Risky Behavior in Teens With Cystic Fibrosis or Sickle Cell Disease: A Multicenter Study

Britto, Maria T.; Garrett, Joanne M.; Dugliss, M. A. J.; Daeschner, Charles W.; Johnson, Cory; Leigh, Margaret W.; Majure, Joseph M.; Schultz, William H.; Konrad, Thomas R.

doi:10.1542/peds.101.2.250

Cited by 126 publications

(91 citation statements)

References 23 publications

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“…Further analysis of the data revealed that by the time participants in the sample reached full sexual maturity (Tanner stage V), at least half reported being sexually active, compared to less than a third in the earlier stages of pubertal development. Noteworthy is the fact that the rates of sexual activity reported in this study are similar to rates of sexual activity reported in studies of adolescents with other chronic diseases such as cystic fibrosis and sickle cell anemia (Britto et al, 1998). Consistent with the findings of Brown et al (2000), health status as reflected by the level of severe immunosuppression (absolute CD4 counts below 200 cells/mm 3 ) did not preclude adolescents from being sexually active.…”

Section: Discussionsupporting

confidence: 84%

A Longitudinal Study of Adolescents with Perinatally or Transfusion Acquired HIV Infection: Sexual Knowledge, Risk Reduction Self-efficacy and Sexual Behavior

2006

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As HIV-positive children are surviving to adolescence and beyond, understanding their HIV knowledge and sexual behavior is critical. Forty HIV+ adolescents/young adults were interviewed twice, approximately 21 months apart (mean age 16.6 and 18.3 years, respectively). Data on demographics, safer sex knowledge, sexual risk behaviors, risk reduction self-efficacy, and Tanner stage were collected. Twenty-eight percent of HIV+ youth at Time 1 and 41% at Time 2 reported being sexually active. HIV transmission/safer sex knowledge was low, increased with age, and both self-efficacy for and actual condom use was relatively high. Secondary prevention messages should be incorporated into routine medical settings.

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Section: Discussionsupporting

confidence: 84%

A Longitudinal Study of Adolescents with Perinatally or Transfusion Acquired HIV Infection: Sexual Knowledge, Risk Reduction Self-efficacy and Sexual Behavior

2006

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“…59 Dental health items included frequency of dental appointments and brushing and flossing teeth, and prophylactic antibiotic use before dental procedures that may cause bleeding, which is one of the few CHD-specific health behaviors Based on previous studies (eg, refs 60 -62), risk-perception and self-efficacy questions were developed for attending cardiac appointments, exercise, antibiotics prophylaxis, taking cardiac medications, and quitting smoking. Risk of CHD complications and self-efficacy to affect heart health and well being in general were assessed also.…”

Section: Predictor Variablesmentioning

confidence: 99%

Prevalence and Correlates of Successful Transfer From Pediatric to Adult Health Care Among a Cohort of Young Adults With Complex Congenital Heart Defects

et al. 2004

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ABSTRACT. Objectives. More than 85% of children born today with chronic medical conditions will live to adulthood, and many should transfer from pediatric to adult health care. The numbers of adults with congenital heart defects (CHDs) are increasing rapidly. Current guidelines recommend that just over half of adult CHD patients should be seen every 12 to 24 months by a cardiologist with specific CHD expertise at a regional CHD center, because they are at risk for serious complications (eg, reoperation and/or arrhythmias) and premature mortality. The present study aimed to determine the percent of young adults with CHDs who successfully transferred from pediatric to adult care and examine correlates of successful transfer.Design. Cross-sectional study with prevalence data from an entire cohort.Setting and Patients. All patients (n ‫؍‬ 360) aged 19 to 21 years with complex CHDs who, according to current practice guidelines, should be seen annually at a specialized adult CHD center were identified from the database of the cardiology program at the Hospital for Sick Children in Toronto, Canada, a pediatric tertiary care center. Of these patients, 234 completed measures about health beliefs, health behaviors, and medical care since age 18 years.Main Outcome Measure. All 15 specialized adult CHD centers in Canada formed the Canadian Adult Congenital Heart (CACH) Network. Attendance for at least 1 follow-up appointment at a CACH center before the age of 22 years was ascertained for all eligible patients. Attendance at a CACH center provides a clear criterion for successful transfer.Results. In the total cohort, 47% (95% confidence interval [CI]: 42-52) had transferred successfully to adult care. There was no difference in rates of successful transfer between patients consenting to complete questionnaires (48%) and those who declined (47%). More than one quarter (27%) of the patients reported having had no cardiac appointments since 18 years.In Conclusions. This is the first study to document the percent of young adults with a chronic illness who successfully transfer to adult care in a timely manner. Patients were from an entire birth cohort from the largest pediatric cardiac center in Canada, and outcome data were obtained on all eligible patients. Similar data should be obtained for other chronic illnesses. There is need for considerable improvement in the numbers of young adults with CHDs who successfully transfer to adult care. At-risk adolescents with CHDs should begin the transition process before their teens, should be educated in the importance of antibiotic prophylaxis, should be contacted if a follow-up appointment is missed, and should be directed to a specific CHD cardiologist or program, with the planned timing being stated explicitly.Adult care needs to be discussed in the pediatric setting, and patients must acquire appropriate beliefs about adult care well before transfer. Developmentally appropriate, staged discussions involving the patient, with and without parents, throughout adolescence may help pa...

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“…The prevalence of alcohol use in adolescents varies from 7.8% to 78.9%12 , 14 , 15 around the world and from 26% to 71% in Brazil 1621 There are studies in adolescents with specific CDs, generally with small samples and variable frequencies of alcohol use (4.8%-70%), such as juvenile idiopathic arthritis,22 obesity and overweight,23 asthma,24 cystic fibrosis and sickle cell disease 25. This finding in our CDs patients may be related to the availability of alcohol at parties, pubs, stores and homes in Brazil 16…”

Section: Discussionmentioning

confidence: 99%

Substance misuse and sexual function in adolescents with chronic diseases

Araújo

Carvalho

Weelden

et al. 2016

Revista Paulista de Pediatria (English Edition)

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Objective:To evaluate alcohol/tobacco and/or illicit drug misuse in Chronic Diseases (CDs).Methods:A cross-sectional study with 220 CDs adolescents and 110 healthy controls including: demographic/anthropometric data; puberty markers; modified questionnaire evaluating sexual function, alcohol/smoking/illicit drug misuse and bullying; and the physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk.Results:The frequencies of alcohol/tobacco and/or illicit drug use were similar in both groups (30% vs. 34%, p=0.529), likewise the frequencies of bullying (42% vs. 41%, p=0.905). Further analysis solely in CDs patients that used alcohol/tobacco/illicit drug versus those that did not use showed that the median current age [15 (11–18) vs. 14 (10–18) years, p <0.0001] and education years [9 (5–14) vs. 8 (3–12) years, p <0.0001] were significant higher in substance use group. The frequencies of Tanner 5 (p <0.0001), menarche (p <0.0001) and spermarche (p=0.001) were also significantly higher in patients with CDs that used alcohol/tobacco/illicit, likewise sexual activity (23% vs. 3%, p <0.0001). A trend of a low frequency of drug therapy was observed in patients that used substances (70% vs. 82%, p=0.051). A positive correlation was observed between CRAFFT score and current age in CD patients (p=0.005, r=+0.189) and controls (p=0.018, r=+0.226).Conclusions:A later age was evidenced in CDs patients that reported licit/ilicit drug misuse. In CDs adolescent, substance use was more likely to have sexual intercourse. Our study reinforces that these patients should be systematically screened by pediatricians for drug related health behavioral patterns.

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Risky Behavior in Teens With Cystic Fibrosis or Sickle Cell Disease: A Multicenter Study

Cited by 126 publications

References 23 publications

A Longitudinal Study of Adolescents with Perinatally or Transfusion Acquired HIV Infection: Sexual Knowledge, Risk Reduction Self-efficacy and Sexual Behavior

A Longitudinal Study of Adolescents with Perinatally or Transfusion Acquired HIV Infection: Sexual Knowledge, Risk Reduction Self-efficacy and Sexual Behavior

Prevalence and Correlates of Successful Transfer From Pediatric to Adult Health Care Among a Cohort of Young Adults With Complex Congenital Heart Defects

Substance misuse and sexual function in adolescents with chronic diseases

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