Journal of Adolescent Health最新文献

{"title":"Effectiveness of Educational Interventions on Adolescent Knowledge and Practices for Preventing Noncommunicable Diseases in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.","authors":"Sugandha Jauhari, Monika Agarwal, Pratyaksha Pandit, Prashant K Bajpai, Abhishek Singh, Christopher D James","doi":"10.1016/j.jadohealth.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2024.12.014","url":null,"abstract":"<p><p>Noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, and cancers are major global health concerns, disproportionately impacting low- and middle-income countries (LMICs). Adolescents in LMICs are particularly vulnerable due to urbanization, lifestyle changes, and limited preventive care access. This study evaluates the effectiveness of educational interventions in improving adolescents' knowledge, and behaviors, for NCD prevention in LMICs. The systematic review and meta-analysis followed patient, intervention, comparison, outcome and preferred reporting items for systematic reviews and meta-analyses guidelines, targeting studies involving adolescents aged 10-19 who received educational interventions for NCD prevention. A comprehensive search across 5 databases identified 22 eligible studies. Study quality was assessed using the Cochrane risk-of-bias tool, and statistical analyses were conducted in R, with effect sizes expressed as risk ratios and mean differences, calculated with 95% confidence intervals (CIs). Educational interventions significantly improved knowledge about the health benefits of fruit consumption (mean difference: 0.52; 95% CI: 0.31-0.74; p < .001) and awareness of the harms of deep-fried foods (mean difference: 0.60; 95% CI: 0.43-0.76; p < .001). Interventions also reduced screen time (mean difference: 534.09 minutes; 95% CI: 345.39-722.80). However, changes in body mass index (mean difference: 0.04; 95% CI: -0.02 to 0.11; p = .193) and waist circumference (mean difference: 0.06; 95% CI: -0.33 to 0.45; p = .778) were not statistically significant. Multisession interventions involving parents and teachers showed greater improvements in physical fitness, dietary habits, and quality of life. Single-session interventions were effective mainly when involving parents. Educational interventions improve knowledge and reduce screen time among adolescents, laying a foundation for healthier behaviors. However, achieving sustained behavior change requires targeted strategies beyond education alone. Future programs should incorporate skill-building, follow-up, family or community involvement to support adolescents in adopting and maintaining healthy habits. Comprehensive, multicomponent interventions are essential for fostering long-term lifestyle changes and reducing NCD risk among adolescents in LMICs.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Geographic Variation of Serious Mental Illness Among Young Adults Enrolled in Medicaid in New York State.","authors":"Aaron H Rodwin, Deborah Layman, Molly Finnerty, Sadiq Y Patel, Junghye Jeong, Qingxian Chen, Michelle R Munson","doi":"10.1016/j.jadohealth.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.010","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate the prevalence and geographic variation of serious mental illness (SMI) among young adults enrolled in Medicaid and to identify individual and community-level factors associated with SMI.</p><p><strong>Methods: </strong>We used New York Medicaid data for over 1.6 million young adults aged 18-34 years with continuous Medicaid enrollment from April 2021 through March 2022. We merged 3 additional county and zip code-level datasets, including the Distressed Communities Index, Area Health Resource File, and New York homelessness data. We used descriptive analyses, data visualization methods, and multivariable logistic regression to estimate the prevalence of SMI and identify individual- (sex, race and ethnicity, age, disability aid, and homelessness) and community-level (geography, community distress, number of hospital beds, and community mental health centers per capita) factors associated with SMI.</p><p><strong>Results: </strong>The 12-month prevalence of SMI was 8.3% in New York State, with wide geographic variation by zip codes, ranging from 0% to 39%. Young adults identifying as Asian, Black, and Latinx (compared to White), and those living in zip codes with the most community distress were associated with lower odds of SMI, odds ratios (OR) ranged from 0.47 (Asian) (95% confidence interval [CI] [0.46-0.49]) to 0.95 (Latinx) (CI [0.93-0.97]). Young adults identifying as female (compared to male), receiving disability, experiencing homelessness, and rural residence were associated with higher odds of SMI, ORs ranged from 1.64 (female) (95% CI [1.62-1.66]) to 5.49 (homelessness) (95% CI [5.33-5.66]).</p><p><strong>Discussion: </strong>SMI prevalence varies by individual- and community-level factors, including homelessness and rural residence, signaling the need for specific interventions and policies.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time Trends and Socioeconomic Inequalities in Parental Physical Aggression and Adolescent Physical Fighting: Three Brazilian Birth Cohort Studies Over Twenty Years, 2000-2020.","authors":"Vanessa Iribarrem Avena Miranda, Carolina V N Coll, Alicia Matijasevich, Ina S Santos, Helen Gonçalves, Aluisio J D Barros, Luciana Tovo-Rodrigues, Joseph Murray","doi":"10.1016/j.jadohealth.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.019","url":null,"abstract":"<p><strong>Purpose: </strong>Violence prevention requires robust data on trends in different forms of violence and measures of progress toward reduction across subgroups of the population. This study aimed to investigate trends and related socioeconomic inequalities in parental physical aggression and involvement in physical fights among adolescents.</p><p><strong>Methods: </strong>Three population-based birth cohorts were conducted, including all births in the calendar years 1982, 1993, and 2004 in Pelotas city, Southern Brazil, with over 4,200 births in each cohort. Confidential self-report questionnaires were used to measure parental physical aggression (ages 11 and 15 years) and involvement in physical fights (ages 11, 15, and 18). The prevalence of violence outcomes was estimated, stratifying by sex and family income group for each cohort, and income-related inequalities were assessed through time.</p><p><strong>Results: </strong>There were significant reductions in parental physical aggression between cohorts, at ages 11 (prevalence ratio (PR): 0.83) and 15 years (PR: 0.70), and there was some evidence of reductions in income-related inequality regarding harsh parenting, mainly for boys. Considering physical fighting, there was a small increase through time for boys at age 11 (PR: 1.22), but no change for either sex at age 15, and declines for girls at age 18 years (PR: 0.50). There were income inequalities in physical fighting for girls at ages 11 and 15 (with a higher prevalence among the poorest adolescent girls in comparison to the richest), which persisted through time. However, income inequality in fighting among girls at age 18 reduced through time. There was little income inequality in fighting among boys at any age in any cohort.</p><p><strong>Discussion: </strong>Encouraging declines in parental physical aggression have occurred over the past 2 decades in this population of adolescents, but there is less clear evidence of changes in physical fights. Continued monitoring is vital to inform violence prevention policies.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Co-Occurring Prevalence of Non-Suicidal Self-Injury and Disordered Eating Among Adolescents and Young Adults: A Systematic Review.","authors":"Sarah R Eisenman, Isabella Jackson, Lee D Hudson, Adriana Vázquez-Vázquez","doi":"10.1016/j.jadohealth.2025.01.016","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.016","url":null,"abstract":"<p><p>Disordered eating (DE) and non-suicidal self-injury (NSSI) are transdiagnostic phenomena particularly prevalent among youth; but documentation of the prevalence of DE/NSSI comorbidity is limited. This review aimed to (1) synthesize existing prevalence data on comorbid DE/NSSI among this population and (2) describe co-occurring NSSI and specific DE behaviors where possible. PubMed, PsycINFO, EMBASE, and Web of Science were searched; 15 studies were included in this review. The Newcastle-Ottawa Scale adapted for cross-sectional studies was used to assess the risk of bias; five studies were rated as low risk of bias and 10 as moderate risk of bias. The weighted average comorbid prevalence of DE/NSSI was 4.46%, and differences across gender, age, DE behaviors, and measure types are discussed. There was limited available data for the characteristics of NSSI within comorbid DE. Clinicians should screen for comorbidity when either DE or NSSI is present. The primary methodological issue of included studies was the variance in reliability and validity of DE and NSSI measures; future research should address these issues and prioritize inclusion of non-White, non-Western, and gender/sexual minority youth.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the Complexities Between Reasons and Motivations Behind Suicide Behaviors: A Population-Based Study of Hong Kong Secondary School Students.","authors":"Zixu Li, Yu Cheng Hsu, Paul Siu Fai Yip","doi":"10.1016/j.jadohealth.2025.01.005","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.005","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the importance of and interconnected nature between the reasons and motivations underlying suicide behaviors among adolescents in Hong Kong.</p><p><strong>Methods: </strong>Suicide behaviors include suicidal ideation and suicide attempts. A subset of data was extracted for analysis from the 2016 wave of the Hong Kong Youth Sexuality Study. This subset comprised 1,744 adolescents who had considered, or attempted, suicide. Descriptive and network analysis was applied to explore the connections between suicide behavior reasons and motivations.</p><p><strong>Results: </strong>Both the descriptive and network analyses revealed that Hong Kong adolescents experienced multiple reasons and motivations behind their suicidal thoughts and suicide attempts. The primary reasons were emotional problems, family-related issues, and academic pressures. The main motivations were to get relief from a terrible state of mind, to escape from an impossible situation, and to end suffering. While these three main motivations were prevalent across nearly all the reasons, distinctive associations also emerged. Desire to die was a key motivation when suicide behaviors stemmed from a sense of meaninglessness or financial problems. Expressing love was a significant motivation when suicide behavior was related to the loss of a loved one. Sex differences were observed in the patterns of reasons and motivations.</p><p><strong>Discussion: </strong>The factors driving suicide behaviors among adolescents are complex and exhibit sex differences. Suicide behaviors may function as a coping mechanism for severe psychological distress. Distinctive reason-motivation connections underscore elevated risk levels among specific groups of adolescents and provide critical insights for designing targeted interventions.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Social Ecological Approach to Identifying Barriers and Proposing Interventions at Multiple Levels to Improve Healthcare for LGBTQIA+ Youths in the United States.","authors":"Julia Wickman, Sruti Mukherjee, Abby Mintz, Jennifer L Northridge","doi":"10.1016/j.jadohealth.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.009","url":null,"abstract":"<p><p>Young people who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other sexual and gender minorities (LGBTQIA+) in the United States experience poorer health than US youths overall. A social ecological approach that recognizes the multidimensional and multilevel influences on healthcare was used to identify barriers and propose interventions to achieve health equity for LGBTQIA+ adolescents and young adults. Database searches were conducted for original articles published within the last decade (2014-2024) that identified healthcare barriers for LGBTQIA+ individuals with participants aged 10-24 years and/or their family members or healthcare providers. The 36 studies included in this evidence-based, integrative review were conducted in 6 healthcare environments. Thirty-five barriers at the 6 levels of the Social Ecological Model were identified as follows: 5 individual, 10 interpersonal, 9 organizational, 6 community, 3 public policy, and 2 societal. The most frequently cited barrier was anti-LGBTQIA+ stigma at the societal level (21 studies). Findings point to interventions at multiple levels that would improve healthcare for LGBTQIA+ youths and youths overall: updating clinical education to address the needs of LGBTQIA+ youths, expanding Medicaid to cover costs of services in all US states, forming partnerships among LGBTQIA+ groups and healthcare organizations, and implementing inclusive intake forms.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Sociocultural Perspective of HPV Vaccine-Related Decision Making Among Immigrant Mothers in the United States.","authors":"Obianuju Aliche, Mia Liza A Lustria, Mary A Gerend","doi":"10.1016/j.jadohealth.2025.01.011","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.011","url":null,"abstract":"<p><strong>Purpose: </strong>The U.S. immigrants are at high risk for human papillomavirus (HPV) infection and death from HPV-related diseases. Children of immigrants have lower HPV vaccine initiation and completion rates compared to children of U.S.-born parents. Previous research suggests that sociocultural factors may play a role in these disparities, but this is still largely understudied. This study examines the relationship between sociocultural factors and immigrant mothers' HPV vaccine-related decision-making.</p><p><strong>Methods: </strong>An online survey was administered to 272 immigrant women (18+ years) residing in the United States with children ages 9-25 years. Multivariate logistic regression was employed to determine sociocultural predictors (i.e., acculturation) of HPV vaccine initiation and refusal. We also examined the relationship between HPV vaccination behaviors and vaccine-related decision-making in immigrant households.</p><p><strong>Results: </strong>Immigrant mothers who had a greater orientation toward their home culture were less likely to initiate HPV vaccination for their children (odds ratio [OR] = 0.92; 95% CI [0.87, 0.98]). Mothers who made vaccination decisions for their families either solely (OR = 0.37; 95% CI [-0.99, 0.47]) or jointly with their partners (OR = 0.24; 95% CI [-1.42, 0.46]) were less likely to refuse HPV vaccination for their children compared to mothers who relied solely on their partners to make these decisions. Lastly, mothers who were more adapted to the United States were more likely to make vaccination decisions jointly with their partners (OR = 1.03; 95% CI [1.01, 1.06]).</p><p><strong>Discussion: </strong>Findings show that acculturation and decision-making processes in immigrant households are significantly associated with HPV vaccination. Culturally appropriate interventions that address both partners' perceived barriers to HPV vaccination are needed.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Reasons to Quit or Reduce Vaping and Associations With Quitting Outcomes Among High School Adolescents in Connecticut.","authors":"Krysten W Bold, Grace Kong, Meghan E Morean, Akshika Sharma, William Courtney, Wei Li, Danielle R Davis, Deepa Camenga, Rachel Ouellette, Suchitra Krishnan-Sarin","doi":"10.1016/j.jadohealth.2025.01.004","DOIUrl":"10.1016/j.jadohealth.2025.01.004","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding youth experiences quitting vaping is important for informing youth-focused e-cigarette cessation interventions to improve public health. This study aims to examine reasons for quitting/reducing vaping and associations with quitting outcomes.</p><p><strong>Methods: </strong>We surveyed high school students in Connecticut in 2022 using a brief, anonymous online questionnaire assessing e-cigarette use. Adolescents (N = 756; mean age = 15.9, SD = 1.2) who reported lifetime e-cigarette use answered questions about previous experiences trying to quit or reduce vaping, including reasons for quitting/reducing and quitting outcomes.</p><p><strong>Results: </strong>Among adolescents who had ever vaped, 56.8% only vaped a few times and did not continue, while 32.2% reported seriously trying to quit or reduce vaping. Common reasons for quitting/reducing vaping included concerns about health (50.2%), addiction (45.5%), and cost (42.5%). Additional reasons cited were impacting ability to play sports (30.0%), spending too much time vaping (23.2%), and resetting tolerance (21.5%). Among those who tried to quit, 40.3% reported they were successful, 39.6% reported continuing vaping, and 20.1% reported quitting vaping but using other nicotine/tobacco products (e.g., cigarettes, cigarillos, blunts, nicotine pouches). Quitting due to influence of friends was associated with success quitting (vs. still vaping or using other nicotine/tobacco products, p ≤ .02), while quitting due to punishment (e.g., suspension) or losing e-cigarette access temporarily (e.g., family vacation) were associated with continued vaping (p ≤ .03).</p><p><strong>Discussion: </strong>Adolescents endorse many reasons for quitting or reducing vaping that may help inform e-cigarette interventions. Interventions should consider encouraging cessation of all nicotine/tobacco products while leveraging peer support strategies and minimizing punitive measures to support quitting.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the Changing Landscape of Younger Adult Mortality in the United States from 1999 to 2021.","authors":"Virginia Cafferky, Shufang Sun, Frances B Saadeh, Eric B Loucks","doi":"10.1016/j.jadohealth.2024.11.247","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2024.11.247","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate temporal trends and drivers of mortality among younger adults (aged 18-39), from 1999 to 2021.</p><p><strong>Methods: </strong>Observational study using nationally representative United States mortality data from 1999 to 2021, acquired via the US Centers for Disease Control Wide-ranging Online Data for Epidemiologic Research database. Exposure of interest was cause of death. Primary outcomes were population-level mortality rates and percent increase from 1999 to 2021. Secondary outcomes were cause-specific and subgroup-specific (sex, race, ethnicity) mortality rates and percent increases.</p><p><strong>Results: </strong>From 1999 to 2021, US younger adults aged 18-39 experienced a 54.1% increase in annual mortality (from 113.4 deaths per 100,000 in 1999 to 174.7 deaths per 100,000 in 2021; Cochran-Armitage p < .0001). Before COVID, from 1999 to 2019, younger adults experienced a 10.8% increase in mortality, compared to a 1.5% increase among the broader US population. The top driver of increased younger adult mortality, from 1999 through 2021, was accidental poisoning and exposure to noxious substances. Mortality trends varied by demographic variables with notable increases among American Indian/Alaskan Native Americans.</p><p><strong>Discussion: </strong>US younger adults are suffering from rising premature mortality. Resources should be calibrated to better support this generation.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of a Routine Requirement for In-Person Abortion Care for Adolescents in England and Wales: A Prepost Evaluation.","authors":"Hannah McCulloch, Sarah Salkeld, Melissa J Palmer, Kayleigh Hills, Jonathan Lord, Amy Green, Patricia A Lohr","doi":"10.1016/j.jadohealth.2024.12.016","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2024.12.016","url":null,"abstract":"<p><strong>Purpose: </strong>No-test medication abortion involves a teleconsultation, gestational age dating by last menstrual period (LMP), and home-use of medicines. In England and Wales, British Pregnancy Advisory Service (BPAS) and MSI Reproductive Choices UK (MSIUK) began offering no-test medication abortion to patients of all ages with pregnancies ≤69 days' gestation in April 2020. In May 2021, BPAS changed policy; adolescents aged 15 years and less could initiate care via teleconsultation but must have an in-person safeguarding assessment review (screening for harm/abuse/neglect), and an ultrasound. We assessed the impact of this change on accessibility, safeguarding, and gestational age estimation.</p><p><strong>Methods: </strong>We compared waiting time from first contact to abortion, abortions conducted at ≤6 and ≤10 weeks' gestation, and safeguarding referrals to support organizations using routine data from BPAS or MSIUK for abortion patients aged 15 years and less over 5 months before and after BPAS' policy change. For BPAS patients postpolicy change, we determined safeguarding referral source (teleconsultation/in-person) and diagnostic accuracy of LMP and other menstrual history features versus ultrasound for determining gestational age.</p><p><strong>Results: </strong>Between December 1, 2020 and September 30, 2021, 614 adolescents were treated. Postpolicy change, median waiting time from the first contact to abortion at BPAS significantly increased (7 vs. 11 days, p < .001) and proportion of abortions provided within 1 week of contact decreased (52.7% vs. 25.9%, p < .01). Both were stable at MSIUK (9 vs. 9 days [p = .59]; 38.2% vs. 39.2% [p = .99]). At BPAS, all indicated safeguarding referrals were identified at initial teleconsultation. Ten of 201 BPAS patients (5.0%) became ineligible for medication abortion (gestation > 69 days) while waiting for routine ultrasound; both LMP and ultrasound dating suggested eligibility (gestation ≤ 69 days) at first contact.</p><p><strong>Discussion: </strong>Requiring in-person adolescent consultation is associated with reduced access to medication abortion without enhancing safeguarding.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}