Healthy Youth Development Prevention Research Center

摘要 关键的所有医疗保健服务，保密是特别重要的是在提供性健康服务 (SHS)青少年-一个同时学习使用医疗保健系统的群体， 亲密关系的领域，并与父母重新谈判边界。虽然一个小的文学有 研究了法律的保密保证对青少年医疗保健使用的影响， 父母在促进青少年在使用卫生保健方面的过渡方面的作用。同样， 提供者在帮助青少年协商卫生保健过渡方面的作用还没有得到充分的探讨。拟议 项目（现金：保密的青少年性健康服务）的目的是审查提供保密的 为11-17岁的青少年提供性健康服务。该项目将建立在 明尼苏达大学预防研究中心（UMN PRC; PI筛分）在了解交叉点 青少年发展、卫生保健系统和性健康，并扩大青少年 健康联盟项目（PI Klein和Santelli，与美国儿科学会合作） 目前正在审查提供临床预防服务的私人时间和保密性， 年长的青少年和年轻人。基于我们的集体专业知识，CASH项目将探索 从青少年的角度来看，向青少年提供保密的社会科学及人文科学服务的细微差别和障碍， 父母和供应商。我们会调查私人时间的重要性和保密性的收据 性健康和生殖健康方面的筛查、咨询和服务。目标1将查明障碍 通过与提供者的深入定性访谈，为青少年提供保密的社会科学及人文科学服务， 父母和青少年（11-17岁）在明尼苏达州的四个县。我们将抽样调查24个初级保健机构， 提供者-在城市和农村县工作的儿科医生、家庭医生和执业护士， 在青少年怀孕率较高和较低的地区，以及48组青少年和父母， 供应商的做法。目标2将探讨基层医疗服务提供者观点的区域差异 通过全国抽样的8个焦点小组， 儿科医生、家庭医生和执业护士（n=80名初级保健提供者）。目标3 记录青少年接受适合发育的SHS的流行率（例如，筛查，教育， 咨询和服务，如疫苗、避孕套、避孕和暴露前预防）， 互联网调查（NIS）与青少年/父母二人组（n=1000二人组）的全国概率样本。的NIS 还将探讨高质量社会科学及人文科学服务的态度、动机、障碍和促进因素。拟议的研究将 提出改进青少年社会科学及人文科学服务的建议-包括针对青少年的信息， 以及如何调整卫生保健系统以促进提供高质量的社会科学及人文科学服务。

Abstract Key to all healthcare services, confidentially is particularly important in the delivery of sexual health services (SHS) to adolescents – a group that is simultaneously learning to use healthcare systems, to negotiate the new terrain of intimate relationships, and to renegotiate boundaries with parents. While a small literature has examined the impact of legal guarantees for confidentiality on adolescent healthcare use, little is known about parents’ roles in fostering adolescents’ transitions regarding the use of health care. Likewise, the role of providers in helping adolescents negotiate health care transitions has been poorly explored. The proposed project (CASH: Confidential Adolescent Sexual Health services) aims to examine the provision of confidential sexual health services to adolescents ages 11-17 years. This project would build upon the strengths of the University of Minnesota Prevention Research Center (UMN PRC; PI Sieving) in understanding the intersection of adolescent development, health care systems, and sexual health, and extend the work of the Adolescent Health Consortium project (PIs Klein and Santelli, in collaboration with the American Academy of Pediatrics) which is currently examining private time and confidentiality in the delivery of clinical preventive services to older adolescents and young adults. Grounded in our collective expertise, the CASH project will explore nuances and barriers to provision of confidential SHS to adolescents from the perspectives of adolescents, parents and providers. We would investigate the importance of private time and confidentiality in the receipt of screening, counseling, and services around sexual and reproductive health. Aim 1 would identify barriers and facilitators to confidential SHS for adolescents through in-depth qualitative interviews with providers, parents, and adolescents (11-17 years) in four counties in Minnesota. We would sample 24 primary care providers -- pediatricians, family physicians, and nurse practitioners working in urban and rural counties and in areas with higher and lower rates of adolescent pregnancy, as well as 48 sets of adolescents and parents from providers’ practices. Aim 2 would explore regional variations in perspectives of primary care providers regarding private time, confidentiality, and SHS for adolescents through 8 focus groups with a national sample of pediatricians, family physicians and nurse practitioners (n=80 primary care providers). Aim 3 would document prevalence of adolescents’ receipt of developmentally-appropriate SHS (e.g., screening, education, counseling, and services such as vaccines, condoms, contraception, and pre-exposure prophylaxis) through an internet survey (NIS) with a national probability sample of adolescent/parent dyads (n=1000 dyads). The NIS would also explore attitudes, motivations, barriers and facilitators to quality SHS. The proposed research will result in recommendations for improving delivery of adolescent SHS -- including messages for adolescents, parents, and providers; and ways for restructuring health care systems to facilitate the delivery of quality SHS.