Mary A. Ott

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https://hdl.handle.net/1805/11716

Developmental & Relationship Contexts of Adolescent Sexual Behavior and Sexually Transmitted Infections

Mary Ott’s research examines adolescent health and development with a focus on sexual behavior, unintended pregnancy and sexually transmitted infections (STIs).

Dr. Ott started with a rigorous scientific examination of sexual abstinence as a health decision. Abstinence had become a highly politicized primary approach to reducing adolescent pregnancy, yet our scientific understanding of how adolescents made decisions about abstinence was limited. Dr. Ott’s interdisciplinary research program advances our understanding of how development, relationships and social contexts influence adolescent abstinence decisions. Four linked studies use a mix of qualitative and quantitative research methods that are drawn from psychology, sociology, anthropology, and medicine. Her research findings have been translated into practice on several levels: (1) a developmental framework for office-based counseling; (2) evaluation and improvement of Indiana RESPECT, an abstinence-focused public health education program; and (3) research findings have been directly incorporated into Society for Adolescent Medicine policy statements.

Dr. Ott’s current research is a developmental examination of how adolescent boys’ make decisions about romantic and sexual relationships, and the impact of those decisions on STIs. Results suggest important roles for families in STI prevention, and identify patterns of communication that can inform both office-based STD prevention counseling and STD prevention programs.

She has provided technical assistance and consultation in adolescent health for several community organizations. For example, focus groups with Indiana youth across the state on their health related priorities provided important youth input to the Indiana Coalition to Improve Adolescent Health for the first Indiana state health plan for adolescents.

Professor Ott’s long-term goal is to inform and improve interventions that promote healthy sexual development and prevent adolescent unintended pregnancy and STIs.

Dr. Ott’s contributions to better understanding adolescent health and decision-making is an example of how IUPUI's faculty members are TRANSLATING their RESEARCH INTO PRACTICE.

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Now showing 1 - 10 of 43

Ethical considerations for research involving pregnant women living with HIV and their young children: a systematic review of the empiric literature and discussion
(BMC, 2021-04-01) Raciti, Catherine G.; Enane, Leslie A.; MacDonald, Katherine R.; Whipple, Elizabeth C.; Ott, Mary A.; McHenry, Megan S.; Pediatrics, School of Medicine
Background: The proper and ethical inclusion of PWLHIV and their young children in research is paramount to ensure valid evidence is generated to optimize treatment and care. Little empirical data exists to inform ethical considerations deemed most critical to these populations. Our study aimed to systematically review the empiric literature regarding ethical considerations for research participation of PWLHIV and their young children. Methods: We conducted this systematic review in partnership with a medical librarian. A search strategy was designed and performed within the following electronic databases: Ovid MEDLINE, Embase and CINAHL. We screened titles and abstracts using the following inclusion criteria: (1) a study population of PWLHIV or children under 5 years of age; and (2) collection of qualitative or quantitative data regarding ethics of research participation. Excluded were reviews, commentaries, policy statements, clinical care-related ethics concerns, abstracts, case studies, or studies unrelated to HIV research. Studies were appraised for quality, data were extracted, and studies were qualitatively analyzed using a principle-based ethical framework within the Belmont Report. Results: Of the 7470 titles identified, 538 full-text articles were reviewed for eligibility and only three articles met full criteria for inclusion within this review. While we allowed for inclusion of studies involving young children born to mothers with HIV, only articles focused on PWLHIV were identified. Within the results of these studies, four themes emerged: (1) adequacy of informed consent; (2) consideration of paternal involvement; (3) balancing risks; and (4) access to research and treatment. A strength of this review is that it included perspectives of international research investigators, community leaders, and male partners. However, only two studies collected empiric data from PWLHIV regarding their experiences participating in research CONCLUSION: Researchers and funding agencies should be aware of these considerations and appreciate the value of and critical need for formative research to ensure clinical trials involving PWLHIV promote ethical, well-informed research participation and, ultimately, improve care outcomes. More research is needed to create a comprehensive ethical framework for researchers when conducting studies with PWLHIV.
IUD Use in Adolescents With Disabilities
(AAP, 2020-08) Robbins, Cynthia; Ott, Mary A.; Pediatrics, School of Medicine
Intrauterine devices (IUDs) are safe, highly effective, and recommended by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists as a first-line contraceptive option for adolescents.1,2 In this month’s Pediatrics, Schwartz et al3 examine the use of IUDs among adolescents with disabilities, providing further evidence that IUDs are safe for menstrual management and contraception in this population. In their work, Schwartz et al3 raise 3 important issues in IUD use and contraceptive decisions among adolescents with disabilities: recognition of the adolescent’s sexuality and rights to sexual and reproductive health; the need to incorporate quality of life into risk/benefit decisions; and the use of shared and supported decision-making approaches to maximize autonomy and dignity.
Sexual Coercion's Impact on Parent and School Connectedness among Rural Adolescents
(Journal of Adolescent Health, 2018-02-01) Muzzey, Allison K.; Hensel, Devon J.; Zaban, Leigh; Ott, Mary A.
School Connectedness Protective Against Bullying In A Rural Community
(Journal of Adolescent Health, 2019-02-01) Katz, Amy J.; Hensel, Devon J.; Zaban, Leigh; Hensley, Monique M.; Ott, Mary A.
Youth Connectedness Mitigates the Impact of Adverse Childhood Experiences (ACEs) on Adolescent Substance Use in a Rural Midwest County
(APHA's 2019 Annual Meeting and Expo (Nov. 2-Nov. 6), 2019) Cope-Barnes, Doug; Hensel, Devon; Katz, Amy; Zaban, Leigh; Hunt, Abby; Ott, Mary A.
Background: Adverse Childhood Experiences (ACEs) increase the risk of adolescent substance abuse. Positive youth connections may mitigate these negative effects. We test whether and how home and school connectedness influences adolescent substance use. Methods: Youth (N=1651 6 th to 8 th graders, N=565, 10 th graders) from a rural, Midwestern low to middle income school district completed a baseline questionnaire prior to a health education program. The outcome, substance use, was a mean index of eight reported substance use behaviors (tobacco, electronic vapor, alcohol, any marijuana [organic or synthetic], prescription pills, inhalants, IV injection; all 6 categories: never to 40+ times). Structural equation modeling (SEM) was used to evaluate both the direct and indirect relationships between ACEs (middle school (MS), α =.700; high school (HS), α=.740), school- (MS α =.805; HS α=.833) and parent- connectedness (MS α =.923; HS α=.942) and substance use (Stata, 15.1). Results: Higher ACEs was directly associated with lower school connectedness (MS: B=-0.29, p<.000; HS: B=- 0.27, p<.000) and lower parent connectedness (MS: B=-0.16, p<.000; HS: B=-0.23, p<.000). Higher school connectedness (MS: B=-0.19; p<.000; HS: B=-0.14, p<.000), higher parent connectedness (MS: B=-0.09; p<.000; HS: B=-0.209, p<.000) and lower ACEs (MS: B=0.27; p<.000; HS: B=-.17, p<000) all directly associated with lower substance use. The impact of ACEs on substance use was mitigated indirectly through higher school connectedness (MS: B=0.01, p<.000; HS: B=0.03, p<.000) and parent connectedness (MS: B=0.03, p<.000; HS: B=-=0.01, p<.000). Conclusion: Prevention programs should be trauma-informed and incorporate parent-youth and teacher-student components.
Risk and Protective Factors for Bullying Victimization and Perpetration among System-Involved Youth
(American Public Health Association, 2019) Katz, Amy; Hunt, Abby; Zaban, Leigh; Hensel, Devon; Ott, Mary A.
Tapping into Community Resiliency in Rural Adolescent Pregnancy Prevention: An Implementation Sciences Approach
(Taylor & Francis, 2020) Ott, Mary A.; Hunt, Abby L.; Katz, Amy J.; Zaban, Leigh S.; Pediatrics, School of Medicine
Although rural youth experience marked inequities in adolescent pregnancy, there is little guidance for implementing evidence-based programs (EBPs) in rural settings. When implementation occurs in rural communities, it frequently focuses on deficits, rather than strengths or capacity for growth. Using the consolidated framework for implementation research (CFIR), we describe a resiliency-focused implementation of two middle school EBPs in rural Midwestern communities, including the intervention, outer and inner settings, individuals, implementation processes and preliminary outcomes. Data included program staff interviews, feedback from local partners, community meetings notes, and participant surveys. Using the CFIR, we describe the engagement of rural communities themselves in a resilience-based implementation of adolescent pregnancy prevention EPBs. Communities self-described as rural, traditional and religious. They identified adolescent pregnancy, substance use, and academic success as priorities. To address infrastructure needs and build on local strengths, funds were used to hire local partners to implement the program. As small communities, stakeholders were closely networked and wanted to address local needs. Local partners selected the EBP based upon community values and priorities. Champions, including local partner organizations and schools were locally based and were well connected. Intensive training of local staff and piloting with adaptation assured fidelity and sustainability, while increasing community implementation skills and comfort. In Clinton County, enrollment was 1946 with students receiving the program in 6th, 7th, and/or 8th grades. In Southern Indiana, 7275 students received the program once in either 6th, 7th, or 8th. We conclude that the CFIR can facilitate the implementation of a community resilience-focused adolescent pregnancy prevention intervention in rural communities.
Human Challenge Studies With Wild-Type Severe Acute Respiratory Sydrome Coronavirus 2 Violate Longstanding Codes of Human Subjects Research
(Oxford, 2021-01) Spinola, Stanley M.; Broderick, Camilla; Zimet, Gregory D.; Ott, Mary A.; Microbiology and Immunology, School of Medicine
This manuscript explores the ethics of human inoculation experiments in young healthy adults with wild-type severe acute respiratory sydrome coronavirus 2 (SARS-CoV-2) as a tool to evaluate vaccine efficacy in the context of the Nuremberg Code, the Declaration of Helsinki, and the Belmont Report, and in the context of dose-response relationships with infectious agents. Despite societal pressure to develop a SARS-CoV-2 challenge model to evaluate vaccines, we argue that there are substantial risks that cannot be adequately defined because the dose of SARS-CoV-2 that causes severe disease in young adults is unknown. In the absence of curative therapy, even if a volunteer consents, longstanding ethical codes governing human subjects research preclude the conduct of such experiments.
Adolescents’ Perceptions of Contraception Access through Pharmacies
(MDPI, 2020-03-28) Meredith, Ashley H.; Vahary, Emily B.; Wilkinson, Tracey A.; Meagher, Carolyn G.; Vielott, Thomas; Ott, Mary A.; Pediatrics, School of Medicine
Adolescent pregnancy is an important public health issue, and pharmacist prescribing has the potential to expand contraceptive access and decrease unintended pregnancy. However, little is known about acceptability and uptake of pharmacist prescribing among adolescents, particularly among youth in socially and politically conservative regions of the country. The study objective was to identify how young women in Indiana perceive pharmacist contraceptive prescribing. Participants were recruited from clinics and completed a simulated pharmacist contraception-prescribing encounter; a demographic and behavioral questionnaire; and an in-depth qualitative interview focused on adolescent perspectives on pharmacist prescribing. Data were analyzed using thematic analysis. Sixty young women aged 14–21 years (mean age 17.0 ± 1.7 years) completed in-depth interviews. The majority expressed interest in pharmacist contraceptive prescribing (n = 33, 55.9%). Three overarching themes were identified, focusing on accessibility; quality of care; and pharmacist knowledge and youth friendliness. Subthemes highlighted the need for improved confidential access; a desire for additional pharmacist training in contraception; and interactions with a pharmacist that can relate to the young person. Increased awareness of the perceptions of young people can inform state policies and pharmacy protocols. Pharmacists, because of their accessibility, are well poised and equipped to assist in this public health concern.
Human Challenge Studies Are Unlikely to Accelerate Coronavirus Vaccine Licensure Due to Ethical and Practical Issues
(Oxford, 2020) Spinola, Stanley M.; Zimet, Gregory D.; Ott, Mary A.; Katz, Barry P.; Pediatrics, School of Medicine

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