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Biomedical subjects

J B Hardy

Publications and source records attributed to J B Hardy.

At least 19 recordsLinked to original sources
PubMed1998

Like mother, like child: intergenerational patterns of age at first birth and associations with childhood and adolescent characteristics and adult outcomes in the second generation.

A 30-year follow-up of 1,758 inner-city children and their mothers in the Pathways to Adulthood Study revealed significant associations in transgenerational timing of age at 1st birth between mothers and their daughters and sons. Intergenerational age patterns were associated with the children's family and personal characteristics during childhood and adolescence and self-sufficiency at age 27-33. Continuity in teenage parenthood was associated with family and personal characteristics unfavorable for optimal child development and successful adult outcomes. Delay in 1st parenthood to age 25 or older was associated with significantly greater odds of more favorable environmental and developmental characteristics and greater adult self-sufficiency. The authors concluded that age at 1st birth of both mothers and children contributes, but in subtly different ways for daughters and sons, to the children's development and adult self-sufficiency.

Adolescent↗
PubMed1997

Adolescent childbearing revisited: the age of inner-city mothers at delivery is a determinant of their children's self-sufficiency at age 27 to 33.

OBJECTIVES: Data from recent interviews with 1758 inner-city children, born between 1960 to 1965 and followed with their mothers in the Pathways to Adulthood Study to age 27 to 33 years, were used to address two related questions. 1) Is maternal age, across the reproductive age range, a determinant of child's adult outcome? and 2) Do covariates of maternal age at delivery reduce or eliminate the effect of maternal age on child's adult outcome? METHODS: An intergenerational life course model of development identified significant maternal and child characteristics at birth associated with the child's self-sufficient outcomes in adulthood: education (more than or equal to a high school diploma); financial independence of public support; and delay of first birth until age 20 or older. Bivariate and multiple logistic regression techniques were used to identify independent relationships between dependent and independent variables and to adjust the outcomes to compensate for the effect of possible confounding of maternal age at delivery by maternal education, parity, poverty status, and the child's race and gender. RESULTS: Each covariate was independently associated with maternal age at delivery. Adjustment for their effects reduced, but did not eliminate, the association between maternal age at birth and the child's outcome at age 27 to 33 years. As a group, children of the oldest mothers (>/=25 years of age) had the most favorable outcomes, and those of teenage mothers (<20 years of age) had the least favorable outcomes; 22% of daughters and 6% of sons of the oldest mothers versus 38% and 18%, respectively, of the youngest mothers became teenage parents. CONCLUSION: The mother's age at delivery is an independent determinant of the child's adult status.

Adolescent↗
PubMed1997

Self-sufficiency at ages 27 to 33 years: factors present between birth and 18 years that predict educational attainment among children born to inner-city families.

OBJECTIVES: Some inner-city infants grow to be successful, self-sufficient adults. This study is designed to identify characteristics from early childhood that foster or impede favorable outcomes and are useful for formulation of public policy. METHODS POPULATION: 2694 children (G-2s), born 1960 through 1965, to 2307 inner-city women (G-1s) enrolled in the Johns Hopkins Collaborative Perinatal Study. DATA: 1) prospective observations (birth through 8 years) of neurologic and cognitive development, health, behavior, and family and neighborhood socioeconomic characteristics and 2) completed interviews with 1758 G-2s (age 27 to 33) and 1552 G-1s, bridging the period from age 9 to present status. An intergenerational, life course model of development identified significant characteristics and events associated with G-2 outcome (education, physical and mental health, healthy lifestyle, and financial independence of public support, emphasizing educational attainment of a high school diploma or a graduate equivalency degree). Multiple logistic regression equations identified independent, predictive variables during infancy, preschool and early school years, and adolescence. The probability of a good outcome was estimated in the presence of combinations of the six variables most strongly associated with that outcome. RESULTS: Among G-2s, 79% had a successful outcome for education, 60% health, 70% lifestyle, and 76% for financial independence. Black G-2s had more favorable outcomes than white G-2s in education and lifestyle, whites for financial outcome; health did not differ by race. The six variables most predictive of adult education were: G-1 education at G-2 birth and G-2 attainment of honor roll, average or better reading skills at 8 years, avoidance of regular smoking, and pregnancy before age 18, and not repeating a grade in school. CONCLUSIONS: Substantial proportions of inner-city children become successful adults. Attention to improving public education, particularly language and reading skills, and the prevention of smoking and adolescent pregnancy are clearly indicated.

Activities of Daily Living↗
PubMed1993

Injuries in children of adolescent mothers: home safety education associated with decreased injury risk.

The purpose of this study was to describe the epidemiology of injuries in children of adolescent mothers (< 18 years old at delivery), in Baltimore, MD, and to explore the relationship between maternal receipt of home safety information and child injury. A random sample of 363 adolescent mothers and their children were followed longitudinally by home interview at 3 and 15 months postpartum. Receipt of home safety information and information source were assessed at the 3-month interview. Injuries requiring medical attention were assessed at the 15-month interview. Sixty-eight children sustained injuries during follow-up and 14% required hospitalization. Falls and burns predominated as the cause of injury, with burns much more common in girls. The children of mothers who received home safety information from family and community-based sources by 3 months postpartum had significantly lower risk of injury during follow-up than children of mothers who had not received home safety information. As the number of information sources increased, the injury rate decreased. Further work is needed to examine the most appropriate timing, repetition, format, and content of injury prevention education.

Accidents, Home↗
PubMed1989

The effect of sexual behavior and a pregnancy on contraceptive method switching among black female teens.

Little is known about determinants of contraceptive method switching and few reports use data that can link events that occur close in time. Using retrospective information from the sexual calendars of black female teens who attended a reproductive health clinic, determinants of method switching in four areas were investigated. Method switchers, those who switched from an unprepared to a prepared method (n = 62) and those who switched from a prepared to an unprepared method (n = 18), were matched with nonswitchers who used the same initial method. Associations between switching and changes in the frequency of intercourse, sexual abstinence, and pregnancy were found. It is suggested that abstinence may have a different role in switching from each type of method. Counselors need to emphasize the importance of method continuation, even when sex has not occurred for a short period of time.

Adolescent↗
PubMed1989

Family support and parenting education in the home: an effective extension of clinic-based preventive health care services for poor children.

A study was designed to assess the effect and cost of providing parenting and child care education in the home to inner-city mothers of poor infants receiving comprehensive health care in a large federal Children and Youth Program. Randomly selected, healthy neonates weighing more than 2000 gm and born to black women aged 18 years and older (n = 131) and to comparable control subjects (n = 132) were followed for a mean of 23.4 and 22.9 months, respectively. A community woman, with educational, social service, and medical backup support from the Children and Youth Program, made home visits 7 to 10 days after the birth and between regularly scheduled well-child-care visits. Improved compliance with well-child care, fewer illness visits, and sharp reductions in hospitalization and in neglect or abuse were found in the visited group compared with the control group, and substantial cost was averted. Prerequisite and concomitant to focusing the mother's attention on the infant was the resolution of the numerous crises and survival problems experienced by these poor women. Only then was parenting education accepted by the mother.

Adult↗
PubMed1988

Teenage fathers and the fathers of infants of urban, teenage mothers.

Data from Certificates of Live Birth, for recorded resident births in Baltimore in 1983, were used to describe fathers whose child was born to a teenage mother. Four groups were identified: 1) both father and mother were teenagers (12 per cent); 2) only the mother was a teenager (14 per cent); 3) only the father was a teenager (2 per cent); 4) both parents were aged 20 years of above (72 per cent). The fathers in the first three groups appeared at serious educational and financial disadvantage as compared with those where neither parent was a teenager. Within the teenage parent groups, White fathers had lower educational attainment than Black; one in four White fathers was married vs less than 5 per cent of Black. Although limited in scope, the data indicate that disadvantages associated with being a teenage father or the father of an infant born by a teenage mother are clear cut.

Adolescent↗
PubMed1987

The Johns Hopkins Adolescent Pregnancy Program: an evaluation.

The obstetric component of The Johns Hopkins Adolescent Pregnancy Program is described and the pregnancy outcome for adolescents delivering between 1976 and 1981 is compared with that of similar young women who were delivered in the same facilities, by the same staff, but who received their prenatal care in other Hopkins-related programs. The adolescent program is comprehensive, providing intensive psychosocial support and patient education in addition to medical care, using a team approach coordinated by an individual case management system. Enrollees had fewer pregnancy complications and lower perinatal mortality. Between 1979 and 1981, the frequency of birth weight below 2500 g was 9.9%, and below 1500 g, 1.9% for program adolescents, compared with 16.4 and 3.9%, respectively, for controls. Younger adolescents in the program entered prenatal care significantly later than older ones. However, those aged 14 years and below had infants with the highest average birth weight and no greater risk of perinatal death than those of older adolescents.

Adolescent↗
PubMed1986

Adolescent pregnancy-prevention program. A model for research and evaluation.

Despite the increased interest in the effects of adolescent pregnancy-prevention programs, most interventions lack the research design and data essential for evaluation. This article describes a model in which evaluative research was incorporated in program design. The derivation of the model, the selection of measurable parameters, characteristics of the population reflected in baseline and subsequent data, and problems in quantifying and interpreting appropriate variables are discussed. Clinic data and aggregate data from three self-administered surveys is used. The surveys were completed by students in the inner-city junior and senior high schools that cooperated in the education and clinical program. We demonstrate how these two types of data augment one another in assessing program effects. The study explores the evaluation and the timing of change in sexual knowledge, attitudes, and behavior (coital, contraceptive, and clinic) and thus may contribute to the design of measurable, replicable interventions.

Adolescent↗
PubMed1986

Substance use and its relation to sexual activity among inner-city adolescents.

A study of inner-city Black and Caucasian males and females in two junior and two senior high schools provided data on sexual knowledge, attitudes and behaviors, and substance use based on over 2500 anonymous, voluntary self-administered questionnaires. Substance use was high among Caucasians, particularly females. Females smoked more cigarettes than males and men drank more alcohol. Marijuana smoking showed only small racial, age, and gender differences. Compared to Blacks, Caucasians used more hard drugs. Using an index scoring types of substances and frequencies of use, sexually active students were higher than virgins in all subgroups, with those who initiated intercourse early appearing highest on the index. A regression model explaining 21% of the variance in substance use showed independent effects of age, race, gender, and sexual activity. The importance of an index for screening early use is discussed, and research on the relationship of low-level youthful experimentation with future dysfunctional use is proposed.

Adolescent↗
PubMed1984

Prevalence of six sexually transmitted disease agents among pregnant inner-city adolescents and pregnancy outcome.

115 pregnant girls aged 13-17 years were investigated during the third trimester for endocervical infection with six sexually transmissible microorganisms. Specimens from 21 patients destroyed the tissue cell monolayers for propagation of Chlamydia trachomatis, but 11 were no longer toxic when recultured after freezing or with additional antimicrobial agents; Trichomonas vaginalis was present in 76% of the toxic specimens. C trachomatis was recovered from 37% of 105 specimens. T vaginalis was recovered from 34% of the 115 subjects, candida from 38%, Mycoplasma hominis from 70%, and Ureaplasma urealyticum from 90%. Neisseria gonorrhoeae was cultured from 1 of 12 girls infected earlier in pregnancy. T vaginalis infection, alone or with C trachomatis or candida, was associated with low gestational age and low birthweight. C trachomatis and candida infections alone had no effect on pregnancy outcome.

Adolescent↗
PubMed1984

A school-, hospital- and university-based adolescent pregnancy prevention program. A cooperative design for service and research.

Based upon prior service and research findings, a program was designed to reduce the incidence of early childbearing among a high-risk, inner-city junior and senior high school population. Combining a strong research design with medical and educational service in a school- and clinic-based program, the project team sought to develop a replicable model the individual components of which could be evaluated against baseline data collected from 1,709 male and female students before the program began. This paper reports levels of sexual activity, contraceptive use and pregnancy in the student population, using data from anonymous, self-administered questionnaires, and outlines the program's objectives and major features. It also suggests variables that can be used in the measurement of program impact.

Adolescent↗
PubMed1981

Preliminary analysis of developmental observations in a survey of morbidity in infants.

Assessment of developmental status, particularly the identification of severe developmental disability, is an important outcome measure of the effect of many types of perinatal and early infant health programs. This report examines the feasibility of the use of a brief battery of developmental observations by a trained lay interviewer in the home as part of a large-scale survey of morbidity in one-year-old infants. A total of 4989 home visits was completed, and of these 3179 were to infants of low birthweight. The interviewers obtained a high degree of cooperation from the infants in this setting. Internal consistency, as measured by coefficient alpha and item-total score correlations, and inter-rater agreement for each observation on a small random sample (137) of revisits indicated reliability sufficient for research purposes for all except receptive language items. Good agreement was found between diagnostic and health are variables obtained through the interview with the mother and a developmental status classification based on the observations. While preliminary, these results are of importance in the design of infant follow-up programs.

Child Behavior↗