Reducing Health Disparities in Unintended Pregnancies Among Hispanic Adolescents Using a Patient-Centered Computer-Based Clinic Intervention

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Investigator: Kathleen P. Tebb, PhD
Sponsor: Patient-Centered Outcomes Research Inst

Location(s): United States

Description

While teen pregnancy rates have declined in the United States over the past two decades, rates among Hispanic/Latina girls remain high, and these women experience a disproportionate burden of adverse health and economic consequences. Most of these pregnancies are unintended—that is, the adolescent did not plan for or desire a pregnancy. Compared with other adolescents, Hispanic teens are less knowledgeable about and less likely to use effective contraceptives. The number of contraceptive options can seem overwhelming, and these teens often avoid sexual health care because of discomfort, stigma, and confidentiality concerns. Clinicians often lack the time, skills, and comfort to provide comprehensive education and counseling for Hispanic teens. Our team of researchers, clinicians, community partners, and Latina youth developed an innovative, interactive, individually tailored computer application (APP), Health-E You, to address these barriers. It is designed to allow users to self-determine their readiness and need for contraception; support their personal decision-making process in selecting an effective method; and improve the quality of the health visit.
  
Objectives: The goal is to improve Latina adolescents’ knowledge of, attitudes about, and use of effective methods of contraception that fit with their personal needs. The long-term goal is to reduce the incidence of unprotected sexual intercourse (and associated unintended pregnancies and sexually transmitted infections [STIs]) over time.
  
Methods: Latina adolescents who are seeking care at high school–based health centers (SBHCs) in Los Angeles Unified School District and who are at risk of becoming pregnant or of acquiring STIs will be invited to participate in the study. In this design, 12 SBHCs will be randomized, with equal chance, to either the intervention or comparison group, with six clinics in each group. The intervention clinics will provide the Health-E You APP to adolescent girls; the control clinics will provide usual care. A total of 1,200 Latina teens will be selected to participate in the study—600 at intervention clinics and 600 at the control clinics—and will receive up to $70 for their participation. We will compare the intervention group with the control group—prior to receiving the intervention, and at three- and six-month follow-up periods—in terms of adolescents’ knowledge of, attitudes about, and use of contraceptives.