Division of Adolescent Medicine, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, 3101 Broadway Blvd, Kansas City, MO, 64111, USA.
Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA.
Matern Child Health J. 2023 Apr;27(4):621-631. doi: 10.1007/s10995-023-03627-2. Epub 2023 Feb 25.
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.
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.
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.
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.
认识到青少年所处环境对其性与生殖健康（SRH）决策的重要影响，需要更深入地了解社区利益相关者在塑造青少年和年轻成年人（AYA）获得 SRH 教育和保健方面所扮演的角色。我们描述了三个堪萨斯州农村拉丁裔社区的社区利益相关者对 AYA 的 SRH 需求的知识、信念和态度。
关键利益相关者完成了一份书面调查，其中纳入了计划行为理论，以评估对支持 AYA 的 SRH 教育和获得保健的态度、规范和意图。
在三个农村移民社区环境中，应答者（N=55）包括 8 名社区卫生工作者、9 名医疗保健提供者、7 名公共卫生官员、19 名学校卫生官员和 12 名社区成员。超过一半的人自我认同为拉丁裔（55%）。有 6 名（11%）参与者，其中一半在卫生部门，认为 SRH 教育会增加青少年发生性行为的可能性。相比之下，其他利益相关者认为提供避孕套（17，30.9%）、除避孕套以外的避孕方法（14，25.5%）和提供 HPV 免疫接种（5，9.6%）会增加发生性行为的可能性。各部门普遍存在对支持 SRH 教育和服务提供的矛盾态度，甚至在支持分发效果较差的避孕方法方面也是如此。对保健的障碍包括移民身份、歧视、缺乏保密服务和交通。
生活在农村社区的关键利益相关者揭示了与提供 SRH 教育和服务相关的误解、负面态度和矛盾信念，这可能会对 AYA 成功获得保健造成障碍。
