Download as PDF, PPTX
![Patient-Provider Communication
“We truly believe the [health screen] was a game changer. It has
allowed us to find and intervene with many issues that would not have
otherwise been revealed and addressed. The iPad has been so crucial in
allowing ‘the space between’ for the adolescent to open up and
mention their issues.”
“I get far more truthful answers with Just Health than I would asking the
questions face to face- especially related to anxiety and sexual health.
Love it!”](https://image.slidesharecdn.com/romerojusthealth-180523172106/75/Sexual-Health-is-Just-Health-Findings-from-a-CDC-National-STD-Prevention-Training-Center-for-Technology-Innovation-49-2048.jpg)
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Sexual Health is Just Health: Findings from a CDC National STD Prevention Training Center for Technology Innovation
The document discusses sexual health, focusing on the rising rates of STDs among adolescents and the challenges in communicating sexual health issues effectively. It introduces 'Just Health', an evidence-based tool designed to improve patient-provider communication and facilitate conversations around sexual behavior and related health concerns without stigma. Emphasizing the importance of data context and understanding, it also addresses underlying issues such as mental health, substance use, and the necessity for sensitive communication in healthcare settings.
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Sexual Health is Just Health: Findings from a CDC National STD Prevention Training Center for Technology Innovation
- 1. Sexual Health isJust Health findings from a National CDC STD Prevention Training Center
- 2. National Center for TechnologyInnovation
- 3. Session Objectives 1. Evaluation& Learning 2. Technology, Sex, & Humans: Bridge to stigma-free communication 3. Data, Context, & Meaning
- 4.
- 5. On Learning K =I∞ ⊗ TDSRP
- 6. On Learning K =I ⊗ T
- 7. On Learning Learning =△Knowledge Knowledge= Information x Thinking K = I⊗ T
- 8.
- 9. On Learning K =I∞ ⊗ T
- 10. Four Universal Patternsof Thinking • Distinction-making: what it is and what it isn’t • Systems - part-whole structures, zoom in and out, sort and group • Relationships –cause and effect, compare & contrast • Perspective – another view on the same point Google: Derek Cabrera Cornell Systems Thinking
- 11. What is Learning K=I∞ ⊗ TDSRP
- 12. What is Learning K=I∞ ⊗ TDSRP Metacognitive Learning how to learn Transfer
- 13. On Evaluation Hypothesis Question Reality Test MVP CollectData Feedback Interpret Respond
- 14. On Evaluation Hypothesis Question Reality Test MVP CollectData Feedback Interpret Respond Can school-linked services improve access to healthcare for adolescents?
- 15. Why: Technology, Sex, &Humans
- 16. On Evaluation Hypothesis Question Reality Test MVP CollectData Feedback Interpret Respond How can technology improve patient-provider communication to improve adolescent health.
- 18. People are havingsex. • Sexually Transmitted Diseases (STDs) are on the rise with 20 million people in the U.S. contract an STD each year. • Over 50% were adolescents under the age of 24 (even though they account for only 17% of the sexually active population). • Most were asymptomatic at diagnosis and CDC experts estimate there could be 2-3 times as many STDs that remain undiagnosed.
- 19. It’s not onlyabout sex. • Mental Health and Trauma • Alcohol and Drugs • Intersectionality • Adolescent Populations
- 22. The problem is communication. •STD and other health experts say their biggest challenge is training healthcare providers to collect comprehensive, consistent, and accurate data on sexual behavior via interview. • Mental health, trauma, and substance use carry similar stigma. They tend to get glossed over, particularly when they are not the primary or presenting concern. • That’s why we created Just Health.
- 23. Just Health getsyou through the difficult questions so you can have a better conversation about all aspects of your health - free of stigma. Just Health isn’t a substitute for the conversation, it’s a bridge to it. The solution is communication.
- 24. On Humans andTechnology
- 25. Just Health Overview MoreCommunication. Less Stigma.
- 26. Just Health isbuilt on evidence-based tools and principles. • Bright Futures Guidelines • HEEADSSS Interview Protocol • Home environment, • Education and employment, • Eating • Activities • Drugs • Sexuality, Suicide/depression, and Safety • PHQ-9 (depression) • GAD 7 (anxiety) • CRAFFT (substance use) • CDC Sexual History Guidelines • Motivational Interviewing Prompts
- 27. Quick Tour ofJust Health
- 48. It’s Working Just Health: •is comprehensive • promotes efficiency • uncovers key sexual health and other issues • opens space to discuss sensitive and vital patient information • encourages more truthful patient history
- 49. Patient-Provider Communication “We trulybelieve the [health screen] was a game changer. It has allowed us to find and intervene with many issues that would not have otherwise been revealed and addressed. The iPad has been so crucial in allowing ‘the space between’ for the adolescent to open up and mention their issues.” “I get far more truthful answers with Just Health than I would asking the questions face to face- especially related to anxiety and sexual health. Love it!”
- 50.
- 51. Quality of Services “Ithink it gives us a great way to gather a LOT of information quickly and then tailor our interventions/education to that specific teen.” “The answers we are getting are more complete and allow us to address concerns at a deeper level than we previously could.”
- 52. A Continuum ofSupport
- 53. Just Health Distinctives Adolescents+ Intersectionality + Communication
- 54. Plans for Improvement •Interoperability • Youth-Centered Design • Decision-making and perception of harm • Library of Counseling Messages
- 55.
- 56. Data, Context &Meaning
- 57. Context gives meaningto data. Data without context is meaningless. Or worse, misleading.
- 58. What is context? •More data • Story behind the data • Thinking: • Distinction-making: what it is and what it isn’t • Systems structure - part-whole, zoom in and out, sort and group • Relationships –cause and effect, compare & contrast • Perspective – shifting the point of view
- 59. What is context? •How are distinct things related to each other? • How are they the same for different people? • How are they different for different groups of people? • What new questions are raised? • What more information do we need?
- 60. 32% 42% 39% Hispanic American Indian White 34%of all students had depressive/anxiety symptoms with some variation based on race/ethnicity, gender, and significant differences based on LGBT status. Percent of Students with Depressive/Anxiety Symptoms 26% 38% Male Female 29% 60% Not LGBT LGBT Depression and Anxiety
- 61. The main underlyingissues were abuse, problems at home, and problems at school 69% of students with depressive/anxiety symptoms had at least one of these issues In fact, most (63%) of students with at least one of these issues had symptoms Percent of Students with Depressive/Anxiety Symptoms 75% 26% Abused Not abused 77% 27% Problems at home No problems at home 62% 23% Problems at school No problems at school Related Factors
- 62. One in four(24%) were positive using revised CRAFFT scoring (1+) Substance Use
- 63. One in four(24%) were positive using revised CRAFFT scoring (1+) 22% 41% Not LGBT LGBT LGBT students were significantly more likely to be CRAFFT1+ than non-LGBT students Percent of Students who were CRAFFT1+ Substance Use and LGBT
- 64. 44% 20% Depressive symptoms No depressive symptoms 42% 18% Problems at school Noproblems at school The main underlying issues were problems at school, depressive symptoms, time in jail, and abuse. 68% of students who were CRAFFT1+ had at least one of these issues. However, 60% of students with one or more of these issues were not CRAFFT1+. Percent of Students who were CRAFFT1+ 70% 23% Ever in jail Never in jail 50% 20% Abused Not abused Related Factors
- 65. 7.4% 13.5% 1.7% Bisexual (108) Gayor Lesbian (37) Heterosexual (1547) Sexual Orientation and Self-Reported Experience of Bullying (N =1746) Bullying and Sexual Orientation
- 66. 2.9% 1.2% 29.0% Female (992) Male(765) Another Gender ID (14) Gender and Self-Reported Experience of Bullying (N =1791) Bullying and Gender Identity
- 67. 74.4% 77.4% 11.1% 23.2% 22.2% 93.5% Female (997) Male (780) Another Gender ID (14) Genderand Self-Reported Levels of Feeling Threatened (N = 1791) Low Moderate High 1.4 % Safety and Gender Identity
- 68. 21.3% 29.7% 54.8% 24.1% 21.6% 24.8% 54.6% 48.6% 20.4% Bisexual (108) Gay or Lesbian (37) Heterosexua l(1547) Sexual Orientation and Self-Reported Levels of Anxiety (N =1746) Low Moderate High Anxiety and Sexual Orientation
- 69. 44.4% 61.7% 27.1% 23.1% 11.1% 28.5% 15.3% 92.8% Female (997) Male (780) AnotherGender ID (14) Gender and Self-Reported Levels of Anxiety ( N = 1791) Low Moderate High Anxiety and Gender Identity
- 70. 52.8% 54.1% 33.7% Bisexual (51)Gay or Lesbian (17) Heterosexual (1015) Sexual Orientation and Self-Reported Sexual Activity (N= 1729) Sexual Activity and Sexual Orientation
- 71. 37.2% 29.5% 66.7% Female (992) Male(765) Another Gender ID (14) Gender and Self-Reported Sexual Activity (N = 1771) Sexual Activity and Gender Identity
- 73. One out of5 of all Just Health participants sext 73% 41% Youth who sext Youth who don't sext Self-Reported Sexual Activity Youth who sext are more likely to be sexually active Sexting and Sexual Activity
- 74. Youth who sextare more likely to have multiple partners 46% 34% Youth who sext Youth who don't sext Self-Reported Multiple Partners (2+) Sexting and Sexual Activity
- 75. Youth who sextare more likely to have multiple partners AND never use a condom 55% 40% Youth who sext Youth who don't sext Youth with Multiple Partners who Never Use a Condom Sexting and Sexual Activity
- 76. 9% of sexually activeyouth engage in anal sex 33% always use a condom 31% never use a condom Condom Use and Anal Sex
- 77. 9% of sexually activeyouth engage in anal sex 33% always use a condom 31% never use a condom 43% LGBTQ 49% Straight Females Condom Use and Anal Sex
- 78. Youth tend notto discuss past sexual history, including STDs, with their partners 20% 30% 29% Male Female Transgender Percent of Sexually Active Youth who Discuss Past Sexual History, Including STDs, with their Partners Disclosure
- 79. Youth tend notto discuss past sexual history, including STDs, with their partners 20% 30% 29% Male Female Transgender Percent of Sexually Active Youth who Discuss Past Sexual History, Including STDs, with their Partners Highest rate of discussion was from youth engaging in anal sex with multiple partners and no condom use 35% Disclosure
- 80. Despite 4 outof 10 youth being sexually active, few sexually active youth are routinely tested for STDs 22% 20% Gonorrhea and Chlamydia HIV Percent of Sexually Active Youth Tested for STDs Highest rate of testing for gonorrhea and chlamydia is for those who have multiple partners and do not use condoms Highest rate of testing for HIV is for those with multiple partners who do use condoms 26% 29% Testing
- 82. Session Objectives 1. Evaluation& Learning 2. Technology, Sex, & Humans: Bridge to stigma-free communication 3. Data, Context, & Meaning
- 83.