Objective: Social media has been recognized as a promising tool for delivering health interventions and facilitating study recruitment. However, research is needed to understand how social media might be used to enhance the experiences of adolescent participants in ongoing studies. In a prospective cohort study addressing social and structural influences on health trajectories among 599 adolescents in a California agricultural community, we evaluated the effectiveness of and engagement with a human-centered, Instagram-based outreach campaign, with a focus on study retention, enhancement of participants' experiences, and increasing community awareness of the study.Methods: We adopted a youth-centered approach to design a three-month pilot study, which included participatory design sessions, a geo-targeted Instagram campaign, and in-person events at schools. We conducted pre-/post-pilot surveys with study participants, analyzed social media metrics, and collected process measures, such as study visit show rates.Results: After three months, the study Instagram account had 209 followers and 806 total engagements. Survey responses showed little change in study participants' attitudes about the study; most survey respondents agreed that the study is very important for the community (54% pre-pilot and 52% post-pilot). However, the study's Instagram account appeared to influence study participation, with 43% of post-pilot respondents who use Instagram (n¼65 of 153) indicating that the Instagram account influenced their decision to continue coming to study visits.Conclusion: Despite little change in the participants' attitudes about the study, the findings of this pilot study suggest that Instagram is a promising tool to support engagement of adolescent participants in ongoing research, particularly if the content is designed with adolescents as partners. In addition to assessing the effectiveness of an Instagram outreach campaign to support retention, this paper also presents suggestions and insights for creating similar social media interventions targeting youth.

The health of adolescents, perhaps more than in any other period of their life, is shaped by the social determinants of health (SDH). The constellation of SDH that disadvantages a specific group’s health may also make members of that population unable or unwilling to engage in health research. To build a comprehensive body of knowledge about how SDH operate within a specific social context, researchers must design studies that take into account how various vulnerabilities and oppressions may affect people’s experiences of being recruited, interviewed and retained in a study. In 2014, we initiated a prospective cohort study with Latino youth living in the agricultural area of Salinas, California. We began this study with the understanding that it was imperative to develop methodological strategies that actively addressed potential challenges in ways that were culturally responsive, community engaged and inclusive. In this article, we describe our approach to developing best practices in four key areas: 1) building community partnerships and engagement; 2) consideration of staffing and staff support; 3) engaging youth’s perspectives; and 4) developing culturally appropriate research protocols. In our sample of 599 participants, nearly all youth identify as Latinx (94 per cent), half (49 per cent) have at least one parent employed as a farmworker, 60 per cent reside in crowded housing conditions, and 42 per cent have mothers who did not complete high school. Given these multiple vulnerabilities, we view a robust number of youth expressing interest in study participation, the willingness of their parents to permit their children to be enrolled, and the achievement of an ambitious sample target as evidence that our efforts to undertake best practices in community-engaged and inclusive research were well received.

Foreign-born youth have a lower risk of sexual initiation than native born youth, yet most research has focused on Latinos. An ethnically diverse sample of 200, 14-21 year-old youth were surveyed in Denver in 2014. We used logistic regression models to predict the odds of intentions to have sex and sexual experience, adding covariates that could account for differences in outcomes by immigrant generation. First generation youth were less likely to intend to have sex and to have sexual experience than third generation youth after controlling for racial/ethnic group, suggesting that first generation immigrants of multiple racial/ethnic groups, not just Latinos alone, have a lower risk for sexual initiation. Having a supportive community reduced the odds of sexual intentions and sexual experience. Our findings support future research using a larger sample of black, white, and Asian immigrant youth to corroborate and to explore reasons behind these associations.

OBJECTIVES: To examine whether social aspects of the neighborhood environment are associated with early sexual initiation in a California agricultural community of predominantly Latinx adolescents. METHODS: In a prospective cohort study of 599 eighth graders recruited from middle schools in Salinas, California (2015–2019), participants completed five interviews over 2 years. Social environment measures included neighborhood social dynamics (neighborhood disorder, social cohesion, and social network gang exposure); experiences of discrimination; and school connectedness. We estimated associations between baseline social environment and early sexual initiation (<15 years) using Poisson regression with robust standard errors. We compared contraceptive self-efficacy and attitudes by sexual initiation status using ANOVA. RESULTS: Most youth were Latinx (94%) and age 13 (70%) at enrollment; 53% were female and 49% had a parent employed in agriculture. Additionally, 14% reported first vaginal sex before age 15. Neighborhood disorder (relative risk [RR], 1.13; 95% confidence interval [CI], 1.05–1.21), social network gang exposure (RR, 2.23; 95% CI, 1.49–3.33), and experiences of discrimination (RR, 1.67 [1–2 events versus none], 95% CI, 1.09–2.55; RR, 2.33 [3+ events versus none], 95% CI, 1.07–4.64) were associated with early sexual initiation. School connectedness was protective (RR, 0.44, 95% CI, 0.29–0.69). Youth who initiated sex before age 15 had more negative birth control attitudes and expressed lower motivation to use contraceptives. CONCLUSIONS: Findings underscore opportunities to promote early adolescent sexual health through strengthening supportive and safe neighborhood environments with the promise of addressing disparities in unintended pregnancy and sexually transmitted infection rates in later adolescence.