A Culture Centered Narrative Approach for Health Promotion

描述（由申请人提供）：拉丁裔青少年的出生率、艾滋病毒感染率和其他性传播感染（STIs）率很高，无论是在全国还是在霍利约克州。1拉丁裔青少年的出生率是美国主要少数民族/种族中最高的，为70.1/1000，而总体青少年出生率为39.1/1000。2在所有种族/民族群体中，拉丁裔在所有成人和青少年艾滋病毒诊断中排名第二2009年，美国15-19岁的拉丁裔衣原体感染率为21.9/1000，相比之下，同龄白人衣原体感染率为11.37/1000试图在拉丁裔/非拉丁裔青年中促进安全性行为的行为干预措施往往无法解决可以驱动个人决定和行动的文化价值观。因此，他们往往是无效的很明显，有必要识别、传播和

DESCRIPTION (provided by applicant): Latina adolescents experience high rates of birth, HIV infection, and other sexually transmitted infections (STIs), both nationwide and in Holyoke.1 Latinas have the highest teen birth rate of any major ethnic/racial minority in the U.S. at 70.1/1000 births, in comparison to an overall teen birth rate of 39.1/1000.2 Among all racial/ethnic groups, Latinos rank second for all adult and adolescent HIV diagnoses.3 In 2009, U.S. Latinas ages 15-19 had rates of Chlamydia at 21.9/1000, in comparison to 11.37/1000 for their white peers.4 Behavioral interventions that seek to promote safer sex among Latino/a youth often fail to address the cultural values that can drive individual's decisions and actions. As a result, they are often ineffective.5 There is a clear imperative to identify, disseminate, and implement culturally specific narrative-based interventions. Interventions that engage youth participants in arts- and narrative-based processes, 6-8 while also acknowledging their everyday realities and the variability in meanings of sexuality, including a positive sexuality perspective, 9, and 10 may be effective for promoting sexual health and wellbeing. By foregrounding the voices of young Latinas to articulate their own meanings of health, and considering these perspectives in the development of health promotion programs,11 culture-centered approaches can effectively promote positive sexual health outcomes.12,13 While culturally centered content has been linked to sexual health promotion among young Latinas, with culture-centric health promotion messages evaluated for their overall effectiveness,13,19,20 the narrative process itself has not been well tested for the way that it works as a mechanism of health promotion. Our multidisciplinary project team proposes to use a "young person-driven, researcher-facilitated" narrative methodology21 to address this research gap. The proposed project takes a narrative approach, using digital storytelling (DST) to rigorously map the mechanisms by which participants form culturally specific meanings of sexuality, sexual health, and wellbeing. Resulting culturally specific data will be used to inform the future development of culturally centered sexual health interventions. The impact of the process will result in increased levels in self-esteem and clarity of personal sexual values, increases in sexual decision-making and communication skills, and an increase in perceived choices in one's actions among participants. The specific aims of this project are to (1) Identify cultural paradigms of sexual health among three groups of adolescent Puerto Rican Latinas; (2) Assess the effects of the process of creating digital stories on participants' sexual attitudes/values, self-determination, and use of protective behaviors; and (3) Explore the perceived value of produced digital stories for workshop participants, to inform the choice of resonant digital stories for use in a larger scale promotion effort in the next phase of research.