Supporting Patient-centered Communication on Adolescent Sexual and Reproductive Health-Perspectives to Build an Appointment Planning Tool.

Abstract

STUDY OBJECTIVE\nInput from adolescents and healthcare providers is needed to develop electronic tools that can support patient-centered sexual and reproductive (SRH) care. This study explores facilitators and barriers to patient-centered communication in the context of developing an electronic appointment planning tool to promote SRH communication in clinic settings.\n\n\nDESIGN\nIn-depth interviews were conducted to explore what constitutes adolescent-friendly SRH care and communication, as well as on the design of the appointment planning tool. Interviews were coded iteratively, and analyzed using the software Atlas.TI v8.\n\n\nSETTING\nAn adolescent primary care clinic, and a pediatric and adolescent gynecology clinic.\n\n\nPARTICIPANTS\nAdolescent girls (N=32; ages 14-18) and providers who care for adolescent girls (N=10).\n\n\nMAIN OUTCOME MEASURES\nThematic analyses explored facilitators/barriers to SRH communication and care and preferences for the tool.\n\n\nRESULTS\nFacilitators identified by adolescents and providers included: direct patient/provider communication; adolescent-driven decision-making regarding care and contraceptive choice; supplementing clinic visits with electronic resources; and holistic care addressing physical, mental, and social needs. Barriers identified by participants included: limited time for appointments; limited adolescent autonomy in appointments; and poor continuity of care when adolescents cannot see the same provider. Given the complexity of issues raised, adolescents and providers were interested in developing an appointment planning tool to guide communication during appointments, and contributed input on its design. The resulting Appointment Planning Tool app pilot is in progress.\n\n\nCONCLUSIONS\nQualitative interviews with adolescents and providers offer critical insights for the development and implementation of mobile health (mHealth) tools that can foster patient-centered care.