Telehealth for Reproductive Health Services for Economically Disadvantaged Youth.

Purpose: There is a lack of studies describing reproductive health service use and outcomes with telehealth in publicly funded clinics in community settings for economically disadvantaged adolescents and young adults (AYA). This study sought to compare use of reproductive health services before and during the COVID-19 pandemic and analyze the types and quality of reproductive health-care services for patients who did and did not complete a telehealth visit.

Methods: Medical records were reviewed for AYA who sought reproductive health services at 9 urban family planning and school-based clinics.

Adolescents Accessing School-Based versus Family Planning Clinics: Chlamydia and Gonorrhea Testing and Treatment Outcomes.

The prevalence and treatment of chlamydia (CT) and gonorrhea (GC) at school-based clinics (SBCs) requires revisiting. To assess whether clinic type influences CT/GC testing and treatment for minors (individuals 13-17 years of age), our study compared four SBCs with five family planning clinics (FPCs) in the Houston, Harris County metropolitan area of Texas, USA for: (1) the prevalence of CT/GC infection (pre-COVID-19 and during COVID-19); (2) treatment rates at the last positive diagnosis; and (3) the time, in days, from testing-to-diagnosis and testing-to-treatment. Between January 2019 and December 2020, 2439 unique patients (1579 at SBCs, 860 at FPCs) were seen.

Enhancing Parent Consent for School-Based Primary and Reproductive Health Care Among Vulnerable Youth.

This quality-improvement initiative evaluated procedures to increase parental consent for students, 13 to 18+ years old, to access a school-based health clinic that provides primary and reproductive health care in a Hispanic immigrant neighborhood in the U.S. Southwest.

Choice of Postpartum Contraception: Factors Predisposing Pregnant Adolescents to Choose Less Effective Methods Over Long-Acting Reversible Contraception.

Purpose: The purposes were to determine contraceptive methods pregnant adolescents intend to use postpartum and to understand factors that predispose intention to use less effective birth control than long-acting reversible contraception (LARC).

Methods: Participants were 247 pregnant minority adolescents in a prenatal program. Intention was assessed by asking "Which of the following methods of preventing pregnancy do you intend to use after you deliver?" Multinomial logistic regression analysis was used to determine factors associated with intent to use nonhormonal (NH) contraception (male/female condoms, abstinence, withdrawal and no method) or short-/medium-acting hormonal (SMH) contraception (birth control pill, patch, vaginal ring, injectable medroxyprogesterone acetate) compared with LARC (implant and intrauterine device) postpartum.

Evaluation of the professional process portfolio: an innovative tool to help develop and demonstrate leadership competency.

The professional process portfolio (PPP) was adopted by the Maternal Child and Health Bureau (MCHB) as an 'innovation' in best practice for all Leadership in Education and Adolescent Health (LEAH) Training Programs; however it had not been formally evaluated. Thus the objective was to evaluate the utility of the PPP for graduates of the LEAH training program in terms of (1) how alumni have used, adapted, and applied it since completing fellowship, (2) what fellows learned or gained through completing it, and (3) how it can be improved for continued use in training programs. Graduates from six disciplines were asked via telephone or email to participate in a survey regarding their experience with the PPP.

Feasibility of providing sexually transmitted infection testing and treatment in off-campus, nonclinic settings for adolescents enrolled in a school-based research project.

Background: This study examined the acceptability and feasibility of using a biological outcome measure to evaluate a school-based sexuality education program. Confidential field-delivered sexually transmitted infection (STI) testing by nonmedical field staff and STI treatment by medically trained field staff was assessed in off-campus and off-clinic settings for adolescents enrolled in the trial.

Methods: After parental and adolescent consent were obtained, a convenient time and location was identified to collect urine to test for chlamydia (Chlamydia trachomatis, CT), gonorrhea (Neisseria gonorrheae, NG), and trichomonas (Trichomonas vaginalis, TV) infection and to treat students with positive results.

Relationship between health literacy, reading comprehension, and risk for sexually transmitted infections in young women.

We investigated the relationship between health literacy, comprehension of sexually transmitted infection information, and sexual behavior in 127 women aged 16-21 years attending a reproductive health clinic. Women with lower health literacy scores demonstrated lower comprehension of written information related to sexually transmitted infections but did not have greater high-risk sexual behaviors.

Efficacy of a motivational behavioral intervention to promote chlamydia and gonorrhea screening in young women: a randomized controlled trial.

Background: Seeking screening and treatment for chlamydia (CT) and gonorrhea (GC) by young women is critical to reduction of asymptomatic cervicitis and its complications.

Objectives: To evaluate the efficacy of a client-centered motivational behavioral intervention (MBI), to promote seeking of sexually tranmitted infection (STI) checkups by young women.

Methods: Three hundred seventy-six of 770 eligible sexually active, nonpregnant, English-speaking women (mean age 18.

Correlates of consistent condom use with main-new and main-old sexual partners.

An exploratory study identified correlates of consistent condom use for young women reporting Main-new or Main-old partners in the past 3 months: frequency of vaginal sex (across partner types); perceived likelihood of getting a STI (Main-new); age and STI history (Main-old). To enhance programmatic efficacy in community clinics, these key correlates of condom use for main partner types should be incorporated in STI risk reduction counseling.

Young women's perspective of the pros and cons to seeking screening for chlamydia and gonorrhea: an exploratory study.

Study Objective: To identify young women's pros and cons (decisional balance) to seeking chlamydia (CT) and gonorrhea (NGC) screening.

Design: Prospective, cross sectional study

Setting: Community-based reproductive health clinic

Participants: 192 young women (66% African American; mean age 18.9 years).

Enhancing recruitment and retention of minority young women in community-based clinical research.

Women are disproportionately affected by the sexually transmitted infections (STI) epidemic, with African-Americans and Latinos at significantly higher risk for STIs than Caucasians. Successful recruitment and retention strategies used with young minority women in community-based STI prevention or intervention research have not been previously reported. This communication presents eight key strategies learned in the recruitment and retention of 16- to 21-year-old urban women participating in a 12-month randomized clinical trial designed to promote STI screening to decrease the duration of untreated chlamydia and gonorrhea infection.

Pelvic inflammatory disease in adolescents.

Pelvic inflammatory disease (PID) is a polymicrobial infection typically occurring in sexually active females. It occurs when microorganisms ascend from the lower genital tract into the upper genital tract. The clinical presentation varies in severity, with most patients presenting with mild disease.

Pelvic inflammatory disease in adolescents.

Pelvic inflammatory disease (PID) is an infection of the upper female genital tract. It encompasses an array of inflammatory disorders, including endometritis, parametritis, salpingitis, oophoritis, tubo-ovarian abscess, peritonitis, and perihepatitis. In most adolescents with acute severe infections it is difficult to differentiate some of these entities; thus the term PID is used commonly.

Chlamydia and gonorrhea screening in asymptomatic young women.

Background: Adolescent and young adult minority women are at high risk for chlamydia (CT) and gonorrhea (NGC) cervical infections, which are significant causes of pelvic inflammatory disease, impaired fertility, ectopic pregnancy and chronic pain. The purpose of this article is to review among young women in the United States: (1) the epidemiology of CT and NGC cervical infection and their medical complications; (2) current public health recommendations to promote asymptomatic CT and NGC screening; (3) current screening practices and challenges of implementing public health recommendations; (4) testing and cost issues; and (5) future directions in promoting asymptomatic CT and NGC screening.

Methods: We conducted a MEDLINE search for articles published over the last two decades relating to CT and NGC screening in young women and then systematically reviewed all relevant articles.

Gonorrhea and chlamydia screening in sexually active young women: the processes of change.

A pilot study conducted with young women in an urban clinic examined a Transtheoretical Model processes of change measure to better understand strategies and behavioral mechanics that facilitate seeking gonorrhea and chlamydia screening. This information may be useful in developing interventions to improve sexually transmitted infection (STI) screening. Consistent with other studies, greater use of experiential and behavioral processes was associated with the action/maintenance stages for seeking gonorrhea and chlamydia screening.

Neural tube defects: knowledge and preconceptional prevention practices in minority young women.

Objective: To assess 1) knowledge of neural tube defect (NTD) prevention by folic acid, 2) frequency of intake of multivitamins and folate- and folic acid-fortified food, and 3) factors associated with knowledge and prevention practices among sexually active minority adolescent and young adult women.

Methods: Young minority women were enrolled in a folic acid program at 3 urban Houston, Texas, reproductive health clinics and assessed for NTD knowledge and preventive practices. A 3-month supply of multivitamins was also dispensed at enrollment.

Gonorrhea and chlamydia screening among young women: stage of change, decisional balance, and self-efficacy.

Purpose: To assess perceived sexually transmitted disease (STD) (gonorrhea and chlamdydia) screening behaviors among young women at risk for STDs by evaluating readiness, pros and cons, and self-efficacy to seek STD screening in the absence of symptoms.

Methods: Two hundred forty young urban women (mean 18.8 years +/-1.

Learning about pap smears: an educational skit for Hispanic adolescents.

Purpose: To assess the efficacy of an educational skit on improving knowledge and decision making/behavior toward obtaining a Pap smear.

Methods: Ninety-two Hispanic high school female volunteers participated in an intervention, single-sample, preintervention/postintervention survey. Data were collected prior to (T(0)), immediately after (T(1)), and seven weeks after (T(2)) the intervention.

Use of hymenal measurements in the diagnosis of previous penetration.

Objective: To determine the usefulness of measurements of the vaginal opening and amount of hymenal tissue present inferiorly and laterally in the diagnosis of vaginal penetration.

Methods: The transhymenal diameters and the amount of tissue present between the hymenal edge and vestibule inferiorly at 6 o'clock and laterally at 3 o'clock and 9 o'clock were measured from photographs of 189 prepubertal children with a validated history of digital or penile penetration and 197 children who denied previous sexual abuse. Statistical analyses were conducted to compare the mean values and hymenal symmetry between groups as well as to determine the sensitivity and specificity of various cutoff points.