Abstract
INTRODUCTION: Teen pregnancy (TP) rates are 1.5 times higher among Latina youth than the United States national average and one-third times higher in rural counties. The Socio-Ecological framework recognizes the myriad of issues that impact TP, including four bidirectional levels of influence on teenagers' behaviors: macro, community, institutional, and interpersonal levels. We aim to fill critical knowledge gaps regarding the influence of key community stakeholders living in rural, Latino-majority communities shaping Latino/a, immigrant adolescents' TP-related environments. METHODS: A purposive sample of 48 key stakeholders was drawn from three rural counties (Finney, Ford, and Seward) in southwestern Kansas from 2016 to 2017; participants completed a brief demographic survey and a semi-structured qualitative interview. Qualitative data analysis followed grounded theory within a Socio-Ecological framework, and we used descriptive statistics to analyze survey data. RESULTS: Respondents (N = 48) included 5 public health department staff, 8 community health workers, 8 healthcare workers, 9 community members, and 18 high school/college administrators. The mean age was 43 years (SD = 15.5) and 50% self-identified as Latino/a. Recommendations included developing TP prevention education programs for parents, utilizing ongoing events and familiar venues, and keeping content consistent with local culture and norms. CONCLUSIONS: Key stakeholders' perceptions regarding TP are often unaccounted for but play a role in shaping youth's decision-making environments. POLICY IMPLICATIONS: This information could inform the development of culturally specific TP prevention interventions, especially considering the controversial politics centered on immigration to the U.S. and its negative impact on the overall health of Immigrant Latinos living in the U.S.