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

项目摘要/摘要： 避孕咨询是一个过程，通过这个过程，卫生专业人员教育一个人关于他们的 避孕选择，包括有效性、正确使用和副作用，并帮助他们选择最佳选择 方法。然而，在初级保健环境中通常实施的避孕咨询并不是 为青少年独特的性、认知和社会发展量身定做的发展，导致 不合理的使用模式和不成比例的负面性健康和生殖健康结果 影响脆弱社区，并使健康和经济不利的循环永久化。此外， 青少年，特别是有色人种的年轻人，报告说他们感觉受到了提供者的胁迫，选择并继续 长效法。尽管青少年怀孕率和生育率在过去几年里稳步下降 在过去的20年里，美国的青少年继续经历着不成比例的高怀孕率和 生育率高于其他高收入国家的生育率。种族/民族和性别/性别 少数族裔青年意外怀孕和性传播感染的比率特别高。 青少年怀孕比成年人意外怀孕的可能性要大得多。未成年母亲的孩子 有较高的不良生育结局、身心健康问题和 十几岁的父母自己。青少年时期第一次生育的人受教育程度较低， 在他们的一生中获得经济成就。此外，美国青少年的性传播感染比率正在上升。如果没有 及时治疗，性传播感染可能导致严重的终生健康问题，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做避孕咨询 体验，以提高避孕满意度，持续、一致使用，减少 减少强迫的经历，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 不同的种族/民族和性别/性别认同，以创建一个数字决策支持工具，以评估 在访问之前，青少年对避孕的知识、关注和偏好，然后向他们提供 向提供者提供信息，以促进有重点的、适合发育的避孕咨询 会议。具体地说，我们将确定年轻人认为需要的数字决策工具的功能 促进其避孕决策和初级保健临床医生切实有效地 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。这个项目将产生 未来支持该工具临床试验的R01应用程序所需的数据。

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.