A Mobile Health Contraception Decision Support Intervention for Latina Adolescents: Implementation Evaluation for Use in School-Based Health Centers
| Autor: | Maryjane Puffer, Kathleen P. Tebb, Rosario Rico, Sang Leng Trieu, Felicia Rodriguez, Robert Renteria |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
pregnancy in adolescence 020205 medical informatics Adolescent Health Informatics Information technology 02 engineering and technology 03 medical and health sciences 0302 clinical medicine Pregnancy Health care 0202 electrical engineering electronic engineering information engineering medicine Cluster Analysis Humans 030212 general & internal medicine mHealth School-based health centers mobile health Contraception Behavior Reproductive health School Health Services Medical education Original Paper Schools business.industry Hispanic or Latino T58.5-58.64 adolescent health Los Angeles Mobile Applications Health equity Health education Female Public aspects of medicine RA1-1270 Outcomes research business Psychology Adolescent health Program Evaluation |
| Zdroj: | JMIR mHealth and uHealth JMIR mHealth and uHealth, Vol 7, Iss 3, p e11163 (2019) |
| ISSN: | 2291-5222 |
| Popis: | BackgroundHealth 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. ObjectiveThis 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. MethodsThis 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. ResultsImplementation 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. ConclusionsThis 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 RegistrationClinicalTrials.gov NCT02847858; https://clinicaltrials.gov/ct2/show/NCT02847858 (Archived by WebCite at http://www.webcitation.org/761yVIRTp). |
| Databáze: | OpenAIRE |
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