BY ADOLESCENTS, FOR ADOLESCENTS: CO-CREATING ‘FIRST STEPS,’ A MESSAGING TOOLKIT TO IMPROVE ADOLESCENT SEXUAL AND REPRODUCTIVE HEALTH SERVICES AND EDUCATION

Objectives

Adolescents experience poor sexual and reproductive health outcomes, yet existing education and health services are insufficient. This study aims to improve adolescent sexual health knowledge and outcomes by co-creating service improvements with adolescent mothers based on their experiences from pre-pregnancy through parenting.

Methods

Using human-centered design, 16 adolescent mothers in New York City participated in 47 interviews to identify problems in adolescent sexual and reproductive health services and education. In two co-creation workshops, participants (n=10) designed solution prototypes, with a specific focus on improving contraceptive counseling. Healthcare stakeholders (n=10) informed \ prototype refinement.

Results

Participants highlighted deficiencies in sexual health education and emphasized the roles of healthcare providers and parents, rather than schools, in improving it. Adolescent participants designed messaging to support quality conversations between adolescents, parents, and providers and created a pre-appointment checklist to help young patients initiate conversations with providers. Young participants stressed that the toolkits address topics beyond STIs and pregnancy, like emotional health and relationships. They created guidelines for healthcare providers outlining communication strategies to provide respectful, unbiased care and contraceptive counseling that encourages adolescent autonomy. Participants shared specific suggestions for how to respectfully support young parents. Healthcare stakeholders recommended adding information on confidential care and supporting LGBTQ youth and suggested dissemination techniques. Prototypes were revised based on feedback.

Conclusions

This study highlighted the important roles that parents and healthcare workers play in adolescent sexual health education. Co-created toolkits offer a practical approach for providers, adolescents, and parents to have adolescent-centered conversations that promote adolescent autonomy, safety, and well-being.