Sex Communication in Young People

Sophia I. Sanchez Author

08/03/2020 Added

38 Plays

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A mix methods analysis of short-answer questions regarding sex communication in young people, particularly sexual and racial/ethnic minorities.

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[00:00:00.960]Hello and thank you for joining me! My name is Sophia Sanchez. I am a fourth
[00:00:04.720]year undergraduate student in the psychology department.
[00:00:07.440]I'm also an undergraduate research assistant in the WISH lab housed within
[00:00:10.559]the Center for Brain, Biology and Behavior.
[00:00:13.120]My research project this summer is titled: A mixed methods investigation of
[00:00:16.400]young people's communication with healthcare providers about sexual
[00:00:19.279]well-being. I completed this under the direction of
[00:00:21.600]Dr. Tierney Lorenz. For some background, previous research
[00:00:26.080]has shown us that sexual dysfunction in young adults is actually much more
[00:00:28.800]ubiquitous than one might think. In a population of 405 young folks,
[00:00:33.440]nearly 79% of the male studied cited problems with
[00:00:36.239]erectile function, sexual satisfaction and desire
[00:00:39.360]and nearly 85% of the females in the same study described problems with orgasm and
[00:00:43.360]with pelvic pain. This is compounded by the fact that,
[00:00:46.239]in the United States, our sexual education is
[00:00:48.480]really lacking in the realm of sexual well-being, desire and pleasure,
[00:00:52.399]instead focusing on more of an abstinence-based education system
[00:00:56.399]in addition to just preventing unwanted pregnancies and sexually transmitted
[00:01:00.320]infections. And, for some, this is remedied by the
[00:01:03.680]talk at home with their parents, but for minority populations, that's not the case.
[00:01:07.120]so Kim and Ward reported that Asian American adolescents
[00:01:11.200]experience a "culture of silence" when it comes to talking about sex with their
[00:01:14.479]parents. So if young folks can't turn to their
[00:01:16.960]parents or their teachers for sexual information or sexual education,
[00:01:20.560]one would think that doctors would be the next best bet,
[00:01:23.759]but unfortunately, they're currently not. In one research study, doctors treating
[00:01:27.840]Latina adolescents focused entirely on preventing what they perceived to be
[00:01:31.360]inappropriate pregnancies, so instead of letting their patient's
[00:01:34.720]culture and those cultural nuances such as
[00:01:37.119]the value that Latinas place on their fertility and ability to bear children
[00:01:41.680]instead of letting those guide their patient's treatment, they instead
[00:01:45.600]chose their own culture over their patient's, which led to culturally
[00:01:49.360]incompetent care. In 2005, researchers found that doctors
[00:01:54.159]in the UK felt embarrassed about talking to their LGBTQ+ patients in regards
[00:01:58.640]to their sexual health. And lastly, a study of a group of
[00:02:01.840]homeless female youths in Canada reported that their doctors assumed the sexual
[00:02:05.360]activity status of their patients, which led to a deep-seated sense of
[00:02:08.800]distrust. So in light of this gap in communication
[00:02:13.120]between patient and clinician and also the gap in the literature,
[00:02:16.640]we decided to take a look at some data that we have from a mass survey that we
[00:02:20.319]run every semester titled SADEY. SADEY stands for sexually adverse
[00:02:23.760]events in young people, and for this project we analyzed the
[00:02:26.959]following short answer questions: question one is "what, if anything, gets in
[00:02:30.560]the way of talking to medical professionals
[00:02:32.720]or mental health care providers about your sexuality?" and question
[00:02:36.000]two is "what do you think is most important for doctors to know about sex
[00:02:39.280]and mental illness?" So our objectives are to tell our
[00:02:44.319]participant's stories first and foremost.
[00:02:46.480]Something to think about throughout the duration of this presentation
[00:02:50.160]is the importance and the salience of our participants responses, so
[00:02:57.519]the things that they're telling us are so important to them at the moment that
[00:03:01.040]they're taking this survey that they would take the
[00:03:03.200]time to write them out in short answer form
[00:03:06.319]and that is really a lot of effort, so it must be really truly important to them
[00:03:11.040]so that's not something that we take lightly. We want to
[00:03:14.080]tell those stories, we want to be their voice,
[00:03:17.120]we want to outline those responses and inform their audience,
[00:03:21.360]which is the medical community. We also want to discover demographic predictors
[00:03:26.080]that increase or decrease the likelihood of a participant citing a particular
[00:03:29.599]problem. We'll talk about that more in a little
[00:03:31.360]bit. And then lastly to uncover new research directions. So, this project
[00:03:35.599]is not like most. It is not an experimental design, so
[00:03:39.360]we can't form any causal predictions or anything
[00:03:42.239]like that. We can just use the importance and the
[00:03:45.760]salience of our participant's stories to kind of
[00:03:49.519]guide us in a particular direction for future iterations of the survey.
[00:03:53.360]So once we find the relationships from these questions we can
[00:04:00.080]add measures, make measures, add study items
[00:04:04.799]so that we can continue to kind of tease out those relationships
[00:04:08.799]and maybe find even more future directions.
[00:04:13.120]So in order to analyze these data, we used concept mapping,
[00:04:16.479]which is a method pioneered by Jackson and Trochim.
[00:04:19.680]It is comprised of four distinct steps, so the first step
[00:04:23.120]is to clean the data into one concept statements.
[00:04:26.880]We have some participants who are kind of more talkative; they give us
[00:04:30.400]longer statements, sometimes paragraphs, two to three sentences,
[00:04:34.400]so our end goal is to have just one concept, one
[00:04:37.520]theme in each piece. So for example, we have a less talkative
[00:04:43.440]person who is giving us a very short list, so
[00:04:47.199]let's say for example we have discomfort comma fear of judgment. Those are two
[00:04:52.560]distinct concepts and we want to keep those apart.
[00:04:56.240]We did have a set of rules that we
[00:04:59.200]adhered to throughout this first portion of the
[00:05:02.080]project in order to make sure that we were being systematic in the way that we
[00:05:05.680]separated statements or kept them together, and
[00:05:09.520]once those were cleaned, we had five researchers from the WISH
[00:05:13.600]Lab, including myself, sort those statements into categories of
[00:05:17.199]their choice. Really, the only thing that we couldn't do was have a
[00:05:20.080]miscellaneous pile, so each statement has a place.
[00:05:24.720]So if they didn't fit into a category that was already made, it would just get
[00:05:29.360]its own category and maybe another statement would come
[00:05:32.160]to join it later. So, the beauty in this is that it's so
[00:05:37.440]subjective. Everybody has their own perception of where things should fall.
[00:05:41.280]Certainly, there were groupings that were very similar across researchers but
[00:05:45.039]some statements were more ambiguous and that's where this kind of
[00:05:51.759]humanness comes in. So we're celebrating the fact that
[00:05:55.919]we do have bias, whether through our own personal experiences just in life or
[00:06:01.520]through academia as well, so that's that's really the beauty of this
[00:06:06.000]particular method is that we're celebrating those differences
[00:06:09.360]instead of kind of trying to push them down.
[00:06:13.520]So once that was done, we analyzed the groupings by a factor analysis,
[00:06:17.919]so we kind of looked at the average of where
[00:06:21.360]folks place things in order to determine where each statement should fall in what
[00:06:25.680]group, and then finally we determined the final
[00:06:28.800]groupings. That looks like a decision maker
[00:06:31.680](me) who kind of looked through the conceptual framework that the
[00:06:37.120]computer gave us. So the computer gives us these groupings,
[00:06:40.479]whether six, seven clusters, and then it's my job
[00:06:44.880]to look through and see whether or not this
[00:06:47.039]makes sense. So, for example, we had one issue where the
[00:06:50.319]computer gave us six groupings and one of those groups
[00:06:54.639]was very diffuse and not very connected and it
[00:06:58.400]didn't make sense conceptually, so we decided to run the factor analysis
[00:07:02.160]again and add another group so that kind of made a little bit more sense
[00:07:06.560]conceptually and we were able to move forward.
[00:07:09.440]So once we have determined our final groupings, we can run directional
[00:07:13.599]analyses, which again we'll talk about in a second,
[00:07:16.800]and throughout this process, we used In Vivo coding, which preserves the
[00:07:20.400]affective component of participants responses, because again, sex
[00:07:24.720]is a very taboo topic in our culture and in many cultures so
[00:07:28.160]we want to preserve that kind of emotional component
[00:07:31.360]both for the researchers benefit so that it's easier for us to
[00:07:35.520]kind of understand what people are feeling when
[00:07:39.199]they are filling out our survey and better categorize things and also, when
[00:07:44.000]the time comes for us to tell these stories, to tell them more accurately.
[00:07:48.560]So following our directional analyses, we theorized about the results and
[00:07:51.919]discussed future study items for addition into the
[00:07:54.720]SADEY survey and future iterations. So these are some of the demographic
[00:08:00.080]measures that we looked at for our exploratory analyses. Essentially what
[00:08:03.680]we're looking at here is if membership in a particular group
[00:08:08.960](such as people with clinical depression) does that make you
[00:08:12.639]more or less likely to fall into, so does that make you more or less
[00:08:18.240]likely to say something that falls into a particular group. So
[00:08:22.240]for example, clinical depression: does clinical
[00:08:25.599]depression make you more or less likely to say something that falls under the
[00:08:28.879]category of discomfort? So we're looking to prove
[00:08:32.240]or disprove those hypotheses here.
[00:08:36.560]So I have some raw data here; these are just the ones that I
[00:08:42.640]found to be the most powerful and also to be the most representative
[00:08:46.800]of the data set and of the population as a whole.
[00:08:49.600]"Sometimes I get a cold and judgmental vibe from medical professionals"
[00:08:54.000]"It's awkward to discuss sex with someone you don't know"
[00:08:57.360]"I don't want them to share my sexuality with my parents" - that kind of goes back
[00:09:00.560]to aloss of confidentiality - and "they are
[00:09:03.760]people too but with different and morecomplex
[00:09:06.839]needs". So, I'm going to move myself really
[00:09:11.760]quickly so that you can see these final groupings.
[00:09:16.080]So this is for question one; on the right here, we have a cluster dendrogram
[00:09:21.040]so we can see these two large groups and then we have all of our subgroups in
[00:09:26.720]here. So once we get down to these like very closely clustered
[00:09:32.880]little groupings, it's really not in our best interest any longer to continue to
[00:09:37.279]tease out the differences in those groups.
[00:09:39.839]We have kind of a law of diminishing returns there.
[00:09:42.959]And then we can look over here kind of on a statement level where each
[00:09:47.440]statement fell. So we have kind of more clustered up here, very
[00:09:52.080]closely clustered, and then we have kind of a more diffuse
[00:09:55.600]grouping over here. So we did end up with seven clusters, so
[00:10:00.480]this is our cluster solution for question one.
[00:10:03.200]So we have our non-responses, which is likely this group over here because it
[00:10:06.480]was similarly grouped across researchers, we
[00:10:10.240]have fear of judgment, not difficult, discomfort, not necessary,
[00:10:15.040]doctors are strangers, and not applicable. And then we have for question two
[00:10:21.200]something similar - for question two, it does look a little bit different.
[00:10:26.079]So you'll notice that there's not as many like really closely clustered
[00:10:30.880]groups except for this one, this one over here;
[00:10:34.240]this is a reflection of the fact that
[00:10:37.839]The statements and responses that we got for question two - just because of the way
[00:10:41.839]the question was worded - were a lot different and more difficult to
[00:10:46.079]categorize than for question one so that's why
[00:10:50.240]they're a little bit more spread out - because our researchers had very
[00:10:54.959]different groupings for this particular question.
[00:10:58.959]We did also settle on a seven cluster solution for this question
[00:11:04.240]so we have non-responses, not applicable, mental illness sex and how to help,
[00:11:09.360]things for doctors to know, unsure, all is well,
[00:11:12.640]and nothing.
[00:11:16.240]So future directions - in Fall of 2020 and Spring of 2021,
[00:11:21.519]we are hoping to complete the same process with another short answer survey
[00:11:25.200]question: "what is hard about talking to your
[00:11:27.600]parents about sex" so we're wanting to compare doctor
[00:11:31.279]communication versus parent communication and we are thinking that
[00:11:34.399]there will be a difference there. And also to potentially add some new
[00:11:38.480]measures to a new iteration of the SADEY survey.
[00:11:43.680]I would like to thank Dr. Lorenz for her unwavering patience and guidance
[00:11:48.079]throughout this whole project and for being my
[00:11:51.360]statistician. I feel so lucky to get to work under you
[00:11:55.360]every day. I would also like to thank the
[00:11:58.480]researchers in the WISH Lab for your dedication and willingness to
[00:12:02.160]try new things; I know that this was a very new method for all of us,
[00:12:06.000]but you took it in stride and I so appreciate your efforts
[00:12:09.519]and I'm looking forward to getting to do this again next semester.
[00:12:13.360]Lastly, I would like to thank my roommates and my partner for their
[00:12:16.240]emotional support throughout the coding process.
[00:12:18.399]It was a tough couple of weeks but you got me through it so
[00:12:22.480]thank you, and thank you for sticking with me through this.

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Sex Communication in Young People

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