Assessing parenting attitudes among adolescents seeking healthcare with a brief pregnancy and parenting attitudes questionnaire.

Purpose: To use modified Parenthood/Pregnancy Attitude, Timing and How important is pregnancy prevention (PATH) questions to assess parenting attitudes and reproductive desires in adolescents and young adults (AYAs).

Methods: Between November 2020 and January 2022, we recruited participants 13-22 years old via a convenience sample from an Adolescent Medicine outpatient clinic at an urban children's hospital to participate in a cross-sectional survey. The survey was self-administered on a tablet and was adapted from the original PATH questions.

Implementation of Contraception Care for Psychiatrically Hospitalized Adolescents: A Hybrid Type 2 Effectiveness-Implementation Study.

Purpose: To examine the implementation and effectiveness of a contraception care intervention for adolescents hospitalized with psychiatric disorders.

Methods: This prospective, observational, hybrid type 2 effectiveness-implementation study examined the effectiveness of the Contraception Care at the Behavioral Health Pavilion (CC@BHP) intervention in 4 inpatient psychiatric units at a quaternary children's hospital. A multifaceted implementation blueprint guided implementation.

An Exploration of Contraceptive Choice Pathways in Adolescents and Young Adults.

Purpose: To visualize contraceptive choice pathways among adolescent and young adults (AYA) designated female at birth (DFAB) as a means of exploring the relationships between current contraceptive use, desired contraceptive, and ultimately, chosen contraceptive method.

Methods: A retrospective cross-sectional study was conducted of AYA DFAB (N = 2369), aged 14-24 years, presenting for initial visit at a contraceptive clinic with standardized efficacy-based counseling. Sankey diagrams were utilized to visualize patient flow through the contraceptive decision-making process.

Assessing perspectives on an intervention connecting adolescents in outpatient psychiatry care to contraceptive counseling in the United States.

Background: Adolescents with psychiatric disorders have high rates of unintended pregnancy and experience barriers to accessing sexual and reproductive health (SRH) care. Outpatient psychiatry visits are potential opportunities to connect adolescents to SRH care. This study informs the development of the Link2BC intervention which links adolescents in outpatient psychiatry care to SRH care.

Development of an Implementation Blueprint to Scale-Up Contraception Care for Adolescents with Psychiatric Conditions in a Pediatric Hospital.

Implementation blueprints are comprehensive plans that describe implementation strategies, goals, timelines, and key personnel necessary for launching new interventions. Although blueprints are a foundational step in driving intervention rollout, little is known about how blueprints are developed, refined, and used in practice. The objective of this study was to describe a systematic, collaborative approach to developing, refining, and utilizing a formal implementation blueprint for scaling up the Contraception Care at Behavioral Health Pavilion (CC@BHP) intervention for adolescents hospitalized in psychiatric units within a pediatric hospital in the United States.

Bringing Reproductive Health Guidelines Into Fellowship Training: A National Survey of Adult and Pediatric Rheumatology Fellows and Program Directors.

Objective: This study seeks to assess rheumatology fellows' (RFs') and program directors' (PDs') interests in different educational tools and methods and to facilitate curriculum development for reproductive health related to rheumatic disease.

Methods: Constructs were conceptualized in four dimensions: 1) RF and PD confidence in their current curriculum relating to the American College of Rheumatology (ACR) Reproductive Health Guidelines (RHGs), 2) personal interest in this topic, 3) opinions of the importance of this topic, and 4) interest in a range of learning materials and educational experiences. The final survey was distributed to 753 RFs and 179 PDs in the United States using the ACR Committee on Training and Workforce email list.

Increasing Contraceptive Prescriptions in Adolescent Females With Documented Interest in Contraception: A Quality Improvement Project.

Background: Adolescent pregnancy is a significant cause of morbidity and mortality among women and infants. Timely and comprehensive reproductive care in the medical home is essential in preventing unintended adolescent pregnancy.

Methods: This quality improvement (QI) project was completed within the Division of Primary Care Pediatrics at Nationwide Children's Hospital in Columbus, a large pediatric quaternary medical center.

A Pilot Study of Adolescent and Young Adult Experience with Subcutaneous Depot Medroxyprogesterone Acetate.

Study Objective: To describe satisfaction with and preference for subcutaneous depot medroxyprogesterone acetate (DMPA-SC), along with adherence and feasibility, in adolescents and young adults (AYAs) METHODS: Survey of a sample of AYA patients who received DMPA-SC prescription and injection RESULTS: Of 108 eligible patients, 34 completed the survey, and 29 respondents received at least 1 DMPA-SC injection. The mean age was 16.9 years.

Preventing Teen Pregnancies on Teratogenic Drugs by Quality Improvement and Behavioral Economics.

Background: Adolescents with chronic disease engage in sexual activity similar to their healthy peers, with generally low utilization of contraception. Adolescents with rheumatic diseases prescribed teratogenic medications may be at risk for unplanned pregnancy.

Methods: Using structured quality improvement (QI) methods with behavior economic (BE) principles, a multidisciplinary team aimed to implement pregnancy prevention processes for females on high-risk medications.

Society of Family Planning committee consensus on self-administration of subcutaneous depot medroxyprogesterone acetate (DMPA-SC).

Depot medroxyprogesterone acetate (DMPA) is a highly-effective, injectable contraceptive method that requires injections every 12 to 15 weeks. The need for return visits to a healthcare provider may present barriers to access, use, and continuation of DMPA. Studies demonstrate that self-administration of subcutaneous DMPA (DMPA-SC) outside clinical settings is safe, effective, feasible, acceptable, and can improve continuation.

Practice Facilitation Improves Adolescent Reproductive Health Preventive Services in Primary Care.

Objectives: Provision of reproductive health preventive services to adolescents is critical given their high rates of sexually transmitted infections and unintended pregnancies. Pediatricians are well positioned to provide these services but often face barriers. With this project, we aimed to build quality improvement (QI) capacity within pediatric practices to improve adherence to national guidelines for adolescent reproductive health preventive services.

Disparities in HIV Education and Testing Between Metropolitan and Nonmetropolitan Adolescents and Young Adults in the U.S.

Purpose: To examine receipt of formal sexual health education on Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) and receipt of HIV testing in adolescents and young adults (AYAs) residing in nonmetropolitan versus metropolitan areas.

Methods: A secondary data analysis of the 2015-2017 National Survey of Family Growth of AYAs ages 15-24 years (N = 3,114). Logistic regression models predicted associations between nonmetropolitan versus metropolitan status and outcomes of interest (formal sexual health education on HIV/AIDS and HIV testing).

Contraception for Adolescents During the Coronavirus Disease 2019 Pandemic.

Our recent publication, Providing Contraception for Young People During a Pandemic is Essential Healthcare, was written in response to the sudden shift towards low-contact or no-contact medicine in the wake of the COVID-19 pandemic. Ensuring access to contraception is essential as every 6 months of lockdown can result in 47 million women losing access to contraception, resulting in an additional 7 million of unintended pregnancies. We welcome the letters submitted by Alouini/Venslauskaite and Uzoigwe/Ali as they exemplify common misperceptions within the medical community about contraception.

Reproductive health needs of adolescent and young adult women with pediatric rheumatic diseases.

Background: The purpose of this study was to identify reproductive health knowledge gaps and topics that concern adolescent and young adult (AYA) women with pediatric rheumatic diseases and their parents.

Methods: Data collection occurred in two cohorts. In the first cohort, young women (15-20 years old) with pediatric-onset rheumatic conditions and their parents were recruited from a single, academic pediatric rheumatology center.

Best Practices for Counseling Adolescents about the Etonogestrel Implant.

Among young persons, ease of use, high efficacy, and high acceptability makes the etonogestrel contraceptive implant an important choice for this age group. Adolescent-friendly, patient-centered counseling considers the patient's cognitive development, the influence of friends and family, as well as their own preferences and values. Age-appropriate language, graphics, and models are useful to explain contraceptive options and relevant side effects.

Provider Adherence to Preventative Health Care Guidelines in Adolescent Girls Presenting for Well Visit.

A dearth of research exists examining provider adherence to preventative health care guidelines at adolescent well-care visits. We examined adherence in 3 domains: documentation of sexual activity, documentation of menstrual characteristics, and administration of the human papillomavirus vaccine. We identified electronic health records of a random sample of 124 adolescent girls seen within the hospital-affiliated pediatric primary care clinics from July 1, 2014, to June 30, 2015.

Can Pediatricians Provide Long-Acting Reversible Contraception?

Study Objective: In the United States, 40% of high-school students have sex; few use highly effective and safe long-acting reversible contraceptives (LARCs): intrauterine devices and implants. Pediatricians are key health providers for many adolescents, yet few provide LARCs. Our objective was to understand the pragmatics of provision of LARCs (rather than beliefs or attitudes) and identify barriers to and opportunities for LARC provision by community-practicing pediatricians.

A Retrospective Chart Review of Contraceptive Use among Adolescents with Opioid Use Disorder.

Study Objective: To describe contraceptive use among female adolescents initiating outpatient treatment for opioid use disorder.

Design: Retrospective chart review.

Setting: Outpatient clinic providing medication-assisted treatment for substance use disorders to adolescents and young adults.

Video Intervention to Increase Perceived Self-Efficacy for Condom Use in a Randomized Controlled Trial of Female Adolescents.

Study Objective: To assess the effects of the Seventeen Days interactive video on young women's perceived self-efficacy for using condoms 6 months after being offered the intervention, relative to a control.

Design: Multisite randomized controlled trial.

Setting: Twenty participating health clinics and county health departments in Ohio, Pennsylvania, and West Virginia.