Denise Dion Hallfors
Dados Biográficos
| ID | 341868 |
|---|---|
| NOME | Denise Dion Hallfors |
| PRENOMES | Denise Dion |
| SOBRENOME | Hallfors |
| ASSINATURA | HALLFORS D D |
| AFILIAÇÕES | Pacific Institute For Research and Evaluation |
| ORCID | 0000-0003-0047-1454 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 26 |
| TOTAL DE CITAÇÕES | 76 |
| TOTAL COMO AUTOR | 26 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2004 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2021 |
| ÍNDICE H | 5 |
Ethics of pursuing targets in public health
The use of targets to direct public health programmes, particularly in global initiatives, has become widely accepted and commonplace. This paper is an ethical analysis of the utilisation of targets in global public health using our fieldwork on and experiences with voluntary medical male circumcision (VMMC) initiatives in Kenya. Among the many countries involved in VMMC for HIV prevention, Kenya is considered a success story, its programmes havi…
Consent Challenges and Psychosocial Distress in the Scale-up of Voluntary Medical Male Circumcision Among Adolescents in Western Kenya
If the mother does not know, there is no way she can tell the adolescent to go for drugs”
I think the parent should be there because no one was born alone”
Despite a pressing need for adolescent HIV research in sub-Saharan Africa, ethical guidance for conducting research among minor adolescents is lacking. One ethical issue is the degree to which parents should be involved in the research process. The existing discourse is predominantly speculative and focuses on negative consequences of parental involvement. We use empirical data to describe the perspectives of Kenyan adolescents on parental involv…
Experiences along the HIV care continuum
To be effective, HIV programmes should be responsive to the unique needs of diverse groups of infected adolescents. We highlight a range of adolescent perspectives on HIV services, including those who acquired HIV perinatally or sexually and those who were either in care, had dropped out of care, or had never enrolled in care. We conducted semi-structured interviews with 29 adolescents (aged 15-19) and 14 caregivers in western Kenya. Data were an…
The Significance of Benefit Perceptions for the Ethics of HIV Research Involving Adolescents in Kenya
Assessment of benefits is traditionally regarded as crucial to the ethical evaluation of research involving human participants. We conducted focus group discussions (FGDs) with health and other professionals engaged with adolescents, caregivers/parents, and adolescents in Siaya County, Kenya, to solicit opinions about appropriate ways of conducting HIV research with adolescents. Our data revealed that many focus group participants have a profound…
Influence of school support on early marriage experiences and health services utilization among young orphaned women in Zimbabwe
School support programs reduce school dropout, early marriage, and early pregnancy for a majority of young orphaned women. We used a mixed-methods approach to examine why these programs are less effective for a significant minority by exploring their influence on marriage and health services utilization. Participants were from a randomized controlled trial testing school support as HIV prevention. Half as many intervention as control participants…
Marital Age Disparity Among Orphaned Young Women and Their Husbands
I thought if I marry the prophet I would not die
This study examines the association between religious affiliation and reasons for marriage, perceived church attitudes, and reproductive health-seeking behaviors, including HIV testing, among young women in eastern rural Zimbabwe. The sample comprised women (N = 35) who had married by 2012 while participating in a larger randomized controlled trial (RCT) to test the effects of school support on HIV-related risk. The RCT sample was identified in 2…
HIV infection and related risk behaviors
Research is limited on whether providing school support to female adolescent orphans mitigates their HIV risk disadvantage compared to other female adolescents. This paper examines 2011 Zimbabwe Demographic and Health Survey (ZDHS) HIV-related biomarker and behavior data for orphaned and nonorphaned rural adolescent females to compare findings from a similar sample participating in a randomized controlled trial (RCT) testing school support as HIV…
Educational Outcomes for Orphan Girls in Rural Zimbabwe
Educational achievement has important implications for the health and well-being of young women in sub-Saharan Africa. The authors assessed the effects of providing school support on educational outcomes of orphan girls in rural Zimbabwe. Data were from a randomized controlled trial offering the intervention group comprehensive schooling support and controls no treatment initially and then fees only. Results indicated comprehensive support reduce…
Use of HIV and HSV-2 Biomarkers in Sub-Saharan Adolescent Prevention Research
Self-report of sexual behavior among adolescents is notoriously inconsistent, yet such measures are commonly used as outcomes for human immunodeficiency virus (HIV) prevention intervention trials. There has been a growing interest in the use of HIV and other sexually transmitted disease biomarkers as more valid measures of intervention impact in high HIV prevalence areas, particularly in sub-Saharan Africa. We examine the challenges, benefits, an…
A Mixed Methods Mapping of Church Versus Secular School Messages to Influence Sexual Decision Making as Perceived by Zimbabwean Orphan Girl Students
This study examined the messages perceived by adolescent girls with orphanhood to influence their sexual decision-making. Participants were 125 students (mean age =14.7 years), 54% of whom attended church schools in a rural district of eastern Zimbabwe. We collected and analyzed data using concept mapping, a mixed method approach that enabled the construction of message clusters, with weighting for their relative importance. Messages that cluster…
Preventing HIV by providing support for orphan girls to stay in school
Findings contradict an earlier seminal study that Apostolics are relatively protected from HIV compared to other Christian denominations. Young Apostolic women are at increased risk of HIV infection through early marriage. The Apostolic Church is a large and growing denomination in sub-Saharan Africa and many Apostolic sects discourage medical testing and treatment in favor of faith healing. Since this can increase the risk of undiagnosed HIV inf…
Apostolic faith church organization contexts for health and wellbeing in women and children
The findings suggest that the structural activities of the church for health and wellbeing could also have the paradoxical effect of exposing women and children to health risks from obligatory roles
Supporting Adolescent Orphan Girls to Stay in School as HIV Risk Prevention
Objectives. Using a randomized controlled trial in rural eastern Zimbabwe, we tested whether comprehensive support to keep orphan adolescent girls in school could reduce HIV risk. Methods. All orphan girls in grade 6 in 25 primary schools were invited to participate in the study in fall 2007 (n = 329). Primary schools were randomized to condition. All primary schools received a universal daily feeding program; intervention participants received f…
Evaluating Group-Based Interventions When Control Participants Are Ungrouped
Individually randomized treatments are often administered within a group setting. As a consequence, outcomes for treated individuals may be correlated due to provider effects, common experiences within the group, and/or informal processes of socialization. In contrast, it is often reasonable to regard outcomes for control participants as independent, given that these individuals are not placed into groups. Although this kind of design is common i…
Sexual and Drug Behavior Patterns and HIV and STD Racial Disparities
Objectives. We used nationally representative data to examine whether individuals’ sexual and drug behavior patterns account for racial disparities in sexually transmitted disease (STD) and HIV prevalence. Methods. Data were derived from wave III of the National Longitudinal Study of Adolescent Health. Participants were aged 18 to 26 years old; analyses were limited to non-Hispanic Blacks and Whites. Theory and cluster analyses yielded 16 unique …
Gene-Environment Contributions to Young Adult Sexual Partnering
Sexual Behavior and Drug Use Among Asian and Latino Adolescents
Hallfors and Steckler Respond
We appreciate Rotheram-Borus’s interest in our study and her letter. We agree that interventions often need to be reconsidered when they do not fit the context for which they were developed. We conducted a feasibility test of a screening instrument for suicide that was specifically developed for high school students in the school setting. It should be noted that we did not develop the screening instrument and that we were testing it within a rand…
Feasibility of Screening Adolescents for Suicide Risk in “Real-World” High School Settings
Objectives. We evaluated the feasibility of a population-based approach to preventing adolescent suicide. Methods. A total of 1323 students in 10 high schools completed the Suicide Risk Screen. Screening results, student follow-up, staff feedback, and school responses were assessed. Results. Overall, 29% of the participants were rated as at risk of suicide. As a result of this overwhelming percentage, school staffs chose to discontinue the screen…
Efficacy vs Effectiveness Trial Results of an Indicated “Model” Substance Abuse Program
Objectives. The US Department of Education requires schools to choose substance abuse and violence prevention programs that meet standards of effectiveness. The Substance Abuse and Mental Health Services Agency certifies “model” programs that meet this standard. We compared findings from a large, multisite effectiveness trial of 1 model program to its efficacy trial findings, upon which the certification was based. Methods. 1370 high-risk youths …
Which Comes First in Adolescence—Sex and Drugs or Depression?
Implications of Racial and Gender Differences In Patterns of Adolescent Risk Behavior for HIV And Other Sexually Transmitted Diseases
Adolescents' risk behavior patterns vary by race and gender, and do not necessarily correlate with their STD prevalence. Further investigation of adolescents' partners and sexual networks is needed
Sexual and Drug Behavior Patterns and HIV and STD Racial Disparities
Objectives. We used nationally representative data to examine whether individuals’ sexual and drug behavior patterns account for racial disparities in sexually transmitted disease (STD) and HIV prevalence. Methods. Data were derived from wave III of the National Longitudinal Study of Adolescent Health. Participants were aged 18 to 26 years old; analyses were limited to non-Hispanic Blacks and Whites. Theory and cluster analyses yielded 16 unique …
Implications of Racial and Gender Differences In Patterns of Adolescent Risk Behavior for HIV And Other Sexually Transmitted Diseases
Adolescents' risk behavior patterns vary by race and gender, and do not necessarily correlate with their STD prevalence. Further investigation of adolescents' partners and sexual networks is needed
Apostolic faith church organization contexts for health and wellbeing in women and children
The findings suggest that the structural activities of the church for health and wellbeing could also have the paradoxical effect of exposing women and children to health risks from obligatory roles
Feasibility of Screening Adolescents for Suicide Risk in “Real-World” High School Settings
Objectives. We evaluated the feasibility of a population-based approach to preventing adolescent suicide. Methods. A total of 1323 students in 10 high schools completed the Suicide Risk Screen. Screening results, student follow-up, staff feedback, and school responses were assessed. Results. Overall, 29% of the participants were rated as at risk of suicide. As a result of this overwhelming percentage, school staffs chose to discontinue the screen…
Supporting Adolescent Orphan Girls to Stay in School as HIV Risk Prevention
Objectives. Using a randomized controlled trial in rural eastern Zimbabwe, we tested whether comprehensive support to keep orphan adolescent girls in school could reduce HIV risk. Methods. All orphan girls in grade 6 in 25 primary schools were invited to participate in the study in fall 2007 (n = 329). Primary schools were randomized to condition. All primary schools received a universal daily feeding program; intervention participants received f…
Gene-Environment Contributions to Young Adult Sexual Partnering
A Mixed Methods Mapping of Church Versus Secular School Messages to Influence Sexual Decision Making as Perceived by Zimbabwean Orphan Girl Students
This study examined the messages perceived by adolescent girls with orphanhood to influence their sexual decision-making. Participants were 125 students (mean age =14.7 years), 54% of whom attended church schools in a rural district of eastern Zimbabwe. We collected and analyzed data using concept mapping, a mixed method approach that enabled the construction of message clusters, with weighting for their relative importance. Messages that cluster…
I thought if I marry the prophet I would not die
This study examines the association between religious affiliation and reasons for marriage, perceived church attitudes, and reproductive health-seeking behaviors, including HIV testing, among young women in eastern rural Zimbabwe. The sample comprised women (N = 35) who had married by 2012 while participating in a larger randomized controlled trial (RCT) to test the effects of school support on HIV-related risk. The RCT sample was identified in 2…
Preventing HIV by providing support for orphan girls to stay in school
Findings contradict an earlier seminal study that Apostolics are relatively protected from HIV compared to other Christian denominations. Young Apostolic women are at increased risk of HIV infection through early marriage. The Apostolic Church is a large and growing denomination in sub-Saharan Africa and many Apostolic sects discourage medical testing and treatment in favor of faith healing. Since this can increase the risk of undiagnosed HIV inf…
The Significance of Benefit Perceptions for the Ethics of HIV Research Involving Adolescents in Kenya
Assessment of benefits is traditionally regarded as crucial to the ethical evaluation of research involving human participants. We conducted focus group discussions (FGDs) with health and other professionals engaged with adolescents, caregivers/parents, and adolescents in Siaya County, Kenya, to solicit opinions about appropriate ways of conducting HIV research with adolescents. Our data revealed that many focus group participants have a profound…
Efficacy vs Effectiveness Trial Results of an Indicated “Model” Substance Abuse Program
Objectives. The US Department of Education requires schools to choose substance abuse and violence prevention programs that meet standards of effectiveness. The Substance Abuse and Mental Health Services Agency certifies “model” programs that meet this standard. We compared findings from a large, multisite effectiveness trial of 1 model program to its efficacy trial findings, upon which the certification was based. Methods. 1370 high-risk youths …
Implications of Racial and Gender Differences In Patterns of Adolescent Risk Behavior for HIV And Other Sexually Transmitted Diseases
Adolescents' risk behavior patterns vary by race and gender, and do not necessarily correlate with their STD prevalence. Further investigation of adolescents' partners and sexual networks is needed
Implications of Racial and Gender Differences In Patterns of Adolescent Risk Behavior for HIV And Other Sexually Transmitted Diseases
CONTEXT: Sexual and substance use behaviors covary in adolescence. Prevalence of HIV and other sexually transmitted diseases (STDs) differs according to race and gender, yet few studies have systematically investigated risk behavior patterns by subgroup, particularly with nationally representative data. METHODS: A priori considerations and K-means cluster analysis were used to group 13,998 non-Hispanic black and white participants in the National…
Which Comes First in Adolescence—Sex and Drugs or Depression?
Sexual Behavior and Drug Use Among Asian and Latino Adolescents
Hallfors and Steckler Respond
We appreciate Rotheram-Borus’s interest in our study and her letter. We agree that interventions often need to be reconsidered when they do not fit the context for which they were developed. We conducted a feasibility test of a screening instrument for suicide that was specifically developed for high school students in the school setting. It should be noted that we did not develop the screening instrument and that we were testing it within a rand…
Feasibility of Screening Adolescents for Suicide Risk in “Real-World” High School Settings
Objectives. We evaluated the feasibility of a population-based approach to preventing adolescent suicide. Methods. A total of 1323 students in 10 high schools completed the Suicide Risk Screen. Screening results, student follow-up, staff feedback, and school responses were assessed. Results. Overall, 29% of the participants were rated as at risk of suicide. As a result of this overwhelming percentage, school staffs chose to discontinue the screen…
Efficacy vs Effectiveness Trial Results of an Indicated “Model” Substance Abuse Program
Objectives. The US Department of Education requires schools to choose substance abuse and violence prevention programs that meet standards of effectiveness. The Substance Abuse and Mental Health Services Agency certifies “model” programs that meet this standard. We compared findings from a large, multisite effectiveness trial of 1 model program to its efficacy trial findings, upon which the certification was based. Methods. 1370 high-risk youths …
Sexual and Drug Behavior Patterns and HIV and STD Racial Disparities
Objectives. We used nationally representative data to examine whether individuals’ sexual and drug behavior patterns account for racial disparities in sexually transmitted disease (STD) and HIV prevalence. Methods. Data were derived from wave III of the National Longitudinal Study of Adolescent Health. Participants were aged 18 to 26 years old; analyses were limited to non-Hispanic Blacks and Whites. Theory and cluster analyses yielded 16 unique …
Gene-Environment Contributions to Young Adult Sexual Partnering
Evaluating Group-Based Interventions When Control Participants Are Ungrouped
Individually randomized treatments are often administered within a group setting. As a consequence, outcomes for treated individuals may be correlated due to provider effects, common experiences within the group, and/or informal processes of socialization. In contrast, it is often reasonable to regard outcomes for control participants as independent, given that these individuals are not placed into groups. Although this kind of design is common i…
Apostolic faith church organization contexts for health and wellbeing in women and children
The findings suggest that the structural activities of the church for health and wellbeing could also have the paradoxical effect of exposing women and children to health risks from obligatory roles
Supporting Adolescent Orphan Girls to Stay in School as HIV Risk Prevention
Objectives. Using a randomized controlled trial in rural eastern Zimbabwe, we tested whether comprehensive support to keep orphan adolescent girls in school could reduce HIV risk. Methods. All orphan girls in grade 6 in 25 primary schools were invited to participate in the study in fall 2007 (n = 329). Primary schools were randomized to condition. All primary schools received a universal daily feeding program; intervention participants received f…
Preventing HIV by providing support for orphan girls to stay in school
Findings contradict an earlier seminal study that Apostolics are relatively protected from HIV compared to other Christian denominations. Young Apostolic women are at increased risk of HIV infection through early marriage. The Apostolic Church is a large and growing denomination in sub-Saharan Africa and many Apostolic sects discourage medical testing and treatment in favor of faith healing. Since this can increase the risk of undiagnosed HIV inf…
Use of HIV and HSV-2 Biomarkers in Sub-Saharan Adolescent Prevention Research
Self-report of sexual behavior among adolescents is notoriously inconsistent, yet such measures are commonly used as outcomes for human immunodeficiency virus (HIV) prevention intervention trials. There has been a growing interest in the use of HIV and other sexually transmitted disease biomarkers as more valid measures of intervention impact in high HIV prevalence areas, particularly in sub-Saharan Africa. We examine the challenges, benefits, an…
A Mixed Methods Mapping of Church Versus Secular School Messages to Influence Sexual Decision Making as Perceived by Zimbabwean Orphan Girl Students
This study examined the messages perceived by adolescent girls with orphanhood to influence their sexual decision-making. Participants were 125 students (mean age =14.7 years), 54% of whom attended church schools in a rural district of eastern Zimbabwe. We collected and analyzed data using concept mapping, a mixed method approach that enabled the construction of message clusters, with weighting for their relative importance. Messages that cluster…
HIV infection and related risk behaviors
Research is limited on whether providing school support to female adolescent orphans mitigates their HIV risk disadvantage compared to other female adolescents. This paper examines 2011 Zimbabwe Demographic and Health Survey (ZDHS) HIV-related biomarker and behavior data for orphaned and nonorphaned rural adolescent females to compare findings from a similar sample participating in a randomized controlled trial (RCT) testing school support as HIV…
Educational Outcomes for Orphan Girls in Rural Zimbabwe
Educational achievement has important implications for the health and well-being of young women in sub-Saharan Africa. The authors assessed the effects of providing school support on educational outcomes of orphan girls in rural Zimbabwe. Data were from a randomized controlled trial offering the intervention group comprehensive schooling support and controls no treatment initially and then fees only. Results indicated comprehensive support reduce…
Influence of school support on early marriage experiences and health services utilization among young orphaned women in Zimbabwe
School support programs reduce school dropout, early marriage, and early pregnancy for a majority of young orphaned women. We used a mixed-methods approach to examine why these programs are less effective for a significant minority by exploring their influence on marriage and health services utilization. Participants were from a randomized controlled trial testing school support as HIV prevention. Half as many intervention as control participants…
Marital Age Disparity Among Orphaned Young Women and Their Husbands
I thought if I marry the prophet I would not die
This study examines the association between religious affiliation and reasons for marriage, perceived church attitudes, and reproductive health-seeking behaviors, including HIV testing, among young women in eastern rural Zimbabwe. The sample comprised women (N = 35) who had married by 2012 while participating in a larger randomized controlled trial (RCT) to test the effects of school support on HIV-related risk. The RCT sample was identified in 2…
Experiences along the HIV care continuum
To be effective, HIV programmes should be responsive to the unique needs of diverse groups of infected adolescents. We highlight a range of adolescent perspectives on HIV services, including those who acquired HIV perinatally or sexually and those who were either in care, had dropped out of care, or had never enrolled in care. We conducted semi-structured interviews with 29 adolescents (aged 15-19) and 14 caregivers in western Kenya. Data were an…
The Significance of Benefit Perceptions for the Ethics of HIV Research Involving Adolescents in Kenya
Assessment of benefits is traditionally regarded as crucial to the ethical evaluation of research involving human participants. We conducted focus group discussions (FGDs) with health and other professionals engaged with adolescents, caregivers/parents, and adolescents in Siaya County, Kenya, to solicit opinions about appropriate ways of conducting HIV research with adolescents. Our data revealed that many focus group participants have a profound…
I think the parent should be there because no one was born alone”
Despite a pressing need for adolescent HIV research in sub-Saharan Africa, ethical guidance for conducting research among minor adolescents is lacking. One ethical issue is the degree to which parents should be involved in the research process. The existing discourse is predominantly speculative and focuses on negative consequences of parental involvement. We use empirical data to describe the perspectives of Kenyan adolescents on parental involv…
Consent Challenges and Psychosocial Distress in the Scale-up of Voluntary Medical Male Circumcision Among Adolescents in Western Kenya
If the mother does not know, there is no way she can tell the adolescent to go for drugs”
Medicine (22 obras) · Psychology (21 obras) · Adolescent Sexual and Reproductive Health (17 obras) · Psychiatry (12 obras) · Population (11 obras) · Demography (10 obras) · Family medicine (10 obras) · Environmental health (9 obras) · HIV/AIDS Research and Interventions (9 obras) · Sociology (9 obras)