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The Impact of a Sexual and Reproductive Health Intervention for American Indian Adolescents on Predictors of Condom Use Intention.

ABSTRACT: American Indian (AI) adolescents experience inequalities in sexual health, in particular, early sexual initiation. Condom use intention is an established predictor of condom use and is an important construct for evaluating interventions among adolescents who are not yet sexually active. This analysis evaluated the impact of Respecting the Circle of Life (RCL), a sexual and reproductive health intervention for AI adolescents, on predictors of condom use intention.We utilized a cluster randomized controlled trial design to evaluate RCL among 267 AIs ages 13-19. We examined baseline psychosocial and theoretical variables associated with condom use intention. Generalized estimating equation regression models determined which baseline variables predictive of condom use intention were impacted.Mean sample age was 15.1 years (standard deviation 1.7) and 56% were female; 22% had initiated sex. A larger proportion of RCL versus control participants had condom use intention post intervention (relative risk [RR] = 1.39, p = .008), especially younger (ages 13-15; RR = 1.42, p = .007) and sexually inexperienced adolescents (RR = 1.44, p = .01); these differences attenuated at additional follow-up. Baseline predictors of condom use intention included being sexually experienced, having condom use self-efficacy, as well as response efficacy and severity (both theoretical constructs). Of these, the RCL intervention significantly impacted condom use self-efficacy and response efficacy.Results demonstrate RCL intervention efficacy impacting variables predictive of condom use intention at baseline, with greater differences among younger, sexually inexperienced adolescents. To sustain intervention impact, future RCL implementation should reinforce education and training in condom use self-efficacy and response efficacy and recruit younger, sexually inexperienced AI adolescents.

SUBMITTER: Tingey L

PROVIDER: S-EPMC5326598 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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The Impact of a Sexual and Reproductive Health Intervention for American Indian Adolescents on Predictors of Condom Use Intention.

Tingey Lauren L Chambers Rachel R Rosenstock Summer S Lee Angelita A Goklish Novalene N Larzelere Francene F

The Journal of adolescent health : official publication of the Society for Adolescent Medicine 20161227 3

<h4>Purpose</h4>American Indian (AI) adolescents experience inequalities in sexual health, in particular, early sexual initiation. Condom use intention is an established predictor of condom use and is an important construct for evaluating interventions among adolescents who are not yet sexually active. This analysis evaluated the impact of Respecting the Circle of Life (RCL), a sexual and reproductive health intervention for AI adolescents, on predictors of condom use intention.<h4>Methods</h4>W ...[more]

PMID: 28034609

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Project description:BackgroundImproved access to sexual and reproductive health (SRH) services and information is essential for supporting adolescents and youth in making informed decisions and optimizing each young person's outcomes related to their SRH, health and well-being and countries' current and future social and economic development. Mobile phones offer opportunities for young people to privately access SRH content and to be linked to SRH services. The objective of this study was to develop the content for an SMS (short message service or "text message") platform jointly with adolescents and youth in three regions in Peru (Lima, Ayacucho and Loreto) as part of the ARMADILLO (Adolescent/Youth Reproductive Mobile Access and Delivery Initiative for Love and Life Outcomes) Study.MethodsContent development was done in three stages. During Stage 1, we held community consultations with 13-17 year old adolescents, 18-24 year old youth and professionals who work with young people through the education and health sectors ("adult advisers") to identify and rate SRH topics of interest through group free- and guided-brainstorming activities and an individual written sharing activity. During Stage 2, the team developed the preliminary domains, sub-domains and content for the SMS platform. During Stage 3, we held focus groups with adolescents to validate the SMS content, including both individual scoring of and group feedback for each SMS. Group feedback asked about their general impressions and understanding and their thoughts about the language and usefulness of the SMS.ResultsA total of 172 adolescents and youth ages 13-24 and 20 adult advisers participated. Adolescents and youth brainstormed and rated SRH topics and sub-topics that led to the initial structure for the SMS platform, with 9 domains, 25 sub-domains and 146 draft SMS. Adolescents provided high scores for the SMS, with all sub-domains receiving average scores of 3.0 or higher (out of 4.0) for the SMS included. Adolescents also provided suggestions to optimize content, including improvements to unclear messages, resulting in SMS with adolescent-friendly content in simple, straightforward language. This process also revealed that adolescents lacked knowledge and had misconceptions related to contraceptive methods.ConclusionThis study details the systematic process used to develop relevant and accessible SRH information through a participatory approach. We document critical information about what young people know and how they think, enabling us to understand their perspective and literally speak their language. Results also provide future directions for programmatic, research and policy efforts with young people, in particular around gender norms, interpersonal violence, and access to SRH information and services, in similar settings.

Project description:ImportanceChild maltreatment adversely affects health and development, but evidence is needed regarding whether and how Child Protective Services (CPS) interventions may mitigate risks.ObjectiveTo assess whether different forms of CPS intervention are associated with sexual and reproductive health outcomes among female adolescents investigated by CPS for suspected exposure to maltreatment during childhood.Design, setting, and participantsThis cohort study used linked, longitudinal, statewide administrative data from Wisconsin, including medical assistance and CPS records, to examine the rates and correlates of sexual and reproductive health outcomes (sexual transmitted infections, pregnancies, births, and high-risk sexual behavior) among 9392 female adolescents tracked from age 13 through 17 years who were investigated by CPS for suspected exposure to maltreatment prior to their 13th birthday. The study assesses how these outcomes were associated with types and frequency of CPS involvement and intervention and with adolescent and family demographic characteristics. Participants were female adolescents born from 2000 through 2002 who were investigated by Wisconsin CPS for suspected exposure to maltreatment before 13 years of age and who were covered by medical assistance at least 85% of the time from 13 to 17 years of age.ExposuresVarying levels and intensities of CPS interventions, ranging from a single investigation to adoption from foster care.Main outcomes and measuresDependent variables were pregnancy, birth, sexually transmitted infection, and an aggregate measure of sexual health concerns from 13 to 17 years of age. Primary explanatory variables were the intensity of CPS intervention (investigation only, in-home services, and foster care) and frequency of maltreatment concerns (number of investigations, continued involvement during adolescence). Logistic regression was used to assess the association of CPS measures with differences in sexual health outcomes. Data were analyzed from March 1 to October 12, 2021.ResultsThis cohort study included 9392 female adolescents, among whom 3156 (33.6%) were born in 2000, 3064 (32.6%) in 2001, and 3173 (33.8%) in 2002; 2501 adolescents [26.6%] were Black, 1568 [16.7%] were Hispanic, 1024 [10.9%] were multiracial, 4024 [42.8%] were White, and 275 [2.9%] were listed as other [which included American Indian, Asian or Pacific Islander, or unknown race or ethnicity]). By 18 years of age, sizable proportions of maltreated female adolescents had at least 1 concerning sexual health outcome (23.5%), including diagnoses of gonorrhea, chlamydia, or trichomoniasis (8.4%), pregnancy (11.2%), and parenthood (6.1%). Compared with CPS investigation without formal intervention, foster care was associated with lower odds of pregnancy (adjusted odds ratio, 0.82; 95% C, 0.69-0.98) and live birth (adjusted odds ratio, 0.78; 95% CI, 0.61-0.99). Recurrent and ongoing CPS involvement was associated with adverse sexual health outcomes.Conclusions and relevanceThis cohort study found that maltreated girls face increased risks of adverse sexual health outcomes in adolescence, but CPS interventions were associated with limited influence. More effective interventions are needed to help maltreated girls avoid teen pregnancy, sexually transmitted infections, and risky sexual behaviors in adolescence.

Dataset Information

The Impact of a Sexual and Reproductive Health Intervention for American Indian Adolescents on Predictors of Condom Use Intention.

Publications

The Impact of a Sexual and Reproductive Health Intervention for American Indian Adolescents on Predictors of Condom Use Intention.

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