Developing and piloting an intervention to increase adolescent access to sexual and reproductive healthcare: a mixed-methods study.

Abstract

This mixed-methods study describes the development and pilot testing of AccessKCTeen, an intervention to improve sexual and reproductive health (SRH) access for marginalized youth. Community discussions guided development of an intervention featuring SRH outreach events to disseminate information, share resources, and connect teens to care via telemedicine and mobile health clinics. During eight outreach events, we recruited adolescent participants for baseline assessments (demographics, event satisfaction, and trust in the medical profession) and one-month follow-up (trust and SRH utilization). We documented feedback on SRH resources (e.g. condoms), telemedicine, and mobile care with field notes. Among 96 participants (46% Black; 23% Hispanic; 23% gender minority; 50% sexual minority), most were 'very' (76%) or 'somewhat' (9%) satisfied with the event; 15% were 'neutral'. At baseline, trust was moderate (16.4 ± 2.7; scale range 5-25). Many accepted SRH items for future use. Field notes documented adolescent comments regarding telemedicine as safe, private, and convenient, and the mobile clinic as private and trustworthy. At follow-up, 20% obtained healthcare; trust was 17.2 ± 2.8. Our findings indicate that a community-integrated, multi-component intervention is acceptable to adolescents and warrants further evaluation of its impact on SRH outcomes.