Correlates of Sexual and Reproductive Health Discussions During Preventive Visits: Findings From a National Sample of U.S. Adolescents

Renee E. Sieving; Christopher Mehus; Janna R. Gewirtz O'Brien; Riley J. Steiner; Shuo Wang; Marina Catallozzi; Julie Gorzkowski; Stephanie A. Grilo; Kristen Kaseeska; Annie Laurie McRee; John Santelli; Jonathan D. Klein

doi:10.1016/j.jadohealth.2021.10.013

Correlates of Sexual and Reproductive Health Discussions During Preventive Visits: Findings From a National Sample of U.S. Adolescents

Renee E. Sieving, Christopher Mehus, Janna R. Gewirtz O'Brien, Riley J. Steiner, Shuo Wang, Marina Catallozzi, Julie Gorzkowski, Stephanie A. Grilo, Kristen Kaseeska, Annie Laurie McRee, John Santelli, Jonathan D. Klein

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Abstract

Purpose: This study examines characteristics of healthcare delivery, providers, and adolescents associated with provider-adolescent discussions about sexual and reproductive health (SRH) during preventive visits. Methods: Data were from a 2019 national internet survey of U.S. adolescents ages 11–17 years and their parents. Adolescents who had a preventive visit in the past 2 years (n = 853) were asked whether their provider discussed each of eight SRH topics at that visit: puberty, safe dating, gender identity, sexual orientation, whether or not to have sex, sexually transmitted infections including human immunodeficiency virus, birth control methods, and where to get SRH services. Eight multivariable logistic regression models were examined (one for each SRH topic as the outcome), with each model including modifiable healthcare delivery and provider characteristics, adolescent beliefs, behaviors, and demographic characteristics as potential correlates. Results: Provider-adolescent discussions about SRH topics at the last preventive visit were positively associated with face-to-face screening about sexual activity for all eight topics (range of adjusted odds ratios [AORs] = 3.40–9.61), having time alone with the adolescent during that visit (seven topics; AORs = 1.87–3.87), and ever having communicated about confidentiality with adolescents (two topics; AORs = 1.88–2.19) and with parents (one topic; AOR = 2.73). Adolescents’ perception that a topic was important to discuss with their provider was associated with provider-adolescent discussions about seven topics (AORs = 2.34–5.46). Conclusions: Findings that provider-adolescent discussions about SRH during preventive visits were associated with modifiable practices including time alone between providers and adolescents and screening about sexual activity can inform efforts to improve the delivery of adolescent SRH services within primary care.

Original language	English (US)
Pages (from-to)	421-428
Number of pages	8
Journal	Journal of Adolescent Health
Volume	70
Issue number	3
DOIs	https://doi.org/10.1016/j.jadohealth.2021.10.013
State	Published - Mar 2022

Bibliographical note

Funding Information:
This research was supported by Cooperative Agreement Number (U48DP006414; R. Sieving, PI) funded by the Centers for Disease Control and Prevention , Prevention Research Center Program , and by funds from the Maternal and Child Health Bureau , Health Resources and Services Administration , U.S. Department of Health and Human Services ( T71MC00006 ; R. Sieving, PI). The findings and conclusions of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of these funders.

Publisher Copyright:
© 2021 Society for Adolescent Health and Medicine

Keywords

Adolescent health
Confidentiality
Health services
Primary care
Sexual and reproductive health

PubMed: MeSH publication types

Journal Article
Research Support, U.S. Gov't, P.H.S.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Sieving, R. E., Mehus, C., Gewirtz O'Brien, J. R., Steiner, R. J., Wang, S., Catallozzi, M., Gorzkowski, J., Grilo, S. A., Kaseeska, K., McRee, A. L., Santelli, J., & Klein, J. D. (2022). Correlates of Sexual and Reproductive Health Discussions During Preventive Visits: Findings From a National Sample of U.S. Adolescents. Journal of Adolescent Health, 70(3), 421-428. https://doi.org/10.1016/j.jadohealth.2021.10.013

Sieving, RE, Mehus, C, Gewirtz O'Brien, JR, Steiner, RJ, Wang, S, Catallozzi, M, Gorzkowski, J, Grilo, SA, Kaseeska, K, McRee, AL, Santelli, J & Klein, JD 2022, 'Correlates of Sexual and Reproductive Health Discussions During Preventive Visits: Findings From a National Sample of U.S. Adolescents', Journal of Adolescent Health, vol. 70, no. 3, pp. 421-428. https://doi.org/10.1016/j.jadohealth.2021.10.013

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abstract = "Purpose: This study examines characteristics of healthcare delivery, providers, and adolescents associated with provider-adolescent discussions about sexual and reproductive health (SRH) during preventive visits. Methods: Data were from a 2019 national internet survey of U.S. adolescents ages 11–17 years and their parents. Adolescents who had a preventive visit in the past 2 years (n = 853) were asked whether their provider discussed each of eight SRH topics at that visit: puberty, safe dating, gender identity, sexual orientation, whether or not to have sex, sexually transmitted infections including human immunodeficiency virus, birth control methods, and where to get SRH services. Eight multivariable logistic regression models were examined (one for each SRH topic as the outcome), with each model including modifiable healthcare delivery and provider characteristics, adolescent beliefs, behaviors, and demographic characteristics as potential correlates. Results: Provider-adolescent discussions about SRH topics at the last preventive visit were positively associated with face-to-face screening about sexual activity for all eight topics (range of adjusted odds ratios [AORs] = 3.40–9.61), having time alone with the adolescent during that visit (seven topics; AORs = 1.87–3.87), and ever having communicated about confidentiality with adolescents (two topics; AORs = 1.88–2.19) and with parents (one topic; AOR = 2.73). Adolescents{\textquoteright} perception that a topic was important to discuss with their provider was associated with provider-adolescent discussions about seven topics (AORs = 2.34–5.46). Conclusions: Findings that provider-adolescent discussions about SRH during preventive visits were associated with modifiable practices including time alone between providers and adolescents and screening about sexual activity can inform efforts to improve the delivery of adolescent SRH services within primary care.",

keywords = "Adolescent health, Confidentiality, Health services, Primary care, Sexual and reproductive health",

author = "Sieving, {Renee E.} and Christopher Mehus and {Gewirtz O'Brien}, {Janna R.} and Steiner, {Riley J.} and Shuo Wang and Marina Catallozzi and Julie Gorzkowski and Grilo, {Stephanie A.} and Kristen Kaseeska and McRee, {Annie Laurie} and John Santelli and Klein, {Jonathan D.}",

note = "Funding Information: This research was supported by Cooperative Agreement Number (U48DP006414; R. Sieving, PI) funded by the Centers for Disease Control and Prevention , Prevention Research Center Program , and by funds from the Maternal and Child Health Bureau , Health Resources and Services Administration , U.S. Department of Health and Human Services ( T71MC00006 ; R. Sieving, PI). The findings and conclusions of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of these funders. Publisher Copyright: {\textcopyright} 2021 Society for Adolescent Health and Medicine",

year = "2022",

month = mar,

doi = "10.1016/j.jadohealth.2021.10.013",

language = "English (US)",

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T2 - Findings From a National Sample of U.S. Adolescents

AU - Sieving, Renee E.

AU - Mehus, Christopher

AU - Gewirtz O'Brien, Janna R.

AU - Steiner, Riley J.

AU - Wang, Shuo

AU - Catallozzi, Marina

AU - Gorzkowski, Julie

AU - Grilo, Stephanie A.

AU - Kaseeska, Kristen

AU - McRee, Annie Laurie

AU - Santelli, John

AU - Klein, Jonathan D.

N1 - Funding Information: This research was supported by Cooperative Agreement Number (U48DP006414; R. Sieving, PI) funded by the Centers for Disease Control and Prevention , Prevention Research Center Program , and by funds from the Maternal and Child Health Bureau , Health Resources and Services Administration , U.S. Department of Health and Human Services ( T71MC00006 ; R. Sieving, PI). The findings and conclusions of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of these funders. Publisher Copyright: © 2021 Society for Adolescent Health and Medicine

PY - 2022/3

Y1 - 2022/3

N2 - Purpose: This study examines characteristics of healthcare delivery, providers, and adolescents associated with provider-adolescent discussions about sexual and reproductive health (SRH) during preventive visits. Methods: Data were from a 2019 national internet survey of U.S. adolescents ages 11–17 years and their parents. Adolescents who had a preventive visit in the past 2 years (n = 853) were asked whether their provider discussed each of eight SRH topics at that visit: puberty, safe dating, gender identity, sexual orientation, whether or not to have sex, sexually transmitted infections including human immunodeficiency virus, birth control methods, and where to get SRH services. Eight multivariable logistic regression models were examined (one for each SRH topic as the outcome), with each model including modifiable healthcare delivery and provider characteristics, adolescent beliefs, behaviors, and demographic characteristics as potential correlates. Results: Provider-adolescent discussions about SRH topics at the last preventive visit were positively associated with face-to-face screening about sexual activity for all eight topics (range of adjusted odds ratios [AORs] = 3.40–9.61), having time alone with the adolescent during that visit (seven topics; AORs = 1.87–3.87), and ever having communicated about confidentiality with adolescents (two topics; AORs = 1.88–2.19) and with parents (one topic; AOR = 2.73). Adolescents’ perception that a topic was important to discuss with their provider was associated with provider-adolescent discussions about seven topics (AORs = 2.34–5.46). Conclusions: Findings that provider-adolescent discussions about SRH during preventive visits were associated with modifiable practices including time alone between providers and adolescents and screening about sexual activity can inform efforts to improve the delivery of adolescent SRH services within primary care.

AB - Purpose: This study examines characteristics of healthcare delivery, providers, and adolescents associated with provider-adolescent discussions about sexual and reproductive health (SRH) during preventive visits. Methods: Data were from a 2019 national internet survey of U.S. adolescents ages 11–17 years and their parents. Adolescents who had a preventive visit in the past 2 years (n = 853) were asked whether their provider discussed each of eight SRH topics at that visit: puberty, safe dating, gender identity, sexual orientation, whether or not to have sex, sexually transmitted infections including human immunodeficiency virus, birth control methods, and where to get SRH services. Eight multivariable logistic regression models were examined (one for each SRH topic as the outcome), with each model including modifiable healthcare delivery and provider characteristics, adolescent beliefs, behaviors, and demographic characteristics as potential correlates. Results: Provider-adolescent discussions about SRH topics at the last preventive visit were positively associated with face-to-face screening about sexual activity for all eight topics (range of adjusted odds ratios [AORs] = 3.40–9.61), having time alone with the adolescent during that visit (seven topics; AORs = 1.87–3.87), and ever having communicated about confidentiality with adolescents (two topics; AORs = 1.88–2.19) and with parents (one topic; AOR = 2.73). Adolescents’ perception that a topic was important to discuss with their provider was associated with provider-adolescent discussions about seven topics (AORs = 2.34–5.46). Conclusions: Findings that provider-adolescent discussions about SRH during preventive visits were associated with modifiable practices including time alone between providers and adolescents and screening about sexual activity can inform efforts to improve the delivery of adolescent SRH services within primary care.

KW - Adolescent health

KW - Confidentiality

KW - Health services

KW - Primary care

KW - Sexual and reproductive health

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Correlates of Sexual and Reproductive Health Discussions During Preventive Visits: Findings From a National Sample of U.S. Adolescents

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

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