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Biomedical subjects

Nancy E Adler

Publications and source records attributed to Nancy E Adler.

5 recordsLinked to original sources

Relative power between sexual partners and condom use among adolescents.

PURPOSE: To examine how the relative power of adolescent sexual partners in the domain of emotional intimacy is related to condom use. METHODS: Interviewed 228 adolescents who visited an STD clinic in San Francisco. Adolescents were aged 14-19 years, 69% were female, and they were ethnically diverse. We developed a measure of relative power in the domain of emotional intimacy, by adapting five items from existing measures and developing three items ourselves. The partner who had less desire for emotional intimacy was considered to have more power in that domain. We also measured relative decision-making power. Data were analyzed using logistic regression and Student's t-tests. RESULTS: Adolescents who had more power than their partners in the domain of emotional intimacy were more likely to get their way about condom use than adolescents who had less power in this domain. Decision-making power was not related to whether adolescents got their way about condom use. Young men reported greater emotional intimacy power and greater decision-making power than young women. However, gender was not related to getting one's way about condom use. CONCLUSIONS: The results suggest the importance of assessing relative power in the sexual relationships of adolescents when predicting condom use.

Adolescent↗

Socioeconomic status and health: the role of sleep.

OBJECTIVE: Examine the role of sleep in the relationship between socioeconomic status (SES) and health. METHOD: Self-reported measures of income and education, sleep quantity and quality, and mental and physical health were obtained in a community sample of 1139 adults. RESULTS: More education was associated with higher income (p <.001), and higher income was associated with better physical health (p <.001) and psychological outcomes (p <.001). The effects of income on both mental and physical health were mediated by sleep quality (p values <.01), and sleep quantity was related to both measures of health (p values <.01) but to neither index of SES. CONCLUSION: Sleep quality may play a mediating role in translating SES into mental and physical well-being, and income seems to mediate the effect of education on sleep and, in turn, health.

Adolescent↗

Socioeconomic disparities in health: pathways and policies.

Socioeconomic status (SES) underlies three major determinants of health: health care, environmental exposure, and health behavior. In addition, chronic stress associated with lower SES may also increase morbidity and mortality. Reducing SES disparities in health will require policy initiatives addressing the components of socioeconomic status (income, education, and occupation) as well as the pathways by which these affect health. Lessons for U.S. policy approaches are taken from the Acheson Commission in England, which was charged with reducing health disparities in that country.

Delivery of Health Care↗

The trade-off between hormonal contraceptives and condoms among adolescents.

CONTEXT: Adolescents' dual use of condoms and hormonal contraceptives is low, and the motivations underlying their decisions to combine contraceptives are not understood. METHODS: To examine how pregnancy concerns, sexually transmitted disease (STD) concerns and type of sexual partner influence contraceptive use, we recruited 436 sexually experienced adolescents from two clinics. In structured interviews, we asked adolescents to describe their recent partners, their method use, and their pregnancy and STD concerns. Data were analyzed using logistic regression. RESULTS: The odds that adolescents used condoms with main partners were significantly lower among those who used hormonal contraceptives than among nonusers of these methods (odds ratios, 0.4 for young women and 0.3 for young men). With casual partners, no association existed between adolescents' condom and hormonal contraceptive use. Concerns about pregnancy and STDs influenced this association for women with main partners. Among young women who perceived pregnancy as more negative, hormonal contraceptive users had reduced odds of using condoms (0.1). No association existed between use of the two methods among young women whose view of pregnancy was less negative. Young women who perceived themselves to be less at risk of acquiring an STD had reduced odds of using condoms if they were using hormonal contraceptives (0.2). Among young women who perceived themselves to be more at risk of acquiring an STD, no association existed. CONCLUSIONS: Adolescents trade off between hormonal contraceptives and condoms according to partner type and perceived risks. Adolescents' dual-method use may improve if providers tailor counseling to adolescents' perceived risk of STDs and pregnancy, and if they address prevention of both as a related decision.

Adolescent↗