the contexts for adolescent female sexual decision-making
DESCRIPTION
The Contexts for Adolescent Female Sexual Decision-making. Robert Wm. Blum, MD, MPH, PhD William H. Gates, Sr. Professor and Chair Department of Population, Family and Reproductive Health Johns Hopkins Bloomberg School of Public Health. Prepared for: Girls Decide Conference - PowerPoint PPT PresentationTRANSCRIPT
The Contexts for Adolescent Female Sexual Decision-making
Robert Wm. Blum, MD, MPH, PhDWilliam H. Gates, Sr. Professor and Chair
Department of Population, Family and Reproductive HealthJohns Hopkins Bloomberg School of Public Health
Prepared for:Girls Decide Conference
Amsterdam, The Netherlands16-17 September 2010
Individual Response
Inequality
Discrimination
Poverty
Family
Peers
Involuntary
Response
VoluntaryResponse
School
Biological Factors
Early Sexual
Engagement
Temperament &
Cognitive Factors
MacrolevelEnvironment
alFactors
Proximal LevelEnvironmentalIndividualFactors Factors
Response
Outcome
Neighborhood
A Contextual Model
Individual Response
Early Sexual
Engagement
Outcome
A Contextual Model
Individual Response
Social change
Customs
Early Sexual
engagement
MacrolevelEnvironment
alFactors
Outcome
Policies
A Contextual Model
Neighborhood
Neighborhood Factors: Poverty
Lower gradesLower educational attainmentMore school drop outMore precocious sexual
activity/child bearing
How does Poverty Impact Outcomes?
Less social and financial capitalMore social disorganizationLess collective efficiencyMore discriminationMore inequality
Individual
Response
Social Change
Customs
Neighborhood
Family
Early sexual
engagement
MacrolevelEnvironment
alFactors
Outcome
Policies
A Contextual Model
Proximal LevelEnvironmentalFactors
Family Factors
Globally family has consistently been shown to be the most protective factor in the lives of young people.
When adolescent girls report connection to parents they are less likely to engage in early sexual behaviors
Elements of Positive Parenting
Behavioral MonitoringCloseness and ConnectednessEmotional ResponsivenessKnowing child’s friends, their friends’
parents, their teachersSetting high behavioral and educational
expectations
Individual
Response
Social change
Customs
Neighborhood
Family
School
Early Sexual
engagement
MacrolevelEnvironment
alFactors
Proximal LevelEnvironmentalFactors Outcome
Policies
A Contextual Model
School Factors
Young girls who are attached to school marry later and delay first sexual encounters.
Factors that Appear to Influence School Attachment
Perceiving teachers as emotionally caring
Experiencing academic supportNot experiencing discrimination based
on gender or SESParental support for schoolingBelieving that education will improve
future prospects
Behavioral Consequences of Low School Engagement (Vietnam data)
Ever smoked Ever been drunk Less likely to always wear a motorcycle a helmet Low self esteem More often hanging out on streets and causing public
disorder Less optimistic about the future More likely to think of suicide More often having premarital sex Blum et al. 2010
Individual
Response
Social change
customs
Neighborhood
Family
Peers
School
Early sexual
engagement
MacrolevelEnvironment
alFactors
Proximal LevelEnvironmentalFactors Outcome
Policies
A Contextual Model
Peers
Peers tend to be a positive socializing force.
Close Prosocial Peer Relationships are associated with:
Later age first sexLess tobacco use, Less depressionLess drug useBetter academic performance
Peer Pressure
Youth are more likely to conform behaviorally to the views of peers than parents.Additionally, they conform more to their perceptions of peer behaviors than what their friends actually do.
Individual
Response
Social change
Customs
Neighborhood
Family
Peers
School
Biological Factors
Early Sexual
engagement
MacrolevelEnvironment
alFactors
Proximal LevelEnvironmentalIndividualFactors Factors
Outcome
Policies
A Contextual Moel
Brain development occurs within the context of the environment.
Environments have both direct and indirect effects.
Adolescent Neurodevelopment and behavior
During adolescence the frontal lobe fully develops
Frontal lobe controls executive functioning: emotional reactivity, impulse control, reasoned actions
“Toxic” environments diminish emotional control
Individual
Response
Social change
Customs
Neighborhood
Family
Peers
Involuntary
Response
VoluntaryResponse
School
Biological Factors
Early Sexual
engagement
Temperament &
Cognitive Factors
MacrolevelEnvironment
alFactors
Proximal LevelEnvironmentalIndividualFactors Factors
Response
Outcome
Policies
A Contextual Model