Juvenile Court Approaches to Reduce Reproductive Health Disparities

 说明(申请人提供)：少数民族青年在少年司法系统中的比例不成比例，就像他们在生活在贫困中的人、在杂乱无章的邻里环境中长大的人以及患有性传播感染和意外怀孕的人中的比例过高一样。多种社会和结构因素与这些青年的性健康结果较差有关，包括获得保健服务及其社会(和性传播)网络的机会和可得性有限。JJ青年可能会受到更多的法律指控，并被监禁到成年，从而在成人刑事司法系统中长期存在种族和民族健康差距。尽管在卫生和法律制度中都存在种族和族裔差异，但青少年司法参与与健康(包括性)差异之间的关系研究严重不足。宪法授权要求在惩教场所获得医疗检测和治疗，包括免费获得性保健服务；然而，被监禁的青少年仅占被捕青少年的大约20%，目前青少年司法的趋势是远离监禁。等到青年被限制在提供更多获得性健康服务的机会时，就错过了改善更广泛的青少年群体的性健康结果和缩小差距的巨大机会。因此，这项研究的目的是提供数据，为公共卫生和少年司法结构性干预发展和政策提供信息，旨在增加参与法院的非监禁(CINI)青少年获得和接受性健康预防、治疗、护理和支助服务的机会。我们寻求从少年法庭和卫生部的主要告密者那里收集定性和定量的数据，这些数据将为CINI青少年获得和接受性健康服务的障碍和促进者提供新的文件。定性的半结构化访谈和对美国法院和卫生部环境的不同样本(N=300名受访者)的大规模调查相结合，将提供关于限制或允许CINI青少年获得性健康服务的系统态度、认知、做法和政策的数据。

 DESCRIPTION (provided by applicant): Racial and ethnic minority youth are disproportionately represented in the juvenile justice (JJ) system, just as they are overrepresented among those living in poverty, those growing up in disorganized neighborhood environments and those with sexually transmitted infections (STIs) and unwanted pregnancies. Multiple societal and structural factors are associated with poorer sexual health outcomes for these youth, including limited access to, and availability of, health care services and their socia (and sexual transmission) networks. JJ youth are likely to accrue further legal charges and be incarcerated into adulthood, thereby perpetuating racial and ethnic health disparities within the adult criminal justice system. Despite that racial and ethnic disparities exist in both health and legal systems, the relationship between juvenile justice involvement and health (including sexual) disparities is highly understudied. Constitutional mandates require access to medical testing and treatment in correctional settings, including free access to sexual health care services; however, confined juveniles only represent approximately twenty percent of arrested youth and the current trend in juvenile justice is away from confinement. Waiting until youth are confined to provide increased access to sexual health services misses a tremendous opportunity to improve sexual health outcomes and reduce disparities for a broader group of juveniles. The objective of this study is therefore to provide data that will inform public health and juvenile justice structural intervention development and policy geared toward increasing access to and uptake of sexual health prevention, treatment, care and support services for court- involved, non-incarcerated (CINI) youth. We seek to collect qualitative and quantitative data from juvenile court and department of health key informants that will provide novel documentation of the barriers to and facilitators of increasing access to and uptake of sexual health services for CINI juveniles. A combination of qualitative semistructured interviews and a large-scale survey of a diverse US sample of court and department of health settings (N=300 respondents) will provide data on system attitudes, perceptions, practices and policies that limit or enable access to sexual health services for CINI juveniles.