To ensure that adolescents have access to sexual and reproductive health care which includes both preventive counseling and treatment in all nursing practice sites, nurses need to gain the knowledge and hone the skills required to deliver evidence-based counseling and services to adolescents and parents.
Collectively, nurses can use their unique combination of knowledge and skills to make a positive impact on adolescent sexual and reproductive outcomes.
Nurses have the capacity and opportunity to disseminate information about sexual and reproductive health to adolescents and their parents in communities, schools, public health clinics, and acute care settings.
Adolescents Sexual health nurse role as a scientist a variety of critical sexual and reproductive health challenges, such as unplanned pregnancy and sexually transmitted infections STIsincluding HIV infection. While these conditions are readily preventable with access to adequate sexual and reproductive health care including both preventive counseling and treatmentadolescents often lack easy access to condoms and other contraception as well as counseling; thus, their sexual health challenges go unaddressed and often lead to serious outcomes.
Even in pediatric hospitals, which might afford the best opportunities to deliver preventive sexual and reproductive health, thereby reducing adolescent morbidity and mortality and improving birth outcomes, assessment of pregnancy risk is inconsistent. Adolescent health is shaped by a complex variety of biological and social factors, but risky behavior at this age can often have a disproportionate effect on health across the life span. Medicaid-eligible families can obtain free vaccination from the Vaccines for Children Program see www.
In Octoberthe CDC changed its recommendation on the number of HPV vaccine doses to be administered to toyear-olds; rather than the previously recommended three doses, the CDC now recommends two doses, the second to be given six to 12 months after the first. All of the current studies on vaccine uptake and vaccination series completion rates are based on the three-shot recommendation. Barriers to adolescent vaccination uptake include limited knowledge among providers 12 as well as a variety of parental factors, including fears about vaccine safety, 13 the assumption that vaccination leads to increased sexual activity, 14 and the beliefs that children are not sexually active 15 and are too young for a vaccine against STIs.
Another recent study found that poor, less-educated, Spanish-speaking, rural, uninsured, and Hispanic parents reported less collaborative provider—parent communication, which is also a barrier to vaccine uptake. The United Nations Convention on the Rights of the Child declared that adolescents across the globe have the human right "Sexual health nurse role as a scientist" receive sexual and reproductive health care.
The goals and recommendations align with those set forth by the American Academy of Pediatrics and the World Health Organization. This article highlights specific recommendations that nurses can follow to improve sexual and reproductive health care delivery and adolescent health outcomes.
Because many adolescents do not get annual preventive health examinations, the CDC recommends screening adolescents for sexual and reproductive health and pregnancy risks at every encounter in all health care settings. For resources on adolescent sexual and reproductive health for nurses, see Table 1.
Adolescents use health services for well and sick visits, sports physicals, immunizations, and emergency care. Nurses can and should offer developmentally appropriate sexual and reproductive health screening and counseling to adolescents and their parents as part of annual examinations.
This approach is associated with reduced teen pregnancy and improved contraceptive use. Outside of the annual examination, nurses can provide adolescent behavioral risk screenings during intake procedures and add automatic prompts to electronic health record systems to cue providers to conduct sexual and contraceptive history screening, counseling, and referrals for all adolescent patients.
It is essential to the delivery of sexual and reproductive health services that nurses provide behavioral screenings to adolescent patients. Sexual and reproductive behavior screenings and risk assessments include appropriate testing; discussions about risk reduction and avoidance strategies; HPV vaccination; HIV preexposure prophylaxis PrEP eligibility screening; and safety assessments of home, school, and social environments to determine whether adolescents are subject to physical, emotional, or sexual abuse, bullying, or dating violence see Table 2 for recommended talking points and discussion strategies for counseling both adolescents
Sexual health nurse role as a scientist parents.
The CDC recommends using pregnancy screening checklists in all adolescent health care settings to assess the risk of unintended pregnancy.
This has been shown to decrease unprotected sex and increase contraceptive use. Adolescents suggest that the best way to encourage nurse—adolescent discussions is to increase private consultation time with a nurse who has established trust and confidence.
Nurses can advocate for confidential health visits by posting state statutes in plain sight in waiting and examination rooms and reviewing them with adolescents and parents at each visit.
Parents have varying and sometimes conflicting perspectives on confidentiality in the context of adolescent sexual and reproductive health care. When asked, two-thirds of parents reported that it was very or somewhat important for adolescents to have private time with health care providers. Nurses can advise parents on the importance of confidential access to sexual and reproductive health counseling and inform them of state policies and minor consent laws, reinforcing the idea that the provision of confidential care and private nurse—adolescent time improves sexual and reproductive health outcomes.
Nurses can access state laws regarding adolescent sexual and reproductive health care and confidentiality at www. To provide effective sexual and reproductive health care services to adolescents, nurses require knowledge and skills in counseling, behavioral screening, risk avoidance and reduction methods, and STI testing, as well as knowledge of treatment guidelines. A recent study of nursing students who completed 16 hours of education in the Families Talking Together FTT training model—an evidence-based adolescent sexual health program for parents—found statistically significant improvements in sexual and reproductive health counseling self-efficacy, ability to address barriers to sexual and reproductive health communication, and skills in engaging both adolescents and their parents.
Researchers showed that adolescents preferred behavioral screenings done with an audio computer-assisted self-interview system rather than provider interviews; techniques like this may enhance the disclosure of sensitive information such as sexual behaviors and therefore help identify youth at risk for STIs.
Nurses can and should counsel parents at every health care visit—beginning before their children become sexually active—on protective practices, including parent—child communication, parental involvement, and parental monitoring of behavior in order to delay sexual debut, decrease sexual activity, and increase condom and hormonal contraceptive use in sexually active adolescents.
Parent—child communication and parental monitoring have been shown to improve sexual and reproductive health "Sexual health nurse role as a scientist." Nurses should verbally endorse the importance of parent—child sexual health communication at each visit, particularly to promote communication prior to sexual debut for younger adolescents. While there is no single method that will reach all parents, clinic and community delivery models have demonstrated success. One recent study used focus groups with both parents and toyear-olds to learn what kind of game features potential users would want in an intergenerational sexual health education game, to be played by parent—child dyads.
Nurses can also increase their own knowledge and skills to improve delivery of evidence-based sexual and health services and initiate parent-based adolescent sexual and reproductive health counseling.
Nurses should be encouraged to provide these services independently and also within collaborative interprofessional health care teams.
Further research is needed to identify best practices in the effective implementation of these strategies to prepare practicing nurses and nursing students to incorporate adolescent sexual and reproductive health education across various health care delivery settings. We look forward to improved outcomes and better access to sexual and reproductive health care for all adolescents through nurse-driven health care delivery and advocacy for adolescent-friendly environments.
The authors have disclosed no potential conflicts of interest, financial "Sexual health nurse role as a scientist" otherwise. National Center for Biotechnology InformationU. Author manuscript; available in PMC Jul An evidence-based guide to delivering counseling and services to adolescents and parents.
Author information Copyright and License information Disclaimer. Diane Santa Maria, ude. The publisher's final edited version of this article is available at Am J Nurs. Open in a separate window. Adolescents should have universal access to comprehensive sexual and reproductive health information and services that are evidence based, confidential, developmentally appropriate, and culturally sensitive.
Department of Health and Human Services Teen pregnancy prevention www. Sexual and reproductive health across care settings Adolescents use health services for well and sick visits, sports physicals, immunizations, and emergency care.
Topic Adolescents Parents Talking Points Strategies Talking Points Strategies Sexual health communication Discuss "Sexual health nurse role as a scientist" of and strategies for communicating with parents, sexual partner, and nurse about current or anticipated sexual activity and necessity for honest disclosure to parents of whereabouts and about friends. Identify effective parent—child sexual health communication and monitoring practices.
Discuss the importance of early initiation of sexual health communication. Role-play communicating with the child about reasons youths have sex. Identify roadblocks to communication and make a plan to overcome them. Sexual orientation Inquire about sexual orientation, gender identity, and safety in school and at home.
Provide local resources for counseling and peer support. Discuss HPV as a cancer prevention vaccine and bundle it with other scheduled adolescent vaccines. Role-play scenarios such as parties with no parents present, going out with friends who use drugs or alcohol, someone wanting to go farther sexually than you do. Discuss parental strategies to decrease adolescent sexual health risks such as, open parent—child communication, connectedness, parental involvement, and parental monitoring.
Ask parents about their communication and monitoring strategies, and brainstorm ways to improve them. Ask parents to set a date when they will next communicate with their child about sexual health and safety. Identify monitoring Sexual health nurse role as a scientist and rule setting to decrease the risk of sexual situations.