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Biomedical subjects

N E Adler

Publications and source records attributed to N E Adler.

At least 37 records · Page 2Linked to original sources
PubMed1996

Adolescents and the contraceptive pill: the impact of beliefs on intentions and use.

OBJECTIVES: To determine which beliefs about the contraceptive pill predict adolescent females' intentions to use the pill and their actual pill use, and to examine how intentions toward other birth control methods influence adolescents' intentions to use the pill and their eventual pill use. METHODS: Three hundred forty-five adolescents were interviewed about their beliefs regarding the consequences of using the pill and about their intentions to use the pill and other contraceptive methods. Follow-up interviews were conducted 1 year later, during which subjects reported their sexual activity and oral contraceptive use over the course of the year. RESULTS: Concerns about health and physical appearance differentiated subjects who intended to use the pill from those who did not, those who reported actually using the pill at all from those who did not, and those who did or did not use the pill consistently. The impact of beliefs differed between sexually active subjects and those who first had sex after the initial interview. Intentions to use withdrawal were negatively related to subjects' use of the pill (beta = -0.19, P < .05), although intentions to use condoms were unrelated to pill use. Intentions toward abortion were unrelated to either intentions to use the pill or eventual pill use. CONCLUSIONS: Female adolescents' beliefs about the contraceptive pill predicted their initial intentions to use the pill and their actual pill use over the course of a year. Adolescents may view withdrawal-although apparently not condoms-as an alternative to pill use. Abortion appears to be a backup to pill use rather than a substitute.

Abortion, Induced↗
PubMed1994

Socioeconomic status and health. The challenge of the gradient.

Socioeconomic status (SES) is consistently associated with health outcomes, yet little is known about the psychosocial and behavioral mechanisms that might explain this association. Researchers usually control for SES rather than examine it. When it is studied, only effects of lower, poverty-level SES are generally examined. However, there is evidence of a graded association with health at all levels of SES, an observation that requires new thought about domains through which SES may exert its health effects. Variables are highlighted that show a graded relationship with both SES and health to provide examples of possible pathways between SES and health end points. Examples are also given of new analytic approaches that can better illuminate the complexities of the SES-health gradient.

Health Behavior↗
PubMed1994

Initiation of substance use in early adolescence: the roles of pubertal timing and emotional distress.

Two hypotheses regarding the effects of pubertal timing on substance use were tested in a prospective study of 221 young adolescents. A maturational-deviance hypothesis predicted that early-maturing girls and late-maturing boys would experience heightened emotional distress, which in turn would influence initiation and use of substances. Alternatively, an early-maturation hypothesis predicted that early-maturing girls would engage in more substance use than all other groups, independent of emotional distress. Early-maturing adolescents reported more substance use within 1 year. Adolescents experiencing elevated levels of negative affect also reported greater substance use within the next year. However, pubertal timing was not related to emotional distress. Results support the early-maturation hypothesis for girls and suggest its extension to boys.

Adolescent↗
PubMed1994

Perceived competencies, peer group affiliation, and risk behavior among early adolescents.

This study examined the role of self-esteem and peer group membership in risk behavior among 183 8th graders in a multiethnic school. The hypothesis was that domain-specific rather than global self-esteem would be associated with "crowd" membership that in turn would be related to risk behavior. Data were gathered through informant interviews and individual surveys. Domain-specific self-esteem was related to crowd affiliation as well as to alcohol and cigarette use; global self-esteem was not related. Crowd affiliation related to alcohol use and sexual behavior after controlling for the effects of demographic and self-esteem variables, but crowd membership did not fully mediate the relationship between self-esteem and risk behavior. Availability of alcohol and cigarettes mediated the relationship between crowd affiliation and use of these substances. Findings support growing evidence that multiple adolescent peer groups exist and that group membership is closely tied to behavior.

Adolescent↗
PubMed1994

Risk factors for delayed immunization among children in an HMO.

OBJECTIVES: Improving the timely delivery of childhood immunizations has become a national imperative. This study aimed to identify nonfinancial predictors of delayed immunization among patients with good financial access to preventive care. METHODS: This prospective cohort study used telephone interviews and a computerized immunization tracking system to evaluate 13-month-old children (n = 530) in a regional group-model health maintenance organization. RESULTS: More than one third of parents interviewed did not know when the next immunization was due. Thirteen percent were late for the measles-mumps-rubella immunization, recommended at 15 months of age, by 90 days or more. Independent predictors of delayed immunization included having a larger number of children (odds ratio [OR] = 1.4, P < .01), not having a regular doctor (OR = 2.9, P < .05), not knowing when the shot was due (OR = 2.0, P < .01), and not worrying about the risks of shots (OR = 1.4, P < .05). CONCLUSIONS: Financial access alone does not guarantee timely childhood immunization. In managed care settings, which may cover increasing numbers of children under health care reform, interventions are needed to better inform parents of when immunizations are due.

California↗
PubMed1992

Psychological factors in abortion. A review.

Psychological research is increasingly involved in debates regarding abortion. While recognizing the diversity of ethical and moral issues intertwined with abortion, the American Psychological Association (APA) has focused its involvement on psychological factors, most recently by appointing an expert panel to review the literature on psychological effects. This article notes the history of APA involvement and reports on the panel's conclusions. It presents evidence that abortion is not likely to be followed by severe psychological responses and that psychological aspects can best be understood within a framework of normal stress and coping rather than a model of psychopathology. Correlates of more negative responses following abortion are also discussed.

Abortion, Induced↗
PubMed1992

Health-risk behaviors and health concerns among young adolescents.

This study examined the health concerns and behaviors of 563 adolescents (aged 11 through 14) from a variety of social, racial, and ethnic backgrounds. Behaviors associated with adolescent morbidity and mortality were examined, including sexual behavior, substance use, and injury-related behaviors. Although young adolescents are often viewed as unlikely participants in these risk behaviors, the results of this study suggest that greater attention should be paid to this younger group and their health-risk behaviors. A majority of the sample had tried alcohol and tobacco, and almost a third had used marijuana. Twenty-one percent were sexually active. Prevalence rates varied by social class, race-ethnicity, gender, and age. More than 75% of the sample had visited a physician during the prior year, suggesting an important role physicians may serve as sources of information and positive role models for these young adolescents. The results suggest that we stop viewing young adolescents as naive children and begin to view them as observers of and participants in a changing social environment that has important implications for their current and future health status. Without a realistic appraisal of the young adolescent, we can expect to have little overall effect on the status of adolescent health in the United States.

Adolescent↗
PubMed1990

Psychological responses after abortion.

A review of methodologically sound studies of the psychological responses of U.S. women after they obtained legal, nonrestrictive abortions indicates that distress is generally greatest before the abortion and that the incidence of severe negative responses is low. Factors associated with increased risk of negative response are consistent with those reported in research on other stressful life events.

Abortion, Induced↗
PubMed1990

Adolescent contraceptive behavior: an assessment of decision processes.

The utility of a rational model of contraceptive use in adolescents was evaluated in a cohort of 325 sexually active adolescents aged 14 to 19 years. Adolescents were interviewed regarding their beliefs about the consequences of using each of four methods of contraception, evaluation of those consequences, perception of the wishes of others regarding use of each method, motivation to comply with those wishes, general attitude toward using the method, view of general social expectations regarding their use of the method, and their intention to use the method during the next year. They were reinterviewed 1 year later to determine actual use. The results support the utility of this model for understanding adolescent behavior. Significant associations were found between intentions to use contraceptive methods and their actual use. Intentions were significantly related to adolescents' attitudes toward using the methods and their perception of social expectations regarding use. General attitudes were significantly related to a summary score reflecting the adolescents' beliefs about specific consequences of use weighted by their evaluations of them. General social perceptions were significantly related to a summary score of perceived desires of specific individuals multiplied by the adolescent's desire to comply with those desires. These findings indicate that physicians can be more effective in clinical practice by querying adolescents about their beliefs and intentions and about their perceptions of significant individuals in their lives.

Adolescent↗
PubMed1990

The utility of multiple strategies for understanding complex behaviors.

Nickerson's critique of our brief report on changes in knowledge, attitudes and use of condoms among adolescents over a year's time mistakenly interprets the paper as examining an attitude/behavior discrepancy. A number of her criticisms follow from this mistaken interpretation. We agree with some of her general points but identify several errors in her analysis and note areas of disagreement about strategies for studying complex behaviors.

Adolescent↗
PubMed1989

Adolescents and condoms. Associations of beliefs with intentions to use.

Sexually active adolescents should use condoms to prevent the transmission of sexually transmitted diseases, including human immunodeficiency virus. This study examined, among male and female adolescents, which beliefs about condoms are associated with intentions to use them if they have coitus in the next year. Teenagers attending adolescent health clinics completed self-administered surveys. Although most adolescents knew that condoms prevent sexually transmitted diseases, an increasing belief in the preventive effects of condoms was not associated with an increased motivation to use them. Instead, other immediate, short-term consequences, such as the ease with which they can be used and discomfort associated with their use, were most strongly associated with adolescents' intentions to use condoms. To encourage condom use, messages from physicians and other health care professionals must focus on adolescents' beliefs that are most likely to encourage or inhibit use of condoms. Health considerations should not be the sole emphasis of such communications if the goal is to increase the use of condoms among sexually active adolescents.

Adolescent↗
PubMed1988

A comparison of two measures of egocentrism.

This study examined the relationship between two prominent measures of egocentrism, Enright's Adolescent Egocentrism Scale (AES) and Elkind's Imaginary Audience Scale (IAS), in a sample of 458 adolescents, between 10 and 15 years old. Both correlational and factor analyses indicated that the two measures assess distinctly different phenomena. As predicted, IAS scores were correlated with self-reported levels of shyness, nervousness, and social skills. These results provide partial evidence for the validity of the IAS as a measure of self-consciousness, though not necessarily egocentrism per se. The validity of the AES was not examined.

Adolescent↗
PubMed1988

Sexually active adolescents and condoms: changes over one year in knowledge, attitudes and use.

Over a year when public health information regarding AIDS intensified, changes in perceptions and use of condoms in a sample of sexually active adolescents in San Francisco were examined. Although perceptions that condoms prevent sexually transmitted diseases (STDs) and the value and importance placed on avoiding STDs remained high, these were neither reflected in increased intentions to use condoms nor in increased use.

Adolescent↗
PubMed1985

A comparison of nurses' attitudes toward hospitalized adolescents and adults.

To examine possible health-care provider stereotypes of adolescent patients and the potential consequences for their management, this study compares nurses' responses to the same noncompliant behavior when evidenced by an adolescent or adult patient. Nurses (n = 136) read a description of a difficult adolescent or adult patient and indicated their probable responses to him. They also rated the patient with regard to difficulty of management, as well as several descriptive adjectives, and speculated on the cause of his behavior. No significant differences were found in nurses' preferred management alternatives or ratings for the adolescent or adult patient. However, nurses were significantly more likely to attribute the behavior of the adolescent patient to his developmental level (p less than 0.001). These findings suggest that health-care providers are aware of the hospitalized adolescents' problems, rather than supporting the existence of providers' stereotypes of or different management approach to, difficult adolescent patients.

Adolescent↗
PubMed1984

Sources of anxiety about pelvic examinations among adolescent females.

Sources of anxiety about pelvic examinations were examined in 84 female adolescents seen in an adolescent clinic. The most common concerns about the examination were: fear of the discovery of pathology; fear of pain; and embarrassment about undressing and about personal cleanliness. Adolescent concerns were highly associated with their level of anxiety prior to, during, and following the examination. The concern most highly associated with anxiety was fear of pain. Fear that the pelvic examination might be painful may be the most important concern to alleviate in the adolescent patient. The most frequent source of information about the pelvic examination was peers, and the most common specific message from peers was that the examination was painful. Provider messages were more diffuse and rarely mentioned the physical sensations associated with the procedure, which may have less impact on the adolescent than the specific warnings of peers.

Adolescent↗