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Bustos B, Lopez M, Dodge KA, Lansford JE, Copeland WE, Odgers CL, Bruckner TA. Family cash transfers in childhood and birthing persons and birth outcomes later in life. SSM Popul Health 2024; 25:101623. [PMID: 38420110 PMCID: PMC10899058 DOI: 10.1016/j.ssmph.2024.101623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 03/02/2024] Open
Abstract
Much literature in the US documents an intergenerational transmission of birthing person and perinatal morbidity in socioeconomically disadvantaged groups. A separate line of work indicates that family cash transfers may improve life chances of low-income families well into adulthood. By exploiting a quasi-random natural experiment of a large family cash transfer among a southeastern American Indian (AI) tribe in rural North Carolina, we examine whether a "perturbation" in socioeconomic status during childhood improves birthing person/perinatal outcomes when they become parents themselves. We acquired birth records on 6805 AI and non-AI infants born from 1995 to 2018. Regression methods to examine effect modification tested whether the birthing person's American Indian (AI) status and exposure to the family cash transfer during their childhood years corresponds with improvements in birthing person and perinatal outcomes. Findings show an increase in age at childbearing (coef: 0.15 years, 95% confidence interval [CI]: 0.05, 0.25) and a decrease in pre-pregnancy body mass index (BMI; coef: -0.42, 95% CI: -0.76, -0.09) with increased duration of cash transfer exposure during childhood. The odds of large-for-gestational age at delivery, as well as mean infant birthweight, is also reduced among AI births whose birthing person had relatively longer duration of exposure to the cash transfer. We, however, observe no relation with other birthing person/perinatal outcomes (e.g., tobacco use during pregnancy, preterm birth). In this rural AI population, cash transfers in one generation correspond with improved birthing person and infant health in the next generation.
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Affiliation(s)
- Brenda Bustos
- Program in Public Health, University of California, Irvine, 856 Health Sciences Quad Irvine, CA, 92697, USA
| | - Marcela Lopez
- Department of Epidemiology and Biostatistics, University of California, Irvine, 856 Health Sciences Quad Irvine, CA, 92697, USA
| | - Kenneth A. Dodge
- Sanford School of Public Policy, Duke University, 201 Science Drive, Durham, NC, 27708, USA
| | - Jennifer E. Lansford
- Sanford School of Public Policy, Duke University, 201 Science Drive, Durham, NC, 27708, USA
| | - William E. Copeland
- Department of Psychiatry, University of Vermont, 1 South Prospect, Burlington, VT, 05405, USA
| | - Candice L. Odgers
- School of Social Ecology, University of California, Irvine, 4326 Social & Behavioral Sciences Gateway, Irvine, CA, 92697, USA
| | - Tim A. Bruckner
- Program in Public Health, University of California, Irvine, 856 Health Sciences Quad Irvine, CA, 92697, USA
- Center for Population, Inequality, and Policy, University of California, Irvine, School of Social Sciences, Irvine, CA, 92697, USA
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Burns A, DeAtley T, Short SE. The maternal health of American Indian and Alaska Native people: A scoping review. Soc Sci Med 2023; 317:115584. [PMID: 36521232 PMCID: PMC9875554 DOI: 10.1016/j.socscimed.2022.115584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/21/2022] [Accepted: 11/26/2022] [Indexed: 11/30/2022]
Abstract
Indigenous people in the United States experience disadvantage in multiple domains of health. Yet, their maternal health receives limited research attention. With a focus on empirical research findings, we conduct a scoping review to address two questions: 1) what does the literature tell us about the patterns and prevalence of maternal mortality and morbidity of American Indian and Alaska Native (AI/AN) people? and 2) how do existing studies explain these patterns? A search of CINAHL, Embase and Medline yielded 4757 English-language articles, with 66 eligible for close review. Of these, few focused specifically on AI/AN people's maternal health. AI/AN people experience higher levels of maternal mortality and morbidity than non-Hispanic White people, with estimates that vary substantially across samples and geography. Explanations for the maternal health of AI/AN people focused on individual factors such as poverty, cultural beliefs, and access to healthcare (e.g. lack of insurance). Studies rarely addressed the varied historical and structural contexts of AI/AN tribal nations, such as harms associated with colonization and economic marginalization. Research for and by Indigenous communities and nations is needed to redress the effective erasure of AI/AN people's maternal health experiences and to advance solutions that will promote their health and well-being.
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Affiliation(s)
- Ailish Burns
- Department of Sociology, Brown University, 108 George St Box 1916, Providence RI, 02912, USA; Population Studies and Training Center, Brown University, 68 Waterman St Box 1836, Providence RI, 02912, USA.
| | - Teresa DeAtley
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA
| | - Susan E Short
- Department of Sociology, Brown University, 108 George St Box 1916, Providence RI, 02912, USA; Population Studies and Training Center, Brown University, 68 Waterman St Box 1836, Providence RI, 02912, USA
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Skye M, Craig S, Donald C, Kelley A, Morgan B, Rajani K, Singer M, Zaback T, Lambert W. Are American Indian/Alaska Native Adolescent Health Behaviors Different? A Review of AI/AN Youth Involved in Native STAND Curriculum, 2014-2017 United States. Matern Child Health J 2021; 25:1893-1902. [PMID: 34705192 PMCID: PMC8599210 DOI: 10.1007/s10995-021-03256-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To explore health behavior profiles of AI/AN youth involved in native students together against negative decisions (STAND), a national culture-based curriculum. METHODS We analyzed data from 1236 surveys conducted among AI/AN youth at 40 native STAND implementation sites located in 16 states throughout the US from 2014 to 2017. Health profiles included demographics, sexual orientation, sexual activity, STI testing, cigarette use, and suicide attempts in the past 12-months. We used t-tests and chi square tests of independence to compare risk behavior prevalence among the sample. RESULTS Health behavior profiles of AI/AN youth indicate that 45.6% of youth did not use condoms the last time they had sex, and 82.7% have never been tested for STIs. Differences in cigarette smoking were observed in questioning youth (questioning: 80.3%, straight/heterosexual: 63.8%, LGBTQ2S + : 49.9%, p = 0.03). CONCLUSIONS FOR PRACTICE Health behaviors related to sex, substance, violence and self-harm, are at least as common for AI/AN youth as those observed in other US teens. Future research should consider similarities and differences in health profiles of AI/AN youth when designing interventions that affect them. Further, our findings underscore the need for culturally-relevant curricula like native STAND, not because their health behavior is different, but because their socio-ecologic environment is different.
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Affiliation(s)
- Megan Skye
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA.
| | - Stephanie Craig
- Northwest Portland Area Indian Health Board, Portland, OR, 97201, USA
| | - Caitlin Donald
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| | | | - Brittany Morgan
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| | - Kavita Rajani
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| | - Michelle Singer
- Northwest Portland Area Indian Health Board, Portland, OR, 97201, USA
| | - Tosha Zaback
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
| | - William Lambert
- Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA
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Maslowsky J, Powers D, Hendrick CE, Al-Hamoodah L. County-Level Clustering and Characteristics of Repeat Versus First Teen Births in the United States, 2015-2017. J Adolesc Health 2019; 65:674-680. [PMID: 31474434 PMCID: PMC6814573 DOI: 10.1016/j.jadohealth.2019.05.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/01/2019] [Accepted: 05/30/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Approximately 16% of U.S. births to women aged 15-19 years are repeat (second or higher order) births. Repeat teen mothers are at elevated risk for poor perinatal outcomes. Geographic clustering and correlates of repeat teen birth are unknown. METHODS Data from birth certificates on N = 629,939 teen births in N = 3,108 U.S. counties in 2015-2017 were merged with data on county-level demographic, socioeconomic, and health provider characteristics. We identified contiguous clusters of counties with significantly elevated rates of first teen births only, repeat teen births, both, or neither between 2015 and 2017 and compared demographic, socioeconomic, and medical provider characteristics of counties between 2010 and 2016 in each cluster type. RESULTS A total of 193 counties (6.21%) had high rates of repeat births only; 504 (16.22%) had high rates of first teen birth only; 991 (31.89%) had high rates of both repeat and first teen births; and 1,420 (45.69%) had neither. Counties with high repeat (vs. first only) birth rates had higher rates of poverty and unemployment, higher levels of income inequality, lower high school graduation rates, a higher share of racial and ethnic minority residents, fewer publicly funded family planning clinics per capita, and more women receiving contraceptive services at publicly funded clinics. CONCLUSIONS First and repeat teen births cluster in differentially resourced geographic areas. Counties with high repeat teen birth rates have lower socioeconomic conditions than counties with high rates of first teen births only. These counties are more reliant on publicly funded family planning clinics but have fewer of them per capita.
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Affiliation(s)
- Julie Maslowsky
- Department of Kinesiology and Health Education, College of Education, University of Texas at Austin, Austin, Texas.
| | - Daniel Powers
- Department of Sociology, College of Liberal Arts, University of Texas at Austin, Austin, Texas
| | - C Emily Hendrick
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Leila Al-Hamoodah
- Lyndon B. Johnson School of Public Affairs, University of Texas at Austin, Austin, Texas
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Shrestha U, Hanson J, Weber T, Ingersoll K. Community Perceptions of Alcohol Exposed Pregnancy Prevention Program for American Indian and Alaska Native Teens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1795. [PMID: 31117177 PMCID: PMC6572356 DOI: 10.3390/ijerph16101795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/16/2019] [Accepted: 05/18/2019] [Indexed: 12/14/2022]
Abstract
A community needs assessment during a tribally-led Changing High-Risk Alcohol Use and Increasing Contraception Effectiveness Study (CHOICES) intervention highlighted the need to reduce the risk for alcohol exposed pregnancy (AEP) among American Indian and Alaska Native (AIAN) adolescent girls. The CHOICES for American Indian Teens (CHAT) Program aims to reduce the risk of AEP among AIAN teens in one Northern Plains tribal community. The CHAT team adopted an iterative process to modify the tribally-led CHOICES curriculum for AIAN teens. This paper describes the iterative process as well as the community perception towards AEP prevention among AIAN teens. The CHAT team conducted several levels of formative and qualitative research, including one-on-one interviews (n = 15) with community members, AIAN elders and school counsellors; and three focus groups with AIAN adolescent girls (n = 15). A qualitative data analysis identified several recommendations that centered on making the information regarding alcohol and birth control appealing to teens; ensuring the confidentiality of the participants; making the program culturally relevant; and including boys in the program. This study outlines various components prioritized by community members in creating a culturally-relevant and age-appropriate AEP prevention program and provides community perceptions of AEP prevention for the teens in this community.
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Affiliation(s)
- Umit Shrestha
- Department of Community and Behavioral Health, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13055 East 17th Avenue, Aurora, CO 80045, USA.
| | - Jessica Hanson
- Behavioral Sciences, Sanford Research, 2301 East 60th Street North, Sioux Falls, SD 57104, USA.
| | - Tess Weber
- Behavioral Sciences, Sanford Research, 2301 East 60th Street North, Sioux Falls, SD 57104, USA.
| | - Karen Ingersoll
- University of Virginia School of Medicine, 310 Old Ivy Way, Charlottesville, VA 22903, USA.
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Tingey L, Chambers R, Rosenstock S, Larzelere F, Goklish N, Lee A, Rompalo A. Risk and Protective Factors Associated With Lifetime Sexual Experience Among Rural, Reservation-Based American Indian Youth. J Prim Prev 2018; 39:401-420. [PMID: 30046947 DOI: 10.1007/s10935-018-0517-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Early sexual initiation is a catalyst for sexually transmitted infection and unintended pregnancy. American Indian/Alaska Native (AI/AN) youth initiate sex prior to age 13 more often than other U.S. youth, contributing to current inequalities in sexual health. Identifying what factors were associated with lifetime sexual experience among AI/AN youth can inform the development of primary prevention programming to delay sexual initiation, alleviate the costs of early sexual activity, and improve sexual health outcomes in this population. We analyzed cross-sectional data from 267 AI youth ages 13-19, recruited from a rural, reservation-based community. We used multivariate logistic regression models to estimate associations between independent variables and lifetime sexual experience (vaginal and/or anal sex) across the following categories: sociodemographic, knowledge, attitudes/perceptions, beliefs, intentions, skills, behaviors, and theoretical constructs. The sample was 56.2% female, mean age 15.1 years (SD = 1.7), and 22.5% were sexually experienced. In our final model, condom use self-efficacy (attitude/perception factor) and intentions to remain abstinent until marriage (intention factor) were associated with lower odds of lifetime sexual experience. Age (sociodemographic factor), intention to have sex (intention factor), use of any contraception (behavior factor), and higher response efficacy (theoretical construct) were associated with lifetime sexual experience. Of these, intention to have sex was the strongest indicator. These results both corroborate and contrast with other research conducted among rural, reservation-based AI/AN youth. Our findings show programs targeting intentions may have the greatest impact among reservation-based AI youth, and justify program delivery stratified by age group in this setting.
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Affiliation(s)
- Lauren Tingey
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, John Hopkins University, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA.
| | - Rachel Chambers
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, John Hopkins University, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Summer Rosenstock
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, John Hopkins University, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Francene Larzelere
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, John Hopkins University, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Novalene Goklish
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, John Hopkins University, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Angelita Lee
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, John Hopkins University, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
| | - Anne Rompalo
- Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, John Hopkins University, 415 N. Washington St., 4th Floor, Baltimore, MD, 21231, USA
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Griese ER, Kenyon DB, McMahon TR. Identifying sexual health protective factors among Northern Plains American Indian youth: An ecological approach utilizing multiple perspectives. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2016; 23:16-43. [PMID: 27536896 PMCID: PMC5463740 DOI: 10.5820/aian.2304.2016.16] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study examined aspects of the sociocultural context in which American Indian (AI) teen pregnancy occurs, focusing specifically on protective factors for Northern Plains AI youth. Principles of community-based participatory research guided the qualitative data collection from 185 community members (focus groups with AI youth, youth parents, and elders; interviews with health care providers and school personnel) from a reservation and an urban community. Results indicated three protective systems impacted the sexual health and behaviors of AI youth: school, family, and enculturation. These findings provide a better understanding of how specific protective factors within these systems may buffer AI youth from involvement in risky sexual behaviors and work to inform culturally relevant prevention and intervention efforts.
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Jensen J, Baete Kenyon DY, Hanson JD. Preventing alcohol-exposed pregnancy among American-Indian youth. SEX EDUCATION 2015; 16:368-378. [PMID: 27429593 PMCID: PMC4942809 DOI: 10.1080/14681811.2015.1082070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Research has determined that the prevention of alcohol-exposed pregnancies (AEP) must occur pre-conceptually with women, either by reducing alcohol intake in women planning pregnancy or at-risk for becoming pregnant, or by preventing pregnancy in women drinking at risky levels. One such AEP prevention programme with non-pregnant American Indian women is the Oglala Sioux Tribe (OST) CHOICES (Changing High-risk alcohOl use and Increasing Contraception Effectiveness Study) Programme, which shows promise in reducing AEP risk in American Indian women aged 18 or older. A community needs assessment was conducted with key informant interviews and focus groups with an emphasis on how to expand OST CHOICES. To identify interconnected themes, a content analysis methodology was used on the qualitative feedback from the focus groups and interviews. Altogether, key informant interviews were completed with 25 health and social service professionals. Eight focus groups were held with 58 American Indian participants, including adult women of child-bearing age, elder women, and adult men. Several sub-themes regarding the prevention of AEP with youth were identified, expanding the OST CHOICES curriculum into the schools, and the role of family and culture within AEP prevention.
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Hanson JD, McMahon TR, Griese ER, Kenyon DB. Understanding gender roles in teen pregnancy prevention among American Indian youth. Am J Health Behav 2014; 38:807-15. [PMID: 25207506 PMCID: PMC4206259 DOI: 10.5993/ajhb.38.6.2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To examine the impact of gender norms on American Indian (AI) adolescents' sexual health behavior. METHODS The project collected qualitative data at a reservation site and an urban site through 24 focus groups and 20 key informant interviews. RESULTS The reasons that AI youth choose to abstain or engage in sexual intercourse and utilize contraception vary based on gender ideologies defined by the adolescent's environment. These include social expectations from family and peers, defined roles within relationships, and gender empowerment gaps. CONCLUSIONS Gender ideology plays a large role in decisions about contraception and sexual activity for AI adolescents, and it is vital to include redefinitions of gender norms within AI teen pregnancy prevention program.
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Palacios JF, Strickland CJ, Chesla CA, Kennedy HP, Portillo CJ. Weaving dreamcatchers: mothering among American Indian women who were teen mothers. J Adv Nurs 2014; 70:153-63. [PMID: 23713884 PMCID: PMC3815508 DOI: 10.1111/jan.12180] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2013] [Indexed: 11/29/2022]
Abstract
AIMS The aim of this study was to explore the mothering experience and practice among reservation-based adult American Indian women who had been adolescent mothers. BACKGROUND Adolescent American Indian women are at an elevated risk for teen pregnancy and poor maternal/child outcomes. Identifying mothering practices among this population may help guide intervention development that will improve health outcomes. DESIGN A collaborative orientation to community-based participatory research approach. METHODS Employing interpretive phenomenology, 30 adult American Indian women who resided on a Northwestern reservation were recruited. In-depth, face-to-face and telephone interviews were conducted between 2007-2008. FINDINGS Women shared their mothering experience and practice, which encompassed a lifespan perspective grounded in their American Indian cultural tradition. Four themes were identified as follows: mother hen, interrupted mothering and second chances, breaking cycles and mothering a community. Mothering originated in childhood, extended across their lifespan and moved beyond mothering their biological offspring. CONCLUSION These findings challenge the Western construct of mothering and charge nurses to seek culturally sensitive interventions that reinforce positive mothering practices and identify when additional mothering support is needed across a woman's lifespan.
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Affiliation(s)
- Janelle F. Palacios
- Postdoctoral Fellow in the Center for Vulnerable Populations/Health Disparities, University of California-Los Angeles School of Nursing
| | - Carolyn J. Strickland
- Associate Professor, Psychosocial & Community Health, University of Washington School of Nursing
| | - Catherine A. Chesla
- Thelma Shobe Professor, Department of Family Health Care Nursing, University of California- San Francisco School of Nursing
| | | | - Carmen J. Portillo
- Professor and Chair, Department of Community Health Systems, University of California-San Francisco School of Nursing
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de Ravello L, Jones SE, Tulloch S, Taylor M, Doshi S. Substance use and sexual risk behaviors among american Indian and alaska native high school students. THE JOURNAL OF SCHOOL HEALTH 2014; 84:25-32. [PMID: 24320149 PMCID: PMC4311718 DOI: 10.1111/josh.12114] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 03/15/2013] [Accepted: 05/12/2013] [Indexed: 05/17/2023]
Abstract
BACKGROUND We describe the prevalence of behaviors that put American Indian and Alaska Native (AI/AN) high school students at risk for teen pregnancy and sexually transmitted infections (STIs) and the relationships among race/ethnicity and these behaviors. METHODS We analyzed merged 2007 and 2009 data from the national Youth Risk Behavior Survey, a biennial, self-administered, school-based survey of US students in grades 9-12 (N = 27,912). Prevalence estimates and logistic regression, controlling for sex and grade, were used to examine the associations between race/ethnicity, and substance use, and sexual risk behaviors. RESULTS Of the 26 variables studied, the adjusted odds ratios (AOR) were higher among AI/AN than White students for 18 variables (ranging from 1.4 to 2.3), higher among AI/AN than Black students for 13 variables (ranging from 1.4 to 4.2), and higher among AI/AN than Hispanic students for 5 variables (ranging from 1.4 to 1.5). Odds were lower among AI/AN than Black students for many of the sexual risk-related behaviors. CONCLUSIONS The data suggest it is necessary to develop targeted, adolescent-specific interventions aimed at reducing behaviors that put AI/AN high school students at risk for teen pregnancy, STI/HIV, and other health conditions.
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Affiliation(s)
- Lori de Ravello
- Public Health Advisor, (), Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS F-74, Atlanta, GA 30341-3717
| | - Sherry Everett Jones
- Health Scientist, (), Division of Adolescent and School Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS F-74, Atlanta, GA 30341
| | - Scott Tulloch
- Public Health Advisor, (), Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E02, Atlanta, GA 30333
| | - Melanie Taylor
- Medical Epidemiologist, (), Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E02, Atlanta, GA 30333
| | - Sonal Doshi
- Health Scientist, (), Office of State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-E70, Atlanta, GA 30341
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Penman-Aguilar A, Carter M, Snead MC, Kourtis AP. Socioeconomic disadvantage as a social determinant of teen childbearing in the U.S. Public Health Rep 2013; 128 Suppl 1:5-22. [PMID: 23450881 PMCID: PMC3562742 DOI: 10.1177/00333549131282s102] [Citation(s) in RCA: 159] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES We reviewed the literature focused on socioeconomic influences on teen childbearing and suggested directions for future research and practice related to this important indicator of teen sexual health. METHODS We conducted an electronic search of Medline, ERIC, PsychLit, and Sociological Abstracts databases for articles published from January 1995 to November 2011. Selected articles from peer-reviewed journals included original quantitative analyses addressing socioeconomic influences on first birth among teen women in the U.S. Articles were abstracted for key information, ranked for quality according to the U.S. Preventive Services Task Force guidelines, assessed for bias, and synthesized. RESULTS We selected articles with a range of observational study designs. Risk for bias varied across studies. All 12 studies that considered socioeconomic factors as influences on teen childbearing (vs. moderators or mediators of other effects) reported at least one statistically significant association relating low socioeconomic status, underemployment, low income, low education levels, neighborhood disadvantage, neighborhood physical disorder, or neighborhood-level income inequality to teen birth. Few reports included any associations contradicting this pattern. CONCLUSIONS This review suggests that unfavorable socioeconomic conditions experienced at the community and family levels contribute to the high teen birth rate in the U.S. Future research into social determinants of sexual health should include multiple levels of measurement whenever possible. Root causes of teen childbearing should be evaluated in various populations and contexts. Interventions that address socioeconomic influences at multiple levels could positively affect large numbers of teens and help eliminate disparities in teen childbearing.
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Affiliation(s)
- Ana Penman-Aguilar
- Centers for Disease Control and Prevention, Office of Minority Health and Health Equity, Atlanta, GA 30333, USA.
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