Family Support, Neighborhood Risk, and Adolescent Reproductive Health Behaviors

Background and Purpose: Adolescence is a critical developmental period where risk behaviors become more pronounced. Although sexual behavior during adolescence is normative, inconsistent contraceptive use or multiple sexual partners can jeopardize long term reproductive health (Ayerdi Aguirrebengoa et al., 2020). Social determinants of health research highlight the impact of environmental and neighborhood conditions on health and well-being. Among environmental risk factors, low perceived safety and poor neighborhood conditions have been linked to earlier sexual initiation (Green et al., 2019). This period of adolescence is also marked by a shift in parental and familial caregiving support, where adolescents may experience increased or decreased parental support. Adolescents who receive greater family support are less likely to initiate sex early, have unprotected sexual intercourse, and have sex with more sexual partners (Abiodun et al., 2020). Research has not yet explored the role of neighborhoods on sexual behaviors. It is not known if increased family support can attenuate the negative effects of neighborhood characteristics on sexual behaviors that can jeopardize reproductive health. The current study examines the effects of neighborhood conditions and family support on reproductive health behaviors of adolescents.

Methods: Wave 3 (N=502) of the Birmingham Youth Violence Study (BYVS) was used for data analysis. Participant recruitment utilized a two-stage probability sampling process, with attention given to racial/ethnic, sex, and SES composition to reflect a representative sample of public school students. The sample includes adolescents aged 16-23 (M_age = 17.64, 52% female, 81.3% African American, 18.7% White). Self-reports of family support, sexual behaviors, neighborhood conditions were measured. Family support was examined using 20-items to understand the youth’s relationship to family members. Neighborhood conditions were assessed with a focus on ambient hazards and safety (Perkins, Florin, & Rich, 1990). Sexual behaviors were measured by first sexual initiation, age at first sexual intercourse, frequency of (past year) contraceptive abuse, and number of lifetime sexual behaviors.

Results: Multiple logistic and linear regressions were used to test the relationship between family support, neighborhood hazards and perceived neighborhood safety with sexual initiation and reproductive health behaviors. After controlling for age, sex and racial minority status, results demonstrated that more neighborhood hazards were related to a greater likelihood of sexual initiation by age 17 (OR=1.74; 95% CI[1.13, 2.66]). Greater family support was linked to older age of sexual initiation (β=0.15, SE=0.05, p < .01), more frequent contraceptive use (β = 0.17, SE = 0.06, p < .01), and fewer lifetime sexual partners (β=-0.16, SE=0.05, p < .01). Family support did not moderate the relationship between neighborhood conditions and reproductive health behaviors. Results suggests that youth with increased neighborhood risks initial sexual activity earlier. However, across different types of neighborhoods, family support is an important factor in reducing risky reproductive health behaviors that are associated with sexually transmitted infections and unplanned pregnancy.

Conclusion and Implications: Study findings support the essential role of family support in addressing behavioral health inequities. This poster presentation will incorporate research, teaching, and practice implications for social work educators, practitioners, and researchers.