Dataset Information

A Research Agenda for Emergency Medicine-based Adolescent Sexual and Reproductive Health.

ABSTRACT: OBJECTIVE:The objective was to identify key questions for emergency medicine (EM)-based adolescent sexual and reproductive health and to develop an evidence-based research agenda. METHODS:We recruited national content experts to serve as advisory group members and used a modified Delphi technique to develop consensus around actionable research questions related to EM-based adolescent reproductive and sexual health care. Author subgroups conducted literature reviews and developed the initial list of research questions, which were iteratively refined with advisory members. External stakeholders then independently rated each item for its importance in expanding the evidence base (1 = not important to 5 = very important) via electronic survey. RESULTS:Our final list of 24 research questions included items that intersected all sexual and reproductive health topics as well as questions specific to human immunodeficiency virus/sexually transmitted infections (HIV/STIs), pregnancy prevention, confidentiality/consent, public health, and barriers and facilitators to care. External stakeholders rated items related to HIV/STI, cost-effectiveness, brief intervention for sexual risk reduction, and implementation and dissemination as most important. CONCLUSIONS:We identified critical questions to inform EM-based adolescent sexual and reproductive health research. Because evidence-based care has potential to improve health outcomes while reducing costs associated with HIV/STI and unintended pregnancy, funders and researchers should consider increasing attention to these key questions.

SUBMITTER: Miller MK

PROVIDER: S-EPMC6885091 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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A Research Agenda for Emergency Medicine-based Adolescent Sexual and Reproductive Health.

Miller Melissa K MK Chernick Lauren S LS Goyal Monika K MK Reed Jennifer L JL Ahmad Fahd A FA Hoehn Erin F EF Pickett Michelle S MS Stukus Kristin K Mollen Cynthia J CJ

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 20190726 12

<h4>Objective</h4>The objective was to identify key questions for emergency medicine (EM)-based adolescent sexual and reproductive health and to develop an evidence-based research agenda.<h4>Methods</h4>We recruited national content experts to serve as advisory group members and used a modified Delphi technique to develop consensus around actionable research questions related to EM-based adolescent reproductive and sexual health care. Author subgroups conducted literature reviews and developed t ...[more]

PMID: 31148339

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Project description:BackgroundExtensive documentation exists on a range of negative sexual and reproductive health outcomes and rights violations occurring during humanitarian emergencies. We explore two central questions: Do existing policies, services, and research adequately address the SRH rights, priorities and HIV risks of adolescent girls and young women in emergency settings? What are the missed opportunities for holistically addressing the vulnerabilities experienced by those living with HIV during rapid onset disasters and long term, protracted emergencies? Authors review considerations informing real-time decision making, and highlight missed opportunities to apply a gendered lens in the delivery of AGYW-centered SRHR/HIV services.MethodsA scoping review identified studies on HIV intervention and outcomes in emergency settings, published in the peer-reviewed literature (2002-2017). This exercise was complemented with a desk review of normative guidance, frameworks, and implementation guidelines on HIV and SRH in emergency responses, and by consultations with subject matter experts.ResultsThe existing frameworks and guidance pay scant attention to the sexual reproductive health and rights of young women living with HIV (WLHIV), focusing mainly on prevention of mother to child transmission (PMTCT), antiretroviral therapy (ART), HIV testing services, and linkage to treatment services. Applying a gendered sexual and reproductive health lens to the response offers opportunities to identify critical implementation questions, and highlight promising practices, to better tailor current services for AGYW.ConclusionsA plurality of competing needs crowds out dedicated time and space to effectively integrate HIV and sexual and reproductive health interventions in emergency settings. Political will is required to advance multi-sectoral cooperation, through joint planning, rights-informed learning and integrative responses, and to promote creative solutions for ART continuation, drug supply and HIV testing, treatment and care. Recent advancements in policy and practice would suggest that a more AGYW-centered response is feasible.

Project description:BackgroundAn estimated 70.8 million people are forcibly displaced worldwide, 75% of whom are women and children. Prioritizing a global research agenda to inform guidance, service delivery, access to and quality of services is essential to improve the survival and health of women, children and adolescents in humanitarian settings.MethodA mixed-methods design was adapted from the Child Health and Nutrition Research Initiative (CHNRI) methodology to solicit priority research questions across the sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) domains in humanitarian settings. The first step (CHNRI) involved data collection and scoring of perceived priority questions, using a web-based survey over two rounds (first, to generate the questions and secondly, to score them). Over 1000 stakeholders from across the globe were approached; 177 took part in the first survey and 69 took part in the second. These research questions were prioritized by generating a research prioritization score (RPP) across four dimensions: answerability, program feasibility, public health relevance and equity. A Delphi process of 29 experts followed, where the 50 scored and prioritized CHRNI research questions were shortlisted. The top five questions from the CHNRI scored list for each SRMNCAH domain were voted on, rendering a final list per domain.ResultsA total of 280 questions were generated. Generated questions covered sexual and reproductive health (SRH) (n = 90, 32.1%), maternal health (n = 75, 26.8%), newborn health (n = 42, 15.0%), child health (n = 43, 15.4%), and non-SRH aspects of adolescent health (n = 31, 11.1%). A shortlist of the top ten prioritized questions for each domain were generated on the basis of the computed RPPs. During the Delphi process, the prioritized questions, based on the CHNRI process, were further refined. Five questions from the shortlist of each of the SRMNCAH domain were formulated, resulting in 25 priority questions across SRMNCAH. For example, one of the prioritized SRH shortlisted and prioritized research question included: "What are effective strategies to implement good quality comprehensive contraceptive services (long-acting, short-acting and EC) for women and girls in humanitarian settings?"ConclusionData needs, effective intervention strategies and approaches, as well as greater efficiency and quality during delivery of care in humanitarian settings were prioritized. The findings from this research provide guidance for researchers, program implementers, as well as donor agencies on SRMNCAH research priorities in humanitarian settings. A global research agenda could save the lives of those who are at greatest risk and vulnerability as well as increase opportunities for translation and innovation for SRMNCAH in humanitarian settings.

Project description:INTRODUCTION:Previous studies have attempted to review the vast body of evidence on adolescent sexual and reproductive health (ASRH), but none has focused on a complete mapping and synthesis of the body of inquiry and evidence on ASRH in sub-Saharan Africa (SSA). Such a comprehensive scoping is needed, however, to offer direction to policy, programming and future research. We aim to undertake a scoping review of studies on ASRH in SSA to capture the landscape of extant research and findings and identify gaps for future research. METHODS AND ANALYSIS:This protocol is designed using the framework for scoping reviews developed by the Joanna Briggs Institute. We will include English and French language peer-reviewed publications and grey literature on ASRH (aged 10-19) in SSA published between January 2010 and June 2019. A three-step search strategy involving an initial search of three databases to refine the keywords, a full search of all databases and screening of references of previous review studies for relevant articles missing from our full search will be employed. We will search AJOL, JSTOR, HINARI, Scopus, Science Direct, Google Scholar and the websites for the WHO, UNICEF, UNFPA, UNESCO and Guttmacher Institute. Two reviewers will screen the titles, abstracts and full texts of publications for eligibility and inclusion-using Covidence (an online software). We will then extract relevant information from studies that meet the inclusion criteria using a tailored extraction frame and template. Extracted data will be analysed using descriptive statistics and thematic analysis. Results will be presented using tables and charts and summaries of key themes arising from available research findings. ETHICS AND DISSEMINATION:Ethical approval is not required for a scoping review as it synthesises publicly available publications. Dissemination will be through publication in a peer-review journal and presentation at relevant conferences and convening of policymakers and civil society organisations working on ASRH in SSA.

Project description:Adolescent sexual and reproductive health (ASRH) in East Africa has prioritized research on the barriers to care, communication, and ASRH knowledge, attitudes, and practices. However, there is little research examining the extent to which meaningful adolescent engagement in research is achieved in practice and how this influences the evidence available to inform ASRH services. This review offers a critical step towards understanding current approaches to adolescent engagement in ASRH research and identifying opportunities to build a strengthened evidence base with adolescent voices at the centre. This scoping review is based on Arksey and O’Malley’s (2005) framework, employing a keyword search of four databases via OVID: Medline, Global Health, Embase and PsycINFO. Two reviewers screened title, abstract and full text to select articles examining ASRH in Tanzania, Rwanda, Kenya, and Uganda, published between 2000 and 2020. After articles were selected, data was extracted, synthesized, and thematically organized to highlight emerging themes and potential opportunities for further research. The search yielded 1201 results, 34 of which were included in the final review. Results highlight the methods used to gather adolescent perspectives of ASRH (qualitative), the content of those perspectives (knowledge, sources of information, gaps in information and adolescent friendly services), and the overall narratives that frame discussions of ASRH (risky sexual behaviour, stigma, and gender norms). Findings indicate the extent of adolescent engagement in ASRH research is limited, resulting in a lack of comprehensive evidence, consistent challenges with stigma, little information on holistic concepts and a narrow framing of ASRH. In conclusion, there is opportunity for more meaningful engagement of adolescents in ASRH research. This engagement can be achieved by involving adolescents more comprehensively throughout the research cycle and by expanding the range of ASRH topics explored, as identified by adolescents.

Dataset Information

A Research Agenda for Emergency Medicine-based Adolescent Sexual and Reproductive Health.

Publications

A Research Agenda for Emergency Medicine-based Adolescent Sexual and Reproductive Health.

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