Study Objective: Input from adolescents and healthcare providers is needed to develop electronic tools that can support patient-centered sexual and reproductive (SRH) care. This study explores facilitators and barriers to patient-centered communication in the context of developing an electronic appointment planning tool to promote SRH communication in clinic settings.

Design: In-depth interviews were conducted to explore what constitutes adolescent-friendly SRH care and communication, as well as on the design of the appointment planning tool. Interviews were coded iteratively, and analyzed using the software Atlas.TI v8.

Setting: An adolescent primary care clinic, and a pediatric and adolescent gynecology clinic.

Participants: Adolescent girls (N=32; ages 14-18) and providers who care for adolescent girls (N=10).

Main Outcome Measures: Thematic analyses explored facilitators/barriers to SRH communication and care and preferences for the tool.

Results: Facilitators identified by adolescents and providers included: direct patient/provider communication; adolescent-driven decision-making regarding care and contraceptive choice; supplementing clinic visits with electronic resources; and holistic care addressing physical, mental, and social needs. Barriers identified by participants included: limited time for appointments; limited adolescent autonomy in appointments; and poor continuity of care when adolescents cannot see the same provider. Given the complexity of issues raised, adolescents and providers were interested in developing an appointment planning tool to guide communication during appointments, and contributed input on its design. The resulting Appointment Planning Tool app pilot is in progress.

Conclusions: Qualitative interviews with adolescents and providers offer critical insights for the development and implementation of mobile health (mHealth) tools that can foster patient-centered care.

研究目标：开发电子工具需要青少年和医疗保健提供者的投入，以支持以患者为中心的性与生殖 (SRH) 护理。本研究在开发电子预约计划工具以促进临床环境中 SRH 沟通的背景下，探讨了以患者为中心的沟通的促进因素和障碍。

设计：进行了深入访谈，探讨什么是青少年友好的性健康和生殖健康护理和沟通，以及预约规划工具的设计。访谈被迭代编码，并使用软件 Atlas.TI v8 进行分析。

地点：青少年初级保健诊所以及儿科和青少年妇科诊所。

参与者：青春期女孩（N=32；14-18 岁）和照顾青春期女孩的提供者（N=10）。

主要成果衡量标准：主题分析探讨了性健康与生殖健康沟通和护理的促进因素/障碍以及对该工具的偏好。

结果：青少年和提供者确定的促进者包括：直接患者/提供者沟通；青少年主导的有关护理和避孕选择的决策；用电子资源补充诊所就诊；以及满足身体、心理和社会需求的整体护理。参与者发现的障碍包括： 预约时间有限；青少年在预约方面的自主权有限；当青少年无法见到同一提供者时，护理的连续性较差。鉴于所提出问题的复杂性，青少年和服务提供者有兴趣开发一种预约规划工具来指导预约期间的沟通，并为其设计提供了意见。由此产生的预约计划工具应用程序试点正在进行中。

结论：对青少年和医疗服务提供者的定性访谈为移动医疗 (mHealth) 工具的开发和实施提供了重要的见解，这些工具可以促进以患者为中心的护理。