Development of a Socioecological Adolescent Sexual Health Index and Atlas: A Case Study in Washington State

ABSTRACT

Adolescent sexual health programs often frame needs assessments using risk-taking, disease, or fertility data, fostering a narrow perspective of sexual health and limiting scopes of related programs. We address the gap between traditional measures and the socioecological lens used by many in the field. Using Washington State as an example, we report methods for developing and mapping an index of sex education needs that integrates social determinants of health (SDH) to reflect the complex, interrelated influences affecting adolescents. The generated index and maps support a holistic approach to assessing inequity, resource allocation gaps, and specific programmatic needs of young people. This case study demonstrates that it is possible and important to align adolescent sexual health measurement strategies with more holistic adolescent sexuality development frameworks. We recommend that public health professionals consider a broader range of data on SDH in their sex education policy and program decision making.

KEYWORDS:

• Social determinants of health
• community mapping
• school-based sex education
• geographic information systems
• adolescent health
• sexual and reproductive health

Acknowledgments

This work was supported through Washington Working to Institutionalize Sex Education (WISE) operated by Cardea Services as part of the national WISE initiative led by the Grove Foundation and a collaboration of regional and national funders. Ann Vander Stoep, PhD, at the University of Washington provided mentorship on data analysis, interpretation, and index development. The National Library of Medicine Community Health Mapping project provided technical assistance and financial assistance to realize the mapping components of this work. Several stakeholders at public agencies and nonprofit organizations throughout Washington contributed their perspectives through key informant interviews to the refinement of this index and resultant maps. Finally, Wendy Nakatsukasa-Ono, MPH, April Pace, JD, and countless other colleagues at Cardea Services supported this concept from its inception and created the space for it to flourish.

Additional information

Funding

Grove Foundation