Education for sexual and reproductive health and rights (SRHR): a mapping of SRHR-related content in higher education in health care,police, law and social work in Sweden

ABSTRACT

Knowledge of sexual and reproductive health and rights (SRHR) by health care, police, legal and social work professionals has been shown to be insufficient. This lack of competence is likely to affect the quality of services. The aim of this study was to describe SRHR indicators in educational programmes in health care, police, legal and social work higher education in Sweden. A text-based analysis was conducted of written material from all educational programmes in law, midwifery, nursing, occupational therapy, physiotherapy, police work, psychology, social work and undergraduate medicine (93 educational programmes at 27 universities and university colleges). Representation of different SRHR indicators varied, but most were poorly covered in the educational programmes. Existing educational programmes lack comprehensiveness in their coverage of SRHR and are unequal both within and between the professions and universities. This situation creates the risk of inequalities in SRHR competence and suggests that needs within this field may be unmet. There is an urgent need therefore to enhance the presence of SRHR in health care, social work and law enforcement education in Sweden.     

Foster Youth Need Sex Ed,Too!: Addressing the Sexual Risk Behaviors of System-Involved Youth

ABSTRACT

The social, economic, and environmental determinants of health include employment, housing, and education; exposure to environmental factors like lead or access to healthy food; and poverty, racism and oppression. Many of these conditions can lead to Adverse Childhood Experiences that may put children and youth at risk for abuse or maltreatment leading to involvement in the child welfare or juvenile justice systems. All young people experience important developmental milestones on their path to becoming healthy adults, and while this time of change is full of promise, it can be a time of increased vulnerability or risk. For system-involved youth, navigating this time of change can be fraught with even more challenges or barriers. Without strong family and social networks, they may face increased risk of engaging in high-risk behaviors—such as unprotected sex and sex with multiple partners—as well as unintended pregnancy, HIV, and other sexually transmitted infections. Our study examined survey data to assess the overall sexual reproductive health behaviors for youth aged 14–21 in out-of-home care in an urban environment (n = 270; 60.7% male; 82% African American; 7.9% Latinx). Youth were recruited between 2012 and 2016; 76.4% of these teens had had sexual intercourse at some point in their lifetime. Of these, 86.0% were sexually active before the age of 16. Although there were numerous risk factors related to contraception and condom use as well as partner demographics, there were assets or strengths identified. A discussion of how these findings can be utilized to develop effective prevention intervention strategies is provided.     

Disentangling the effect of out-of-home care on child mental health

BackgroundChildren in out-of-home care are consistently found to have poor mental health compared to children in the general population. However, UK research has so far failed to disentangle the impact of the care system on children’s mental health outcomes from the effects of the adverse circumstances that led to their admission to care.ObjectiveThis research investigated the association between care placement and the presence of child mental health problems after controlling for children’s pre-care experiences. It also identified factors associated with mental health problems among children in care.Participants and SettingThe sample comprised three groups of children involved with child welfare services due to maltreatment, including children in out-of-home care (n = 122), reunified children (n = 82) and those who had never been in care (n = 159).MethodsThe mental health of the children in the three groups was compared, using information collected from their parents/foster carers and social workers.ResultsThe odds of a child in out-of-home care having a mental health problem were not significantly higher than those of a child who had never been in care (AOR = 1.24; p = 0.462). However, the odds of a child in out-of-home care having reactive attachment disorder (RAD) were significantly higher than those of a child who had never been in care (AOR=1.92; p = 0.032).ConclusionsThese findings make an important contribution to international debates about whether placing children in care is beneficial or detrimental to their wellbeing, and highlight a range of inter-linking factors associated with the mental health of children in out-of-home care.     

Community Colleges: Rethinking STD Prevention for the Nontraditional College Campus

ABSTRACT

As increased attention and proposed funding are being directed toward community colleges, it is important to consider the sexual and reproductive health care needs of this growing population. Existing data suggest there are significant sexual health needs among this population and often insufficient provision of services. Some community college students are more likely than students at 4-year colleges to test positive for sexually transmitted diseases (STDs). Given resource constraints, creative solutions are required. These may include campus-wide policies addressing STD/HIV (human immunodeficiency virus) prevention, referral systems to connect students to care in the community, and partnerships with local health departments, Federally Qualified Health Centers, or community-based organizations to assist with the provision of services. Colleges have the unique opportunity to provide students with valuable information about sexual health and services. Community colleges, in particular, are uniquely positioned to reach at-risk community members for STD testing and sexual health care who might otherwise be lost to care. More research is needed on the sexual health needs of community college students, especially on factors such as geographic location, how embedded the school is into the community, social norms around sexual health on college campuses, and health services offered. New and innovative ways to promote linkage to care for testing and counseling could offer potential health benefits to this growing at-risk population.     

The health and wellbeing of international students at an Australian university

A representative sample of undergraduate and postgraduate international students at a large Australian university (n=979, 64% females) completed a mail-back survey of their health and wellbeing. Most students evaluated their current and previous physical and mental health positively. Health-related risk practices such as unprotected sexual activity, drug use, smoking and gambling, were reported by few students. There was little change in health or risk behaviours since coming to Australia and few changes that were health compromising. Few demographic or situational variables, including age and gender, had a significant impact on students' wellbeing. This study has revealed that few international students find the experience of studying in an overseas country detrimental to their wellbeing. Nevertheless, for those students who encounter difficulties or are at increased risk of health-compromising outcomes, we must ensure better delivery of health promotion education, and access to, and use of, available counselling and health services.

Considerations for Sexuality Education and Services for LGB Elders

Sexuality education and health services for elderly individuals who reside in care settings (e.g., assisted living facilities, nursing homes, retirement communities) have received limited attention in the professional literature. However, the lack of sexual health promotion practices in elder care facilities can be detrimental to older adults’ overall health and quality of life. Barriers to sexuality education services for lesbian, gay, and bisexual (LGB) elders are explored and include history of LGB equality in the United States and lack of social support, as well as discrimination among formal care facilities and health care professionals. The Community Readiness Model (CRM) is proposed for addressing these barriers. The purpose of the CRM is to assess readiness characteristics of a community before program implementation and then build capacity with programming in that community for support and education. Sexuality educators currently have the opportunity to develop and implement sexual health education and promotion resources that can potentially improve the quality of life for LGB individuals transitioning into the latter stages of the life course.     

糖尿病住院病人保健知识需求调查分析

目的：了解糖尿病住院病人对糖尿病保健知识的需求情况,从而进行合理的保健指导。方法：采用问卷方式对2009年7月至2009年12月南阳医专一附院内分泌科糖尿病住院病人进行调查,所得数据用SPSS13.0统计软件进行分析。结果：住院病人的糖尿病保健知识相对缺乏;了解糖尿病保健知识的愿望非常迫切;保健知识获得途径有限。结论：通过此次调查,掌握了糖尿病住院患者对糖尿病保健知识的需求情况,为进一步改进护理工作提供依据。     

Thriving at the Intersection: Integrating Social Determinants of Health and Sexual Health Education to Achieve Positive Outcomes for Youth

Abstract

Social determinants of health are the key to understanding and addressing persistent disparities in adolescent pregnancy in the United States. However, there is little guidance on what concrete steps organizations can take to work at the intersection of social determinants of health (SDoH) and sexual and reproductive health (SH). Two community-based organizations completed a case study using a structured interview guide to illustrate their transition working at this intersection. The Alexandria Campaign on Adolescent Pregnancy and Identity, Inc. arrived at the intersection of SDoH and SH from opposite ends of the road. Despite clear differences in their trajectory, their experiences share four key elements that marked their success in expanding their core work: (a) both organizations enjoyed ample community and political support, (b) they used data to drive strategic decisions, (c) they used funding opportunities to move toward the intersection of sexual health and social determinants, and (d) they leveraged existing programs to sustain their efforts. Organizations working at the intersection must continuously leverage community, political, and financial capital to pursue partners, expand services, and change policies that sustain a holistic approach to youth health and well-being.     

No More Silos: Animating Integrated Health and Behavioral Health Care Practices in the Classroom

ABSTRACT

Over the last decade, there has been increased momentum to bring the worlds of physical and behavioral health care together. Instead of social work education simply reacting to this change, it is imperative that we be proactive and prepare students to be “multilingual,” that is, be able to speak and function in both the worlds of health and mental health so they can move seamlessly into the new world of integrated care. The purpose of this article is to explore curricular and pedagogical strategies needed to prepare graduate social work students for the coming shift in practice toward integrated health and mental health care.     

Factors affecting Canadian teachers' willingness to teach sexual health education

Non-specialist teachers in Canada are increasingly required to teach sexual health topics. However, research suggests that they do not always do so willingly. This study examined the associations between the characteristics of non-specialist elementary and middle school teachers (n = 294) in Canadian schools and their willingness to provide sexual health education (SHE) and their perceptions of factors affecting their willingness to provide SHE. On average, the teachers were only somewhat willing to teach SHE and their willingness varied between topics. The teachers who reported greater willingness to teach SHE were more likely to be teaching middle school, have less teaching experience, have received training to teach SHE, feel more knowledgeable about sexual health, and view broad-based SHE as more important. More than 20% of participants identified 10 out of 11 factors as making them less willing to teach sexual health education; conversely, more than 20% of participants identified nine of these 11 factors as making them more willing to teach sexual health education. Teachers who were middle school teachers, had received training to teach sexual health, had more experience teaching SHE, and felt more knowledgeable about sexual health topics were more likely to regard all of these factors as enhancing their willingness to teach SHE. The results are discussed in terms of their implications for training designed to increase teachers' willingness to teach sexual health.     

Development of the ‘Museum Health and Social Care Service’ to promote the use of arts and cultural activities by health and social care professionals caring for older people

ABSTRACT

It is well documented that engagement in arts and cultural activities contributes to improving and maintaining the health and well-being of older people. Despite this, many health and social care professionals do not recognize or accept arts and cultural activities as relevant to their care remit. To address this, a team of 17 individuals comprising older service users, and staff from a range of health and social care, arts, and museum and archive services in North East England worked collaboratively to design and develop the Museum Health and Social Care Service (MHSCS). MHSCS is a resource and training package that reinforces the care and clinical benefits of arts and cultural activities to older people’s health and wellbeing, aimed at supporting health and social care professionals to acknowledge and use these activities as integral to care delivery.     

Exploring Views about LARCs Among Parenting Rural Latinx Teenagers,Their Mothers,and Providers: Implications for Sexuality Education and Care

While long-acting reversible contraception (LARC) reduces risk of repeat-births, use remains low among rural Latinx adolescent mothers. This qualitative study identified perspectives about factors that influence LARC use among this population. Participants were dyads of parenting Latinx adolescent daughters and their mothers (n?=?9 dyads) and nurses (n?=?17). Findings revealed themes specific to this vulnerable population including (a) distinct ways LARC characteristics fit into parenting teenagers’ lives, (b) supportive health care climate toward LARCs, and (c) factors that inhibit LARC uptake. The study has implications for sexuality education that seeks to reduce repeat-births among this population.     

Making sense of children's sexual behavior in child care: An analysis of adult responses in special investigation reports

This paper investigates how adults respond to sexual behavior among children in child care. Culturally, childhood sexuality is variously understood as natural curiosity, a sign of sexual abuse, or a symptom of a sex-offender in the making. Given these competing cultural meanings, how are sexual-like behaviors by children managed by the adults who care for them? An analysis of qualitative data from Special Investigation Reports by childcare licensing consultants in the state of Michigan is used to examine how parents, child care providers, and child care licensing consultants manage and respond to sexual behavior between children in the context of child care. How sexual behavior is responded to depends primarily on who is doing the responding – parent, childcare provider, or state licensing consultant – rather than what type of behavior is being responded to. Parents respond to a wide range of behaviors between children as if they are incidents of sexual abuse. Childcare providers respond to many of those same incidents as misbehavior. Licensing consultants understand these incidents as violation of rules of supervision, but they were also the only group to ever ask if children's sexual behavior was potentially a sign of a child having been sexually abused in another setting. Providers and parents need more education about what kinds of sexual behavior to be concerned about and what kind to understand as common. More education that sexuality that is “rare” and persistent could be a sign of sexual abuse is needed by all parties.     

‘Can you get pregnant when u r in the pool?’: young people's information seeking from a sexual health text line

Young people have questions about sex and development but may have trouble getting answers to them. Text messaging services can serve as a resource. This study analysed 1351 text messages sent to a sexual health text message service designed for young people in North Carolina to determine the types of questions asked of a confidential, accurate source of information. The majority of texts sought information about sexual health topics (89%). A smaller proportion asked for advice (7%) or reassurance (4%) that the sender was developing normally. Questions mainly asked about sexual acts (33.9%), unplanned pregnancy (20.2%), contraception (13.7%), physical or sexual development (12.9%) and sexually transmitted diseases (10.8%). Findings suggest that a confidential and accurate sexual health text message service could be an important resource for young people, especially if they seek advice before engaging in risky sexual behaviour.     

Prescribing Jewish Sensibilities Off-Label: A Reflective Essay

ABSTRACT

When Jewish Sensibilities were formulated (2003) as a framework, it was not for the purpose of teaching Jews how or why to be Jewish. Rather, Jewish Sensibilities were a way for Jews to reflect on the Jewish content already in their lives; they also allowed practitioners in the field of health care to think about the Jewish patients and families they were encountering with greater comprehension and compassion. But of late, Jewish Sensibilities have been used in an “off-label way” to teach Jewish wisdom and codes of behavior to those who are unfamiliar with them. This article considers the efficacy of that strategy.     

我国医疗服务采购机制的构建与运行

由于医疗服务体制的主体利益多元性和复杂性,不少国家的医疗服务提供的形式是第三方采购,这不仅对医疗服务需方而且对医疗服务供方发挥监管作用。我国的医疗保险机构对医疗服务供方监管的无效乃至缺失,没有成为真正意义上的第三方采购者。构建名副其实的医疗服务"第三方采购"机制,是我国医疗体制改革的方向。     

How and where we live,learn, and play matters: An introduction to the special issue

Abstract

A holistic approach to providing health education and services integrates the Social Determinants of Health (SDH)—an approach Healthy Teen Network calls Youth 360°—to recognize that where youth live, learn, and play matters. Long promoted by such stalwarts in the public health field as the World Health Organization and Centers for Disease and Control, the SDH are now broadly recognized, including in the field of adolescent sexual and reproductive health (ASRH), as the only way to engage and address the needs of all youth. But stating this and truly understating how to make this happen are very different animals.