described how the experience of becoming a mother helped empower them to improve their lives. Yet efforts to decrease risky sexual behavior were overshadowed by more immediate concerns and by relationship issues of gender and power and of trust.

Adolescent↗

PubMed2002

Public health nursing care for adolescent mothers: impact on infant health and selected maternal outcomes at 1 year postbirth.

PURPOSE: To compare effects of an early intervention program (EIP) of intense home visitation by public health nurses (PHNs) with effects of traditional public health nursing care (TPHN) on infant health and selected maternal outcomes of adolescent mothers. METHODS: EIP adolescents (N = 102) received preparation-for-motherhood classes and individual home visits (from pregnancy through 1 year postpartum) from PHNs employed in a county health department. Participants were predominantly Latina (64%) and African-American (11%) and from impoverished backgrounds. Infant health outcomes were determined based on medical record data; interviews and standardized questionnaires evaluated other program effects (e.g., maternal educational achievement and psychological status). Data were analyzed using Chi-square and repeated measures ANOVA. RESULTS: Infants of EIP mothers experienced significantly fewer total days (n = 74) and actual episodes (n = 14) of hospitalization during the first year of life than those receiving TPHN (n = 154, n = 24, respectively). Similarly, positive program effects were found for immunization rates. There were no group differences in emergency room visits or repeat pregnancy rates. Alcohol, tobacco, and marijuana use significantly increased from pregnancy through 1 year postpartum in both groups but remained markedly lower than rates prior to pregnancy (lifetime rates). CONCLUSIONS: These findings demonstrate the positive effects of a PHN home visitation program on health outcomes for children of adolescent mothers. Days of infant hospitalization were substantially reduced and immunization rates increased during the first year of life for children of EIP mothers. Greater efforts need to be directed toward preventing repeat pregnancy and return to substance use following childbirth in at-risk adolescent mothers.

Adolescent↗

PubMedDate not supplied

Project CHARM: an HIV prevention program for adolescent mothers.

Effects were examined of a human immunodeficiency virus (HIV) prevention program for adolescent mothers offered in pregnant minor and parenting programs in Los Angeles County. The sample included young women (N = 497) of predominantly poor, Latina backgrounds who had complete data from baseline to the one-year follow-up. The treatment group demonstrated statistically significant improvements in AIDS knowledge and intentions to use condoms, and fewer sex partners at the six-month follow-up as compared to the control group. Findings related to the effects of the intervention on theoretical variables provide some support for selected concepts from Social Cognitive Theory and the Theory of Reasoned Action.

Adolescent↗

PubMedDate not supplied

Tailoring STI & HIV prevention programs for teens.

Successful HIV/sexually transmitted infection (STI) prevention programs are not "one size fits all." To effectively meet the HIV/STI prevention needs of all adolescents, programs should be developmentally and gender specific, should integrate an understanding of racial/ethnic culture, and should be open to variations in sexual expression. Nurse researchers have demonstrated the importance of these differences in programs, and this article offers concrete suggestions for ways to apply this knowledge in community programs.

Adolescent↗

PubMedDate not supplied

Health disparities among vulnerable populations: evolution of knowledge over five decades in Nursing Research publications.

BACKGROUND: Considerable attention has been focused recently on conducting research on the health disparities experienced by some Americans as the result of poverty, ethnicity, and/or marginalized social status. Nursing research has a major role to play in developing this body of knowledge. PURPOSE: The purpose of this paper is to review the contributions that Nursing Research made through its publications over the last five decades in developing the body of tested knowledge about health disparities in vulnerable groups and to analyze the progress made. METHODS: Criteria for reviewing the literature were established. All Nursing Research publications between 1952 and 2000 were searched manually, indexes of each year's bound volumes were reviewed, and computer searches were conducted. Included in the review were research reports, research briefs, and methodology articles. RESULTS: Seventy-nine papers were found that met basic criteria for inclusion. The number of relevant publications increased each decade, with a sizable increase in numbers since 1990, and may be related to the social, political, and economic climate of each decade. The research questions asked and the methods used became more complex over time. CONCLUSIONS: Nursing Research has made a significant contribution in disseminating the body of tested knowledge related to the health disparities experienced by vulnerable populations and the methodologies associated with vulnerable populations research. Areas for future research are community-based studies, intervention studies that provide tangible resources, and methodologic approaches that involve participants in the research process.

Attitude to Health↗

PubMedDate not supplied

Nurse visitation for adolescent mothers: two-year infant health and maternal outcomes.

BACKGROUND: Children of adolescent mothers have higher rates of morbidity and unintentional injuries and hospitalizations during the first 5 years of life than do children of adult mothers. OBJECTIVE: The purpose of this study was to evaluate the 2-year postbirth infant health and maternal outcomes of an early intervention program (EIP) of home visitation by public health nurses (PHNs). METHODS: In a randomized controlled trial, a sample of predominantly Latina and African American adolescent mothers was followed from pregnancy through 2 years postpartum. The experimental group (EIP, n = 56) received preparation-for-motherhood classes plus intense home visitation by PHNs from pregnancy through 1 year postbirth; the control group (TPHNC, n = 45) received traditional public health nursing care (TPHNC). Health outcomes were determined based on medical record data; other measures evaluated selected maternal behaviors, social competence, and mother-child interactions. RESULTS: The total days of non-birth-related infant hospitalizations during the first 24 months was significantly lower in the EIP (143 days) than the TPHNC group (211 days) and episodes of hospitalization were fewer; more EIP than THHNC infants were never seen in the emergency room. The EIP mothers had 15% fewer repeat pregnancies in the first 2 years postbirth than TPHNC mothers. The TPHNC mothers significantly increased marijuana use over time, whereas EIP mothers did not. CONCLUSIONS: The EIP improved in selected areas of infant and maternal health, and these improvements were sustained for a period of 1 year following program termination. These findings have important implications for healthcare services.

Adolescent↗