Notification Policy Research Articles

Parental Notification: A New Strategy to Reduce Alcohol Abuse on Campus

This article summarizes the results of a survey completed by senior judicial officers at 189 colleges and universities. The survey concerned institutional responses to a section of the Higher Education Reauthorization Act of 1998 that allows, but does not require, institutions to notify parents of students under the age of 21 who have violated institutional alcohol policies. The study found that, as of January 2000, 44% of the participating institutions had implemented parental notification policies; 15% did not have policies, but notified parents in practice; and 25% were actively considering adopting policies. Factors triggering and inhibiting development of parental notification policies, circumstances under which notification is allowed by policy and implemented in practice, notification procedures and frequencies, support of policies by parents notified, and effects of policies on numbers of alcohol violations on campus were also assessed in this study.

Parental Notification: A New Strategy to Reduce Alcohol Abuse on Campus

This article summarizes the results of a survey completed by senior judicial officers at 189 colleges and universities. The survey concerned institutional responses to a section of the Higher Education Reauthorization Act of 1998 that allows, but does not require, institutions to notify parents of students under the age of 21 who have violated institutional alcohol policies. The study found that, as of January 2000, 44% of the participating institutions had implemented parental notification policies; 15% did not have policies, but notified parents in practice; and 25% were actively considering adopting policies. Factors triggering and inhibiting development of parental notification policies, circumstances under which notification is allowed by policy and implemented in practice, notification procedures and frequencies, support of policies by parents notified, and effects of policies on numbers of alcohol violations on campus were also assessed in this study.

Women living with HIV: disclosure, violence, and social support.

This paper describes the frequency of women's disclosure of their HIV status, examines the extent to which they experience adverse social and physical consequences when others learn they are infected, and analyzes correlates of these negative outcomes. There were 257 HIV-positive women between the ages of 18 and 44, recruited from HIV/AIDS primary care clinics and from community sites, who completed a face-to-face interview. Women in the sample were 33 years old on average; 92% were African-American; 54% had less than 12 years of education; 56% had used intravenous drugs; and 30% knew they were HIV positive for 5 or more years. There were 97% who disclosed their HIV status; 64% told more than 5 people. Negative consequences associated with others knowing they were HIV-positive were reported by 44%, most commonly the loss of friends (24%), being insulted or sworn at (23%), and being rejected by family (21%). There were 10 women (4%) who reported being physically or sexually assaulted as a result of their being HIV positive, and 16% reported having no one they could count on for money or a place to stay. Violence was widespread in this sample, with 62% having experienced physical or sexual violence, including sexual abuse or rape (27%), being beaten up (34%), and weapon-related violence (26%). Logistic regression analysis indicated that women with a history of physical and sexual violence were significantly more likely to experience negative social and physical consequences when their infection became known to others, adjusting for age and the number of people women had disclosed to, both of which were only marginally significant. Partner notification policies and support programs must be responsive to the potential negative consequences associated with others learning that a woman is HIV positive. The high rates of historical violence in the lives of women living with HIV underscore the need for routine screening and intervention for domestic violence in all settings that provide health care to HIV-positive women.

Partner notification for gonorrhoea: a comparative study with a provincial and a metropolitan UK clinic.

OBJECTIVE: To compare partner notification practice and outcomes at a provincial and a metropolitan clinic. DESIGN: Prospective study, following standardisation of partner notification policy. SETTINGS: Sheffield Department of Genitourinary Medicine,...

HIV partner notification policy and practice within GUM clinics in England: where are we now?

OBJECTIVES: To evaluate the extent to which larger genitourinary medicine (GUM) clinics in England have established local clinic policies for HIV Partner Notification (PN) and to describe the process of...

Adolescent contraceptive behavior: The impact of the provider and the structure of clinic-based programs

To characterize general trends in research on the impact of provider variables on adolescent contraceptive behavior and to identify useful frameworks for designing clinic-based programs aimed at reducing unintended adolescent pregnancy. A computerized search of Psychological Abstracts, Sociological Abstracts, and MEDLINE identified English-language articles from 1990 to 1995 on adolescent contraceptive behavior in the United States. All relevant citations within these articles also were examined. Studies were selected that focused on any aspect of provider characteristics as they relate to adolescent contraceptive behavior. Based on a conceptual integration of the articles, three general research issues on provider characteristics were identified; 1) the effectiveness of adolescent-based clinic programs and provider variables that discriminate successful versus unsuccessful programs, 2) the effects of parental notification policies on adolescent clinic use, and 3) whether the presence of clinics promotes sexual activity on the part of adolescents. Issues that must be considered in the structuring of provider-based programs include the strategic focus of the program, the target behaviors, the target population, and the structuring of educational materials. The effectiveness of adolescent-based clinic programs is mixed. Parental notification of adolescent use of a clinic can, in some cases, decrease the likelihood of clinic use. There is little convincing evidence that the presence of adolescent clinics promotes sexual activity.

Mandated life versus mandatory death: New York's disgraceful partner notification record.

In New York City in 1993, there were some 18,000 positive HIV tests but only 350 partner notifications completed by the New York City Health Department. The bleak disparity between these two numbers should haunt us all. We will never know for certain how many lives could have been saved by universally available notification services, but looking at the results of current, obstructive New York State notification law and policy, we have to know we are facing an enormous public health failure. In states and cities with well-established notification programs, between 50 and 90% of HIV-positive clients cooperate voluntarily with notification and, typically, 90% of partners contacted seek HIV-testing and preventive counseling. There are no differences in cooperation based on race, gender or sexual orientation. In New York, urgently required reform means legislation to mandate that notification services are offered to all people who test positive and to require the state to supply enough trained personnel to undertake sensitive notification and counselling. With Black and Latina women--most of whom are mothers--now at the highest risk for sexual HIV infection, New York's refusal to undertake the life-saving policies common elsewhere has not only resulted in a horrible abandonment of a very vulnerable population, but also accelerated the orphaning of children at unprecedented rates.

Priority Ordering in Interruptible Electric Power Service with Irreversible Early Notification

A multi-period model of interruptible electric power service that includes early notification may be described as a stochastic control problem:whom to notify when. When customer interruption losses are multiplicative or submodular, an optimal priority ordering exists, allowing for a simple notification policy.

Is the medical community ready for worker notification?

Although the potential for early detection of disease has been of central importance in the evolution of worker notification policy and practice, it is not the only positive outcome of medical intervention. The provider-patient encounter also creates an important opportunity for patient-centered risk communication that may result in workplace modifications as well as lifestyle changes to reduce the likelihood of subsequent illness and injury--both work and nonwork related. At the same time, it may signal the beginning of a series of social, legal, and political actions that may have positive or negative consequences for notified workers. This article identifies several important roles for members of the medical community relating to worker and community notification programs and explores the readiness of health care professionals in assuming these roles. It is suggested that health care providers lack both the training and sociopolitical sensitivity needed for meaningful participation in the notification process. This article addresses possible short-term and long-term approaches to enhancing the readiness of health care providers and suggests that effective intervention with notified workers requires a willingness to step beyond the confines of the medical model.

Adolescent contraceptive use and parental notification.

Little research exists regarding the relationship between family communication and the sexual behavior and contraceptive use of adolescent females. A self-administered questionnaire was used to survey 196 adolescent females regarding communication with their parents about sexual issues and their reaction to proposed parental notification of the dispensing of prescription contraception. Parents of 80% of the subjects who were sexually experienced were aware of this activity. Parents of 80% of those subjects who had used contraception were aware of this use; 59% of these subjects informed their parents before their family planning visit. The majority of female adolescents (57%) were unwilling to communicate with their parents about sexual issues; 64% felt they should be able to receive prescription contraception without parental knowledge. Communication regarding sexual issues was related to lifetime contraceptive use. Eighteen percent of the sexually experienced subjects would not allow their parents to be notified of their family planning visit; 86% would use less effective contraception if family planning services were not sought. Our findings suggest that a parental notification policy will not compel all adolescents to inform parents about their contraceptive use; most adolescents will resort to less effective contraceptive methods.

HIV Antibody Screening and Confirmatory Testing of Italian Blood Donors

During the first year (1986) of blood donor screening for antibody to HIV, 201,750 subjects were tested in 40 blood banks of Lombardia (Italy). All sera repeatedly positive by ELISA were submitted to our reference center for confirmation by Western blot (WB). Only 40 (0.02%) of 286 repeatedly reactive donors were positive by WB, whereas another 45 (0.022%) gave atypical antibody reactivities on WB, mainly directed against HIV core proteins. Of the 16 donors with inconclusive WB results followed for 4-12 months, 3 developed a full-blown antibody response, 5 maintained the anti-core reactivity throughout the follow-up period, and 8 lost all reactivities. The use of recombinant env and core antigen ELlSAs seems to decrease the proportion of sera with inconclusive WB reactions, and to identify as true positive all seroconverting donors in advance of the WB test. The large majority (35 out of 40) of WB-positive donors and all seroconverters for antibody to HIV admitted to belong to a group at risk for AIDS. Among the 19 first-time donors with HIV infection, we found 3 subjects with serological evidence of LAV-2 infection. We describe also the diagnostic and ethical issues when a donor notification policy is based on WB confirmatory procedures.

Anti-HTLV III ELISA and Western Blot Testing in a Blood Donor Population: Implications for Donor Notification

We have evaluated the western blot (WB) test for distinguishing anti-HTLV III ELISA-positive donors who have likely been exposed to HTLV III from those that are false positives. Of 1,955 donors, 26 were positive for anti-HTLV III by ELISA testing. Only 6 (23%) were positive by WB: 5 of these 6 were male homosexuals with multiple partners and 5 of 6 had low Th/Ts ratios. The WB-positive donors gave the highest absorbance values in the anti-HTLV III ELISA assay. The immunologic abnormalities in the WB-positive donors suggest that they should be notified of their test results. We conclude that basing a donor notification policy on WB results is the optimum public health strategy for blood banks at the present time.

Telling Parents: Clinic Policies and Adolescents' Use of Family Planning and Abortion Services

Most teens tell their parents when seeking birth control or abortion services. However, if all family planning and abortion facilities had to notify parents, some 33,000 more unwanted pregnancies would occur among teens now practicing effective contraception; some 42,000 now obtaining legal abortions would turn to illegal practitioners or have unwanted births. U.S. courts have consistently upheld the right of mature minors to consent for contraceptive and abortion services.' In 1976, the Supreme Court ruled in Planned Parenthood of Central Missouri v. Danforth2 and in Bellotti v. Baird3 that parents cannot veto a minor's decision to obtain an abortion. In 1979, the Court reaffirmed that decision, indicating that neither consent nor notification may be required without offering a minor prompt administrative or judicial review to determine whether she is mature enough to give informed consent and, if she is not, whether the abortion is in her best interests .4 These decisions have also been interpreted as establishing the right of mature minors to obtain prescription contraceptives on their own; their right to obtain nonprescription contraceptives was established by the Supreme Court in 1977 in its ruling in Carey v. Population Services International.5 Despite these decisions, a number of states have attempted to impose parental consent requirements through legislative action; these laws have generally been struck down by the courts,6 usually because they did not allow prompt judicial review. Two states, however, have recently enacted parental consent requirements: Louisiana's law was passed late in 1980, and the Massachusetts law is being stayed under a temporary restraining order until the U. S. Court of Appeals for the First Circuit has reviewed an appeal of a lower-court decision upholding the law. Both the Louisiana and Massachusetts laws differ from previous statutes in that they allow a teenager to petition the court in order to obtain an abortion without previously notifying or involving her parents. 7 Only four states-Maryland, Montana, Tennessee and Utah-have notification requirements for the provision of abortion services to minors (in Maryland, doctors are not required to notify parents if they believe that the minor will be subjected to physical or psychological abuse if her parents know about her abortion).8 The Utah law has been appealed to the U.S. Supreme Court after being upheld by the Utah State Supreme Court;9 a decision is expected early in 1981. Family planning agencies that receive federal funds under Title X of the Public Health Services Act or under Titles XIX or XX of the Social Security Act are required to provide services to sexually active minors "without regard to age or marital status." A recent federal district court decision has held that no agency receiving such funds can require parental consent or notification before providing birth control services to minors. 10 Private agencies providing abortion or family planning services that do not receive such federal funds, however, are free, in the absence of a specifically applicable statute, to require consent or notification of parents or to serve minors on their own consent. It is not likely, given the current concern about family values, that there will be a quick end to the controversy over parental involvement in the decision of adolescents to use birth control and obtain abortions. It is useful, therefore, to examine the current parental consent and notification policies followed by abortion and family planning service programs, as well as the extent to which teenagers are already talking to their parents about these decisions, and, if they are not, what they would do if their parents were told. This article summarizes the findings of two national surveys conducted by The Alan Guttmacher Institute (AGI) that address these questions.