Reproductive Health Counseling Research Articles

Abstract 13983: Reproductive Health Counseling and Experiences Among Females With Congenital Heart Defects: Results From the Congenital Heart Survey to Recognize Outcomes, Needs, and Well-Being

Introduction: The American Heart Association (AHA) recommends clinicians discuss reproductive health with women with congenital heart defects (CHD) beginning in adolescence due to their unique pregnancy and contraceptive needs. Therefore, we assessed reproductive health counseling and experiences among women with CHD, and differences by CHD severity. Methods: Women with CHD ages 19 to 38 years, identified in active, population-based birth defects registries from Arkansas, Arizona, and Atlanta, GA, completed the Congenital Heart Survey To Recognize Outcomes, Needs, and well-beinG (CH STRONG) from 2016 to 2019, including questions about reproductive health counseling, concerns and experiences. Prevalence estimates standardized to all CH STRONG-eligible women and adjusted prevalence ratios (aPR), calculated with multivariable Poisson regression, assessed differences by CHD severity. Results: Of 765 female respondents, 40.7% were 19-24 years, 66.7% were non-Hispanic white, and 67.7% had > high school education. Overall, 21.3% received CHD-specific contraceptive counseling, 28.3% pregnancy counseling, and 12.8% advice to avoid pregnancy (Fig). Women with severe, compared to non-severe CHD, were more likely to receive clinician counseling about safe contraception (aPR=3.0, 95% confidence interval [CI]: 2.2-4.0), pregnancy (aPR=3.5, 95% CI: 2.7-4.6), and advice to avoid pregnancy (aPR=4.3, 95% CI: 2.9-6.5), and they were more likely to be concerned about their ability to have children (aPR=1.4, 95% CI: 1.1-1.8) and delay/avoid pregnancy (aPR=2.2, 95% CI: 1.5-3.2). No differences were seen in ever being pregnant (aPR=0.83, 95% CI: 0.6-1.1). Conclusions: Results suggest most women with CHD are not receiving AHA-recommended reproductive health counseling. Almost one in three women with severe CHD received clinician advice to avoid pregnancy, although AHA guidelines state pregnancy is contraindicated for few women with CHD.

Decision-Making on Contraceptive Use among Women Living with Human Immunodeficiency Virus in Malaysia: A Qualitative Inquiry.

Malaysia is the first country in the Western Pacific Region to receive the validation certificate for the elimination of mother-to-child transmission of human immunodeficiency virus (HIV). The validation report recommends making sexual and reproductive health and rights of women living with HIV a priority. This article explores and assesses the sexual and reproductive health, rights, and access to healthcare services of Malaysia's women living with HIV (WLHIV). A qualitative secondary analysis conducted on 73 WLHIV from all over Malaysia comprised 11 in-depth interviews and 16 focus group discussions. Data were extracted from the original interview transcripts that emerged from the following questions: (1) "What are your experiences as a woman living with HIV in relation to your sexual and reproductive health and rights?" (2) "What are your experiences in accessing contraception?" (3) "What are your day-to-day experiences as a woman living with HIV?" Data were analyzed using thematic analysis. Four themes emerged from the study findings: "lack of negotiation," "idealism in pregnancy," "coping with restrictions," and "past and future fears." The four themes are grounded in religion, a patriarchal culture, meaning and expectations of motherhood, taking risks and going against medical advice to pursue fertility desires, fear of HIV transmission, and the side effects of contraceptive use. The complexities involved in decision-making regarding contraceptive use revealed how WLHIV may have unresolved reproductive health needs inconsistent with healthcare providers' focus on HIV management and prevention. Suggestions are made for improving the sexual and reproductive health and rights of WLHIV in Malaysia, which include establishing a reproductive health counseling program.

Patient and Partner Perspectives of Pregnancy-Related Counseling and Information Needs in Women With Kidney Disease: An Australian National Survey

The experiences and information needs for reproductive health counseling in women with chronic kidney disease (CKD) are poorly defined, despite the known importance of pregnancy planning in this higher-risk cohort. Australian adult women with CKD and their partners or family members completed a consumer codesigned survey about experiences of and preferences for pregnancy-related counseling, support, and education. Data were analyzed descriptively and with qualitative content analysis of free-text responses. Responses were received from 102 women (CKD, n= 60; dialysis, n= 11; transplant, n= 26; unsure, n = 5 ) and 17 partners/family members. Pregnancy-related discussions were initiated mostly by women themselves (60.0%) compared to nephrologists (26.7%), and only after conception in 14.7%. Women found pregnancy-related discussions satisfactory (68.0%) and useful (50.7%) but also stressful (66.7%), with only 54.7% feeling in control of decision-making. Information deficits and quality, preformed decisions, clinician-patient disconnect, and burden of decision-making contributed to usefulness and outcomes of pregnancy-related counseling. Women received insufficient information about contraception (not provided in 35.2% of cases), medication safety (40.9%), fetal complications (33.8%) and emotional and psychological impact of pregnancy (73.2%). Women preferred counseling from nephrologists (86.4%), face-to-face settings (79.6%), websites (72.7%), handouts (61.4%), and online support groups (46.6%). High-quality, multiformat information by content experts, peer support, and psychological support were also strongly desired. This study highlights that preconception counseling and information needs of women with CKD are currently not being met. Frameworks and tools to assist patients and clinicians, particularly nephrologists, to initiate and conduct sensitive, useful, and informed shared decision-making (SDM) about pregnancy are urgently needed.

Empowering Youth: The Role of Reproductive Health Education in Mitigating Adolescent Misbehavior

This research aims to analyze: (1) planning; (2) implementation; and (3) the results of Reproductive Health Counseling to Reduce Adolescent Delinquency Cases in Srikamulyan Village. The method used is qualitative, with research subjects consisting of adolescents, counselors, and the government of Srikamulyan Village. The research location is in Srikamulyan Village. Data were obtained through interviews, observations, and documentary studies. (1) The planning of reproductive health counseling in Srikamulyan Village is highly structured through three stages: (a) pre-counseling: preparation of materials, selection of facilitators, scheduling, socialization, preparation of venue and equipment; (b) counseling; (c) post-counseling: evaluation of results and follow-up. (2) The counseling implementation was successful with 43 active adolescent participants in three main sessions delivered by competent facilitators. (3) The results of the counseling reflect the success of the event with positive feedback from participants and facilitators, motivating participants, and enhancing interaction. Follow-up activities are needed, including ongoing activities and utilizing participant feedback for program improvement.

PENGARUH KONSELING CALON PENGANTIN TERHADAP KEPATUHAN IBU DALAM MELAKUKAN PEMERIKSAAN KEHAMILAN SESUAI STANDAR DI PUSKESMAS BANGGAE I MAJENE

Interventions in reducing maternal mortality rates and infant mortality rates are not only carried out on pregnant women but must begin before pregnancy, namely on the prospective bride and groom by providing communication, information, education and reproductive health counseling as well as examinations for future bride and groom. Pre-marital counseling is a process of providing assistance by a professional to prospective husband and wife before carrying out marriage and providing provisions and instructions so that they can form a happy household life. The results of an initial study at Banggae 1 community Health centers on January-December 2022, 180 future bride and groom were counseled. Where among them who checked the pregnancy according to standards (KI) as many as 102 people, while the rest were not according to standards. This shows that there are still many future bride and groom who do not have standardized pregnancy checks. Based on these problems, the researcher is interested in examining how the influence of counseling of future bride and groom on mother's compliance in standardized prenatal checks. The purpose study is to determine the effect of counseling prospective brides on mother's compliance in standardized prenatal checks at Banggae 1 community Health centers. This study is quantitative method with a cross sectional study approach. It will be carried out in May 2023 with a population of 119 pregnant women who visited to Banggae 1 Majene Community Health Centers on January-April 2023 and sample of 54 people. The results showed that out of 54 respondents, 10 were in the category of respondents who did not receive counseling, while those who received counseling were 44 respondents. The conclusion is that there is an influence of prospective bride and groom counseling on mother's compliance in carrying out standard pregnancy checks at Banggae 1 Majene community Health centers.

Penyuluhan Kesehatan Reproduksi sebagai Upaya Pencegahan Seks Bebas Remaja Desa Gongseng Jombang

This community service activity in the form of adolescent reproductive health counseling aims to provide education about: (1) Health education regarding the effects that can be caused by free sex. (2) Health education regarding the phenomenon of early marriage in Indonesia. (3) Health education regarding the incidence of STDs and HIV/AIDS, ways of handling and efforts that can be made to prevent HIV/AIDS for adolescents. The program's target audience are Posyandu Remaja members consisting of 20 teenagers from the village of Gongseng Megaluh, Jombang. This activity was held on 12 October 2022 at the Gongseng Jombang Village Hall. The approach method used in this activity is the lecture method. Before the seminar starts, the team gives the seminar participants a copy of material on reproductive health in preventing free sex which will be delivered by the resource person. Then, after the delivery of the material, it was followed by a question and answer session to the seminar participants. This seminar activity was carried out as a form of problem solving from the partners. In this counseling, the participants were able to accept and master the material that had been presented, this was proven during the discussion where the participants always gave appropriate answers when asked questions by the presenters both orally and in writing. It is better for future counseling to allocate more time so that the results of the material that has been delivered can be reflected as a whole.

Pendidikan Kesehatan Tentang Reproduksi Remaja Terhadap Pengetahuan dan Sikap pada Siswa SMK Pacet Kabupaten Mojokerto

Adolescent problems regarding sexuality and reproductive health are felt to be increasingly complex and concerning. The increasing cases surrounding adolescent reproduction occur due to the incomprehension of adolescents to various aspects of reproduction related to themselves. The purpose of this study was to determine the effect of adolescent reproductive health counseling on knowledge and attitudes in students of SMK Pacet, Mojokerto Regency. This type of research is an experimental study using Pretest and Posttest (One Group Pretest And Posttest Design). The study population of 320 students was taken as a sample with the Stratified Random Sampling technique of 178 respondents. Univariate and bivariate analysis, non-parametric data distribution with Wilcoxon test. The results of the study were that most respondents had sufficient knowledge about adolescent reproductive health before being given counseling, most respondents had good knowledge about adolescent reproductive health after being given counselling. The results of the Wilcoxon test obtained the results of the Asymp.Sig value. (2- tailed) = 0.000, then it can be concluded that there is a significant influence between the knowledge of students of SMK Pacet Mojokerto Regency towards the intervention provided, namely adolescent reproductive health counseling. Schools can collaborate with several relevant agencies to jointly improve adolescent reproductive health counseling programs, as well as provide facilities and infrastructure such as additional media for student learning facilities such as providing several leaflets related to reproductive health, so that they can be used to increase student knowledge.

Supporting Patient-Centered Pregnancy Counseling in Nephrology Care: A Semistructured Interview Study of Patients and Nephrologists

Individuals with chronic kidney disease (CKD) are at increased risk of adverse pregnancy outcomes and are susceptible to disempowerment and decisional burden when receiving reproductive counseling and considering pregnancy. Nephrologists do not frequently counsel about reproductive health, and no tools exist to support patient-centered reproductive counseling for those with CKD. A total of 30 patients aged 18 to 45 years with CKD stages 1 to 5 who were assigned female sex at birth and 12 nephrologists from a single academic medical center participated in semistructured qualitative interviews. They were asked about information needs, decision support needs, and facilitators and barriers to reproductive health care and counseling. Thematic analysis was performed. The following 4 main themes were identified: (i) assessing reproductive intentions; (ii) information about reproductive health and kidney disease; (iii) reproductive risk; and (iv) communication and decision-making needs. Patients' reproductive intentions varied over time and shaped the content of information needed from nephrologists. Patients and nephrologists both felt that risk communication could be improved but focused on different aspects to improve the quality of this counseling; nephrologists focused on providing individualized risk estimates and patients focused on balancing risks with benefits and management. Patients desired nephrologists to bring up the topic of reproductive health and counseling in kidney clinic, and this is not frequently or systematically done currently. This work highlights a critical need for more dialog about reproductive health in kidney care, identified differences in what patients and nephrologists think is important in communication and decision-making, and provides an important step in developing patient-centered reproductive counseling tools in nephrology.

Contraception and Reproductive Health Counseling: This Is Our Lane.

Contraception and Reproductive Health Counseling: This Is Our Lane.

Influence of Educational Videos on Knowledge and Attitude on Reproduktive Health in Adolescent

Aims: Reproductive health education is essential to improve knowledge and attitude to grow up and live healthily. Audiovisual media as teaching method is considered as effective way to deliver message and material for health topic in teenager. It was reported that 10-14 years-old adolescent in Jakarta has reached 874,865 people in 2020. High populated of adolescent increased higher-risk sexual behavior. Sexual and reproductive education aims to increase knowledge about the anatomy and physiology of the organs and also improve attitude to avoid high-risk sex behavior. Objective: We aim to observe the effect of educational videos on the knowledge and attitudes of adolescents about reproductive health. Method: Quasi-experimental research with pre and post-test without control group. Research sample was 100 students of 231 Junior School Jakarta using systematic random sampling. Intervention was educational videos about healthy sex behavior. Result: We found significantly increased average knowledge (15,91 vs 23,24, p= 0,0001) and attitude (34,12 vs 43,26, p= 0,0001) score after the intervention. Conclusion: There was an significant diffrence of adolescents' knowledge and attitudes about reproductive health after educational video interventions. School and teacher play an active role in reproductive health counseling activities for adolescents with the right media.

Experiences of pregnancy prevention among youth experiencing homelessness

Youth experiencing homelessness (YEH) are at high risk for unintended pregnancy and face unique challenges to effectively preventing unintended pregnancy. This qualitative study explored the pregnancy prevention experiences of YEH. A total of 81 diverse youth participated in eight focus group discussions that were conducted to explore their perceptions and experiences related to pregnancy prevention. Youth were recruited from shelters, drop-in centers, and homeless-serving organizations in a large metropolitan area in the southern United States. Thematic content analysis of the data revealed that YEH struggle to engage in sexual and reproductive health services owing, in part, to limited accessibility. Lack of knowledge about contraceptives, perceived adverse side effects of contraceptives, and challenges with adherence to contraceptive methods significantly limited the effective use of contraception among YEH. Youths’ decisions to use contraception were influenced by their relationship status with partners, perceptions about the efficacy and side effects of contraceptives, and the stigma associated with contraceptive use. Providing sexual and reproductive health services to YEH requires a collaborative approach. YEH need comprehensive sexual and reproductive health education and counseling that enables and empowers youth to access, navigate, and utilize such services.

Between Liberty and Faith: Exploring the Dynamics of Childfree Choices in the Islamic Perspective of Malaysia

This study investigates the childfree lifestyle choice phenomenon in Malaysia, particularly within the framework of Islamic teachings as interpreted in "Tafsir Pedoman Muttaqin". Employing a qualitative approach, this research integrates qualitative analysis of religious texts and interviews with five Malaysian individuals. The study reveals that the decision to pursue a childfree life, influenced by factors such as individual freedom, economic considerations, and personal autonomy, contrasts with the interpretations of Islamic teachings on family and procreation. Key Islamic scriptures, notably QS Al-Baqarah: 187 and Al-Imran 14, underscore the significance of marital relations not solely for physical gratification but also for the purpose of producing righteous progeny. These findings illuminate a marked divergence between contemporary social trends and the traditional Islamic viewpoints on family and procreation in Malaysia. The study makes a significant contribution to academic discourse by presenting a unique perspective on how traditional Islamic interpretations shape attitudes toward contemporary lifestyle choices like childfree living. Additionally, it elucidates the intricate interplay of social, economic, and religious dynamics within Malaysian society. This research offers valuable insights that could inform policies and practices in reproductive health, education, and family counseling.

Pendampingan Peningkatan Kapasitas Kader Posyandu Remaja Uswatun Hasanah Desa Cikunir Wilayah Kerja Puskesmas Singaparna

Introduction: Adolescent Reproductive Health Service is an activity and/or a series of activities aimed at adolescents in the context of maintaining reproductive health.Youth Integrated Service Post (Posyandu) is a form of Community-Based Health Efforts (UKBM) that is managed and organized from, by, for and with the community, including youth, in the implementation of health development, in order to empower the community and provide convenience in obtaining health services for adolescents to improve health status and adolescent healthy life skills. In Cikunir Village, Singaparna District, Tasikmalaya Regency, there is a youth Posyandu which has been running for 2 years. Based on information from youth cadres, there are 3 cadres who are not active. In this regard, it is necessary to recruit new youth cadres and enhance the capacity of youth cadres to increase their role in the implementation of youth posyandu. Objective: The purpose of this service was The purpose of this service was increase the capacity of youth posyandu cadres in managing posyandu.The target of the activity included youth posyandu cadres, prospective youth posyandu cadres from each hamlet and youth posyandu working groups in Cikunir village. Method: This public service was conducted by Observational method. Result: The results of the activity obtained increased knowledge of cadres about adolescent reproductive health counseling materials and increased youth skills in implementing the 5 table posyandu system and examination anthropometry. Conclusion: Cadre assistance is able to improve the knowledge and skills of cadres in the implementation of the Youth Integrated Service Post.

1052-P: Reproductive Health Counseling in the T1D Exchange Quality Improvement Collaborative (T1DX-QI)

Background: Preconception planning can reduce complications in pregnancy with type 1 diabetes. However, high periconception HbA1C is not uncommon and increases maternal and fetal risks. Due to limited data regarding preconception counseling, questions about education and contraception use were added to the 2022 T1DX-QI survey. Methods: The annual T1DX-QI survey was conducted August-September 2022 with a site response rate of 94% of 50 sites: 33 pediatric (66%), 17 adult (34%). Respondents answered questions relating to clinic resources and practices. Response data was cleaned and summarized. Results: Most sites report discussing contraception (74%) and pregnancy planning (72%) once a year or more. Of pediatric sites, 42% report always asking about menstruation history compared to 6% of adult sites. Only 12% of adult and 6% of pediatric sites have a formal preconception counseling protocol. Only 12% of adult and 9% of pediatric sites estimated that >80% of their patients of childbearing potential were using contraception, and all sites estimated that <60% had a HbA1C under 7%. Conclusions: Though most sites report discussing contraception and pregnancy planning, estimated rates of formal counseling programs, contraception use and attaining goal HbA1C remain low. QI efforts are needed to determine rates of preconception counseling and implement best practices to improve pregnancy outcomes. Disclosure G.O'malley: Research Support; Dexcom, Inc., Abbott Diabetes, Tandem Diabetes Care, Inc., Omnipod, Eli Lilly and Company. M.Basina: None. R.Fallurin: None. C.J.Levy: Advisory Panel; Dexcom, Inc., Research Support; Abbott Diabetes, Dexcom, Inc., Insulet Corporation, Tandem Diabetes Care, Inc., T1D Exchange. T1dx-qi collaborative: n/a. S.J.Ogyaadu: None. C.Levister: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc., Abbott Diabetes. N.Rioles: None. H.Hardison: None. A.J.Roberts: None. S.Accacha: None. I.Guttmann-bauman: None. F.Vendrame: Consultant; Eli Lilly and Company. Funding The Leona M. and Harry B. Helmsley Charitable Trust

A retrospective textual analysis of sexual and reproductive health counseling for adolescent and young adult people with epilepsy of gestational capacity

RationaleThe American Academy of Neurology (AAN) recommends annual sexual and reproductive health (SRH) counseling for all people with epilepsy of gestational capacity (PWEGC). Child neurologists report discussing SRH concerns infrequently with adolescents. Limited research exists regarding documentation of such counseling. MethodsWe retrospectively studied clinical notes using natural language processing to investigate child neurologists’ documentation of SRH counseling for adolescent and young adult PWEGC. We segmented notes into sentences and evaluated for references to menstruation, sexual activity, contraception, folic acid, teratogens, and pregnancy. We developed training sets in a labeling application and used machine learning to identify additional counseling instances. We repeated this iteratively until we identified no new relevant sentences. We validated results using external reviewers; after removing sentences reviewers disagreed on (n = 13/400), we calculated Cohen’s kappa values between the model and reviewers (>0.98 for all categories). We evaluated labeled texts for each patient per calendar year with descriptive statistics and logistic regression, adjusting for race/ethnicity, age, and teratogen use. ResultsData comprised 971 PWEGC age 13–21 years with 2277 patient-years and 3663 outpatient child neurology notes. Nearly half of patient-years lacked SRH counseling documentation (49.1%). Among all patients, 38.0% never had SRH counseling documented. Documentation was present regarding menstruation in 26.7% of patient-years, folic acid in 25.0%, contraception in 21.9%, pregnancy in 3.5%, teratogens in 3.0%, and sexual activity in 1.8%. Documentation regarding menstruation and contraception was associated with prescription of antiseizure medications that have a higher risk of teratogenic effects (OR = 1.27, p = 0.020, 95% CI = [1.04,1.54]; OR = 1.27, p = 0.027, 95% CI = [1.03,1.58]). Documentation regarding contraception, folic acid, and sexual activity was increased among older patients (OR = 1.28, p < 0.001, 95% CI = [1.21,1.35]; OR = 1.26, p < 0.001, 95% CI = [1.19,1.32]; OR = 1.26, p = 0.004, 95% CI = [1.08,1.47]). Documentation regarding sexual activity was decreased among patients identifying as White/Non-Hispanic (OR = 0.39, p = 0.007, 95% CI = [0.20,0.78]). ConclusionChild neurologists counsel PWEGC on SRH less frequently than recommended by the AAN based on documentation.

Reproductive Health in Female Bariatric Patients: A National Survey of Bariatric Professionals

Abstract Background A significant proportion of bariatric patients are women of childbearing age. Bariatric patients may be at risk of nutritional and surgical complications that can be impacted by and can impact pregnancy. Aims We aimed to investigate perioperative reproductive health practices, knowledge and recommendations of bariatric professionals regarding reproductive health counseling, contraception and pregnancy in female bariatric patients of reproductive age. Methods We conducted a national, online survey among bariatric professionals. Survey topics included demographic factors, perioperative reproductive health practices, attitudes and knowledge about contraception and recommendations regarding pregnancy. Results A total of 72 healthcare professionals participated. The majority of participants responded that female patients of reproductive age are more than the half of the referred bariatric patients. Only 23 respondents (31.9%) referred always female patients of reproductive age to a gynecologist prior to a bariatric procedure, but 75% always discuss family planning. 51.4% of the participants do not recommend a certain type of bariatric operation in women of reproductive age, but 19 (26.4%) and 9 (12.5%) participants recommend Roux-en-Y gastric bypass and sleeve gastrectomy, respectively. There was a strong variance regarding the recommendations about contraception after surgery. Only 51.4% inform the patients about possible surgical, bariatric surgery-related complications during future pregnancies. More than half of the participants reported inadequate knowledge regarding absorption and safety of contraception pills after bariatric surgery. Although most professionals routinely follow- up and provide counselling on maternal and fetal risks in pregnant women with previous bariatric surgery, 65% have no standardized protocol for such patients who present with acute abdominal pain in their practice. Conclusions Despite acknowledging the importance of reproductive health counseling, bariatric professionals address perioperative and contraception issues inconsistently and mostly reported lack of adequate knowledge in the latter. Therefore, a stronger collaboration between bariatric professionals and women`s healthcare providers is needed to improve care of female bariatric patients in reproductive age.

Peer-to-peer counselling and emotional guidance on infertility in Britain and Belgium (1970s–1980s)

In the wake of sexual and reproductive health counselling in postwar Western Europe, emotional guidance on infertility was as yet neither readily recognised nor available. In this article, we show...

THE EFFECT OF HEALTH EDUCATION ON KNOWLEDGE ABOUT ADOLESCENT REPRODUCTIVE HEALTH IN SMK TAMAN SISWA OF NANGGULAN KULON PROGO

Background: The results of the 2017 Indonesian Demographic and Health Survey (SDKI) on Adolescent Reproductive Health (KRR) stated that adolescent knowledge about reproductive health was inadequate due to a lack of information which led adolescents toward risky behavior, such as having sex freely, which causes the emergence of diseases related to reproduction including Sexually Transmitted Infections (STI), Human Immunodeficiency Virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS). The effort to increase adolescent knowledge is made through adolescent reproductive health counseling with video media.&#x0D; The objective of the Research: To investigate the effect of health education on knowledge about adolescent reproductive health at SMK Taman Siswa Nanggulan.&#x0D; Method: This study used a pre-experimental design with one group pretest-posttest design. The population of this study were all students of class XI at SMK Taman Siswa Nanggulan Kulon Progo with the total of 84 people. The sampling technique using purposive sampling obtained 51 samples. Health education interventions on reproductive health use audiovisual, namely video counseling. Data were collected using a reproductive health knowledge questionnaire. Data were analyzed using the Wilcoxon Signed-Rank Test.&#x0D; Results: The knowledge possessed by respondents before being given health counseling showed that most of them had low knowledge (52.9%), while after being given health counseling, they showed moderate knowledge (58.8%). The results of the Wilcoxon Signed-Rank Test obtained a p-value = 0.001 (p &lt;0.05).&#x0D; Conclusion: There is an effect of health education on knowledge about adolescent reproductive health at SMK Taman Siswa Nanggulan.

Improving Reproductive Health Communication Between Providers and Women Affected by Homelessness and Substance Use in San Francisco: Results from a Community-Informed Workshop

ObjectivesMany cisgender women affected by homelessness and substance use desire pregnancy and parenthood. Provider discomfort with patient-centered counseling about reproductive choices and supporting reproductive decisions of these women poses barriers to reproductive healthcare access.MethodsWe used participatory research methods to develop a half-day workshop for San Francisco-based medical and social service providers to improve reproductive counseling of women experiencing homelessness and/or who use substances. Guided by a stakeholder group comprising cisgender women with lived experience and providers, goals of the workshop included increasing provider empathy, advancing patient-centered reproductive health communication, and eliminating extraneous questions in care settings that perpetuate stigma. We used pre/post surveys to evaluate acceptability and effects of the workshop on participants’ attitudes and confidence in providing reproductive health counseling. We repeated surveys one month post-event to investigate lasting effects.ResultsForty-two San Francisco-based medical and social service providers participated in the workshop. Compared to pre-test, post-test scores indicated reduced biases about: childbearing among unhoused women (p < 0.01), parenting intentions of pregnant women using substances (p = 0.03), and women not using contraception while using substances (p < 0.01). Participants also expressed increased confidence in how and when to discuss reproductive aspirations (p < 0.01) with clients. At one month, 90% of respondents reported the workshop was somewhat or very beneficial to their work, and 65% reported increased awareness of personal biases when working with this patient population.Conclusions for PracticeA half-day workshop increased provider empathy and improved provider confidence in reproductive health counseling of women affected by homelessness and substance use.

Fertility preservation in pediatric leukemia and lymphoma: A report from the Children's Oncology Group.

Certain chemotherapy agents, radiation, and surgery can all negatively impact future fertility. Consults regarding treatment-related risk for infertility and gonadal late effects of these agents should occur at the time of diagnosis as well as during survivorship. Counseling on fertility risk has traditionally varied significantly across providers and institutions. We aim to provide a guide to standardize the assignment of gonadotoxic risk, which can be used in counseling patients both at the time of diagnosis and in survivorship. Gonadotoxic therapies were abstracted from 26 frontline Children's Oncology Group (COG) phase III protocols for leukemia/lymphoma, in use from 2000-2022. A stratification system based on gonadotoxic therapies, sex, and pubertal status was used to assign treatments into minimal, significant, and high level of increased risk for gonadal dysfunction/infertility. Risk levels were assigned to protocols and different treatment arms to aid oncologists and survivor care providers in counseling patients regarding treatment-related gonadotoxicity. Males were most commonly at high risk, with at least one high-risk arm in 14/26 protocols (54%), followed by pubertal females (23% of protocols) and prepubertal females (15% of protocols). All patients who received direct gonadal radiation or hematopoietic stem cell transplant (HSCT) were considered at high risk. Partnering with patients and their oncology/survivorship team is imperative for effective fertility counseling both prior to and post treatment, and this comprehensive guide can be used as a tool to standardize and improve reproductive health counseling in patients undergoing COG-based leukemia/lymphoma care.