Social determinants of sexual health among Latinx adolescents and emerging adults in an agricultural community

农业社区拉丁裔青少年和新兴成年人性健康的社会决定因素

基本信息

批准号：
10661034
负责人：
ALEXANDRA M MINNIS
金额：
$ 58.11万
依托单位：
RESEARCH TRIANGLE INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-08-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10661034
关键词：
Address Adolescence Adolescent Adolescent and Young Adult Adult Affect Age Agriculture Area Biological Testing Birth Rate California Child Child Health Child Rearing Communities Contraceptive Usage County Data Data Collection Destinations Developed Countries Development Disadvantaged Economic Burden Economic Factors Education Employment Epidemic Female Generations Goals Health Home Immigrant Incidence Individual Inequity Infection Infrastructure Intergenerational transfer Intervention Interview Latina Population Latinx Latinx population Lead Life Measures Mediator Methods Mexican Neighborhoods Outcome Parents Participant Pattern Personal Satisfaction Population Population Growth Population Intervention Positioning Attribute Pregnancy Pregnancy in Adolescence Prospective, cohort study Reproductive Health Research Risk Rural Rural Population Seasons Sexual Health Sexually Transmitted Diseases Shapes Social Environment Socioeconomic Factors Teenagers Time United States Unsafe Sex Visit Work Youth adolescent health aged agricultural community cohort early adolescence eighth grade emerging adult emerging adulthood ethnic disparity family structure follow-up health care service health disparity housing instability improved infection rate intervention effect junior high school male migration neglect outcome disparities racial disparity recruit retention rate school district sex sexual debut sexual health intervention social social cohesion social determinants social factors socioeconomic disadvantage socioeconomic disparity structural determinants teen birth unintended pregnancy urban area young adult youth violence

项目摘要

PROJECT SUMMARY/ABSTRACT The highest teen birth rates in California are primarily in Latinx populations in the rural agricultural coastal and central valley regions where distinct socioeconomic and social factors play a role in adolescent well- being. These areas also constitute the core population growth areas in California. Nationally, sexually transmitted infections (STIs) have increased substantially, with rates in California reaching epidemic levels that exceed national rates. Half of these infections occur among youth aged 15 to 24. Intervening on underlying social determinants of sexual health is central to addressing the persistently high rates of unintended pregnancy and rising STI incidence in Latinx youth. Much of the research guiding sexual health intervention approaches for US youth has been conducted in large urban areas, in which social determinants such as concentrated disadvantage and neighborhood social cohesion have been shown to affect adolescent health. However, understanding the unique underlying contexts that contribute to health disparities among rural Latinx populations is vital to achieving substantive improvements in the health of adolescents and young adults. The overarching goal of this study is to identify social environment influences on sexual health among Latinx youth residing in an agricultural community as they transition from adolescence to emerging adulthood (ages 18 to 21). We will accomplish this by extending a prospective cohort study of approximately 600 Latinx youth recruited and followed since 8th grade (age 13), with high retention (92% at 2 years). We propose to conduct four additional annual waves of follow-up, including quantitative data collection, biological testing for STIs and pregnancy, and in-depth interviews. The Specific Aims are: Aim 1. Examine the effects of social determinants in adolescence on unintended pregnancy, STIs, contraceptive use, and use of reproductive health care services during the period of emerging adulthood; Aim 2. Use a mixed methods approach to identify mediators of the effects of social determinants on sexual health outcomes to elucidate modifiable targets for intervention in emerging adulthood; and Aim 3. Estimate population intervention effects of social determinants and mediators on sexual health outcomes in emerging adulthood. Our established infrastructure, strong community-engaged partnerships, and existing cohort position us for efficient initiation, rigorous implementation, and synthesis of results across a total of eight waves of follow-up. This will allow us to examine the timing and cumulative effects of social determinants of sexual health, identify mediators, and determine the most impactful intervention targets to decrease unintended pregnancy and STIs during the time when the highest rates occur. The focus on emerging adulthood constitutes a high priority and often neglected developmental period, with opportunities to address substantial gaps in understanding effective ways to support transitions to adulthood that promote well-being and positive sexual health.

项目概要/摘要加州青少年出生率最高的主要是沿海农村农业地区的拉丁裔人口和中央山谷地区，这些地区独特的社会经济和社会因素在青少年健康中发挥着作用存在。这些地区也构成了加州的核心人口增长区。全国性、性方面传播感染（STI）大幅增加，加州的感染率已达到流行病水平超过国家标准。其中一半感染发生在 15 至 24 岁的青少年中。性健康的根本社会决定因素对于解决持续居高不下的性健康率至关重要拉丁裔青年的意外怀孕和性传播感染发病率上升。许多指导性健康的研究对美国青年的干预方法是在大城市地区进行的，其中社会决定因素例如集中的劣势和邻里社会凝聚力已被证明会影响青少年健康。然而，了解有助于健康的独特的潜在背景拉丁裔农村人口之间的差异对于实现健康状况的实质性改善至关重要青少年和年轻人。本研究的总体目标是确定社会环境的影响居住在农业社区的拉丁裔青年在从青春期到成年初期（18 至 21 岁）。我们将通过扩展预期来实现这一目标对大约 600 名拉丁裔青少年进行的队列研究从八年级（13 岁）起就被招募和跟踪，结果显示，保留率（2 年时为 92%）。我们建议每年进行四波额外的后续行动，包括定量数据收集、性传播感染和妊娠的生物检测以及深入访谈。具体目标是：目标 1. 检查青春期社会决定因素对意外怀孕的影响，性传播感染、避孕药具的使用以及新兴时期生殖保健服务的使用成年期；目标 2. 使用混合方法来确定社会决定因素影响的中介因素性健康结果，以阐明成年初期干预的可修改目标；和目标 3。估计社会决定因素和中介因素对性健康结果的人口干预影响即将成年。我们已建立的基础设施、强大的社区参与伙伴关系以及现有的队列使我们能够有效启动、严格实施和综合结果八波后续。这将使我们能够检查社会影响的时间和累积影响性健康的决定因素，确定调节因素，并确定最有影响力的干预目标在发生率最高的时期减少意外怀孕和性传播感染。重点关注成年初期是一个高度优先且经常被忽视的发展时期，其中蕴藏着机会解决在理解支持向成年过渡的有效方法方面存在的巨大差距，从而促进幸福和积极的性健康。