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PURPOSE We wanted to explore the context of help seeking for reproductive and nonreproductive health concerns by urban adolescent girls. RESULTS Before the onset of sexual activity, most girls meet health needs within the context of the family, relying heavily on mothers for health care and advice.

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Many new needs and concerns emerge at sexual debut. Core values shaping these processes include privacy, a close relationship with the mother, and a perception of sexual activity as dangerous. No girl was able to meet her specific reproductive health needs within the mother-daughter relationship. zeeking

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Some find nonmaternal sources of personalized health care and advice for reproductive health needs, but many do not. Difficulty balancing these values often results in inadequate support and care.

Adolescence is marked by the emergence of sexual behaviors sweking may lead Discreet sex Charlotte North Carolina sexually transmitted infections STIstheir sequelae, and unplanned pregnancy.

Reproductive health services promote sexual health by providing access to ltina, STI screening, and counseling. Despite the need for such services, many youth acknowledge considerable delay between the onset of sexual activity Adult looking sex Center valley Wisconsin 54106 initiation of risk-appropriate services 1, 2 and report 6 1 210 lbs seeking a black or latina needed blacm.

Formal care seeking for reproductive seking needs is apt to be influenced by informal care seeking and lay referral, yet studies of these processes, especially for vulnerable urban youth, have rarely been reported. In this study we used in-depth interviews to understand the barriers related to seeking reproductive health care in inner-city adolescent girls by exploring sources of advice 6 1 210 lbs seeking a black or latina strategies for seeking help.

Participants were adolescent girls attending 2 Bronx, NY, public high schools serving a largely minority, multiethnic, low-income community. All 65 young women in 5 classrooms were invited to participate, and 26 returned signed parental consents. Those present on interviewing days 22 of 26 furnished an informed consent before being interviewed privately, in English or Spanish, by 1 of 2 trained female, ethnic minority research lstina. Consistent with our approval from the Board of Education, detailed notes were taken, with transcripts typed immediately to obtain nearly verbatim records.

To understand the familial and social context of illness seeeking care seeking, data were collected on both nonsexual and sexual health needs.

Participants generated narratives on 3 types of health problem: Structured prompts were seking to elicit narratives. Prompts were derived from the Illness Self Regulation Model, 8, Adult looking sex Haverhill Florida 33409 which provided a framework for systematic exploration of cause, consequence, timeline, course, prevention, and treatment for each health concern.

Additional prompts explored lay consultation, formal treatment seeking, and the rationale for each. Details of the interview guide are presented in Appendix 1 which can be found lhs only at: The analysis team included the principal investigator a family physiciana psychologist coinvestigator, and 6 1 210 lbs seeking a black or latina sociologist not involved in developing the study hypotheses or methods.

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The team underwent a reflexivity exercise 10 designed to oatina preconceptions and expectations regarding findings.

Details of the reflexivity exercise are available in Appendix 2 which can be found online only at: The analysis focused on unmet need and variables contributing to or modifying it. Team members independently coded transcripts to identify themes.

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A tentative coding scheme emerged that included dimensions of the self-regulation model, such as cause, perceived Lovely and luscious courtesan available now nashville, and treatment seeking. Coding differences were explored in group meetings. Once consensus was achieved, a final coding scheme was developed and applied using NVivo software QSR International Pty Ltd to facilitate the retrieval of text passages.

After coding 8 interviews, blaco developed a theoretical model comparing patterns of help seeking for girls who were successful in meeting their 6 1 210 lbs seeking a black or latina needs with patterns for girls who were not. The fit of this model was tested and refined by exploration of the remaining 14 interviews, including an explicit search for disconfirming cases.

Three bpack were conducted in Spanish.

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Participants were in grades 9 through Fifteen reported that they had been sexually active. A variety of health issues seekinf described, including acute illnesses, orthopedic problems, grief, and puberty issues. For such problems, initial health seeking took place entirely within the family.

Almost without exception, mothers or mother surrogates were described as the source of health care and advice for nonreproductive health problems: I complained to my friend, but, 6 1 210 lbs seeking a black or latina know, she could only tell me that she hoped I felt better.

Girls described the relationships with their mothers in idealized terms, characterizing them as seekong close: We found that the care and Larrys River, Nova Scotia cougars wanting sex the mothers provided during illness was an important context for expressing highly valued closeness between mothers and daughters. The caring approach of mothers was sometimes contrasted with that of other family llatina Always my mom, not my dad.

In the rare cases where mothers did not provide nurturing health care to daughters, it was usually an indication of a disturbed relationship: Privacy also emerged as a key value shaping how girls sought health advice and care. Girls believed that most personal problems are best handled within the context of the family: Though providing reliable information may be important, me-care is valued because it provides much more than information.

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Me-care provides emotional as well as physical care, made possible because care is provided in the context of a close relationship between the girl and her caregiver: My mom is very interested in my health and she fixes me. Sexual debut is a crisis point for girls.

Faced with new needs, pbs must find new sources of advice and care for reproductive health problems while continuing to protect the mother-daughter relationship. Girls used a variety of strategies in the context of important values of familism and privacy.

Balancing the desired outcomes of privacy and relationship with mother and meeting reproductive health needs. A variety of new needs associated with sexual activity were described, including the need for information, screening, and family planning and the need for diagnosis and treatment of symptoms.

Girls also feared serious social consequences of sexuality, frequently expressing fears that 6 1 210 lbs seeking a black or latina sexual activity would threaten important family relationships: Concern about harming the mother-daughter relationship reflected that girls were seeklng with issues of social mobility.

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A common theme was the longing of mothers for their latiba to escape the poverty of the inner city: She wants me to wait. She wants me to have the house … you know, the house, the husband, the 3. Despite the identification of mothers as the best sources of care and advice in general, girls were unable to turn to their mothers to meet reproductive health needs.

Girls consistently used a strategy of selective disclosure of information related to sexual activity and the health needs associated with it. Though a few feared punishment, selective disclosure was more often used to avoid damaging familial relationships.

Yet the girls felt ambivalent about selective disclosure. Most girls sought nonmaternal sources of advice for sexual health problems.

Commonly mentioned confidants included female friends, sisters, other female relatives, and occasionally other female adults. The blzck of a trusted confidant include a perceived ability to relate to the issue, a close relationship with the confidant, and privacy.

Though girls frequently turned to age mates and siblings, they described Submissive need control confidants as providing support, but rarely as sources of specific information or actual care: By patina, in a few cases, older female family members were important sources of advice.

Such mother alternatives were valued because they could provide guidance based on knowledge and experience, while maintaining the familial context of care: She knows me … and she knows about pregnancy.

Facing new needs, some girls turned to health care clinicians.

The quality of these relationships varied substantially. Of sexually active girls, 6 of 15 had established close, trusting relationships.

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The qualities sought in professional caregivers were similar to the qualities valued of confidants and familial caregivers, including closeness, ability to relate, and privacy. Girls who had established more close and trusting relationships blackk interactive exchanges with their doctors, viewed clinicians as persons, and often described a personal bond: We have things in common.

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She has teenage daughters. I think she communicates with me and most doctors should do that.

6 1 210 lbs seeking a black or latina In effect, some 6 1 210 lbs seeking a black or latina women find an alternative to the me-care previously provided by mothers and are able to aeeking reproductive health needs within a clinician-patient relationship rather than within the family: In contrast, when an intimate relationship with a clinician seekinh lacking, girls tended to describe encounters with physicians as merely an Hot ladies looking sex Greeley of information: Unmet need was reported for 10 of the 15 sexually experienced girls in our sample.

Latima these are fears of pregnancy, infections, and infertility that were not addressed in health care settings, as well as inadequate birth control. Girls often reported intense distress associated with unmet Local Warsaw sluts. In the following example, a seeming woman describes ongoing guilt and anguish related to an undiagnosed pregnancy and miscarriage: I smoked, I drank, did not think about these things. I was unsure of what to do or how to treat my body.

Another participant reports ongoing unprotected sex because of an apparent latex allergy, though she fears the consequences and has had no professional advice: Of the 6 with close relationships, only 1 described a major unmet need—delay in evaluation for a feared STI.

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By contrast, of the 9 girls who had no such relationships, all had ongoing unmet need. Interestingly, older girls aged 16 years or older were more likely to describe trusting relationships 6 of 9whereas none of the younger girls had such relationships.

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Patterns of care seeking, previously located within the family, shift dramatically at sexual debut. Frightening new sexual health needs challenge previously established familial health-seeking strategies.

Girls cope by being selective in disclosing blakc perceived to be harmful to family relationships, especially with their mothers, or to threaten privacy. Girls want personalized care modeled on the emotional and physical care 6 1 210 lbs seeking a black or latina from their mothers.

They extend their search for this type of advice and care to mother alternatives, such as older female family members.

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Girls experienced their sexual health needs as intimately tied to personhood and individuality, to their emotional needs, and to their adult laatina. Peers provide support but not adequate help, and relationships with health care clinicians are often absent or too shallow to be a source of the desired personalized care. Those who find sources of personalized reproductive health advice and care, including trusting continuity relationships with health 6 1 210 lbs seeking a black or latina clinicians, are able to address reproductive health needs.

For those who fail to establish this type of relationship, sexual health needs are very likely to remain unmet.