Sexual Health

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

TL;DR

A community-integrated, multi-component intervention (AccessKCTeen) featuring SRH outreach events, telemedicine, and mobile health clinics is acceptable to marginalized adolescents and warrants further evaluation of its impact on SRH outcomes.

Key Findings

The AccessKCTeen intervention was developed through community discussions and featured SRH outreach events, telemedicine access, and mobile health clinics to improve sexual and reproductive health access for marginalized youth.

  • Development was guided by community discussions prior to pilot testing
  • The intervention was multi-component, including outreach events to disseminate information, share resources, and connect teens to care
  • Care access modalities included telemedicine and mobile health clinics
  • Eight outreach events were conducted during the pilot phase

The pilot study recruited 96 adolescent participants with a demographically diverse sample that included substantial proportions of racial, gender, and sexual minorities.

  • Total sample size was 96 participants recruited across eight outreach events
  • 46% of participants identified as Black and 23% as Hispanic
  • 23% identified as gender minority and 50% as sexual minority
  • Participants completed baseline assessments covering demographics, event satisfaction, and trust in the medical profession, with one-month follow-up assessments

The majority of adolescent participants expressed high satisfaction with the outreach events.

  • 76% of participants reported being 'very' satisfied with the event
  • 9% reported being 'somewhat' satisfied
  • 15% were 'neutral'
  • No participants reported dissatisfaction, based on the reported percentages

Baseline trust in the medical profession among participants was moderate.

  • Mean baseline trust score was 16.4 ± 2.7
  • The trust scale range was 5–25
  • A score of 16.4 out of 25 represents a moderate level of trust

Trust in the medical profession showed a slight increase at one-month follow-up compared to baseline.

  • Baseline trust score was 16.4 ± 2.7
  • One-month follow-up trust score was 17.2 ± 2.8
  • The increase was approximately 0.8 points on the 5–25 scale
  • Both measurements used the same trust scale (range 5–25)

Twenty percent of participants obtained healthcare in the month following the outreach events.

  • SRH utilization was measured at one-month follow-up
  • 20% of participants reported obtaining healthcare at follow-up
  • This represents utilization among adolescents who were engaged at outreach events

Adolescents accepted SRH resources such as condoms for future use and expressed positive perceptions of telemedicine and mobile clinic services.

  • Many participants accepted SRH items (e.g., condoms) for future use
  • Field notes documented adolescent comments describing telemedicine as 'safe, private, and convenient'
  • The mobile clinic was described by adolescents as 'private and trustworthy'
  • Qualitative data were captured through field notes during the eight outreach events

What This Means

This research describes the development and early testing of a program called AccessKCTeen, designed to help marginalized teenagers access sexual and reproductive health services. The program was built with community input and included health information events, free supplies like condoms, the ability to see a doctor through telemedicine, and visits from a mobile health clinic. The study recruited 96 teenagers at eight community events, many of whom were Black, Hispanic, gender minority, or sexual minority youth — groups that often face greater barriers to healthcare. The results suggest the program was well-received: most participants were very satisfied with the events, many accepted health supplies to use later, and teens described telemedicine and the mobile clinic as private, safe, and trustworthy. One month after the events, 20% of participants had obtained healthcare, and average trust in the medical profession was slightly higher than at the start of the study (17.2 out of 25, compared to 16.4 at baseline). This research suggests that combining community outreach events with telemedicine and mobile clinics is an acceptable approach for reaching teenagers who might otherwise struggle to access sexual and reproductive healthcare. The study was a small pilot, so the authors conclude that the program shows enough promise to justify a larger study to properly measure its impact on teens' health outcomes.

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Citation

Miller M, Barral R, Noel-Macdonnell J, Goggin K, Hays C, McNeill-Johnson A, et al.. (2025). Developing and piloting an intervention to increase adolescent access to sexual and reproductive healthcare: a mixed-methods study.. Health education research. https://doi.org/10.1093/her/cyaf036