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David M. Rubin, MD, MSCE; Amanda L. R. O鈥橰eilly, MPH; Xianqun Luan, MS; et al.
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Arch Pediatr Adolesc Med. 2011;165(3):198-204. doi:10.1001/archpediatrics.2010.221
ObjectiveTo examine, following statewide dissemination, the influence of an evidence-based home visitation program for first-time mothers on reductions of subsequent pregnancies across time and different locations.DesignRetrospective cohort study.SettingReplication sites for the Nurse-Family Partnership (17 urban sites and 6 rural sites) across the Commonwealth of Pennsylvania between January 1, 2000, and December 31, 2007.ParticipantsA total of 3844 Nurse-Family Partnership clients matched by propensity score to 10聽938 local-area controls.Main ExposureProgram enrollment.Main Outcome MeasureTime to second pregnancy resulting in a live birth within 2 years of the first infant's birth.ResultsThere were no program effects on time to first pregnancy in the early years of the program (2000-2003), but clients whose first infants were born after 2003 had fewer second pregnancies compared with controls (hazard ratio聽=聽0.87; 95% confidence interval, 0.80-0.96). This benefit occurred principally among mothers who were aged 18 years or younger (hazard ratio聽=聽0.73, 95% confidence interval, 0.61-0.89) and was twice as strong among mothers aged 18 years or younger from rural locations (hazard ratio聽=聽0.40; 95% confidence interval, 0.22-0.73) compared with those from urban locations (hazard ratio聽=聽0.79; 95% confidence interval, 0.65-0.95).ConclusionsProgram effects on pregnancy planning emerged after an implementation period of 3 years in both urban and rural locations, but they were particularly strong in rural locations and among younger mothers.
David C. Grossman, MD, MPH; Virginia A. Moyer, MD, MPH; Bernadette M. Melnyk, PhD, RN; et al.
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Arch Pediatr Adolesc Med. 2011;165(3):205-210. doi:10.1001/archpediatrics.2010.299
Dominic Wilkinson, MBBS, BMedSci, MBioeth, DPhil, FRACP
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Arch Pediatr Adolesc Med. 2011;165(3):211-215. doi:10.1001/archpediatrics.2011.4
Sylvie Nguyen The Tich, MD, PhD; Peter J. Anderson, PhD; Rod W. Hunt, MBBS; et al.
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Arch Pediatr Adolesc Med. 2011;165(3):216-222. doi:10.1001/archpediatrics.2011.9
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Lindsey Turner, PhD; Frank J. Chaloupka, PhD
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Arch Pediatr Adolesc Med. 2011;165(3):223-228. doi:10.1001/archpediatrics.2010.215
ObjectiveTo examine the availability of beverages for sale in elementary schools.DesignNationally representative mail-back survey.SettingUS public and private elementary schools during the 2006-2007, 2007-2008, and 2008-2009 school years.ParticipantsSurvey respondents at elementary schools.Main Outcome MeasureAvailability of beverages offered in competitive venues and school lunches.ResultsPublic elementary school students' access to beverages for sale in any competitive venue on campus (vending machines, stores, snack bars, and/or 脿 la carte) increased from 49.0% in 2006-2007 to 61.3% in 2008- 2009 (P聽<聽.01). The percentage of public school students with access to only beverages allowed by the Institute of Medicine guidelines for competitive beverages (ie, water, 100% juice, and 1% or nonfat milk) increased from 10.0% to 16.1% (P聽<聽.01). Access to higher-fat milk (2% or whole milk) in school lunches decreased from 77.9% of public school students in 2006-2007 to 68.3% in 2008-2009 (P聽<聽.001). Flavored milk was available at lunch on most days for 92.1% of public school students.ConclusionsAs of the 2008-2009 school year, high-calorie beverages and beverages not allowed by national guidelines were still widely available in elementary schools.
Matthew A. Lapierre, MA; Sarah E. Vaala, MA; Deborah L. Linebarger, PhD
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Arch Pediatr Adolesc Med. 2011;165(3):229-234. doi:10.1001/archpediatrics.2010.300
Sarah E. Anderson, PhD; Robert C. Whitaker, MD, MPH
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Arch Pediatr Adolesc Med. 2011;165(3):235-242. doi:10.1001/archpediatrics.2010.292
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Anna V. Song, PhD; Bonnie L. Halpern-Felsher, PhD
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Arch Pediatr Adolesc Med. 2011;165(3):243-249. doi:10.1001/archpediatrics.2010.214
ObjectivesTo (1) identify the temporal order between oral and vaginal sex onset; (2) test whether oral sex or vaginal sex is a risk or protective factor for the other; and (3) determine whether the relationship between oral and vaginal sex varies across time.DesignProspective, longitudinal study with 6-month assessments conducted between 2002 and 2005.SettingSelf-administered surveys completed during class time.ParticipantsAt baseline, 627 ninth grade high school students from 2 northern California schools were included in the study.Main Outcome MeasureOral and vaginal sex onset.ResultsAmong sexually active adolescents, most initiated vaginal sex after or within the same 6-month period of oral sex initiation. Adolescents who initiated oral sex at the end of ninth grade had a 50% chance of initiating vaginal sex by the end of 11th grade. In comparison, adolescents who delayed until the end of 11th grade had a 16% chance of initiating vaginal sex by the end of 11th grade.ConclusionsThe first 2 years of high school may be a critical age period for adolescents' vulnerability to vaginal sex initiation via oral sex behaviors. Comprehensive evidenced-based interventions and provision of preventive services aimed toward reducing sexual risk should be expanded to include the role oral sex plays in adolescent sex behavior.
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Jennifer R. Havens, PhD, MPH; April M. Young, MPH; Christopher E. Havens, RN, BSN
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Arch Pediatr Adolesc Med. 2011;165(3):250-255. doi:10.1001/archpediatrics.2010.217
ObjectivesTo compare the prevalence of nonmedical prescription drug use among adolescents residing in urban, suburban, and rural areas of the United States and to determine factors independently associated with rural nonmedical prescription drug use among adolescents aged 12 to 17 years.DesignCross-sectional, population-based survey.SettingNoninstitutionalized residents in the United States.ParticipantsParticipants included adolescents aged 12 to 17 years (N聽=聽17聽872), most of whom were residing in urban areas (53.2%), male (51%), and white (59%).Main ExposureLiving in rural compared with urban area.Main Outcome MeasuresNonmedical use of prescription drugs (pain relievers, tranquilizers, sedatives, and stimulants). Data were from the 2008 National Survey on Drug Use and Health.ResultsRural adolescents were 26% more likely than urban adolescents to have used prescription drugs nonmedically (adjusted odds ratio, 1.26; 95% confidence interval, 1.01-1.57) even after adjustment for race, health, and other drug and alcohol use. When examining the rural adolescents in particular, factors positively associated with nonmedical use of prescription drugs included decreased health status, major depressive episode(s), and other drug (marijuana, cocaine, hallucinogens, and inhalants) and alcohol use. Protective factors for nonmedical prescription drug use among rural adolescents included school enrollment and living in a 2-parent household.ConclusionsRural adolescents were significantly more likely than urban adolescents to report nonmedical prescription drug use. However, these results suggest there are multiple potential points of intervention to prevent initiation or progression of use among rural adolescents including preventing school dropout, increased parental involvement, and increased access to health, mental health, and substance abuse treatment.
Gary R. Maslow, MD; Abigail A. Haydon, MPH; Carol Ann Ford, MD; et al.
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Arch Pediatr Adolesc Med. 2011;165(3):256-261. doi:10.1001/archpediatrics.2010.287
Journal Club
Jill S. Halterman, MD, MPH; Peter G. Szilagyi, MD, MPH; Susan G. Fisher, PhD; et al.
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Arch Pediatr Adolesc Med. 2011;165(3):262-268. doi:10.1001/archpediatrics.2011.1
Anthony Spirito, PhD; Holly Sindelar-Manning, PhD; Suzanne M. Colby, PhD; et al.
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Arch Pediatr Adolesc Med. 2011;165(3):269-274. doi:10.1001/archpediatrics.2010.296