A qualitative assessment of the influence of family dynamics on adolescents' sexual risk behaviour in a migration-affected community

[Individual, family, and community factors associated with the use of emergency contraception by Brazilian adolescent students]

This study aimed to estimate the proportion of use of emergency contraception at least once in life among Brazilian adolescent students, as well as the association of individual, family, and community factors with use. A cross-sectional study was carried out, including 38,779 Brazilian adolescent students, aged 13 to 17 years, participating in the Brazilian National Survey of School Health (PeNSE) in 2019, who declared sexual initiation. The proportion of emergency contraception use at least once in life and the form of access to the method were estimated. Proportion ratios were estimated to assess the factors associated with the use of emergency contraception at some point in life. The proportion of adolescents who used emergency contraception, or who reported the use by their partners, at some point in their lives was 37.9%. Regarding the access to the emergency contraception, commercial pharmacies were the main source of purchase. Adolescents aged 16 and 17 years, those who sought health services in the last year, those living in the Central-West and Southeast regions, and those who had a history of sexual violence used emergency contraception or reported their partners using them at least once in their lives. Living in the South region of Brazil was associated with a lower proportion of adolescents who used emergency contraception or who reported the use by their partners at least once in their lives. The association with individual, family, and community factors related to the use of emergency contraception may reflect the non-use or failures in the use of other contraceptive methods, revealing gaps in public policies related to the sexual and reproductive health of adolescents in Brazil.

Factors influencing utilization of healthcare services for internal migrant older adults in Xuzhou, China: based on Anderson's model

Background

As population migration increases and the aging process accelerates, the number of migrant older adults is growing significantly. This trend presents a substantial challenge to urban health services in regions experiencing an influx of older adults individuals. Consequently, examining the healthcare service utilization of the migrant older adults population is crucial to promote healthy aging.

Methods

A multi-stage random sampling method was employed to select a study population of 568 migrant older adults individuals, aged 60 years and above, residing in urban Xuzhou City. Multivariate logistic regression analysis, based on Anderson's model, was conducted to explore the factors influencing outpatient and inpatient health service utilization among this population.

Results

Among the 568 migrants, 73 (12.9%) had received outpatient services within the past 2 weeks, while 109 (19.2%) had received inpatient services within the past year. Migrant older adults with education level, time to health centers, and self-assessed health status negatively influenced the outpatient services utilization among migrant older adults. Possession of pension insurance, convenience to visit, sick for the past 2 weeks, and health services need positively influenced the outpatient services utilization among migrant older adults. Furthermore, age, possession of pension insurance and health insurance, convenience to visit, number of chronic diseases, sick for the past 2 weeks, and healthcare service need positively influenced inpatient service utilization among migrant older adults. Education level, self-assessed health status, and time to health centers negatively influenced the inpatient services utilization among migrant older adults.

Conclusion

The overall utilization of healthcare services by migrant older adults in Xuzhou remains inadequate. Addressing this issue requires enhanced medical policy support and assistance, stronger health education initiatives, and improved social integration for the older adults. Additionally, efforts should be made to reduce their financial burdens and improve the accessibility of healthcare services.

School Connectedness and Risk for Sexual Intercourse and Nonconsensual Sex in Adolescence

The CDC reports that 30% of high school students have engaged in sexual intercourse. Evidence suggests biological, personal, peer, societal, and family variables affect when a child will initiate sex. The school environment plays an important role in a child's development. Evidence suggests that greater attachment to the school community can modify sexual risk-taking activity in adolescents. Future of Families and Child Wellbeing Study (FFCWS) comprises a cohort of approximately 4,700 families of children born in the U.S. between 1998-2000, over-sampled for non-marital births in large U.S. cities. Adolescents (N = 3,444 of 4,663 eligible) completed the wave six teen survey at approximately age 15. School connectedness was self-reported with four items measuring inclusiveness, closeness, happiness, and safety felt by the adolescent in their school environment. Sexual intercourse and nonconsensual sex were self-reported by the adolescent. Hierarchical regression analyses were conducted examining sexual intercourse, nonconsensual sex, risk factors, and school connectedness. In this sample of adolescents (48% female, 49% Black, 25% Hispanic, ages 14-19), school connectedness appears to reduce boys' risk of nonconsensual sex (OR = 0.29, p < 0.01), and reduce girls' risk of engaging in sexual intercourse (OR = 0.55, p < 0.01). Findings suggest gender differences in the association between school connectedness and sexual practices in adolescents. School connectedness may confer protection for boys' risk of nonconsensual sex, and for girls' risk of engaging in sexual intercourse. Further exploration of the relationship between school connectedness may allow for recommendations into preventative measures for teenage sexual behaviors.

Prevalence of sexual initiation and associated factors in school adolescents in Piauí, Brazil, 2015

OBJECTIVE

to analyze prevalence of sexual initiation and associated factors in adolescents in Piauí.

METHODS

this was a cross-sectional study, with secondary data from the 2015 National Adolescent School-based Health Survey. Hierarchical analysis was performed using robust Poisson regression.

RESULTS

a total of 3.872 adolescents were interviewed. Prevalence of sexual initiation was 24.2%; risk factors for sexual initiation were being male [prevalence ratio (PR) = 2.18; 95% confidence interval (95%CI) 1.90;2.47], being 15 years old or over (PR = 2.49; 95%CI 2.18;2.76), living with mother (PR = 0.68; 95%CI 0.54;0.82), working (PR = 1.82; 95%CI 1.55;2.10), attending a public school (PR = 1.39; 95%CI 1.09;1.75), practicing bullying (PR = 1.50; 95%CI 1.31;1.72), using alcohol (PR = 2.35; 95%CI 2.09;2.64), using cigarettes (PR = 1.46; 95%CI 1.22;1.70) and using illicit drugs (PR = 1.40; 95%CI 1.15;1.66).

CONCLUSION

prevalence of sexual initiation was high and associated with sociodemographic characteristics and vulnerable health behaviors, indicating the need for health promotion strategies.

Understanding sexual and reproductive health from the perspective of late adolescents in Northern Thailand: a phenomenological study

BACKGROUND

Worldwide, Sexual Reproductive Health (SRH) issues comprise a third of health problems for women aged 15-44. SRH education equips people with knowledge of concepts around sexuality and reproduction, and the skills help to make informed decisions to prevent sexual and reproductive ill-health, including unplanned pregnancy and HIV/AIDS, and other sexually transmitted infections (STIs). The aim of this study was to explore the experiences of late adolescents relating to SRH, examining their attitudes toward sex and contraception, and to identify the gaps in knowledge pertiaing to decision-making around risk-taking behaviour.

METHODS

A qualitative phenomenological study was undertaken with 30 adolescents aged 18-19, purposively and snowball sampled from a university in Northern Thailand. Data collaction took place from July 2020 to January 2021. In-depth individual interviews were conducted until data saturation was reached. Data were recorded, transcribed, and analysed in ATLAS.ti version 9, using Modified Interpretative Phenomenological Analysis to identify pertinent themes.

RESULTS

Participants revealed five key experiences of SRH related to sex and contraception: Keeping a secret; Seeking Freedom and Love; Having SRH education; Self-protection; Parental acceptance. All findings reflected the value and impact of SRH on the experiences of late adolescents.

CONCLUSIONS

This study provides detailed knowledge about adolescents' perspectives of SRH and rights in terms of accessing sexual and reproductive health care and information as well as autonomy in sexual and reproductive decision-making. Gaining SRH education can assist decision-making concerning contraceptive methods for family planning and STI prevention. The study recommends that SRH and rights-based education should be designed responsively and appropriately for female and male adolescents, their families, and society. The content of SRH should be informed and advocated by healthcare providers, educators, policy makers, and systems to empower adolescents in order to achieve effective SRH education.

The Role of Family Health in Mediating the Association between Smartphone Use and Health Risk Behaviors among Chinese Adolescent Students: A National Cross-Sectional Study

The direct impact of smartphones on health risk behaviors of adolescent students has been verified. However, the mediating mechanisms that underly this relationship remain largely unknown. Therefore, the aim of the study is to explore the role of family health in mediating the relationship between the frequency of smartphone use and adolescent students' health risk behaviors. A questionnaire was used to collect cross-sectional data from 693 adolescent students aged 12-18 in China and a structural equation model was analyzed. Among the nine health risk behaviors, the most frequent health risk behaviors in Chinese adolescent students were non-compliance walking behaviors (M=Mean; SD = Standard deviation) (M ± SD) (2.78 ± 1.747), eating unhygienic food (M ± SD) (2.23 ± 1.299), being subjected to physical violence (M ± SD) (2.19 ± 0.645), and leaving home (M ± SD) (2.13 ± 0.557). The SEM results showed that the adolescent students' smartphone use had a positive impact on delaying the age of first alcohol consumption (β = 0.167, CI:0.067 0.287) and a negative impact on the non-compliance walking behaviors (β = 0.176, CI:0.011 0.266). Family health plays an indirect-only mediated role (the proportions of indirect-only mediated roles are 11.2%, 12.4%, and 11.5%) in the relationship between smartphone use and adolescent students' partial health risk behaviors: (CI: -0.042 -0.002), (CI: -0.049 -0.005), and (CI: -0.043 -0.002). These findings provided a theoretical and practical basis for better interventions in adolescent health risk behaviors.

Sex education for adolescents: Indonesian nurse educators’ experience as parents

Objectives

Sex education toward adolescent remains the most controversial subject due to the various thoughts and ideas of different values present in society. Nurse educators as parents must exemplify sex education to their children. The aim of this present study was to explore parents’ experience, with nurse educators background to be exact, on how they convey sex education to their children.

Methods

This study is a descriptive qualitative study, and the sample is recruited by using the purposive sampling technique. The qualified participants filled in the informed consent, provided demographic data, and were interviewed. Saturation data were obtained at the 6th interview in this study. The interview is transcribed to find themes and subthemes using conventional content analysis.

Results

We derived 3 main themes: parents’ approach, sex education topic, and children's reaction. Parents’ approach contained 4 subthemes, namely, gender match, parent–child closeness, media, and attitude. Sex education topic included 5 subthemes of bodily autonomy, health and safety, reproductive anatomy, puberty-related changes, and how to maintain healthiness. Children's reaction experiences also included 4 subthemes of uncomfortable, questioning, acknowledging, and laughing.

Conclusions

As a matter of fact, some parents in eastern countries, such as Indonesia, conveyed sex education to their children. Children might have various reactions to that topic, but it is important to keep them safe, especially in reproductive health, regardless of the culture or tradition. Based on nurse educators as exemplifiers, nurses and nursing students might acquire the picture in conveying sex education to adolescents.

Factors Influencing the Booking Gestational Age Among Antenatal Clinic Attendees at Primary Health Centers in South West, Nigeria: A Cross-Sectional Study

Background

Antenatal care (ANC) is a recognized factor for favorable pregnancy outcomes. Despite the benefits associated with early initiation of antenatal care, late booking still predominates in sub-Saharan Africa including Nigeria.

Objective

This study aimed to assess the factors, including family dynamics, associated with the booking gestational age among women attending ANC clinics in a Local Government Area of Osun State, Nigeria.

Methods

A descriptive cross-sectional study was conducted among 255 pregnant women attending ANC at the Primary Health Centres in Osun State, who were selected by stratified random sampling technique. Data were obtained with aid of a semi-structured questionnaire and subjected to descriptive and inferential analyses.

Results

The mean age of respondents was 27.3 ± 5.1 years. Their mean booking gestational age was 23.0 ± 6.6 weeks, while the majority (85.3%) booked late for ANC. Most (122, 54.2%) of the respondents booked in the second trimester. The opinion of the husband influenced most women (54.2%) in the decision regarding the time of ANC booking. There was no association between the booking gestational age and each of respondents’ age, education, parity, perceived family support, level of family functioning, and other sociodemographic characteristics. The booking GA was however significantly related to the previous booking GA at the last pregnancy ( p = .004).

Conclusion

Late initiation of antenatal care was high among pregnant women attending PHCs in the study area and it was not associated with measures of family dynamics. The predominant influence of husbands’ opinion on time of booking suggests the need for strategic outreach to males through relevant reproductive health educational campaigns.

Addressing Learner-Centred Barriers to Sexuality Education in Rural Areas of South Africa: Learners' Perspectives on Promoting Sexual Health Outcomes

Introduction

The school-based sexuality education programmes in South Africa aim to improve the sexual and reproductive health of school-going adolescents. However, the high rate of unplanned pregnancy and sexually transmitted infections among learners in some schools in rural areas of King Cetshwayo district suggests that the programmes in these schools might not be effective due to certain learner-centred factors.

Method

This qualitative study explored lived experiences of 84 learners from nine public schools in 2020 through focus group interviews. Data was analysed using Interpretative Phenomenological Analysis.

Results

Learner-centred barriers to effective school-based sexuality education identified in this study were attitudes, age disparity, psychological status, peer pressure, socio-economic status, the exploratory attitude of learners, media, lack of role models, previous experiences, socio-economic status, and lack of parental love. These factors could reduce good sexual health. Learner-targeted interventions such as campaigns, using guest professionals, condom distribution, videos, on-site family planning, formal demonstrations, and on-site counselling could address these barriers.

Conclusions

Addressing these barriers and implementing the proposed interventions will enhance school-based sexuality education and consequently improve adolescents' sexual health.

Policy Implications

The findings could guide programming, implementation, and delivery of school-based sexuality education leading to improved adolescents' sexual and reproductive health.