SEXUAL AND REPRODUCITVE HEALTH MODULE

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Updated March 2020

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Contraception

 

Learning Objectives:

  1. Examine your values around prescribing contraception to adolescents and young adults, and discuss professional responsibility to provide evidence-based care 
  2. Describe the US Medical Eligibility Criteria and Selected Practice Recommendations for Contraceptive Use, and understand how to apply these in counseling patients about options and providing contraception
  3. Discuss the various options for emergency contraception, including efficacy, mechanism of action, indications for use, and patient counseling points 
  4. Explain the various contraceptive methods, including ideal and typical failure rates, mechanism of action, benefits, and side effects, as well as addressing common myths about contraception
  5. Apply a shared decision-making framework to contraceptive counseling methods in working with teens
  
Readings and videos

Readings: 
  1. Committee on Adolescence. Contraception for adolescents. Pediatrics. 2014;134(4):e1244-1256. 
  2. Society for Adolescent Health and Medicine. Emergency Contraception for Adolescents and Young Adults: Guidance for Healthcare Professionals. Journal of Adolescent Health 2016;58(2):245-8. 
  3. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep 2016;65(3):1-103.     
  4. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep 2016;65(4):1-66. 
  5. Gold, RB. Guttmacher Policy Review, Guarding Against Coercion While Ensuring Access: A Delicate Balance, Guttmacher Institute. Volume 17, Issue 3, 2014. 


Videos (Contraceptive CHOICE Project): 

  1. Pathways to CHOICE 
  2. Which birth control is right for you? 


Websites: 

  1. www.cdc.gov/reproductivehealth/contraception/usmec.htm  
    • CDC MEC ipad/iphone app, summary chart, and additional resources
  2. www.bedsider.org  
    • Contraceptive efficacy chart 
    • Emergency Contraception comparison chart 

Webinars: 

  1. Contraception [webinar] by Dr. Steinauer as part of Quality Care and Public Health Implications [online course] - Link to materials   


Interactive Learning Opportunities

Family Planning National Training Center, Available online for free at:
https://www.fpntc.org/training-packages/contraceptive-services 
 
  1. Quality Contraceptive Counseling & Education: A Client Centered Conversation eLearning
  2. Quality Family Planning (QFP) Services Application: Clinical Scenarios

Materials to Develop Educational Sessions

Improving Contraceptive Counseling through Shared Decision-Making Curriculum [slideset]. Innovating education in reproductive health
ARSHEP PowerPoint modules available at: https://prh.org/arshep-ppts     
  1. Emergency Contraception (EC) and adolescents 
  2. Essentials of contraception and adolescents 
  3. Long-Acting Reversible Contraception
  4. Collaboration or Coercion

ARSHEP case videos available at: https://prh.org/arshep-ppts/

1.    Drop-In Visit for Emergency Contraception 

2.    Long-Acting Reversible Contraception (IUDs)

3.    Request for birth control: young adolescent


Online Resources: 
  1. SAHM Sexual and Reproductive Health Resources 

Clinical and Community Settings
  • Outpatient (adolescent clinic, primary care clinic, pediatric OB/GYN)
  • Inpatient (wards)
  • Emergency department


Pregnancy Options Counseling


Learning Objectives:
  1. Provide teens with non-judgmental counseling about all of their pregnancy options and community resources
  2. Describe the public health impact of unintended adolescent pregnancy, including abortion, adoption, and teen parenting
Readings and Videos

Readings:
  1. Kumar V, Herbitter C, Karasz A, Gold M. Being in the room: reflections on pregnancy options counseling during abortion training. Fam Med. 2010;42(1):41-46.
  2. Finer LB, Zolna MR. Declines in Unintended Pregnancy in the United States, 2008-2011. N Engl J Med 2016;374(9):843-52.
  3. Counseling and Informed Consent. Available as part of Goodman S, Wolfe M, and the TEACH Trainers Collaborative Working Group
Videos:
  1. Exploring All Options: Pregnancy Counseling Without Bias (within Title X Regulations). Family Planning National Training Center (FPNTC), Videos and
Webinars: 
  1. Decision Counseling for Positive Pregnancy Test Results [webinar] by Dr. Perrucci as part of Quality Care and Public Health Implications [online course] 
Interactive Learning Opportunities

Values Clarification. Available as part of Goodman S, Wolfe M, and the TEACH Trainers Collaborative Working Group. Early Abortion Training Workbook, Fourth Edition. UCSF Bixby Center for Global Reproductive Health: San Francisco, CA (2012).

Materials to Develop Educational Sessions
  1. Pregnancy Options Counseling with Adolescents 
  1. Unintended pregnancy 
  2. Hoping for a positive pregnancy test 
 
Clinical and Community Settings
  • Outpatient (adolescent clinic, primary care clinic, pediatric OB/GYN)
  • Emergency department

 

Abortion


Learning Objectives:
  1. Provide teens with evidence-based information about medication and aspiration abortion, including safety, efficacy, indications, and expected side effects

Readings and Videos

Readings:
  1. Early Abortion Options. Available as part of Goodman S, Wolfe M, and the TEACH Trainers Collaborative Working Group. Early Abortion Training Workbook, Fourth Edition. UCSF Bixby Center for Global Reproductive Health: San Francisco, CA (2012).
  2. Comparison of early abortion options. RHEDI.
 
Videos and Websites
  1. Abortion Out Loud. Stories and videos available 
  2. A better way to talk about abortion. Aspen Baker. 
  3. AJ+. How to get an abortion in the United States

Interactive Learning Opportunities
Features of Medical and Surgical Abortion (in Counseling for Medication Abortion) as part of Early options: A Provider’s Guide to Medication Abortion
 
Materials to Develop Educational Sessions

ARSHEP PowerPoint modules 

1.    Pregnancy Options Counseling with Adolescents 

2.    Abortion and adolescents
 

Clinical and Community Settings
  • Outpatient (adolescent clinic, primary care clinic, pediatric OB/GYN)
  • Emergency department

 

Sexually Transmitted Infections


Learning Objectives:
  1. Apply guidelines for routine STI/HIV screening and prevention in clinical care, including special considerations for youth at higher risk of infection
  2. Review evidence-based STI treatment guidelines, including expedited partner therapy (EPT) 
  3. Recognize signs and symptoms of common STIs and acute HIV
  4. Recognize the diagnostic criteria and use up-to-date management for pelvic inflammatory disease, vaginitis, and urethritis 

Readings and Videos

Readings:
  1. Committee on Adolescence; Society for Adolescent Health and Medicine. Policy Statement: Screening for nonviral sexually transmitted infections in adolescents and young adults. Pediatrics. 2014 Jul;134(1):e302-11.

Websites and Resources:
  1. CDC STD Treatment Guidelines
    • phone and ipad app
  2. CDC STD Fact Sheets
  3. Learn About PrEP, Preventing New HIV Infections, CDC 
  4. Expedited partner therapy (EPT). Guidance including legal status by state. 

Consultation:
  1. CDC “warmline” to reach faculty from the National Network of STD/HIV Clinical Prevention Training Centers for advice on complex cases. 
Interactive Learning Opportunities
 
  1. National STD Curriculum 
  2. Pre-exposure Prophylaxis for HIV Prevention: Clinical cases. Available from the  National LGBT Health Education Center at: 
  3. PrEP Action Kit. Available from the  National LGBT Health Education Center 
 
Materials to Develop Educational Sessions

STD 101 in a Box: Ready-to-use Presentations 


ARSHEP case videos: https://prh.org/arshep-ppts/#sexually-transmitted-infections  
  1. STI screening
  2. Annual visit, sexually transmitted infection

ARSHEP PowerPoint modules:  
  1. HIV pre-exposure prophylaxis (PrEP) and adolescents
  2. Human papillomavirus and adolescents 
  3. STIs: epidemiology, testing and treatment for adolescents

Pedicases:
  1. HIV and the Adolescent: Michael’s Disclosure 
  2. STDs: The Burning Issue
 
Clinical and Community Settings
  • Outpatient (adolescent clinic, primary care clinic, pediatric OB/GYN)
  • Emergency department
 

 

Menstrual Cycle and Common Menstrual Disorders


Learning Objectives:
  1. Describe the normal female menstrual cycle, and understand the concept of anovulatory cycling during pubertal development 
  2. Describe the differential diagnosis, initial evaluation, and management options for common menstrual disorders including amenorrhea, irregular menses, abnormal uterine bleeding, and dysmenorrhea
  3. Explain options for menstrual regulation in adolescents with physical or developmental disabilities 

Readings and Videos
 
Readings:
  1. Gray SH. Menstrual disorders. Pediatr Rev 2013;34(1):6-17; quiz 17-8.
  2. ACOG Committee Opinion No. 349, November 2006: Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Obstet Gynecol 2006;108(5):1323-8.
  3. Talib HJ, Coupey SM. Excessive uterine bleeding. Adolesc Med State Art Rev 2012;23(1):53-72.
  4. Committee Opinion No. 668: Menstrual Manipulation for Adolescents With Physical and Developmental Disabilities. Obstet Gynecol. 2016 Aug;128(2):e20-5.

Materials to Develop Educational Sessions

Pedicases:
  1. Dysfunctional Uterine Bleeding: Too Many Periods.
  2. Amenorrhea: Missing Menses
Clinical and Community Settings
  • Outpatient (adolescent clinic, primary care clinic, pediatric OB/GYN)
  • Emergency department


 

Male Reproductive Health


Learning Objectives:
  1. Describe male adolescent reproductive health care needs
  2. Demonstrate the ability to take an appropriate male sexual health history
  3. Demonstrate the ability to perform a male GU exam and identify common abnormal findings

Readings and Videos

Readings: 
  1. Adolescent and young adult male health: a review. Bell DL, Breland DJ, Ott MA.Pediatrics. 2013 Sep;132(3):535-46.
  2. Marcell, A.V. and the Male Training Center for Family Planning and Reproductive Health. Preventive Male Sexual and Reproductive Health Care: Recommendations for Clinical Practice.  
  3. The Male Genital Examination: A Position Paper of the Society for Adolescent Health and Medicine. Journal of Adolescent Health. 2012;50(4):424–5.

Websites: 
  1. Health Provider Toolkit for adolescent and young adult males
 
Interactive Learning Opportunities
Caring for Adolescent and Young Adult Males: Tools for Clinicians, FPNTC, October 2014.   
Materials to Develop Educational Sessions
 
ARSHEP videos and discussion guides: 
  1. Discomfort Wearing Condoms
  2. Sports physical and sexual history
  3. Male adolescent reproductive health

ARSHEP PowerPoint modules
  1. Male adolescent sexual and reproductive health
 
Clinical and Community Settings
  • Outpatient (adolescent clinic, primary care clinic, pediatric OB/GYN)
  • Emergency department


 

Sexual and Gender Minority Youth


Learning Objectives:
  1. Discuss the health related challenges and screening recommendations for LGBTQIA+ youth 
  2. Incorporate appropriate LGBTQIA+ sensitive language into gender and sexual history taking for all adolescents and young adults 
  3. Summarize evidence-based guidelines for supporting gender diverse youth
  4. Describe local and national resources for LGBTQIA+ youth 
 
Readings and Videos

Readings: 
  1. Committee On Adolescence. Office-based care for lesbian, gay, bisexual, transgender, and questioning youth. Pediatrics 2013;132(1):198-203. 
  2. Telfer, M.M., Tollit, M.A., Pace, C.C., & Pang, K.C. Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents Version 1.1. Melbourne: The Royal Children’s Hospital; 2018. 
  3. SAMHSA, A Practitioner’s Resource Guide: Helping Families to Support Their LGBT Children. HHS Publication No. PEP14- LGBTKIDS. 2014. 
Videos:
  1. Voices of Transgender Adolescents in Healthcare. Adolescent Health Initiative 

Websites:
  1.  Family Acceptance Project 
  2. Sexual Orientation: Overview, Theories About Gay, Lesbian, and Bisexual Sexuality, Developmental Stages of Gay, Lesbian, and Bisexual Adolescents Available via Medscape 

Interactive Learning Opportunities
 
National LGBT Health Education Center webinars
  1. Caring for LGBT Youth in Clinical Settings
  2. Sexual Orientation, Gender Identity, and Mental Health in Children and Adolescents
  3. Gender Nonconforming Youth in Pediatrics & Primary Care: Opportunities for Better Outcomes

Materials to Develop Educational Sessions

ARSHEP PowerPoint modules
  1. Caring for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth
  2. Caring for Transgender youth

ARSHEP videos and discussion guides:
  1. Coming Out 
  2. Sexual History Taking & Gender 

LGBTQ+ Care Spark training materials. Adolescent Health Initiative:  

 
Clinical and Community Settings
  • Outpatient (adolescent clinic, primary care clinic, pediatric OB/GYN)
  • Emergency department
 

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