Primary Care for Urban Adolescent Girls from Ethnically Diverse Populations: Foregone Care and Access to Confidential Care
Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, USA.Journal of Health Care for the Poor and Underserved (Impact Factor: 1.1). 12/2006; 17(4):759-74. DOI: 10.1353/hpu.2006.0131
Adolescent girls face unique challenges in health care utilization, which can result in unmet needs. We sought to describe settings of usual care and primary care use, and to identify predictors of foregone care and experience of confidential care in a primarily racial/ethnic minority low-income sample. We conducted an anonymous computer-assisted self-administered survey of 9th-12th grade girls (n=819) in three Bronx public high schools, the majority of whom were Hispanic (69.8%) and Black (21.4%). Most (80%) reported having a usual source of care. Of these, 77.2% had a regular doctor. Those least likely to have a usual source of care were non-U.S. born girls (73.1% vs. 83.1%) and less acculturated girls. Predictors of foregone care in the last year include being sexually active, poor family social support, and low self esteem. Predictors of access to confidential care at last visit were age, self-efficacy for confidential care, having a regular doctor, setting of care, and having had a recent physical exam. Many urban adolescent girls, especially non-U.S. born girls, lack a usual source of care and regular health care provider. Continued attention to reducing both financial and non-financial barriers to care is required to ensure access to and quality of care for diverse populations.
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ABSTRACT: MySpace is a popular social networking Web site where users create individual Web profiles. Little data are available about what types of health risk behaviors adolescents display on MySpace profiles. There are potential risks and intervention opportunities associated with posting such information on a public Web site. To examine publicly available 16- and 17-year-old MySpace Web profiles and determine the prevalence of personal risk behavior descriptions and identifiable information. Cross-sectional observational study using content analysis of Web profiles. www.MySpace.com. In order to target frequently visited adolescent Web profiles, we sequentially selected 142 publicly available Web profiles of 16 and 17 year olds from the class of 2008 MySpace group. None. Prevalence of displayed health risk behaviors pertaining to substance use or sexual behavior, prevalence of personally identifying information, date of last log-in to Web profile. Of Web profiles, 47% contained risk behavior information: Twenty-one percent described sexual activity; 25% described alcohol use; 9% described cigarette use; and 6% described drug use. 97.2% Contained personally identifying information: Seventy-four percent included an identifiable picture; 75% included subjects' first names or surnames; and 78% included subjects' hometowns. Eighty-six percent of users had visited their own profiles within 24 hours. Most 16- and 17-year-old MySpace profiles include identifiable information, are frequently accessed by owners, and half include personal risk behavior information. Further study is needed to assess the risks associated with displaying personal information and to evaluate the use of social networking sites for health behavior interventions targeting at-risk teens.MedGenMed: Medscape general medicine 02/2007; 9(4):9.
Article: Research Ethics in the MySpace Era[Show abstract] [Hide abstract]
ABSTRACT: Social networking web sites are popular among adolescents and may represent a new venue for conducting adolescent health research. Conducting research by using social networking web sites raises several concerns, including the social value of this research, fair subject selection, confidentiality, privacy, and informed consent. Addressing each of these concerns, we offer an ethical framework to promote informed and appropriate decisions.PEDIATRICS 02/2008; 121(1):157-61. DOI:10.1542/peds.2007-3015 · 5.47 Impact Factor
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