Community Violence and Reproductive Health among Youth in Salinas, California

项目摘要/摘要 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， 解决农村农业社区在结构性和人际因素方面的研究差距， 影响青少年怀孕期间发生的青少年暴力和性健康风险 从青春期早期过渡到青春期中期。在加利福尼亚州，每八个美国青少年中就有一个居住着拉丁裔 保持最高的青少年出生率，2010年，青少年出生率为41%，但青少年出生率为73% 出生。青春期性健康研究主要集中在城市青年；然而，三分之一的人 加州青少年的出生是指居住在农村县的拉丁裔青少年。无数的结构性和人际性 (家庭、同伴、伴侣)形成风险环境的因素在城市和农村社区之间有所不同。 了解这些造成健康差距的潜在背景对于实现实质性的 改善健康状况。我们由美国国立卫生研究院资助的旧金山拉美裔青少年研究 在过去的12年里，社区暴力和意外的青少年之间存在着强烈的联系 怀孕了。虽然传统上被认为是城市的帮派，但帮派已经在许多城市以外的地区出现 美国。这项研究将在加利福尼亚州的萨利纳斯进行，这是一个位于蒙特利的农业社区 加利福尼亚州中部海岸的一个县。美国司法部将萨利纳斯列为六个高风险人群之一 在全国范围内为青年帮派暴力建立社区。蒙特利县2010年的青少年出生率位居第六 在加州的58个县中。在加利福尼亚州萨利纳斯，青少年暴力和早育的高比率， 再加上墨西哥几代人的移民造成的根深蒂固的社会经济差距 农业部门就业，使研究制定适当的干预措施势在必行。这一背景 提供了一个机会来研究结构性因素和人际因素对年轻人的相对重要性 暴力和生殖健康在一个农村县，就像整个加州中部的许多其他县一样。这 这项研究是由蒙特利县卫生局发起的，并已与合作伙伴共同开发 有一支经验丰富的NIH调查团队。在健康的社会生态模式下，我们将 通过混合方法设计实现我们的目标，其中包括形成性定性研究 焦点小组，随后对600名8年级学生进行了为期2年的前瞻性队列研究， 其中40人将被选中完成预期的深度采访。我们的目标是调查 结构性和人际性因素，分别和共同与参与暴力有关 加州萨利纳斯8年级拉丁裔男女学生的行为和性健康风险；2) 检查暴力行为和性风险随着时间的推移的轨迹，以及它们在 从8年级到10年级的过渡；以及3)确定影响 从8年级到10年级过渡过程中的暴力行为和性健康风险。

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.