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Examining Short- And Long-Term Effects Of Preconception Counseling Delivered During Adolescence on Risk-taking Behaviors, Condom use, and Sexually Transmitted Infections among Females with Type 1 Diabetes

Thurheimer, Jennifer (2015) Examining Short- And Long-Term Effects Of Preconception Counseling Delivered During Adolescence on Risk-taking Behaviors, Condom use, and Sexually Transmitted Infections among Females with Type 1 Diabetes. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Aims: To examine the short-term efficacy (3-months post-intervention during adolescence) and long-term efficacy (15-years post-intervention) of receiving preconception counseling (READY-Girls) as an adolescent on risk-taking behaviors, condom use, and STI acquisition among females with type 1 diabetes (T1D).
Methods: Secondary analysis was conducted on data from randomized-control-trials of READY-Girls using a cohort of women with T1D during adolescence (N=136) and an expanded follow-up study of these and other adult women with T1D (N=75) using online surveys to measure risk-taking behaviors (e.g., substance use and unsafe sex), birth control (BC) use and STIs.
Results: Overall, there were no significant changes in risk-taking behaviors in this cohort over time. Only 25% of the adolescent sample reported having ever been sexually active. As adolescents, 60% reported having unprotected sex compared to 58% as adults. The three BC methods most frequently used by this cohort over time: oral contraceptives, condoms and withdrawal. Sixteen-percent had reported ever being diagnosed with an STI. No significant differences between groups were noted at 3-month post-READY-Girls in adolescence. However, adult women who received READY-Girls as adolescents were more likely to report later sexual debut and used condoms. READY-Girls appeared to increase adolescent perception of susceptibility, which was significantly associated with less unprotected sex during adulthood.
Conclusion: READY-Girls did not directly impact short or long-term risk-taking behaviors or STIs. However, READY-Girls focused on the effects of diabetes on reproductive health and the prevention of unplanned pregnancies to avoid complications. Consistent with our previous findings, it impacted age of sexual debut. Only a few adolescent health beliefs were associated with some sexual risk-taking behaviors as adults. The three most frequently used BC methods: oral contraceptives, condoms, and withdrawal remained consistent over time. Episodes of unprotected sex and use of withdrawal which started during adolescence and continued into adulthood was concerning. Our findings suggest, starting in adolescence, that some women with T1D appeared to engage in some risk-taking behavior and ineffective BC use, thereby, increasing their risks for STIs. Adding information to PC, including READY-Girls, on avoiding risk-taking behaviors, engaging in safer sexual practice and using condoms to prevent STIs is warranted.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Thurheimer, Jenniferjlt92@pitt.eduJLT92
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCharron-Prochownik, Denisedcpro@pitt.eduDCPRO
Committee CoChairSereika, Susan Mssereika@pitt.eduSSEREIKA
Committee MemberFounds, Sandrafoundss@pitt.eduFOUNDSS
Committee MemberDowns,
Date: 6 May 2015
Date Type: Publication
Defense Date: 10 April 2015
Approval Date: 6 May 2015
Submission Date: 28 April 2015
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 172
Institution: University of Pittsburgh
Schools and Programs: School of Nursing > Nursing
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: risk-taking behaviors, condom use, sexually transmitted infections, type 1 diabetes, reproductive health, preconception counseling
Date Deposited: 06 May 2015 17:49
Last Modified: 15 Nov 2016 14:28


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