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.

中文翻译：

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预防性访问期间性健康和生殖健康讨论的相关性：来自美国青少年全国样本的调查结果

目的

本研究调查了医疗保健提供者、提供者和青少年的特征，这些特征与预防性访问期间提供者-青少年关于性健康和生殖健康 (SRH) 的讨论有关。

方法

数据来自 2019 年对美国 11-17 岁青少年及其父母进行的全国互联网调查。在过去 2 年中接受过预防性访问的青少年 (n = 853) 被问及他们的提供者在那次访问中是否讨论了八个 SRH 主题中的每一个：青春期、安全约会、性别认同、性取向、是否发生性行为、性传播的感染，包括人类免疫缺陷病毒、节育方法以及在哪里获得 SRH 服务。检查了八个多变量逻辑回归模型（每个 SRH 主题一个作为结果），每个模型都包括可修改的医疗保健提供和提供者特征、青少年信仰、行为和人口特征作为潜在的相关因素。

结果

在最后一次预防性访问中，提供者与青少年关于 SRH 主题的讨论与所有八个主题的性活动面对面筛查呈正相关（调整后的比值比范围 [AOR] = 3.40-9.61），与青少年独处的时间在那次访问期间（七个主题；AOR = 1.87–3.87），并且曾经与青少年（两个主题；AOR = 1.88–2.19）和父母（一个主题；AOR = 2.73）就保密问题进行过交流。青少年认为与他们的提供者讨论一个话题很重要的看法与提供者-青少年关于七个主题的讨论有关 (AOR = 2.34–5.46)。

结论

预防性访问期间提供者与青少年关于 SRH 的讨论与可修改的做法相关，包括提供者与青少年之间的独处时间和性活动筛查可以为改善初级保健中青少年 SRH 服务的提供提供信息。