Using the Social-Ecological Model to Improve Access to Care for Adolescents and Young Adults

Harper, Christopher R.; Steiner, Riley J.; Brookmeyer, Kathryn A.

doi:10.1016/j.jadohealth.2018.03.010

Cited by 17 publications

(15 citation statements)

References 14 publications

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“…The lack of financial autonomy was a key risk factor for early adolescent pregnancy in our study. Providing sex for money has been identified elsewhere in Ghana as a main cause of adolescents engaging in sexual activity [11][12][13][14][15][16][17][18][19][20][21][22][23]25]. In two qualitative studies in the Accra metropolis with teenage mothers, lack of money was a key factor that pushed adolescents to become sexually active [12,24].…”

Section: Discussionmentioning

confidence: 99%

“…Positing on the premise that early adolescent pregnancy and decision making is complex, the socioecological model was considered appropriate to allow for a more holistic understanding of the individual, interpersonal, organizational, community, or policy factors involved. The Social Ecological Model (SEM) [14,15] posits that behavior and decision making are shaped by individual, relationship, community, and societal factors. It is a theory-based framework for understanding the multifaceted and interactive effects of personal and environmental factors that determine behaviors, and for identifying behavioral and organizational soft spots and intermediaries for health promotion within organizations.…”

Section: Introductionmentioning

confidence: 99%

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Decision-making preferences and risk factors regarding early adolescent pregnancy in Ghana: stakeholders’ and adolescents’ perspectives from a vignette-based qualitative study

et al. 2020

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Background Worldwide, over half of the adolescent pregnancies recorded are unintended. The decision to continue the pregnancy to term or to opt for an abortion is a constant dilemma that is directly or indirectly influenced by stakeholders and also by the wider social environment. This study aimed at understanding the perceived decision-making preferences and determinants of early adolescent pregnancy in the Jamestown area of Accra in Ghana. Methods A vignette-based qualitative study design was used. Eight focus group discussions were carried among various purposively selected groups of participants: parents, teachers, adolescent students who had not been pregnant before, and adolescents who had had at least one pregnancy in the past. The vignette was a hypothetical case of a 15-year-old high school student who had not experienced her menses for the past 6 weeks. The data were analyzed using a thematic analysis approach. Results Lack of parent-daughter communication, the taboo on discussing sex-related issues in households and weak financial autonomy were considered to be the main contributing factors to the high early adolescent pregnancy rates in the community. Partner readiness to assume responsibility for the girl and the baby was a key consideration in either continuing the pregnancy to term or opting for an abortion. The father was overwhelmingly considered to be the one to take the final decision regarding the pregnancy outcome. Irrespective of the fact that the respondents were very religious, opting for an abortion was considered acceptable under special circumstances, especially if the pregnant adolescent was doing well in school. Conclusion Inadequate and inappropriate communication practices around sexuality issues, as well as weak financial autonomy are the major predictors of early adolescent pregnancy in this community. The father is perceived to be the main decision maker regarding a young adolescent’s pregnancy outcome. Policy-makers should carefully evaluate the implications of this overwhelming perceived desire for the father to be the final decision-maker regarding adolescent pregnancy outcomes in this community.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Decision-making preferences and risk factors regarding early adolescent pregnancy in Ghana: stakeholders’ and adolescents’ perspectives from a vignette-based qualitative study

et al. 2020

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“…In addition to active information-seeking, the media's ubiquitous presence in everyday lives presents opportunities for passive exposure to varying and often con icting opinions on health behaviors, including vaccinations. Given the presence and potential in uence of the media on HPV vaccination attitudes [15], more exploration is needed to focus on the ways in which media exposure to HPV vaccination information may affect parental decisions about provider HPV recommendations [15].…”

Section: Introductionmentioning

confidence: 99%

The Role of the Media on Parental Confidence in Provider HPV Recommendation

Walker

Owens

Zimet

2020

Preprint

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Background Despite a growing understanding of the importance of provider HPV recommendation on parental acceptance, US HPV vaccination rates remain suboptimal. Given the prevalence and use of the media for health decisions, this study examined the relationship between the media and provider HPV recommendation on parental HPV vaccine hesitancy. Methods Thirty individual interviews with vaccine accepting mothers in the Midwest were conducted to examine their experiences with initial hesitancy to accept HPV vaccination at point of provider recommendation and their suggestions for improving the HPV vaccine patient/provider recommendation experience. Results Results found that the media served as an antecedent to hesitancy for three main vaccination concerns: protection, efficacy and sexual stigma. A model for understanding the influence of the media as it relates to the three topical HPV vaccination concerns and its process on parental HPV vaccine decision making emerged. Conclusions Findings suggest that mothers experience hesitancies from passive and active HPV vaccination media information that prompt confusion and fear with accepting provider HPV vaccination recommendation. Providers’ approach to HPV vaccination recommendation must consider concerns reported in the media with delivery techniques modified to adjust to parental fears absorbed from adverse media information.

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“…In today's health conscious society, seeking information about health topics is increasing, with one in three U.S. adults using the Internet in 2013 to self-diagnose or learn about a health concern [21]. The growth in internet use and increase in health information available on the web has changed the landscape of health information [21]. At one time, medical knowledge was almost entirely disseminated by health professionals.…”

Section: Introductionmentioning

confidence: 99%

The Role of the Media on Maternal Confidence in Provider HPV Recommendation

Walker

Owens

Zimet

2020

Preprint

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Background: Despite a growing understanding of the importance of provider HPV recommendation on parental acceptance, U.S. HPV vaccination rates remain suboptimal. Given the prevalence and use of the media for health decisions, this study examined the relationship between the media and provider HPV recommendation on maternal HPV vaccine hesitancy. Methods: Thirty individual interviews with HPV vaccine-accepting mothers in the Midwest U.S. were conducted to examine their feelings of hesitancy around the decision to accept HPV vaccination at the time of provider recommendation and their suggestions for improving the recommendation experience by addressing media concerns. Results: Media exposure was an antecedent to hesitancy for three main vaccination concerns: protection, efficacy and sexual stigma. Although mothers accepted vaccination, they continued to feel confused and hesitant about HPV vaccination. They had several recommendations for how providers could combat hesitancy to improve confidence in HPV vaccine acceptance. Conclusions: Providers’ approach to HPV vaccination recommendation must consider concerns reported in the media with delivery techniques modified to adjust to maternal fears absorbed from adverse media information.

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Using the Social-Ecological Model to Improve Access to Care for Adolescents and Young Adults

Cited by 17 publications

References 14 publications

Decision-making preferences and risk factors regarding early adolescent pregnancy in Ghana: stakeholders’ and adolescents’ perspectives from a vignette-based qualitative study

Decision-making preferences and risk factors regarding early adolescent pregnancy in Ghana: stakeholders’ and adolescents’ perspectives from a vignette-based qualitative study

The Role of the Media on Parental Confidence in Provider HPV Recommendation

The Role of the Media on Maternal Confidence in Provider HPV Recommendation

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