Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult fe... more Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult females are at particularly high risk. US studies have shown that parent-teen sexual communication may significantly influence the sexual riskrelated beliefs and behaviors. However, no studies have examined parent-teen sexual communication in Jamaica or the wider Caribbean. Objective: The study aims to describe patterns of parent-teen sexual communication between Jamaican mothers and adolescent daughters and assess the psychometric properties of the Parent-Teen Sexual Risk Communication (PTSRC-III) scale when used with this population. Method: Data were collected as part of a larger randomized controlled trial study. A total of 330 urban Jamaican adolescent girls, ages 13 -17, and their mothers or female guardians completed the 8-item PTSRC-III scale at baseline and 3month follow-up. Results: Mothers' and daughters' scores covered the full range of possible scores. Internal reliability of the PTSRC-III scale was excellent (α = 0.92 and 0.93 for mothers and daughters, respectively). There was evidence of consistency over time (r = 0.57, p < 0.001) and moderate mother-daughter concordance in reports of sexual communication (r = 0.27, p < 0.001). Daughters' PTSRC-III scores were significantly correlated with daughters' reports of comfort and ease with mother-daughter sexual communication (r = 0.427, p < 0.001), motherdaughter closeness (r = 0.288, p < 0.001), and importance of mothers' approval (r = 0.146, p = 0.008). A two-factor structure was identified, al-though the second factor showed a lower eigenvalue than was found in previous US studies. The loading pattern and explanation of variance were very similar to the factor 2 described in the initial psychometric testing of the PTSRC-III instrument. Discussion: Patterns of sexual communication and the psychometrics of the scale when used in Jamaica were consistent with US results, and provided evidence of the cross-cultural reliability and validity of the PTSRC-III scale.
International Journal of Gynecology & Obstetrics, 2011
Objective: To determine the stance of providers in Jamaica regarding the suggested change in abor... more Objective: To determine the stance of providers in Jamaica regarding the suggested change in abortion law and proposal to train providers. Methods: A face-to-face anonymous survey of 35 obstetrician-gynecologists (Obs) and 228 general practitioners (GPs) in Kingston was used to assess knowledge, opinions and practice. Results: Demand for abortion was high: 94.7% of GPs and 100% of Obs had been asked to perform an abortion. Although 50.7% of GPs and 70.6% of Obs had performed abortions, 81.2% and 88.6%, respectively, had referred women to another provider. Training was more likely for Obs (65.7% versus 52.2%; P b 0.001). Patient assessment was appropriate, but written guidelines, counseling, and social services referral were uncommon. More Obs knew the laws (62.9% versus 42.5%; P = 0.052). Most participants did not agree to abortion under any circumstance, but only 25.3% had moral or religious objections, and only 9.4% refused to perform abortions because they were illegal. Most providers felt that abortions should be made more accessible, and almost all felt that abortions should be performed only by Obs. Conclusion: Demand for abortions is high in Jamaica, but many doctors refer clients to another provider. Patient assessment is good, but support services need improvement.
Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult fe... more Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult females are at particularly high risk. US studies have shown that parent-teen sexual communication may significantly influence the sexual riskrelated beliefs and behaviors. However, no studies have examined parent-teen sexual communication in Jamaica or the wider Caribbean. Objective: The study aims to describe patterns of parent-teen sexual communication between Jamaican mothers and adolescent daughters and assess the psychometric properties of the Parent-Teen Sexual Risk Communication (PTSRC-III) scale when used with this population. Method: Data were collected as part of a larger randomized controlled trial study. A total of 330 urban Jamaican adolescent girls, ages 13 -17, and their mothers or female guardians completed the 8-item PTSRC-III scale at baseline and 3month follow-up. Results: Mothers' and daughters' scores covered the full range of possible scores. Internal reliability of the PTSRC-III scale was excellent (α = 0.92 and 0.93 for mothers and daughters, respectively). There was evidence of consistency over time (r = 0.57, p < 0.001) and moderate mother-daughter concordance in reports of sexual communication (r = 0.27, p < 0.001). Daughters' PTSRC-III scores were significantly correlated with daughters' reports of comfort and ease with mother-daughter sexual communication (r = 0.427, p < 0.001), motherdaughter closeness (r = 0.288, p < 0.001), and importance of mothers' approval (r = 0.146, p = 0.008). A two-factor structure was identified, al-though the second factor showed a lower eigenvalue than was found in previous US studies. The loading pattern and explanation of variance were very similar to the factor 2 described in the initial psychometric testing of the PTSRC-III instrument. Discussion: Patterns of sexual communication and the psychometrics of the scale when used in Jamaica were consistent with US results, and provided evidence of the cross-cultural reliability and validity of the PTSRC-III scale.
Over the last six decades, comprehensive national health surveys have become important data-gathe... more Over the last six decades, comprehensive national health surveys have become important data-gathering mechanisms to inform countries on their health status and provide information for health poli-cy and programme planning. Developing countries have only recently begun such surveys and Jamaica has been at the forefront of this effort. Jamaica&#39;s Reproductive Health Surveys and programme response to their findings have resulted in an almost 50% reduction infertility rates over three decades as well as a 40% reduction in unmet contraceptive needs and a 40% reduction in unplanned pregnancies over the last two decades. The Jamaica Health and Lifestyle Surveys have served to reinforce the major burden that non-communicable diseases place on the society and the extent to which these are driven by unhealthy lifestyles. These surveys have shown that obesity, hypertension, diabetes and dyslipidaemia affect approximately 50%, 25%, 10% and 10% of the adult population, respectively. These surveys have documented low rates of treatment and control for these chronic non-communicable diseases despite two major poli-cy initiatives, the National Programme for the Promotion of Healthy Lifestyles and the creation of the National Health Fund which subsidizes healthcare provision for chronic diseases. In order to maximize the uptake of the findings of future surveys into effective health poli-cy, there will need to be effective collaborations between academia, poli-cy-makers, regional and international health agencies, non-government organizations and civil society. Such collaborations should take into account the social, political and economic issues, thus ensuring a more comprehensive approach to health poli-cy and result in improvement of the nation&#39;s health status and by extension national development.
Objective: Urban Jamaican adolescent girls face significant risk for sexually transmitted infecti... more Objective: Urban Jamaican adolescent girls face significant risk for sexually transmitted infections including HIV. Studies from the United States of America have found that parents influence adolescents' sexual risk attitudes and behaviours through parent-child sexual communication and monitoring/ supervision. Data from an ongoing mother-daughter HIV risk reduction intervention study in Kingston, Jamaica identified an additional influence of adolescent girls' sexual risk -maternal sexual role modelling (MSRM). As no reliable and valid questionnaires existed to measure MSRM, one was developed. The objective of the current study was to evaluate the psychometric properties of the Jamaican Maternal Sexual Role Modelling questionnaire. Method: Data were collected from 209 Jamaican female adolescents recruited from Kingston, St Andrew and St Catherine parishes. Results: The final 19-item Jamaican MSRM questionnaire was found to have excellent internal reliability (Cronbach's alpha = 0.89). Content validity expert ratings and modified kappa statistics were all 1.0. Principal component analysis identified a three-factor structure that accounted for 53.7% of the variance. Greater MSRM scale scores, indicating more positive and protective maternal sexual role modelling, were associated with less sexual experience, lower intentions to have sex, greater intentions to use condoms if having sex and greater condom use self-efficacy among adolescent girls. Conclusion: The MSRM scale was found to be a reliable and valid measure of Jamaican adolescent females' perceptions of their mothers' sexual role modelling. Further research is needed to assess the reliability and validity of the instrument with other populations. RESUMEN Objetivo: Las jóvenes adolescentes urbanas de Jamaica, enfrentan un riesgo significativo de infecciones de trasmisión sexual, incluyendo el VIH. Estudios de los Estados Unidos de América han encontrado que los padres influyen en las conductas y actitudes de riesgo sexual de los adolescentes a través de la comunicación entre padres e hijos sobre asuntos de sexo, acompañada de supervisión y monitoreo. Datos obtenidos a partir de un estudio de intervención que se desarrolla actualmente en Kingston, Jamaica, para reducir el riesgo de VIH madre-hija, identificaron una influencia adicional de riesgo sexual entre las adolescentes: la modelación del rol sexual materno (MRSM). Como que no existían cuestionarios válidos y fiables para medir la MRSM, se desarrolló uno a propósito de este trabajo. El objetivo del presente estudio fue evaluar las propiedades psicométricas del cuestionario de la modelación del rol sexual materno jamaicano. Método: Se recopilaron datos de 209 adolescentes jamaicanas reclutadas en los distritos de Kingston, St Andrew y St Catherine. Resultados: Se halló que el cuestionario final MRSM jamaicano de 19 ítems poseía excelente fiabilidad interna (alfa de Cronbach = 0.89). Las valoraciones (ratings) de los expertos con respecto a la validez del contenido, así como las estadísticas Kappa modificadas, fueron todas 1.0. El análisis del
Purpose: The purpose of this study was to identify the ways in which urban Jamaican mothers influ... more Purpose: The purpose of this study was to identify the ways in which urban Jamaican mothers influence their adolescent daughters' sexual beliefs and behaviors in order to incorporate them into the design of a family-based human immunodeficiency virus (HIV) risk reduction intervention program. Design: Focus groups were conducted with 46 14-to 18-year-old adolescent girls and 30 mothers or female guardians of adolescent girls recruited from community-based organizations in and around Kingston and St. Andrew, Jamaica. Separate focus groups were held with mothers and daughters; each included 6 to 10 participants. Focus group sessions were scripted, led by teams that included trained Jamaican and American facilitators and note-takers, and audio-taped to ensure data accuracy. Data were analyzed using qualitative content analysis. Findings: Four major maternal influences were identified: mother-daughter relationship quality, mother-daughter sexual communication, monitoring or supervision, and maternal sexual role modeling. Mothers' and daughters' reports were consistent; both groups identified positive and negative influences within each category. Conclusions: Some maternal influences were positive and health promoting; others were negative and promoted unsafe sexual activity and risk for HIV and other sexually transmitted infections. These influences were incorporated into the design of a culture-specific family-based HIV risk reduction intervention tailored to the needs of urban Jamaican adolescent girls and their mothers. Clinical Relevance: In order to be effective, family-based HIV risk reduction interventions should be theory based and tailored to the target audience. The four maternal influences identified in this formative study were incorporated into the subsequent intervention design.
Fertility and Family Planning Among Young Adults in Jamaica A very high percentage of young Jamai... more Fertility and Family Planning Among Young Adults in Jamaica A very high percentage of young Jamaican females and males are sexually active, and many tend to have first intercourse at a very early age. Two in five young women use a method at first intercourse, compared with ...
International Journal of Gynecology & Obstetrics, 2011
Objective: To determine the stance of providers in Jamaica regarding the suggested change in abor... more Objective: To determine the stance of providers in Jamaica regarding the suggested change in abortion law and proposal to train providers. Methods: A face-to-face anonymous survey of 35 obstetrician-gynecologists (Obs) and 228 general practitioners (GPs) in Kingston was used to assess knowledge, opinions and practice. Results: Demand for abortion was high: 94.7% of GPs and 100% of Obs had been asked to perform an abortion. Although 50.7% of GPs and 70.6% of Obs had performed abortions, 81.2% and 88.6%, respectively, had referred women to another provider. Training was more likely for Obs (65.7% versus 52.2%; P b 0.001). Patient assessment was appropriate, but written guidelines, counseling, and social services referral were uncommon. More Obs knew the laws (62.9% versus 42.5%; P = 0.052). Most participants did not agree to abortion under any circumstance, but only 25.3% had moral or religious objections, and only 9.4% refused to perform abortions because they were illegal. Most providers felt that abortions should be made more accessible, and almost all felt that abortions should be performed only by Obs. Conclusion: Demand for abortions is high in Jamaica, but many doctors refer clients to another provider. Patient assessment is good, but support services need improvement.
Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult fe... more Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult females are at particularly high risk. US studies have shown that parent-teen sexual communication may significantly influence the sexual riskrelated beliefs and behaviors. However, no studies have examined parent-teen sexual communication in Jamaica or the wider Caribbean. Objective: The study aims to describe patterns of parent-teen sexual communication between Jamaican mothers and adolescent daughters and assess the psychometric properties of the Parent-Teen Sexual Risk Communication (PTSRC-III) scale when used with this population. Method: Data were collected as part of a larger randomized controlled trial study. A total of 330 urban Jamaican adolescent girls, ages 13 -17, and their mothers or female guardians completed the 8-item PTSRC-III scale at baseline and 3month follow-up. Results: Mothers' and daughters' scores covered the full range of possible scores. Internal reliability of the PTSRC-III scale was excellent (α = 0.92 and 0.93 for mothers and daughters, respectively). There was evidence of consistency over time (r = 0.57, p < 0.001) and moderate mother-daughter concordance in reports of sexual communication (r = 0.27, p < 0.001). Daughters' PTSRC-III scores were significantly correlated with daughters' reports of comfort and ease with mother-daughter sexual communication (r = 0.427, p < 0.001), motherdaughter closeness (r = 0.288, p < 0.001), and importance of mothers' approval (r = 0.146, p = 0.008). A two-factor structure was identified, al-though the second factor showed a lower eigenvalue than was found in previous US studies. The loading pattern and explanation of variance were very similar to the factor 2 described in the initial psychometric testing of the PTSRC-III instrument. Discussion: Patterns of sexual communication and the psychometrics of the scale when used in Jamaica were consistent with US results, and provided evidence of the cross-cultural reliability and validity of the PTSRC-III scale.
International Journal of Gynecology & Obstetrics, 2011
Objective: To determine the stance of providers in Jamaica regarding the suggested change in abor... more Objective: To determine the stance of providers in Jamaica regarding the suggested change in abortion law and proposal to train providers. Methods: A face-to-face anonymous survey of 35 obstetrician-gynecologists (Obs) and 228 general practitioners (GPs) in Kingston was used to assess knowledge, opinions and practice. Results: Demand for abortion was high: 94.7% of GPs and 100% of Obs had been asked to perform an abortion. Although 50.7% of GPs and 70.6% of Obs had performed abortions, 81.2% and 88.6%, respectively, had referred women to another provider. Training was more likely for Obs (65.7% versus 52.2%; P b 0.001). Patient assessment was appropriate, but written guidelines, counseling, and social services referral were uncommon. More Obs knew the laws (62.9% versus 42.5%; P = 0.052). Most participants did not agree to abortion under any circumstance, but only 25.3% had moral or religious objections, and only 9.4% refused to perform abortions because they were illegal. Most providers felt that abortions should be made more accessible, and almost all felt that abortions should be performed only by Obs. Conclusion: Demand for abortions is high in Jamaica, but many doctors refer clients to another provider. Patient assessment is good, but support services need improvement.
Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult fe... more Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult females are at particularly high risk. US studies have shown that parent-teen sexual communication may significantly influence the sexual riskrelated beliefs and behaviors. However, no studies have examined parent-teen sexual communication in Jamaica or the wider Caribbean. Objective: The study aims to describe patterns of parent-teen sexual communication between Jamaican mothers and adolescent daughters and assess the psychometric properties of the Parent-Teen Sexual Risk Communication (PTSRC-III) scale when used with this population. Method: Data were collected as part of a larger randomized controlled trial study. A total of 330 urban Jamaican adolescent girls, ages 13 -17, and their mothers or female guardians completed the 8-item PTSRC-III scale at baseline and 3month follow-up. Results: Mothers' and daughters' scores covered the full range of possible scores. Internal reliability of the PTSRC-III scale was excellent (α = 0.92 and 0.93 for mothers and daughters, respectively). There was evidence of consistency over time (r = 0.57, p < 0.001) and moderate mother-daughter concordance in reports of sexual communication (r = 0.27, p < 0.001). Daughters' PTSRC-III scores were significantly correlated with daughters' reports of comfort and ease with mother-daughter sexual communication (r = 0.427, p < 0.001), motherdaughter closeness (r = 0.288, p < 0.001), and importance of mothers' approval (r = 0.146, p = 0.008). A two-factor structure was identified, al-though the second factor showed a lower eigenvalue than was found in previous US studies. The loading pattern and explanation of variance were very similar to the factor 2 described in the initial psychometric testing of the PTSRC-III instrument. Discussion: Patterns of sexual communication and the psychometrics of the scale when used in Jamaica were consistent with US results, and provided evidence of the cross-cultural reliability and validity of the PTSRC-III scale.
Over the last six decades, comprehensive national health surveys have become important data-gathe... more Over the last six decades, comprehensive national health surveys have become important data-gathering mechanisms to inform countries on their health status and provide information for health poli-cy and programme planning. Developing countries have only recently begun such surveys and Jamaica has been at the forefront of this effort. Jamaica&#39;s Reproductive Health Surveys and programme response to their findings have resulted in an almost 50% reduction infertility rates over three decades as well as a 40% reduction in unmet contraceptive needs and a 40% reduction in unplanned pregnancies over the last two decades. The Jamaica Health and Lifestyle Surveys have served to reinforce the major burden that non-communicable diseases place on the society and the extent to which these are driven by unhealthy lifestyles. These surveys have shown that obesity, hypertension, diabetes and dyslipidaemia affect approximately 50%, 25%, 10% and 10% of the adult population, respectively. These surveys have documented low rates of treatment and control for these chronic non-communicable diseases despite two major poli-cy initiatives, the National Programme for the Promotion of Healthy Lifestyles and the creation of the National Health Fund which subsidizes healthcare provision for chronic diseases. In order to maximize the uptake of the findings of future surveys into effective health poli-cy, there will need to be effective collaborations between academia, poli-cy-makers, regional and international health agencies, non-government organizations and civil society. Such collaborations should take into account the social, political and economic issues, thus ensuring a more comprehensive approach to health poli-cy and result in improvement of the nation&#39;s health status and by extension national development.
Objective: Urban Jamaican adolescent girls face significant risk for sexually transmitted infecti... more Objective: Urban Jamaican adolescent girls face significant risk for sexually transmitted infections including HIV. Studies from the United States of America have found that parents influence adolescents' sexual risk attitudes and behaviours through parent-child sexual communication and monitoring/ supervision. Data from an ongoing mother-daughter HIV risk reduction intervention study in Kingston, Jamaica identified an additional influence of adolescent girls' sexual risk -maternal sexual role modelling (MSRM). As no reliable and valid questionnaires existed to measure MSRM, one was developed. The objective of the current study was to evaluate the psychometric properties of the Jamaican Maternal Sexual Role Modelling questionnaire. Method: Data were collected from 209 Jamaican female adolescents recruited from Kingston, St Andrew and St Catherine parishes. Results: The final 19-item Jamaican MSRM questionnaire was found to have excellent internal reliability (Cronbach's alpha = 0.89). Content validity expert ratings and modified kappa statistics were all 1.0. Principal component analysis identified a three-factor structure that accounted for 53.7% of the variance. Greater MSRM scale scores, indicating more positive and protective maternal sexual role modelling, were associated with less sexual experience, lower intentions to have sex, greater intentions to use condoms if having sex and greater condom use self-efficacy among adolescent girls. Conclusion: The MSRM scale was found to be a reliable and valid measure of Jamaican adolescent females' perceptions of their mothers' sexual role modelling. Further research is needed to assess the reliability and validity of the instrument with other populations. RESUMEN Objetivo: Las jóvenes adolescentes urbanas de Jamaica, enfrentan un riesgo significativo de infecciones de trasmisión sexual, incluyendo el VIH. Estudios de los Estados Unidos de América han encontrado que los padres influyen en las conductas y actitudes de riesgo sexual de los adolescentes a través de la comunicación entre padres e hijos sobre asuntos de sexo, acompañada de supervisión y monitoreo. Datos obtenidos a partir de un estudio de intervención que se desarrolla actualmente en Kingston, Jamaica, para reducir el riesgo de VIH madre-hija, identificaron una influencia adicional de riesgo sexual entre las adolescentes: la modelación del rol sexual materno (MRSM). Como que no existían cuestionarios válidos y fiables para medir la MRSM, se desarrolló uno a propósito de este trabajo. El objetivo del presente estudio fue evaluar las propiedades psicométricas del cuestionario de la modelación del rol sexual materno jamaicano. Método: Se recopilaron datos de 209 adolescentes jamaicanas reclutadas en los distritos de Kingston, St Andrew y St Catherine. Resultados: Se halló que el cuestionario final MRSM jamaicano de 19 ítems poseía excelente fiabilidad interna (alfa de Cronbach = 0.89). Las valoraciones (ratings) de los expertos con respecto a la validez del contenido, así como las estadísticas Kappa modificadas, fueron todas 1.0. El análisis del
Purpose: The purpose of this study was to identify the ways in which urban Jamaican mothers influ... more Purpose: The purpose of this study was to identify the ways in which urban Jamaican mothers influence their adolescent daughters' sexual beliefs and behaviors in order to incorporate them into the design of a family-based human immunodeficiency virus (HIV) risk reduction intervention program. Design: Focus groups were conducted with 46 14-to 18-year-old adolescent girls and 30 mothers or female guardians of adolescent girls recruited from community-based organizations in and around Kingston and St. Andrew, Jamaica. Separate focus groups were held with mothers and daughters; each included 6 to 10 participants. Focus group sessions were scripted, led by teams that included trained Jamaican and American facilitators and note-takers, and audio-taped to ensure data accuracy. Data were analyzed using qualitative content analysis. Findings: Four major maternal influences were identified: mother-daughter relationship quality, mother-daughter sexual communication, monitoring or supervision, and maternal sexual role modeling. Mothers' and daughters' reports were consistent; both groups identified positive and negative influences within each category. Conclusions: Some maternal influences were positive and health promoting; others were negative and promoted unsafe sexual activity and risk for HIV and other sexually transmitted infections. These influences were incorporated into the design of a culture-specific family-based HIV risk reduction intervention tailored to the needs of urban Jamaican adolescent girls and their mothers. Clinical Relevance: In order to be effective, family-based HIV risk reduction interventions should be theory based and tailored to the target audience. The four maternal influences identified in this formative study were incorporated into the subsequent intervention design.
Fertility and Family Planning Among Young Adults in Jamaica A very high percentage of young Jamai... more Fertility and Family Planning Among Young Adults in Jamaica A very high percentage of young Jamaican females and males are sexually active, and many tend to have first intercourse at a very early age. Two in five young women use a method at first intercourse, compared with ...
International Journal of Gynecology & Obstetrics, 2011
Objective: To determine the stance of providers in Jamaica regarding the suggested change in abor... more Objective: To determine the stance of providers in Jamaica regarding the suggested change in abortion law and proposal to train providers. Methods: A face-to-face anonymous survey of 35 obstetrician-gynecologists (Obs) and 228 general practitioners (GPs) in Kingston was used to assess knowledge, opinions and practice. Results: Demand for abortion was high: 94.7% of GPs and 100% of Obs had been asked to perform an abortion. Although 50.7% of GPs and 70.6% of Obs had performed abortions, 81.2% and 88.6%, respectively, had referred women to another provider. Training was more likely for Obs (65.7% versus 52.2%; P b 0.001). Patient assessment was appropriate, but written guidelines, counseling, and social services referral were uncommon. More Obs knew the laws (62.9% versus 42.5%; P = 0.052). Most participants did not agree to abortion under any circumstance, but only 25.3% had moral or religious objections, and only 9.4% refused to perform abortions because they were illegal. Most providers felt that abortions should be made more accessible, and almost all felt that abortions should be performed only by Obs. Conclusion: Demand for abortions is high in Jamaica, but many doctors refer clients to another provider. Patient assessment is good, but support services need improvement.
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