Despite overall decreases in fertility rates throughout Latin America, fertility among adolescents has remained stubbornly persistent, particularly in countries such as Honduras which experiences some of the highest adolescent fertility rates in the region as well as globally. Honduras is also one of the 5 top countries from which the most illegal immigrants arrive in the US, many of whom are adolescents. Innovative research that integrates the understanding of the demographic and geographic determinants of adolescent fertility in Honduras with cutting edge social networks and social norms research can provide important insights into the pathways by which adolescent fertility in this population can be prevented. This Mentored Research Scientist Development Award (K01) will provide me with experience in formal demographic methods specific to researching fertility, expertise in the social determinants of adolescent fertility, as well as methods in spatial and social demography. This training and experience will foster my development as an independent researcher who can bridge the fields of spatial and social demography with the conceptual and methodological skills of social network analysis and social norms theory. My career development plan is designed to augment my training in global public health and allow me to: 1) gain experience in formal demography, with a focus on methods specific to understanding fertility, 2) develop expertise in the social determinants of adolescent fertility in Latino populations and 3) Obtain methodological expertise in spatial demography and geo-informatics, including analysis of spatial data, and integration of spatial variables into statistical analyses. These training goals will be achieved through didactic courses, workshops, hands-on research, and mentoring from an interdisciplinary team of experts. The overall objective of my research project is to identify the social and spatial determinants of adolescent fertility with the goal of informing future work on prevention within this vulnerable population. The project will utilize data from a Bill and Melinda Gates Foundation funded social network study to capitalize on its extensive research infrastructure. Previous research has suggested that social norms are an important determinant of adolescent fertility in Latin America, although these norms have, up to now not been measured quantitatively. Spatial demography provides the tools necessary to understand the geographic and social clustering of norms and attitudes, through the ability to parse out the effects of each component individually. Specifically, the research aims for this K01 are to: 1) Using formal demographic methods, determine the distribution as well as the social and demographic determinants of adolescent fertility (AF) for both girls and boys on a complete population within 160 villages in rural Honduras, 2) Assess the relationship between spatial clustering and social networks as determinants of AF, and test the effect of social network cohesion on the relationship between fertility-related social norms and AF, and 3) Assess the utility of a men's participation intervention on an adolescent boy's chance of becoming a father. This project will provide the groundwork for an R01 looking at a cohort of children from the original study population to extend the measures in this study to include an understanding of how migration, and family processes impact adolescent fertility. These training and research activities will position me as one of a few researchers in the field of public health with this uniue skill set and enable me to develop an independent research career.

Public Health Relevance

Adolescent fertility in low-income settings is both a result of-- and a determinant of-- the entrenched social inequity that negatively impacts lifetime health and well-being. Despite overall decreases in fertility rates throughout Latin America, fertility among adolescents has remained stubbornly persistent, particularly in countries such as Honduras which experiences some of the highest adolescent fertility rates in the region. This study will combine social network analysis with spatial and formal demography to understand the distribution and social determinants of adolescent fertility (AF) in rural Honduras, with a specifi focus on the role and distribution of social norms.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01HD087551-04
Application #
9685690
Study Section
National Institute of Child Health and Human Development Initial Review Group (CHHD)
Program Officer
King, Rosalind B
Project Start
2016-04-01
Project End
2021-03-31
Budget Start
2019-04-01
Budget End
2020-03-31
Support Year
4
Fiscal Year
2019
Total Cost
Indirect Cost
Name
University of California, San Diego
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
Shakya, Holly B; Perkins, Jessica M; Traeger, Margaret et al. (2018) Social network correlates of IPV acceptance in rural Honduras and rural Uganda. SSM Popul Health 4:236-243
Raj, Anita; Silverman, Jay G; Klugman, Jeni et al. (2018) Longitudinal analysis of the impact of economic empowerment on risk for intimate partner violence among married women in rural Maharashtra, India. Soc Sci Med 196:197-203
Shakya, Holly B; Fleming, Paul; Saggurti, Niranjan et al. (2017) Longitudinal associations of intimate partner violence attitudes and perpetration: Dyadic couples data from a randomized controlled trial in rural India. Soc Sci Med 179:97-105
Shakya, Holly B; Christakis, Nicholas A; Fowler, James H (2017) An exploratory comparison of name generator content: Data from rural India. Soc Networks 48:157-168
Shakya, Holly B; Fariss, Christopher J; Ojeda, Christopher et al. (2017) Social Network Clustering of Sexual Violence Experienced by Adolescent Girls. Am J Epidemiol 186:796-804
Dey, Arnab; Shakya, Holly Baker; Chandurkar, Dharmendra et al. (2017) Discordance in self-report and observation data on mistreatment of women by providers during childbirth in Uttar Pradesh, India. Reprod Health 14:149