Development of a digital decision support tool to facilitate developmentally appropriate adolescent contraceptive counseling in primary care

项目概要/摘要： 避孕咨询是卫生专业人员教育一个人关于他们的健康的过程。 避孕选择，包括疗效，正确使用和副作用，并帮助他们选择最佳的 法然而，在初级保健环境中通常实施的避孕咨询并不 根据青少年独特的性、认知和社会发展而定制， 不理想的使用模式和消极的性健康和生殖健康结果， 影响弱势社区，使健康和经济不利状况的循环永久化。此外，本发明还 青少年，特别是有色人种的青少年，报告说，他们感到被供应商强迫选择并继续使用 长效方法。尽管2000年少女怀孕率和生育率稳步下降， 在过去的二十年里，美国的青少年继续经历不成比例的高怀孕率， 生育率高于其他高收入国家。种族/族裔和性/性别 少数民族青年的意外怀孕和性传播感染率特别高。 青少年怀孕比成年人意外怀孕的可能性要大得多。未成年母亲的子女 出生不良后果、身心健康困难和成为 青少年父母自己。青少年时期第一次生育的人受教育程度较低， 在他们一生中的经济成就。此外，美国青少年的性传播感染率正在上升。没有 及时治疗，性传播感染可能导致严重的终身健康问题，包括癌症，慢性疼痛， 以及成年后的不孕症我们研究的长期目标是为青少年量身定制避孕咨询 经验，以提高避孕满意度，连续性和一致使用，减少 减少强迫经历，减少意外怀孕和性传播感染。在这个项目中，我们将与年轻人合作， 不同种族/民族和性/性别身份，以创建一个数字决策支持工具， 青少年的知识，关注，和偏好的避孕之前访问，然后提供 向提供者提供信息，以促进有针对性的、适合发展的避孕咨询 上网时段具体而言，我们将确定青年认为必要的数字决策工具的功能， 促进他们的避孕决策，并由初级保健临床医生， 在初级保健访问中实施。我们将设计该工具并优化其可用性。该项目将产生 用于支持该工具临床试验的未来R 01应用程序的必要数据。

Project Summary/Abstract: Contraceptive counseling is the process by which a health professional educates a person about their contraceptive options, including efficacy, proper use, and side effects, and helps them choose their optimal method. However, contraceptive counseling as typically implemented in primary care settings is not developmentally tailored to adolescents’ unique sexual, cognitive, and social development, resulting in suboptimal patterns of use and negative sexual and reproductive health outcomes that disproportionately impact vulnerable communities and perpetuate a cycle of health and economic disadvantage. Further, adolescents, particularly youth of color, have reported feeling coerced by providers to choose and continue a long-acting method. Although rates of adolescent pregnancy and childbearing have declined steadily over the past two decades, adolescents in the U.S. continue to experience disproportionately higher pregnancy and childbearing rates than their counterparts in other high-income countries. Racial/ethnic and sexual/gender minority youth have particularly high rates of unintended pregnancy and sexually transmitted infections (STIs). Adolescents’ pregnancies are much more likely than adults’ to be unintended. Children of adolescent mothers are at elevated risk of negative birth outcomes, physical and mental health difficulties, and of becoming teenage parents themselves. Individuals who first give birth as adolescents experience lower educational and economic attainment across their lifetimes. Further, rates STIs are rising among US adolescents. Without timely treatment, STIs can result in serious lifelong health problems, including risks of cancer, chronic pain, and infertility in adulthood. The long-term goal of our research is to tailor adolescents’ contraceptive counseling experience in order to improve contraceptive satisfaction, continuation, and consistent use, reduce experiences of coercion, and reduce unintended pregnancies and STIs. In this project, we will work with youth of diverse racial/ethnic and sexual/gender identities to create a digital decision support tool to assess adolescent knowledge, concerns, and preferences on contraception prior to the visit, then deliver the information to the provider to facilitate a focused, developmentally appropriate contraceptive counseling session. Specifically, we will identify the features of a digital decision tool deemed necessary by youth to facilitate their contraceptive decision making and by primary care clinicians to feasibly and effectively implement in primary care visits. We will design the tool and optimize its usability. This project will yield the necessary data for a future R01 application supporting a clinical trial of the tool.