Development of a Socioecological Adolescent Sexual Health Index and Atlas: A Case Study in Washington State

ABSTRACT

Adolescent sexual health programs often frame needs assessments using risk-taking, disease, or fertility data, fostering a narrow perspective of sexual health and limiting scopes of related programs. We address the gap between traditional measures and the socioecological lens used by many in the field. Using Washington State as an example, we report methods for developing and mapping an index of sex education needs that integrates social determinants of health (SDH) to reflect the complex, interrelated influences affecting adolescents. The generated index and maps support a holistic approach to assessing inequity, resource allocation gaps, and specific programmatic needs of young people. This case study demonstrates that it is possible and important to align adolescent sexual health measurement strategies with more holistic adolescent sexuality development frameworks. We recommend that public health professionals consider a broader range of data on SDH in their sex education policy and program decision making.     

Counselling skills training for adolescent health: A WHO approach to meet a global need

In recent years as public health measures such as improved sanitation, water supply, and immunization have taken effect in developing as well as economically developed countries, there has been an increase in attention to health problems arising from voluntary behaviour such as sexual activity and substance abuse rather than simply from passively acquired infection. This is of special relevance to adolescents who have generally been given lower priority in health services because they are relatively disease-free yet whose patterns of behaviour have great significance for their present and future health. However establishing or changing health behaviour during the dynamic period of adolescence can be difficult especially when the environment is rapidly changing too. This is especially so in developing countries where the traditional directive approach to guidance may need to give way to a somewhat more non-directive style of counselling in order to accommodate greater adolescent autonomy, without loss of fundamental cultural values. Because few people in developing countries are experienced in such techniques WHO has developed a module for training counselling skills for adolescent sexual and reproductive health which preserves culture specificity in a non-directive approach and uses behavioural techniques to train communication microskills.     

Clear Self,Better Relationships: Adolescents’ Self‐Concept Clarity and Relationship Quality With Parents and Peers Across 5 Years

This study examined reciprocal associations between adolescents’ self‐concept clarity (SCC) and their relationship quality with parents and best friends in a five‐wave longitudinal study from age 13 to 18 years. In all, 497 adolescents (57% boys) reported on their SCC and all informants (i.e., adolescents, both parents, and adolescents’ best friends) reported on support and negative interaction. Within‐person cross‐lagged analyses provided systematic evidence for both parent effects and child effects, with the direction of effects being strongly dependent on the relational context. For example, higher maternal support predicted higher adolescent SCC, supporting a parent effects perspective, whereas higher SCC predicted lower paternal negative interaction, supporting a child effects perspective. Peer effects on adolescent SCC were not consistently found across adolescent and best friend reports.     

Factors shaping parent–adolescent communication about sexuality in urban China

Within a rapidly changing cultural and socio-economic context, young people in China are increasingly engaging in romantic experiences and sexual behaviours with consequences such as unwanted pregnancies and sexually transmitted infections. Across a range of contexts, parental communication about sexuality has been recognised as protective in terms of increasing the likelihood of sexual abstinence and safer sexual practice. This study focuses on the factors shaping parent–adolescent communication about sexuality. Thirty-eight young people and twenty-seven parents, recruited from two high schools in a Northern-Eastern city of China, were interviewed. Thematic analysis of their interview responses was conducted using a social constructionist framework. Four main themes were identified: timing; discomfort and uncertainty; assumptions; and the parent–adolescent relationship. Findings suggest that communication between parents and children is influenced by individual as well as interpersonal factors and factors relating to the broader Chinese sociocultural context. To facilitate communication, both parents and young people need support from health and other professionals, while parents need more help and support in overcoming historical, social and cultural barriers to open communication about sex.     

Personal Universes: revealing community college students’ competences though their organization of the cosmos

In this article I present a study on learners’ conceptions in cosmology by situating the results in the context of broader historical and sociocultural themes. Participants were community college students in California from non-dominant cultural and linguistic backgrounds finishing their first semester of astronomy. Data were collected through a drawing activity and card sort given during clinical-style interviews. This type of work is typically done from the perspective of conceptual change theory, using drawings to reveal student “misconceptions.” I argue that in analyzing this kind of data, we need to come from the perspective that students are competent, and put their conceptions in context. I begin by presenting traditional frameworks for evaluating and describing learning, all of which rely on an outdated “banking” or “transmission” model of learning that puts an over-emphasis on the performance and attributes of individuals. Not only do these theories provide an incomplete picture of what learning looks like, they create and reify unnecessary divides between “scientific” and “unscientific” that can contribute to student alienation from the world of science. To illustrate this, I present my own results as a window into the logic of learners’ assumptions within a sociocultural context, and suggest ways to support their learning trajectories, rather than figuring out how to unlearn their misconceptions. Through this analysis, I hope to show how taking student conceptions out of sociocultural context can potentially exclude students from non-dominant cultural and linguistic backgrounds from science.     

Mentoring,Undergraduate Research,and Identity Development: A Conceptual Review and Research Agenda

Mentored undergraduate research has been identified as a high-impact practice that enhances teaching and learning in higher education. It is reported to influence students’ academic, affective, and behavioral outcomes. However, there is only an emerging literature related to student outcomes associated with identity development, specifically students’ personal and professional identities. This integrative literature review examines the intersections and interrelationship across mentoring, undergraduate research, and student identity development. Its results uncover the complexity of the constructs, and their dynamic interrelationship, especially when viewed through the lenses of the sociocultural perspective grounded in the notion of mediated action. Two assumptions undergird this perspective: first, that all investigation takes place at the intersection of these constructs with mediated action, not individuals in isolation, as a unit of analysis; and, second, that any study of identity must focus on an understanding of identity as multiple, dynamic, and situated in personal and cultural contexts (institutional, disciplinary, and external community culture and values). Thus, the sociocultural perspective and its underlying assumptions shape the proposed research agenda. This research agenda has the potential to advance current knowledge related to mentored undergraduate research and the confluence of elements that contribute to student personal and cultural identities (academic, disciplinary, and professional). Findings from this work will inform our understanding of learning and knowledge construction in sociocultural context, and the trajectory of identity development of students engaged in high-impact learning experiences.     

Relations between sociocultural pressures and weight control behavior among early adolescent boys

Guided by the biopsychosocial model, we examined (a) the prevalence of weight control behaviors (WCBs; i.e., trying to stay the same weight, lose weight, gain weight, or do nothing about weight) among early adolescent boys by race/ethnicity and grade level, and (b) how the boys’ perceptions of sociocultural pressures (from parents, peers, and media) to lose weight, gain weight, exercise, and diet predicted their WCBs while accounting for body composition and grade level. Early adolescent boys ( n = 508) in middle schools completed survey measures of WCB and sociocultural pressures and objective assessment of body mass index as body composition. Multinomial logistic regressions revealed that sixth graders were more likely than seventh and eighth graders to be trying to lose weight. Moreover, greater pressure to gain weight and lower pressure to exercise predicted a greater likelihood of trying to gain weight. The significant roles of grade levels and different sociocultural pressures in predicting WCBs suggest that health professionals and school staff should consider these factors when intervening with early adolescent boys.     

Longitudinal Trajectories of Family Functioning Among Recent Immigrant Adolescents and Parents: Links With Adolescent and Parent Cultural Stress,Emotional Well-Being,and Behavioral Health

This study examined longitudinal effects of adolescent and parent cultural stress on adolescent and parent emotional well-being and health behaviors via trajectories of adolescent and parent family functioning. Recent immigrant Latino adolescents (M_age = 14.51) and parents (M_age = 41.09; N = 302) completed measures of these constructs. Latent growth modeling indicated that adolescent and parent family functioning remained stable over time. Early levels of family functioning predicted adolescent and parent outcomes. Baseline adolescent cultural stress predicted lower positive adolescent and parent family functioning. Latent class growth analyses produced a two-class solution for family functioning. Adolescents and parents in the low family functioning class reported low family functioning over time. Adolescents and parents in the high family functioning class experienced increases in family functioning.     

On the cultural validity of science assessments

We propose the concept of cultural validity as a form of test validity in science assessment. The conceptual relevance of cultural validity is supported by evidence that culture and society shape an individual's mind and thinking. To attain cultural validity, the process of assessment development must consider how the sociocultural context in which students live influences the ways in which they make sense of science items and the ways in which they solve them. These sociocultural influences include the values, beliefs, experiences, communication patterns, teaching and learning styles, and epistemologies inherent in the students' cultural backgrounds, as well as the socioeconomic conditions prevailing in their cultural groups. We contend that current approaches to handling student diversity in assessment (e.g., adapting or translating tests, providing assessment accommodations, estimating test cultural bias) are limited and lack sociocultural perspective. We find that attaining cultural validity may conflict with current basic principles and assumptions in testing, such as item independence and standardization. We discuss the ways in which adopting cultural validity as a criterion for test validity makes it necessary to shift assessment paradigms and adopt new procedures for assessment development. © 2001 John Wiley & Sons, Inc. J Res Sci Teach 38: 553–573, 2001     

Reproductive health through community involvement with special attention to adolescents and clinical contraception. RAS/98/P63

This article outlines the objectives, strategies and main activities of Save the Children Fund/Bangladesh to increase reproductive health (RH) through community involvement with special attention to adolescents and clinical contraception. It is noted that the ways to increase the range of reproductive information and care available to adolescents are being explored, with a view to improving their sexual and RH knowledge and practices, and to increasing clinical contraception use. The following strategies are being implemented: 1) strengthen the capacity of local partners, which include the districts of Khulna, Moulavibazar, Cox's Bazar and Panchagarh; 2) conduct participatory workshops with adolescent groups; 3) promote advocacy for adolescents regarding their needs; 4) develop a platform for adolescent and adolescent-friendly clinics; and 5) promote community-based programs in RH and family planning, especially contraception. A summary of the main program activities of the project is given.     

Positioning within a cultural context: using Ricoeur’s preunderstandings as a heuristic for narrative data analysis in exploring identity,structure, and agency

I argue that Ricoeur’s preunderstandings can be used as a heuristic to aid researchers who collect narratives as data (1) to identify cultural meanings that become resources for participants’ positioning work, (2) to ground the identified cultural meanings in participants’ experiences, and (3) to understand participants’ interpretations of constraint and agency within that context. I outline how the philosophical hermeneutics of Ricoeur is consistent with a sociocultural perspective on positioning and identity, as well as present data analysis questions developed from Ricoeur’s ideas of narrative configuration to explore common cultural meanings used by participants in interpreting their lived experience. These questions provide a strategy to examine how participants may be referring to common cultural meanings but their individual interpretations of these meanings can have different implications for their feelings of agency.     

Without Sex Education: Exploring the social and sexual vulnerabilities of rural Bangladeshi girls and boys

In 1997, two organizations, BRAC (Bangladesh Rural Advancement Committee) and ICDDR,B (International Center for Diarrheal Disease Research), as part of their collaborative research model, developed an HIV/AIDS prevention strategy for rural Bangladeshi youth. Currently, HIV/AIDS is not apparent in rural Bangladesh. Other sexual and reproductive health problems are more pressing. Moreover, there are few inor out-of-school sex education programs for adolescents in Bangladesh. Therefore, preliminary qualitative research was conducted to understand the broad parameters of sexual and reproductive health within the sociocultural context of young people's risks and vulnerabilities. Exploratory research revealed that youth were vulnerable to sexual diseases, late-term abortions, sexual violence, reproductive tract infections, and premarital pregnancies. Adolescents and adults thought that youth today need sex education. Adults said that youth should not be educated about condom use because this would conflict with a girl's prospects for an arranged marriage. Bangladeshi youth today are being exposed to experiences unfamiliar to their parents. Lacking appropriate knowledge, information and awareness about sexual and reproductive health unduly heightens young people's fears, and increases their social and sexual vulnerabilities.     

Examining the Experiences of a Short Break Scheme amongst Adolescents with Disabilities (Service Users) and their Parents

Globally, families who care for a child or adolescent with disabilities have been found to experience high levels of maternal ill health, stress, depression and family breakdown. In extreme cases, children and adolescents may have to move away from their family to a permanent residential placement. A potentially more appropriate and cost-effective approach is the provision of family support services; predominantly these have taken the form of short break schemes, whereby temporary (respite) care is issued to provide short-term relief for the family (e.g. regular afternoon care). This research reported the impact of a short break scheme from the perspective of the service users and their parents by conducting interviews with adolescents with disabilities and quantitative questionnaires with the parents, following a summer short break scheme.     

Adolescent suicide: An ecological approach

Adolescent suicide, which has been ranked among the top 10 causes of death in the world, is an issue of increasing concern to school psychologists, educators, and parents. Here an ecological approach is proposed to enhance our understanding of how personal, interpersonal, and sociocultural factors contribute to the increased risk for suicide among adolescents. The ecological approach allows exploration of how adolescent suicide is determined by multiple factors related to the adolescent's personal history or ontogenic development (e.g., depression), the influences of those individuals with whom adolescents have immediate contact with, or the microsystems (e.g., family and school), the larger social units, or the exosystems, that indirectly influence adolescents (e.g., media), and the larger culture or macrosystems (e.g., cultural differences in attitudes about suicide). In this article the interaction of several factors within and between the permeable boundaries of each of the layers of the ecological paradigm is also highlighted. Finally, examples of intervention and prevention strategies at each level of the system are set forth. © 2002 Wiley Periodicals, Inc.     

Strengthening strategies to improve adolescent reproductive health through materials development. Indonesia

This article concerns a 3-year materials development project that was implemented by the Indonesian Planned Parenthood Association and the Bureau of Non-Physical Family Resilience. The project was developed in response to the need for improving adolescent reproductive health in Jakarta, Yogyakarta and West Java, where adolescent problems have been increasing during the last decade. The project's long-term goal is centered on raising the commitment of families to instill in their children a better understanding of adolescent reproductive health concepts and desirable family values. For its short-term objectives, the project seeks to develop a basic information, education and communication (IEC)/counseling strategy and policy in support of a family-centered approach to adolescent reproductive health; promote better understanding of reproductive health needs of adolescents among the policy-makers; and improving the IEC/counseling skills of personnel at the community level. The project used five strategies to achieve its goals; namely, 1) preparation of a media development and production plan; 2) conducting a needs assessment; 3) production of three types of materials; 4) implementation of three key activities; and 5) periodic monitoring of activities.     

青春期儿童父母性教育状况调查研究

青春期儿童的性教育是家庭性教育中的重要组成部分.青春期是儿童身体快速成熟的时期,生理和心理上发生的新变化会在生活和学习等方面给儿童带来一定的挑战.家庭性教育对于帮助他们顺利度过青春期,获得身心全面健康发展具有积极的促进作用.本文通过对处于青春期的儿童的父母进行性教育知识、性教育态度及家庭性教育开展状况调查,发现受访父母...     

Survey reveals slow strides in promoting adolescent reproductive health in Vietnam

This article presents the findings of a survey evaluating the adolescent reproductive health program by the Vietnamese Government. Conducted by the Population Research Consultants, survey findings revealed several setbacks of the adolescent reproductive health program; these included the following: 1) adolescents favor radio, television and newspapers as sources of reproductive health (RH) information; 2) adolescents have no knowledge of pregnancy, sexually transmitted diseases, and HIV/AIDS prevention; 3) the demand for RH information varies according to the sociodemographic characteristics of respondents; 4) while the majority of adolescents do not favor premarital sex and premarital pregnancy, their choice is to keep and deliver the baby in case of a premarital pregnancy; 5) adolescents give a poor rating to the quality of RH/family planning services at the centers; 6) adolescents need to further understand RH but not knowing its meaning, they cannot tell what type of information they require; 6) adolescents have poor knowledge of adolescent reproductive health; 7) friendship and love are often discussed among adolescents, but sexuality rarely is; and 8) adolescents have poor knowledge of RH and poor interest in RH/family planning service facilities.     

Adolescent-parent conflict in middle-class African American families

Everyday conflicts between adolescents and parents were examined in 95 middle-class African American families, 44 with preadolescents and 51 with early adolescents, who were further divided into two groups based on family income. The incidence, frequency, and intensity of conflicts were assessed using the Issues Checklist, and content, justifications, and resolutions were coded from individual interviews. Conflicts were relatively frequent, low in intensity, and occurred over issues such as the adolescent's room, chores, choice of activities, and homework. Early adolescents rated conflicts as more intense than did preadolescents, but mothers' ratings of conflict intensity and families' ratings of conflict frequency differed by family income. African American adolescents primarily reasoned about conflicts as issues of personal jurisdiction, whereas their mothers primarily appealed to social conventions. Nearly all conflicts were resolved by adolescents giving in to parents, but adolescent concession declined with age, whereas unresolved conflicts and use of punishment increased. Number and intensity of conflicts and adolescent concession were predicted by both parenting practices and sociodemographic background; conflict frequency and joint resolution were predicted only by parents' educational attainment. Although conflict may reflect normative developmental processes of individuation, the cultural and ecological context of middle-class African American families influences its expression and resolution.     

Identifying and developing crosscutting environmental education outcomes for adolescents in the twenty-first century (EE21)

Abstract

While multiple valid measures exist for assessing outcomes of environmental education (EE) programs, the field lacks a comprehensive and logistically feasible common instrument that can apply across diverse programs. We describe a participatory effort for identifying and developing crosscutting outcomes for Environmental Education in the twenty-first Century (EE21). Following extensive input and debate from a wide range of EE providers and researchers, we developed, tested and statistically validated crosscutting scales for measuring consensus-based outcomes for individual participants in youth EE programs using confirmatory factor analysis across six unique sites, including two single-day field trip locations, four multiday residential programs and one science museum in the United States. The results suggest that the scales are valid and reliable for measuring outcomes that many EE programs in the United States can aspire to influence in adolescent participants, ages 10–14.     

Everyday objects of learning about health and healing and implications for science education

The role of science education in rural development is of great interest to science educators. In this study I investigated how residents of rural Kirumi, Kenya, approach health and healing, through discussions and semistructured and in‐depth interviews with 150 residents, 3 local herbalists, and 2 medical researchers over a period of 6 months. I constructed objects of learning by looking for similarities and differences within interpretive themes. Objects of learning found comprise four types of personal learning tools, three types of relational learning tools, three genres of moral obligation, and five genres of knowledge guarding. Findings show that rural people use (among other learning tools) inner sensing to engage thought processes that lead to health and healing knowledge. The sociocultural context is also an important component in learning. Inner sensing and residents' sociocultural context are not presently emphasized in Kenyan science teaching. I discuss the potential use of rural objects of learning in school science, with specific reference to a health topic in the Kenyan science curriculum. In addition, the findings add to the literature in the Science, Technology, Society, and Environment (STSE) approach to science education, and cross‐cultural and global science education. © 2005 Wiley Periodicals, Inc. J Res Sci Teach 43: 172–193, 2006