Social normative and social network factors associated with adolescent pregnancy: a cross-sectional study of 176 villages in rural Honduras

Shakya, Holly B.; Barker, Kathryn M.; Weeks, John R.; Christakis, Nicholas A.

doi:10.7189/jogh.10.010706

Cited by 8 publications

(8 citation statements)

References 27 publications

(38 reference statements)

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“…This study adds to the growing body of literature on the importance of social norms around MC use in Kenya, and echoes similar recommendations to engage with larger social networks and community-level norms as a way to increase MC Use [30,[36][37][38]. Kenya's laws concerning adolescent MC use are generally in line with WHO recommendations, particularly around the availability and accessibility of contraceptives for adolescents [39].…”

Section: Discussionsupporting

confidence: 66%

“…However, given the variation in social norms within geographical clusters, estimating collective norms within an individual’s specified reference group may provide more accurate estimates of social influence effects on individual norms perceptions and behavior than a more geographically aggregate approach [ 25 ]. A study by Shakya et al [ 30 ] was unique in that it assessed the influence of proximal reference group members’ normative perceptions on adolescent childbirth, in addition to village-level injunctive norms and behavioral prevalence. To our knowledge, the relationship between collective norms, operationalized as behavioral prevalence within a proximal social network, and individual behavior has not yet been applied in the adolescent family planning literature in sub-Saharan Africa.…”

Section: Introductionmentioning

confidence: 99%

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The role of social norms on adolescent family planning in rural Kilifi county, Kenya

et al. 2023

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Purpose Despite Kenya’s encouraging progress in increasing access to modern contraception among youth, several barriers remain preventing large-scale efforts to reduce demand-side unmet need for family planning. Shifting social norms around the use and acceptability of modern contraception may represent a potent target for future interventions. However, the structure of normative influence on individual modern contraceptive use among youth needs to be determined. Therefore, our aim was to estimate the influence of individual and group-level normative influence on modern contraceptive use among adolescents from two villages in rural Kenya. Methods Trained enumerators collected data from individuals aged 15–24 who provided oral informed consent, or parental informed consent, in two villages in rural Kilifi county. Participants completed a questionnaire related to modern contraceptive use and were asked to nominate one to five people (referents) with whom they spend free time. The enumerators photographed each individual who nominated at least one referent using Android phones and matched them with their nominated referents. Using this social network data, we estimated group-level normative influence by taking an average of referents’ modern contraception use. We then explored associations between descriptive norms, injunctive norms, and network modern contraceptive use on individual modern contraceptive use, controlling for known confounders using logistic regression models. We also conducted sensitivity analyses to test a pattern of differential referent influence on individual modern contraceptive use. Results There was a positive association between pro-modern contraception descriptive and injunctive norms and individual modern contraception use (adjusted Odds Ratio (aOR) = 1.29, 95% confidence interval (CI) = 1.05–1.6, and aOR = 1.31, CI = 1.06–1.62, respectively). Network modern contraceptive use was associated with individual use in the bivariate model (aOR = 2.57, CI = 1.6–4.12), but not in the multivariable model (aOR = 1.67, CI = 0.98–2.87). When stratified by sex and marital status, network modern contraceptive use was associated with individual modern contraceptive use among female participants (aOR = 2.9, CI = 1.31–6.42), and unmarried female participants (aOR = 5.26, CI = 1.34–20.69), but not among males. No interactive effects between norms variables were detected. Sensitivity analyses with a different estimate of network modern contraceptive use showed similar results. Conclusions Social norms are multilevel phenomena that influence youth modern contraceptive use, especially among young women in rural Kenya. Unmarried women with modern contraceptive users in their social network may feel less stigma to use contraception themselves. This may reflect gendered differences in norms and social influence effects for modern contraceptive use. Future research should investigate group-level normative influence in relation to family planning behaviors.

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

The role of social norms on adolescent family planning in rural Kilifi county, Kenya

et al. 2023

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“…In contrast, in areas with less outside interaction, FP decisions were mainly determined by social influence (Kohler et al, 2001). Research in rural Honduras found that while social influence at the community level may play a role (Shakya et al, 2019), the factor most strongly associated with adolescent birth is the adolescent birth experiences of proximal network members (Shakya et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Social network and social normative characteristics of married female adolescents in Dosso, Niger: Associations with modern contraceptive use

Shakya

Challa

Nouhou

et al. 2020

Global Public Health

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In this study we analysed the social networks of a sample of married adolescent girls (ages 13-19 years) residing in Dosso, Niger (N = 322); data were collected for evaluation of a family planning (FP) intervention. Participants were asked to name individuals important in their lives (alters) using three name generating questions as part of a larger survey on reproductive health, social norms, and FP. One alter per girl was then recruited to be separately interviewed (N = 250). This provided us with two separate datasets: one with data from each respondent regarding each person that they nominated, and one with the interviewed alters matched with the respondent who nominated them. We found that married adolescent girls who were nulliparous were more likely to have no alters and that those in the intervention had the most alters. Alters of treatment participants were more likely to have used FP. Respondents were more likely to have used FP when their sisters or in-laws had, but there was no correlation with use by friends. Our results provide evidence of diffusion of the FP program to those close to intervention participants. Future research should study these dynamics, crucial to understanding intervention costing, impact, and normative change.

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“…If girls in these relationships are becoming pregnant at such high rates, one can assume that unprotected sex is common. Teen pregnancy decreases girls' education and employment opportunities, and further increases their vulnerability ( Shakya et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

Social normative origins of the taboo gap and implications for adolescent risk for HIV infection in Zambia

Nesamoney

Mejía‐Guevara²,

Cislaghi³

et al. 2022

Social Science & Medicine

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Social normative and social network factors associated with adolescent pregnancy: a cross-sectional study of 176 villages in rural Honduras

Cited by 8 publications

References 27 publications

The role of social norms on adolescent family planning in rural Kilifi county, Kenya

The role of social norms on adolescent family planning in rural Kilifi county, Kenya

Social network and social normative characteristics of married female adolescents in Dosso, Niger: Associations with modern contraceptive use

Social normative origins of the taboo gap and implications for adolescent risk for HIV infection in Zambia

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