Youths' Knowledge and Perceptions of Health Risks Associated With Unprotected Oral Sex.

PURPOSE: Although rates of sexually transmitted infections (STIs) and human papillomavirus (HPV)-related head and neck cancers associated with oral sex are increasing, less than 10% of youths report using protection. This study aims to assess youths' knowledge and perceptions of oral sex risk and barriers to protection use. METHODS: Our study uses MyVoice, a national text message poll of youths aged 14-24 years. Four open-ended probes were fielded to 1,215 youths in March 2019. Qualitative data were analyzed using thematic analysis and quantitative data were summarized with descriptive statistics. RESULTS: Nine hundred and nine youths responded to the survey (relative risk [RR]=74.8%). Youths' responses regarding why protection is frequently not used centered around: lack of education (22.4%), no perceived STI risk (19.8%), decreased pleasure (19.3%), and no pregnancy risk (15.7%). Youths believed that comprehensive education (53.7%), normalization in popular culture and media (19.1%), increased access to protection (15%), and improved protection options (10.5%) would increase protection use during oral sex. CONCLUSION: Youths demonstrated limited knowledge of the risks of oral sex, dissatisfaction with current protection options, and a need for normalization in popular culture. Programs developed with youths in mind may be able to successfully increase protection use and decrease rates of STI transmission and oral sex-related HPV head and neck cancer.VISUAL ABSTRACT.

Application of Mixed Methods in Health Services Management Research: A Systematic Review.

Mixed methods research (MMR) is versatile, pragmatic, and adaptable to constraints and opportunities during a research process. Although MMR has gain popularity in health services management research, little is known about how the research approach has been used and the quality of research. We conducted a systematic review of 198 MMR articles published in selected U.S.-based and international health services management journals from 2000 through 2018 to examine the extent of MMR application and scientific rigor. Results showed limited, yet increasing, use of MMR and a high degree of correspondence between MMR designs and study purposes. However, most articles did not clearly justify using MMR designs and the reporting of method details and research integration were inadequate in a significant portion of publications. We propose a checklist to assist the preparation and review of MMR manuscripts. Additional implications and recommendations to improve transparency, rigor, and quality in MMR are discussed.

Active Shooter Drills in the United States: A National Study of Youth Experiences and Perceptions.

PURPOSE: The purpose of this study was to understand youth experience and opinion surrounding active shooter drills. METHODS: MyVoice is a national text message poll of the youth ages 14-24 years that collects youth opinion on salient policy issues. Participants are recruited to meet national benchmarks. Five open-ended probes were posed to participants on August 2, 2019. Qualitative data were analyzed using thematic analysis; quantitative data were summarized using descriptive statistics. RESULTS: Among respondents (815 of 1283; 63.5%), the average age was 18.7 years (SD = 2.9). Most were girls (52.9%), non-white (42.8%), and with < high school diploma (56.9%). Responses centered around three themes: drill methods vary, active shooter drills cause emotional distress, and youth perceive drills to have questionable benefit. The majority (60.2%) mentioned that drills make them feel "scared and hopeless," but many (56.1%) also noted drills "teach kids on what to do." Others (24%) stated drills do not improve safety because they inform potential shooters or are ineffective because "people will likely panic, forgetting their drill." CONCLUSIONS: Many youth report that active shooter drills have a negative effect on their emotional health and are conflicted on their effectiveness.