CHIP Principal Investigator Stephanie Milan has a new National Institute on Child Health and Development grant to study the cultural context of health disparities in adolescent girls in New Britain, Connecticut.
Milan, an associate professor of psychology, is focusing the research on two health outcomes – reproductive health and overweight/ obesity – where health disparities already are well-documented by adolescence, with African American and Latina girls at greatest risk.
For instance, pregnancy rates are about two to three times as high and obesity rates are about one and a half times as high for African American and Latina girls as for their white non-Hispanic peers.
“These two health outcomes are not typically studied together, but behaviors impacting them are both heavily influenced by cultural factors,” said Milan, the grant’s principal investigator. “Many areas where health disparities exist, such as cancer and HIV, are universally perceived as undesirable outcomes; in contrast, perceptions of early childbearing and weight are individually and culturally defined.”
To date, there has been very little research on the cultural influences on adolescent health, Milan explained. Also, concepts important to understanding families of color may not emerge in studies of non-Hispanic whites, she said.
The two-year, $426,914 NIH R21 exploratory grant aims to identify ways that parents’ culturally rooted ideas about gender are infused into family life and may indirectly influence risk of sexually transmitted diseases (STDs), unintended pregnancy and overweight/ obesity in adolescent girls.
Milan brings her expertise in adolescent reproductive health to the project and her co-investigator, CHIP Principal Investigator and Assistant Professor of Psychology Amy Gorin, brings her expertise in understanding the social and environmental factors that contribute to obesity to the project. They both have experience in delivering evidence-based health behavior interventions to low-income and minority populations.
The study will be guided by developmental niche theory which organizes information about the microenvironment of the child into three interrelated components: 1) physical and social settings, 2) customs involved in childrearing, and 3) ethno-theories of the caregivers. Analysis of these three components provides a means of detailing the complex and implicit ways that culture is instantiated into daily family life. This approach is consistent with calls from leading scholars and NIH to move beyond broad labels of race, ethnicity, or immigration status and instead focus on the processes by which culture and acculturation shape child development.
For the study, the research team will conduct interviews with 200 adolescent girls (50 percent Latina, 25 percent African American and 25 percent non-Hispanic White) in 9th and 10th grade at New Britain High School. The team also will interview the girls’ mothers or other female caretakers.
The researchers will use a combination of quantitative and qualitative measures including self-report surveys, daily calendars, a “four rules” task, a q-sort and interviews.
In their daily calendars, the girls will record their activities and with whom they spent their time. For the four rules task, mothers and daughters separately will explain four household rules and if/how they would differ for sons and daughters. For the q-sort, mothers and daughters will sort words into categories such as how they see themselves or their daughters and the attributes they believe women need for success. The interviews will ask mothers to describe where they envision their daughters in five years.
The study also will include two follow-up sessions by phone within six months.
Milan and Gorin hope that the findings from this two-year study will inform efforts to develop evidence-based, gender-responsive, developmentally and culturally-relevant health programming at New Britain High School, New Britain YMCA and other local community centers.
“If we help create an intervention that promotes more positive health outcomes for this generation of girls, who will be the next generation of mothers, we’re potentially impacting their future parenting styles and the health and well-being of their children as well,” Milan said.
UConn Human Development and Family Studies Professor Sara Harkness, who developed developmental niche theory with Human Development and Family Studies Professor Charles Super, is serving as a consultant on the grant.