Public Release: 

Factors associated with sexual coercion among adolescents in rural communities

Pediatric Academic Societies

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TORONTO, May 5, 2018 - A new study examining factors associated with sexual coercion among 10th graders in a rural Midwestern, low-to-middle income high school found that sexual coercion was reported by 18 percent (13 percent of males and 23 percent females). The research findings will be presented during the Pediatric Academic Societies (PAS) 2018 Meeting.

Predictors included age, race, ethnicity, prior alcohol, marijuana and/or prescription drug use, controlling relationship, adverse childhood experiences, sexual self-efficacy and comfort talking to a parent/guardian about sex.

Among males, sexual coercion was associated with higher adverse childhood experiences, controlling relationship behavior, alcohol use and lower sexual self-efficacy. Among females, sexual coercion was associated with lower sexual self-efficacy and lower comfort talking about sex with a parent.

Consent is essential to healthy adolescent relationships, and sexual coercion is associated with poor sexual health outcomes. Modifiable predictors are poorly understood, particularly among adolescents in rural areas who may have less access to sexual health resources.

"On a national level, sex education policy has been reduced to a battle over abstinence," said Dr. Mary Ott, one of the authors of the study. "This community-based work, conducted in partnership with Health Care Education and Training, provides a more nuanced picture of adolescents' educational needs, particularly around sexual consent. The associations with adverse childhood experiences and parent communication highlight the importance of healthy environments in adolescent development. The associations with controlling behaviors and sexual self-efficacy point to the importance of teaching healthy relationship skills, including respect and gender equity."

The study concluded that sexual coercion is common among adolescents in rural communities. In order to achieve positive sexual health outcomes, comprehensive adolescent pregnancy prevention programming in rural areas must integrate education on consent, identification of controlling behaviors, effects of substance use on decision-making, and parent/child communication.

Dr. Ott will present findings from "Only 'Yes' Means Yes: Sexual Coercion Among Adolescents in a Rural High School" during the PAS 2018 Meeting on Sunday, May 6 at 10:30 a.m. EDT. Reporters interested in an interview with Dr. Ott should contact PAS2018@piercom.com.

Please note: Only the abstract is being presented at the meeting. In some cases, the researcher may have additional data to share with media.

The PAS 2018 Meeting, taking place in Toronto on May 5-8, 2018, brings together thousands of pediatric scientists and other health care providers to improve the health and well-being of children worldwide. For more information about the PAS 2018 Meeting, please visit http://www.pas-meeting.org.

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About The Pediatric Academic Societies (PAS) Meeting

The Pediatric Academic Societies (PAS) Meeting brings together thousands of pediatricians and other health care providers united by a common mission: improve the health and well-being of children worldwide. This international gathering includes researchers, academics, as well as clinical care providers and community practitioners. Presentations cover issues of interest to generalists as well as topics critical to a wide array of specialty and sub-specialty areas. The PAS Meeting is produced through a partnership of four pediatric organizations that are leaders in the advancement of pediatric research and child advocacy: American Pediatric Society, Society for Pediatric Research, Academic Pediatric Association and American Academy of Pediatrics. For more information, please visit http://www.pas-meeting.org. Follow us on Twitter @PASMeeting and #PAS2018, or like us on Facebook.

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Abstract: Only 'Yes' Means Yes: Sexual Coercion Among Adolescents in a Rural High School

Background: Consent is essential to healthy adolescent relationships, and sexual coercion is associated with poor sexual health outcomes. Modifiable predictors are poorly understood, particularly among adolescents in rural areas who may have less access to sexual health resources.

Objective: We examine factors associated with sexual coercion among 10th graders in a rural high school.

Design/Methods: We surveyed 10th graders (N=328; Table 1) in a rural, Midwestern, low-to-middle income high school prior to an evidence-based pregnancy prevention program. Sexual coercion was 1 item: "In your lifetime, has anyone you were dating or going out with forced you to do sexual things that you did not want to do?" (never vs. 1 or more times). Predictors included (Table 2): age, race, ethnicity, prior alcohol, marijuana and/or prescription drug use (no/yes), controlling relationship behaviors (1-item "has [any partner] tried to control where YOU go, who you see, or what you do?"), adverse childhood experiences (8-items, ?=0.74; e.g. incarcerated parents, family violence), sexual self-efficacy (6 items, ?=0.65, e.g., "I can say no to sex") and comfort talking to a parent/guardian about sex (7-items; ?=0.61; e.g. "My parent would answer my question [about sex] honestly"). Significant factors from bivariate models (chi-square and t-tests) were retained for a final logistic regression model. We tested for and found interactions with gender, so all models were stratified by gender (SPSS, 24.0). We report significance to p<.10 because stratified analysis limited power.

Results: (Tables 1 & 2) The mean age was 15.6, half were male, and half were Latino. Sexual coercion was reported by 18% (13% of males and 23% females). Among males, sexual coercion was associated with higher adverse childhood experiences (aOR=1.32, p<.10), controlling relationship behavior (aOR=10.56, p<.001) and alcohol use (aOR=4.18, p<.10, and lower sexual self-efficacy (aOR=0.06, p<.001); among females, sexual coercion was associated with lower sexual self-efficacy (aOR=0.53, p<.05) and lower comfort talking about sex with a parent lowered sexual coercion in females (aOR=0.51, p<.05).

Conclusion(s): Sexual coercion is common among adolescents in rural communities. In order to achieve positive sexual health outcomes, comprehensive adolescent pregnancy prevention programming in rural areas must integrate education on consent, identification of controlling behaviors, effects of substance use on decision-making, and parent/child communication.

Authors: Amy Katz, Devon Hensel, Leigh Zaban, Monique Hensley, Abby Hunt, Mary Ott; Health Care Education and Training, Inc. served as the Project Director

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