Pilot Study of Reproductive Health Counseling in a Pediatric Rheumatology Clinic

Authors


Abstract

Objective

To assess perception and behavior after reproductive health counseling among adolescent patients in a tertiary care–based pediatric rheumatology clinic.

Methods

Adolescent females seen at a Stanford pediatric rheumatology clinic were prospectively enrolled during routine visits. At the study start, standard clinic procedures were reviewed with providers for the following: 1) the home, education, activities, drugs, sexual activity, and suicide/depression (HEADSS) assessment; 2) reproductive health counseling; and 3) medical record documentation. Patients were enrolled if providers indicated that they performed the HEADSS assessment and reproductive health counseling. At enrollment, patients completed a survey to assess their perceptions of reproductive health counseling. Chart reviews confirmed documented discussions. A followup survey performed 3–5 months after enrollment tracked reproductive health information–seeking behavior.

Results

In total, 90 females (mean ± SD age 17 ± 2 years) participated. Almost all patients (99%) agreed that reproductive health was discussed; 71% reported that pregnancy risks were discussed, 42% had recent concerns about reproductive health, and 33% reported their provider recommended that they seek further reproductive health care. Eighty-four patients completed followup phone surveys, with 25% reporting seeking further information on reproductive health concerns, but with only 9.5% actually seeking further care. Only 18% of patients reported having ever asked their rheumatology provider for guidance regarding reproductive health care concerns.

Conclusion

Routine reproductive health discussion and counseling are necessary in a rheumatology clinic because, in our experience, a substantial number of adolescents have concerns and actively seek reproductive health information. Despite these discussions, adolescents rarely pursue further reproductive health care. Further work to bridge this gap is needed.

Ancillary