Development of a digital decision support tool to facilitate developmentally appropriate adolescent contraceptive counseling in primary care

开发数字决策支持工具，以促进初级保健中适合发育的青少年避孕咨询

• 批准号: 10703409
• 负责人: Julie M Maslowsky
• 金额: $ 20.63万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-12 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10703409
• 关键词: Adolescent; Adolescent Development; Adult; Affect; Age; Area; Behavior; Birth; Caring; Chicago; Child; Clinic; Clinical; Clinical Trials; Coercion; Cognitive; Color; Communities; Contraceptive Agents; Contraceptive methods; Contracts; Counseling; Country; Data; Decision Making; Development; Dimensions; Economics; Education; Educational workshop; Effectiveness; Ethnic Origin; Family Planning; Feedback; Feeling; Focus Groups; Foundations; Future; Gender; Gender Identity; Goals; Hand; Health; Health Personnel; Health Professional; Healthcare; Hormonal; Implant; Income; Individual; Infertility; Information Centers; Intervention; Interview; Intrauterine Devices; Justice; Knowledge; Mental Health; Methodology; Methods; Outcome; Patients; Pattern; Persons; Population; Pregnancy; Pregnancy in Adolescence; Primary Care; Process; Provider; Public Health; Qualitative Research; Race; Recording of previous events; Reporting; Reproductive Health; Research; Research Methodology; Research Personnel; Risk; Risk Behaviors; Sampling; San Francisco; Science; Sexual Development; Sexual Health; Sexual and Gender Minority Youth; Sexuality; Sexually Transmitted Diseases; Social Development; Teenagers; Testing; United States; Visit; Work; Youth; addiction; adolescent sexual health; aged; cancer risk; child bearing; children of color; chronic pain; cognitive development; community burden; condom use rate; condoms; design; digital; digital tool; economic disparity; empowerment; evidence base; executive function; experience; health inequalities; human centered design; improved; individual patient; infection rate; insight; low socioeconomic status; multidisciplinary; novel; patient oriented; physical conditioning; preference; pregnancy prevention; prevent; primary care clinician; primary care provider; primary care setting; primary care visit; racial diversity; reproductive; satisfaction; school based health center; sexually active; side effect; social; support tools; teenage mother; teenage parents; tool; unintended pregnancy; usability; vulnerable community

Project Summary/Abstract: Contraceptive counseling is the process by which a health professional educates a person about their contraceptive options, including efficacy, proper use, and side effects, and helps them choose their optimal method. However, contraceptive counseling as typically implemented in primary care settings is not developmentally tailored to adolescents’ unique sexual, cognitive, and social development, resulting in suboptimal patterns of use and negative sexual and reproductive health outcomes that disproportionately impact vulnerable communities and perpetuate a cycle of health and economic disadvantage. Further, adolescents, particularly youth of color, have reported feeling coerced by providers to choose and continue a long-acting method. Although rates of adolescent pregnancy and childbearing have declined steadily over the past two decades, adolescents in the U.S. continue to experience disproportionately higher pregnancy and childbearing rates than their counterparts in other high-income countries. Racial/ethnic and sexual/gender minority youth have particularly high rates of unintended pregnancy and sexually transmitted infections (STIs). Adolescents’ pregnancies are much more likely than adults’ to be unintended. Children of adolescent mothers are at elevated risk of negative birth outcomes, physical and mental health difficulties, and of becoming teenage parents themselves. Individuals who first give birth as adolescents experience lower educational and economic attainment across their lifetimes. Further, rates STIs are rising among US adolescents. Without timely treatment, STIs can result in serious lifelong health problems, including risks of cancer, chronic pain, and infertility in adulthood. The long-term goal of our research is to tailor adolescents’ contraceptive counseling experience in order to improve contraceptive satisfaction, continuation, and consistent use, reduce experiences of coercion, and reduce unintended pregnancies and STIs. In this project, we will work with youth of diverse racial/ethnic and sexual/gender identities to create a digital decision support tool to assess adolescent knowledge, concerns, and preferences on contraception prior to the visit, then deliver the information to the provider to facilitate a focused, developmentally appropriate contraceptive counseling session. Specifically, we will identify the features of a digital decision tool deemed necessary by youth to facilitate their contraceptive decision making and by primary care clinicians to feasibly and effectively implement in primary care visits. We will design the tool and optimize its usability. This project will yield the necessary data for a future R01 application supporting a clinical trial of the tool.

项目摘要/摘要： 避孕咨询是卫生专业人员对一个人进行教育的过程 避孕选择，包括有效性，适当使用和副作用，并帮助他们选择最佳 方法。但是，在初级保健环境中通常实施的避孕咨询不是 为青少年独特的性，认知和社会发展量身定制的发展，导致 使用的次优模式以及不成比例的性和生殖健康结果 影响脆弱的社区，并使健康和经济灾难的循环永存。此外， 青少年，尤其是有色青年，已经报告说，供应商强迫的感觉并继续 长效方法。尽管青少年怀孕和生育的率在稳步下降 在过去的二十年中，美国的青少年继续经历更高的怀孕和 在其他高收入国家的生育率比其同行。种族/种族和性别/性别 少数族裔青年的怀孕和性传播感染（性传播感染）的率特别高。 青少年的怀孕比成年人更有可能是意想不到的。青春期母亲的孩子 面临负面结果负面结果，身心健康困难的风险较高，并且 十几岁的父母自己。作为青少年首次分娩的个人经历了较低的教育和 一生的经济成就。此外，在美国青少年中，性传播感染正在上升。没有 及时治疗，性传播感染可能导致严重的终身健康问题，包括癌症的风险，慢性疼痛， 和成年的不育症。我们研究的长期目标是量身定制青少年的避孕咨询 经验以提高避孕满意度，延续和一致使用，减少 胁迫的经历，并减少意外怀孕和性传播感染。在这个项目中，我们将与青年合作 各种种族/种族和性/性别身份的认同，以创建数字决策支持工具来评估 访问前的青少年知识，关注和偏好，然后交付 向提供商提供信息，以促进专注的，开发的适当避孕咨询 会议。特别是，我们将确定年轻人认为必要的数字决策工具的特征 促进他们的避孕决策和初级保健临床医生可行有效地 在初级保健访问中实施。我们将设计该工具并优化其可用性。这个项目将产生 未来R01应用程序的必要数据支持该工具的临床试验。