Women's health (Hillsdale, N.J.)最新文献

We examined the effects of intimate violence on the physical and psychological health of women over time. Changes in levels of physical and psychological abuse, injuries, physical health symptoms, anxiety, and depression were assessed three times: immediately after exit from a domestic violence program and at 81/2- and 141/2-month follow-ups. Analyses showed a significant decline in abuse, physical health symptoms, anxiety, and depression over time. Longitudinal structural equation modeling demonstrated that ongoing abuse was significantly related to increased physical and psychological health problems from one time period to the next, even when prior levels of physical and psychological health were controlled. Within each time interval, the effects of abuse on physical symptoms appeared to be mediated through anxiety and depression; although this relationship was replicated at several time points, the mediation was not verified across time, probably because measurement intervals were too long to reflect the underlying causal sequence. Although injuries were the direct result of abuse, injuries showed no significant effect on physical symptoms, anxiety, or depression. Implications for intervention and future research are discussed.

A home-based telephone and mail intervention was evaluated for its effectiveness in promoting walking in a sample of sedentary, ethnic minority women. One hundred twenty-five women (ages 23-54) were randomly assigned to behavioral or brief educational interventions. Women in the 8-week behavioral condition received behavior change materials through the mail and 6 structured telephone counseling sessions. Educational condition participants received a single 5-min telephone call and educational information. Both groups reported significantly increased walking at a 2-month posttest (M change = 86 and 81 min per week for behavioral and educational groups, respectively) and 5-month follow-up (M change = 40 and 52 min per week). A 30-month follow-up of 50 participants indicated both groups continued to report more walking than at baseline. The behavioral intervention was not superior to the educational condition at any assessment point. The findings may be explained as (a) both interventions were equally effective, so extensive telephone counseling is unnecessary; (b) changes over time reflected secular trends; or (c) increases in self-reported walking may be due to socially desirable reporting. Other strategies need to be evaluated for promoting walking that are tailored to the needs of ethnic minority women.

The controversy concerning the efficacy of mammography screening for reducing breast cancer mortality among women aged 40 to 49 has continued throughout much of this decade. We examined the impact of this controversy on a community sample of women aged 40 to 60 in 2 data collections (n = 146 and n = 51, respectively), each time following a critical point in the controversy. At initial data collection, only 19% of women identified the specific nature of the debate. Women reported that physicians did not recommend waiting to age 50 to be screened. The women supported screening in the 40s. Those in their 40s intended to continue screening. At 2nd data collection, women showed awareness of inaccuracies in mammography screening, but intended to continue screening nonetheless. These results suggest that health care consumers will not easily relinquish medical innovations that previously have been integrated into usual health care.

HIV and AIDS is a growing health risk for heterosexual women, particularly women of color (Centers for Disease Control and Prevention, 1997). Our research identified 5 types of HIV sexual risk taking in 3 independent samples of adult women from a New England Community: Group A women were noted by low to moderate levels of the 4 risk markers (i.e., unprotected vaginal sex, perceived partner-related risk, number of sexual partners, and unprotected anal sex); Group B women reported very high frequency of unprotected vaginal sex; Group C women were characterized by unprotected anal sex; Group D women had high perceived partner risk; and Group E women reported extremely high levels on all 4 HIV risk markers. Sexual risk groups were validated by demonstrating significant differences among groups on relevant behaviors, interpersonal experiences, and attitudes. Compared to other women, higher risk types reported greater behavioral risk practices (substance use, prostitution, diverse sexual experience), interpersonal risk experiences (sexual abuse, violence), initiation sexual assertiveness, and attitudinal risks (psychosocial distress). They reported less interpersonal assurance (surety of own and partner's HIV status), sexual assertiveness (for condom use and partner communication), psychosocial strengths (sexual self-acceptance), and transtheoretical readiness for change (condom use efficacy, readiness to consider condoms). Results provide additional support for the multifaceted model of HIV risk and the transtheoretical model. Suggestions for specifically focused interventions are given, depending on the pattern of sexual risk taking.

We surveyed 119 female undergraduates to investigate if the health belief model for both cervical cancer and sexually transmitted diseases (STDs) would predict pelvic examination intentions. Results for cervical cancer and STDs were similar, with barriers to obtaining an exam and perceived susceptibility contributing most consistently to intentions. Respondents rated themselves as more susceptible to cervical cancer than to STDs and rated STDs more serious than cancer. Discriminant analysis found sexual activity, barriers, susceptibility to STDs, benefits of a pelvic exam for cervical cancer, and age to reliably distinguish women who had gotten a pelvic exam from those who had not. Contrary to previous research, physique anxiety was a positive predictor of intentions when health beliefs were controlled, suggesting it may represent generalized body anxiety for some women.

This study describes factors that place crack-addicted female jail inmates at risk for HIV infection. The study provides a portrait of the spheres of influences that directly and indirectly promote HIV risk-taking behaviors, women's efforts toward protecting themselves, and reported sexual behaviors. The study documents the far-reaching effects of crack addiction. One-and-a-half-hour interviews were conducted with 14 inmates recovering from crack addiction. The women were aged 19 to 39, and 13 were African American. The results of this study suggest that women's addictions are greatly shaped by their family and intimate relationships. Addictive behavior often precluded safer sex behaviors and increased a woman's likelihood of engagement in HIV-risky behaviors. Many women were victims of childhood and adulthood sexual and physical victimization. Women sought to protect themselves through sexual self-protection strategies, although these measures were often not effective HIV risk-reduction strategies.

The Women's Healthy Lifestyle Project is a 5-year randomized clinical testing whether a behavioral intervention aimed at lifestyle changes in diet and physical activity can prevent the rise in weight and low-density lipoprotein cholesterol (LDL-c) observed during menopause. Cardiovascular risk factor and behavioral data from 489 participants (intervention group n = 236; control group n = 253) who attended baseline, 6-month, and 18-month clinical assessments were analyzed to determine how well initial improvements achieved at 6 months were maintained over the subsequent year of follow-up. Results indicated that the treatment effect persisted at 18 months for weight, body mass index, total cholesterol, LDL-c, systolic blood pressure (SBP), and glucose levels. Intervention participants maintained improvements in physical activity, caloric intake, dietary cholesterol, SBP, and glucose levels between 6 and 18 months, although weight, total cholesterol, and LDL-c began to rise during this period. Eighty percent of intervention participants compared to 45% of controls were at or under baseline weight at 18 months, suggesting that promoting modest weight loss may be an effective approach to preventing weight gain in these women.

This study compared a sample of low-income African American women in the southeastern United States who had and had not yet undergone HIV counseling and testing on risk-related cognitive mediating variables and self-reported sexual behaviors. Four hundred sixty (N = 460) African American women were recruited from health clinics and community settings in a southern city. Forty-five percent of the women (n = 207) had undergone HIV counseling and testing, whereas 55% (n = 253) had never been tested. Women who were seropositive were excluded from the analyses. After providing informed consent, the women completed a battery of cognitive mediating measures assessing AIDS knowledge, attitudes theoretically relevant to risk reduction, and self-reported sexual behavior. In addition, each participant demonstrated condom application skills using a penile model. Women who had undergone testing were younger, rated HIV disease as more serious, considered AIDS a greater health concern, had more positive attitudes toward HIV prevention, expressed greater intentions to use condoms, and evidenced a greater commitment to self-protective behavior than women who were not yet tested. Women who had undergone HIV antibody testing, however, showed no differences in sexual behavior from women who were never tested. Sexual behavior, including numbers of partners, frequency of unprotected intercourse, and inconsistent condom use, left women in both groups at significant and comparable risk for HIV and sexually transmitted disease infection. HIV counseling and testing alone may not be effective primary prevention strategies for promoting risk reduction among African American women.

This study addressed how parents' relative involvement in child care is related to marital-role quality and psychological distress. These relationships were examined in a random sample of 133 mothers and fathers in dual-earner couples. Regression analyses employing hierarchical linear modeling techniques indicated that the more fathers participated in child care relative to their wives, the lower the father's distress. For mothers, the effect of child care involvement was complex: Although there were psychological benefits to spending proportionally more time involved in child care (lowered distress), these benefits were offset by a decrease in marital-role quality, which in turn increased distress. These findings indicate that the relation between child care involvement and the psychological health of both women and men in dual-earner couples is intertwined and complex.

Using an economically diverse random sample of 300 full-time employed men and women in dual-earner couples from two communities in the Northeast, we estimated the relation between the direction and magnitude of disagreement about gender role ideology (GRI) within couples and psychological distress. We conceptualized GRI within couples as both the couple mean or stable gender-role ideology (the "couple ideology") and as each partner's deviation from the other partner's score. Moreover, for each partner, we estimated the relation between both the stable (i.e., mean) component and the change (i.e., time-varying) component of GRI and distress. Finally, for each partner we estimated the moderating effect of GRI on the relation between job-role quality and distress. Findings are: (a) the more egalitarian the husband's average GRI is relative to his wife's, the less distressed he is; (b) if over time a wife's GRI becomes less egalitarian relative to her husband's, then her distress will be more affected by changes in her job-role quality; (c) for husbands, as the couple's average GRI becomes more egalitarian over time, the effect of job-role quality on distress is lessened; and (d) for a man in a couple with a more egalitarian stable GRI, the effects of change in job-role quality on distress are less pronounced than for a man in a couple with a less egalitarian stable GRI. Results are discussed in terms of new conceptions of GRI revealing the dynamic interaction of within-couples' gender-role ideologies.