Primary care provider adherence to reproductive healthcare guidelines in adolescents and young adults with disabilities: A retrospective matched cohort study¹

Article type: Research Article

Authors: Roden, Rosemary Claire^a | Oholendt, Kyle^b | Lange, Hannah^c | Noritz, Garey^{b; d} | Bonny, Andrea E.^{a; b; c; *}

Affiliations: [a] Division of Adolescent Medicine, Nationwide Children’s Hospital, Columbus, OH, USA | [b] The Ohio State University College of Medicine, Columbus, OH, USA | [c] Center for Clinical and Translational Research, The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA | [d] Division of Complex Care, Nationwide Children’s Hospital, Columbus, OH, USA

Correspondence: [*] Corresponding author: Andrea E. Bonny, Nationwide Children’s Hospital, Division of Adolescent Health, 700 Children’s Drive, Suite LA5E, Columbus, OH 43205-2664, USA. Tel.: +1 614 722 2458; Fax: +1 614 355 3583; E-mail: Andrea.Bonny@nationwidechildrens.org.

Note: [1] Previous Presentations: This information has been presented as a short presentation at the 2017 Annual Research Retreat at Nationwide Children’s Hospital in Columbus, OH on November 28, 2017. This research was presented at a poster symposium at the 50th Annual Meeting of the Society of Adolescent Health and Medicine in Seattle, WA on March 17, 2018. This research was also presented at the 2018 Annual Meeting of the American Academy for Cerebral Palsy and Developmental Medicine in Cincinnati, OH on October 13, 2018.

Abstract: PURPOSE: Assessing provider adherence to preventative sexual and reproductive healthcare guidelines in adolescents and young adults (AYA) patients with physical and intellectual disabilities (PWD). METHODS: Records of PWD (N= 42) age 12–26 receiving health maintenance between 01/01/11–12/31/16 were reviewed for: (1) initiation and completion of human papilloma virus (HPV) vaccination series, (2) initiation and completion of meningococcal vaccination, (3) screening for human immunodeficiency virus (HIV), and documentation of (4) sexual, (5) menstrual, and (6) pregnancy histories. Unaffected age and gender-matched patients provided comparison data (Comparison Cohort, CC). RESULTS: The mean age of both groups was 17.3 years ± 3.8 and 40.5% were female. There was no significant difference between groups regarding the completion of HPV or meningococcal vaccine series. Among those 15+ years of age, 7.1% of PWD and 28.6% of CC were screened for HIV (p= 0.04). Sexual history was documented in 19.0% of PWD versus 73.8% of CC (p< 0.001). Among females, menstrual regularity was recorded in 11.8% of PWD versus 47.1% of CC (p= 0.02) and pregnancy history in 0.0% of PWD versus 29.4% of CC (p= 0.04). CONCLUSIONS:Adherence to sexual health guidelines was suboptimal, and lower among PWD. Vaccination rates did not differ between the two groups.

Keywords: Reproductive health, primary care, disability, sexual health, menstrual health, guidelines, adolescence, young adults, vaccination

DOI: 10.3233/PRM-180589

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 12, no. 3, pp. 317-324, 2019