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Austin, Sydney

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Austin

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Austin, Sydney
Author's Publications: search.filters.isAuthorOfPublication.30f9a177-ce3f-4ae9-8d10-9d7985873f1e

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Now showing 1 - 8 of 8
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    Clustered risk: An ecological understanding of sexual activity among adolescent boys and girls in two urban slums in Monrovia, Liberia
    (Elsevier BV, 2019-03) Gausman, Jewel; Lloyd, Danielle; Kallon, Thomas; Subramanian, Sankaran; Langer, Ana; Austin, Sydney
    Many young people experience sexual debut before they are able to manage risk in order to avoid adverse consequences. Gender norms, social position, and power can undermine an adolescent's ability to exercise agency in their first sexual encounters and negotiate safer sexual behavior. This study examines the intersection of psychosocial and interpersonal factors with the social and physical environment to form an ecological understanding of how the determinants that shape sexual activity differ between boys and girls in two urban slums in Monrovia, Liberia. This study focuses on three different levels: 1) intrapersonal and psychosocial factors, 2) the role of the family and other interpersonal relationships, and 3) the overall community structure. Fifty-three adolescents aged 15–17 years (27 males and 26 females) were recruited to participate in a concept mapping exercise. Concept mapping is a participatory research method that uses both qualitative and quantitative approaches through 1) group discussion, 2) brainstorming, 3) sorting factors into meaningful clusters, and 4) interpretation of the results to create a visual map. Cluster maps include both positive and negative factors that participants believe to influence adolescent sexual activity in their communities, including parental pressure, transactional sex, family status, goals and aspirations, and poverty. The influence of these factors diverged according to participant gender. Participants described how psychosocial, interpersonal, family, and community factors interact with economic and social forces to influence their sexual experience and combine to exacerbate the prevalence of transactional and forced sex. The results highlight the need for multi-level interventions to shape adolescent sexual and reproductive health in positive, rather than harmful, ways.
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    Sexual orientation differences in teen pregnancy and hormonal contraceptive use: an examination across 2 generations
    (Elsevier BV, 2013) Charlton, Brittany; Corliss, Heather; Missmer, Stacey; Rosario, Margaret; Spiegelman, Donna; Austin, Sydney
    OBJECTIVE: To examine whether sexual orientation is associated with disparities in teen pregnancy and hormonal contraception use among adolescent females in 2 intergenerational cohorts. STUDY DESIGN: Data were collected from 91,003 women in the Nurses' Health Study II (NHSII), born between 1947-1964, and 6463 of their children, born between 1982-1987, enrolled in the Growing Up Today Study (GUTS). Log-binomial models were used to estimate risk ratios for teen pregnancy and hormonal contraception use in sexual minorities compared with heterosexuals and metaanalysis techniques were used to compare the 2 cohorts. RESULTS: Overall, teen hormonal contraception use was lower and teen pregnancy was higher in NHSII than GUTS. In both cohorts, lesbians were less likely, whereas the other sexual minorities were more likely, to use hormonal contraception as teenagers compared with their heterosexual peers. All sexual minority groups in both cohorts, except NHSII lesbians, were at significantly increased risk for teen pregnancy, with risk ratios ranging from 1.61 (95% confidence interval, 0.40-6.55) to 5.82 (95% confidence interval, 2.89-11.73). Having an NHSII mother who was pregnant as a teen was not associated with teen pregnancy in GUTS participants. Finally, significant heterogeneity was found between the 2 cohorts. CONCLUSION: Adolescent sexual minorities have been, and continue to be, at increased risk for pregnancy. Public health and clinical efforts are needed to address teen pregnancy in this population.
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    Reproductive Health Screening Disparities and Sexual Orientation in a Cohort Study of U.S. Adolescent and Young Adult Females
    (Elsevier BV, 2011) Charlton, Brittany; Corliss, Heather; Missmer, Stacey; Frazier, Lindsay; Rosario, Margaret; Kahn, Jessica A.; Austin, Sydney
    Purpose To examine sexual orientation group disparities in Pap and STI/HPV tests among adolescents and young adult females. Methods Survey data from 4,224 adolescents and young adults aged 17-25 who responded to the 2005 wave questionnaire of the Growing Up Today Study were examined cross-sectionally with multivariable generalized estimating equations regression. We examined associations between sexual orientation and reproductive health care utilization as well as abnormal results with completely heterosexuals as the referent group, controlling for age, race/ethnicity, geographic region, and sexual history. Results After accounting for sociodemographics and sexual history, mostly heterosexual/bisexual females had 30% lower odds of having a Pap test within the last year and almost 40% higher odds of being diagnosed with an STI, as compared to the completely heterosexual group. Additionally, lesbians had very low odds of having a Pap test in life (OR=.13, p-value=<.0001) and having a Pap test within the last year (OR=.25, p-value=.0002), compared to completely heterosexuals. Conclusions Our study demonstrates that sexual minority adolescent and young adult women underutilize routine reproductive health screenings including Pap smears and STI tests. Providers and health educators should be aware of these disparities so that they can provide appropriate care to young women and their families and ensure that all young women receive reproductive health screening. Further research is needed to explore reasons sexual minority females are not accessing care as recommended since this may suggest opportunities to improve reproductive health screenings as well as broader health care access issues.
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    Body Satisfaction, Weight Gain, and Binge Eating Among Overweight Adolescent Girls
    (2012) Sonneville, Kendrin; Calzo, Jerel; Horton, Nicholas J.; Haines, Jess; Austin, Sydney; Field, Alison E.
    Objective: To examine if body satisfaction is associated with body mass index (BMI) change and whether it protects against the development of frequent binge eating among overweight and obese adolescent girls. Methods: We used prospective data from 9 waves of an ongoing cohort study of adolescents, the Growing Up Today Study. At enrollment in 1996, participants were 9 to 14 years old. Questionnaires were mailed to participants annually until 2001, then biennially through 2007. Girls who were overweight or obese in 1996 were included in the analysis (n=1 559). Our outcomes were annual change in BMI and incident frequent binge eating, defined as binge eating at least weekly and no use of compensatory behaviors. Results: At baseline, 57.2% of the overweight and obese girls were at least somewhat satisfied with their bodies. During 11 years of follow-up, 9.5% (95% confidence interval (CI) [7.8, 10.8]) of the girls started to binge eat frequently. Controlling for BMI and other confounders, overweight and obese girls who reported being at least somewhat satisfied with their bodies made smaller BMI gains (β=−0.10 kg/m\(^2\), 95% CI [−0.19, −0.02]) and had 61% lower odds of starting to binge eat frequently (odds ratio (OR)=0.39, 95% CI [0.24, 0.64]) than their less satisfied peers. Compared to girls who were the least satisfied with their bodies, girls who were the most satisfied had 85% lower odds of starting to binge eat frequently (OR=0.15, 95% CI [0.06, 0.37]). The association between body satisfaction and starting to binge eat frequently was stronger for younger adolescents than older adolescents. Conclusions: While body dissatisfaction is common among overweight and obese girls, body satisfaction may protect against excessive weight gain and binge eating. Prevention of body dissatisfaction must begin early and should be considered as a component of both obesity and eating disorder prevention programs.
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    A Public Health Approach to Eating Disorders Prevention: It’s Time for Public Health Professionals to Take a Seat at the Table
    (BioMed Central, 2012) Austin, Sydney
    Background: The societal burden of eating disorders is clear, and though there is a compelling need for a public health approach to eating disorders prevention, public health professionals have yet to take up the challenge. Discussion: The article lays out an argument for what steps need to be taken to bring a public health approach to eating disorders prevention. First, stock is taken of what the field has achieved so far, using tools from the prevention science literature, and, second, a research plan of action is offered that plays to the unique strengths of public health, drawing on a triggers-to-action framework from public health law. Minimal participation was found from public health professionals in eating disorders prevention research, and the vast majority of prevention research to date was found to be concentrated within the disciplines of psychology and psychiatry. Extreme disciplinary concentration of the research has led to a preponderance of individually targeted prevention strategies with little research focused on environmental targets, particularly at the macro level. New environmental initiatives are now emerging, such as a government-sponsored mass media anti-dieting campaign, and legal bans on extremely thin models in advertising, but for the most part, they have yet to be evaluated. A triggers-to-action framework, which focuses on evidentiary base, practical considerations, and political will, developed in public health law provides a basis for a strategic research plan for a public health approach to eating disorders prevention. Summary: There is enormous potential for growth in the scope and diversity of eating disorder prevention research strategies, particularly those targeting the macro environment. A public health approach will require a strategic plan for research that leverages the macro environment for prevention. The full engagement of public health professionals will bring to the field the much broader range of preventive strategies and perspectives needed to tackle the problem of eating disorders.
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    Effect of the Planet Health Intervention on Eating Disorder Symptoms in Massachusetts Middle Schools, 2005–2008
    (Centers for Disease Control and Prevention, 2012) Austin, Sydney; Spadano-Gasbarro, Jennifer L.; Greaney, Molly L.; Blood, Emily Alice; Hunt, Anne T.; Richmond, Tracy K.; Wang, Monica; Mezgebu, Solomon; Osganian, Stavroula K.; Peterson, Karen
    Introduction: The Planet Health obesity prevention curriculum has prevented purging and abuse of diet pills (disordered weight control behavior [DWCB]) in middle-school girls in randomized trials, but the effects of Planet Health on DWCB when implemented by schools under dissemination conditions are not known. Methods: Massachusetts Department of Public Health and Blue Cross Blue Shield of Massachusetts disseminated Planet Health as part of the 3-year, Healthy Choices obesity prevention program in middle schools. We conducted an evaluation in 45 schools from fall 2005 to spring 2008. We gathered data from school staff to quantify intervention activities, and we gathered anonymous cross-sectional survey data from students on DWCB at baseline and Year 3 follow-up (n = 16,369). Multivariate logistic analyses with generalized estimating equations examined the effect of intervention activities on odds of students reporting DWCB at follow-up. Results: Students in schools reaching a high number of youth with Planet Health lessons on reducing television viewing had lower odds of DWCB at follow-up (odds ratio [OR], 0.80 per 100 lesson-exposures; 95% confidence interval [CI], 0.74–0.85). In addition, reduced odds of DWCB at follow-up were found in schools with active staff teamwork (OR, 0.76; 95% CI, 0.66–0.86) and the presence of programs addressing television viewing goals with staff (OR, 0.38; 95% CI, 0.28–0.53). Conclusion: Combined evidence from efficacy and effectiveness trials and now from dissemination research indicates that appropriately designed obesity prevention programs can achieve DWCB prevention on a large scale.
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    Body Satisfaction and Body Weight: Gender Differences and Sociodemographic Determinants
    (BioMed Central, 2009) Austin, Sydney; Haines, Jess; Veugelers, Paul J
    Background: Given the documented links between body satisfaction, weight-related behaviors, and weight change in adolescents, we sought to examine the prevalence of poor body satisfaction in prepubescent girls and boys and its associations with body weight, socioeconomic factors, and rural residence. Methods: We obtained data from 4254 girls and boys participating in a population-based survey of grade five students in the province of Nova Scotia, Canada. We examined gender specific associations between the prevalence of poor body satisfaction and body mass index (BMI) with generalized additive models and applied multilevel logistic regression methods to estimate associations of body satisfaction with BMI, rural residence, parental education and income, and neighborhood household income. Results: We observed a linear increase in poor body satisfaction with increasing BMI in girls. Among boys, however, we found a U-shape association where boys with low BMI and those with high BMI reported higher levels of poor body satisfaction. We also found that poor body satisfaction was more prevalent among girls whose parents had lower educational attainment and among those who reside in rural areas. Conclusion: Insight into the unique relationships between body satisfaction and BMI experienced by prepubescent children, males, and populations diverse in parental education and geographic location may help to inform public health initiatives designed to improve weight-related behaviors and reduce overweight in children.
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    Screening High School Students for Eating Disorders: Results of a National Initiative
    (Centers for Disease Control and Prevention, 2008) Austin, Sydney; Ziyadeh, Najat J.; Forman, Sara; Prokop, Lisa A.; Keliher, Anne; Jacobs, Douglas
    Introduction: Early identification and treatment of disordered eating and weight control behaviors may prevent progression and reduce the risk of chronic health consequences. Methods: The National Eating Disorders Screening Program coordinated the first-ever nationwide eating disorders screening initiative for high schools in the United States in 2000. Students completed a self-report screening questionnaire that included the Eating Attitudes Test (EAT-26) and items on vomiting or exercising to control weight, binge eating, and history of treatment for eating disorders. Multivariate regression analyses examined sex and racial/ethnic differences. Results: Almost 15% of girls and 4% of boys scored at or above the threshold of 20 on the EAT-26, which indicated a possible eating disorder. Among girls, we observed few significant differences between ethnic groups in eating disorder symptoms, whereas among boys, more African American, American Indian, Asian/Pacific Islander, and Latino boys reported symptoms than did white boys. Overall, 25% of girls and 11% of boys reported disordered eating and weight control symptoms severe enough to warrant clinical evaluation. Of these symptomatic students, few reported that they had ever received treatment. Conclusion: Population screening for eating disorders in high schools may identify at-risk students who would benefit from early intervention, which could prevent acute and long-term complications of disordered eating and weight control behaviors.