Browsing by Subject "Sexual and reproductive health"

Now showing 1 - 4 of 4
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    Adolescents' Discussion of Sexual and Reproductive Health Care Topics With Providers: Findings From a Nationally Representative Probability Sample of U.S. Adolescents
    (Elsevier, 2021-03) Hensel, Devon J.; Herbenick, Debby; Beckmeyer, Jonathon J.; Fu, Tsung-chieh; Dodge, Brian; Pediatrics, School of Medicine
    Purpose National practice guidelines encourage providers address sexual and reproductive health (SRH) as part of all clinical encounters with adolescents. Yet, no studies provide nationally representative estimates of how frequently adolescents are screened. Methods Data were adolescent participants (aged 14–17 years; N = 826) in the 2018 National Survey of Sexual Health and Behavior, an online, nationally representative study of sexual health experiences of people in the U.S. SRH variables were: (all no/yes) pregnancy prevention, sexual identity, STD/HIV prevention, sexual difficulties, sexually transmitted infections testing, and sexual activity. We used descriptive statistics and weighted logistic regression (Stata 16.0; all p < .05) to examine differences in the odds of SRH discussion with provider by sexual identity, age, gender, and race/ethnicity. Results The coverage of SRH topics was poor. The most common topic was asking about sexual activity (52.9%), and the least common was being offered a sexually transmitted infection test (21.7%). An adolescent’s sexual identity, race/ethnicity, and age affected the odds of topic screening. Conclusions Health care providers appear to both infrequently and inconsistently address key SRH topics during encounters with young people. Targeted interventions should focus on strengthening the regularity and depth of clinicians’ SRH conversations regardless of adolescent demographic or history.
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    Capacity to Consent to Research Among Adolescent-Parent Dyads in Rakai, Uganda
    (Elsevier, 2023) Kreniske, Philip; Hoffman, Susie; Ddaaki, William; Nakyanjo, Neema; Spindler, Esther; Ssekyewa, Charles; Isabirye, Dauda; Nakubulwa, Rosette; Proscovia, Nabakka; Daniel, Lee; Haba, Nao; Maru, Mahlet; Thompson, Julia; Chen, Ivy S.; Nalugoda, Fred; Ssekubugu, Robert; Lutalo, Tom; Ott, Mary A.; Santelli, John S.; Pediatrics, School of Medicine
    Objectives: To assess the cognitive capacity of early, middle, and late adolescents and their parents or guardians to provide informed consent to a population-based cohort study. Study design: Adolescent-parent/guardian dyads including 40 early (n = 80; 10-14 years), 20 middle (15-17 years), and 20 late (18-19 years) adolescents were recruited from the Rakai Community Cohort Study, an open demographic cohort in Uganda. Participants were administered the MacArthur Competence Assessment Tool for Clinical Research, a structured open-ended assessment; interviews were recorded and transcribed. Twenty transcripts were scored independently by two coders; the intraclass correlation coefficient was 0.89. The remaining interviews were scored individually. We compared mean scores for early and middle/late adolescents using a one-sided t test and score differences between parent/guardian and adolescent dyads using two-sided paired t tests. Results: Early adolescents (mean score, 28.8; 95% CI, 27.1-30.5) scored significantly lower (P < .01) than middle/late adolescents (32.4; 31.6-33.1). In paired dyad comparisons, we observed no statistically significant difference in scores between parents/guardians and middle/late adolescents (difference, -0.2; 95% CI, -1.0-0.6). We found a statistically significant difference in scores between parents/guardians and early adolescents (difference, 3.0; 95% CI, 1.2-4.8). Conclusions: The capacity of adolescents-of different ages and in diverse settings-to comprehend risks, benefits, and other elements of informed consent is a critical but understudied area in research ethics. Our findings support the practice of having middle and late adolescents provide independent informed consent for sexual and reproductive health studies. Early adolescents may benefit from supported decision-making approaches.
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    Enhancing the Sexual Health of Youth in Systems of Care: Factors Affecting Risky Sexual Behaviors and Implications for Pregnancy Prevention Programs
    (2024-05) Armstrong Richardson, Eprise AJ; Adamek, Margaret E.; Ott, Mary A.; Mariscal, Susana; Glassburn, Susan
    This study investigates factors contributing to risky sexual behaviors and teenage pregnancies among youth in systems of care (YSC). Secondary analyses were conducted on quality improvement data from two sexual education programs in the urban Midwest. Descriptive analyses uncovered disparities in risky sexual behaviors between the study samples; moreover, both groups exhibited higher rates compared to those reported in existing literature and the general population. In the Indiana Proud and Connected Teens (IN-PACT) study (N = 1916, mean age = 16.1 years), multivariate analysis showed that, when controlling for age, adverse childhood experiences (ACEs), and system involvement, pregnancy risk scores—a measure of participants' engagement in risky sexual behaviors—were positively associated with decision-making capacity and negatively associated with perceptions of pregnancy as undesirable. Furthermore, among a population of youth currently involved, or at risk of future involvement, in systems of care, those within juvenile justice (JJ) systems reported higher pregnancy risk scores, while youth in child welfare (CW) systems reported lower scores. In the Healthy Teen Connection (HTC) study (N = 603, mean age = 15.7 years), descriptive analyses revealed that 6.3% of participants scheduled appointments post-intervention, indicating limited success in linking participants to reproductive health clinics. The analyses also highlighted patterns regarding participants’ sociodemographic and sexual health characteristics, including an increased proportion of youth reporting sex under the influence during the pandemic. Thematic analysis of coordinators’ reflections links the intervention’s limited success to multifaceted barriers hindering participants’ access to sexual and reproductive health (SRH) services, resources, and education. However, coordinators suggested that, by fostering a safe and supportive environment and engaging caregivers in the intervention, HTC was successful in empowering participants in their sexual health. Acknowledging limitations such as reliance on self-reported data, the findings lay the groundwork for comprehensive policy and practice recommendations. Collaborative efforts are needed to provide YSC with tailored sexual health programming, including comprehensive and developmentally appropriate sexual health education, and accessible SRH resources and services. Future research should prioritize comprehensive needs assessments and explore disparities in sexual health behaviors and outcomes to enhance program development and implementation efforts.
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    Telemedicine Use During the COVID-19 Pandemic in 8 Countries From the International Sexual Health and Reproductive Health Consortium: Web-Based Cross-Sectional Survey Study
    (JMIR, 2025-03-04) Tan, Rayner Kay Jin; Hensel, Devon; Ivanova, Olena; Bravo, Raquel Gomez; Olumide, Adesola; Adebayo, Emmanuel; Cleeve, Amanda; Gesselman, Amanda; Shah, Sonam Jyoti; Adesoba, Helen; Marley, Gifty; Tang, Weiming; Pediatrics, School of Medicine
    Background: Telemedicine is an important way to fill in the access gap to in-person health care services during challenging times like pandemics. Objective: This study aimed to investigate the role that telemedicine played during the COVID-19 pandemic by multicountry comparison of the use of telemedicine prior to and during the pandemic. Methods: This study analyzes data from the second wave of the International Sexual Health and Reproductive Health study. This included data collected between April 2021 and July 2022 in 8 countries, including Armenia (n=296), Egypt (n=889), Germany (n=138), Moldova (n=311), Nigeria (n=205), Portugal (n=951), Singapore (n=13), and Spain (n=54). This study covered sociodemographics, sexual and reproductive health (SRH), and telemedicine use. Descriptive statistics and multilevel modeling were used to assess the factors influencing the use of telemedicine. Results: Overall, 2857 participants were recruited. Approximately 57.6% (n=1646) of participants had never used telemedicine prior to COVID-19 measures, while 45.9% (n=1311) of participants required health care but reported not using telemedicine services following the introduction of COVID-19 measures. In high-income countries, the most common mode reported was audio-based telemedicine services, with 283 (71.8%) and 417 (73.5%) participants doing so before and during COVID-19, respectively. This was followed by text-based telemedicine services, with 152 (38.6%) and 173 (30.5%) participants doing so before and during COVID-19, respectively. In low- to middle-income countries, many participants also reported using audio-based telemedicine services, with 288 (35.3%) and 237 (40.8%) participants doing so before and during COVID-19, respectively. This was followed by chat-based telemedicine services, with 265 (32.4%) and 217 (37.3%) participants doing so before and during COVID-19, respectively. Multilevel modeling revealed that those who were older (adjusted odds ratio [aOR] 0.99, 95% CI 0.99-1.00) and were in countries with a higher gross domestic product per capita (aOR 0.99, 95% CI 0.98-1.00) were less likely to have ever used telemedicine. Participants who were of male sex assigned at birth (aOR 0.79, 95% CI 0.65-0.96) were less likely to use telemedicine during the pandemic. Participants who perceived that they were worse off financially were more likely to have switched to telemedicine during COVID-19 (aOR 1.39, 95% CI 1.02-1.89) and were more likely to report having a poor or fair experience of telemedicine services (aOR 1.75, 95% CI 1.34-2.29). When sexual orientation was included in the model, nonheterosexual individuals were more likely to ever use telemedicine prior to COVID-19 (aOR 1.35, 95% CI 1.08-1.69), more likely to have used telemedicine during COVID-19 (aOR 1.58, 95% CI 1.24-2.02), and more likely to have switched to telemedicine during COVID-19 (aOR 1.55, 95% CI 1.09-2.21). Conclusions: Telemedicine played a key role in addressing health care needs during the COVID-19 pandemic. Age, sex, economic status, and sexual orientation influenced its use.