Description
- Abstract:
- A Spatial Analysis of Condom Availability in Rhode Island: OBJECTIVES: The purpose of this study was to use spatial analysis to identify potential gaps in adolescent access of the condom distribution program of the Rhode Island Department of Health (RIDOH). BACKGROUND: RIDOH receives dedicated funding for the distribution of condoms to high risk populations and distributes over 250,000 condoms annually as one of its core HIV and sexually transmitted infections (STI) prevention strategies. Disparities exist in age, race, ethnicity, and neighborhood of residence that influence STI transmission. Using Geographic Information Systems (GIS) and spatial analysis, the current distribution of RIDOH-sponsored free, publicly available condoms was analyzed. METHODS: Multiple data sets were utilized for the analysis to create layers in ArcMap 10.4.1. Locations of free, publicly available condom dispensers and their spatial correlation to adolescent chlamydia diagnoses, high schools, and race and ethnicity in the state and in the city of Providence were analyzed. Spatial clustering was assessed using Nearest Neighbor, Local Anselin Spatial Clustering, and Optimized Hot Spot analysis. Ordinary Least Squares Regression was performed to check for significant associations between layers. RESULTS: Geographically, publicly available dispensers are clustered on both the state level (NNR = 0.60, Z = -5.31, P=0.00) and within Providence itself (NNR = 0.70, Z = -3.25, P=0.00), as well as within specific neighborhoods in Providence. Out of 129 schools, 35 schools (27.1%) are within a 15-minute walk of a publicly available dispensing location. Providence accounts for 70.2% of the publicly available dispensers in the state but only 32.3% of all reported adolescent chlamydia cases. Sixty-eight percent (68.6%) of reported cases of adolescent chlamydia occurred in just six municipalities. In Providence, 2015 adolescent chlamydia case counts were not significantly associated with dispenser count, but were significantly associated with ethnicity and borderline significant with race, when analyzing by neighborhood. CONCLUSIONS: Spatial analysis reveals that publicly available dispensers are highly clustered and therefore inaccessible to the majority of adolescents in the state, particularly some minority populations and adolescents living in areas of high chlamydia burden. The RIDOH should consider expanding geographic access by adding more dispensers throughout Providence and the state. Additional research is needed to understand the underlying social and behavioral factors associated with adolescent condom use in Rhode Island. Optimizing an Existing Condom Distribution Program for Rhode Island’s Adolescents: Key Informant Perspectives OBJECTIVES: The goal of this study was to obtain the opinions and insight of social service staff and public health professionals who interact with adolescents regarding the social and structural barriers to condom access and use among 15-19 year-olds in Rhode Island. BACKGROUND: Social and structural barriers exist that deter or prevent adolescents from accessing or using condoms in their communities. Findings of this study broaden our understanding of the barriers to adolescent condom access and use in Rhode Island. METHODS: Data collection occurred online between June 2016 and August 2016. Respondents were adults and public health professionals in Rhode Island recruited using initial seeding techniques and subsequent snowball sampling. Both qualitative and quantitative data were collected to assess their opinions and attitudes on the following topics: potential locations where adolescents could access condoms, parental views on adolescent sexual health, potential locations where adolescents would access condoms, adolescent attitudes towards sexual health, and potential barriers to condom use among adolescents. Basic summary statistics were calculated. RESULTS: Forty-two complete responses were recorded. Commonly identified places where adolescents spend time include malls, community locations, sports-related locations, food-related locations, and afterschool programs. Over one-quarter of respondents (28.6%) said that parents felt negatively about condom accessibility for adolescents. Healthcare provider offices and schools were identified as top locations where adolescents would access condoms. Embarrassment and parental oversight were ranked as the most prominent barriers to condom access. When describing the attitudes of adolescents towards sexual health, nine overarching themes were identified. CONCLUSIONS: Geographic access to and cost of condoms are structural factors ranked as potential barriers to condom access by key informants. However, issues such as embarrassment and parental oversight are potentially larger and more socially-motivated barriers to access. It is clear that attention must be paid to both types of barriers in efforts to increase condom access for adolescents.
- Notes:
- Thesis (M. P. H.)--Brown University, 2017
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Citation
Civitarese, Anna Marie,
"A Spatial Analysis of Condom Availability in Rhode Island AND Optimizing an Existing Condom Distribution Program for Rhode Island’s Adolescents: Key Informant Perspectives"
(2017).
Public Health Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://doi.org/10.7301/Z05T3HZS
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Public Health Theses and Dissertations
Theses and Dissertations for the Public Health department....