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- Access to Care (1)
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- Cancer: Prostate Cancer (2)
- Case Study (1)
- Children/Adolescents (2)
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- (-) Sexual Health (17)
- Shared Decision Making (1)
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- Vaccination (2)
- Women (8)
- Young Adults (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 17 of 17 Research Studies DisplayedLi R, Wittmann D, Nelson CJ
Unmet sexual health needs of patients and female partners following diagnosis and treatment for prostate cancer.
This study’s objective was to perform a qualitative study to identify unmet sexual needs of patients and female partners after prostate cancer diagnosis. The authors conducted a qualitative study of posts to the Inspire Us TOO Prostate Cancer Online Support and Discussion Community. They identified 6,192 posts in the Sexual Health & Intimacy forum of the community, of which 661 posts were from female authors. A random sample of 10% of posts from female partners and an equal number of randomly selected posts from male patients were analyzed. Multiple themes emerged that were unique to female partners of prostate cancer survivors including included expanding the sexual repertoire, feeling invisible, contextualizing sexual intimacy within the broader picture of survival, and addressing relationship concerns. Patients and their partners had common concerns, including not receiving sufficient information from healthcare providers regarding sexual side effects from prostate cancer and its treatment. A limitation may be that members of the online community may not be representative of all couples facing prostate cancer. This study also does not examine sexual health needs among gay and bisexual couples.
AHRQ-funded; HS026120.
Citation: Li R, Wittmann D, Nelson CJ .
Unmet sexual health needs of patients and female partners following diagnosis and treatment for prostate cancer.
J Sex Med 2022 Dec; 19(12):1797-803. doi: 10.1016/j.jsxm.2022.08.195..
Keywords: Sexual Health, Cancer: Prostate Cancer, Cancer
Teixeira da Silva D, Petsis D, Santos T
Chlamydia trachomatis/neisseria gonorrhea retesting among adolescents and young adults in a primary care network.
This study describes retesting following Chlamydia trachomatis/Neisseria gonorrhea (CT/NG) diagnosis among adolescent and young adult patients at Title X and non-Title X clinics and measures the association of patient-level factors with CT/NG retesting. Findings showed that guideline-recommended retesting following CT/NG diagnosis was low in this young primary care cohort, especially among male and non-Title X clinic patients.
AHRQ-funded; HS026116.
Citation: Teixeira da Silva D, Petsis D, Santos T .
Chlamydia trachomatis/neisseria gonorrhea retesting among adolescents and young adults in a primary care network.
J Adolesc Health 2022 Nov;71(5):545-51. doi: 10.1016/j.jadohealth.2022.06.014..
Keywords: Children/Adolescents, Young Adults, Sexual Health, Infectious Diseases, Primary Care
Glenn BA, Nonzee NJ, Herrmann AK
Impact of a multi-level, multi-component, system intervention on HPV vaccination in a federally qualified health center.
This paper evaluates the effectiveness of a multi-component, system-level intervention to improve human papillomavirus (HPV) vaccination rates in Federally Qualified Health Center (FQHC) clinics. The eight participating clinics were randomly assigned to study condition (four intervention, four usual care) that serve a primarily low-income Latino population. The intervention included parent reminders for HPV vaccine series completion, provider training, clinic-level audit and feedback, and workflow modifications to reduce missed opportunities for vaccination. The authors compared HPV vaccination rates among patients, ages 11 to 17 during a 12-month preintervention period and a 15-month intervention period. There was a greater increase in vaccination completion rates among boys, but not girls.
AHRQ-funded; HS000046.
Citation: Glenn BA, Nonzee NJ, Herrmann AK .
Impact of a multi-level, multi-component, system intervention on HPV vaccination in a federally qualified health center.
Cancer Epidemiol Biomarkers Prev 2022 Oct 4;31(10):1952-58. doi: 10.1158/1055-9965.Epi-22-0156..
Keywords: Infectious Diseases, Sexual Health, Vaccination
Henninger ML, Bean SI, Lin JS
Screening for syphilis infection in nonpregnant adults and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this systematic review was to summarize the available published evidence on the potential benefits and harms of screening for syphilis infection in non-pregnant, asymptomatic adults and adolescents at increased risk for syphilis infection, for the purpose of supporting the 2022 United States Prevention Services Task Force recommendations statement on screening for syphilis infection.
AHRQ-funded; 75Q80120D00004.
Citation: Henninger ML, Bean SI, Lin JS .
Screening for syphilis infection in nonpregnant adults and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Sep 27;328(12):1250-52. doi: 10.1001/jama.2022.8612..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Prevention, Sexual Health, Infectious Diseases, Evidence-Based Practice
Storck KE, Gawron LM, Sanders JN
"I just had to pay the money and be supportive": a qualitative exploration of the male-partner role in contraceptive decision-making in Salt Lake City, Utah family planning clinics.
This study explored in contraceptive decision-making using interviews with 30 male-female cis-hetero couples in Salt Lake City. The participants were stratified by sex assigned at birth and current contraceptive method and either long-acting reversible contraception (LARC) vs non-LARC users. Men and women both indicated a strong desire to prevent pregnancy, and felt that men’s actual contributions to decision-making were limited. To many couples, ideal partner support centered around emotional, financial, and logistical support options and placed high importance on interpersonal communication. The decision to use a LARC method did not influence sentiments around male-partner involvement or stated desire for partner involvement.
AHRQ-funded; HS027220.
Citation: Storck KE, Gawron LM, Sanders JN .
"I just had to pay the money and be supportive": a qualitative exploration of the male-partner role in contraceptive decision-making in Salt Lake City, Utah family planning clinics.
Contraception 2022 Sep;113:78-83. doi: 10.1016/j.contraception.2022.04.005..
Keywords: Sexual Health, Shared Decision Making
Eliason EL, A Spishak-Thomas, Steenland MW
Association of the Affordable Care Act Medicaid expansions with postpartum contraceptive use and early postpartum pregnancy.
The purpose of this study was to assess the relationship of the Affordable Care Act (ACA) Medicaid expansion with postpartum contraception use and pregnancy. The researchers found that Medicaid expansion was associated with a 7.0 percentage point increase in postpartum use of the contraceptive implant and intrauterine device LARC, a 3.1 percentage point decrease in short-acting contraception, and a 3.9 percentage point decrease in non-prescription contraceptive use overall. Increases in LARC use were concentrated among non-Hispanic, White, and Black respondents. Medicaid expansion was associated with a decrease in early postpartum pregnancy only among non-Hispanic Black respondents. The researchers concluded that the ACA Medicaid expansion improved postpartum contraceptive access and led to shifts from methods with a lower upfront out-of-pocket cost for people without insurance towards methods with the higher upfront out-of-pocket cost for people without insurance. These changes suggest that Medicaid expansions increased access to the full range of contraceptive methods.
AHRQ-funded; HS027464; HS000011
Citation: Eliason EL, A Spishak-Thomas, Steenland MW .
Association of the Affordable Care Act Medicaid expansions with postpartum contraceptive use and early postpartum pregnancy.
Contraception 2022 Sep;113:42-48. doi: 10.1016/j.contraception.2022.02.012..
Keywords: Sexual Health, Pregnancy, Maternal Care, Women, Medicaid, Access to Care, Policy
Thompson I, Bryant AG, Stuebe AM
Centering the patient in postpartum contraceptive counseling.
This article discusses the timing of postpartum contraceptive counseling and the fact that many health care providers believe prevention of future pregnancies is a priority in the postpartum period and that the inpatient postpartum stay is an ideal time to discuss contraception. However, this belief is not necessarily shared by the birthing parent, and they might be unready to discuss contraceptives, especially for people whose reproduction has been marginalized. The authors state that health care providers must acknowledge this harmful and racist history to change counseling practices actively and thoughtfully to best meet patient needs while simultaneously respecting patient autonomy.
AHRQ-funded; HS027260.
Citation: Thompson I, Bryant AG, Stuebe AM .
Centering the patient in postpartum contraceptive counseling.
Clin Obstet Gynecol 2022 Sep 1;65(3):588-93. doi: 10.1097/grf.0000000000000725..
Keywords: Maternal Care, Pregnancy, Women, Sexual Health
Peaker B, Biondokin E
AHRQ Author: Peaker B
Screening for chlamydia and gonorrhea.
In this Putting Prevention into Practice case study, a 20-year-old woman presents for a wellness examination. She states that she has no health concerns, does not have a history of any sexually transmitted infections, and does not use tobacco, alcohol, or drugs. Last year, she began taking oral contraceptives and reports regular monthly menses. Three multiple-choice questions are presented, followed by their answers.
AHRQ-authored.
Citation: Peaker B, Biondokin E .
Screening for chlamydia and gonorrhea.
Am Fam Physician 2022 Jul;106(1):81-82..
Keywords: U.S. Preventive Services Task Force (USPSTF), Guidelines, Screening, Prevention, Sexual Health, Infectious Diseases, Case Study
Moniz MH, Peahl AF, Zinsser D
Social vulnerability and use of postpartum long-acting reversible contraception and sterilization.
This retrospective cohort analysis examined whether social determinants like transportation, housing quality, childcare, and structural racism may plausibly shape individuals’ postpartum contraceptive preferences and access. The authors used administrative claims data from a statewide collaborative quality initiative to identify childbirth episodes from January 2016 to December 2019. Outcomes included long-acting reversible contraceptive (LARC) and sterilization use by 60 days postpartum. They used the CDC’s Social Vulnerability Index (SVI) to evaluate associations between the outcomes and exposures to the highest quintile SVI by census tract by theme and controlling for patient characteristics. Individuals with the highest quintile of socioeconomic vulnerability and minority status and language vulnerability were the most likely to use LARCs, while those with the highest household composition vulnerability were least likely. Housing/transportation vulnerability was not associated with LARC utilization. Sterilization use was less like to be taken up by those with the highest socioeconomic vulnerability and minority status/language vulnerability, while it was for those with the highest housing/transportation vulnerability and household composition vulnerability.
AHRQ-funded; HS025465.
Citation: Moniz MH, Peahl AF, Zinsser D .
Social vulnerability and use of postpartum long-acting reversible contraception and sterilization.
Am J Obstet Gynecol 2022 Jul;227(1):111-13.e2. doi: 10.1016/j.ajog.2022.03.031..
Keywords: Sexual Health, Women
Kramer RD, Higgins JA, Everett B
A prospective analysis of the relationship between sexual acceptability and contraceptive satisfaction over time.
This analysis examined the relationship between contraceptive method and sex life satisfaction. Eligible participants were individuals in the HER Salt Lake Contraceptive Initiative who switched contraceptive methods and continued their new method for at least 1 month and completed all relevant surveys. Primary predictor variables included changes in sexual functioning, sexual satisfaction, and perceived impact of the contraceptive method of sex life at one month. The sample included 1879 individuals. At 3 months 52.1% of participants were completely satisfied with their contraceptive method, 30.7% were somewhat satisfied, and 6.2% were completely dissatisfied. Patients at 3 months who said the method improved their sex life “a lot” had 7.7 times increased odds of greater satisfaction at 3 months than patients who said their contraceptive method made their sex life “a lot” worse at 1 month. Patients whose method improved their sex life a “little” had 5.88 times increased odds of greater satisfaction. Experiencing less or no vaginal bleeding was significantly associated with increased satisfaction.
AHRQ-funded; HS027220.
Citation: Kramer RD, Higgins JA, Everett B .
A prospective analysis of the relationship between sexual acceptability and contraceptive satisfaction over time.
Am J Obstet Gynecol 2022 Mar;226(3):396.31-96.e11. doi: 10.1016/j.ajog.2021.10.008..
Keywords: Sexual Health, Women
Moniz MH, Dalton VK, Smith RD
Feasibility and acceptability of a toolkit-based process to implement patient-centered, immediate postpartum long-acting reversible contraception services.
The objectives of this single-site study were to develop a theory-informed toolkit, to evaluate the feasibility of toolkit-based implementation of immediate postpartum long-acting reversible contraception services, and to refine the toolkit. The study was conducted at a large academic medical center. The authors concluded that the toolkit-based process was associated with high acceptability but mixed healthcare quality outcomes. They suggested that future research should test the effectiveness of the refined toolkit in a multisite, prospective trial.
AHRQ-funded; HS025465.
Citation: Moniz MH, Dalton VK, Smith RD .
Feasibility and acceptability of a toolkit-based process to implement patient-centered, immediate postpartum long-acting reversible contraception services.
Am J Obstet Gynecol 2022 Mar; 226(3):394.e1-94.e16. doi: 10.1016/j.ajog.2021.10.009..
Keywords: Maternal Care, Patient-Centered Healthcare, Women, Sexual Health
Sanders JN, Kean J, Zhang C
Measuring the sexual acceptability of contraception: psychometric examination and development of a valid and reliable prospective instrument.
This study’s objective was to develop and examine the psychometric properties of reliability, separation, and item fit of a new Contractive Sexual Acceptability (CSA) instrument among enrolled participants of the longitudinal cohort study HER Salt Lake. Study elements included the Female Sexual Function Index, the New Sexual Satisfaction Scale, measures of physical and mood-related side effects, and self-reported perceptions of contraception's sexual impacts. The authors evaluated (i) the reproducibility of relative measure location on the modeled linear latent variable, (ii) the number of statistically unique performance levels that can be distinguished by the measure, and (iii) the discrepancy between item responses and expectations of the model. They developed a 10-item CSA scale that exceeded the thresholds and sufficiently covered domains for use in contraceptive research and clinical settings. Starting with data on 39-items from 4,387 individuals, they identified 10-items that best measured the CSA latent construct. Final items included questions with scaled responses about pleasure and orgasm (orgasm quality, orgasm frequency, giving partner pleasure), physical (arousal and function) and psychological (emotional connection, surrender) components, general questions of satisfaction and frequency, and a measure of perceived impact of contraception on sexual experiences in the previous 4 weeks.
AHRQ-funded; HS027220.
Citation: Sanders JN, Kean J, Zhang C .
Measuring the sexual acceptability of contraception: psychometric examination and development of a valid and reliable prospective instrument.
J Sex Med 2022 Mar; 19(3):507-20. doi: 10.1016/j.jsxm.2021.12.007..
Keywords: Sexual Health, Women
Dude AM, Schueler K, Schumm LP
Preconception care and severe maternal morbidity in the United States.
This study’s objective was to measure the association between preconception care and the odds of severe maternal morbidity among women with Medicaid using a secondary analysis of Medicaid claims using Medicaid Analytic Extract files. Findings showed that contraceptive services in the year before conception and routine exams for women with chronic disease were associated with decreased odds of severe maternal morbidity or death for Medicaid enrollees.
AHRQ-funded; HS027027.
Citation: Dude AM, Schueler K, Schumm LP .
Preconception care and severe maternal morbidity in the United States.
Am J Obstet Gynecol MFM 2022 Mar;4(2):100549. doi: 10.1016/j.ajogmf.2021.100549..
Keywords: Maternal Care, Pregnancy, Women, Labor and Delivery, Sexual Health
Joyce DD, Wallis CJD, Luckenbaugh AN
Sexual function outcomes of radiation and androgen deprivation therapy for localized prostate cancer in men with good baseline function.
This retrospective review study sought to compare sexual function through 5 years for men undergoing radiation treatment for localized prostate cancer with and without systemic androgen deprivation therapy. Out of a cohort of 167 patients, 73 underwent radiation alone and 94 received androgen therapy deprivation therapy plus radiation. Androgen deprivation therapy was associated with worse sexual function through the first year regardless of disease risk. By 3 years the difference was no longer significant for the 51 patients with intermediate-risk disease. Worse sexual function for high-risk disease patients who received androgen deprivation therapy was shown at 3 years but not at 5 years.
AHRQ-funded; HS019356; HS022640.
Citation: Joyce DD, Wallis CJD, Luckenbaugh AN .
Sexual function outcomes of radiation and androgen deprivation therapy for localized prostate cancer in men with good baseline function.
Prostate Cancer Prostatic Dis 2022 Feb;25(2):238-47. doi: 10.1038/s41391-021-00405-5..
Keywords: Cancer: Prostate Cancer, Cancer, Sexual Health, Men's Health
Tabaac AR, Sutter ME, Haneuse S
The interaction of sexual orientation and provider-patient communication on sexual and reproductive health in a sample of U.S. women of diverse sexual orientations.
This study’s goal was to examine associations among provider-patient communication, past-year contraceptive use, and lifetime sexually transmitted infection. The authors analyzed data cross-sectionally from 22,554 women in the Growing Up Today Study and Nurses' Health Study 3 for the follow-up period of 1996 to 2020. Provider-patient communication was associated with higher likelihood of using all methods of past-year contraceptive use and lifetime STI diagnosis. Completely heterosexual women were 13% more likely than lesbians and 4% less likely than other groups to report a provider ever discussed their sexual and reproductive health (SRH). Sexual minority women whose providers discussed their SRH were less likely to report contraceptive non-use in the past year.
AHRQ-funded; HS026120.
Citation: Tabaac AR, Sutter ME, Haneuse S .
The interaction of sexual orientation and provider-patient communication on sexual and reproductive health in a sample of U.S. women of diverse sexual orientations.
Patient Educ Couns 2022 Feb; 105(2):466-73. doi: 10.1016/j.pec.2021.05.022..
Keywords: Sexual Health, Women, Clinician-Patient Communication, Communication
Van Gerwen OT, Austin EL, Camino AF
"It's behaviors, not identity": attitudes and beliefs related to HIV risk and pre-exposure prophylaxis among transgender women in the Southeastern United States.
Investigators aimed to explore beliefs associated with HIV Pre-Exposure Prophylaxis (PrEP) among transgender women (TGW) in the Southeastern U.S., framed by the Health Belief Model. They identified several themes: frustration with conflation of transgender identity and HIV risk, inappropriate transgender representation in PrEP advertising, concerns for interactions between PrEP and hormone therapy, perception that PrEP is meant for cisgender men who have sex with men, and limited trans-affirming healthcare. Given the diversity of this population, they recommended nuanced messaging to educate and engage TGW in HIV prevention strategies, including PrEP.
AHRQ-funded; HS013852.
Citation: Van Gerwen OT, Austin EL, Camino AF .
"It's behaviors, not identity": attitudes and beliefs related to HIV risk and pre-exposure prophylaxis among transgender women in the Southeastern United States.
PLoS One 2022 Jan 27;17(1):e0262205. doi: 10.1371/journal.pone.0262205..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Sexual Health
Bastani R, Glenn BA, Singhal R
Increasing HPV vaccination among low-income, ethnic minority adolescents: effects of a multicomponent system intervention through a county health department hotline.
The human papillomavirus (HPV) vaccine has cancer prevention benefits, yet low uptake. The purpose of the study was to evaluate an intervention intended to improve vaccine uptake in low-income, ethnic minority adolescents using a telephone hotline to seek county health department services. The researchers recruited participants through randomization of health department hotline callers who were caregivers of never-vaccinated adolescents aged 11-17. The intervention included multi-lingual print and telephone education and personalized referral to a low cost or free provider of vaccines. Participants completed baseline, 3-month, and 9-month telephone surveys. The study found that by the end of the 9-month follow up period, the HPV vaccination rates had increased, however there were no differences between the intervention (45%) and control (42%) groups. The researchers also observed significant improvements in perceived HPV knowledge, perceived HPV risk, and barriers to vaccination. The study concluded that the county hotline intervention did not produce a greater increase in HPV vaccine rates in the intervention group than the group without the intervention. The study authors recommend that future studies should evaluate interventions which are more intensive and address accessing and using services in complex, safety net settings. The authors also noted that because 44% of unvaccinated adolescents in both the intervention and control groups received at least one dose of the vaccine during the study period, investigators of future studies should be aware of the potential priming effects of participation in the study, which may impact the results of interventions.
AHRQ-funded; HS000046.
Citation: Bastani R, Glenn BA, Singhal R .
Increasing HPV vaccination among low-income, ethnic minority adolescents: effects of a multicomponent system intervention through a county health department hotline.
Cancer Epidemiol Biomarkers Prev 2022 Jan;31(1):175-82. doi: 10.1158/1055-9965.Epi-20-1578..
Keywords: Children/Adolescents, Vaccination, Low-Income, Racial and Ethnic Minorities, Sexual Health, Prevention