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Article Reference Troff document (with manpage macros)Availability of Services Related to Achieving Pregnancy in U.S. Publicly Funded Family Planning Clinics
Background Recognizing that quality family planning services should include services to help clients who want to become pregnant, the objective of our analysis was to examine the distribution of services related to achieving pregnancy at publicly funded family planning clinics in the United States. Methods A nationally representative sample of publicly funded clinics was surveyed in 2013–2014 (n = 1615). Clinic administrators were asked about several clinical services and screenings related to achieving pregnancy: basic infertility services, reproductive life plan assessment, screening for body mass index, screening for sexually transmitted diseases, provision of natural family planning services, infertility treatment, and primary care services. The percentage of clinics offering each of these services was compared by Title X funding status; prevalence ratios (PR) and 95% confidence intervals (CIs) were estimated after adjusting for clinic characteristics. Results Compared to non-Title X clinics, Title X clinics were more likely to offer reproductive life plan assessment (adjusted PR [aPR], 1.62; 95% CI, 1.42–1.84), body mass index screening for men (aPR, 1.10; 95% CI, 1.01–1.21), screening for sexually transmitted diseases (aPRs ranged from 1.21 to 1.37), and preconception health care for men (aPR, 1.10; 95% CI, 1.01–1.20). Title X clinics were less likely to offer infertility treatment (aPR, 0.55; 95% CI, 0.40–0.74) and primary care services (aPR, 0.74; 95% CI, 0.68–0.80) and were just as likely to offer basic infertility services, preconception health care services for women, natural family planning, and body mass index screening in women. Conclusions The availability of selected services related to achieving pregnancy differed by Title X status. A follow-up assessment after publication of national family planning recommendations is underway.
Located in MPRC People / Marie Thoma, Ph.D. / Marie Thoma Publications
Article ReferenceImplications of Unstable Trends in Marriage, Birth, and Divorce
Using birth, marriage, and divorce data from the U.S. Census, this study examines the stability in trends between 1920 and 2008. Our investigation substantiates the reactive nature of family trends to any intervention or change in its environment. We find that changes in family trends, which might have been initiated by changes in policies or other interventions, are permanent and do not fade away by reversing policies or interventions. Hence, family and consumer scientists, policymakers, and practitioners must explicitly allow for unstable trends when researching or targeting the dynamics of birth, marriage, and divorce, and prescribing interventions that they view as stabilizers of family dynamics.
Located in MPRC People / Manouchehr (Mitch) Mokhtari, Ph.D. / Mitch Mokhtari Publications
Article Reference Troff document (with manpage macros)Sexual and Gender Minority Youth Alcohol Use: Within-Group Differences in Associations with Internalized Stigma and Victimization
Sexual and gender minority (SGM) youth are more likely to use alcohol than their heterosexual cisgender peers. At the same time, SGM youth experience sexuality- and gender identity-specific stressors known to exacerbate negative health outcomes. Though scholars have established a link between minority stressors (e.g., internalized stigma and victimization) and increased alcohol use for SGM youth as a whole, there is little indication of whether internalized stigma and victimization are more strongly associated with alcohol use for specific groups of SGM youth. A United States sample of 11,811 racially and geographically diverse 13–17 year old SGM youth was used to employ a series of gender-stratified multivariable regression models to examine the association among internalized stigma, victimization, and alcohol-related behaviors, and whether they differed for specific groups of sexual minority youth. Sexual orientation moderated several associations between sexual minority stressors (i.e., victimization and stigma) and youth’s alcohol use (i.e., recent use and heavy episodic drinking) across models stratified by gender (i.e., male, female, and non-binary). For example, bisexual boys had stronger associations between SGM-specific victimization and alcohol use frequency and heavy episodic drinking relative to gay boys; conversely, victimization and alcohol use frequency were more weakly associated among bisexual girls relative to lesbian/gay girls. Pansexual girls showed weaker associations between internalized stigma and alcohol use frequency compared to lesbian/gay girls. This paper demonstrates who among SGM youth are more likely to engage in alcohol-related behaviors as a function of differential forms of SGM-related victimization and stigma. These findings can inform substance use interventions that are tailored to youth of diverse sexual orientations and gender identities.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article ReferenceLGBTQ Youth-Serving Community-Based Organizations: Who Participates and What Difference Does it Make?
LGBTQ youth are at greater risk for compromised health, yet large-scale health promotion programs for LGBTQ young people have been slow to develop. LGBTQ community-based organizations—which provide LGBTQ-focused support and services—have existed for decades, but have not been a focus of the LGBTQ youth health literature. The current study used a contemporary sample of LGBTQ youth (age 15–21;  M  = 18.81;  n  = 1045) to examine who participates in LGBTQ community-based organizations, and the association between participation and self-reported mental health and substance use. Youth who participated in LGBTQ community-based organizations were more likely to be assigned male at birth, transgender, youth of color, and accessing free-or-reduced lunch. Participation was associated with concurrent and longitudinal reports of mental health and substance use. LGBTQ community-based organizations may be an underutilized resource for promoting LGBTQ youth health.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article Reference Troff document (with manpage macros)Risk and protective factors associated with BV chronicity among women in Rakai, Uganda
Objectives To assess risk and protective factors associated with bacterial vaginosis (BV) chronicity ascertained by Nugent score criteria. Methods A longitudinal cohort study included 255 sexually experienced, postmenarcheal women who provided weekly self-collected vaginal swabs for up to 2 years. Vaginal swabs were scored using Nugent criteria and classified as normal (≤3), intermediate (4–6) and Nugent-BV (≥7). Detailed behavioural/health information were assessed every 6 months. A per-woman longitudinal summary measure of BV chronicity was defined as the percentage of each woman’s weekly vaginal assessments scored as Nugent-BV over a 6-month interval. Risk and protective factors associated with BV chronicity were assessed using multiple linear regression with generalised estimating equations. Results Average BV chronicity was 39% across all follow-up periods. After adjustment, factors associated with BV chronicity included baseline Nugent-BV (β=35.3, 95% CI 28.6 to 42.0) compared with normal baseline Nugent scores and use of unprotected water for bathing (ie, rainwater, pond, lake/stream) (β=12.0, 95% CI 3.4 to 20.5) compared with protected water sources (ie, well, tap, borehole). Women had fewer BV occurrences if they were currently pregnant (β=−6.6, 95% CI −12.1 to 1.1), reported consistent condom use (β=−7.7, 95% CI −14.2 to 1.3) or their partner was circumcised (β=−5.8, 95% CI −11.3 to 0.3). Conclusions Factors associated with higher and lower values of BV chronicity were multifactorial. Notably, higher values of BV chronicity were associated with potentially contaminated bathing water. Future studies should examine the role of waterborne microbial agents in the pathogenesis of BV.
Located in MPRC People / Marie Thoma, Ph.D. / Marie Thoma Publications
Article Reference Troff document (with manpage macros)Marital Status and Mothers’ Time Use: Childcare, Housework, Leisure, and Sleep
Assumptions that single mothers are “time poor” compared with married mothers are ubiquitous. We tested theorized associations derived from the time poverty thesis and the gender perspective using the 2003–2012 American Time Use Surveys (ATUS). We found marital status differentiated housework, leisure, and sleep time, but did not influence the amount of time that mothers provided childcare. Net of the number of employment hours, married mothers did more housework and slept less than never-married and divorced mothers, counter to expectations of the time poverty thesis. Never-married and cohabiting mothers reported more total and more sedentary leisure time than married mothers. We assessed the influence of demographic differences among mothers to account for variation in their time use by marital status. Compositional differences explained more than two-thirds of the variance in sedentary leisure time between married and never-married mothers, but only one-third of the variance between married and cohabiting mothers. The larger unexplained gap in leisure quality between cohabiting and married mothers is consistent with the gender perspective.
Located in MPRC People / Liana C. Sayer, Ph.D. / Liana Sayer Publications
Article Reference Troff document (with manpage macros)Who Experiences Leisure Deficits? Mothers' Marital Status and Leisure Time
The authors used the 2003 to 2012 American Time Use Survey to examine marital status variation in mothers' leisure time. They found that never‐married mothers have more total leisure but less high‐quality leisure when compared with married mothers. Never‐married mothers' leisure is concentrated in passive and socially isolated activities that offer fewer social and health benefits. Black single mothers have the highest amount of socially isolated leisure, particularly watching television alone. Results suggest that differences in the context and type of leisure are salient dimensions of the divergent and stratified life conditions of married, divorced, and single mothers.
Located in MPRC People / Liana C. Sayer, Ph.D. / Liana Sayer Publications
Article Reference Troff document (with manpage macros)The Economic Gap Among Women in Time Spent on Housework in Former West Germany and Sweden
The quantitative scholarship on domestic labor has documented the existence of a gender gap in its performance in all countries for which data are available. Only recently have researchers begun to analyze economic disparities  among  women in their time spent doing housework, and their studies have been largely limited to the U.S. We extend this line of inquiry using data from two European countries, the former West Germany and Sweden. We estimate the “economic gap” in women’s housework time, which we define as the difference between the time spent by women at the lowest and highest deciles of their own earnings. We expect this gap to be smaller in Sweden given its celebrated success at reducing both gender and income inequality. Though Swedish women do spend less time on domestic labor, however, and though there is indeed less earnings inequality among them, the economic gap in their housework is only a little smaller than among women in the former West Germany. In both places, a significant negative association between women’s individual earnings and their housework time translates into economic gaps of more than 2.5 hours per week. Moreover, in both countries, women at the highest earnings decile experience a gender gap in housework that is smaller by about 4 hours per week compared to their counterparts at the lowest decile.
Located in MPRC People / Liana C. Sayer, Ph.D. / Liana Sayer Publications
Article ReferenceTeen Mothers’ Family Support and Adult Identity in the Emerging Adulthood: Implications for Socioeconomic Attainment Later in Life
We examined the prospective role of parental support and adult identity profiles in the transition to adulthood on teen mothers’ socioeconomic outcomes in adulthood. Analyses were based on the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of youth followed over a decade. We used data from Waves 1, 3, and 4 (mean age = 28.6, Wave 4). Analytical sample consisted of 981 females who gave birth before age 20. Analysis included design-based regression models. Findings from adjusted regression models showed no statistically significant associations between teen mothers’ parental support and socioeconomic outcomes. While teen mothers have already achieved an important marker of adulthood, variability in adult identity profiles was observed. Teen mothers with older subjective age, regardless of their levels of psychosocial maturation, had higher socioeconomic attainment on some indicators. Findings suggest that teen mothers’ adult identity profiles differentiate their socioeconomic trajectories later in life.
Located in MPRC People / Kerry Green, Ph.D. / Kerry Green Publications
Article Reference Troff document (with manpage macros)Sexual Minority-related Discrimination across the Life Course: Findings from a National Sample of Adults in the United States
In the United States, sexual minority (SM) status is associated with a number of health disparities. Based on mounting evidence, stigma and discrimination have been cited as key barriers to health equity for this population. We estimated the prevalence of three types of discrimination as a function of age among SM adults from the National Epidemiological Study of Alcohol Use and Related Conditions III (NESARC-III) (2012–2013). Among SM adults, reports of past-year general discrimination, victimization, and healthcare discrimination varied by age, with peaks in early adulthood and again in midlife. Age trends varied by biological sex, with males experiencing significantly more general discrimination, victimization, and healthcare discrimination at specific ages. Age trends also varied by sexual identity, as LGB-identifying SMs were significantly more likely to experience all forms of discrimination across all ages. Policies preventing homophobic discrimination and victimization are necessary given the pervasiveness of these experiences across adulthood.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications