Prioritizing Gender-Affirming Care for Youth: The Role of Pediatric-Focused Clinicians.

Gender-affirming care (GAC) acknowledges the right of each individual to live in the gender that is most authentic to them and to receive nonjudgmental, developmentally appropriate care. For transgender and gender-diverse (TGD) individuals, this care may include transition-related care, such as puberty blockers, gender-affirming hormones, and therapies, including surgery. All youth, including TGD youth, deserve confidential, adolescent-friendly care.

Something Has to Give: An Urban Community-Engaged Focus Group Study of Teen Sleep.

Sleep is critical to teen physical and mental health, daily function, and school performance. Yet, sleep deficiency is prevalent among ethnoracially diverse teens. The purpose of this community-engaged focus group study was to explore multilevel influences on teen sleep from teen and community stakeholder perspectives and to use this information to develop a tailored sleep health intervention.

"Here I Don't Feel Like a Stranger": Adolescents' Perspectives on School-Based Health Centers.

This study explored adolescent perspectives on school-based health center (SBHC) services and how services differed from school nurses and community agencies. Six focus groups were conducted with adolescents, 13-19 years old, as part of a larger mixed-methods study. Data were analyzed for themes using content analysis.

Pediatric Nurse Practitioners' Perspectives on Engaging Adolescents to Shift from Pediatric to Adolescent-Focused Health Care Services.

Introduction: This study examined the perspectives of pediatric nurse practitioners (PNPs) on the shift from pediatric to adolescent-focused health care services (HCS). This movement coincides with the early stages of the health care transition process.

Method: Conference attendees (N = 170) participated in a discussion on the shift from pediatric to adolescent-focused HCS.

The Essential Elements of Adolescent-friendly Care in School-based Health Centers: A Mixed Methods Study of the Perspectives of Nurse Practitioners and Adolescents.

Purpose: In this study we identified the essential elements of adolescent-friendly care in school-based health centers (SBHCs) from the perspectives of the nurse practitioners (NPs) providing care to adolescents and the adolescents, as the consumers of these services.

Design And Methods: Complex adaptive systems provided the philosophical and theoretical foundation for this study. An explanatory sequential mixed methods study was conducted.

Pediatric Nurse Practitioners' Perspectives on Health Care Transition From Pediatric to Adult Care.

Introduction: This study examined the perspectives of pediatric nurse practitioners (PNPs) regarding the needs of adolescents, parents/caregivers, clinicians, and institutions in the health care transition (HCT) process for adolescents/young adults.

Methods: PNPs (N = 170) participated in a luncheon for those interested in transition at an annual conference. Small groups discussed and recorded their perspectives related to health care transition from adolescent to adult services.

"Treat Me Like a Normal Person!" A Meta-Ethnography of Adolescents' Expectations of Their Health Care Providers.

Purpose: Preventive health care services provide an important opportunity to assist adolescents to establish and maintain a healthy lifestyle and assume an increasing independent role in their health care. National guidelines emphasize the importance of an annual wellness visit to identify and address risk-behaviors that contribute significantly to the morbidity and mortality in this population. Despite these recommendations, adolescents utilize preventive health care at declining rates throughout adolescence.

"Contraceptive Care for Adolescents in School-Based Health Centers Is Essential!": The Lived Experience of Nurse Practitioners.

Adolescents often face hurdles that may interfere with accessing contraceptive services. School-based health centers (SBHCs) are available to many teens in the United States; however, only half of SBHCs that serve adolescents are permitted to provide contraception. The aim of this descriptive phenomenological study was to describe the lived experience of nurse practitioners (NPs) providing contraceptive care to teens in SBHCs.

What influences adolescents' contraceptive decision-making? A meta-ethnography.

Increased access to and use of contraception has contributed significantly to the decline in teen birth rates since 1991, yet many teens use contraception inconsistently or not at all. This meta-ethnography was conducted to identify the factors that influence adolescents' contraceptive decision-making. Fourteen qualitative studies were examined using G.

Adolescent Balloon Analog Risk Task and Behaviors that Influence Risk of Motor Vehicle Crash Injury.

Risk-taking propensity is a pivotal facet of motor vehicle crash involvement and subsequent traumatic injury in adolescents. Clinical encounters are important opportunities to identify teens with high risk-taking propensity who may later experience serious injury. Our objective was to compare self-reports of health risk behavior with performance on the Balloon Analog Risk Task (BART), a validated metric of risk-taking propensity, in adolescents during a clinical encounter.

The prevalence of HPV associated cervical intraepithelial neoplasia in women under age 21: who will be missed under the new cervical cancer screening guidelines?

Study Objective: To quantify the number of adolescent females < age 21 years with pre-cancerous cervical lesions (cervical intraepithelial neoplasia grade 2 or higher (CIN 2+) or adenocarcinoma in situ (AIS)) in Connecticut in the time period before new cervical screening recommendations went into effect and identify any demographic associations with a diagnosis of CIN 3.

Design: Descriptive analysis, surveillance.

Setting: CIN 2+/AIS precancerous cervical lesions have been reportable conditions in Connecticut since 2008 for the purpose of public health surveillance.

Adolescent-friendly remedies for the challenges of focus group research.

Focus groups are an increasingly popular method of qualitative research; however, as with any research method, limitations emerge that were not anticipated. This article reviewed the limitations reported in 21 research studies, published between 2002 and 2012, to identify the common concerns of researchers in focus group studies with adolescents. Limitations focused on methodological concerns, recruitment challenges, and the potential influences of peers and the moderator on research results.

Tailoring clinical services to address the unique needs of adolescents from the pregnancy test to parenthood.

Clinicians across disciplines and practice settings are likely to encounter adolescents who are at risk for a pregnancy. In 2010, 34.2/1000 15-19-year-old teens had a live birth in the United States, many more will seek care for a pregnancy scare or options counseling.

A clinical guideline for intrauterine device use in adolescents.

Purpose: To present an evidence-based review of the data for and against the use of the intrauterine device (IUD) in adolescent females and to provide guidelines for selection of appropriate candidates.

Data Sources: Clinical research, expert opinions, and systematic reviews of IUD use in adolescents.

Conclusions: The use of the IUD in adolescents has been questioned in the past as a result of concerns surrounding increased risks for pelvic inflammatory disease and infertility in adolescents.

Rethinking school-based health centers as complex adaptive systems: maximizing opportunities for the prevention of teen pregnancy and sexually transmitted infections.

This article examines school-based health centers (SBHCs) as complex adaptive systems, the current gaps that exist in contraceptive access, and the potential to maximize this community resource in teen pregnancy and sexually transmitted infection (STI) prevention efforts. Adolescent pregnancy is a major public health challenge for the United States. Existing community resources need to be considered for their potential to impact teen pregnancy and STI prevention efforts.

Rationale for reducing the spread of human papillomavirus in adolescents: strategies to improve outcomes (CME multimedia activity).

As detailed in this online CME activity (http://cmeaccess.com/cme/JAH_HPV_program/index.asp?link_id=2), human papillomavirus (HPV) infection is the cause of cervical cancer and neoplasias in women, and genital warts in men and women.

Contraceptive services in SBHCs: A community experience in creating change.

School Based Health Centers (SBHCs) are teen-friendly community resources currently underutilized in efforts to prevent teen pregnancy. Much of the decline in the teen birth rate has been attributed to increased access and use of contraception by adolescents. Yet 60% of SBHCs nationwide, which provide health care services to adolescents, are prohibited from prescribing and/or dispensing contraception.

Providing adolescent-friendly HPV education.

Human papillomavirus (HPV) is the most common sexually transmitted infection, affecting more than 6.2 million individuals every year. Most new infections occur in adolescents and young adults shortly after the onset of sexual activity.

Emergency contraception: a primer for pediatric providers.

Emergency contraception (EC) is a contraceptive method used safely and successfully by women for more than 30 years to prevent pregnancy. Nurses at all levels are often the first point of contact for a woman who is requesting EC, thus it is particularly important for them to stay abreast of both the facts regarding the use of this product and the current political controversies. It is particularly important for Nurse Practitioners (NPs) working in primary care with adolescents to remain cognizant of the significant barriers that remain for many women of all ages trying to access this important contraceptive tool.

Reproductive care and rates of pregnancy in teenagers with negative pregnancy test results.

Purpose: The purpose of this study was to follow-up adolescent girls with negative pregnancy tests (NPTs) through an 18-month follow-up analysis of health services received, patterns of contraception use, and pregnancy outcomes.

Method: This study involved a retrospective review of medical records of 129 adolescent patients who had a NPT result from clinical sites in an urban medical center during a 3-month period in 1997. A stratified random sample of participants was selected from adolescents who received care at 2 school-based health centers, a women's health center, and an adolescent health clinic associated with a large academic medical center.

Adolescent girls with negative pregnancy tests.

Unlabelled: STUDY OBJECTIVES AND DESIGN: This descriptive study assessed background characteristics and attitudes about pregnancy held by adolescent girls presenting for pregnancy tests and receiving negative results. An additional aim was to determine types of health care services that would be of perceived benefit to them to reduce their risk of subsequent pregnancy.

Setting: Two health care sites in an urban community included a hospital-based adolescent clinic and a hospital-based women's health care clinic.

Negative pregnancy tests in urban adolescents: an important and often missed opportunity for clinicians.

This study describes a project to determine the incidence of negative pregnancy tests performed in an urban community for teens 18-years old and younger. Pregnancy test logs were kept at a variety of clinical agencies for a three-month period. Five hundred and fifty urine pregnancy tests were performed; 77% were negative.