| dc.description.abstract | Statement of the Problem. Adolescents and young adults underutilize sexual and reproductive health (SRH) services, contributing to health disparities related to sexually transmitted infections (STIs) and unintended pregnancies. These SRH health outcomes are especially relevant to youth who do not identify as cisgender or heterosexual. Summary of the Literature. A review of the literature showed that receiving appropriate SRH care is crucial for young people, as health-care providers are in a vital position to screen for risk and to support health-promoting behaviors as teens grow into adulthood. Thesis Statement. The purpose of this study was to explore barriers and facilitators associated with early initiation of SRH services among Oklahoma emerging adults. The two groups examined were cisgender/heterosexual individuals and lesbian, gay, bisexual, transgender, queer, or other sexual and gender minority individuals (LGBTQ+). The researcher hypothesized that compared to cisgender/heterosexual respondents (H1), LGBTQ+ respondents will initiate the utilization of SRH services at an older age; (H2) peers and partners will be stronger influencers on SRH service utilization for LGBTQ+ respondents; and (H3) LGBTQ+ respondents will report greater numbers of barriers to utilizing SRH services. Methodology. This retrospective cross-sectional study involved a 46-item online-administered questionnaire to assess young people’s experiences with initiating SRH services. Four-hundred adult participants with diverse sexual and gender identities were recruited to provide enough statistical power to find significance. Differences between the two groups were measured using independent t tests and variables were descriptively examined using crosstabulations tables. Analysis was completed using SPSS version 24.0 software. Results. The results of an independent t test showed the mean age at initiation of SRH services among LGBTQ+ participants (M = 16.92, SD = 2.39) was not statistically different from the mean age at initiation of SRH services among cisgender/heterosexual participants (M = 17.26, SD = 2.41; t(356) = 1.317, p = .189). The data violated one of the assumptions of chi-square analysis for the second research question, so influencers on the initiation of SRH services was only examined descriptively. These results showed that peers and partners were hardly influencers on participants initiating SRH services (1.4%), and personal responsibility (44.2%) and recommendations from a provider (27.0%) were the strongest influencers on initiation of SRH services, overall. Finally, the results of an independent t-test found that the mean number of barriers reported by cisgender/heterosexual participants (M = 2.32, SD = 1.84) was significantly less than the mean number of barriers reported by LGBTQ+ participants (M =3.08, SD = 2.25; t(279) = -3.117, p = .002). Because there was no statistically significant difference in the average age at initiation of SRH services overall between the two groups, the first null hypothesis was accepted. A descriptive examination of the second research question showed that the strongest influencers on initiation of SRH services vary slightly between the two groups. The final null hypothesis was rejected, and the results concluded that LGBTQ+ respondents report a greater number of barriers to utilizing SRH services compared to their cisgender/heterosexual peers. Significance of Findings. This study adds to the literature on adolescent SRH and factors shaping SRH service utilization among LGBTQ+ and cisgender/heterosexual youth. The findings demonstrate that SRH service utilization remains low for all youth and facilitating access to SRH services is especially important for LGBTQ+ individuals, who report significant barriers to care and poorer sexual health outcomes than their cisgender/heterosexual peers. Future Research. To address the limitations and gaps in these findings, future research should aim to recruit a more diverse sample and limit the number of measured influencers on SRH utilization to prevent violating assumptions of analysis. | en_US |
