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Supporting Patient-centered Communication on Adolescent Sexual and Reproductive Health—Perspectives to Build an Appointment Planning Tool - 27/08/21

Doi : 10.1016/j.jpag.2021.04.009 
Marie A. Brault, PhD 1, , Leslie A. Curry, MPH, PhD 2, 3, Trace S. Kershaw, PhD 1, Karen Singh, MPH 1, Alla Vash-Margita, MD, FACOG 4, Deepa R. Camenga, MD, MHS 5
1 Department of Social and Behavioral Sciences, 60 College Street, PO Box 208034, Yale School of Public Health, New Haven, CT, 06520-8034, USA 
2 Global Health Leadership Initiative, 100 Church Street South, Yale School of Public Health, New Haven, CT, 06519, USA 
3 Department of Health Policy and Management, 60 College Street, PO Box 208034, Yale School of Public Health, New Haven, CT, 06520-8034, USA. 
4 Department of Obstetrics, Gynecology, and Reproductive Sciences, Farnham Memorial Building, Yale School of Medicine, New Haven, CT, 06520, USA 
5 Department of Emergency Medicine, 464 Congress Avenue, Suite 260, Yale School of Medicine, New Haven, CT, 06519, USA 

Address correspondence to: Marie A. Brault, Department of Social and Behavioral Sciences, 60 College Street, PO Box 208034, Yale School of Public Health, New Haven, CT 06520-8034, USA. phone: 01-615-584-5699.Department of Social and Behavioral Sciences60 College Street, PO Box 208034, Yale School of Public HealthNew HavenCT06520-8034USA

Abstract

Study Objective: Input from adolescents and healthcare providers is needed to develop electronic tools that can support patient-centered sexual and reproductive (SRH) care. This study explores facilitators and barriers to patient-centered communication in the context of developing an electronic appointment planning tool to promote SRH communication in clinic settings.

Design: In-depth interviews were conducted to explore what constitutes adolescent-friendly SRH care and communication, as well as on the design of the appointment planning tool. Interviews were coded iteratively, and analyzed using the software Atlas.TI v8.

Setting: An adolescent primary care clinic, and a pediatric and adolescent gynecology clinic.

Participants: Adolescent girls (N=32; ages 14-18) and providers who care for adolescent girls (N=10).

Main Outcome Measures: Thematic analyses explored facilitators/barriers to SRH communication and care and preferences for the tool.

Results: Facilitators identified by adolescents and providers included: direct patient/provider communication; adolescent-driven decision-making regarding care and contraceptive choice; supplementing clinic visits with electronic resources; and holistic care addressing physical, mental, and social needs. Barriers identified by participants included: limited time for appointments; limited adolescent autonomy in appointments; and poor continuity of care when adolescents cannot see the same provider. Given the complexity of issues raised, adolescents and providers were interested in developing an appointment planning tool to guide communication during appointments, and contributed input on its design. The resulting Appointment Planning Tool app pilot is in progress.

Conclusions: Qualitative interviews with adolescents and providers offer critical insights for the development and implementation of mobile health (mHealth) tools that can foster patient-centered care.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Adolescent, Sexual and reproductive health, Contraception, Communication, Patient-centered care, mHealth, Qualitative methods


Mappa


 A.V.-M. and D.C. are employees of the Yale School of Medicine and Yale New Haven Hospital. The remaining authors indicate no conflicts of interest.
 Funding: This project was supported by grant number K12HS023000 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.


© 2021  North American Society for Pediatric and Adolescent Gynecology. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 34 - N° 5

P. 725-731 - ottobre 2021 Ritorno al numero
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