Developmental Assets and Risky Sexual Behaviors among American Indian Youth

Parenting in 2 Worlds: Testing improved parent-adolescent communication about sexuality in Urban American Indian families

Urban American Indian (AI) adolescents are more likely than non-Natives to have early sexual debut, teen pregnancies, sexually transmitted infections, and inadequate sexual health information. A RCT in three Arizona cities, with 585 parents of urban AI adolescents, tested whether a culturally tailored parenting intervention for urban AI families, Parenting in 2 Worlds (P2W), increased parent-adolescent communication about sexuality, compared to an informational family health intervention that was not culturally tailored. P2W produced significantly larger increases on two measures: communication about general sexual health and about sexual decision-making. The desired effects of P2W on the first measure were stronger short-term for cross-gender dyads, while for the second measure, they were stronger long-term for both mothers and fathers of adolescent sons.

A systematic review of social processes and mechanisms in the community that influence risky sexual behaviour among adolescents and young adults

AIMS

To examine the associations between social processes and mechanisms within the community and risky sexual behaviour (RSB) among adolescents and young adults.

DESIGN

Systematic review.

METHODS

We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and conducted a literature search in August 2020. From 11,216 identified articles, 605 were for full-text screen. We used 24 articles, 22 after applying inclusion criteria and 2 manually searched relevant articles.

RESULTS

Social processes and mechanisms within the community included collective efficiency and social support, community safety and community norm. Collective efficacy and social support and community safety were examined using 10 and 16 studies, respectively. We found that collective efficiency and social support, and community norms partially supported the occurrences of RSB among adolescents and young adults. Community safety displayed inconclusive relationships with RSB.

CONCLUSIONS

The findings highlight the importance of social processes and mechanisms within the community in preventing RSB among adolescents and young adults. Community-based programs to improve community efficacy and social support would be effective strategies to reduce such RSB and to promote better reproductive health among adolescents and young adults.

The Role of Family Support and Communication on PrEP Attitudes and Stigma Among Black Men who Sex with Men (BMSM)

BACKGROUND

This study addresses the gap in the literature on protective factors for preexposure prophylaxis (PrEP) stigma and attitudes among Black men who have sex with men (BMSM) and young adults using the Developmental Assets Framework to examine how external assets (eg, family support, open family communication, and communication with parents about sex and drugs) can help reduce stigma and increase positive attitudes toward PrEP use.

METHODS

A cross-sectional survey was administered to participants (N = 400, mean age = 23.46, standard deviation = 2.59) using Amazon Mechanical Turk, social media sites, and community-based organization. A path analysis was conducted to examine associations between stigma and positive attitudes toward PrEP among external assets (family support, communication with parents about sex and drugs, and open family communication).

RESULTS

Communication with parents about sex and drugs was positive and directly associated with PrEP stigma (β = 0.42, P < 0.001). Family support was negative and indirectly associated with stigma associated with PrEP (β = -0.20, P < 0.001).

CONCLUSIONS

This is the first study to use a developmental asset framework to assess positive PrEP attitudes and stigma among young BMSM. Our results underscore that parents have an influence on human immunodeficiency virus prevention behaviors for BMSM. In addition, their influence can be both positive by helping lowering PrEP stigma and negatively lowering PrEP attitudes. It is critical that we develop culturally competent human immunodeficiency virus and sexuality prevention and intervention programs for BMSM and their families.

Socially Disadvantaged Community Structures and Conditions Negatively Influence Risky Sexual Behavior in Adolescents and Young Adults: A Systematic Review

Objectives: This review aims to examine the association between community-level factors, namely, community structure and condition, and risky sexual behavior (RSB) including early sexual debut, having multiple sex partners, and unprotected sex, in adolescents and young adults.

Methods: In total, 17 observational studies were identified for review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Among the 11,216 identified articles, excluded articles comprised 8,361 duplicates, 2,855 articles by title screening, 893 by abstract screening, and 667 by full-text screening. Finally, eight additional articles were added by manual search.

Results: The community structural factors included social disadvantage, economic, employment, education status, racial or ethnic composition, residential stability, and physical environment. The current review found that social disadvantage (six studies) and economic status (10 studies) were most frequently examined. Particularly, higher levels of social disadvantage were associated with higher rates of early sexual initiation, inconsistent condom use, and multiple sexual partners.

Conclusion: This study highlights that community structure and conditions in terms of social disadvantages should be addressed to prevent RSB in the young population.

Improving communication between American Indian youth and caregivers to prevent teenage pregnancy

American Indian (AI) youth are at increased risk for poor reproductive health outcomes. Parental communication and monitoring are established predictors of sexual risk-taking among adolescents. No program evaluations of sexual risk avoidance programs have focused exclusively on AI youth and parents. This study assesses the impact of the Respecting the Circle of Life (RCL) Teenage Pregnancy Prevention program on parent-youth communication and parental monitoring through a randomized controlled trial with AI youth ages 11-19 and their trusted adults (parents/caregivers) (N = 518). RCL consists of 8-peer group and one parent-youth session. Trusted adult participants completed the Parental Monitoring Scale and the Parent Adolescent Communication Scale at baseline and 3 and 9 months post-intervention via self-report. Intervention impact was evaluated using linear regression models, which included an indicator for study group. At 3 months post, trusted adults in the intervention reported significantly higher levels of sexual health communication (P = 0.042) and spoke to their child more often about how to get condoms (P = 0.001), get birth control (P = 0.014) and protect themselves from human immunodeficiency virus (P = 0.005) compared with trusted adults in the control condition. Program impact varied by age and sex. This study adds to literature and extends findings on RCL impact.

Inadequate Data Limit the Analysis of Health Disparities and Causes: A Call for Research on Youth Interpersonal Violence

Interpersonal violence among racial and ethnic minority youth is of great concern in health disparity research. Child maltreatment (CM), adolescent dating abuse (ADA), sexual abuse, and polyvictimization are key forms of interpersonal violence that require surveillance and national epidemiological data. However, national data systems and published evidence do not depict this health burden for all racial and ethnic populations. Prevalence and incidence rates for American Indians, Eskimo, and Asian youth are absent from most estimates. This commentary provides a brief overview of the gaps in the literature and offers suggestions for addressing these gaps.

External Developmental Assets and Positive Identity Among Emerging Adults in Norway, Romania, Slovenia, and Turkey

The present study adopts The Developmental Assets and Positive Youth Development (PYD) perspectives which (in contrast to the deficit-based approaches which highlight risks and deficit in youth development) claim that young people have potencies to achieve optimal development if supported by their social environment. Extant research indicates that developmental assets are linked with a variety of thriving indicators. The present research aimed to contribute to the PYD research by examining the external developmental assets (support, empowerment, and boundaries and expectations) emerging adults (N = 2055; age range = 18–28) perceived in their social environment and the level of their positive identity in four countries (Norway, Romania, Slovenia and Turkey), which have different rankings in economic, human, and youth development indices. The present study also tested a path model, which examines the links between external development assets and positive identity. Findings indicated that although there are differences in the reports of external developmental assets and positive identity, external assets and positive identity are similarly and positively linked across the four countries. The findings build on the existing literature by showing that developmental assets are conducive to positive outcomes cross-nationally despite country-level differences in the experience of external assets. Policy implications of the findings were discussed from the perspective of ecological theory as well as Developmental Assets and Positive Youth Development Frameworks.

Effects of the school environment on early sexual risk behavior: A longitudinal analysis of students in English secondary schools

INTRODUCTION

The theory of human functioning and school organization proposes that schools promote health by strengthening students' educational engagement. Previous studies have relied on proxy measures of engagement and not examined sexual health. This paper addresses these gaps.

METHODS

Longitudinal data came from the control arm of a randomized trial involving female and male students ages 12-14 in English secondary-schools (n = 3337 students). Exposures measured at baseline included a proxy measure of school-level engagement (value-added education, VAE: the difference between observed absence and attainment rates and those predicted based on student characteristics) and direct measures of school- and student-level engagement (commitment, belonging, relationships and participation). Sexual behavior was measured at 24- and 36-months, including sexual debut and contraception use at first sex.

RESULTS

Higher school-level VAE was associated with an increased risk of early sexual debut at 24-months. Students attending schools with higher overall levels of commitment and belonging were less likely to report sexual debut at 36 months. Students reporting stronger personal commitment to learning and teacher relationships at baseline were less likely to report sexual debut at both follow-up points. Associations involving participation and contraception use were largely nonsignificant.

CONCLUSIONS

Direct measures of the school environment are more strongly associated with reduced sexual risk behavior in early adolescence than the proxy measure, VAE. Results provide some support for the theory and suggest that personal disposition towards school as well as attending a school with high levels of student commitment and belonging are important for subsequent sexual decision making.

Frequent residential mobility among American Indians and early indications of sexual risk among young adolescents

American Indian and Alaska Native (AI/AN) youth are more likely to ever have had sex, and to have engaged in sexual activity prior to age 13 compared to all other race groups. It is essential to understand the development of skills to refuse sexual experience in early adolescence in order to reduce disparities associated with early sexual debut among AI/AN youth. Familial, social, and individual factors can act as protective influences on adolescent sexual experience; however, in other settings, research has shown that frequent residential mobility disrupts these protective influences and may increase the likelihood of adolescent sexual activity. AI/AN youth are highly mobile, and, as a result, may be especially vulnerable to increased sexual risk. To date, no prior study has considered the impact of residential mobility on AI/AN youth sexual experience, nor the influence on precursors that reduce initiation of sex. We used data from a longitudinal study of AI/AN youth attending all middle schools from a Northern Plains reservation from 2006-2009 to estimate a structural equation model based on a cultural and age adapted theoretical framework. The tested model included frequent residential mobility as the independent variable and sex refusal self-efficacy as the dependent variable. Mediating variables included factors related to individual risks, psychological well-being, and social supports. Results indicate a direct association between residential mobility and sex refusal self-efficacy (-.29, p = 0.05) and an indirect association mediated by deviant peers (-.08, p = .05). Other mediating variables did not provide insight on the mechanism by which residential mobility influences skills to refuse sexual intercourse among AI/AN youth in early adolescence. Findings provide evidence for an association between residential mobility and precursors to sexual experience suggesting augmenting sexual health interventions for highly mobile youth.