- Email: [email protected]
Quality of Reproductive Health Care Provided to Latino Adolescents
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Abstracts / 46 (2010) S17–S81
when I am being asked my child’s authorization each time I call the doctor.’’ At the same time, comments revealed that parents considered specialized centers for adolescents as necessary and important. Conclusions: Results show that most parents were satisfied with their involvement in their child’s care, although many wished to communicate better with HPs. There seems to be a degree of ambivalence among parents who understand their adolescent’s need for confidentiality and autonomy but who also want to remain informed and involved in their child’s care. This is a sensitive period for parents, who need to accept that their child is growing up, and for HPs who should not forget that parents still have an important role to play. HPs should accompany parents in the transition from pediatric to adolescent care by communicating with them while respecting patient confidentiality. Sources of Support: None.
Conclusions: This study adds new knowledge about the characteristics of health care providers who work with a population of adolescents with high birth rates. Providers whose patient population included a larger percentage of Latino adolescents had greater confidence in their ability to provide the reproductive health services measured, and also were more willing to provide confidential services to teens. Further research is needed to understand the relationship between these results and factors that influence the high adolescent birth rate among Latina patients. As the number of Latina patients throughout the United States increases, understanding how to best provide effective, culturally competent reproductive health care is essential. Sources of Support: Grant for data collection provided by the Adolescent Pregnancy Prevention Network, Santa Clara County Department of Public Health.
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QUALITY OF REPRODUCTIVE HEALTH CARE PROVIDED TO LATINO ADOLESCENTS Lee Anna Botkin, MD2, Stephanie Fishkin, PhD5, Claire Brindis, Dr PH1, Elizabeth Ozer, PhD4, Cynthia Kapphahn, MD, MPH3. 1 National Adolescent Health Information and Innovation Center &Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco; 2Department of Pediatrics, Santa Clara Valley Medical Center; 3Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine; 4Division of Adolescent Medicine, Department of Pediatrics, University of California, San Francisco; 5Kaiser Permanente
ABDOMINAL PAIN IN ADOLESCENTS PRESENTING TO AN URBAN SCHOOL BASED HEALTH CENTER Robroy MacIver, MD, MPH, Ashlee Walker, BS, Laurie Odell, Cynthia Mears. Children’s Memorial Hospital
Purpose: While overall adolescent birth rates have declined since the early 1990s, births to Latino adolescents remain the highest of all ethnic subgroups. Little data is available regarding the quality of reproductive health services provided to Latino adolescents. We examine whether health care providers who see few Latino adolescent patients differ in level of knowledge or the manner in which they provide reproductive health care services from those providers who see many Latino adolescents. Methods: Awritten survey was mailed to all physicians, nurse practitioners and physician assistants in the fields of pediatrics, internal medicine, family practice and obstetrics/gynecology who lived or practiced in one metropolitan county in northern California. The survey contained questions about provider demographics, practice descriptors, service provision, provider attitudes, and confidence levels regarding reproductive health care services for teens. Results: We mailed a total of 1942 surveys. The overall response rate after 3 mailings and a follow-up post card was 48%. Survey respondents were placed into three groups of equal size based on whether they saw few (0-19%), moderate (20-34%) or many (35100%) Latino patients. There were no significant differences in mean age, gender, or race of providers. Providers seeing many Latino patients were more likely to be NPs or nurse/midwives than doctors (p < .001). They were more likely to provide services in a language other than English (p < .0001), and to serve patients who were uninsured (p < .05) or who had insurance coverage through Medicaid or California’s Office of Family Planning Family PACT program (p < .0001). Types of services offered did not differ among the three groups, although the providers who served the largest number of Latinas were more willing to treat a young adolescent confidentially for cervicitis and prescribe contraception (p < .05). Providers who saw more Latino patients were more confident in their ability to evaluate symptomatic teens for STDs (p < .001), screen asymptomatic sexually active teens (p < .05), and treat STDs (p < .01) than health care providers seeing fewer Latino patients.
Purpose: Abdominal pain is a common complaint among adolescents presenting to outpatient clinics. Children often present multiple times with recurring pain complaints. The purpose of this study is to characterize and study the incidence, demographics and coping strategies of adolescents with abdominal pain presenting to an urban school based health center. Methods: After IRB approval and parental consent was obtained, a random selection of children attending a 6th-12th grade school in Chicago were given a survey consisting of the Pain Beliefs Questionnaire, The Rosenberg Self Esteem Scale and two short questions regarding eating habits. Surveys were proctored by a member of the clinic staff. Students were given the survey once at the end of a 9 month portion of their school year. Data from the survey were then corroborated with the corresponding nine month clinical presentation data from the school’s health center. Results: 93 students were consented and completed a survey out of approximately 540 students. 91/93 students who were given the survey presented to the clinic at least once over the previous 9 months. The majority of the students were African American 77/ 91 (84.6%). 79/91 (86.8%) were on public aid insurance. There were 43 (46.2%) males and 50 (53.8%) females surveyed. The median age was 16.0 years (SD 1.7 years). 74/91 students received lunches from the school (81.3%). 49/93 (52.3%) described having a history of abdominal pain by questionnaire. There were 26 (60.1%) males and 22 (44%) females stating that they had abdominal pain (p ¼ .9). There was a statistical significant difference in the total number of presentations to the clinic for all causes between students that described abdominal pain in the questionnaire (12.1 visits) to those that did not (8 visits) (p ¼ .04). The Rosenberg Self Esteem score revealed a statistical (p ¼ .02), but not a clinically significant difference between the abdominal pain (mean ¼ 21.0) and non-abdominal pain (mean ¼ 23.4) groups. There was no statistical difference between emotion focused versus problem focused pain appraisal between the abdominal pain and nonabdominal pain groups (p ¼ .78). Conclusions: Abdominal pain is a common complaint in adolescent children. We were not able to show any gender, racial or self esteem trends between groups with or without abdominal pain. Reporting abdominal pain in the Pain Beliefs Questionnaire correlated with a higher presentation rate for all causes to the school based health center. Sources of Support: None.
Abstracts / 46 (2010) S17–S81
when I am being asked my child’s authorization each time I call the doctor.’’ At the same time, comments revealed that parents considered specialized centers for adolescents as necessary and important. Conclusions: Results show that most parents were satisfied with their involvement in their child’s care, although many wished to communicate better with HPs. There seems to be a degree of ambivalence among parents who understand their adolescent’s need for confidentiality and autonomy but who also want to remain informed and involved in their child’s care. This is a sensitive period for parents, who need to accept that their child is growing up, and for HPs who should not forget that parents still have an important role to play. HPs should accompany parents in the transition from pediatric to adolescent care by communicating with them while respecting patient confidentiality. Sources of Support: None.
Conclusions: This study adds new knowledge about the characteristics of health care providers who work with a population of adolescents with high birth rates. Providers whose patient population included a larger percentage of Latino adolescents had greater confidence in their ability to provide the reproductive health services measured, and also were more willing to provide confidential services to teens. Further research is needed to understand the relationship between these results and factors that influence the high adolescent birth rate among Latina patients. As the number of Latina patients throughout the United States increases, understanding how to best provide effective, culturally competent reproductive health care is essential. Sources of Support: Grant for data collection provided by the Adolescent Pregnancy Prevention Network, Santa Clara County Department of Public Health.
12.
13.
QUALITY OF REPRODUCTIVE HEALTH CARE PROVIDED TO LATINO ADOLESCENTS Lee Anna Botkin, MD2, Stephanie Fishkin, PhD5, Claire Brindis, Dr PH1, Elizabeth Ozer, PhD4, Cynthia Kapphahn, MD, MPH3. 1 National Adolescent Health Information and Innovation Center &Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco; 2Department of Pediatrics, Santa Clara Valley Medical Center; 3Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine; 4Division of Adolescent Medicine, Department of Pediatrics, University of California, San Francisco; 5Kaiser Permanente
ABDOMINAL PAIN IN ADOLESCENTS PRESENTING TO AN URBAN SCHOOL BASED HEALTH CENTER Robroy MacIver, MD, MPH, Ashlee Walker, BS, Laurie Odell, Cynthia Mears. Children’s Memorial Hospital
Purpose: While overall adolescent birth rates have declined since the early 1990s, births to Latino adolescents remain the highest of all ethnic subgroups. Little data is available regarding the quality of reproductive health services provided to Latino adolescents. We examine whether health care providers who see few Latino adolescent patients differ in level of knowledge or the manner in which they provide reproductive health care services from those providers who see many Latino adolescents. Methods: Awritten survey was mailed to all physicians, nurse practitioners and physician assistants in the fields of pediatrics, internal medicine, family practice and obstetrics/gynecology who lived or practiced in one metropolitan county in northern California. The survey contained questions about provider demographics, practice descriptors, service provision, provider attitudes, and confidence levels regarding reproductive health care services for teens. Results: We mailed a total of 1942 surveys. The overall response rate after 3 mailings and a follow-up post card was 48%. Survey respondents were placed into three groups of equal size based on whether they saw few (0-19%), moderate (20-34%) or many (35100%) Latino patients. There were no significant differences in mean age, gender, or race of providers. Providers seeing many Latino patients were more likely to be NPs or nurse/midwives than doctors (p < .001). They were more likely to provide services in a language other than English (p < .0001), and to serve patients who were uninsured (p < .05) or who had insurance coverage through Medicaid or California’s Office of Family Planning Family PACT program (p < .0001). Types of services offered did not differ among the three groups, although the providers who served the largest number of Latinas were more willing to treat a young adolescent confidentially for cervicitis and prescribe contraception (p < .05). Providers who saw more Latino patients were more confident in their ability to evaluate symptomatic teens for STDs (p < .001), screen asymptomatic sexually active teens (p < .05), and treat STDs (p < .01) than health care providers seeing fewer Latino patients.
Purpose: Abdominal pain is a common complaint among adolescents presenting to outpatient clinics. Children often present multiple times with recurring pain complaints. The purpose of this study is to characterize and study the incidence, demographics and coping strategies of adolescents with abdominal pain presenting to an urban school based health center. Methods: After IRB approval and parental consent was obtained, a random selection of children attending a 6th-12th grade school in Chicago were given a survey consisting of the Pain Beliefs Questionnaire, The Rosenberg Self Esteem Scale and two short questions regarding eating habits. Surveys were proctored by a member of the clinic staff. Students were given the survey once at the end of a 9 month portion of their school year. Data from the survey were then corroborated with the corresponding nine month clinical presentation data from the school’s health center. Results: 93 students were consented and completed a survey out of approximately 540 students. 91/93 students who were given the survey presented to the clinic at least once over the previous 9 months. The majority of the students were African American 77/ 91 (84.6%). 79/91 (86.8%) were on public aid insurance. There were 43 (46.2%) males and 50 (53.8%) females surveyed. The median age was 16.0 years (SD 1.7 years). 74/91 students received lunches from the school (81.3%). 49/93 (52.3%) described having a history of abdominal pain by questionnaire. There were 26 (60.1%) males and 22 (44%) females stating that they had abdominal pain (p ¼ .9). There was a statistical significant difference in the total number of presentations to the clinic for all causes between students that described abdominal pain in the questionnaire (12.1 visits) to those that did not (8 visits) (p ¼ .04). The Rosenberg Self Esteem score revealed a statistical (p ¼ .02), but not a clinically significant difference between the abdominal pain (mean ¼ 21.0) and non-abdominal pain (mean ¼ 23.4) groups. There was no statistical difference between emotion focused versus problem focused pain appraisal between the abdominal pain and nonabdominal pain groups (p ¼ .78). Conclusions: Abdominal pain is a common complaint in adolescent children. We were not able to show any gender, racial or self esteem trends between groups with or without abdominal pain. Reporting abdominal pain in the Pain Beliefs Questionnaire correlated with a higher presentation rate for all causes to the school based health center. Sources of Support: None.