Biomedical subjects

Yvonne Racine

Publications and source records attributed to Yvonne Racine.

8 recordsLinked to original sources

PubMed2006

HIV/AIDS knowledge, women's education, epidemic severity and protective sexual behaviour in low- and middle-income countries.

A fundamental public health strategy to reduce the risk of HIV/AIDS is to increase levels of awareness and knowledge about the disease. Although knowledge about HIV/AIDS and protective sexual behaviour are linked theoretically, relatively little is known about their empirical relationship. Using Demographic and Health Survey data from 23 low- and middle-income countries, this study used multilevel logistic regression models: to examine cross-national variability in the relationship between HIV/AIDS knowledge and protective behaviour (condom use and restricted sex); to investigate the moderating influences of women's educational attainment on this relationship; and to test the extent to which severity of the HIV/AIDS epidemic accounts for cross-national variability in the association between HIV/AIDS knowledge and protective behaviour. There was an association between increased knowledge of HIV/AIDS and condom use that varied in strength and form cross-nationally. This cross-national variation was accounted for partially by the socioeconomic characteristics of women resident in the study countries and between-country differences in the severity of the HIV epidemic. While education modified the association between HIV/AIDS knowledge and protective behaviour--stronger associations at lower levels of education--epidemic severity exerted a stronger influence on behaviour than any other characteristic. Finally, this study indicates that protective sexual practices are disturbingly low. In eight of 23 countries, overall levels of condom use to prevent STDs and HIV/AIDS were less than 5.0%. Waiting for the spread of HIV/AIDS infection to change sexual practices in low- and middle-income countries will result in dramatic unnecessary suffering.

Acquired Immunodeficiency Syndrome↗

PubMed2006

The influence of economic development level, household wealth and maternal education on child health in the developing world.

This study estimates the relative importance to child health (indicated by weight and height for age) of economic development level [gross domestic product (GDP) converted to international dollars using purchasing power parity (PPP) rates: GDP-PPP], household wealth and maternal education and examines the modifying influence of national contexts on these estimates. It uses information collected from mothers aged 15-49-years participating in Demographic Health Surveys (DHS) conducted in 42 developing countries. In multilevel regression models, the three study variables exhibited strong independent associations with child health: GDP-PPP accounted for the largest amount of unique variation, followed by maternal education and household wealth. There was also substantial overlap (shared variance) between maternal education and the other two study variables. The regressions of child health on household wealth and maternal education exhibited substantial cross-national variation in both strength and form of association. Although higher education levels were associated with disproportionately greater returns to child health, the pattern for household wealth was erratic: in many countries there were diminishing returns to child health at higher levels of household wealth. We conclude that there are inextricable links among different strategies for improving child health and that policy planners, associating benefits with these strategies, must take into account the strong moderating impact of national context.

Adolescent↗

PubMed2006

Tobacco use among immigrant and nonimmigrant adolescents: individual and family level influences.

PURPOSE: To identify individual and family level characteristics that might explain differences in rates of tobacco use among immigrant and nonimmigrant adolescents. METHODS: Data for analysis come from a probability sample of 5401 adolescents aged 12-18 years participating in the Ontario Health Survey (OHS). Three groups were compared: (a) adolescents born in Canada to Canadian-born parents (n = 3886), (b) adolescents born in Canada to immigrant parents (n = 1233), and (c) adolescents born outside of Canada (n = 282). Discrete, multilevel logistic regression was used in the analysis. RESULTS: Adolescents born outside of Canada report the lowest rates of tobacco use, despite greater economic hardship. A negative association emerges between family socioeconomic status and tobacco use among adolescents born in Canada but not among adolescents born outside of Canada. Immigrant youth are less likely to affiliate with peers who smoke and are more likely to come from families where parents do not smoke: these differences partially explain the decreased rates of tobacco use among immigrant adolescents. CONCLUSIONS: Although subject to greater economic hardship, immigrant youth are less likely to engage in tobacco use. Protective factors associated with immigrant family life, such as lower rates of parental tobacco use and less exposure among immigrant adolescents to peers who smoke, may counteract some of the negative effects of poverty and social hardship. Future research should begin to address the processes that lead to adaptive outcomes among adolescents from immigrant families, despite greater exposure to social disadvantage.

Adolescent↗

PubMed2004

Single mothers and the use of professionals for mental health care reasons.

In the present study, we examine whether higher rates of mental health service use observed among single-parent mothers is due to greater need (psychopathology) or other factors (predisposing and enabling characteristics) using a socio-behavioural model of health care use. We use data from two large surveys in Canada (the 1994-95 National Population Health Survey and the 1990 Ontario Mental Health Supplement). The bivariate results from both surveys revealed that single-parent mothers were two to three times more likely than married mothers to have sought professional help for mental health reasons over a 12-month period. Multivariate analyses showed that differences in predisposing and enabling characteristics between single and married mothers accounted for very little of the relationship between family structure and service use. Rather, differences in the prevalence of psychiatric disorders accounted for the higher use of services among single mothers. Single mothers are more likely than married mothers to seek professional help for mental health concerns. The use of services appears equitable in that need (higher rates of psychopathology) is the major factor differentiating use between married and single mothers. Further work should examine differences in pathways into formal care between single and married mothers.

Adolescent↗

PubMed2003

Stress, social support and depression in single and married mothers.

BACKGROUND: This study examined the effect of stress and social support on the relationship between single-parent status and depression. METHOD: A secondary data analysis of the 1994-95 National Population Health Survey was conducted. Single and married mothers who participated in the survey were derived from the general sample (N = 2,921). Logistic regression techniques were used to assess the mediating and moderating effects of stress and social support on the relationship between family structure and depression. RESULTS: Bivariate analyses showed that, compared to married mothers, single mothers were more likely to have suffered an episode of depression (12-month prevalence), to report higher levels of chronic stress, more recent life events and a greater number of childhood adversities. Single mothers also reported lower levels of perceived social support, social involvement and frequency of contact with friends and family than married mothers. The results of the multivariate analyses showed that, together, stress and social support account for almost 40% of the relationship between single- parent status and depression. We also found a conditional effect of stress on depression by family structure. Life events were more strongly related to depression in married than in single mothers. CONCLUSIONS: A substantial part of the association between single-parent status and depression can be accounted for by differences in exposure to stress and social support. Our results suggest that it is important to examine multiple sources of stress, as exposure to both distal and proximal stressors were higher among single mothers. Limitations and directions for future research are discussed.

Adolescent↗

PubMed2003

Does low reading achievement at school entry cause conduct problems?

Conduct problems place children at increased risk for a broad array of negative health and social outcomes that include conduct disorder, injuries and violence, school failure, substance abuse, depression, and suicide. Prevention interventions have the potential to interrupt the chain of events linking early conduct problem symptoms to future negative life outcomes, but have received much less emphasis than interventions designed to treat established cases of disorder. Reading problems are a well-established correlate of conduct disorder. However, whether or not reading problems cause conduct disorder continues to be debated. If they are in fact a causal risk factor this would justify the design and evaluation of interventions designed to enhance reading skills and/or remediate problems. In this paper we use logistic regression techniques to evaluate the relation between reading achievement at school entry and conduct problems 30 months later, in a representative, non-clinic sample of kindergarten and grade one children, in Ontario, Canada. The findings show that an eight point increase in reading scores (equivalent to an moderate effect size of 0.5) would result in a 23 per cent decrease in the risk of conduct problems 30 months later, after controlling for gender, income and baseline conduct problem symptoms. We conclude that reading problems may contribute to the early onset of conduct disorder. Randomized experimental studies designed to evaluate the effects of reading programmes in non-clinic samples of children are needed to: (i) establish whether the link between reading problems at school entry and conduct disorder is causal; and (ii) determine whether reading intervention programmes are an effective conduct disorder prevention strategy.

Achievement↗

PubMedDate not supplied

Differential-maternal parenting behavior: estimating within- and between-family effects on children.

This study examined the impact of differential-maternal parenting behavior, evaluated as a family-level experience, on children's emotional-behavioral problems. Data come from 3 child development studies: 2,128 four- to sixteen-year-olds (Ontario Child Health Study), 7,392 four- to eleven-year-olds (National Longitudinal Study of Children and Youth), and 1,992 three- to fourteen-year-olds (National Longitudinal Study of Youth). In 2 of 3 studies, there was consistent evidence that differential-maternal parenting behavior had an adverse impact on all siblings as a group, over and above parenting directed at individual siblings. The strength of association was sensitive to the type of maternal parenting behavior, dimension of child maladjustment, and respondent perspective (stronger for hostile/negative parenting, child externalizing problems, and mother assessments of child emotional-behavioral problems).

Adolescent↗

PubMedDate not supplied

Youth at risk of homelessness in an affluent Toronto suburb.

BACKGROUND: This study examines the characteristics and needs of 69 youth who are homeless, or at risk of homelessness at Pathway's Home Base Youth Drop-In Centre in the affluent suburb of Richmond Hill, Ontario, Canada. METHODS: A semi-structured interview examined demographics, characteristics, living arrangements, family characteristics, substance use, mental health, criminal activity and educational experiences of the youth in this sample. RESULTS: The majority of youth came from economically advantaged families and were currently residing with their parents, but were substantially more at risk than their mainstream peers in measures related to youth homelessness. The majority of Home Base youth had left home and school prematurely, been arrested in their lifetime, and used at least one illicit drug in the past 12 months. A substantial number of youth had been imprisoned, experienced physical abuse, and exhibited depressive symptomatology and suicidal ideation. CONCLUSION: Although living mainly at home and in a relatively affluent suburb, these youth have many attributes related to homelessness and may progress to homelessness without intervention.

Adolescent↗