Last modified: Tuesday, November 1, 2011
IU researchers discuss birth control, childhood obesity and more at the American Public Health Association meeting
Editors: Dozens of studies by Indiana University researchers have been discussed at the American Public Health Association annual meeting Oct. 29-Nov. 2 in Washington, D.C. Below is a sample of the studies.
Bisexual men: When sexual health requires stealth. Bisexual men have unique health needs compared to exclusively homosexual and heterosexual men, but the stigma they face makes learning of their needs -- and even reaching these men in their "hidden communities" -- difficult for public health professionals, say Indiana University researchers. The reported need for privacy, because of the perceived stigma and lack of acceptance in both homosexual and heterosexual communities, is so pervasive that bisexual men often do not feel comfortable accessing sexual health-related services, even those targeted toward "gay and bisexual men," because of a concern over what others would think of their bisexuality. A more general approach to providing services, framed as "men's health" or "men's sexual health," will most likely be more effective, researchers learned. "In terms of designing a specific program for behaviorally bisexual men, we've learned it will not be effective to openly advertise about it or put it on billboards; we have to be more discreet," said Brian Dodge, associate director of the Center for Sexual Health Promotion at IU. Dodge's research for nearly 10 years has involved bisexual behavior and associated health needs, yet these findings from his recent study were "surprising." "The fear of disclosure, desire for privacy, and anticipation of stigma are even more problematic than we anticipated," he said. "The reasons for these issues eventually need to be addressed not only with bisexual men but also at the societal level if we are to increase participation in effective health services without operating in stealth."
About the study:
- This and three other studies discussed at the American Public Health Association's annual meeting are part of a larger study by Dodge and his collaborators, who are looking at health issues specific to bisexual men. This research approach is unique because most studies have combined bisexual men with gay men in previous behavioral science research.
- The IU research involved 75 men in the Indianapolis area who had sex with at least one man and one woman within the previous six months. The participants each underwent in-depth interviews, 15 of which were conducted in Spanish. Of the participants, 25 were black, 25 were white and 25 were Latino.
Dodge's study "Administering Sexual Health-Related Services to Bisexual Men: Privacy, Trust and Appropriate Messaging" was the recipient of the annual Excellence in Abstract Submission award from the HIV/AIDS Section of the APHA. Dodge is delivering an oral presentations about this study on Tuesday, and on Monday discussed "Community Based Research in 'Hidden' Communities: Understanding Individual and Social Health Concerns among Bisexual Men." He also delivered a poster presentation, "Sexual Behaviors and Experiences among Bisexual Men in the Midwestern United States." Co-investigator Omar Martinez on Tuesday is also presenting on issues specific to Latino participants in his talk "Sexual Health and Access to Care: Voices from Bisexual Latino Men in the Midwestern United States."
Dodge, an associate professor in the Department of Applied Health Science in IU's School of Health, Physical Education and Recreation, will discuss "Administering Sexual Health-Related Services" Tuesday, Nov. 1, at 11:30 a.m. in the Washington Convention Center. Co-authors are Phillip Schnarrs, Gabriel Goncalves, Michael Reece and Omar Martinez, all with the IU School of HPER; David Malebranche of Emory University School of Medicine; Ryan Nix of Step Up Inc. in Indianapolis; Barbara Van Der Pol of IU School of HPER; and J. Dennis Fortenberry of the IU School of Medicine.
It takes a community to address childhood obesity? A dynamic community collaboration in Monroe County, Indiana, is taking a team approach to helping children who struggle with weight issues. The 24-week program, which is free and includes eight community partners, has helped children reduce their Body Mass Index (BMI), increase their interest in nutrition amd exercise and improve their self-esteem. "We want to promote healthy eating, fun physical activity and postitive emotions," said Hannah Laughlin, program coordinator of G.O.A.L. (Get Onboard Active Living) and community health educator at Indiana University Health Bloomington. "Our mission is to provide children and families with education and support on nutrition, exercise, behavioral habits and even community resources to help them make positive, healthy, life-long changes." Laughlin discussed the ins and outs of the family-centered program on Monday during a presentation at the American Public Health Association annual meeting in Washington, D.C.
Here are the results after the first year, during which the program involved 40 children ages 6-18.
- 72.5 percent of children had a decreased BMI
- 75.7 percent of children lost inches from their waist
- 91.3 percent reported using food labels to make better food choices
- 76.5 percent of parents reported improved self esteem for their child
- 100 percent of families had fun as a family at G.O.A.L.
Families can be referred to G.O.A.L. by their primary care physician. Once enrolled, community partners provide medical, behavioral, nutrition, exercise and community education and support. The partners include a local hospital, YMCA, public schools, and Indiana University. "G.O.A.L. is unique because it offers the support of so many community partners and utilizes community field trips to introduce families to local resources," Laughlin said. Catherine Sherwood-Laughlin, clinical associate professor in the School of HPER and an evaluator of the program, said the response she receives when discussing the program is predictable. First colleagues, students and community members say the program is remarkable. "And then they ask, 'How do you make it work?'" she said. She said it involves a lot of dedication from the partners and near-constant reassessment of what works and what does not. The individuals involved -- and the institutions and organizations that support them -- realize that maintaining a healthy weight is complicated, much more than simply calculating calories consumed and calories burned. It requires more than diet and exercise assistance. "The G.O.A.L. program team knows that these children experience bullying, have low self-esteem, have experienced discrimination and have been diagnosed with obesity related co-morbidities," said Sherwood-Laughlin. "The approach is multifaceted, multi-dimensional while at the same time is individualized for each child."
The community partners are IU Health Bloomington, Southern Indiana Pediatrics, the City of Bloomington Parks and Recreation, Monroe County YMCA, Monroe County Community School Corp., Richland Bean-Blossom Community School Corp., The Office of Community Health Engagement in IU's School of HPER, and the School of HPER's Department of Kinesiology.
Co-authors of the study are the G.O.A.L. program and planning team: Catherine Sherwood-Laughlin, with IU's Office of Community Health Engagement; Scot B. Moore, M.D., Southern Indiana Pediatrics; Lindsay Buuck, City of Bloomington Parks and Recreation; Stacey Matavuli and Samantha Schaefer, IU Health Bloomington; Jean Sherfick, Monroe County YMCA; Danielle Neukam, IU's Department of Applied Health Science; Jessica Bare, AmeriCorps Improving Health Throughout Indiana; and Ann Moore, behavioral consultant.
Not your mother's birth control, same troubles. Today's hormonal forms of birth control are vastly different from those used by earlier generations of women, both with lower levels of hormones and with different means of delivery (not just a pill), but many of the same problems related to women's pleasure remain. An Indiana University study that examined how newer forms of hormonal contraception affect things such as arousal, lubrication and orgasm, found that they could still hamper important aspects of sexuality despite the family planning benefits and convenience. "Contraception in general is a wonderful way for women to plan their families," said lead researcher Nicole Smith, project coordinator at IU's Center for Sexual Health Promotion. "It's something women are often on for as many as 30 years or more; it plays a huge part in their life. If they're experiencing these negative effects, they might stop using contraception correctly or altogether. They need to know that there are options, such as lubricants or other sexual enhancement products that may help to alleviate some of the negative effects they are experiencing. "Women should also be counseled on the many highly effective forms of birth control currently available; switching to another method might work better for them," she said.
About the study:
- The study involved 1,101 sexually active women split almost evenly between those using a hormonal form of contraception such as the pill, patch, ring or shot, and those women using a non-hormonal form, such as a condom, diaphragm, cervical cap or withdrawal. The study, based on data collected by the Kinsey Institute's Women's Well-being study, which used an online questionnaire, found that the women reported similar levels of sexual satisfaction, which included things such as intimacy and romance, but the women using hormonal contraception experienced less arousal, fewer orgasms, difficulties with lubrication, decreased pleasure and less frequent sex. "A great effort has been made to make condoms more pleasurable for men," Smith said. "But you don't hear about this same effort going toward reducing the negative impact of contraception on women's sexual functioning. It's just not part of the discussion."
- Researchers have examined the relationship between hormonal forms of contraception and sexual functioning but, Smith said, few studies have been conducted since the 1980s. Previous findings were inconclusive and focused on women in Europe. Her study, conducted with colleagues from CSHP and the Kinsey Institute, provides updated findings and also important information for clinicians to use when helping women with their birth control needs. Having worked for a family planning program, Smith said it is common for women to talk about negative side effects such as these with their health care provider.
Smith said she is very interested in seeing whether women's contraception choices change when components of the federal Affordable Care Act are implemented next year, making preventive care features such as contraception free for women with insurance. This will make the more expensive, longer-acting forms of contraception available to more women, Smith said.
Smith, a doctoral student in the Department of Applied Health Science in IU's School of Health, Physical Education and Recreation, presented her study on Monday. Co-authors are Kristen N. Jozkowski, College of Education and Health Professions at the University of Arkansas; and Stephanie A. Sanders, IU's Kinsey Institute for Research in Sex, Gender and Reproduction, and the Department of Gender Studies in the College of Arts and Sciences.
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