1
|
Silva MA, Añez LM, Carroll KM, Jaramillo Y, Kiluk BD, Frankforter T, Ball SA, Gordon MA, Paris M. Computer-based training for cognitive behavioral therapy for Spanish-speaking substance users: adaptation and satisfaction. J Ethn Subst Abuse 2024; 23:251-271. [PMID: 35714996 PMCID: PMC10350903 DOI: 10.1080/15332640.2022.2086194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There are few available culturally and linguistically adapted behavioral health interventions for substance use among Spanish-speaking adults. The authors describe the cultural adaptation of an innovative computer-based training for cognitive behavioral therapy program (CBT4CBT). Based in cognitive-behavioral skills training, CBT4CBT utilizes a telenovela to teach monolingual Spanish-speaking adults who have migrated to the United States to recognize triggers; avoid these situations; and cope more effectively with the consequences of substance use. Participants endorsed high levels of satisfaction with the program content and found the material to be easy to understand and relevant to their life experiences.
Collapse
Affiliation(s)
- Michelle A Silva
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Luis M Añez
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Kathleen M Carroll
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Yudilyn Jaramillo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Brian D Kiluk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Tami Frankforter
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Samuel A Ball
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Melissa A Gordon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Manuel Paris
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| |
Collapse
|
2
|
Martín-Payo R, Gonzalez-Mendez X, Carrasco-Santos S, Muñoz-Mancisidor A, Papin-Cano C, Fernandez-Alvarez MDM. Assessment of content, behavior change techniques, and quality of unintended pregnancy apps in Spain: Systematic search on app stores. Digit Health 2023; 9:20552076231173563. [PMID: 37197412 PMCID: PMC10184260 DOI: 10.1177/20552076231173563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 04/17/2023] [Indexed: 05/19/2023] Open
Abstract
Objective Unintended pregnancies are a public health problem that represents 48% of global pregnancies. Despite the proliferation of smartphones there is limited data on the app's features on unintended pregnancy. The purpose of this research was to identify free apps available in Spanish, in the iOS Store and Google Play, which can be recommended to prevent unintended pregnancies in adolescents. Methods A systematic search to identify apps was performed in the iOS App Store and in Google Play aiming to replicate the way a patient might access an "unintended pregnancy prevention" app. Additionally, the quality, using the Mobile Application Rating Scale, and content were assessed. Results A total of 4614 apps were identified, of which 8 were retrieved for assessment (0.17%). The mean for objective and subject quality was 3.39 (standard deviation (SD) = 0.694) and 1.84 (SD = 0.626), respectively. A total of 16 thematic categories were identified. The mean of topics covered in the apps was 5.38 (SD = 2.925) being those related to contraception the more frequent. Conclusion The results of the present study suggest that only a small percentage of free pregnancy prevention apps in Spanish should be recommended. The contents of the apps retrieved meet the potential necessities of adolescents.
Collapse
Affiliation(s)
- Rubén Martín-Payo
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Avilés, Spain
| | - Xana Gonzalez-Mendez
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
- Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Avilés, Spain
| | - Sergio Carrasco-Santos
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Avilés, Spain
| | - Aranzazu Muñoz-Mancisidor
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Avilés, Spain
| | - Cristina Papin-Cano
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Avilés, Spain
| | - María del Mar Fernandez-Alvarez
- Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Spain
- PRECAM Research Group, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Área Sanitaria 3, Servicio de Salud del Principado de Asturias, Avilés, Spain
| |
Collapse
|
3
|
Bailey JE, Gurgol C, Pan E, Njie S, Emmett S, Gatwood J, Gauthier L, Rosas LG, Kearney SM, Robler SK, Lawrence RH, Margolis KL, Osunkwo I, Wilfley D, Shah VO. Early Patient-Centered Outcomes Research Experience With the Use of Telehealth to Address Disparities: Scoping Review. J Med Internet Res 2021; 23:e28503. [PMID: 34878986 PMCID: PMC8693194 DOI: 10.2196/28503] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/04/2021] [Accepted: 10/03/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Health systems and providers across America are increasingly employing telehealth technologies to better serve medically underserved low-income, minority, and rural populations at the highest risk for health disparities. The Patient-Centered Outcomes Research Institute (PCORI) has invested US $386 million in comparative effectiveness research in telehealth, yet little is known about the key early lessons garnered from this research regarding the best practices in using telehealth to address disparities. OBJECTIVE This paper describes preliminary lessons from the body of research using study findings and case studies drawn from PCORI seminal patient-centered outcomes research (PCOR) initiatives. The primary purpose was to identify common barriers and facilitators to implementing telehealth technologies in populations at risk for disparities. METHODS A systematic scoping review of telehealth studies addressing disparities was performed. It was guided by the Arksey and O'Malley Scoping Review Framework and focused on PCORI's active portfolio of telehealth studies and key PCOR identified by study investigators. We drew on this broad literature using illustrative examples from early PCOR experience and published literature to assess barriers and facilitators to implementing telehealth in populations at risk for disparities, using the active implementation framework to extract data. Major themes regarding how telehealth interventions can overcome barriers to telehealth adoption and implementation were identified through this review using an iterative Delphi process to achieve consensus among the PCORI investigators participating in the study. RESULTS PCORI has funded 89 comparative effectiveness studies in telehealth, of which 41 assessed the use of telehealth to improve outcomes for populations at risk for health disparities. These 41 studies employed various overlapping modalities including mobile devices (29/41, 71%), web-based interventions (30/41, 73%), real-time videoconferencing (15/41, 37%), remote patient monitoring (8/41, 20%), and store-and-forward (ie, asynchronous electronic transmission) interventions (4/41, 10%). The studies targeted one or more of PCORI's priority populations, including racial and ethnic minorities (31/41, 41%), people living in rural areas, and those with low income/low socioeconomic status, low health literacy, or disabilities. Major themes identified across these studies included the importance of patient-centered design, cultural tailoring of telehealth solutions, delivering telehealth through trusted intermediaries, partnering with payers to expand telehealth reimbursement, and ensuring confidential sharing of private information. CONCLUSIONS Early PCOR evidence suggests that the most effective health system- and provider-level telehealth implementation solutions to address disparities employ patient-centered and culturally tailored telehealth solutions whose development is actively guided by the patients themselves to meet the needs of specific communities and populations. Further, this evidence shows that the best practices in telehealth implementation include delivery of telehealth through trusted intermediaries, close partnership with payers to facilitate reimbursement and sustainability, and safeguards to ensure patient-guided confidential sharing of personal health information.
Collapse
Affiliation(s)
- James E Bailey
- Tennessee Population Health Consortium, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Cathy Gurgol
- Patient-Centered Outcomes Research Institute, Washington, DC, United States
| | - Eric Pan
- Westat Inc, Center for Healthcare Delivery Research and Evaluation, Rockville, MD, United States
| | - Shirilyn Njie
- Westat Inc, Center for Healthcare Delivery Research and Evaluation, Rockville, MD, United States
| | - Susan Emmett
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Duke Global Health Institute, Durham, NC, United States
| | - Justin Gatwood
- College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Lynne Gauthier
- Department of Physical Therapy and Kinesiology, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, MA, United States
| | - Lisa G Rosas
- Department of Epidemiology and Population Health, Division of Primary Care and Population Health, Stanford School of Medicine, Palo Alto, CA, United States
- Department of Medicine, Division of Primary Care and Population Health, Stanford School of Medicine, Palo Alto, CA, United States
| | - Shannon M Kearney
- Solution Insights & Validation, Highmark Health, Pittsburgh, PA, United States
| | | | - Raymona H Lawrence
- Community Health Behavior and Education, Jiann-Ping College of Public Health, Georgia Southern University, Statesboro, GA, United States
| | | | - Ifeyinwa Osunkwo
- Cancer Care, Levine Cancer Institute, Atrium Health, Charlotte, NC, United States
| | - Denise Wilfley
- Department of Psychiatry, College of Medicine, Washington University in St. Louis, St Louis, MO, United States
| | - Vallabh O Shah
- Department of Internal Medicine and Biochemistry, School of Medicine, University of New Mexico, Albuquerque, NM, United States
| |
Collapse
|
4
|
Garnett C, Pollack L, Rodriguez F, Renteria R, Puffer M, Tebb KP. The Association Between Nonbarrier Contraceptive Use and Condom Use Among Sexually Active Latina Adolescents. J Adolesc Health 2021; 68:985-990. [PMID: 32933838 DOI: 10.1016/j.jadohealth.2020.07.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/22/2020] [Accepted: 07/29/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study aimed to determine the association between use of highly effective methods of nonbarrier contraception and condom use in a sample of Latina adolescents and whether the change to a more effective method of nonbarrier contraception is associated with a change in condom use. METHODS As part of a larger study, 442 sexually active Latina adolescents aged 14-18 years were surveyed immediately before an appointment with a medical care provider at a school-based health center and 3 months later. Ordinal logistic and linear regression were used in the analysis of cross-sectional and longitudinal data to assess the relationship between patterns of nonbarrier contraception and condom use. RESULTS The use of all types of nonbarrier methods of contraception was significantly associated with decreased condom use. Change over time from a less effective to a more effective nonbarrier method of contraception was also associated with a decrease in condom use. Greater number of sexual encounters was associated with lower the frequency of condom use. CONCLUSIONS The use of highly effective methods of nonbarrier contraception was associated with reduced frequency of condom use. This highlights the need to promote condom use concurrently with nonbarrier methods of contraception to improve protection against both pregnancy and STIs.
Collapse
Affiliation(s)
- Chelsea Garnett
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California.
| | - Lance Pollack
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Felicia Rodriguez
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | - Robert Renteria
- The Los Angeles Trust for Children's Health, Los Angeles, California
| | - Maryjane Puffer
- The Los Angeles Trust for Children's Health, Los Angeles, California
| | - Kathleen P Tebb
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California
| |
Collapse
|
5
|
Tebb KP, Rodriguez F, Pollack LM, Adams S, Rico R, Renteria R, Trieu SL, Hwang L, Brindis CD, Ozer E, Puffer M. Improving contraceptive use among Latina adolescents: A cluster-randomized controlled trial evaluating an mHealth application, Health-E You/Salud iTu. Contraception 2021; 104:246-253. [PMID: 33744300 DOI: 10.1016/j.contraception.2021.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 03/03/2021] [Accepted: 03/07/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of Health-E You/Salud iTu, a mobile health application (app), on increasing knowledge, self-efficacy and contraception use among Latina adolescents, its impact on visit quality, and app satisfaction. STUDY DESIGN This study used cluster-randomized controlled trial (CRCT) of 18 school-based health centers (SBHCs). Prior to the visit, intervention participants received the patient-centered contraceptive decision-making support app and controls answered sexual health questions on iPads. Participants completed a previsit questionnaire and 3 follow-up surveys (48 hours, 3-, and 6-months) after the recruitment visit (where intervention participants completed the app). Differences in adolescents' contraceptive knowledge, self-efficacy, and use over the 6-month follow-up were assessed by generalized mixed effects regression models. RESULTS A total of 1,360 Latina adolescents participated; 57.2% responded to the 48-hour survey, 50.1% to the 3-month, 49.7% to the 6-month, and 42.3% to both the 3- and 6-month surveys. Health-E You users' demonstrated significant increases in pre-post knowledge (p < 0.001). Intervention participants who completed the follow-up survey reported greater increases in mean self-efficacy from baseline (23.2 intervention vs. 22.5 controls) to 6 months (26.1 vs. 23.4; b = 1.58, 95% CI 0.38-2.77, p = 0.01), and greater increases in non-barrier contraceptive use from baseline (29% intervention vs. 30% controls) to 3 months (63% vs. 45%; OR = 3.29, 95% CI 1.04-10.36, p = 0.04) and 6 months (63% vs. 44%; OR = 5.54, 95% CI 1.70-18.06, p = 0.005). Providers and adolescents reported high app satisfaction and stated it improved visit quality. CONCLUSIONS While data suggest that Health-E You improved outcomes, findings must be interpreted cautiously. Intervention participants had higher baseline sexual activity rates, more recruitment visits for pregnancy testing, emergency contraception or birth control, and lower completion rates of follow-up surveys than controls. IMPLICATIONS Despite declines in adolescent pregnancy in the United States, Latinas continue to have disproportionately high rates compared to white females. The Health-E You app may be an effective support tool for both adolescents and providers in SBHCs, and possibly other clinical settings, across the country to increase contraceptive use and thereby decrease unintended pregnancies. It could potentially reduce disparities in adolescent pregnancies and create more efficient visit time spent between clients and their providers.
Collapse
Affiliation(s)
- Kathleen P Tebb
- Department of Pediatrics, University of California San Francisco, CA, USA.
| | - Felicia Rodriguez
- Department of Pediatrics, University of California San Francisco, CA, USA
| | - Lance M Pollack
- Center for AIDs Prevention Studies, University of California, San Francisco, CA, USA
| | - Sally Adams
- Department of Pediatrics, University of California San Francisco, CA, USA
| | - Rosario Rico
- The Los Angeles Trust for Children's Health, Los Angeles, CA, USA
| | - Robert Renteria
- The Los Angeles Trust for Children's Health, Los Angeles, CA, USA
| | - Sang Leng Trieu
- The Los Angeles Trust for Children's Health, Los Angeles, CA, USA
| | - Loris Hwang
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Claire D Brindis
- Department of Pediatrics and the Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Elizabeth Ozer
- Department of Pediatrics and the Office for Diversity and Outreach, University of California San Francisco, San Francisco, CA, USA
| | - Maryjane Puffer
- The Los Angeles Trust for Children's Health, Los Angeles, CA, USA
| |
Collapse
|
6
|
Alimohammadi M, Neisani Samani L, Khanjari S, Haghani H. The Effects of Multimedia-Based Puberty Health Education on Male Students' Self-Esteem in the Middle School. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2019. [PMID: 31041321 PMCID: PMC6456763 DOI: 10.30476/ijcbnm.2019.44882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adolescents, as a large group of the world population, face many physical and psychological changes in their puberty period. They struggle with adjusting to the intensive changes that can lead to the development of low self-esteem. This study was conducted to determine the effect of multimedia-based puberty health education on male students' self-esteem in the middle school. METHODS It is a quasi-experimental study by using multi-stage sampling method which was done on 118 boys from two middle schools in Ilam (an Iranian city) from November 2017 to April 2018. Students were divided into two intervention (N=58) and control (N=60) groups. Then, the intervention group students were trained using a multimedia application. Data were gathered using a demographic questionnaire and Rosenberg's Self-Esteem Scale completed by students in three phases including before, immediately after, and three months after the end of the educational program. The collected data were analyzed using independent t-test, Chi-square, Fisher's exact test, post hoc test, and repeated measures ANOVA. Statistical analysis was performed using SPSS 16, and P<0.05 was considered significant. RESULTS Mean and standard deviation of the self-esteem scores in the intervention and control groups were 28.37±3.58 and 27.89±3.82 before the education, 32.17±3.12 and 27.50±3.56 immediately after the education, and 33.83±3.32 as well as 27.32±4.37 three months later, respectively. Mean self-esteem scores were significantly different post-intervention (P<0.001) and three months later (P<0.001) between the two groups. CONCLUSION Education on puberty health assisted by multimedia application can increase self-esteem in adolescent boys.
Collapse
Affiliation(s)
- Mahsa Alimohammadi
- Department of Nursing and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Neisani Samani
- Nursing Care Research Center, Department of Nursing and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Sedighe Khanjari
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Haghani
- Department of Biostatistics, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
7
|
Tebb KP, Leng Trieu S, Rico R, Renteria R, Rodriguez F, Puffer M. A Mobile Health Contraception Decision Support Intervention for Latina Adolescents: Implementation Evaluation for Use in School-Based Health Centers. JMIR Mhealth Uhealth 2019; 7:e11163. [PMID: 30869649 PMCID: PMC6437609 DOI: 10.2196/11163] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/06/2018] [Accepted: 09/24/2018] [Indexed: 12/17/2022] Open
Abstract
Background Health care providers are a trusted and accurate source of sexual health information for most adolescents, and clinical guidelines recommend that all youth receive comprehensive, confidential sexual health information and services. However, these guidelines are followed inconsistently. Providers often lack the time, comfort, and skills to provide patient-centered comprehensive contraceptive counseling and services. There are significant disparities in the provision of sexual health services for Latino adolescents, which contribute to disproportionately higher rates of teenage pregnancy. To address this, we developed Health-E You or Salud iTu in Spanish, an evidence-informed mobile health (mHealth) app, to provide interactive, individually tailored sexual health information and contraception decision support for English and Spanish speakers. It is designed to be used in conjunction with a clinical encounter to increase access to patient-centered contraceptive information and services for adolescents at risk of pregnancy. Based on user input, the app provides tailored contraceptive recommendations and asks the youth to indicate what methods they are most interested in. This information is shared with the provider before the in-person visit. The app is designed to prepare youth for the visit and acts as a clinician extender to support the delivery of health education and enhance the quality of patient-centered sexual health care. Despite the promise of this app, there is limited research on the integration of such interventions into clinical practice. Objective This study described efforts used to support the successful adoption and implementation of the Health-E You app in clinical settings and described facilitators and barriers encountered to inform future efforts aimed at integrating mHealth interventions into clinical settings. Methods This study was part of a larger, cluster randomized control trial to evaluate the effectiveness of Health-E You on its ability to reduce health disparities in contraceptive knowledge, access to contraceptive services, and unintended pregnancies among sexually active Latina adolescents at 18 school-based health centers (SBHCs) across Los Angeles County, California. App development and implementation were informed by the theory of diffusion of innovation, the Patient-Centered Outcomes Research Institute’s principles of engagement, and iterative pilot testing with adolescents and clinicians. Implementation facilitators and barriers were identified through monthly conference calls, site visits, and quarterly in-person collaborative meetings. Results Implementation approaches enhanced the development, adoption, and integration of Health-E You into SBHCs. Implementation challenges were also identified to improve the integration of mHealth interventions into clinical settings. Conclusions This study provides important insights that can inform and improve the implementation efforts for future mHealth interventions. In particular, an implementation approach founded in a strong theoretical framework and active engagement with patient and community partners can enhance the development, adoption, and integration of mHealth technologies into clinical practice. Trial Registration ClinicalTrials.gov NCT02847858; https://clinicaltrials.gov/ct2/show/NCT02847858 (Archived by WebCite at http://www.webcitation.org/761yVIRTp).
Collapse
Affiliation(s)
- Kathleen P Tebb
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Sang Leng Trieu
- The Los Angeles Trust for Children's Health, Los Angeles, California, CA, United States
| | - Rosario Rico
- The Los Angeles Trust for Children's Health, Los Angeles, California, CA, United States
| | - Robert Renteria
- The Los Angeles Trust for Children's Health, Los Angeles, California, CA, United States
| | - Felicia Rodriguez
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Maryjane Puffer
- The Los Angeles Trust for Children's Health, Los Angeles, California, CA, United States
| |
Collapse
|
8
|
Tebb KP, Pica G, Twietmeyer L, Diaz A, Brindis CD. Innovative Approaches to Address Social Determinants of Health Among Adolescents and Young Adults. Health Equity 2018; 2:321-328. [PMID: 30450488 PMCID: PMC6238651 DOI: 10.1089/heq.2018.0011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Social determinants are the leading causes of health disparities. Yet health care systems have not systemically addressed social determinants of health as it pertains to adolescents and young adults (AYAs), among other populations in need. This study identified promising innovative programs across the United States. Methods: Thirteen representatives from 10 programs completed a 45-min telephone interview. Transcripts were reviewed and analyzed to identify cross-cutting themes. Results: Strategies included increasing access to quality, comprehensive and confidential health services, addressing the holistic needs of AYAs, collaborations across the health care delivery systems and other community services, and leveraging technology. Conclusion: This study showcased innovative approaches to inform future efforts.
Collapse
Affiliation(s)
- Kathleen P Tebb
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Benioff Children's Hospital and the Adolescent and Young Adult Health National Resource Center, University of California, San Francisco, California
| | | | - Lauren Twietmeyer
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Benioff Children's Hospital and the Adolescent and Young Adult Health National Resource Center, University of California, San Francisco, California
| | - Angela Diaz
- Icahn School of Medicine at Mount Sinai and Mount Sinai Adolescent Health Center, New York, New York
| | - Claire D Brindis
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Benioff Children's Hospital and the Adolescent and Young Adult Health National Resource Center, University of California, San Francisco, California.,Philip R. Lee Institute for Health Policy Studies and the Adolescent and Young Adult Health National Resource Center, University of California, San Francisco, California
| |
Collapse
|