TY - JOUR
T1 - Associations Between Agency and Sexual and Reproductive Health Communication in Early Adolescence
T2 - A Cross-cultural, Cross-sectional Study
AU - Koenig, Leah R.
AU - Li, Mengmeng
AU - Zimmerman, Linnea A.
AU - Kayembe, Patrick
AU - Lou, Chaohua
AU - Mafuta, Eric
AU - Ortiz, José
AU - Moreau, Caroline
N1 - Funding Information:
The Global Early Adolescent Study (GEAS) is a multinational study that aims to understand the development of gender norms in early adolescence and its impacts on adolescent health across time and geographies. The study operates in conjunction with the World Health Organization and the Johns Hopkins Bloomberg School of Public Health. Support for the study is made possible in part by the United States Agency for International Development (USAID), the World Health Organization, the David and Lucile Packard Foundation, the Bill and Melinda Gates Foundation, the Oak Foundation, and the United Nations Children's Fund. The GEAS in Kinshasa is supported by USAID and the Bill and Melinda Gates Foundation. The study in Shanghai is supported by the Innovation-oriented Science and Technology Grant from the National Health Comission Key Laboratory of Reproduction Regulation (CX2017-05). In Cuenca, the GEAS project received support from the United Nations Population Fund Agency (UNFPA), the National Secretary of Science and Technology (SENESCYT) of Ecuador, and the University of Cuenca. An earlier version of this work was presented as a poster at the Population Association of America 2019 Conference in Austin, Texas.
Funding Information:
The Global Early Adolescent Study (GEAS) is a multinational study that aims to understand the development of gender norms in early adolescence and its impacts on adolescent health across time and geographies. The study operates in conjunction with the World Health Organization and the Johns Hopkins Bloomberg School of Public Health. Support for the study is made possible in part by the United States Agency for International Development ( USAID ), the World Health Organization , the David and Lucile Packard Foundation , the Bill and Melinda Gates Foundation , the Oak Foundation , and the United Nations Children's Fund . The GEAS in Kinshasa is supported by USAID and the Bill and Melinda Gates Foundation . The study in Shanghai is supported by the Innovation-oriented Science and Technology Grant from the National Health Comission Key Laboratory of Reproduction Regulation (CX2017-05). In Cuenca, the GEAS project received support from the United Nations Population Fund Agency ( UNFPA ), the National Secretary of Science and Technology ( SENESCYT ) of Ecuador, and the University of Cuenca . An earlier version of this work was presented as a poster at the Population Association of America 2019 Conference in Austin, Texas.
Publisher Copyright:
© 2020 Society for Adolescent Health and Medicine
PY - 2020/9
Y1 - 2020/9
N2 - Purpose: To assess the extent to which adolescents aged 10–14 have communicated about sexual relationships, pregnancy, and contraception and how agency in the form of voice and decision-making along with an enabling socioecological environment are associated with sexual and reproductive health (SRH) communication. Methods: Using data from the Global Early Adolescent Study, we included 1,367, 697, and 1,424 adolescents in Kinshasa, Cuenca, and Shanghai, respectively. Patterns of SRH communication and agency levels were described by site and sex. Multivariable logistic regressions assessed odds of SRH communication first in relation to socioecological characteristics and second with levels of agency, after adjustment for social environmental factors. Interaction terms tested sex differences in associations. Results: Experiences of SRH communication ranged from one in ten in Kinshasa to about half in Cuenca. Pregnancy was the most discussed SRH topic. Socioecological factors consistently related to SRH communication included older age and pubertal onset, while others varied by context. In multivariable analyses, voice was linked to all forms of SRH communication in Kinshasa and Cuenca with adjusted odds ratios ranging from 1.6 to 2.2, but not in Shanghai. In Cuenca, decision-making was associated with a 50% and 60% increase in odds of communication about pregnancy and contraception, respectively. In Kinshasa, a stronger association between voice and pregnancy discussions was observed for girls than boys. Conclusions: Developmental characteristics and voice were linked to communication about SRH among young adolescents across two contexts. Results suggest agency may play a role in shaping antecedents, like communication, to sexual behaviors.
AB - Purpose: To assess the extent to which adolescents aged 10–14 have communicated about sexual relationships, pregnancy, and contraception and how agency in the form of voice and decision-making along with an enabling socioecological environment are associated with sexual and reproductive health (SRH) communication. Methods: Using data from the Global Early Adolescent Study, we included 1,367, 697, and 1,424 adolescents in Kinshasa, Cuenca, and Shanghai, respectively. Patterns of SRH communication and agency levels were described by site and sex. Multivariable logistic regressions assessed odds of SRH communication first in relation to socioecological characteristics and second with levels of agency, after adjustment for social environmental factors. Interaction terms tested sex differences in associations. Results: Experiences of SRH communication ranged from one in ten in Kinshasa to about half in Cuenca. Pregnancy was the most discussed SRH topic. Socioecological factors consistently related to SRH communication included older age and pubertal onset, while others varied by context. In multivariable analyses, voice was linked to all forms of SRH communication in Kinshasa and Cuenca with adjusted odds ratios ranging from 1.6 to 2.2, but not in Shanghai. In Cuenca, decision-making was associated with a 50% and 60% increase in odds of communication about pregnancy and contraception, respectively. In Kinshasa, a stronger association between voice and pregnancy discussions was observed for girls than boys. Conclusions: Developmental characteristics and voice were linked to communication about SRH among young adolescents across two contexts. Results suggest agency may play a role in shaping antecedents, like communication, to sexual behaviors.
KW - Agency
KW - Communication
KW - Early adolescence
KW - Empowerment
KW - Sexual and reproductive health
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U2 - 10.1016/j.jadohealth.2020.02.026
DO - 10.1016/j.jadohealth.2020.02.026
M3 - Article
C2 - 32331930
AN - SCOPUS:85083727634
SN - 1054-139X
VL - 67
SP - 416
EP - 424
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 3
ER -