Community Violence and Reproductive Health among Youth in Salinas, California

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PROJECT SUMMARY/ABSTRACT The objective of this study, led by an early-stage investigator building directly on her NICHD K01 research, is to address gaps in research on structural and interpersonal factors in a rural, agricultural community that influence the onset of youth violence and sexual health risks associated with teen pregnancy during the transition from early to middle adolescence. In California, where one in eight U.S. adolescents reside, Latinas maintain the highest teen birth rate, accounting, in 2010, for 41% of the teen population yet 73% of teen births. Adolescent sexual health research has focused primarily on urban youth; however, one in three California teen births are to Latina teens residing in a rural county. Numerous structural and interpersonal (family, peer, partner) factors that shape the risk environment differ between urban and rural communities. Understanding these underlying contexts that contribute to health disparities is vital to achieving substantive improvements in health outcomes. Our NIH-funded research with Latino adolescents in San Francisco over the past 12 years has highlighted a strong connection between community violence and unintended teen pregnancy. Though traditionally regarded as urban, gangs have emerged in many nonurban areas of the United States. This study will take place in Salinas, CA, an agricultural community located in Monterey County on California's central coast. The U.S. Department of Justice named Salinas as one of six high-risk communities nationally for youth gang violence. Monterey County had the sixth highest teen birth rate in 2010 among California's 58 counties. High rates of youth violence and early childbearing in Salinas, California, coupled with entrenched socioeconomic disparities resulting from generations of Mexican migration for agricultural-sector employment, make research to develop appropriate interventions imperative. This context presents an opportunity to examine the relative salience of structural and interpersonal factors to youth violence and reproductive health in a rural county like numerous others throughout central California. This research was initiated by the Monterey County Health Department and has been developed in partnership with an experienced team of NIH investigators. Informed by the Social Ecological Model of Health, we will accomplish our aims through a mixed-methods design that includes formative qualitative research using focus groups, followed by a 2-year prospective cohort study with a random sample of 600 8th grade students, 40 of whom will be selected to complete prospective in-depth interviews. Our aims are to 1) investigate structural and interpersonal factors that are individually and jointly associated with engagement in violent behaviors and sexual health risks among female and male 8th-grade Latino students in Salinas, CA; 2) examine the trajectories of violent behaviors and sexual risk over time, and their interaction, during the transition from 8th grade to 10th grade; and 3) identify structural and interpersonal factors that influence engagement in violent behaviors and sexual health risks during the transition from 8th grade to 10th grade.