Improving Blood Pressure Accuracy in the Outpatient Adolescent Setting.

Introduction: Hypertension (HTN) is increasing in the pediatric population, and hypertensive children become hypertensive adults. Blood pressure (BP) is often overlooked due to factors including distrust in readings, lack of time in visits, and discomfort prescribing antihypertensive medications. The objective of our multistage, clinically based quality improvement project was to improve BP measurement and HTN diagnosis and intervention in adolescents.

Missed Opportunities for Discussing Contraception in Adolescent Primary Care.

Background: Over half of adolescents are sexually active by age 18 years and represent half of sexually transmitted infections (STI). These individuals often do not obtain routine medical care, so discussing contraception at each visit becomes imperative. Our study objectives were to determine the frequency of visits before contraception was discussed/initiated, and to assess factors affecting primary care contraception provision.

Improving Male Genital Examinations in Adolescent Patients: Creation and Preliminary Validation of an Assessment Tool.

Purpose: Providers cite lack of training and knowledge as reasons for omitting male genitourinary (GU) examinations. Also, no standard tools exist for assessment of male GU exams despite instruments for female pelvic exams. The objective of this project was to create and validate a male GU assessment instrument to evaluate trainee skill level.

An examination of eating disorder education and experience in a 1-month adolescent medicine rotation: what is sufficient to foster adequate self-efficacy?

Objective Medical students and professionals report receiving limited education/training related to treating eating disorders. Because medical professionals are the point of initial contact for these patients and are involved necessarily in their treatment, sufficient knowledge on identification and intervention are imperative. This research set out to examine the impact of the eating disorder education and experience offered through a 1-month Adolescent Medicine rotation at a medical university on medical student/resident self-efficacy.

Religious Affiliation, Religiosity, and Spirituality in Pediatric Residents: Effects on Communication and Self-Efficacy with Adolescents in a Clinical Setting.

Religion and spirituality are known influences on medical providers' care of patients, but no studies have assessed resident beliefs related to patient perception of clinical care. The main objective of our study was to assess resident religious affiliation, religiosity, and spirituality in relation to self-efficacy and communication with patients during adolescent clinic visits. We found that religious affiliation and religiosity appear to affect patient perception of communication with residents during adolescent visits; spirituality had little noted effect.

More like him, me, or us: the impact of trait similarity on adolescent women's sexual risk behaviors in relationships.

Ideal partner traits and how they relate to a young woman's current partner and relationship is a knowledge gap in the literature. The objectives of this study were 1) to assess any differences in interpersonal characteristics between a young woman or her partner and relationship and 2) to examine the impact of this difference on sexual monogamy, condom use and frequency of vaginal sex. Study participants (n=387, 14-17 years at enrollment, 90% African American) were recruited from three primary care adolescent health clinics serving areas with high rates of unintended pregnancy and sexually transmitted infection (STI); data were drawn from a longitudinal cohort study of sexual relationships and behaviors among young women.

Medical student self-efficacy, knowledge and communication in adolescent medicine.

Objective: To evaluate student self-efficacy, knowledge and communication with teen issues and learning activities.

Methods: Data were collected during the 8-week pediatric rotation for third-year medical students at a local children's hospital. Students completed a self-efficacy instrument at the beginning and end of the rotation; knowledge and communication skills were evaluated during standardized patient cases as part of the objective structured clinical examination.

Adolescent health care and the trainee: roles of self-efficacy, standardized patients, and an adolescent medicine rotation.

Purpose: Pediatric residents often cite a lack of confidence with adolescents owing to minimal exposure during training. Self-efficacy has been evaluated in a general context but not in relation to perception of knowledge and communication skill. Study objectives were to evaluate resident self-efficacy during a month-long adolescent rotation and to assess knowledge and communication skills in their relationship to self-efficacy.

Pelvic inflammatory disease in the adolescent: understanding diagnosis and treatment as a health care provider.

Background: Pelvic inflammatory disease (PID) is a common clinical syndrome with highest rates in adolescents, but no studies have singularly focused on this population in relationship to established guidelines for diagnosis and treatment. The study objective was to assess knowledge of diagnosis and treatment criteria for PID within an adolescent population and to compare factors associated with adherence to Centers for Disease Control and Prevention guidelines in outpatient settings.

Methods: Data were collected as part of a retrospective chart review of evaluation, diagnosis, and treatment of sexually transmitted infections in adolescent women in an outpatient setting.

Cervicitis in adolescents: do clinicians understand diagnosis and treatment?

Background: Cervicitis is widespread, but no studies have examined cervicitis in accordance with established guidelines for diagnosis and treatment. Study objectives were to describe adherence to Centers for Disease Control and Prevention guidelines for diagnosis and treatment of cervicitis within an adolescent population and to compare factors associated with adherence to guidelines in a primary care setting and the Emergency Department.

Methods: Data were collected as part of a retrospective chart review of evaluation, diagnosis, and treatment of STI in adolescent women in an outpatient setting.

Limb shaking, vomiting and vitamin D deficiency.

Vitamin D deficiency has been identified as a medical concern for centuries. Often regarded in the context of young children and the elderly, vitamin D deficiency has become a common diagnosis in the adolescent population. Associations with other chronic conditions have not been fully explored, but medical personnel must be acutely aware in order to provide the best care.

Gynecological symptoms and sexual behaviors among adolescent women.

Study Objective: The study sought to expand the minimal understanding of the prevalence of gynecological symptoms, such as vulvovaginal pain, pelvic cramps, and vaginal discharge, and the prevalence of the relationship of symptom duration to event-level sexual behaviors.

Design: Data were daily diaries collected from an ongoing, longitudinal cohort with the three symptom variables

Main Outcome Measures: Symptom duration was calculated, and event-level sexual behaviors were included.

Results: It was reported with relative frequency that single symptoms had positive and negative effects, whereas multiple symptoms and long duration of symptoms decreased the likelihood of all noncoital sexual behaviors.

Contraceptive withdrawal in adolescents: a complex picture of usage.

Study Objective: Contraceptive withdrawal, or coitus interruptus, is a widespread method in adolescents, but factors affecting usage have not been longitudinally investigated. Study objectives were to examine usage numbers of withdrawal among a group of sexually active adolescent females and to investigate the influence of personal, partner, and family factors on usage patterns.

Design/setting/participants: Subjects (N=387; 14 to 17 years at enrollment; 92% African American) were recruited from primary care adolescent health clinics in areas with high rates of pregnancy and sexually transmitted infection.

Patterns of oral contraceptive pill-taking and condom use among adolescent contraceptive pill users.

Purpose: Imperfect oral contraceptive pill (OCP) regimen adherence may impair contraceptive effectiveness. The purpose of this study was to describe daily adherence patterns of OCP use, to analyze OCP protection on an event level basis, and to examine pill-taking and condom use during method transitions.

Methods: Women (n = 123, ages 14-17 years) completed quarterly interviews to classify OCP method choice into four categories: stable, initiated, stopped, and discordant use.