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Brown C, Neerland CE, Weinfurter EV, Saftner MA. The Provision of Abortion Care via Telehealth in the United States: A Rapid Review. J Midwifery Womens Health 2023; 68:744-758. [PMID: 38069588 DOI: 10.1111/jmwh.13586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/11/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION The recent Supreme Court decision Dobbs v. Jackson Women's Health that has overruled Roe v. Wade has resulted in severe limitations of abortion access throughout the United States. Telehealth has been put forth as one solution for improving access for reproductive health care, including abortion services. Telehealth has demonstrated safety and efficacy in several health care disciplines; however, its use for abortion care and services has not been explored and synthesized. METHODS As part of a larger review on telehealth and general reproductive health, our team identified a moderate amount of literature on telehealth and abortion care. We conducted a rapid review searching for eligible studies in MEDLINE, Embase, and CINAHL. Information was extracted from each included study to explore 4 key areas of inquiry: (1) clinical effectiveness, (2) patient and provider experiences, (3) barriers and facilitators, and (4) the impact of the coronavirus disease 2019 (COVID-19) pandemic. RESULTS Twenty-five studies on the use of telehealth for providing abortion services published between 2011 and 2022 were included. Telehealth for medical abortion increased during the COVID-19 pandemic and was found to be safe and clinically effective, with high patient satisfaction. Overall, telehealth improved access and removed barriers for patients including lack of transportation. Legal restrictions in certain states were cited as the primary barriers. Studies contained limited information on the perspectives and experiences of health care providers and diverse patient populations. DISCUSSION Abortion care via telehealth is safe and effective with high satisfaction and may also remove barriers to care including transportation and fear. Removing restrictions on telehealth for the provision of abortion services may further improve access to care and promote greater health equity.
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Affiliation(s)
- Camille Brown
- University of Minnesota School of Nursing, Minneapolis, Minnesota
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Saftner MA, Ayebare E. Using Collaborative Online International Learning to Support Global Midwifery Education. J Perinat Neonatal Nurs 2023; 37:116-122. [PMID: 37102558 DOI: 10.1097/jpn.0000000000000722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
BACKGROUND AND LOCAL PROBLEM The COVID-19 pandemic created a gap in global health learning, requiring creative solutions to bridge the divide. Collaborative online international learning (COIL) is a program between universities located in different geographic areas that aims to build cross-cultural learning and collaboration. INTERVENTION Faculty members from Uganda and the United States worked collaboratively to plan a 2-session COIL activity for nursing and midwifery students. Twenty-eight students from the United States and Uganda participated in the pilot quality improvement project. MEASURES Students completed a 13-question REDCap survey measuring satisfaction, time commitment for the activity, and increase in knowledge about differently resourced healthcare systems. Students also were asked to provide qualitative feedback in that survey. RESULTS Survey results indicate a high level of satisfaction and an increased understanding of a new healthcare system. The majority of students wanted more scheduled activity times, the opportunity to meet face to face, and/or more robust sessions in the future. CONCLUSION This COIL activity between students in the United States and Uganda was a no-cost activity that provided global health learning opportunities for students during the global pandemic. The COIL model is replicable, adaptable, and customizable for a variety of courses and time spans.
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Affiliation(s)
- Melissa A Saftner
- School of Nursing, University of Minnesota, Minneapolis (Dr Saftner); and Department of Nursing, Makerere University, Kampala, Uganda (Dr Ayebare)
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Ngabirano TD, Saftner MA, McRee AL, McMorris BJ. Considerations for conducting global health research with adolescents in rural communities. Journal of Global Health Reports 2020. [DOI: 10.29392/001c.17605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Melissa A Saftner
- Department of Nursing, University of Minnesota, Twin Cities, Minnesota, United States
| | - Annie-Laurie McRee
- Department of Pediatrics, University of Minnesota, Twin Cities, Minnesota, United States
| | - Barbara J McMorris
- Department of Nursing, University of Minnesota, Twin Cities, Minnesota, United States
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Abstract
Adolescents in rural Uganda face unique opportunities and challenges to their health. The primary goal of this exploratory cross-sectional survey study was to describe the health behaviors of adolescents of age 13-19 living in four Ugandan fishing communities as a foundation for developing programs to reduce risky health behaviors and HIV/AIDS transmission. The majority of boys (59.6%) and one third of girls reported lifetime sexual intercourse; girls reported earlier sexual debut than boys, as well as higher rates of sexual assault, rape, and/or coerced intercourse. Sexually active youth were more likely to have viewed pornography, be tested for other sexually transmitted infections, and attend boarding schools. Alcohol use was prevalent among both sexes; however, the use of other substances was infrequently reported. Since the majority of adolescents in Uganda attend boarding school, there is an opportunity to expand the school nurse scope of care to include health promotion education and counseling.
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Neerland CE, Avery MD, Looman WS, Saftner MA, Rockwood TH, Gurvich OV. Development and Testing of the Preparation for Labor and Birth Instrument. J Obstet Gynecol Neonatal Nurs 2020; 49:200-211. [PMID: 32035974 DOI: 10.1016/j.jogn.2019.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To develop and assess the reliability and validity of a new instrument used during the third trimester of pregnancy to measure women's confidence in their ability to achieve physiologic birth, the Preparation for Labor and Birth (P-LAB) instrument. DESIGN Two-phase instrument development study that consisted of item generation and a prospective field test. SETTING Field testing occurred in five midwestern U.S. prenatal clinics. PARTICIPANTS Participants in the field test were 203 nulliparous and parous pregnant women who intended to give birth vaginally. METHODS Psychometric testing consisted of test-retest reliability testing and assessments of content validity, face validity, and construct validity. We measured construct validity using exploratory factor analysis and correlation with the Sense of Coherence Scale. RESULTS The 22-item P-LAB showed good content validity, good internal consistency, and stability over time. All items had content validity index scores greater than or equal to 0.8, and the total instrument content validity index was 0.95. We identified four factors related to women's confidence in their ability to achieve physiologic birth: Planned Use of Pain Medication, Relationship With Care Provider and Supportive Birth Environment, Beliefs About Labor, and Labor Support (social and professional). Cronbach's alpha coefficient for the four extracted factors were .93, .76, .73 and .74, respectively. Intraclass correlation [95% confidence interval] for the total questionnaire was .92 [.88, .94]. We found no linear association between total P-LAB scores and sense of coherence. CONCLUSION Our findings demonstrate acceptable initial psychometric properties for the P-LAB instrument. Additional testing is required to evaluate the instrument's construct, convergent, and divergent validity.
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Neerland CE, Avery MD, Saftner MA, Gurvich OV. Maternal confidence for physiologic birth: Associated prenatal characteristics and outcomes. Midwifery 2019; 77:110-116. [PMID: 31319365 DOI: 10.1016/j.midw.2019.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/18/2019] [Accepted: 07/08/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Pregnancy, labor, and birth are normal, physiologic processes. Women often seek information during pregnancy to enhance their confidence for physiologic birth. Little is known about confidence for physiologic birth and associated prenatal characteristics and birth outcomes such as provider type, source of labor and birth information, mode of birth, and use of pain medication in labor. The purpose of this study was to examine prenatal confidence for physiologic birth and associated prenatal characteristics and birth outcomes. DESIGN This study was completed as part of a multi-phased instrument development study, the Preparation for Labor and Birth (P-LAB) instrument. P-LAB confidence scores were examined for their relationship with variables including labor type, provider type, source of labor support, pain medication use, and birth mode. SETTING AND PARTICIPANTS Women (N = 192) from five prenatal clinics in the Midwestern United States who had completed the P-LAB instrument participated in postpartum telephone interviews. FINDINGS Women with previous birth experience had higher confidence than nulliparous women. Prenatal care providers were reported as main source of labor and birth information. Confidence for birth was associated with intention to not use pain medication in labor. Women's overall intention to use or not use pain medication was consistent with use. Prenatal confidence was not associated with mode of birth. IMPLICATIONS FOR FUTURE RESEARCH Special emphasis should be paid to nulliparous women when developing interventions to enhance confidence for physiologic birth. Women rely on their care providers for information regarding labor and birth, therefore one area to strengthen confidence for physiologic birth is within the provider-patient relationship.
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Affiliation(s)
- Carrie E Neerland
- University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, USA.
| | - Melissa D Avery
- University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, USA
| | - Melissa A Saftner
- University of Minnesota, 1035 University Dr, SMed 351, Duluth, MN 55812, USA
| | - Olga V Gurvich
- University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, USA
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Saftner MA, Pruitt KS, McRee AL. Conversation, Condoms, and Contraception: How Does Communication With Sexual Partners Affect Safer Sexual Behaviors Among American Indian Youth? J Sch Nurs 2019; 37:109-116. [DOI: 10.1177/1059840519849097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Communication with sexual partners about protection against sexually transmitted infections (STIs) is associated with safer sexual behaviors among general populations of youth, but little is known about partner communication among American Indian youth. We assessed the prevalence of adolescents’ communication with sexual partners about STI prevention and used multivariable logistic regression to examine associations between communication and safer sexual behaviors (condom use, reliable contraceptive use, and dual method use) among a statewide sample of in-school, American Indian youth in Minnesota in 2013 and 2016 ( n = 739). Half (49.5%) of sexually experienced American Indian youth reported talking about STI prevention at least once with every sexual partner. Communication was associated with all examined safer sexual behaviors among females and only with condom use among males. Study findings highlight the importance of school nurses, health educators, and other clinicians addressing partner communication when counseling adolescent patients.
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Affiliation(s)
| | - Kelsey S. Pruitt
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
- Division of General Pediatrics and Adolescent Health, Medical School, University of Minnesota, Duluth, MN, USA
| | - Annie-Laurie McRee
- Division of General Pediatrics and Adolescent Health, Medical School, University of Minnesota, Duluth, MN, USA
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Sieving RE, Gewirtz O'Brien JR, Saftner MA, Argo TA. Sexually Transmitted Diseases Among US Adolescents and Young Adults: Patterns, Clinical Considerations, and Prevention. Nurs Clin North Am 2019; 54:207-225. [PMID: 31027662 DOI: 10.1016/j.cnur.2019.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This article describes prevalence and recent trends in the most common sexually transmitted diseases (STD) among young people in the United States. Common clinical presentations and best practices related to screening and treatment of these conditions are summarized. Clinical considerations for working with adolescents and young adults in the area of sexual and reproductive health are highlighted. Key approaches for sexually transmitted disease prevention with adolescents and young adults are presented.
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Affiliation(s)
- Renee E Sieving
- School of Nursing and Department of Pediatrics, University of Minnesota, University of MN School of Nursing, 5-140 Weaver Densford Hall, 308 Harvard Street Southeast, Minneapolis, MN 55455, USA.
| | - Janna R Gewirtz O'Brien
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware Street Southeast Suite 353, Minneapolis, MN 55414, USA
| | - Melissa A Saftner
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, 308 Harvard Street Southeast, Minneapolis, MN 55455, USA
| | - Taylor A Argo
- Department of Pediatrics, Pediatric Education Office, University of Minnesota, Room M136, 1st Floor, East Building, 2450 Riverside Avenue, Minneapolis, MN 55454, USA
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Avery MD, Neerland CE, Saftner MA. Women's Perceptions of Prenatal Influences on Maternal Confidence for Physiologic Birth. J Midwifery Womens Health 2018; 64:201-208. [DOI: 10.1111/jmwh.12897] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 06/05/2018] [Accepted: 07/17/2018] [Indexed: 11/29/2022]
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Saftner MA, Neerland C, Avery MD. Enhancing women's confidence for physiologic birth: Maternity care providers' perspectives. Midwifery 2017; 53:28-34. [PMID: 28743051 DOI: 10.1016/j.midw.2017.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 07/13/2017] [Accepted: 07/17/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this research study was to explore MCP's beliefs and attitudes about physiologic birth and to identify components of antenatal care that providers believe may impact a woman's confidence for physiologic labor and birth. METHODS This qualitative descriptive study included maternity care providers (N=31) in the Midwestern United States. Providers participated in semi-structured interviews to describe their beliefs about physiologic birth, their role in providing information to women and specific care practices to promote women's confidence for physiologic birth. FINDINGS Six themes emerged including: positive beliefs about physiologic birth, trusted relationship with provider, woman centered care, education and knowledge, barriers to confidence, and antenatal practices to enhance confidence. Variations in beliefs occurred amongst providers with different training (i.e., physicians and midwives). CONCLUSION Maternity care providers, including midwives, family physicians and obstetrician-gynecologists, overwhelmingly support a physiologic approach to labor and birth. These providers had a number of suggestions about how antenatal care could be enhanced in an effort to increase women's confidence during the antenatal period. Supporting physiologic birth is imperative for providers who wish to enhance outcomes for mothers and babies.
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Affiliation(s)
- Melissa A Saftner
- The University of Minnesota School of Nursing, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
| | - Carrie Neerland
- The University of Minnesota School of Nursing, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
| | - Melissa D Avery
- The University of Minnesota School of Nursing, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
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Abstract
Previous research with American Indian (AI) adolescent sexual risk behavior primarily focused on reservation-dwelling youth despite 70% of AIs living off Native lands. Using grounded theory methodology, I sampled 20 adolescent AI girls via talking circles and interviews to explore the perceptions of AI adolescent girls living in an urban, Midwest area about the influence of family and friends on their sexual behavior. Similar to research with other racial groups, participants cited their family and friends as a major influence. Five unique themes emerged related to family and friend influence. Urban-dwelling AI girls rely on their female family members and peers for information related to sex and receive varying messages from their networks of family and friends, which often overlap. AI youth have unique family groups yet have some similarities to other ethnic groups with regard to family and friend relationships that may allow for enhanced intervention development.
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Munro-Kramer ML, Fava NM, Saftner MA, Darling-Fisher CS, Tate NH, Stoddard SA, Martyn KK. What are we missing? Risk behaviors among Arab-American adolescents and emerging adults. J Am Assoc Nurse Pract 2016; 28:493-502. [PMID: 26990394 PMCID: PMC5010467 DOI: 10.1002/2327-6924.12352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 01/16/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Research on Arab-Americans as a distinct ethnic group is limited, especially when considering the health of Arab-American youth. This study describes health risk (substance use, violence); health promotive behaviors (hope, spirituality); and sexual activity (oral, vaginal, anal sex) of Arab-American adolescents and emerging adults (aged 15-23) within their life context, as well as the association between these behaviors. METHODS A secondary analysis of data on a subset of Arab-American participants obtained from a randomized-control trial was utilized to conduct mixed methods analyses. Qualitative analyses completed on the open-ended questions used the constant comparative method for a subsample (n = 24) of participants. Descriptive quantitative analyses of survey data utilized bivariate analyses and stepwise logistic regression to explore the relation between risk behaviors and sexual activity among the full sample (n = 57). CONCLUSIONS Qualitative analyses revealed two groups of participants: (a) multiple risk behaviors and negative life-events, and (b) minimal risk behaviors and positive life-events. Quantitative analyses indicated older youth, smokers, and those with higher hope pathways were more likely to report vaginal sex. IMPLICATIONS FOR PRACTICE The unique cultural and social contexts of Arab-American youth provide a framework for recommendations for the prevention of risk behaviors.
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Affiliation(s)
| | - Nicole M. Fava
- Florida International Institute Robert Stempel College of Public Health & Social Work, 11200 SW 8 Street, AHC5 505, Miami, FL 33199, Telephone: 305-348-4903,
| | - Melissa A. Saftner
- University of Minnesota School of Nursing, 6-165 Weaver-Densford Hall, Minneapolis, MN 55455-0213, Telephone: 218-726-8934,
| | - Cynthia S. Darling-Fisher
- University of Michigan School of Nursing, 400 N. Ingalls, Room 3176, Ann Arbor, MI 48109-5482, Telephone: 734-647-0328,
| | - Nutrena H. Tate
- Wayne State University College of Nursing, 5557 Cass, 140 Cohn, Detroit, MI 48202, Telephone: 313-557-1754,
| | - Sarah A. Stoddard
- University of Michigan School of Nursing, 400 N. Ingalls, Room 3344, Ann Arbor, MI 48109-5482, Telephone: 734-647-0327,
| | - Kristy K. Martyn
- Director of the Doctor of Nursing Practice Program, Independence Chair in Nursing, Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, NE, Rm 336, Atlanta, GA 30322, Telephone: 404-727-6913,
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Avery MD, Saftner MA, Larson B, Weinfurter EV. A Systematic Review of Maternal Confidence for Physiologic Birth: Characteristics of Prenatal Care and Confidence Measurement. J Midwifery Womens Health 2014; 59:586-595. [DOI: 10.1111/jmwh.12269] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hartmann WE, Wendt DC, Saftner MA, Marcus J, Momper SL. Advancing community-based research with urban American Indian populations: multidisciplinary perspectives. Am J Community Psychol 2014; 54:72-80. [PMID: 24659391 PMCID: PMC4165816 DOI: 10.1007/s10464-014-9643-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The US has witnessed significant growth among urban American Indian (AI) populations in recent decades, and concerns have been raised that these populations face equal or greater degrees of disadvantage than their reservation counterparts. Surprisingly little urban AI research or community work has been documented in the literature, and even less has been written about the influences of urban settings on community-based work with these populations. Given the deep commitments of community psychology to empowering disadvantaged groups and understanding the impact of contextual factors on the lives of individuals and groups, community psychologists are well suited to fill these gaps in the literature. Toward informing such efforts, this work offers multidisciplinary insights from distinct idiographic accounts of community-based behavioral health research with urban AI populations. Accounts are offered by three researchers and one urban AI community organization staff member, and particular attention is given to issues of community heterogeneity, geography, membership, and collaboration. Each first-person account provides “lessons learned” from the urban context in which the research occurred. Together, these accounts suggest several important areas of consideration in research with urban AIs, some of which also seem relevant to reservation-based work. Finally, the potential role of research as a tool of empowerment for urban AI populations is emphasized, suggesting future research attend to the intersections of identity, sense of community, and empowerment in urban AI populations.
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Saftner MA, Martyn KK, Momper SL. Urban Dwelling American Indian Adolescent Girls' Beliefs Regarding Health Care Access and Trust. J Indig Soc Dev 2014; 3:1-15. [PMID: 25541597 PMCID: PMC4274642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Indigenous people, specifically American Indians (AI), have historically had a greater mistrust of the medical system compared to their White counterparts. The purpose of this paper is to explore the perceptions of AI adolescent girls living in an urban, Midwest area about health care providers, health care systems, and access to health care as related to sexual health care. Using grounded theory methodology, twenty 15-19 year old AI girls participated in talking circles and individual interviews. Two distinct themes emerged related to sexual health care: 1) AI adolescent girls trust their health care providers and the health care system; and 2) Access to health care is critical to practicing safe sex and obtaining information about healthy sexual practices. These findings are unique and may help health care providers and social workers providing care and support to the urban adolescent AI girl.
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Affiliation(s)
- Melissa A Saftner
- Clinical Associate Professor, The University of Minnesota School of Nursing, 308 Harvard Street SE, Minneapolis, MN 55455, USA; ; ;
| | - Kristy K Martyn
- Professor and Assistant Dean of Clinical Advancement, Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Rd NE, Atlanta, GA 30322; ; ;
| | - Sandra L Momper
- Assistant Professor, The University of Michigan School of Social Work, 1080 S. University, Ann Arbor, MI 48109; ; ;
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Abstract
PURPOSE The purpose of this study was to explore factors that influence urban adolescent American Indian (AI) girls' sexual risk behavior. DESIGN A qualitative study was conducted with grounded theory methodology to reveal factors and processes that influence sexual risk behavior. METHOD Talking circles, individual interviews, and event history calendars were used with 20 urban AI 15- to 19-year-old girls to explore influences on sexual risk behavior. RESULTS The generated theory-framing sexual risk behavior-describes social and structural factors and processes that influenced the girls' sexual risk behavior. The theory extends Bronfenbrenner's ecological model by identifying microsystem, mesosystem, and macrosystem influences on sexual risk behavior. DISCUSSION Urban AI girls reported similar social and structural influences on sexual risk behavior as urban adolescents from other racial and ethnic groups. However, differences were noted in the family structure, cultural heritage, and unique history of AIs. IMPLICATIONS This theory can be used in culturally responsive practice with urban AI girls.
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Affiliation(s)
| | - Kristy K Martyn
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA
| | - Sandra L Momper
- University of Michigan School of Social Work, Ann Arbor, MI, USA
| | | | - Lisa Kane Low
- University of Michigan School of Nursing, Ann Arbor, MI, USA
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Martyn KK, Saftner MA, Darling-Fisher CS, Schell MC. Sexual risk assessment using event history calendars with male and female adolescents. J Pediatr Health Care 2013; 27:460-9. [PMID: 22742823 PMCID: PMC6549503 DOI: 10.1016/j.pedhc.2012.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Revised: 05/11/2012] [Accepted: 05/11/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION The purpose of this study was to explore male and female adolescents' perceptions of and differences in Event History Calendar (EHC) sexual risk assessment in a clinical setting. METHOD This study is a secondary analysis exploring male and female qualitative data from a mixed methods study of adolescent and provider communication. Participants included 30 sexually active 15- to 19-year-old male (n = 11) and female (n = 19) patients at a school-linked clinic. The adolescents completed a pre-clinic visit EHC and then discussed it with a nurse practitioner during their visit. The adolescents shared their perceptions of the EHCs in a post-clinic visit interview. RESULTS Constant comparative analyses revealed gender differences in: (a) adolescents' perceptions of how EHCs helped report, reflect on, and discuss sexual risk histories; (b) how adolescents self-administered EHCs; and (c) the histories they reported. DISCUSSION The EHC was well received by both male and female adolescents, resulting in a more complete sexual risk history disclosure. Self-administration of the EHC is recommended for all adolescents, but further sexual risk assessment by nurse practitioners who use EHCs is needed.
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Martyn KK, Darling-Fisher C, Pardee M, Ronis DL, Felicetti IL, Saftner MA. Improving sexual risk communication with adolescents using event history calendars. J Sch Nurs 2011; 28:108-15. [PMID: 22071717 DOI: 10.1177/1059840511426577] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study was conducted to explore the effects of an event history calendar (EHC) approach on adolescent sexual risk communication and sexual activity. Adolescent school-linked health clinic patients (n = 30) who reported sexual activity self-administered the EHC that was used by nurse practitioners (NPs; n = 2) during a clinic visit. Immediately pre- and post-visit, and at 1 and 3 months, adolescents reported sexual risk behaviors and perceptions about EHC communication on questionnaires and by interview. NPs reported their perceptions of EHCs by questionnaire after the visit and poststudy interview. The EHC approach facilitated communication and adolescent awareness of their risk behaviors. Scores increased on Amount of Communication, t(29) = 8.174, p < .001; Satisfaction with Communication, t(29) = 3.112, p = .004; Client Involvement in Decision Making, t(29) = 3.901, p = .001, and Client Satisfaction with Interpersonal Style, t(29) = 3.763, p = .001. Adolescents reported decreased sexual intercourse at 1 month, p = .031. School nurses could use the EHC approach to facilitate adolescent communication and tailoring of interventions.
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Affiliation(s)
- Kristy K Martyn
- Division of Health Promotion and Risk Reduction Programs at the University of Michigan, School of Nursing, North Ingalls, Ann Arbor, MI, USA.
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