Original Article

A Survey of Louisiana Pediatricians’ Approach to Parenting Teens and Adolescent Reproductive Health

Authors: S. Amanda Dumas, MD, MSc, Nikka Khorsandi, MD, MPH

Abstract

Objective: The American Academy of Pediatrics recommends that pediatricians provide a medical home for adolescent parents, and this study sought to determine pediatricians' compliance with this recommendation within the context of other adolescent reproductive health services provided.

Methods: An Internet-based survey was administered to Louisiana pediatricians. The survey contained 17 Likert scale questions relating to sexual and reproductive health services provided to female and male adolescents, and ascertaining their comfort and experience with issues related to the care of adolescents, including adolescent mothers. Respondents also had the option of describing why they do or do not provide care to adolescent mothers. Lastly, the survey collected demographic characteristics modeled after the American Academy of Pediatrics Periodic Survey of Fellows.

Results: There were 101 survey respondents. Seventy-nine percent of pediatricians reported that they provide care to adolescent mothers and they were similar to those who did not with respect to sex, age, race and ethnicity, and training, but they differed by practice community and payer mix. Almost 30% of pediatricians never/rarely test their patients for pregnancy, and nearly 50% never/rarely prescribe contraception. Fifty-four percent agreed that adolescent mothers should continue receiving nonobstetric medical care from their pediatricians, and 70% believed that adolescent fathers should continue receiving medical care from their pediatricians.

Conclusions: Our study suggests that most Louisiana pediatricians provide care to adolescent mothers; however, knowledge gaps and misconceptions related to adolescent reproductive health persist among pediatricians, including those who refuse care to adolescent mothers. Research into provider-level barriers may inform interventions that improve adolescent parents’ access to a pediatric medical home.
Posted in: Family Planning & Reproductive Health12

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References

1. Madigan S, Wade M, Tarabulsy G, et al. Association between abuse history and adolescent pregnancy: a meta-analysis. J Adolesc Health 2014;55: 151–159.
 
2. Fuller TR, White CP, Chu J, et al. Social determinants and teen pregnancy prevention: exploring the role of nontraditional partnerships. Health Promot Pract 2018;19:23–30.
 
3. Penman-Aguilar A, Carter M, Snead MC, et al. Socioeconomic disadvantage as a social determinant of teen childbearing in the U.S. Public Health Rep 2013;128(2_suppl1):5–22.
 
4. SmithBattle L Reframing the risks and losses of teen mothering. MCN Am J Matern Child Nurs 2009;34:122–128.
 
5. Magill M, Wilcox R. Adolescent pregnancy and associated risks: not just a result of maternal age. Am Fam Physician 2007;75:1310–1311.
 
6. Fasula AM, Chia V, Murray CC, et al. Socioecological risk factors associated with teen pregnancy or birth for young men: a scoping review. J Adolesc 2019;74:130–145.
 
7. Thompson G. Meeting the needs of adolescent parents and their children. Paediatr Child Health 2016;21:273.
 
8. Garwood SK, Gerassi L, Jonson-Reid M, et al. More than poverty: the effect of child abuse and neglect on teen pregnancy risk. J Adolesc Health 2015;57: 164–168.
 
9. Jolly MC, Sebire N, Harris J, et al. Obstetric risks of pregnancy in women less than 18 years old. Obstet Gynecol 2000;96:962–966.
 
10. Leftwich HK, Alves MVO. Adolescent pregnancy. Pediatr Clin North Am 2017;64:381–388.
 
11. Kawakita T, Wilson K, Grantz KL, et al. Adverse maternal and neonatal outcomes in adolescent pregnancy. J Pediatr Adolesc Gynecol 2016;29: 130–136.
 
12. Hodgkinson S, Beers L, Southammakosane C, et al. Addressing the mental health needs of pregnant and parenting adolescents. Pediatrics 2014;133: 114–122.
 
13. Reid V, Meadows-Oliver M. Postpartum depression in adolescent mothers: an integrative review of the literature. J Pediatr Health Care 2007;21:289–298.
 
14. Pinzon JL, Jones VF, Committee on Adolescence, et al. Care of adolescent parents and their children. Pediatrics 2012;130:e1743–e1756.
 
15. Gemmill A, Lindberg LD. Short interpregnancy intervals in the United States. Obstet Gynecol 2013;122:64–71.
 
16. SmithBattle L, Loman DG, Cibulka NJ. Family-centered primary care for teen parents and their children. J Pediatr Health Care 2020;34:204–211.
 
17. Ford CA, Davenport AF, Meier A, et al. Partnerships between parents and health care professionals to improve adolescent health. J Adolesc Health 2011;49:53–57.
 
18. Hornberger LL, Breuner CC, Alderman EM, et al. Options counseling for the pregnant adolescent patient. Pediatrics 2017;140:e20172274.
 
19. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2018. https://www.cdc.gov/std/stats18/STDSurveillance2018-full-report.pdf. Published 2019. Accessed December 1, 2021.
 
20. Martin JA, Hamilton BE, Osterman MJK, et al. Births: final data for 2018. Natl Vital Stat Rep 2019;68:1–47.
 
21. Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009;42:377–381.
 
22. Harris PA, Taylor R, Minor BL, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform 2019;95:103208.
 
23. Henry-Reid LM, O’Connor KG, Klein JD, et al. Current pediatrician practices in identifying high-risk behaviors of adolescents. Pediatrics 2010; 125:e741–e747.
 
24. Masonbrink AR, Stancil S, Reid KJ, et al. Adolescent reproductive health care: views and practices of pediatric hospitalists. Hosp Pediatr 2019;9: 100–106.
 
25. Hoover KW, Tao G, Berman S, et al. Utilization of health services in physician offices and outpatient clinics by adolescents and young women in the United States: implications for improving access to reproductive health services. J Adolesc Health 2010;46:324–330.
 
26. Rand CM, Goldstein NPN. Patterns of primary care physician visits for US adolescents in 2014: implications for vaccination. Acad Pediatr 2018;18: S72–S78.
 
27. Martone CM, Gjelsvik A, Brown JD, et al. Adolescent access to patient-centered medical homes. J Pediatr 2019;213:171–179.
 
28. Irwin CE, Adams SH, Park MJ, et al. Preventive care for adolescents: few get visits and fewer get services. Pediatrics 2009;123:565–572.
 
29. Marcell AV, Burstein GR. Sexual and reproductive health care services in the pediatric setting. Pediatrics 2017;140:e20172858.
 
30. Hagan J, Shaw J, Duncan P, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents 4th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2017.
 
31. Cox JE, Bevill L, Forsyth J, et al. Youth preferences for prenatal and parenting teen services. J Pediatr Adolesc Gynecol 2005;18:167–174.
 
32. SmithBattle L, Loman DG, Cibulka NJ. Family-centered primary care for teen parents and their children. J Pediatr Health Care 2020;34:204–211.
 
33. Beers LAS, Hollo RE. Approaching the adolescent-headed family: a review of teen parenting. Curr Probl Pediatr Adolesc Health Care 2009; 39:216–233.
 
34. SmithBattle LI. Reducing the stigmatization of teen mothers. MCN Am J Matern Nurs 2013;38:235–243.