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1.
AIDS Educ Prev ; 33(2): 89-102, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33821678

RESUMO

HIV/STDs and unintended pregnancy persist among adolescents in the United States; thus, effective sexual health interventions that can be broadly disseminated are necessary. Digital health interventions are highly promising because they allow for customization and widespread reach. The current project involved redeveloping and expanding HEART (Health Education and Relationship Training)-a brief, digital sexual health intervention efficacious at improving safer sex knowledge, self-efficacy, and behavior-onto an open-source platform to allow for greater interactivity and accessibility while reducing long-term program costs. The authors describe the process of adapting, reprogramming, and evaluating the new program, which may serve as a guide for investigators seeking to adapt behavioral interventions onto digital platforms. The final product is an open-source intervention that can be easily adapted for new populations. Among 233 adolescents (Mage = 15.06; 64% girls), HEART was highly acceptable and generally feasible to administer, with no differences in acceptability by gender or sexual identity.


Assuntos
Infecções por HIV/prevenção & controle , Educação em Saúde/métodos , Promoção da Saúde/métodos , Gravidez na Adolescência/prevenção & controle , Saúde Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Adolescente , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Ciência da Implementação , Masculino , Gravidez , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Sexo Seguro , Autoeficácia , Comportamento Sexual
2.
Reprod Health ; 18(1): 48, 2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33622358

RESUMO

BACKGROUND: Contraceptive use among adolescent girls is low in many sub-Saharan African countries including Kenya. Attitude and perspectives about contraception of community members including adolescent girls themselves may be likely to limit contraceptive use among adolescent girls. This study was conducted to explore and compare adults'/parents' and adolescent girls' narratives and perspectives about contraception in Narok and Homa Bay counties, Kenya. METHODS: Qualitative data from 45 in-depth-interviews conducted with purposively selected consenting adolescent girls aged 15-19 was used. Additionally, twelve focus group discussions were held with 86 consenting adults conveniently recruited from the two counties. All discussions were conducted in the local language and audio recorded following consent of the study participants. Female moderators were engaged throughout the study making it appropriate for the study to solicit feedback from the targeted respondents. RESULTS: Findings highlighted adults' perceptions on adolescents' sexuality and the presence of stringent conceptions about the side-effects of contraception in the study communities. Some participants underscored the need for open contraceptive talk between parents and their adolescent girls. Four main themes emerged from the discussions; (i) Perceptions about adolescents' sexuality and risk prevention, (ii) Conceptions about contraception among nulligravida adolescents: fear of infertility, malformation and sexual libertinism, (iii) Post-pregnancy contraceptive considerations and (iv) Thinking differently: divergent views regarding contraceptives and parent/adolescent discussion. CONCLUSIONS: Our findings suggest the need for increased attention towards adolescents and their caregivers particularly in demystifying contraceptive misconceptions. Programmatic responses and models which include the provision of comprehensive sexuality education and increased access to and utilization of SRH information, products and services through a well-informed approach need to be well executed. Programmatic efforts like SRH community education should further seek to enhance the capacity of parents to discuss sexuality with their adolescents.


Assuntos
Comportamento Contraceptivo , Casamento , Relações Pais-Filho , Percepção , Psicologia do Adolescente , Adolescente , Comportamento do Adolescente/fisiologia , Adulto , Anticoncepção/métodos , Anticoncepção/psicologia , Anticoncepção/estatística & dados numéricos , Comportamento Contraceptivo/psicologia , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepcionais/uso terapêutico , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Quênia/epidemiologia , Casamento/psicologia , Casamento/estatística & dados numéricos , Relações Pais-Filho/etnologia , Gravidez , Gravidez na Adolescência/prevenção & controle , Gravidez na Adolescência/psicologia , Gravidez na Adolescência/estatística & dados numéricos , Pesquisa Qualitativa , Educação Sexual/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adulto Jovem
3.
Acta Obstet Gynecol Scand ; 100(4): 629-640, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33608901

RESUMO

INTRODUCTION: Long-acting reversible contraception (LARC) methods are safe for adolescents and provide the greatest assurance against rapid repeated pregnancy when inserted during the immediate postpartum (IPP) and immediate post-abortion (IPA) period. Despite increasing enthusiasm for IPP/IPA LARC insertion, adolescents' preferences and experiences have seldom been examined. The objective of this review was to examine the attitudes of adolescents (aged 10-19 years) towards IPP/IPA LARC, their experiences and perceptions around having an LARC device fitted IPP/IPA and the factors involved in decision-making to use, not use or discontinue IPP/IPA LARC. MATERIAL AND METHODS: In January 2021, we searched seven bibliographic databases for original research articles published in English, from the year 2000. Studies of any design focused on IPP/IPA LARC were eligible for inclusion. Three of the authors assessed articles for eligibility and extracted data relevant to the outcomes of the review. Joanna Briggs Institute Critical Appraisal Tools were used to assess methodological quality. Key themes emerging from the data were synthesized and reported narratively. RESULTS: We identified 10 relevant articles, four of which were entirely adolescent-focused. Only three addressed IPA LARC. IPP availability was important for ensuring access to LARC postpartum. Attitudes towards LARC IPP were associated with adolescents' sociodemographic characteristics and positive perceptions related to the long duration of action. Determinants of discontinuation and nonuse included poor-quality contraceptive counseling, intolerable side effects and subsequent distress, misconceptions about LARC safety IPP and the influence of partners and community on autonomy. No factors involved in IPA LARC decision-making were available. Limited evidence demonstrated that adolescents may favor contraceptive implants over intrauterine devices, and in certain contexts may face greater barriers to IPA LARC access than adult women do. CONCLUSIONS: Immediate insertion of LARC postpartum appears acceptable to adolescents who do not experience side effects and those with the opportunity to make autonomous contraception decisions. This important topic has been addressed in few studies involving an entirely adolescent population. Very limited evidence is available on IPA LARC. Further research on adolescents' lived experiences of IPP/IPA LARC access and use is necessary to inform the provision of person-centered care when assisting adolescents' contraceptive choice following pregnancy.


Assuntos
Contracepção Reversível de Longo Prazo/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gravidez na Adolescência/prevenção & controle , Aborto Induzido , Adolescente , Feminino , Humanos , Período Pós-Parto , Gravidez
4.
Acta Obstet Gynecol Scand ; 100(4): 641-648, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33483956

RESUMO

The use of intrauterine devices (IUDs), including the copper-bearing device and the levonorgestrel intrauterine system (LNG-IUS), is safe among nulligravidas and adolescent girls. However, several misconceptions limit their use in clinical practice; health-care providers are hesitant to prescribe IUDs, and several myths associated with their usage in nulligravidas and adolescents exist among both providers and women themselves. The high rates of unplanned pregnancies (which in many settings constitute a public health issue, primarily among adolescent females) can be attributed at least partially to lack of awareness and limited use of highly effective contraceptives such as IUDs. In this review, we discuss the role of non-hormonal and hormonal IUDs as effective contraceptives in nulligravidas and adolescent girls. We present a literature review of data that highlight contraceptive efficacy, side effects (including reasons for discontinuation), and continuation rates with the method. We searched the PubMed/MEDLINE, Cochrane Library, Embase, and Scopus databases for all articles published in English between January 1990 through September 2020. A large body of evidence confirmed the effectiveness of IUD/IUS, independent of age and parity. Studies showed a high expulsion rate among adolescents but not among nulligravidas. Additionally, bleeding patterns among adolescents and nulligravidas were similar to those observed among adults and parous women. The high early removal rates observed in adolescents were attributable to bleeding and/or pain, which indicate that compared with adults, adolescents are less likely to accept IUD-induced side effects. IUD placement is an excellent strategy to avoid the high rates of unplanned pregnancies in adolescents and nulligravidas. IUDs are more effective than short-acting reversible contraceptives with failure rates that are equivalent to those observed with permanent contraception. However, few long-term studies have investigated this category of women to definitively establish the role of IUD/IUS as effective means of contraception.


Assuntos
Dispositivos Intrauterinos de Cobre , Dispositivos Intrauterinos Medicados , Gravidez na Adolescência/prevenção & controle , Adolescente , Feminino , Número de Gestações , Humanos , Gravidez , Gravidez não Desejada
5.
Rev. méd. hondur ; 88(2): 99-103, jul.-dic. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1152097

RESUMO

Antecedentes: Aproximadamente 80% de embara-zos en adolescentes se consideran involuntarios, 95% ocurren en países en vías de desarrollo. Entre las características de estas jóvenes destacan: un sinfín de adversidades sociales, maduración temprana, actividad sexual prematura, bajo nivel educativo, ausencia de pareja, historia materna de embarazo en adolescencia y, falta de conocimiento/acceso a métodos contraceptivos. Objetivo: Determinar el uso de métodos anticonceptivos de larga acción (MLA) entre adolescentes en condición de aborto en cuatro hospitales de Honduras, enero 2017-julio 2019. Métodos:Estudio descriptivo transversal utilizando la base de datos Sistema Informático Perinatal (SIP) módulo aborto (SIPA). Incluyó registros de pacientes de 19 años y menos. Se describen variables preestablecidas en la hoja SIP (demográficas, antecedentes patológicos, obstétricos, de uso de anticonceptivos, deseo de anticoncepción y provisión de métodos), analizando frecuencias y porcentajes. Resultados: De 1117 pacientes registradas, 84.9% (949) estaba en el rango de edad 16-19 años, 24.7% (276) había tenido al menos una gesta; 72.4% (809) recibió consejería/información de planificación familiar, 75.5% (843) solicitó un método y 53.1% (448) iniciaron alguno; 84.9% (949) no había usado contraceptivos antes del embarazo actual. Discusión: La información del SIPA en las instituciones participantes muestra la descripción del uso de anticonceptivos en adolescentes en situación de aborto, donde una cuarta parte de ellas había tenido gestas previas. La necesidad de información efectiva sobre uso de métodos anticonceptivos y la existencia de una brecha entre la demanda y la entrega de anticonceptivos en las unidades de salud incluidas, deben ser atendidas urgentemente...(AU)


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Anticoncepcionais Femininos , Contracepção Reversível de Longo Prazo , Gravidez na Adolescência/prevenção & controle , Aborto
6.
BMC Public Health ; 20(1): 1025, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32600290

RESUMO

BACKGROUND: Many unmarried young people in low- and middle-income countries (LMIC) want to avoid pregnancy but do not use modern methods of contraception-as a result, half of teen births in these countries are unintended. Researchers have identified numerous barriers that prevent youth from using contraception. However, much of the research in West Africa is narrowly focused on married women, and relatively little research has been done to understand the needs, preferences, barriers, and solution set for sexually active unmarried young people who would like to avoid pregnancy. The purpose of this study was to gain insight into the behavioral barriers that prevent unmarried young people in eastern Senegal from using modern methods of contraception. METHODS: This qualitative study conducted in 2017 in the Tambacounda and Kedougou regions in Senegal explores attitudes and beliefs relating to sex and contraception among unmarried young women and men through 48 in-depth individual interviews with young people aged 15-24 and parents of youth and 5 sex-segregated focus groups with 6-9 young people per group. The research team conducted a thematic content analysis and synthesized the findings by major theme following the behavioral diagnosis methodology. RESULTS: Drawing insights from behavioral science, the analysis yields five key findings: (1) unmarried young people avoid making a decision about contraception because thinking about contraceptive use provokes uncomfortable associations with a negative identity (i.e., being sexually active before marriage); (2) unmarried young people see modern methods as inappropriate for people like them; (3) unmarried young people are overconfident in their ability to prevent pregnancy through traditional and folk methods; (4) unmarried young people overestimate the social and health risks of modern contraceptive methods; and (5) unmarried young people fail to plan ahead and are not prepared to use modern contraceptive methods before every sexual encounter. CONCLUSIONS: Interventions aimed at increasing uptake of contraceptives among unmarried young people in eastern Senegal must address several significant behavioral barriers in addition to structural, informational, and socio-cultural barriers in order to be successful.


Assuntos
Comportamento Contraceptivo/psicologia , Anticoncepção/psicologia , Gravidez na Adolescência/psicologia , Comportamento Sexual/psicologia , Pessoa Solteira/psicologia , Adolescente , Anticoncepção/estatística & dados numéricos , Serviços de Planejamento Familiar , Feminino , Grupos Focais , Acesso aos Serviços de Saúde , Humanos , Masculino , Gravidez , Gravidez na Adolescência/prevenção & controle , Pesquisa Qualitativa , Senegal , Adulto Jovem
7.
BMC Public Health ; 20(1): 1120, 2020 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-32677930

RESUMO

BACKGROUND: Parent-child communication about sexual issues can reduce risky sexual behaviour amongst adolescents. Risky sexual behaviour is of concern in sub-Saharan Africa where the prevalence of early pregnancy, unsafe abortion and HIV are high. Parent-child communication about sexual issues presents a feasible approach for reducing sexual risk amongst adolescents in sub-Saharan Africa but limited research exists from the region. This study from Zambia examines the sociodemographic and psychosocial factors that are associated with whether parents communicate with their daughters about sexual issues. METHODS: Data from a cluster randomized controlled trial examining the effect of interventions aiming to reduce teenage pregnancy and school drop out in Zambia was used. The data was collected between January-July in 2018 and consists of structured, face to face interviews with 4343 adolescent girls and 3878 parents. Cross sectional analyses examined the associations between parent-child communication about sexual issues and sociodemographic and psychosocial characteristics using univariate and multivariable logistic regression models. RESULTS: Adolescent girls who felt connected to their parents and those who perceived their parents to be comfortable in communicating about sex, were more likely to speak to their parents about sexual issues than those who did not (AOR 1.23, 95% CI 1.01-1.52; and AOR 2.94, 95% CI 2.45-3.54, respectively). Girls whose parents used fear-based communication about sexual issues, and those who perceived their parents as being opposed to education about contraception, were less likely to communicate with their parents about sex than those who did not (AOR 0.76, 95% CI 0.65-0.89; and AOR 0.76, 95% CI 0.63-0.91, respectively). Girls enrolled in school were less likely to communicate with their parents about sex than those out of school (AOR 0.56, 95% CI 0.44-0.71). CONCLUSION: Parenting style, children's perception of parental attitudes and parental communication styles are associated with whether parents and children communicate about sexual issues. This may imply that parents can improve the chances of communicating with their children about sex by conveying non-judgemental attitudes, using open communication styles with neutral messages and appearing comfortable whilst displaying positive attitudes towards communication around sex and contraceptive use. TRIAL REGISTRATION: ISRCTN registry: ISRCTN12727868 , (4 March 2016).


Assuntos
Comportamento do Adolescente/psicologia , Núcleo Familiar/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Saúde Sexual , Aborto Induzido , Adolescente , Adulto , Criança , Comunicação , Comportamento Contraceptivo/psicologia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Gravidez , Gravidez na Adolescência/prevenção & controle , Gravidez na Adolescência/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Assunção de Riscos , Comportamento Sexual/psicologia , Zâmbia
8.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32690806

RESUMO

Long-acting reversible contraceptives are the most effective methods to prevent pregnancy and also offer noncontraceptive benefits such as reducing menstrual blood flow and dysmenorrhea. The safety and efficacy of long-acting reversible contraception are well established for adolescents, but the rate of use remains low for this population. The pediatrician can play a key role in increasing access to long-acting reversible contraception for adolescents by providing accurate patient-centered contraception counseling and by understanding and addressing the barriers to use.


Assuntos
Contracepção Reversível de Longo Prazo , Adolescente , Amenorreia/induzido quimicamente , Confidencialidade , Aconselhamento , Pessoas com Deficiência , Dismenorreia/tratamento farmacológico , Feminino , Acesso aos Serviços de Saúde , Humanos , Consentimento Livre e Esclarecido , Capacitação em Serviço , Dispositivos Intrauterinos , Contracepção Reversível de Longo Prazo/efeitos adversos , Contracepção Reversível de Longo Prazo/economia , Menorragia/tratamento farmacológico , Pediatras/educação , Relações Médico-Paciente , Gravidez , Gravidez na Adolescência/prevenção & controle , Estados Unidos
9.
PLoS One ; 15(6): e0233985, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32492055

RESUMO

INTRODUCTION: In sub-Saharan Mozambique, high adolescent fertility rates are a significant public health problem. Understanding the consequences of teenage pregnancies facilitates effective strategies for improving the quality of care of both mother and the newborn. AIMS: To identify the factors associated with adolescent motherhood in Tete (Mozambique). METHODS: This was a cross-sectional study including 821 pregnant women (255 teenagers) admitted to the general maternity ward of the Provincial Hospital between March and October 2016. The survey included clinical data of the mother and newborn. RESULTS: The overall prevalence of adolescent deliveries was 31.8% (95% CI 27.9% - 34.2%). Multivariate analysis showed that independent factors associated with teenage motherhood were: number of pregnancies (OR 0.066; 95% CI 0.040-0.110), pregnancy follow-up (OR 0.29; CI 0.173-0.488) and previous abortions (OR 4.419; 95% CI 1.931-10.112). When the age of the mother was analysed as a continuous variable, positively associated factors were body mass index, arterial hypertension, HIV infection, previous abortions, pregnancy follow-up, and the weight of the newborn. Negatively associated factors were episiotomy and respiratory distress in the newborn. CONCLUSION: Teenage motherhood is a serious public health problem in Mozambique. Intensive sexual and reproductive health planning for adolescents is needed.


Assuntos
Saúde do Adolescente/estatística & dados numéricos , Saúde do Lactente/estatística & dados numéricos , Saúde Materna/estatística & dados numéricos , Gravidez na Adolescência/estatística & dados numéricos , Aborto Induzido/estatística & dados numéricos , Adolescente , Serviços de Saúde do Adolescente/organização & administração , Estudos Transversais , Feminino , Número de Gestações , Planejamento em Saúde/organização & administração , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Mortalidade Materna , Moçambique/epidemiologia , Gravidez , Gravidez na Adolescência/prevenção & controle , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
10.
Best Pract Res Clin Obstet Gynaecol ; 66: 107-118, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32527659

RESUMO

This article sets out the progress that has been made in reducing levels of adolescent childbearing and in meeting adolescent contraceptive needs, over the last 25 years, and also makes the public health, economic, and human rights rationale for continued attention to and investment in these areas. Using an analytic framework that covers the perspectives of both the use and the provision of contraception, it examines the factors that make it difficult for adolescents to obtain and use contraceptives to avoid unintended pregnancies, and outlines what could be done to address these factors, drawing from research evidence and programmatic experience. In doing this, the article provides concrete examples from low- and middle-countries that have made tangible progress in these areas.


Assuntos
Comportamento Contraceptivo , Anticoncepção/estatística & dados numéricos , Serviços de Planejamento Familiar/organização & administração , Acesso aos Serviços de Saúde , Gravidez na Adolescência/prevenção & controle , Adolescente , Serviços de Saúde do Adolescente , Anticoncepcionais/administração & dosagem , Anticoncepcionais/provisão & distribução , Dispositivos Anticoncepcionais , Feminino , Direitos Humanos , Humanos , Gravidez
11.
West J Emerg Med ; 21(3): 640-646, 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-32421513

RESUMO

INTRODUCTION: Adolescents who seek care in the emergency department (ED) are a cohort at increased risk of unintended pregnancy. Although adolescents are interested in learning about pregnancy prevention in the ED, there is a lack of effective educational interventions in this setting. Long-acting reversible contraceptives (LARC) are highly effective and safe in teens, yet are underutilized. This study assessed contraception use among adolescents in the ED and evaluated the impact of an educational video on their interest in and uptake of LARCs. METHODS: We conducted a two-arm randomized controlled trial on a convenience sample of sexually active females 14 to 21 years old in an urban pediatric ED. Participants were randomized to an educational video or standard care. All participants completed a survey and were given an informational card about affiliated teen clinics with the option to schedule an appointment. We assessed pre-post mean differences between control and intervention participants and pre-post differences among intervention participants. Participants were followed three months after their ED visit to examine use of contraception. RESULTS: A total of 79 females were enrolled (42 control and 37 intervention). The mean age was 17 years, and most were youth of color. The proportion of participants with a prior pregnancy was 18%. Almost all participants reported wanting to avoid pregnancy, yet 18% reported not using contraception at last intercourse. At baseline, 17.7% of participants were somewhat or very interested in the intrauterine device (IUD) or implant. After watching the video, 42.3% were somewhat or very interested in the IUD and 35.7% in the implant. Among those who watched the video, there were significant increases in interest in using an IUD or implant (p<.001). Compared to controls, adolescents who watched the video were also significantly more likely to report wanting an IUD (p<0.001) or implant (p=0.002). A total of 46% were reached for follow-up. Of these, 16% had initiated a LARC method after their ED visit (p=NS). CONCLUSION: Most adolescent females in the ED want to avoid pregnancy, but are using ineffective methods of contraception. A brief educational video on LARCs was acceptable to adolescents and feasible to implement in a busy urban ED setting. Adolescents who watched the video had significantly greater interest in using LARCs, but no demonstrated change in actual adoption of contraception.


Assuntos
Serviço Hospitalar de Emergência , Contracepção Reversível de Longo Prazo/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Educação de Pacientes como Assunto/métodos , Gravidez na Adolescência/prevenção & controle , Sexo sem Proteção/prevenção & controle , Adolescente , Comportamento do Adolescente/psicologia , Feminino , Seguimentos , Comportamentos Relacionados com a Saúde , Humanos , Dispositivos Intrauterinos/estatística & dados numéricos , Contracepção Reversível de Longo Prazo/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gravidez , Gravidez na Adolescência/psicologia , Gravidez não Planejada , Gravidez não Desejada , Estudos Prospectivos , Sexo sem Proteção/psicologia , Gravação em Vídeo , Adulto Jovem
13.
Enferm. clín. (Ed. impr.) ; 30(supl.3): 66-70, mar. 2020. graf, tab
Artigo em Inglês | IBECS | ID: ibc-196114

RESUMO

OBJECTIVE: This study is aimed to analyze the effectiveness of Titeer game toward preventing of teenage pregnancy. METHOD: A quasi experiment with pre-posttest control group was used in this study. One hundreed and thirty eight of tenagers aged 2-10 years were recruited as participants (69 of tenagers each group). Titeer game was given to intervention group during a month. Conventional intervention (leaflet) were provided to control group. The illustrative questionnaires were measured before intervention, 2 and 10 weeks after intervention to measure knowledge, attitude, sefl-eficacy, life skill, peer influenced, behavior, and prevent of pregnancy of tenagers. Independent T-Test and General Linear Model Repeated Measured (GLM-RM) was used to complete of analysis. RESULTS: Knowledge, attitude, self efficacy, life skill peer influenced, and pregnancy prevention were significantly increase 2 and 10 of weeks after intervention. CONCLUSION: The Titeer game could be increase of preventing tenagers' pregnancy aged 2-10 years


No disponible


Assuntos
Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Gravidez na Adolescência/prevenção & controle , Educação Sexual/métodos , Conhecimentos, Atitudes e Prática em Saúde , Jogos e Brinquedos/psicologia , Gravidez na Adolescência/psicologia , Educação Sexual/organização & administração , Inquéritos e Questionários , Autoeficácia , Serviços de Saúde do Adolescente
15.
Reprod Health ; 17(1): 20, 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32005263

RESUMO

BACKGROUND: Zimbabwe has the highest teenage pregnancy rate in Sub Saharan Africa. Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) prevalence in adolescents that are from tribes that perform cultural initiations and subscribe to certain norms are higher than the national prevalence which is estimated at 12% (18 and 13.6% respectively) in Zimbabwe. Indigenous Health Systems (IHSs) and Modern Health Systems (MHSs) in Zimbabwe run parallel thereby introducing challenges in the management of adolescent sexual health due to conflicts. This study seeks to develop strategies that will facilitate the integration of IHSs and MHS in Mberengwa and Umguza districts. METHODS: This research will be conducted in two phases. The first phase would utilise a concurrent triangulation mixed methods design with both qualitative and quantitative approaches. The findings from the qualitative and quantitative approaches would be merged through a comparison of findings side by side. The second phase would focus on the development and validation of strategies that would facilitate the integration of IHSs and MHSs. The Strength, Weakness, Opportunity and Threat (SWOT) analysis would be applied on interfaced findings from phase one. The Basic Logic and the Build, Overcome, Explore and Minimise (BOEM) models would then be used to develop strategies based on the SWOT findings. The developed strategies would be validated through the application of Delphi technique and administration of checklist to selected key stakeholders through organised workshops. DISCUSSION: There have been no known studies found in the literature that explores the possibility and developed strategies of integrating IHSs and MHSs so as to promote safe sexual practices in adolescents. Most programs on sexual health have ignored the role of IHSs and MHSs in influencing safe sexual practices leading to them failing to attain desired goals. A lot of emphases has been targeted at minimising the spread of Sexually Transmitted Infections (STIs) through advocating for utilisation MHSs rather than focussing on an integrating systems that are meant to manage Adolescent Sexual Health (ASH) related issues. The study protocol was approved by the University of Venda Ethics Committee Registration (SHS/19/PH/17/2608) on the 26th of August 2019.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Saúde do Adolescente/normas , Prestação Integrada de Cuidados de Saúde/normas , Gravidez na Adolescência/prevenção & controle , Projetos de Pesquisa/normas , Educação Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , África ao Sul do Saara , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Gravidez , Comportamento Sexual , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/transmissão , Adulto Jovem
16.
J Clin Res Pediatr Endocrinol ; 12(Suppl 1): 28-40, 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32041390

RESUMO

Although pregnancy and abortion rates have declined in adolescents, unintended pregnancies remain unacceptably high in this age group. The use of highly effective methods of contraception is one of the pillars of unintended pregnancy prevention and requires a shared decision making process within a rights based framework. Adolescents are eligible to use any method of contraception and long-acting reversible contraceptives, which are "forgettable" and highly effective, may be particularly suited for many adolescents. Contraceptive methods may have additional non-contraceptive benefits that address other needs or concerns of the adolescent. Dual method use should be encouraged among adolescents for the prevention of both unintended pregnancies and sexually transmitted infections. Health care providers have an important role to play in ensuring that adolescents have access to high quality and non-judgmental reproductive health care services and contraceptive methods in adolescent-friendly settings that recognize the unique biopsychosocial needs of the adolescent.


Assuntos
Anticoncepção , Gravidez na Adolescência/prevenção & controle , Adolescente , Anticoncepção/economia , Anticoncepção/métodos , Anticoncepção Pós-Coito , Aconselhamento , Feminino , Pessoal de Saúde , Humanos , Gravidez , Comportamento Sexual
17.
J Womens Health (Larchmt) ; 29(5): 622-626, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32074475

RESUMO

Objectives: Contraception use reduces teen pregnancy, and long-acting reversible contraception is recommended as first-line treatment. Since many adolescents use the emergency department (ED) as a primary source of health care, it is a potential site of contraceptive counseling and provision. We surveyed female adolescents to assess desire for contraceptive counseling and initiation/change during an ED visit. Materials and Methods: This was a cross sectional study of a convenience sample of female ED patients aged 16-21 years in an urban pediatric ED. Participants completed an anonymous questionnaire about sexual health, contraceptive use, and interest in contraceptive counseling. The primary outcome was adolescent interest in starting/changing contraception during an ED visit. Results: Three hundred eighty-one patients (mean age 19.1 ± 1.6 years) completed the survey. Most (80.5%) had been sexually active with a male partner, and 110 (28.2%) had previously been pregnant. Two-thirds were interested in discussing contraception and 22.5% were likely to start or change contraception during the ED visit. Those who wanted to start or change contraception were more likely to be sexually active with a male partner (93% vs. 82%, p = 0.02) and to report that they were not satisfied with their current contraception (44% vs. 21%, p = 0.0003). Fifteen (17%) of the adolescents likely to start or change contraception were interested in progestin implant initiation in the ED. Conclusions: Adolescents were interested in initiating or changing contraception during the ED visit, providing an important opportunity to discuss and initiate effective contraception.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Serviço Hospitalar de Emergência , Serviços de Planejamento Familiar/métodos , Contracepção Reversível de Longo Prazo/métodos , Comportamento Sexual/estatística & dados numéricos , Adolescente , Anticoncepção , Anticoncepcionais , Dispositivos Anticoncepcionais/estatística & dados numéricos , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Gravidez , Gravidez na Adolescência/prevenção & controle , Inquéritos e Questionários , Adulto Jovem
19.
BMC Health Serv Res ; 20(1): 42, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31948452

RESUMO

BACKGROUND: The youths in Zambia have limited access to information concerning Sexual Reproductive Health (SRH) and this puts them at risk of unwanted pregnancies. Talking about other methods of preventing pregnancy or sexually transmitted infections than abstinence is regarded as culturally unacceptable. The Research Initiative to Support the Empowerment of Girls (RISE) is a cluster randomised controlled trial testing the effectiveness of different support packages on teenage pregnancies, early marriages and school drop-out rates. One of the support packages included youth clubs focusing on Comprehensive Sexual and Reproductive Health Education (CSRHE). Although similar interventions have been implemented in other settings, their integration process has been complex and comprehensive assessments of factors shaping acceptability of CSRHE are lacking. This article qualitatively aimed at identifying factors that shaped the acceptability of CSRHE youth clubs in rural schools in Central Province. METHOD: A qualitative case study was conducted after the youth clubs had been running for a year. Data were gathered through eight focus group discussions with grade eight pupils and eight individual interviews with teachers. Data were analysed using thematic analysis. RESULTS: The perceived advantage and simplicity of the clubs related to the use of participatory learning methods, films and role plays to communicate sensitive reproductive health information made the learners like the youth clubs. Further, the perceived compatibility of the content of the sessions with the science curriculum increased the learners' interest in the youth clubs as the meetings also helped them to prepare for the school examinations. However, cultural and religious beliefs among teachers and parents regarding the use of contraceptives complicated the delivery of reproductive health messages and the acceptability of youth clubs' information among the learners. CONCLUSION: The study indicated that CSRHE youth clubs may be acceptable in rural schools if participatory learning methods are used and head-teachers, teachers as well as parents appreciate and support the clubs.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Saúde Reprodutiva/educação , População Rural , Serviços de Saúde Escolar/organização & administração , Saúde Sexual/educação , Adolescente , Adulto , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Gravidez na Adolescência/prevenção & controle , Pesquisa Qualitativa , População Rural/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/prevenção & controle , Zâmbia
20.
J Relig Health ; 59(1): 555-569, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28616769

RESUMO

This study prospectively investigates associations among youth religiosity, religious denomination, and contraception use. Associations between youth religiosity and religious denomination, and type of contraceptive used and consistent contraceptive use among sexually active youth (N = 757) were analyzed using multinomial and binomial logistic regression. Identifying with a religious denomination was a predictor of dual contraceptive use relative to using no method of contraception (AOR = 2.17). There was no association between youth religiosity and type of contraceptive use or contraceptive consistency. Religious leaders and public health practitioners should collaborate to develop strategies to engage in conversations with sexually active youth about contraceptive use.


Assuntos
Cristianismo/psicologia , Comportamento Contraceptivo/psicologia , Anticoncepção/métodos , Gravidez na Adolescência/prevenção & controle , Religião e Medicina , Religião e Sexo , Comportamento Sexual/psicologia , Adolescente , Comunicação , Anticoncepção/psicologia , Comportamento Contraceptivo/estatística & dados numéricos , Serviços de Planejamento Familiar/métodos , Feminino , Humanos , Masculino , Gravidez , Estudos Prospectivos , Religião , Religião e Psicologia , Comportamento Sexual/estatística & dados numéricos
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