Inpatient Adolescent Sexual Health Services and Long-Acting Reversible Contraception Training.

Abstract

Objective: Inpatient settings provide unique opportunities to deliver sexual health services, such as long-acting reversible contraception (LARC), including intrauterine devices and contraceptive implants, to adolescents. This study aimed to (1) characterize general inpatient screening and management of sexual health services by region and (2) assess clinician preferences about inpatient LARC training.

Patients and methods: We conducted a convergent parallel mixed-methods study with a national online survey and semistructured interviews among pediatric residents, fellows, advanced practice providers, and midlevel clinicians. We analyzed survey data with descriptive and bivariate statistics with significance set at .05 to evaluate sexual health screening and management by region. We analyzed interview data using an iterative deductive and inductive approach and coupled quantitative and qualitative findings.

Results: Overall, 669 clinicians completed the survey and 32 clinicians participated in interviews. Survey and interview findings supported one another. Southern participants reported less screening (χ2(5) = 16.7; P = .01) or management (χ2(5) = 17.0; P = .01) of sexual health needs than other regions. Qualitative findings included the following: (1) gaps in inpatient sexual health services and barriers to training; (2) successful implementation of inpatient sexual health training including contraceptive implants; and (3) clinician concerns about future implementation of inpatient LARC training and perceived solutions to improve feasibility.

Conclusions: Contraceptive implant training might be prioritized by future programs given its feasibility. Future studies can design educational interventions for inpatient clinicians who work with adolescents to ensure adequate delivery of sexual health services tailored to the region of the country.