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Effects of area and family deprivation on risk factors for teenage pregnancy among 13 – 15-year-old girlsSmith, Debbie M.; Elander, James; University of Derby; London Metropolitan University (2006-11-01)Information is needed about how the effects of socio-economic deprivation on teenage pregnancy are mediated by proximal risk factors, in order to target area-wide and family interventions more effectively. Using a 262 factorial design, we tested the separate and interacting effects of area deprivation and family deprivation on six specific proximal risk factors for teenage pregnancy: early sexual activity, life expectations, knowledge and beliefs about contraceptives, attitude to abortion, beliefs about love, and use of local sexual health services. Data were collected from 201 13 – 15- year-old girls in deprived and non-deprived families living in deprived and more affluent areas of the United Kingdom. Area deprivation significantly increased early sexual activity, and both area and family deprivation significantly reduced life expectations. Significant interactions between area and family deprivation showed that the impact of living in a deprived area depends to some extent on family circumstances, with implications for targeting different types of intervention. Living in a deprived area increased early sexual activity much more markedly among girls in deprived families, so interventions to reduce early sexual activity could target individually deprived girls living in deprived areas. Living in a more affluent area increased life expectations, but only among girls in non-deprived families, so both area-wide and individually targeted interventions would be needed to raise life expectations among girls most at risk of teenage pregnancy.
Motivational and behavioural models of change: A longitudinal analysis of change among men with chronic haemophilia-related joint painElander, James; Richardson, Cassandra; Morris, John; Robinson, Georgina; Schofield, Malcolm B.; University of Derby; University of Central Lancashire; Haemophilia Society UK; London Metropolitan University; Centre for Psychological Research; University of Derby; UK; et al. (Wiley, 2017-08-10)Background: Motivational and behavioral models of adjustment to chronic pain make different predictions about change processes, which can be tested in longitudinal analyses. Methods: We examined changes in motivation, coping and acceptance among 78 men with chronic hemophilia-related joint pain. Using cross-lagged regression analyses of changes from baseline to 6 months as predictors of changes from 6 to 12 months, with supplementary structural equation modelling, we tested two models in which motivational changes influence behavioral changes, and one in which behavioral changes influence motivational changes. Results: Changes in motivation to self-manage pain influenced later changes in pain coping, consistent with the motivational model of pain self-management, and also influenced later changes in activity engagement, the behavioral component of pain acceptance. Changes in activity engagement influenced later changes in pain willingness, consistent with the behavioral model of pain acceptance. Conclusions: Based on the findings, a combined model of changes in pain self-management and acceptance is proposed, which could guide combined interventions based on theories of motivation, coping and acceptance in chronic pain.