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Crespo FA, Clare CA, Verma U. Addressing Teenage Pregnancy and Reproductive Health Among Latinx Adolescents and Young Adults. J Pediatr Adolesc Gynecol 2024:S1083-3188(24)00266-3. [PMID: 39147123 DOI: 10.1016/j.jpag.2024.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 08/17/2024]
Abstract
Despite a national decline in teenage pregnancy rates, Latinxs and Black individuals continue to have higher teenage birth rates compared to white teens. In the United States, Latinx females (ages 15-19) are more than twice as likely to have a teenage birth compared to non-Latinx white teens. With an increasingly diverse nation, a shift towards culturally inclusive approaches to care is critical to achieving equitable patient outcomes. Improving access to preventative care, workforce diversity, and insurance coverage will lead to cost-savings and also help restore trust in a system that has failed past generations. In this commentary, targeted recommendations tailored specifically towards Latinx women will be provided including culturally competent birth control counseling, and a focus on reproductive justice. Not speaking English, low socioeconomic status, acculturation, legal status, and being uninsured are all teenage pregnancy risk factors unique to Latinx women. Cultural preferences and attitudes towards contraception must also be considered. Further expansion of Medicaid insurance coverage is also necessary to increase reproductive access among vulnerable populations. A cultural humility framework to reproductive health counseling and services is recommended. Within this framework family engagement is encouraged and women are free from reproductive coercion; they have the freedom to access over-the-counter contraception and receive guidance and support from providers and community health workers who are cognizant of culture and heritage. An integrated community-based approach that is culturally sensitive and in tune with Latinx heterogenicity is necessary to lower teenage pregnancy rates and achieve reproductive justice.
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Affiliation(s)
- Frank A Crespo
- University of Miami, Jackson Memorial Hospital, Department of Obstetrics & Gynecology, Miami, FL, USA.
| | - Camille A Clare
- Downstate Health Sciences University (DHSU), Department of Obstetrics & Gynecology, DHSU School of Public Health, Brooklyn, NY USA
| | - Usha Verma
- University of Miami, Jackson Memorial Hospital, Department of Obstetrics & Gynecology, Miami, FL, USA
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Seiler N, Horton K, Organick-Lee P, Heyison C, Osei A, Dwyer G, Karacuschansky A, Washington M, Spott A, Pearson WS. Use of Community Health Workers to Help End the Epidemic of Sexually Transmitted Infections. Public Health Rep 2024; 139:271-276. [PMID: 37846078 PMCID: PMC11037233 DOI: 10.1177/00333549231199481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Affiliation(s)
- Naomi Seiler
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Katie Horton
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Paige Organick-Lee
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Claire Heyison
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Alexis Osei
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Gregory Dwyer
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Aaron Karacuschansky
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Mekhi Washington
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Amanda Spott
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - William S. Pearson
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Coleman DC, Frederick A, Cron S, Markham C, Guilamo-Ramos V, Santa Maria D. Impact of preparing nursing students to deliver a parent-based sexual health intervention on attitudes and intentions for sexual health education and parent communication counseling: a mixed methods study. BMC Nurs 2023; 22:375. [PMID: 37817237 PMCID: PMC10563268 DOI: 10.1186/s12912-023-01531-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Nurses are well positioned to promote sexual health but are not adequately prepared in their nursing programs to engage families on this topic and often lack the knowledge and confidence necessary to counsel families about sexual health communication. The purpose of this study was to determine how facilitating a parent-based sexual health intervention would impact nursing students' attitudes and intentions about sexual health education and parent communication counseling. METHODS Using an embedded mixed-methods design, which integrated a quasi-experimental framework, we examined the impact of participation in a parent-based sexual health intervention among 126 baccalaureate nursing students enrolled in a community/public health nursing clinical course. Independent t-tests, chi-squared tests, and the Mann-Whitney U test were used to compare intervention and control groups at baseline. Multiple linear regression was used to compare the groups for pre-post changes. Qualitative content analysis was used to analyze exit interview transcripts. RESULTS We found statistically significant differences in nursing students' confidence to teach sexual health (p = < 0.001), satisfaction with skills as a sexual health educator (p = < 0.001), beliefs about the efficacy of parent-adolescent communication for reducing negative sexual outcomes among adolescents (p = < 0.001), and intentions to counsel parents on sexual health (p = < 0.001), with greater improvements in the intervention group than in the control group. Furthermore, we found statistically significant differences in nursing students' intentions to counsel parents about the HPV vaccine (p = < 0.01) and to endorse the HPV vaccine (p = < 0.05), with greater improvements in the intervention group than in the control group. Across all survey categories, qualitative findings confirmed improvements seen on the pre-post survey. CONCLUSION Providing evidence-based adolescent sexual health training, including sexual health education content and discussion strategies, can prepare nursing students to strongly endorse sexual health communication and HPV vaccination uptake and to counsel parents on initiating and navigating these conversations with their youth. Our project exemplifies how a nursing program could organize an immersive experience, or elective within a specialty area, that aligns with the competency-based approach endorsed by the American Association of Colleges of Nursing. TRIAL REGISTRATION This study was registered with ClinicalTrials.gov (NCT02600884) on 09/01/2015; the first participant was recruited on 09/29/2015.
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Affiliation(s)
- Deidra Carroll Coleman
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit. 1440, Houston, TX, 77030, USA.
| | - Anitra Frederick
- Department of Undergraduate Studies, The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, TX, 77030, USA
| | - Stanley Cron
- Department of Research, The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, TX, 77030, USA
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health, Duke University School of Nursing, Durham, MC, 27710, USA
| | - Diane Santa Maria
- Department of Research, The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, TX, 77030, USA
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Noel L, Chen Q, Petruzzi LJ, Phillips F, Garay R, Valdez C, Aranda MP, Jones B. Interprofessional collaboration between social workers and community health workers to address health and mental health in the United States: A systematised review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6240-e6254. [PMID: 36269094 PMCID: PMC10675993 DOI: 10.1111/hsc.14061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/14/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Collaboration between social workers (SW) and community health workers (CHW) plays an essential role in addressing health inequities in the United States (US). However, little is known about the current state of CHW/SW collaboration. The objectives of this review were to identify (a) the nature, goals and setting of CHWs and SW collaboration; (b) the patient outcomes utilised to measure intervention efficacy. The literature search was conducted in December 2020 using six databases. The inclusion criteria were (1) interventions that included CHWs and SWs; (2) US-based; (3) published between 2000-2020; (4) peer-reviewed journal articles; (5) examining health or mental health outcomes. Search results identified 281 articles, and 15 were included in the final analysis. Settings that utilised SW/CHW collaboration included outpatient clinics (n = 10); community organisations (n = 4) or hospital (n = 1). CHW and SW interventions focused on disease prevention (n = 8), chronic care (n = 4) and mental health (n = 3). Health outcomes were the most evaluated (n = 13), and significant improvement of at least one health outcome was reported in those studies. Mental health outcomes (n = 3) were also significantly improved, while social determinants of health (n = 2) were least common and descriptive only. This is the first review of SW and CHW collaboration. Clarity regarding SW and CHW roles and scopes of practice are needed to understand better SW/CHW collaboration and its impacts on community health outcomes and improve the process of collaboration. SW and CHW collaboration may increase clients' access to preventive care, mental health and address health inequities.
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Affiliation(s)
- Lailea Noel
- Steve Hicks School of Social Work at the University of Texas at Austin, Austin, Texas, USA
| | - Qi Chen
- Steve Hicks School of Social Work at the University of Texas at Austin, Austin, Texas, USA
| | - Liana J. Petruzzi
- Steve Hicks School of Social Work at the University of Texas at Austin, Austin, Texas, USA
| | - Farya Phillips
- Steve Hicks School of Social Work at the University of Texas at Austin, Austin, Texas, USA
- Dell Medical School, Health Social Work, Austin, Texas, USA
| | - Ricardo Garay
- Dell Medical School, Population Health, Austin, Texas, USA
| | - Carmen Valdez
- Steve Hicks School of Social Work at the University of Texas at Austin, Austin, Texas, USA
- Dell Medical School, Population Health, Austin, Texas, USA
| | - María P. Aranda
- University of Southern California Susanne Dworak-Peck School of Social Work, Los Angeles, California, USA
| | - Barbara Jones
- Steve Hicks School of Social Work at the University of Texas at Austin, Austin, Texas, USA
- Dell Medical School, Health Social Work, Austin, Texas, USA
- Dell Medical School, LIVESTRONG Cancer Institutes, Austin, Texas, USA
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Maheen H, Chalmers K, Khaw S, McMichael C. Sexual and reproductive health service utilisation of adolescents and young people from migrant and refugee backgrounds in high-income settings: a qualitative evidence synthesis (QES). Sex Health 2021; 18:283-293. [PMID: 34412768 DOI: 10.1071/sh20112] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 06/01/2021] [Indexed: 11/23/2022]
Abstract
Young people with migrant or refugee backgrounds from low- and middle-income countries settle in high-income countries and tend to underutilise sexual and reproductive health (SRH) services. This review aimed to explore perceptions and experiences of SRH services and the factors that shape their use among migrant youth. It focuses on qualitative studies that examine SRH service use among young migrants living in high-income countries. Seven peer-review databases and web-based grey literature were searched using pre-determined search criteria. The review includes 16 articles that met the inclusion criteria. The qualitative evidence synthesis (QES) method was used to synthesise findings. Thematic analysis resulted in five main themes and 11 sub-themes. Findings suggest that despite diversity of countries of origin and host countries, there were considerable similarities in their perceptions of and experiences with SRH services. Some young migrants reported experiences of discrimination by service providers. Cost of care was a deterrent to SRH service use in countries without universal healthcare coverage. Lack of information about SRH services, concerns about confidentiality, community stigma around sexually transmitted infections and premarital sex were key barriers to SRH service use. Health systems should integrate flexible service delivery options to address access barriers of SRH service use in young migrants. Engagement with parents and communities can help to destigmatise sexual health problems, including STIs. Host countries need to equip young migrants with the knowledge required to make informed SRH decisions and access relevant SRH services and resources.
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Affiliation(s)
- Humaira Maheen
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia; and Corresponding author.
| | - Kate Chalmers
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia
| | - Sarah Khaw
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia
| | - Celia McMichael
- School of Geography Faculty of Science, University of Melbourne, 203 Bouverie Street, Carlton, Vic. 3053, Australia
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