What Are We Trying to Improve?
This Quality Improvement (QI) site provides goals, strategies, implementation tips, and resources to guide primary care teams in their efforts to improve adolescent sexual and reproductive health (ASRH) clinical services and youth-friendly practices. They aim to prevent unintended pregnancies and sexually transmitted infections (STIs) and are based on current guidelines and recommendations and published evidence.
Quality Care Goals Related to Preventing Unintended Pregnancies and Sexually Transmitted Infections (STIs)
The first step is to identify adolescent patients who are sexually active. Then you can help them learn safer sex behaviors and reduce risks. Taking a sexual risk assessment and history is foundational and recommended as part of comprehensive psychosocial screening.
Use a patient-centered, open approach when talking with teens about screening, safety, and the full range of contraceptive methods. This means care teams provide counseling with respect for each teen’s preferences and values, considering their reproductive autonomy.
Each goal is a best practice for quality ASRH care. For example, chlamydia and gonorrhea screening is recommended annually for all sexually active cisgender women <25 years of age and should be extended to all transgender men and gender-diverse people with a cervix.
Adolescents want to feel welcome, respected, and comfortable in a clinical environment. Protecting confidentiality is very important, especially as your patients disclose sensitive health information about their sexual behavior.
It’s important, also, to consider that some adolescents have experienced one or more adverse childhood experiences (ACEs) like abuse, neglect, or other types of trauma. Care team members are called upon to integrate a trauma-informed approach to pediatric and adolescent health care to address some of the adverse effects of trauma.
Each goal is a best practice for youth-friendly ASRH care based on published evidence, lessons learned from previous ASRH initiatives, and what youth say is important to them.
Q4T emphasizes health equity, as persistent disparities in ASRH outcomes are evident for racial/ethnic minority groups, adolescents with disabilities, and adolescents who identify as lesbian, gay, bisexual, transgender, queer, intersex, or asexual (LGBTQIA+). Throughout this website, goals and strategies aim to address racism and other forms of discrimination that unfairly disadvantage certain people and lead to social and health inequities.