While the media have been used effectively to promote sexual responsibility in other countries for decades, few such opportunities have been seized in the United States. Mass media may be especially useful for teaching young people about reproductive health because elements of popular culture can be used to articulate messages in young people s terms, in language that won t embarrass them and may even make safe sex more attractive. Media can potentially change the way people think about sex, amidst cultural pressures to have sex at a young age, to have sex forcefully, or to have unsafe sex. Information can be communicated through a variety of channels--small media (e.g., pamphlets, brochures, and the Internet) and mass media--and in a variety of formats--campaigns, news coverage, and educational messages inserted into regular entertainment programming. Several international studies show that exposure to family planning messages through television, radio, and print media are strongly associated with contraceptive use. Domestically, safe sex media campaigns have been associated with increased teen condom use with casual partners, and reductions in the numbers of teenagers reporting sexual activity. Due to private ownership and First Amendment concerns, U.S. sexual health advocates have been working with the commercial media to incorporate subtle health messages into existing entertainment programming.

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Stigma against suicidal ideation and help-seeking is a significant barrier to prevention. Little detail is provided on what types of stigma interfere with help-seeking, how stigma is expressed, and how to reduce it. Five groups of two ethnically diverse community theatre programs were formed to analyze differences in Eastern Montana Caucasian and Native American adolescents and young adults’ experiences with stigma about mental illness and mental health treatment that affect help-seeking for suicidal thoughts and experiences. Over a ten-week period, a grassroots theatre project was used to recruit members from the same population as the audience to write and perform a play on suicide and depression (n = 33; 10 males, 23 females; 12 Native American, 21 Caucasian, ages 14–24). Using textual analysis, the community- and campus-based performance scripts were coded for themes related to stigma. Both ethnic groups reported that stigma is a barrier to expressing emotional vulnerability, seeking help, and acknowledging mental illness. We found that Caucasians’ experiences were more individually oriented and Native Americans’ experiences were more collectively oriented. Understanding the cultural bases of experiences with stigma related to mental health treatment for suicide is necessary to create educational programs to reduce stigma for diverse groups of adolescents and young adults.

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Compliance by patients to prescribed treatment regimens can be considered as the interface between effective therapy and effective disease management. Compliance can be affected by the nature of the relationship between the practitioner and the patient, and their attitudes towards each other. It has also been suggested that practitioner behaviour can influence patient behaviour and health status. However, each individual patient is influenced in his or her attitudes, and reactions to disease and its management, by a wide variety of patient-related factors. These include psychological variables such as mood, beliefs, and the knowledge, motivation and ability of the patient. Social factors may also play a role: these include age, marital and socioeconomic status and level of education. Results from a range of studies in patients with pulmonary or other diseases show that the psychosocial determinants of compliance are only poorly understood, and suggest that compliance cannot be predicted from patients' health status and that social factors are weak indicators only. Furthermore, it appears from available data that patients' beliefs about health issues are not as useful as indicators of likely compliance as was previously believed.

Young adults from Montana have a higher rate of suicide than their national counterparts. There is a clear need for targeted interventions to address this disparity. The authors evaluate a community-based, narrative theater project designed to increase awareness and use of suicide prevention resources among eastern Montana youth. As a first step, seven group interviews with Montana young adults (n = 27) were conducted to identify current perceptions about suicide and suicide prevention. Interviews were conducted before and after subjects were exposed to a community-based theater production about suicide. Emergent thematic categories were organized using the four main constructs of the extended parallel process model. After the performance, participants expressed increased awareness of prevention resources; perceived susceptibility to the threat of suicide and depression; and self-efficacy for accessing help and assisting others. There were mixed results for perceived response efficacy. Implications and recommendations for intervention development are discussed.

The objective was to determine how the Internet is used to promote sexual health among adolescents. Six key words were entered into three search engines producing 87,180 results. Three percent (n = 36) were educational Web sites targeted at teenagers and covered a range of sexually transmitted diseases (STDs). These were content analyzed using sexuality education and usability guidelines. All sites addressed some STD information, but only two covered negotiation. Navigability results were mixed; only one third offered a site map. Sexual health educators may need to include more information on how to negotiate safe sex and improve Web navigability for teenagers.