‘It’s whether or not you got people’: school-based social support to address adolescent sexual and reproductive health inequities

ABSTRACT

Efforts to address adolescent sexual and reproductive health (ASRH) inequities often aim to improve school-based sexuality education and reduce individual risk behaviours. Structural determinants are more rarely the focus of interventions. The youth service providers who formed the community advisory board for this community-based participatory research project identified school-based opportunities to improve ASRH by mitigating the impact of social determinants and structural violence on adolescent health. Semi-structured interviews with board members revealed four areas of potential social support intervention that could mitigate these structural determinants, including mentorship, especially for young people who lack supportive relationships at home; small adult-facilitated groups and clubs at school; staffing and training to meet the needs of historically marginalised students; and school-based counselling. These findings indicate the need for school-based programmes that transcend conventional and short-term didactic forms of sexuality education, to foster social support and address interconnected structural factors affecting ASRH.

KEYWORDS:

• Adolescent sexual and reproductive health
• social determinants of health
• health inequities
• community based participatory research
• systemic racism
• school-based programmes

Acknowledgments

We thank members of the STRIVE CAB for their commitment to communities of colour and social justice in Springfield and their dedication to the project. Caitlin Cornelius provided insightful feedback on previous drafts of this manuscript. Thanks go to Saloonee Adhikari for her contribution to data collection and analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The research reported here was supported by the Family and Youth Services Bureau in the Administration for Children and Families of the US Department of Health and Human Services, grant # [1901MASRAE]. The opinions and views expressed here are the authors’ own and do not necessarily reflect the official policy or position of the Massachusetts Department of Public Health.