Adolescent Health Care Services Research Articles

Correlates of adverse outcomes of adolescent pregnancy in Sidama region, Ethiopia. An unmatched case-control study

IntroductionAdolescent pregnancy has received little attention, despite being it is the leading cause of maternal mortality and morbidity in low-income countries, including Ethiopia. Sidama regional state is one of the regions in Ethiopia that has high rates of adolescent pregnancy. This study aimed to identify factors related to adverse outcomes of adolescent pregnancy, in the Sidama region, Ethiopia. MethodsA hospital-based unmatched case-control study was conducted among 120 cases and 240 controls of pregnant adolescents. Structured interviews and patient record reviews were used to examine the potential correlates and adverse outcomes of adolescent pregnancy. Using binary logistic analysis, adjusted odds ratio (AOR) with 95% confidence intervals, were computed to identify factors related to adverse outcomes of adolescent pregnancies. ResultsA monthly income below the poverty level (AOR: 3.40; 95% CI, 1.21–9.58), lack of antenatal care follow-up (AOR: 4.22; 95% CI, 1.97–9.04), experiencing gender-based violence (AOR: 2.03; 95% CI, 1.16–3.57), and referral to a specialized health facility (AOR: 2.79; 95% CI,1.39, 5.62) were associated with higher odds of adverse pregnancy outcomes. ConclusionSeveral socio-economic and health care system-related determinants are associated with adverse outcomes of adolescent pregnancy. Therefore, it is crucial to improve free and accessible maternal health care services for adolescents, focusing on education, challenging social norms that condone gender-based violence as well as enhancing the referral system to lessen the burden of adverse outcomes of adolescent pregnancy.

Gender lens review of adolescent health care services: a mixed methods study in Bangladesh

Background The application of a gender lens enables the identification of gendered power dynamics that are deeply embedded within structures and institutions. This study delved into a comprehensive analysis of gender norms of male and female adolescents in terms of their health needs, the type of health services offered to them, the barriers and facilitators for utilization of health services at the adolescent-friendly health services (AFHS) across different tiers of government health facilities through a gender lens. Methods The study was conducted at 23 health facilities across four districts of Bangladesh from February 2022 to June 2022. The study design was cross-sectional with a mixed methods approach. A total of 304 adolescents completed the survey, and 28 adolescents participated in in-depth interviews (IDI). Key-informant interviews (KII) were conducted with 48 key stakeholders, including parents, teachers, health service providers, facility managers, and health managers. Quantitative data were analyzed using descriptive statistics, and qualitative data was analyzed using thematic analysis. Results Adolescents have different needs for information about services, types of services provided, and use based on gender. There was a significant association between the marital status of adolescents and the need for different types of health services (P<0.05). Female adolescents receive tetanus-diphtheria (TD) vaccinations and iron folic acid (IFA) tablets, while male adolescents can receive them upon request. TD immunization is common among married female adolescents (14.9%) compared to unmarried female adolescents (11.8%) and unmarried male adolescents (1.1%). Unmarried female adolescents (36.1%) seek help more frequently for menstrual problems, while unmarried male adolescents (24%) are more likely to seek services related to puberty. Parents, teachers, and health service providers have different gendered perceptions of male and female adolescents’ health needs and use of health services. These perceptions contribute to understanding male and female adolescents’ utilization of services. Conclusions This study reveals that gender norms influence adolescents’ health needs, types, and utilization of services. This is probably due to differences in gendered perception of the critical stakeholders for adolescents, who sometimes face barriers in the utilization of health services at the facilities.

Understanding adolescent health care services in Ghana: a scoping review

Understanding adolescent health care services in Ghana: a scoping review

Resilience in Acehnese Teenagers Post Earthquake Disaster

After the earthquake and tsunami in 2004, Aceh Province experienced another earthquake of 6.5 Richter scale hitting Bireuen, Pidie Jaya, and Pidie Districts in December 2016. The disaster had caused some psychological problems in the teenagers living in several boarding schools in these regions. To deal with this, measures should be taken to bring the teenagers’ mental condition back to normal with an effort known as resilience. This study concerned on the resilience of the teenagers studying in the boarding schools of the 2016 earthquake affected areas. The study aimed to investigate the teenagers’ responses who, at the time of the disaster, lived separatedly from the family. The responses could help provided a post-disaster description of resilience in the teenagers. The population of the study included all students at Samalanga Traditional Islamic Boarding School in Bireuen District, Aceh Province. The sample consisted of 301 respondents obtained by using the simple random sampling technique. Data were collected by disseminating the questionnaires. The data were then analyzed by using univariate analysis. The results revealed that the resilience of the teenagers at Samalanga Boarding School was high, reaching 99% (298 people). It is expected that the boarding school continue to optimize their psychological support towards the teenagers by providing the Adolescent Health Care Service and also the Student Health Unit programs. Keywords: earthquake, resilience, youth, Islamic boarding school

Considerations for privacy and confidentiality in adolescent health care service delivery.

A hallmark of delivering quality adolescent health care services is the provision of confidential care. Key tenets when providing confidential care for adolescents include time alone with a health care provider, maintaining the privacy of health information, and securing informed consent for services without permission from a parent, guardian, or caregiver. While confidentiality is a basic principle for all health care encounters regardless of age, the unique considerations for capable adolescent patients are not always realized or appreciated. By ensuring appropriate quantity and quality of confidential care for adolescents, clinicians are better equipped to elicit a comprehensive history and physical examination, while empowering the adolescent involved to develop agency, autonomy, trust, and responsibility for their own health care decision-making and management.

Coding for Adolescent Health Care Services

The problems addressed and types of services provided to adolescent patients often raise questions about coding and billing. This article discusses a few of the topics that frequently result in coding questions. Preventive screening services Counseling and prescription of contraceptives Services to transgender and gender-diverse patients

An Intensive Ambulatory Care Program for Adolescents With Eating Disorders Combining In-Person and Web-Based Care: Protocol for a Single-Site Naturalistic Trial.

The incidence of eating disorders (EDs) among adolescents has significantly increased since the beginning of the COVID-19 pandemic. Hybrid care, which combines web-based and in-person modalities, is a promising approach for adolescents with EDs but remains understudied in this population. We aimed to implement a novel hybrid (web-based and in-person) intensive ambulatory care program for youth and evaluate its feasibility, acceptability, and preliminary effectiveness. We will use a naturalistic pretest-posttest design to evaluate our proposed pilot Intensive Ambulatory Care Program (IACP). This novel type of day hospital care follows evidence-based principles and uses a family-centered, educational, and motivational approach. It will be tailored to the psychological needs of each participant and will be delivered in a hybrid format. A total of 100 participants meeting the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) criteria for EDs, aged 12-18 years, will be recruited over the 2-year trial period. We will examine recruitment, retention, and adhesion-to-protocol rates; participant and family satisfaction; and preliminary effectiveness using quantitative self-report questionnaires. Rolling recruitment will take place from winter 2022 to fall 2023, during which time we expect to recruit approximately 80% (100/120) of eligible participants, retain at least 75% (75/100) of enrolled participants and have at least 70% (70/100) of enrolled participants complete at least one therapeutic session per week and all pre- and postintervention questionnaires. Data collection will occur concurrently. We base our recruitment and retention estimates on previous literature and consider that the highly flexible design of the IACP and the fact that no extra work will be required of individuals in the program to participate in the study, will lead to high levels of feasibility. We anticipate that participants and their families will be satisfied with both the program and hybrid delivery format. We expect that participation in the IACP will be associated with a medium effect size reduction in ED psychopathology from baseline to end of treatment. The data analysis and manuscript writing are expected to be completed by the summer of 2024. Given the high clinical burden associated with EDs, this study has the potential to fill an important research gap by testing the implementation of a novel hybrid mode of intervention. If feasible, acceptable, and effective, the IACP could lead to important improvements in health care services for adolescents with EDs. PRR1-10.2196/37420.

Results of a survey on the treatment of adolescents and young adult (AYA) sarcoma patients in Spain at present time.

We aimed to analyse health care services for adolescents and young adults (AYA) with sarcomas in Spain. A survey was sent to all Spanish cancer centres, including questions about demographic, facilities, and treatment strategies for AYAs with sarcomas in the last 2years. Thirty-five units participated in the survey, 17 paediatric and 15 adult units. There were three specialized AYA units. First line regimen varied depending on whether the treating unit was paediatric or not, for osteosarcomas, rhabdomyosarcomas, and non-rhabdomyosarcomas. By contrast, 91.4% of Ewing sarcomas were treated according to EE2012. In the relapse setting, differences between units were higher in all tumours. Additionally, 48% of the units reported not having trials for this population. There are major differences in the treatment of AYAs with sarcomas between adult and paediatric units. Enormous efforts are needed to homogenize treatments and increase the access to innovation.

ANALISIS DETERMINAN PERILAKU SEKSUAL BERESIKO PADA REMAJA DI SMA LAMPUNG SELATAN TAHUN 2020

Sexual behavior is said to be risky if the behavior brings unwanted consequences such as abortion, pregnancy outside marriage and Sexually Transmitted Diseases (STDs). In 2019 there were 78 cases of pregnancy and childbirth among adolescents in the working area of ​​Candipuro Health Center. This type of research is quantitative. Analytical research design with cross-sectional approach. The population is all high school students grade X, XI, XII in South Lampung Regency as many as 15,259 students. with a sample of 429 respondents. Data analysis used univariate analysis with percentages, bivariate analysis with Chi Square and multivariate analysis with multiple logistic regression. The results showed that there was a relationship between knowledge with at risk sexual behaviorwith p value 0,001,there was a relationship between attitudes with at risk sexual behaviorwith p value 0,000, there was a relationship betweenimformation sources with at risk sexual behavior with p value 0,002, there was a relationship between friends of the same age with at risk sexual behavior with p value 0,000, there was a relationship the role of parents with at risk sexual behavior with p value 0,017. The dominant factor influencing risky sexual behavior in teens in South Lampung High School in 2020 is attitude with OR 12,064. Efforts that can be made to reduce risky sexual behavior in adolescents by increasing knowledge about reproductive health that can be done through adolescent health care service programs (PKPR) in collaboration with puskesmas.

Overview of HIV Risk Reduction Interventions among Adolescents - A Call to Evaluate the HIV Education Curriculum in Nigeria

Background: Adolescence is typically a period of experimentation, new experiences, and vulnerability which influences their HIV risk behaviours. Some may out-grow many risk behaviors, yet prevention efforts are needed to reduce the risk of HIV infection during this period. Knowledge about risk is not sufficient for the prevention of HIV risk behavior. This review examines the existing types of education targeted at reducing HIV risk and their application to adolescents for optimal outcome.
 Methodology: Keywords from objectives of review were used to search for related literatures through online libraries of national and international journals. Out of 60 related studies initially generated, 38 literatures were selected for review.
 Results: School-based health services should ideally be complementary rather than replacement option for the provision of health care services for adolescents. Interventions to improve HIV knowledge and reduce risky sexual behaviour may need to specifically target adolescents. The types of HIV risk reduction education intervention among adolescents is classified into peer-based and health provider-based education. Given the complexity of factors that contribute to risk behavior, prevention efforts that focus exclusively on knowledge are unlikely to be successful. Effective school-based (youth-targeted) HIV prevention programs, which typically rely on principles of social cognitive (Learning) theory could be employed to bridge the gap.
 Conclusion and Recommendations: With this in mind, a comprehensive review of the Family life and HIV education (FLHE) programme in Nigerian secondary schools is long overdue.

Factors Affecting Interests of Adolescent Visit in Poly PKPR (Health Care Service) Public Health Gondang Legi Malang District

A person's interest in services is related to the ability of these service providers to provide care. Interest in adolescents to take advantage of adolescent health care services is influenced by several factors, including perceptions, peers and the role of health workers in the service at puskesmas. The purpose of this study was to analyze the factors that influence the interest of teenage return visits at the PKPR (Youth Caring Health Services) Gondang Legi Health Center in Malang Regency. The design of this study was an observational quantitative study with a cross sectional approach with the focus of the research directed to be analyzing perceptions, the role of peers and the role of health workers on the interest of teenage return visits at the PKPR (Youth Care Health Services) Gondang Legi Public Health Center Malang Regency with a population of 167 respondents and a sample of 113 respondents taken by accidental sampling technique. The findings found that the majority of respondents had less categories of perception as many as 57 respondents (50.4%). In addition, the majority of respondents had the role of less peer categories of 45 respondents (51.3%). In addition, most respondents had the role of health workers in the good category of 59 respondents (52.2%). While the majority of respondents had a high interest category of 62 respondents (54.9%). The results of the study using the Logistic Regression Test showed that a p-value of 0,000 <0.05 then H1 was accepted so it was concluded that there was simultaneously the influence of perception, the role of peers and the role of health workers on the interest of teenage returnees in the PKPR (Youth Care Health Services) ) Gondang Legi Health Center in Malang Regency. The perspective of the patient regarding the available health services raises their perceptions. All friends will make an impact on individuals. And the provision of special services to adolescents through special treatment tailored to the desires, tastes and needs of adolescents has not been implemented

Evaluation of the Quality of Primary Health Care Services for Adolescents With Chronic Illness in Kirkuk City

Background: Providing interventions, and implementing of best-practice care for patients with chronic diseases is of greatest challenges currently facing primary care providers. This study aimed to evaluate the quality of primary health care(PHC)services for adolescents with chronic diseases in Kirkuk city. Methodology: A descriptive (quantitative design) was conducted through (18) primary health care centers (PHCCs) in Kirkuk city. A questionnaires was designed for the purpose of the study. A simple random sample of organization structure PHC services (18) health professional were selected through the use of probability sampling approach. Data were analyzed is performed through the use of descriptive statistical data analysis approach. Results: The overall evaluation of quality of PHC services in Kirkuk city is adequate on (77.7 % : N=14), fair on (16.7 % :N=3) and Inadequate on (5.6%: N=1 ) .Domains such as quality of health service represent high mean of scores on its items, Except on 2 items of Tangibles and on items of Responsiveness 2 on from the quality of PHC are low. Conclusion: The study indicates that the quality of PHC services does not execute impact upon adolescents’ health status. This study depict that the evaluate of the quality of PHC services is adequate relative to all of its dimensions of general health status, tangibles, accreditation, responsiveness, assurance and empathy.

Evaluation of the Quality of Primary Health Care Services for Adolescents With Chronic Illness in Kirkuk City

Evaluation of the Quality of Primary Health Care Services for Adolescents With Chronic Illness in Kirkuk City

Provision of Adolescent Health Care in Resource-Limited Settings: Perceptions and Training Needs of Health Care Workers

Purpose: Adolescent health is increasingly recognized as an important field globally, including in resource-limited settings. However, education around adolescent development and health care needs for health care workers (HCWs) has lagged behind other pediatric training. Other potential barriers to care are HCW attitudes toward adolescents, particularly if HCWs express judgment or condemnation. This mixed method study sought to identify training needs and evaluate the perceptions and attitudes of HCWs regarding adolescent health care services in a rural community in eastern Uganda. Methods: A series …

Needs assessment for gender sensitive reproductive health services for adolescents

Background A dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents. Objective This study aims to assess needs for gender sensitive reproductive health care services for adolescents. Methods This was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21. Results Three hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services. Conclusions Providing gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

Experiences with using an idiographic assessment procedure in primary mental health care services for adolescents

ABSTRACT Purpose: This article aims to explore counsellor experiences using an idiographic assessment procedure implemented in adolescent mental health services. The procedure, Assert, is based on asking the adolescents the question “What matters to you?” to define important topics to address in treatment. Methods: Focus groups and interviews were conducted with counsellors who used Assert (N = 27), and the data were analysed with thematic analysis. Results: Five themes were identified: (a) “What Matters to You?” (b) “Professional Responsibility,” (c) “Empowering the Adolescent,” (d) “Practical Utility of Assert in Treatment,” and (e) “The Implementation of Assert.” Each theme had a number of associated sub-themes. Conclusions: Assert was perceived by the counsellors as enhancing collaboration and conveying to the adolescents that the counsellors took their concerns seriously. It also provided structure by giving the sessions a concrete focus. However, some counsellors found it difficult to surrender control to the adolescents, and finding a balance between helping and directing the adolescents to define topics could be challenging at times. Assert was generally considered a useful and simple way to assess adolescents’ concerns, and it was accepted by the counsellors as a positive contribution to their existing methods.

Organization and content of primary care for adolescents – comparison of actual and desired situation

Abstract To successfully navigate increasing autonomy, independence and health behaviors in adolescence, accessible adolescent health care services (AHS) are essential. AHS comprise all services in primary care that are aimed at the specific needs of adolescents and can be provided in various settings such as public services, private services, schools and hospitals. In the MOCHA project (Models of Child Health Appraised) we assessed the structure and content of AHS in 30 European countries against the standards in the field of adolescent health services: accessibility, staff attitude, communication, staff competency and skills, confidential and continuous care, age appropriate environment, involvement in health care, equity and respect and a strong link with the community. The results revealed that although half of the 30 countries did adopt adolescent-specific policies, many countries did not meet the current standards of quality health care for adolescents. For example, the ability to provide emergency mental health care is limited. In addition, one third of the countries do not have a formal policy which guarantees the confidentiality of a consult and the possibility to consult a physician without parents knowing. Finally, around half of the countries do not have specialized centers in adolescent health care in order to tackle comprehensive health issues. Access to adolescent health care services needs to be improved for vulnerable adolescents such as migrant adolescents. Schools, ambulatory settings and hospitals should offer accessible, comprehensive health care and a culturally appropriate approach, particularly given the number of migrant adolescents living in EU and EEA countries. Finally, the health care systems should improve their communication strategies, to assist young people in understanding their rights and responsibility in the domain of health, and how and where to access to adequate care.

Perceived Body Size and Weight Control Practices of Adolescents in Rural and Urban Communities in South Western Nigeria

Introduction and Objectives: Body size perception has been described as the image of our own shape created in our imagination. Body image perception determines the adolescent engagement in weight control activities, such as bulimia and anorexia. A misperception of body size may lead the adolescent into engagement in weight control activities that may be injurious to adolescent’s health. This study assessed the perceived body size and weight control practices among adolescents in different settings.Methodology: A cross-sectional, multistage cluster sampling method was used to recruit 913 adolescents in Ibadan North Local Government, Ibadan, Nigeria who were interviewed using a semi-structured, self-administered questionnaire. Anthropometric measurements were taken; perceived body size were determine by Stunkard Figure Rating Scale Silhouette. Analysis was done using the Chi-square statistic and p<0.05 level of significance.Results: Over four-fifths (87.4%) of the adolescents wrongly perceived their actual body size. Body size overestimation was reported by both females and males. About 11.3% respondents recorded making an effort to reduce weight whereas, 12.7% recorded they were also involved in gaining weight. Over twice as large urban respondents (14.7%) engaged in weight reduction habits contrast to rural (6.8%). Majority of females with normal weight perceived themselves overweight (l2=50.06, p=0.000). More males were involved in weight gain practise (l2=6.94, p=0.031).Conclusion: The increased frequency of body weight misperceived within rural/urban adolescents and the reported influence and motivation of weight control behaviours, makes adolescent education on assessment of their weight and BMI imperative in adolescent health care services.

Caring for adolescents in Guatemala: provider perspectives.

Purpose Today's generation of adolescents is the largest in history, creating a major challenge for low and middle income countries faced with the necessity of addressing their growing healthcare needs. Our objective was to assess the extent to which health care providers in Guatemala are trained, knowledgeable and feel comfortable providing services to adolescents. Methods A sample of 20 medical providers were recruited from the School of Medicine at San Carlos University and its affiliated hospitals. Providers were interviewed face-to-face for 30-40 min using a semi-structured guide exploring their training, knowledge, skills and experience in adolescent health care. Recruitment continued until thematic saturation was reached. Interviews were recorded and transcribed verbatim, and then analyzed for emergent themes using principles of framework analysis. Results The provider's mean age was 33.7 years [standard deviation (SD) = 10.2]. Most were female (65%) and practiced medicine in a metropolitan location. Results revealed the presence of five major themes: (1) Need for dedicated adolescent health services; (2) Presence of a multitude of barriers to providing adolescent health care; (3) Perceived comfort level in communicating with adolescents; (4) Limited knowledge of current adolescent specific services, programs, and guidelines; and (5) Gaps in medical education and training. Conclusion Providers recognize the need for increased and dedicated adolescent health care services. There is strong support for the creation of a credentialed national adolescent health training program.

Unmet need for healthcare services in adolescents and young adults with cancer and their parent carers.

Cancer in adolescents in and young adults (AYA) has the potential to disrupt health, well-being and developmental trajectories. This study aimed to describe the healthcare support service needs of AYAs with cancer and parent carers and to explore the association of unmet need and emotional distress. As part of a national Australian survey of 15-25year olds with cancer and a nominated parent carer, 196 AYAs reported total and unmet need for 10 clinical services and 204 parents reported on their child's and their own healthcare service needs. Proportions of total and unmet need for specific clinical services are reported. The association of unmet service needs and distress (measured using the Posttraumatic Stress Disorder Checklist) was also examined. AYAs and parent carers expressed high total need for clinical services during treatment. Leading AYA unmet needs were for an exercise therapist (37%), genetic counsellor (30%), dietitian (26%), peer support group (26%) and educational and vocational advisor (24%). After treatment, AYAs and parents had fewer total needs. However, 60% of AYA and 38% of parents had two or more unmet needs, similar to during treatment. Female gender and receiving treatment in an adult setting were significantly associated with unmet need for clinical services. After treatment, higher distress levels in AYAs and parents were associated with two or more unmet service needs. AYAs and parents had high levels of total and unmet service need, which were associated with greater emotional distress. These results highlight opportunities to re-orientate services to better meet AYA and parent needs.