- August 26, 2022
- Jennifer Salerno
What immediately comes to mind when you think about June 24, 2022?
On this date, the U.S. Supreme Court overturned Roe v. Wade, and as a result, the landscape of pregnancy care and reproductive health in America changed in a really big and serious way. Healthcare professionals across settings and states are now grappling with the way new laws affect their ability to provide quality pregnancy care for women of all ages, including youth.
Teen pregnancy in the U.S. has been declining for the past 3 decades, due in part to fewer teens being sexually active and more teens using one or more forms of birth control. Yet, teen pregnancy continues to be associated with increased social and economic costs in the near-term and long-term for both teen parents and their children.
Adolescent mothers are more likely to:
- Have lower school achievement and/or drop out of school
- Have more health problems
- Be incarcerated during adolescence
- Face unemployment as a young adult
So, when pediatric and school-based healthcare professionals meet with youth with unplanned pregnancies, many questions arise. What risks do I face and how can I stay safe? What resources can help me care for this baby? What if I am not ready to be a parent? What if I am?
These questions are deeply personal and incredibly important. Life-changing, even.
But –
What if we allow ourselves a moment to ask other questions in this post-Roe era? Questions that might help us understand better how to decrease the number of unplanned pregnancies from occurring in the first place? Questions that move us from reaction to prevention?
Is there a place for new solutions – like prevention technology – for old problems?
Youth sexual health (including teen pregnancy) is a weighty issue that we aim to address with facts about what the research says actually works. In this article, we invite you to join us for:
- A brief overview of youth sexual health services and sexual health; and
- Specific evidence-based prevention measures that healthcare professionals and programs can implement to support youth with safer sex action plans. (Hint: there’s an amazingly effective prevention technology available to you and your team.)
Youth Sexual Health Services
Let’s start with a few definitions to ground our discussion: sexual health and sexual health services.
Sexual Health
The healthcare community’s understanding of sexual health has shifted over time as culture has evolved. The World Health Organization (WHO) first began publishing definitions of sexual health in 1975. The most recent definition is listed here:
When we talk about youth sexual health, then, we are talking about far more than preventing unplanned pregnancy. We are looking at holistic wellness and global risk factors for all youth – we are interested in their physical, emotional, and social wellness. This is important because prevention services must be comprehensive in order to be effective. Case in point –
- If a community health clinic provides multiple free birth control options to a teen patient who self-reports sexual activity, but doesn’t identify the teen’s history of dating violence, those teens are less likely to use their birth control effectively.
- If a school-based health center regularly shares prevention and treatment information on Sexually Transmitted Infections (STIs), but fails to connect with students in an empathetic manner that yields trust, those students are less likely to be honest about their experiences and more likely to continue their unsafe sexual practices.
Sexual Health Services
The Centers for Disease Control and Prevention (CDC) defines sexual health services broadly as sexual health preventative measures, including:
- Taking a sexual history or risk assessment
- Providing health education, guidance, and/or counseling
- Testing and treatment for STs
- Testing and treatment for HIV
- Contraceptive services
Sexual health services are a critically important part of our discussion because they are the cornerstone of effective prevention. Indeed, effective sexual health services are a huge part of the answer to our questions above.
Effective sexual health services can change the trajectory of a youth’s life – they have the potential to improve immediate and long-term health outcomes by identifying health issues early and intervening with relevant services. Accurate education and timely counseling can prevent unplanned pregnancy. Early treatment can eliminate STIs or enable effective treatment for STIs. And more.
Sexual Health Prevention Technology
Let’s look now at one sexual health service in depth: a virtual health educator technology called Adolescent Counseling Technologies (ACT).
ACT is an evidence-based technology platform that provides behavioral health interventions through a virtual health educator. Its reach goes beyond youth sexual health and includes interventions for risks like substance use and disordered eating.
ACT includes 3 key components:
| Risk assessment | Tailored risk coaching and action plan | Continued engagement via text |
The ACT risk assessment yields a comprehensive sexual health history that uncovers youths’ risk.
Risk behaviors may put youth at increased risk for adverse health outcomes, like unplanned pregnancy or STI. Examples of risky behaviors include:
- Early onset of sexual activity
- Multiple sexual partners
- Not using a condom during last intercourse
- Not using contraceptives
Risk factors that contribute to unsafe sexual decision-making may include:
- Substance use prior to sex
- Depression, low self-esteem
- Homelessness
- School failure and lack of future goals
- Sexting
- History of abuse
- Dating violence
Digital Empathy
Many youth find it difficult to disclose their complete sexual health history and current sexual activity. They may be reluctant to share personal information face-to-face with a professional and even more so if a parent is in the room with them.
Studies have shown, however, that youth are more honest about their thoughts, attitudes, and behaviors when using technology. The ACT questionnaire is embedded with digital empathy, meaning it expresses the care and concern of the healthcare professional in the wording of its questions and through the user-friendly layout of the survey.
Youth have the option to read the questions silently (multiple languages are available) and/or hear them read aloud. They complete questions one at a time in a remote setting – from their phone, tablet, or laptop. And, it only takes about 7 minutes to complete.
Grounded in Research
ACT is grounded in empirical research and scientific theory: stages of change theory and motivational interviewing. Principles of both psychological theories are embedded throughout the platform. For example, “… If you’re ready, we can give you more information about adding condoms as a second form of protection.” This honors the youth’s ability and desire to make decisions for themself. When the tech explicitly asks permission to give the youth educational information, the youth is more likely to accept, read, and implement that information.
Supports Healthcare Professionals
Finally, ACT is an effective supplement to the work that you, healthcare professionals, are doing. It does not replace you. It supports your work by standardizing sexual health care for all youth and ensuring consistent implementation of national screening guidelines and counseling recommendations. ACT guides youth toward creating a safer sex action plan and gives them the opportunity to opt-in to follow-up text messages that are tailored to their safer sex action plan. In other words, it is an easy and highly-effective prevention measure. In the post-Roe world we are living in, it is an excellent tool that you can begin using immediately to help youth experience sexual health wellness and decrease or eliminate adverse sexual outcomes.
What’s Next?
The new school year is here and the fiscal year is coming to a close just next month for many of us. So, healthcare professionals in primary care, pediatrics, and school-based health clinics – let’s double down on high-quality prevention services to support safer sex plans for the youth we serve. It’s time to invest our resources in effective engagement and intervention. The Adolescent Counseling Technologies for Sexual Health is one way to focus on prevention services. ACT-SH is an evidence-based virtual health educator tool to support your care plans. It is embedded with digital empathy, offers a user-friendly interface, and creates tailored action plans to meet the unique needs of each youth.
Ready to explore how ACT-SH can make a meaningful difference in the care of your youth? Schedule a call or get in touch here. We’d love to partner with you as you guide youth towards safer sex action plans.