Community Violence and Reproductive Health among Youth in Salinas, California

描述：这项研究的目标是由一位直接基于她的NICHD K01研究的早期调查人员领导的，旨在解决农村农业社区中结构和人际因素的研究空白，这些因素在从青春期早期到中期的过渡期间影响青少年暴力的发生和与青少年怀孕相关的性健康风险。在加利福尼亚州，每八个美国青少年中就有一个居住在那里；拉丁裔保持着最高的青少年出生率，2010年占青少年人口的41%，但占青少年出生率的73%。青春期性健康研究主要集中在城市青年；然而，加州三分之一的青少年出生于居住在农村县的拉丁裔青少年。众多的结构 而形成风险环境的人际因素(家庭、同伴、伴侣)在城市和农村社区之间也不同。了解这些造成健康差距的潜在背景对于实现健康结果的实质性改善至关重要。在过去的12年里，我们由美国国立卫生研究院资助的对旧金山拉美裔青少年的研究突出了社区暴力和意外怀孕之间的强烈联系。虽然传统上被认为是城市，但帮派已经在美国的许多非城市地区出现。这项研究将在加利福尼亚州萨利纳斯进行，这是一个位于加利福尼亚州中部海岸蒙特利县的农业社区。美国司法部将萨利纳斯列为全国六个青少年帮派暴力的高危社区之一。2010年，蒙特利县的青少年出生率在加州58个县中排名第六。加利福尼亚州萨利纳斯的青年暴力和早产率很高，再加上墨西哥几代人为了农业部门就业而移徙造成的根深蒂固的社会经济差距，因此必须进行研究，以制定适当的干预措施。这一背景提供了一个机会，可以审查结构性和人际因素在一个农村县对青少年暴力和生殖健康的相对突出程度，就像整个加利福尼亚州中部的许多其他县一样。这项研究是由蒙特利县卫生局发起的，并与经验丰富的NIH调查团队合作开发。在健康的社会生态模型的启发下，我们将通过混合方法设计来实现我们的目标，其中包括使用焦点小组进行形成性定性研究，然后进行为期两年的前瞻性队列研究，随机抽样600名8年级学生，其中40人将被选中完成前瞻性深度访谈。我们的目标是1)在加利福尼亚州萨利纳斯的8年级拉丁裔男女学生中，调查与暴力行为和性健康风险个别和共同相关的结构性和人际因素；2)考察暴力行为和性风险在从8年级到10年级的过渡期间随时间的轨迹及其相互作用；以及3)确定在从8年级到10年级的过渡期间影响暴力行为和性健康风险的结构性和人际因素。

DESCRIPTION: 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.