J. Bowling

This qualitative study examined the acceptability of female condoms in urban India, with a focus on sexual pleasure. We conducted focus group discussions with 50 women and 19 men, as well as a small number of individual interviews with women ( n = 3), in Chennai and New Delhi. Perceived benefits of female condoms included protection against unintended pregnancy and sexually transmitted infections, increased sense of empowerment for women, and simple clean up. The most common drawback was reduced sensation. Participants suggested structural changes to the female condom to ease insertion and use. Consent and privacy were discussed as increasing sexual pleasure. Pleasure should be acknowledged in design and education efforts to increase female condom use.

To describe the development of a peer support intervention and test an enhanced version compared to a standard protocol. Participants (N = 36 females) were assigned to an Enhanced Peer Support (PS) vs Standard weight loss group for 4 months. The PS component consisted of skills training and practice between sessions using social networking. The PS group perceived significantly more peer support and experienced higher levels of social interaction. When meeting frequency decreased, the PS group showed an increase in overall types of support from group members. Findings suggest that an intervention targeting peer support skills results in greater feelings of peer support.

Sixty-six women participated in this study, which compared two 16-week motivationally enhanced weight loss interventions. Both intervention groups, which are entitled "Minimal" and "Enhanced" throughout the description that follows, received a motivationally enhanced initial face-to-face weight loss session. The initial session was followed by a 16-week Internet behavioral weight loss program, which included a study website with weekly lessons, an online self-monitoring diary form, web links to related sites, and separate message boards. The Enhanced group also received weekly moderated online chat group sessions led using motivational techniques. Both groups lost weight over time (p<0.001), however the group by time interaction was non-significant (p=0.19). The Minimal group lost 5.22+/-4.72 kg and the Enhanced group lost 3.71+/-4.46 kg. In the Enhanced group, online chat session attendance averaged 8.0 of the 16 chats offered. Greater program utilization was associated with greater weight loss in both groups. The addition of weekly motivationally enhanced online chats did not increase weight loss in this study. Further research is needed on the type and frequency of group support that is most desirable and beneficial in Internet weight loss interventions and could also explore building motivation for program utilization.

Moms and Teens for Safe Dates (MTSD) is a dating abuse (DA) prevention program for teens exposed to domestic violence. In a randomized controlled trial (RCT), MTSD prevented certain types of DA victimization (psychological and physical) and perpetration (psychological and cyber) among teens with higher, but not lower, exposure to domestic violence. We built on these findings by using moderated mediation analysis to examine whether level of teen exposure to domestic violence conditioned the indirect effects of MTSD on these types of DA through targeted mediators. MTSD consisted of six mailed activity booklets. Mothers who had been former victims of domestic violence delivered the program to their teens. Mother and teen pairs were recruited into the RCT through community advertising and completed baseline and 6-month follow-up interviews (N = 277 pairs). As expected, MTSD had significant favorable effects for teens with higher but not lower exposure to domestic violence on several mediators that guided program content, including teen conflict management skills and mother-perceived severity of DA, self-efficacy for enacting DA prevention efforts, and comfort in communicating with her teen. MTSD had significant main effects on other mediators including teen feeling of family closeness and cohesion and mother-perceived susceptibility of her teen to DA. As expected, all significant indirect effects of MTSD on DA outcomes through mediators were for teens with higher exposure to domestic violence. Findings have implications for developing DA victimization and perpetration prevention programs for teens with high exposure to domestic violence.

Adolescents exposed to domestic violence are at increased risk of dating abuse, yet no evaluated dating abuse prevention programs have been designed specifically for this high-risk population. This article describes the process of adapting Families for Safe Dates (FSD), an evidenced-based universal dating abuse prevention program, to this high-risk population, including conducting 12 focus groups and 107 interviews with the target audience. FSD includes six booklets of dating abuse prevention information, and activities for parents and adolescents to do together at home. We adapted FSD for mothers who were victims of domestic violence, but who no longer lived with the abuser, to do with their adolescents who had been exposed to the violence. Through the adaptation process, we learned that families liked the program structure and valued being offered the program and that some of our initial assumptions about this population were incorrect. We identified practices and beliefs of mothe...

Domestic violence protective orders (DVPOs) are the nation's most widely used intimate partner violence (IPV)-related legal intervention, and there is emerging evidence that DVPOs are effective. However, little is known about DVPO defendants. We examined a population-based sample of male DVPO defendants. Most had previous IPV-related offenses, mental health issues, and alcohol and drug-use histories. Court personnel should be aware of the severity of violence plaintiffs are likely experiencing, and the potential danger posed by defendants, and ensure that expedited and appropriate protection is awarded. Concurrent treatment for substance abuse and mental health may enhance the effectiveness of DVPOs.

Online cancer-related support is an under-studied resource that may serve an important function in the information seeking, care, and support of cancer patients and their families. With over 9.8 million cancer survivors (defined as anyone living with cancer) in the United States alone and the number growing worldwide, it is important to understand how they seek and use online resources to obtain the information they need, when they need it, and in a form and manner appropriate to them. These are stated cancer communication goals of the US National Cancer Institute. Our purposes are to (1) present background information about online mailing lists and electronic support groups, (2) describe the rationale and methodology for the Health eCommunities (HeC) study, and (3) present preliminary baseline data on new subscribers to cancer-related mailing lists. In particular, we describe subscribers' use of mailing lists, their reasons for using them, and their reactions to participating shortly after joining the lists. From April to August 2004, we invited all new subscribers to 10 Association of Cancer Online Resources mailing lists to complete Web-based surveys. We analyzed baseline data from the respondents to examine their perceptions about cancer-related mailing lists and to describe how cancer patients and survivors used these lists in the period shortly after joining them. Cumulative email invitations were sent to 1368 new mailing list subscribers; 293 Web surveys were completed within the allotted time frame (21.4% response rate). Most respondents were over age 50 (n = 203, 72%), white (n = 286, 98%), college graduates (n = 161, 55%), and had health insurance (n = 283, 97%). About 41% (n = 116) of new subscribers reported spending 1 to 3 hours per day reading and responding to list messages. They used the mailing lists for several reasons. Among the most frequently reported, 62% (n = 179) strongly agreed they used mailing lists to obtain information on how to deal with cancer, 42% (n = 121) strongly agreed they used mailing lists for support, and 37% (n = 109) strongly agreed that they were on the mailing lists to help others. Smaller proportions of new subscribers strongly agreed that others on the mailing lists had similar cancer experiences (n = 23, 9%), that they could relate to the experiences of others on the lists (n = 66, 27%), and that others on the list gave them good ideas about how to cope with cancer (n = 66, 27%). Cancer-related online mailing lists appear to be an important resource, especially for information seeking but also for support of cancer survivors. These were the primary motivators most members reported for joining mailing lists. The modest proportion of subscribers who strongly agreed that they could relate to others' cancer experiences (as well as similar responses to other process questions) is undoubtedly due at least in part to the short duration that these subscribers were involved with the mailing lists. Emerging data, including our own, suggest that mailing lists are perhaps under-used by minority patients/survivors. These preliminary data add to a growing body of research on health-related online communities, of which online mailing lists are one variant.

Whereas both popular and public health attention regarding homicide and violence have focused on urban areas and male victims, very little is known about the magnitude of female homicide in rural areas, or how the situations in which these fatalities occur may differ from urban violence. This study addresses this gap by using data abstracted from the North Carolina State Medical Examiner System to identify how the rates and circumstances of female homicide differ for women living in rural counties compared with women living in the state's urban and intermediate counties. The study identified a nonlinear pattern, with the intermediate counties having the highest female homicide rate, followed by the urban, and then the rural counties. Additional findings suggest that a greater proportion of rural female victims are killed by intimate partners, and that the effects of urban-rural status are eclipsed by race and, to a lesser extent, by age.

Stigma associated with HIV and risk behaviors is known to be a barrier to health care access for many populations. Less is known about female sex workers (FSW) in Russia, a population that is especially vulnerable to HIV-infection, and yet hard-to-reach for service providers. We administered a questionnaire to 139 FSW to better understand how stigma and discrimination influence HIV service utilization. Logistic regression analysis indicated that HIV-related stigma is negatively associated with uptake of HIV testing, while sex work-related stigma is positively associated with HIV testing. HIV-positive FSW are more likely than HIV-negative FSW to experience discrimination in health care settings. While decreasing societal stigma should be a long-term goal, programs that foster inclusion of marginalized populations in Russian health care settings are urgently needed.