Rachel Jones, PhD, RN   •   Marsha Oliver, MS, RN, ANP

This study explored reasons women engaged in unprotected sex with male partners they distrusted and perceived to engage in HIV risk behaviors. Seven focus groups were held in public housing and neighborhood centers in the urban Northeast with 43 African American and Latina women. Content analysis was conducted by open and axial coding. Barrett’s theory of power as knowing participation in change and sex script theory guided interpretation. Results indicated that Patterns of Unprotected Sex is a usual practice to maintain hope, sensuality, intimacy, strategic gain, and stability with a male partner. In low power sex scripts the salient risks of HIV were buried under an awareness of oneself as having to satisfy a man and accept cheating. High power sex scripts involved women’s awareness of themselves as worthy of self care with diverse choices. High power scripts can be integrated into normative sex scripts as exemplars of more powerful ways of being and acting to reduce HIV risk.

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Rachel Jones, PhD, RN

This article discusses young urban women's HIV sexual risk behavior in the context of a social environment that is replete with stereotypical gender expectations to have sex [10]. In this context, unprotected sex is viewed as necessary in securing and maintaining dyadic male-female relationships [11]. Further, HIV sexual risk is considered in the context of heightened emotions that may be characteristic of intimate partner relationships [4]. Sex script theory [12,13] and Barrett's theory of power as knowing participation in change [14,15] are integrated into a framework to explain young adult urban woman's unprotected sexual behavior, particularly with men they perceive to be engaging in HIV risk behavior. Application of this framework helps to explain how powerful sex scripts can influence women to act consistently to reduce HIV risk while enjoying thier relationships with men.

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Rachel Jones, PhD, RN

This study was designed to examine the relationships of sexual imposition, dyadic trust, and sensation seeking with HIV sexual risk behavior in 257 young urbanwomen. Interviewswere conducted using Audio Computer-Assisted Self-Interview (ACASI). Hierarchical multiple regression revealed that sexual imposition, dyadic trust, and sensation seeking explained 18.3% of the variance in sexual risk behavior. Although sexual imposition was positively related to sexual risk, pressure to satisfy a male partner sexually was more common than physical coercion. Dyadic trust was negatively related, indicating that women engaged in sexual risk behavior withmen they distrusted. Sensation seeking was positively related to sexual risk. Findings suggest the need for enhancing awareness of non–sexually imposing relationship alternatives and incorporating thrill and excitement in health promotion messages. 2004 Wiley Periodicals, Inc. Res Nurs Health 27:185–197, 2004

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Rachel Jones, PhD, RN

The purpose of this study was to develop the Sexual Pressure Scale (SPS) as a valid and reliable measure of gender stereotypical expectations to engage in sexual behavior. Data were collected using audio computer-assisted self-interview in 306 urban women, aged 18 to 29. Exploratory principal components analysis with varimax rotation yielded 19 items consisting of five factors: Condom Fear, Sexual Coercion, Women’s Sex Role, Men Expect Sex, and Show Trust, accounting for 62% of the variance. Divergent and convergent validity were supported, respectively, by negative relationships of SPS factors with dyadic trust and positive relationships with sexual victimization and sexual risk behavior. Alpha reliability was .81; factor reliabilities ranged from .63 to .82. A valid assessment of sexual pressure can suggest the extent to which stereotypical gender expectations structure women’s freedom to explore partner and condom use choices. 2006 Wiley Periodicals, Inc. Res Nurs Health 29:281–293, 2006

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Rachel Jones, PhD, RN

The Audio Computer Assisted Self-Interview (ACASI) is a computer application that allows a research participant to hear survey interview items over a computer headset and read the corresponding items on a computer monitor. The ACASI automates progression from one item to the next, skipping irrelevant items. The research participant responds by pressing a number keypad, sending the data directly into a database. The ACASI was used to enhance participants’ sense of privacy. A convenience sample of 257 young urban women, ages 18 to 29 years, were interviewed in neighborhood settings concerning human immune deficiency virus (HIV) sexual risk behaviors. Notebook computers were used to facilitate mobility. The overwhelming majority rated their experience with ACASI as easy to use. This article will focus on the use of ACASI in HIV behavioral research, its benefits, and approaches to resolve some identified problems with this method of data collection.

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Rachel Wilson (Rachel Jones), PhD, RN   •  Terry Fulmer, PhD, RN, FAAN

Eight home health nurses from the Visiting Nurse Service of New York participated in a focus group discussion after their initial experiences using wireless, pen-based computing in the inner-city, home care environment. Transcripts of the nurses' responses to open-ended questions were analyzed and central themes were found, following the method of concept analysis described by Strauss and Corbin (1990). The central concepts were "Readiness," "A thousand pounds on my back," "Call for support," "Problems with transmission," "Using the computer as an assistant." "Nurses discovered glitches," and "Everybody has to have a computer" These themes reflected the nurses' initial experiences with the wireless computers and also revealed their concerns. This article will describe these themes and will discuss the implicalions of current improvements in wireless computing for health care. The focus group themes aided in undersranding how this group of experienced home health nurses began to transition from handwriting on several different forms to checking-off items on a small, hand-held computer screen. fmni innovating methods to communicate when telephones were not available. to using a wireless computer to send and receive data involved in the patient admission process.

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Rachel Wilson (Rachel Jones), PhD, RN   •  Terry Fulmer, PhD, RN, FAAN

The purpose of this qualitative study is to understand how a sample of visiting nurses experienced the practice of home health nursing in the inner city and how they perceived the anticipated introduction of wireless, pen-based computing into their practice. Focus groups were held with visiting nurses 1 week before the introduction of the wireless, pen-based computers. The data were analyzed using Strauss and Corbin's (1990) method for concept development. The following central concepts emerged from the focus groups with visiting nurses: "Missing contact in the field," "Consumption of time writing on forms,"Using the computer to help with the practice of home health nursing," and "Home nursing is a lifeline." These concepts, based on the commentaries by visiting nurses, help one to understand the problems encountered by visiting nurses in the delivery of home health care, identify ways to incorporate evolving technologies to enhance nursing practice, and consider approaches to computer skill acquisition.

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