Increasing Oral Health Team's Knowledge, Attitudes, and Intention to Recommend the HPV Vaccine.

This study aims to assess the impact of an educational intervention on the knowledge, attitudes, and intentions of oral health providers regarding the recommendation of the human papillomavirus (HPV) vaccine. A qualitative evaluation was conducted in 2021 with dental professionals who participated in a training program focused on HPV vaccination. Saturation was reached at 12. Results showed increased knowledge and awareness of the link between HPV infection and oropharyngeal cancers among participants. Intention to recommend was universally endorsed. The use of role-play with youth actors was highly regarded as an effective method for improving communication skills and confidence in recommending the vaccine. These findings emphasize the importance of targeted interventions to enhance oral health professional education and the intention to recommend HPV vaccine.

Increased Parent Support for Comprehensive Sexuality Education Over 15 Years.

PURPOSE: Comprehensive sexuality education (CSE) has been shown to reduce sexual risk-taking behaviors and promote healthy sexual development, and studies have shown high support for this approach. However, the past decade has seen many changes in the political landscape and social controversies. The present study reports on an updated survey and analysis of changes in support from 2006 to 2021. METHODS: Survey data were collected by telephone in 2006 (N = 1,605) and online and in-person in 2021 (N = 719) from separate samples of Minnesota parents of school-age children. Parents responded to items regarding preferences for CSE, support for teaching numerous specific sexuality education topics, and the grade level at which topics should be introduced. Chi-square tests and logistic regression (with weighted 2021 data) were used to detect differences in support between survey years and across demographic and personal characteristics. RESULTS: At both time points, approximately 90% of parents thought that CSE should be taught in schools, with significant increases in support within several demographic categories. Support for including all specific topics was high, including for topics typically considered highly controversial (e.g., gender identity, 68.7%; abortion, 77.7% in 2021). Parents endorsed introducing most topics in elementary or middle school years. DISCUSSION: Findings suggest that policy makers and educators in Minnesota can be confident of strong parental support for CSE covering a wide range of content to meet students' needs. Advocacy and action to advance the use of national sexuality education standards are in keeping with the views of the overwhelming majority of parents of school-age children.

Prime time: 18-month violence outcomes of a clinic-linked intervention.

Prime Time, a youth development intervention, aims to reduce multiple risk behaviors among adolescent girls seeking clinic services who are at high risk for pregnancy. The purpose of the current study was to examine whether Prime Time involvement produced changes in relational aggression, physical violence, and related psychosocial and behavioral outcomes. Qualitative case exemplars illustrated social contexts of intervention participants with differing longitudinal patterns of relational aggression and physical violence. Data were from a randomized efficacy trial with 13-17 year-old girls (n = 253) meeting specified risk criteria. Intervention participants were involved in Prime Time and usual clinic services for 18 months, control participants received usual clinic services. Participants in the current study completed self-report surveys at baseline and 18 months following enrollment. Outcomes analyses revealed significantly lower levels of relational aggression perpetration in the intervention group versus controls. In contrast, Prime Time involvement did not result in significant reductions in physical violence. Exploratory dose-response analyses indicated that reductions in relational aggression may have been most pronounced among girls actively involved in Prime Time case management and peer leadership activities. Qualitative findings suggested that the intervention's emphasis on modeling and building supportive relationships contributed to reductions in relational aggression. This study contributes to what has been a very limited evidence base regarding effective approaches to preventing violence among high-risk adolescent girls. Findings suggest that offering youth development interventions through clinic settings hold promise in reducing violence risk among vulnerable youth.

Barriers to providing the sexuality education that teachers believe students need.

BACKGROUND: Sexuality education teachers' perspectives are important to gain a full understanding of the issues surrounding teaching this subject. This study uses a statewide sample of public school teachers to examine what sexuality education content is taught, what barriers teachers face, and which barriers are associated with teaching specific topics. METHODS: Participants included 368 middle and high school teachers with sexuality education assignments in Minnesota. Survey data included topics they teach, what they think they should teach, and barriers they face. Logistic regression was used to examine associations between barriers and teaching each of 9 sexual health topics, among those who believed the topic should be taught. RESULTS: Almost two thirds of participants faced structural barriers; 45% were concerned about parent, student, or administrator response; and one quarter reported restrictive policies. Structural barriers were inversely associated with teaching about communication (OR = 0.20), teen parenting (OR = 0.34), and abortion (OR = 0.32); concerns about responses were associated only with teaching about sexual violence (OR = 0.42); and restrictive policies were inversely associated with teaching about abortion (OR = 0.23) and sexual orientation (OR = 0.47). CONCLUSIONS: Addressing teachers' barriers requires a multipronged approach, including curriculum development and evaluation, training, and reframing the policy debate to support a wider range of sexuality education topics.

Prime time: sexual health outcomes at 24 months for a clinic-linked intervention to prevent pregnancy risk behaviors.

IMPORTANCE: Preventing early pregnancy among vulnerable adolescents requires innovative and sustained approaches. Prime Time, a youth development intervention, aims to reduce pregnancy risk among adolescent girls seeking clinic services who are at high risk for pregnancy. OBJECTIVE: To evaluate sexual risk behaviors and related outcomes with a 24-month postbaseline survey, 6 months after the conclusion of the Prime Time intervention. DESIGN: Randomized controlled trial. SETTING: Community and school-based primary care clinics. PARTICIPANTS: Of 253 sexually active 13- to 17-year-old girls meeting specified risk criteria, 236 (93.3%) completed the 24-month follow-up survey. INTERVENTION: Offered during an 18-month period, Prime Time includes case management and youth leadership programs. MAIN OUTCOME MEASURES: Self-reported consistency of condom, hormonal, and dual-method contraceptive use with most recent male sex partner and number of male sex partners in the past 6 months. RESULTS: At 24-month follow-up, the intervention group reported significantly more consistent use of condoms, hormonal contraception, and dual-method contraception than the control group. Intervention participants also reported improvements in family connectedness and self-efficacy to refuse unwanted sex, and reductions in the perceived importance of having sex. No between-group differences were found in the number of recent male sex partners. CONCLUSIONS AND RELEVANCE: This study contributes to what has been a dearth of evidence regarding youth development interventions offered through clinic settings, where access to high-risk adolescents is plentiful but few efforts have emphasized a dual approach of strengthening sexual and nonsexual protective factors while addressing risk. Findings suggest that health services grounded in a youth development framework can lead to long-term reductions in sexual risk among vulnerable youth.

A clinic-based, youth development approach to teen pregnancy prevention.

OBJECTIVE: To provide a description of Prime Time, an intervention to reduce pregnancy risk behaviors among high-risk adolescent girls. METHODS: Prime Time, a clinic-based, multicomponent youth development intervention aims to reduce sexual risk behaviors, violence involvement, and school disconnection. RESULTS: We highlight key considerations in conceptualization, design, and methods for a Prime Time randomized trial. CONCLUSIONS: Prime Time comes at a time of great interest in restructuring adolescent health services. This study represents an important effort to expand preventive and youth development services among young people most vulnerable to early pregnancy, for whom services must go beyond traditional problem-oriented approaches.