Rural African American adolescents and factors affecting condom use: a path analysis study

The purpose of this dissertation was to assess factors affecting condom use among rural African American adolescents. Data from the National Longitudinal Study of Adolescent Health was used to conduct the study. Condom use behavior was examined with a sample of 539 sexually active rural African American adolescents ages 15 to 18 years. The Health Belief Model was used to inform the conceptual framework of this study. Several factors that were associated with condom use among adolescents were examined. These factors included perceived susceptibility to HIV/AIDS and other STIs, perceived barriers to protect self from infections, parent-child sex communication, parental attitudes toward sex communication, and condom knowledge. Path analysis using the structural equation modeling framework was used to assess the models. The results revealed that being female was related to condom knowledge, perceived susceptibility, and parent-child sex communication. Parent-child sex communication mediated the relationship between parental attitudes toward sex communication and perceived barriers. Finally, none of the factors were related to condom use. Several implications for future research with this population are provided. First, other individual-level factors and contextual-level factors that were not measured in this study should be assessed. Second, future studies should include the assessment of parent-child sex communication with fathers and other guardians in addition to mothers. Last, future studies should include sexual minority adolescents, as sex communication about protective behaviors may differ for this population of adolescents

Condom Use Self-Efficacy Among Younger Rural Adolescents: The Influence of Parent-Teen Communication, and Knowledge of and Attitudes Toward Condoms

This study examines the role of condom use knowledge and attitudes, and parent-teen communication about sex and relationship quality on reports of condom use self-efficacy among rural, African American youth. Participants were 465 North Carolinian youth (10–14 years). Results indicated that greater condom use self-efficacy was predicted by greater knowledge of condom use (β = .206; p < .001), more favorable attitudes toward condom use (β = −.20; p < .0001) and parent-teen communication about sex (β = .13; p < .05), and actual parent-teen communication about sex and dating (β = .14; p < .05). There was low agreement between parents and youth on measures related to parent-teen communication about sex. Findings call for interventions targeting improvement of condom use knowledge among early adolescents, as well as parent-teen communication about sex. In addition, given the low parent-teen agreement regarding sexual communication, parent-teen sexual communication is an important point of intervention

The Effect of Teach One Reach One (TORO) on Youth Acceptance of Couple Violence

This study evaluated the impact of the Teach One Reach One intervention, a community-based participatory research project designed to address the co-occurrence of adolescent risk behaviors on acceptance of teen dating violence. Data were derived from 331 rural African American youth between 10–14 years of age who participated in caregiver-youth dyads as either: 1) peer lay health advisor dyads, or Ambassadors, 2) caregiver-youth dyads recruited by Ambassadors, or Allies, or 3) comparison dyads. The following study focuses on participating youth only and our results indicated that: 1) Ambassadors and Allies reported less acceptance of couple violence than youth within the comparison group, and 2) less family cohesion, greater family conflict, and greater knowledge of healthy dating behaviors predicted greater acceptance of couple violence. Our findings highlight the efficaciousness of the TORO intervention, which directly engaged participants in prevention efforts through community-based participatory research methods and the use of lay heath advisors

A Process Evaluation of an HIV/STI Intervention for Rural African American Youth

We evaluated the fidelity and implementation of an HIV/AIDS and sexually transmitted infections intervention for rural African American youth. Using a community-based evaluation approach, community partners and researchers monitored four core process-evaluation components: reach, fidelity, dose delivered, and dose received. Researchers collected evaluation data through session observations, facilitator debriefing interviews, a youth focus group, and a satisfaction survey. For reach, more than half of the participants attended the 13 sessions. Participation varied between 62% and 100%. For fidelity, not all sessions were implemented as intended; multiple modifications occurred across sessions. For dose delivered, some lessons were missing materials and content was omitted; facilitators omitted content when there was insufficient time to complete a lesson. For dose received, engagement varied across lessons but youth reported high levels of satisfaction with the intervention. This formative process evaluation enabled us to identify and address multiple challenges to implementation

You Don\u27t Want Your Parents Knowing That You\u27re Taking Pre-exposure Prophylaxis : Pre-exposure Prophylaxis Stigma Among Black and Latinx Adolescents

Pre-exposure prophylaxis (PrEP) stigma is an understudied barrier to PrEP uptake among Black and Latinx adolescents. U.S. Black and Latinx adolescents (13-17 years) completed an online survey or participated in focus groups/interviews. Associations between PrEP stigma, PrEP disclosure, and provider-initiated PrEP discussion preferences were examined using logistic-regression models. Qualitative data provided further context to quantitative findings. The survey sample included 208 adolescents (53% female; 58% Latinx; M = 15 years), with 98% endorsing PrEP stigma. The qualitative sample included 26 adolescents (54% female; 34% Latinx; M = 15 years). PrEP stigma was associated with lower odds of PrEP disclosure to parents/guardians, and preference for health care providers to initiate PrEP-related discussions only with patients the provider judged to be at high risk for HIV. Qualitative data supported quantitative results: Adolescents endorsed multiple negative stereotypes about PrEP users. Mitigating PrEP stigma among Black and Latinx adolescents is an important step in overcoming challenges related to PrEP uptake

Condom Use Self-Efficacy Among Younger Rural Adolescents

This study examines the role of condom use knowledge and attitudes, and parent-teen communication about sex and relationship quality on reports of condom use self-efficacy among rural, African American youth. Participants were 465 North Carolinian youth (10-14 years). Results indicated that greater condom use self-efficacy was predicted by greater knowledge of condom use (β = .206; p &lt; .001), more favorable attitudes toward condom use (β = −.20; p &lt; .0001) and parent-teen communication about sex (β = .13; p &lt; .05), and actual parent-teen communication about sex and dating (β = .14; p &lt; .05). There was low agreement between parents and youth on measures related to parent-teen communication about sex. Findings call for interventions targeting improvement of condom use knowledge among early adolescents, as well as parent-teen communication about sex. In addition, given the low parent-teen agreement regarding sexual communication, parent-teen sexual communication is an important point of intervention. </jats:p