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The primary approach to health promotion and disease prevention is through the family. Children and adults are nurtured, provided for, and taught about health values in families. This is done by word and by example. It is in families that a person learns to make choices that promote his or her own physical and emotional health, mainly by influencing the health behaviors of its members. Therefore, “healthy behavior, including the judicious use of preventive health care services, is a significant area of family responsibility for the personal health of its members” (Edelman, 1994, p.187).

Low socioeconomic status parents have more stresses as a result of life circumstances, and stress affects the way parents carry out their functions. In a study of 585 children from the lowest socioeconomic class, it was found that low socioeconomic status was significantly correlated with the following eight factors in the child’s socialization and social context: harsh discipline, lack of maternal warmth, exposure to aggressive adult models, maternal aggressive values, family life stressors, mother’s lack of social support, peer group instability, and lack of cognitive stimulation (Dodge et al., 1994).

Our goal as health care providers should be to imporve child health and development by enhancing long term family stability and promoting the growth of a community of support among families. One way to accomplish this is to develop a program model which uses comprehensive social services and an educational/skills-building format along with a collaborative network of service providers. Parents could be offered individualized services and participate in activities that increase knowledge of child health and development, build self-esteem, and develop peer support.

The Family Systems Stressor-Strength Inventory can be used to identify stressful situations in families and the strengths families use to maintain healthy family functioning. A Family Care Plan can also be used to prioritize diagnoses, set goals, develop prevention/intervention strategies, and evaluate outcomes. This assessment/measurement instrument was developed by Karen B. Mischke, RN, NP, PhD, CFLE and Shirley M.H. Hanson, RN, NP, PhD, FAAN, CFLE, LMFT.

Dodge, K. et al. (1994). Socialization mediators or the relation between socioeconomic status and child conduct problems. Child Development, 65, 649-665.

Edelman, C. (1994). Health Promotion Throughout The Lifespan (3rd ed.), St. Louis: Mosby.

Mischke, K.,  Hanson, S. (1991).  Pocket Guide To Family Assessment And Intervention. St. Louis: Mosby.

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Is there a relationship between perceptions of family functioning and the initiation of sexual activity?

     Human sexuality develops from the moment of conception onward through all life stages, and it is affected by all of one’s experiences. It is also affected by the period in which one is born as well as a person’s heritage. Multigenerational family and social systems, which are in continuing interaction with each other, are related to a person’s development as a feminine or masculine human being. The sexual development of adolescents is heavily influenced by many factors in their infancy and childhood. Children are observed to exhibit sexual interests and feelings, but how these interests and feelings are expressed is a result of many factors including the nature of the family system. In both overt and covert ways, almost every activity and relationship within families tramsmits messages regarding sexuality and dealing with sex roles and functions, values, and styles of interpersonal relationships. Family relationships are extremely important and operate on many levels of awareness in total human development, including the development of sexuality at many life stages. Knowing the dynamics of the adolescent’s family is essential to the understanding of adolescent decision making because of the family’s early influence on belief systems and behavior. Family function is how the family behaves towards one another and the quality of the relationships. It is thought to be the most important component in determining “family health”. Family problems is part of a web of social problems that influence the development of many potential health problems.

     The family should be recognized as a potentially important sphere to be considered and incorporated into multi-targeted prevention programs for the reduction of sexual risk in young women. According to Blum’s Model, a person’s sexual activities and their family interaction status directly affects a person’s health status. One way to look at family functioning is through family systems theory. This theory helps us to understand how families operate. “Systems theory is useful in explaining the complex interactions of a family and the factors that influence the processes by which a family makes decisions, sets and achieves particular goals, and establishes rules that regulate behavior. The theory also explains how a family responds to chnage, including developmental changes in family members” (Bigner, 1998, p.93). An adolescent’s perception of family functioning may be related to their initiation of sexual activity. That’s why analysis of family functioning is so critical. Various kinds of family services may be helpful to families who are dealing with stresses of transition at midstage. These stresses could include depressive reactions of a parent or parents, marital conflicts, sex equity issues, financial pressures, and so on. Helping adults in the family deal with their own stresses could greatly reduce the need for direct services to adolescents whose own problems may dwindle as parental lives improve.  There is strong possibiliy that parents suggest either verbally or through their behavior that early sexual activity is either acceptable or unacceptable. Demographic and socioeconomic studies have linked early sexual activity with factors such as family economic disadvantage, large famy size, and an unstable family environment. It is important to consider maternal and family characteristics and behavior that occurs after the child is born but before his or her initiation of sexual activity.


Bigner, J. (1998). Parent-Child Relations, Columbus: Prentice Hall.

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