Provider Perceptions and Practices related to Delivery of Sexual and Reproductive Health Services to Adolescents in Primary Care
PRC researchers Renee Sieving, Annie-Laurie McRee, and Christopher Mehus are co-authors on a recent Pediatrics Academic Societies presentation given by Kristen Kaseeska from the American Academy of Pediatrics, drawing on findings from the Confidential Adolescent Sexual Health Services (CASH) study. The CASH study examines facilitators and barriers to providing confidential sexual and reproductive health (SRH) services to adolescents from adolescents’, parents’ and primary care providers’ perspectives. This particular presentation examines perspectives and practices of primary care clinicians from 30 states regarding delivery of SRH services to adolescents.
This presentation featured findings from an analysis of ten focus groups conducted by the CASH study team with 71 primary care clinicians – family physicians, pediatricians, and nurse practitioners. Focus group discussions explored clinicians’ attitudes and experiences regarding adolescent SRH services and their delivery in primary care, including interactions with adolescents and their families and confidentiality practices.
Sieving noted “clinicians’ approaches to delivery of sexual and reproductive health services during routine adolescent check-ups were guided by discussion topics that they prioritize for that visit, their views on their role in supporting parent-adolescent communication, and their comfort discussing various SRH topics. Clinicians also noted that an adolescent’s physical and emotional readiness, having time alone with the teen, and in some cases an adolescent’s gender, influenced the SRH topics they broached during a routine check-up. Finally, clinicians described characteristics of the clinic system -- like billing and insurance and electronic health records -- as both barriers and potential facilitators to providing confidential SRH services to adolescents.”
“This research is important as it helps to understand why a substantial gap exists between professional guidelines around confidential SRH services for adolescents and real-world practice,” said Sieving. “Findings from this study point out opportunities for additional training about specific SRH topics for providers and clinic staff. Likewise, these findings point to a need to employ a more standard approach to adolescent check-ups so that discussion of sexual and reproductive health topics is not so variable based on individual clinician or patient characteristics,” said Mehus.
McRee commented, “understanding these barriers and facilitators to providing SRH services gives us important information for trainings and resources for clinicians, clinic staff, and parents. If we can create clear protocols for primary care clinicians and clinic staff to use in discussing sexual and reproductive health with adolescents, we can standardize delivery of this component of adolescent preventive care and improve the quality of health care young people receive.”
To access the poster information via the Pediatric Academic Societies Meeting, please click here, and then click on Kristen Kaseeska's name.