Abstract
Study Objective
This study identified clinician and clinic staff perspectives on facilitators and
barriers to providing sexual and reproductive health (SRH) care to depressed young
women, a population at increased risk for adverse SRH outcomes.
Design
We conducted in-person semi-structured qualitative interviews, which were audio-recorded,
transcribed, and coded by two researchers. We used thematic analysis to identify themes
pertaining to care facilitators and barriers within a socio-ecological framework.
Setting
This study was conducted in seven diverse clinics in the U.S. New England region.
Participants
Participants were 28 clinicians and staff (4/clinic), including behavioral health
clinicians (n = 9), nurse practitioners (n = 7), nurses (n = 3), medical doctors (n = 3),
administrative associates (n = 2), practice managers (n = 2), family planning counselor
(n = 1), and medical assistant (n = 1).
Main Outcome Measures
We queried how clinicians and clinic staff identify and manage depression and sexual
risk, and what they perceive as facilitators and barriers affecting provision of ideal
SRH care to depressed young women.
Results
Themes represented facilitators of and barriers to providing ideal SRH care to high-risk
depressed young women at five socio-ecological levels: individual (facilitator: trust
in providers; barrier: stigma experiences), interpersonal/provider (facilitator: frequent
patient–provider communication; barrier: lack of time during clinic visits to build
trust), clinic (facilitator: integration of care; barrier: lack of scheduling flexibility),
organization/community (facilitator: training for providers; barrier: funding constraints),
and macro/societal (facilitator: supportive policies; barrier: mental health stigma).
Conclusion
Optimizing SRH care to high-risk depressed young women necessitates attention to factors
on all socio-ecological levels to remove barriers and bolster existing facilitators
of care.
Key Words
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Article info
Publication history
Published online: March 04, 2020
Footnotes
The authors report no conflict of interest.
This work was presented at the annual meeting of the Society for Adolescent Health and Medicine in Washington, DC, March 6–9, 2019.
Identification
Copyright
© 2020 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
