Invited Commentary: Broadening the Evidence for Adolescent Sexual and Reproductive Health and Education in the United States

Scientific research has made major contributions to adolescent health by providing insights into factors that influence it and by defining ways to improve it. However, US adolescent sexual and reproductive health policies—particularly sexuality health education policies and programs—have not benefited from the full scope of scientific understanding. From 1998 to 2009, federal funding for sexuality education focused almost exclusively on ineffective and scientifically inaccurate abstinence-only-until-marriage (AOUM) programs. Since 2010, the largest source of federal funding for sexual health education has been the “tier 1” funding of the Office of Adolescent Health’s Teen Pregnancy Prevention Initiative. To be eligible for such funds, public and private entities must choose from a list of 35 programs that have been designated as “evidence-based” interventions (EBIs), determined based on their effectiveness at preventing teen pregnancies, reducing sexually transmitted infections, or reducing rates of sexual risk behaviors (i.e., sexual activity, contraceptive use, or number of partners). Although the transition from primarily AOUM to EBI is important progress, this definition of evidence is narrow and ignores factors known to play key roles in adolescent sexual and reproductive health. Important bodies of evidence are not treated as part of the essential evidence base, including research on lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth; gender; and economic inequalities and health. These bodies of evidence underscore the need for sexual health education to approach adolescent sexuality holistically, to be inclusive of all youth, and to address and mitigate the impact of structural inequities. We provide recommendations to improve US sexual health education and to strengthen the translation of science into programs and policy.     

Memory, History, and Nostalgia in Berlin’s Jewish Museum

The Jewish Museum in Berlin is devoted to telling the 2,000-year history of Jews in Germany in a stunning building designed by Daniel Libeskind. It is Germany’s premier museum devoted to Jewish history and memory, but it is expressly not a Holocaust museum and most reference to the Holocaust is architectural. In its interactive and sophisticated exhibitions, the Jewish Museum represents contemporary international trends in museology and in many ways resembles the many Holocaust and other memorial museums around the world, one of the most prominent and striking international museological trends. However, in rejecting the categorization as a memorial museum and in focusing on a celebration of German–Jewish culture and history rather than the tragedy of the Holocaust, the Jewish Museum is what we might call a countermemorial museum. As such, it challenges the new norms around the creation of memorial museums and other sites of memory to be self-reflexive meditations on the negative past and its trauma. If memorial museums emerge from a particular orientation toward the past that Jeffrey Olick calls the “politics of regret” and claims is a major characteristic of our age, then the Jewish Museum might represent a parallel trend that we can call a “politics of nostalgia.” The museum serves, in many ways, as a screen upon which present-day Germany can project an idealized image of its past, masking some of the present tensions around German national identity and ideas of German multiculturalism. At the same time, the museum often seems to be in conflict with Libeskind’s building, which is infused with Holocaust symbolism and meaning.     

Ignoring Hello Kitty: globalization and resistance in Austria

This essay studies the processes of globalization and resistance in Austria by using the Japanese cartoon character, Hello Kitty, as a case study. Bringing in a number of significant researches on this cartoon character, it targets the “hybridization” process involved in the Hello Kitty Magazine, a major form of publicity in the country, before moving onto actual reception of the character in Austria, which has apparently taken the form of “resistance”. As such, the essay fills the gap in current researches on globalization in Austrian studies, which mainly focus on Americanization but not Japanization, as well as supplements Kinsella’s influential essay on the Japanization of European youths, which focuses on the United Kingdom, but not the rest of Europe.

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Maternal Predictors of Noncoital Sexual Behavior: Examining a Nationally Representative Sample of Asian and White American Adolescents Who Have Never had Sex

Current research in adolescent sexuality has largely focused on vaginal-penile intercourse, with less attention to noncoital sexual activity. This study examined how maternal factors influence the transition from virginity to noncoital behavior among White and Asian American youth who have never experienced vaginal intercourse. We conducted logistic regression analyses to examine whether traditional maternal predictors of coital sex were important in understanding noncoital sexual activity of these two populations. Waves 1 and 2 of the National Longitudinal Study of Adolescent Health were utilized. For White Americans (n = 3,926), direct and indirect maternal factors were associated with noncoital sexual involvement: maternal support, control, mother–child communication about sex, and adolescents’ perceptions of maternal approval of sex. In contrast, only maternal support was associated with the onset of noncoital sexual behavior for Asian Americans (n = 611). The study underscores the need to explore culturally specific factors that may influence Asian American adolescent noncoital sexual behaviors.

Constructing NAFTA: Myth, Representation, and the Discursive Construction of U.S. Foreign Policy

The passage of the North American Free Trade Agreement in November 1993 signified the acceptance of Mexico as an equal trading partner with the United States and Canada. However, accepting Mexico as an equal partner challenged a deeply ingrained U.S. image of Mexico as inferior, childlike, dependent, and suspicious. How was it possible for the U.S. public and its congressional representatives to accept equal economic integration with a country that embodied such a negative image? Addressing this dilemma through a constructivist approach, this article argues that the existing image of Mexico remained intact. The passage of NAFTA instead resulted from a discursive construction of NAFTA that emphasized a positive U.S. self-image through American myths thereby allowing the simultaneous acceptance of Mexico as inferior and as an equal trading partner. American myths and other representational elements constructed NAFTA for the American public and created a policy success for President Clinton. This article relies on an empirical investigation of newspaper advertisements to demonstrate how myths contributed to the discursive construction of NAFTA.     

Connecting with New Partners in COVID-19 Response

The COVID-19 crisis has called for the mobilization of diverse resources and coordination through administrative networks. This mobilization has brought to light the challenges involved in the recruitment and retention of diverse administrative networks. This Viewpoint essay reviews the importance and difficulties of maintaining diverse administrative networks. The review is followed by concrete strategies for building and maintaining diverse networks in Norman, Oklahoma. The lessons emphasize the role of active and imaginative recruitment and a realistic assessment of the challenges facing members of the network that can interfere with their participation.     

Does Spending More Get More? Health Care Delivery and Fiscal Implications From a Medicare Fee Bump

While salient features of the Affordable Care Act include insurance expansions and private coverage reforms, various other provisions are embedded within the law. We focus on a temporary 10 percent fee increase for primary care visits supplied to publicly insured (Medicare) beneficiaries. Using administrative and survey data, we assess the price shock's impact on service volume, physician labor supply, and quality of care. Primary care physicians (PCPs) in independent practices demonstrate, at most, a marginal 2 percent increase in new patient visits while horizontally and vertically integrated PCPs show no change. Both PCP organizational types witness declines in established patient visits, on average, but there is marked heterogeneity: established patient visits increase by 1 to 2 percent among PCPs with fewer Medicare claims in the pre‐period. The Medicare fee bump did not observably impact other labor supply outcomes and quality of care margins. We estimate that the policy introduced a $1.5 billion transfer from taxpayers to providers during the initiative's first three years.