Abstract
Introduction
Recognition of the importance of adolescents’ environments in influencing their sexual and reproductive health (SRH) decision-making necessitates a deeper understanding of the role that community stakeholders play in shaping Adolescent and Young Adults (AYA) access to SRH education and care. We describe community stakeholders’ knowledge, beliefs, and attitudes about AYA’s SRH needs in three rural Latino communities in Kansas.
Methods
Key stakeholders completed a written survey incorporating the theory of Planned Behavior to assess attitudes, norms, and intentions to support AYA’s SRH education and access to care.
Results
Across three rural immigrant community settings, respondents (N = 55) included 8 community health workers, 9 health care providers, 7 public health officials, 19 school health officials, and 12 community members. More than half self-identified as Latino (55%). Six (11%) participants, half of whom were in the health sector, thought SRH education would increase the likelihood that teens would engage in sexual activities. In contrast, other stakeholders thought that providing condoms (17, 30.9%), contraception other than condoms (14, 25.5%), and providing HPV immunization (5, 9.6%) would increase the likelihood of engaging in sexual activity. Ambivalence regarding support for SRH education and service provision prevailed across sectors, reflected even in the endorsement of the distribution of less effective contraceptive methods. Obstacles to care include immigration status, discrimination, lack of confidential services, and transportation.
Conclusion
Key stakeholders living in rural communities revealed misconceptions, negative attitudes, and ambivalent beliefs related to the delivery of SRH education and services, potentially creating barriers to AYA’s successful access to care.
Significance
Little is known about the knowledge, beliefs and attitudes held by key stakeholders in rural immigrant Latino communities regarding their level of support for AYA’s SRH needs. Key stakeholders may harbor influential and ambivalent opinions regarding AYA’s sexuality considering existing cultural norms, therefore, stigmatizing access to SRH education and care. We examined key community stakeholders’ attitudes and norms as measures of intentions to support AYA’s SRH education and care. We identify actionable steps needed to eliminate existing barriers to AYA’s access to SRH education and care among at-risk immigrant Latino communities in the rural Midwest.
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Data Availability
Deidentified survey data collected is available in Research Electronic Data Capture (REDCap).
Code Availability
Not applicable.
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Acknowledgements
The authors would like to thank the Juntos Center for Advancing Latino Health for helping to coordinate the study at community centers in southwest Kansas. The authors would also like to thank the Society for Adolescent Health and Medicine’s (SAHM) Research and Mentoring forum for providing guidance and support through every aspect of this project.
Funding
Katharine Berry Richardson grant, Children’s Mercy Hospital, Kansas City; National Institutes of Health [P20MD000198-MT]; Dr. Brindis’ time was supported in part by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) (under #U45MC27709, Adolescent and Young Adult Health Capacity Building Program), with supplemental support from HRSA grants #UA6MC27378. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government. The sponsors had no role in the preparation or submission of this article.
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All authors contributed to the study’s conception and design. Material preparation and data collection were performed by RLB and MR. Data analysis was performed by AS and the writing of initial drafts of the manuscript was performed by RLB, LH and CDB. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Dr. Trent receives research grant funding/supplies from Hologic, Inc. and SpeeDx, LLC to Johns Hopkins University. She also serves on the Trojan Sexual Health Advisory Council sponsored by Church and Dwight, Inc.
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Barral, R.L., Brindis, C.D., Hornberger, L. et al. The Perfect Storm: Perceptions of Influencing Adults Regarding Latino Teen Pregnancy in Rural Communities. Matern Child Health J 27, 621–631 (2023). https://doi.org/10.1007/s10995-023-03627-2
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DOI: https://doi.org/10.1007/s10995-023-03627-2