Sexual Coercion Among Rural Adolescents 2
Implications and ContributionConsent is essential to healthy adolescent relationships, but sexual consent and coercion are under-studied in rural youth. In our study, youth from a rural high school commonly experienced sexual coercion, and female and male students identified different modifiable risk and protective factors.Sexual Coercion Among Rural Adolescents 3 ABSTRACT Purpose: Sexual consent is important to healthy relationships; however sexual coercion is common. We examine modifiable risk and protective factors for sexual coercion among high school students in a rural community.
Methods:We surveyed 10 th graders (N=442) in a rural, Midwestern, low-to-middle income county prior to receiving an evidence-based sex education program. Sexual coercion was a single item, "has anyone you were dating or going out with forced you to do sexual things that you did not want to do?". We examined associations between sexual coercion and demographics, risk behaviors, sexual self-efficacy, controlling relationship behaviors, parent communication and adverse childhood experiences (ACEs).
Results: Approximately 22% of females and 8% of males reported experiencing sexual coercion at least once in their lifetime. Gender differences emerged in associated risk and protective factors, including: sexual sex-efficacy, controlling relationship behaviors, parent-adolescent communication about sex and ACEs. Conclusions: Sexual coercion is common among adolescents in rural communities. Prevention interventions should target modifiable risk and protective factors.
Mistrust of health care providers among persons of color is a significant barrier to engaging them in research studies. Underrepresentation of persons of color is particularly problematic when the health problem under study disproportionately affects minoritized communities. The purpose of this study was to test the validity and reliability of an abbreviated and adapted version of the Group Based Medical Mistrust Scale. The GBMMS is a 12-item scale with three subscales that assess suspicion, experiences of discrimination, and lack of support in the health care setting. To adapt for use in the research setting, we shortened the scale to six items, and replaced “health care workers” and “health care” with “medical researchers” and “medical research,” respectively. Using panelists from a market research firm, we recruited and enrolled a racially and ethnically diverse sample of American adults (N = 365) and adolescents aged 14–17 (N = 250). We administered the adapted scale in a web-based survey. We used Cronbach’s alpha to evaluate measure internal reliability of the scale and external factor analysis to evaluate the relationships between the revised scale items. Five of the six items loaded onto a single factor, with (α = 0.917) for adolescents and (α = 0.912) for adults. Mean scores for each item ranged from 2.5–2.9, and the mean summary score (range 6–25) was 13.3 for adults and 13.1 for adolescents. Among adults, Black respondents had significantly higher mean summary scores compared to whites and those in other racia/ethnic groups (p<0.001). There was a trend toward significance for Black adolescents as compared to white respondents and those in other racial/ethnic groups (p = 0.09). This five-item modified version of the GBMMS is reliable and valid for measuring research mistrust with American adults and adolescents of diverse racial and ethnic identities.
Background:
Reproductive issues as related to CHD must be discussed in the clinic and at home. Providers can ensure that correct information is imparted to the adolescent and encourage mothers to provide support and guidance to the adolescent. The level to which these conversations occur is unknown.
Methods:
A survey distributed to female adolescent/mother dyads assessed self-reported conversations with the healthcare provider and between each other about reproductive health topics. A clinician survey was completed to assess CHD diagnosis, risk of hormonal contraception, and pregnancy risk.
Results:
Among 91 dyads, 33.0% of adolescents and 42.9% of mothers reported discussing recurrence risk of CHD with the provider. In regard to the cardiac lesion affecting a baby, 30.7% of adolescents and 28.7% of mothers reported discussing this with a provider. Significantly less adolescents and mothers reported discussing the risks of hormonal contraception and pregnancy with a provider. In assessing conversations between adolescents and mothers, only 44.2% of adolescents and 52.3% of mothers reported discussing with each other the safety of using birth control and 46.5% of adolescents and 64.0% of mothers reported discussing the safety of pregnancy.
Conclusions:
Adolescents with CHD and their mothers report low rates of reproductive health-related conversations with the healthcare provider, and mothers report low rates of having these conversations with their daughters. These topics should be discussed at each appointment with the cardiologist and must be encouraged to continue at home.
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