title: Substantiating the need for primary care-based sexual health promotion interventions for ethnic minority adolescent women experiencing health disparities.
abstract: OBJECTIVE
  Assess the context of psychological distress, violence, and substance use among African- and Mexican-American adolescent women with a history of STI, violence, or high sexual risk behavior. These adolescents experience multiple health disparities, limited access to care, and are at particularly high risk of adverse sexual health outcomes. The results will inform sexual health promotion interventions provided by advanced practice nurses in primary care-based settings for women experiencing these disparities.
  
  
  METHODS
  Analysis of self-report data obtained at study entry from African- and Mexican-American adolescent women (n = 559) enrolled in a randomized trial of a behavioral intervention for sexual risk reduction.
  
  
  CONCLUSIONS
  High levels of psychological distress, sexual risk behavior, sexually transmitted infection (STI), personal and friend/peer substance use, alcohol use, and violence were reported by women at study entry. Analyses found that STI, physical violence, and substance-using friends were twice as likely associated with personal substance use. Alcohol users were five times more likely to use other substances. Mexican Americans were three times more likely than African Americans to use substances.
  
  
  CONCLUSIONS
  Recommendation is made for integration of multicomponent sexual health promotion interventions as advanced practice nurse provider services addressing these health disparities within primary care-based settings.
authors.affiliation: School of Nursing, The University of Texas at Austin, Austin, Texas.
authors.forename: Jane Dimmitt
authors.initials: JD
authors.lastname: Champion
authors.affiliation: School of Nursing, The University of Texas at Austin, Austin, Texas.
authors.forename: Cara
authors.initials: C
authors.lastname: Young
authors.affiliation: School of Nursing, The University of Texas at Austin, Austin, Texas.
authors.forename: Lynn
authors.initials: L
authors.lastname: Rew
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000523:psychology; D005260:Female; D006293:Health Promotion / Q000379:methods / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D017058:Mexican Americans / Q000523:psychology; D054525:Minority Health / Q000208:ethnology / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D060728:Reproductive Health / Q000208:ethnology / Q000706:statistics & numerical data*; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000517:prevention & control / Q000628:therapy
keywords: Adolescents; ethnic minorities; health disparities; health promotion; primary care; role of advanced practice nurse; sexual health