PATCH-ing up Communication Between Providers and Teenagers

Posted September 27, 2016 by Josh Grant

Teenager Talking With Her Doctor
Connecting teens and healthcare providers can help young patients improve their reproductive health. 

This post is in support of Infant Mortality Awareness Month, a great opportunity for everyone from patients to healthcare providers to think about how they can contribute to better health outcomes for infants around the country. 

Teenage pregnancy is declining in the United States. In 2014, about 249,000 babies were born to 15-19-year-olds, a 9 percent decrease from 2013. However, this is still a high rate for an industrialized nation – it’s more than double the teenage pregnancy rates in France and Canada. 
 
The Wisconsin Providers and Teens Communicating for Health (PATCH) program is helping to reduce teen pregnancy rates in Wisconsin by enhancing communication between teenagers and their healthcare providers. The PATCH program trains and employs Teen Educators who then educate medical professionals on how to communicate with younger patients, with a particular focus on sensitive subjects, including sexual and reproductive health. 
 
How Stigma and Discomfort Hurt Communication
One of the keys to PATCH is helping doctors overcome some of the societal and social stigmas, such as the embarrassment that some teenagers feel when asked to talk about behaviors that might impact their sexual and reproductive health. The discomfort around these conversations is compounded when a young patient doesn’t feel safe speaking with a perceived authority figure.

“Sex, contraception and related issues are so stigmatized in our culture that it’s a very hard for doctors to talk to teens about openly and honestly about them,” said Amy Olejniczak, MS, MPH, the Associate Director of the Wisconsin Alliance for Women’s Health. “But when a provider offers a safe space and invites their young patients to play a critical role in conversations about their health and their futures, the teens are often grateful to be included and empowered to be responsible for their healthcare.

In addition to sexual and reproductive health, PATCH as created a number of resources for providers to use to improve services for adolescents. These include tools for mental health appointments, office visit techniques and drug use. Visit the PATCH website to learn more.

The PATCH for Providers workshop is one key activity of the PATCH Program. In these workshops, PATCH Teen Educators present to healthcare providers on different methods for engaging their adolescent patients in a clinical setting. Through skits, directed conversations and other activities, healthcare providers learn how to broach certain subjects and create an ongoing dialogue, which will allow them to better understand what type of unique services and support a young patient needs. 

Among other tools and lessons, PATCH teaches how to guide a patient interview so there’s a natural escalation in topics without causing any discomfort. When a healthcare provider steers the conversation gradually towards sensitive issues, a teenage patient is more likely to open up instead of shutting down and avoiding further questions. This has helped some of the providers who’ve attended workshops change how they address all of their patients, not just teenagers.

“It’s not just about young people; the environment we create has to feel safe for everyone,” says Olejniczak. “We provide real skills and tools that providers can use as soon as they leave our workshops. Many have told us they’re still applying what they learned months later and that they’ve seen improvements in their communication."

Why Reproductive Health Needs to Be Addressed Early
States with higher rates of teen pregnancies that improve health services for that population may find it leads to reductions in infant mortality as well. In 2009, the Centers for Disease Control and Prevention reported that teenage mothers had the highest rate of infant mortality at 9.05 infant deaths per 1,000 live births. New interventions and services are needed for this population in order to reduce unintended pregnancies and ensure young women’s health when they want to become pregnant. 

“Every woman of childbearing age has a right to know about her reproductive health and learn what she can do to avoid becoming pregnant if she doesn’t want to be,” says Pat Heinrich, RN, MSN, CLE, the executive project director of the NICHQ/U.S. Maternal and Child Health Department-led Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN). “Doctors, nurses, every healthcare provider really, should engage young women and educate them on contraceptives, their general well-being, and preconception and perinatal health for those who want to become or are pregnant.”

For providers to be able to do that, their patients have to trust them. In many PATCH workshops, attendees frequently ask the Teen Educators how they can build that trust. 

“We’re keenly aware that teenagers go through different emotions and realities than adults, so healthcare professionals are very interested in discovering how to become trusted adults who patients will come to when they’re ready to have these larger discussions and not just during routine appointments,” says Olejniczak.
With trust and communication, healthcare providers and teenagers will be able to better come together to discuss reproductive health in Wisconsin, and the rest of the U.S.

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