Browsing by Author "Stupiansky, Nathan W."

Now showing 1 - 5 of 5
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    Alcohol Use Trajectories after High School Graduation among Emerging Adults with Type 1 Diabetes
    (Elsevier, 2014-08) Hanna, Kathleen M.; Stupiansky, Nathan W.; Weaver, Michael T.; Slaven, James E.; Stump, Timothy E.; IU School of Nursing
    Objective Explore alcohol involvement trajectories and associated factors during the year post-high school (HS) graduation among emerging adults with type 1 diabetes. Methods Youth (N=181) self-reported alcohol use at baseline and every 3 months for 1 year post-HS graduation. Data were also collected on parent-youth conflict, diabetes self-efficacy, major life events, living and educational situations, diabetes management, marijuana use, cigarette smoking, and glycemic control. Trajectories of alcohol use were modeled using latent class growth analysis. Associations between trajectory class and specific salient variables were examined using analysis of variance, chi square, or generalized linear mixed model, as appropriate. Results Identified alcohol involvement trajectory classes were labeled as: 1) Consistent Involvement Group (n=25, 13.8%) with stable, high use relative to other groups over the 12 months; 2) Growing Involvement Group (n=55, 30.4%) with increasing use throughout the 12 months; and 3) Minimal Involvement Group (n=101, 55.8%) with essentially no involvement until month nine. Those with minimal involvement had the best diabetes management and better diabetes self-efficacy than those with consistent involvement. In comparison to those minimally involved, those with growing involvement were more likely to live independently of parents; those consistently involved had more major life events; and both the growing and consistent involvement groups were more likely to have tried marijuana and cigarettes. Conclusions This sample of emerging adults with type 1 diabetes has 3 unique patterns of alcohol use during the first year after high school. Implication and Contribution Among youth with type 1 diabetes in the year post-HS graduation, alcohol involvement knowledge was extended by identifying patterns of such use. Further research of alcohol use patterns is needed to guide health care professionals in their assessments and researchers in testing interventions that target unique patterns.
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    Differences in cervical cancer screening knowledge, practices, and beliefs: An examination of survey responses
    (Elsevier, 2016-12-21) Kasting, Monica L.; Wilson, Shannon; Zollinger, Terrell W.; Dixon, Brian E.; Stupiansky, Nathan W.; Zimet, Gregory D.; Department of Epidemiology, Richard M. Fairbanks School of Public Health
    Among the identified barriers to HPV vaccination is the concern that women may compensate for their reduced susceptibility to cervical cancers by reducing cervical cancer screening. This exploratory study examined the relationship between cervical cancer screening rates and HPV vaccination. We conducted a cross-sectional survey using a convenience sample of women aged 21-35 attending a local minority health fair in July 2015. Data were analyzed in 2015-2016. Outcomes assessed were: receiving a Pap test within the last three years, awareness and comfort with current Pap test recommendations, and knowledge regarding the purpose of a Pap test. A total of 291 women were included in the analyses. Mean age was 28.5 years and 62% were non-Hispanic black. 84% had received a Pap test in the last three years and 33% had received at least one HPV vaccine. Logistic regression results showed that women who had been vaccinated did not have lower odds of having a Pap test in the past three years (OR = 1.32; 95% CI = 0.66-2.65). In an adjusted regression model controlling for age and race, vaccinated women were significantly more likely to have had a Pap test (AOR = 3.06; 95% CI = 1.37-6.83). Yet only 26% of women knew the purpose of a Pap test and the proportion who answered correctly was higher among non-Hispanic white women. Women who have been vaccinated for HPV are more likely to have been screened for cervical cancer. These results suggest areas for more robust studies examining pro-health attitudes, behaviors, and communication regarding vaccination and preventive screening.
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    Human Papillomavirus Vaccines: Successes and Future Challenges
    (Springer, 2018-09) Perez, Samara; Zimet, Gregory D.; Tatar, Ovidiu; Stupiansky, Nathan W.; Fisher, William A.; Rosberger, Zeev; Pediatrics, School of Medicine
    Over a decade has passed since the first human papillomavirus (HPV) vaccine was introduced. These vaccines have received unequivocal backing from the scientific and medical communities, yet continue to be debated in the media and within the general public. The current review is an updated examination that the authors made five years ago on some of the key sociocultural and behavioral issues associated with HPV vaccine uptake and acceptability, given the changing HPV vaccine policies and beliefs worldwide. We explore current worldwide HPV vaccination rates, outline HPV vaccine policies, and revisit critical issues associated with HPV vaccine uptake including: risk compensation, perceptions of vaccine safety and efficacy, age of vaccination, and healthcare provider (HCP) recommendation and communication. While public scrutiny of the vaccine has not subsided, empirical evidence supporting its safety and efficacy beyond preventing cervical cancer has amassed. There are conclusive findings showing no link that vaccinated individuals engage in riskier sexual behaviors as a result of being immunized (risk compensation) both at the individual and at the policy level. Finally, HCP recommendation continues to be a central factor in HPV vaccine uptake. Studies have illuminated how HCP practices and communication enhance uptake and alleviate misperceptions about HPV vaccination. Strategies such as bundling vaccinations, allowing nurses to vaccinate via “standing orders,” and diversifying vaccination settings (e.g., pharmacies) may be effective steps to increase rates. The successes of HPV vaccination outweigh the controversy, but as the incidence of HPV-related cancers rises, it is imperative that future research on HPV vaccine acceptability continues to identify effective and targeted strategies to inform HPV vaccination programs and improve HPV coverage rates worldwide.
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    The Influence of Age, Health Literacy, and Affluence on Adolescents’ Capacity to Consent to Research
    (Springer, 2016-04) Nelson, Lance R.; Stupiansky, Nathan W.; Ott, Mary A.; Department of Pediatrics, IU School of Medicine
    While adults are assumed to have the capacity to consent to medical research, and young children to have no capacity, adolescents’ capacity to consent is not well described. Adapting the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), we describe adolescents’ capacity to consent to medical research and factors influencing that capacity. Our pilot study included a community-based sample of 30 adolescents, 14 to 21 years of age, who completed the MacCAT-CR after undergoing a simulated informed consent process. We found that adolescents’ capacity to consent to research was associated with age, health literacy, and family affluence. These findings suggest that investigators and institutional review boards should be aware that factors other than age may influence capacity to consent, and, for modifiable factors, such as health literacy, consent processes for medical research with adolescents can be modified.
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    Vaccinating sons against HPV: results from a U.S. national survey of parents
    (PLoS, 2014-12-26) Taylor, Jaime L.; Zimet, Greg D.; Donahue, Kelly L.; Alexander, Andreia B.; Shew, Marcia L.; Stupiansky, Nathan W.; Department of Pediatrics, IU School of Medicine
    PURPOSE: The quadrivalent HPV vaccination was approved for use in males ages 9 to 26 in 2009 and recommended for routine administration in 2011. The purpose of this study was to uncover predictable commonalities amongst parents who chose to vaccinate their 11-17 year old sons against HPV. METHODS: We compiled data from a U.S. national sample of 779 parents with sons 11-17 years old using a web-based survey to gather information about behavioral and sociodemographic factors which predicted receipt of 1 or more HPV vaccine doses based on parental report. Predictors were first modeled individually for univariable associations. Significant predictors (p<0.10) were combined in a multivariable model. RESULTS: In the adjusted model, independent predictors included receipt of flu vaccination, health insurance coverage and sexual health topic discussions with sons. Sons who had received a flu shot in the last two years more frequently received at least one dose of the vaccine (OR 1.82; 95% CI 1.45-2.26). Sons covered by private health insurance had decreased odds of HPV vaccination (OR 0.56 95% CI 0.37-0.83). Lastly, parents who had discussed sexual health topics with their sons were more likely to vaccinate (OR 1.61; 95% CI 1.37-1.89). CONCLUSIONS: Male vaccination rates in the U.S. have increased, but males continue to be under-immunized. Utilization of health care is an important factor in HPV vaccine uptake; therefore, health care providers should use every contact as an opportunity to vaccinate. Communication about sexual health topics may provide a forum for parents and health care providers to have conversations about HPV vaccination as those more comfortable discussing these topics may also be more comfortable discussing HPV vaccination.