A Culture Centered Narrative Approach for Health Promotion

描述（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（STI）率都很高，无论是在全国范围内还是在霍利约克。1拉丁裔青少年的出生率在美国任何主要少数民族/种族中都是最高的，为70.1/1000，而整体青少年出生率为39.1/1000。2在所有种族/种族群体中，拉丁美洲人在所有成人和青少年艾滋病毒诊断中排名第二。3 2009年，美国15-19岁的拉丁美洲人的衣原体感染率为21.9/1000，而他们的白色同龄人的衣原体感染率为11.37/1000。因此，它们往往是无效的。 实施针对具体文化的叙事干预措施。 让青年参与以艺术和叙事为基础的过程6-8，同时也承认他们的日常现实和性的含义的可变性，包括积极的性观点9和10的干预措施，可能对促进性健康和福祉有效。通过突出拉丁美洲年轻人的声音来表达他们自己对健康的意义，并在制定健康促进计划时考虑这些观点，11以文化为中心的方法可以有效地促进积极的性健康结果。19，20叙述过程本身并没有很好地测试它作为健康促进机制的工作方式。我们的多学科项目团队建议使用“年轻人驱动，研究人员促进”的叙述方法21来解决这一研究差距。 拟议的项目采用叙事方法，使用数字讲故事（DST）严格映射参与者形成性，性健康和幸福的文化特定意义的机制。由此产生的特定文化数据将用于为以文化为中心的性健康干预措施的未来发展提供信息。这一过程的影响将导致自尊水平的提高和个人性价值观的清晰度，性决策和沟通技能的提高，以及参与者在行动中的感知选择的增加。该项目的具体目标是：（1）确定三个波多黎各拉丁裔青少年群体的性健康文化模式;（2）评估数字故事创作过程对参与者的性态度/价值观、自决和保护行为的影响;以及（3）探索为研讨会参与者制作的数字故事的感知价值，为下一阶段研究中更大规模的推广工作提供选择共鸣数字故事的信息。

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.