Contraception for Adolescents During the Coronavirus Disease 2019 Pandemic

Our recent publication, Providing Contraception for Young People During a Pandemic is Essential Healthcare, was written in response to the sudden shift towards low-contact or no-contact medicine in the wake of the COVID-19 pandemic. Ensuring access to contraception is essential as every 6 months of lockdown can result in 47 million women losing access to contraception, resulting in an additional 7 million of unintended pregnancies. We welcome the letters submitted by Alouini/Venslauskaite and Uzoigwe/Ali as they exemplify common misperceptions within the medical community about contraception. The question of whether a physical exam is required prior to a contraception prescription, the safety of emergency contraception, and abstinence counseling are addressed below

Contraception for Adolescents During the Coronavirus Disease 2019 Pandemic

Our recent publication, Providing Contraception for Young People During a Pandemic is Essential Healthcare, was written in response to the sudden shift towards low-contact or no-contact medicine in the wake of the COVID-19 pandemic. Ensuring access to contraception is essential as every 6 months of lockdown can result in 47 million women losing access to contraception, resulting in an additional 7 million of unintended pregnancies. We welcome the letters submitted by Alouini/Venslauskaite and Uzoigwe/Ali as they exemplify common misperceptions within the medical community about contraception. The question of whether a physical exam is required prior to a contraception prescription, the safety of emergency contraception, and abstinence counseling are addressed below

Dual Protection Messaging for Adolescents and Young Adults in the Setting of Over-the-Counter Hormonal Contraception: A Human-Centered Design Approach

Study Objective To use human-centered design approaches to engage adolescents and young adults in the creation of messages focused on dual method use in the setting of over-the-counter hormonal contraception access Design Baseline survey and self-directed workbooks with human-centered design activities were completed. The workbooks were transcribed and analyzed using qualitative methods to determine elements of the communication model, including sender, receiver, message, media, and environment. Setting Indiana and Georgia Participants People aged 14-21 years in Indiana and Georgia Interventions Self-directed workbooks Main Outcome Measures Elements of the communication model, including sender, receiver, message, media, and environment Results We analyzed 54 workbooks, with approximately half from each state. Stakeholders self-identified as female (60.5%), white (50.9%), Hispanic (10.0%), sexually active (69.8%), and heterosexual (79.2%), with a mean age of 18 years. Most strongly agreed (75.5%) that they knew how to get condoms, but only 30.2% expressed the same sentiment about hormonal contraception. Exploration of the elements of the communication model indicated the importance of crafting tailored messages to intended receivers. Alternative terminology for dual protection, such as “Condom+____,” was created. Conclusion There is a need for multiple and diverse messaging strategies about dual method use in the context of over-the-counter hormonal contraception to address the various pertinent audiences as this discussion transitions outside of traditional clinical encounters. Human-centered design approaches can be used for novel message development

Assessing and Promoting Cardiovascular Health for Adolescent Women: User-Centered Design Approach

BackgroundCardiovascular disease (CVD) is the leading cause of death among women in the United States. A considerable number of young women already have risk factors for CVD. Awareness of CVD and its risk factors is critical to preventing CVD, yet younger women are less aware of CVD prevalence, its risk factors, and preventative behaviors compared to older women. ObjectiveThe purpose of this study is to assess CVD awareness among adolescent and young adult women and develop a lifestyle-based cardiovascular risk assessment tool for the promotion of CVD awareness among this population. MethodsThis study used a 3-phase iterative design process with young women and health care practitioners from primary care and reproductive care clinics in Atlanta, Georgia. In phase 1, we administered a modified version of the American Heart Association Women’s Health Survey to young women, aged 15-24 years (n=67), to assess their general CVD awareness. In phase 2, we interviewed young women, aged 13-21 years (n=10), and their health care practitioners (n=10), to solicit suggestions for adapting the Healthy Heart Score, an existing adult cardiovascular risk assessment tool, for use with this age group. We also aimed to learn more about the barriers and challenges to health behavior change within this population and the clinical practices that serve them. In phase 3, we used the findings from the first 2 phases to create a prototype of a new online cardiovascular risk assessment tool designed specifically for young women. We then used an iterative user-centered design process to collect feedback from approximately 105 young women, aged 13-21 years, as we adapted the tool. ResultsOnly 10.5% (7/67) of the young women surveyed correctly identified CVD as the leading cause of death among women in the United States. Few respondents reported having discussed their personal risk (4/67, 6%) or family history of CVD (8/67, 11.9%) with a health care provider. During the interviews, young women reported better CVD awareness and knowledge after completing the adult risk assessment tool and suggested making the tool more teen-friendly by incorporating relevant foods and activity options. Health care practitioners emphasized shortening the assessment for easier use within practice and discussed other barriers adolescents may face in adopting heart-healthy behaviors. The result of the iterative design process was a youth-friendly prototype of a cardiovascular risk assessment tool. ConclusionsAdolescent and young adult women demonstrate low awareness of CVD. This study illustrates the potential value of a cardiovascular risk assessment tool adapted for use with young women and showcases the importance of user-centered design when creating digital health interventions