Activate’s Agenda for Developing Research-Based Sexual and Reproductive Health Resources

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P
rofessionals who work on behalf of young people have an important opportunity to assure youth receive accurate information about sexual and reproductive health.

Through an initial needs assessment conducted by the Activate team, youth-supporting professionals said they need research-informed, useful, and accessible resources (e.g., tools, trainings, and other job aids) to support their work in sexual and reproductive health. This brief describes Activate’s priorities for research-to-practice translation, the rationale for these priorities, and the initial goals for resource development.

Child Trends, in partnership with Chapin Hall and Healthy Teen Network, established Activate, a collective of researchers, youth-supporting professionals, and young people, to bring sexual and reproductive health research and resources to youth-supporting professionals. Activate is funded by the Office of Population Affairs (OPA) to bridge the gap between research and practice in support of OPA’s mission to promote health across the reproductive lifespan through innovative, evidence-based adolescent health and family planning programs, services, strategic partnerships, evaluation, and research. Activate translates research into practice by curating, adapting, and creating research-informed resources. The resources will address the needs of youth-supporting professionals who work on behalf of youth involved the child welfare system and/or justice systems, youth experiencing homelessness, and opportunity youth (youth who are out of work and out of school).

The Activate team conducted an initial needs assessment to identify the priorities and initial goals for Activate’s research-to-practice translation agenda. The team used the findings from the needs assessment to develop priorities for resource development and determine the initial goals for research translation and resource development. Below, we summarize Activate’s priorities for research translation, methods for the needs assessment, and initial goals.

Needs Assessment Methods

The needs assessment explored the need for resources among stakeholders, the availability of research, and gaps in resources based on a specific set of topics associated with sexual and reproductive health.

Stakeholders need for resources: We gathered information from youth-supporting professionals, researchers, and young people through input from the Activate Research Alliance. The Research Alliance includes 38 professionals who work in systems with or on behalf of youth, researchers, and young adults with relevant lived experiences.

To assess need for resources, we held three meetings with the full Research Alliance, conducted a survey of the Research Alliance and other stakeholders, and conducted two discussion groups of youth and youth-supporting professionals.

Available research literature: We conducted a search of peer-reviewed literature and coded 167 research articles, including both peer-reviewed and gray literature, that address select sexual and reproductive health topics including contraception and STIs. All the articles focused on youth involved in the child welfare and/or justice systems, youth experiencing homelessness, and opportunity youth.

Available resources: Through a review of 67 websites, we identified 35 research-informed resources focused on the same sexual and reproductive health topics for youth-supporting professionals who work on behalf of Activate’s focal populations.

Priorities for Resource Development

Below, we summarize Activate’s agenda in more detail, including priorities for research translation and the rationale for each priority based on findings from the needs assessment.

Address a broad range of sexual and reproductive health topics, beyond pregnancy prevention and sexually transmitted infections (STIs). Activate enhances youth-supporting professionals’ capacity to address youths’ sexual and reproductive health through a wide array of relevant topics, in addition to traditional topics such as pregnancy and STI prevention.

Our needs assessment found that condoms, STIs, and pregnancy were the most studied topics directly related to Activate’s focal youth populations’ sexual and reproductive health. Studies of these topics often examined their relationship to substance use, mental health, and risk avoidance. Meanwhile, stakeholders expressed a need for resources that center youths’ needs, can be used in practice with youth, and cover a broader range of sexual and reproductive health-related topics. Youth-supporting professionals shared they need resources that address communication with youth about their sexual and reproductive health rights, access to sexual and reproductive health services and supports, options for youth who are pregnant, and resources for professionals to become more informed about youth and sex trafficking, among other critical topics.

Prioritize youth-supporting professionals’ and youths’ voices in the resource development process to ensure resource content is relevant. Activate’s resource development process uses both a human-centered design and a participatory approach to develop resources to center professionals’ needs.

Youth-supporting professionals value credible, easy-to-use, and engaging resources that are informed by and address topics important to youth. Professionals say the resources they use provide the content, framing, and language they use in their work with young people. Many professionals say they use the language and the words included within these resources when they talk with youth. Young people say words matter and they do not pay attention when language is not relevant or words are difficult to understand.

Recognize that young peoples’ sexual and reproductive health is best understood within the larger context of their lives, rather than youths’ involvement in public systems. Resources will address the multiple influences on adolescent sexual and reproductive health.

A broad range of factors shape sexual and reproductive health-related behaviors, access to services, and outcomes among youth involved in the child welfare and/or justice systems, youth experiencing homelessness, and opportunity youth. Key influences on sexual and reproductive health are rooted in the social determinants of health (e.g., healthcare access and quality, education access and quality, social and community context such as connections to supports, economic stability, and experiences of trauma).1 Meanwhile, available research and resources often define young people based on their connection to a system (e.g., the child welfare or justice systems) and describe their characteristics and experiences within systems. The focus on systems without context contributes to a siloed approach that limits the value of sexual and reproductive health resources for youth-supporting professionals who work with systems-involved youth.

Center racial equity and cultural relevance in resource development. Activate resources recognize racial oppression and focus on cultural relevance, reflecting sensitivity to the lived experiences of youth.

Activate’s focal youth populations are disproportionately Black, Indigenous, and Hispanic.2 People of color have historically and systematically been denied the right to bodily autonomy, including reproductive rights. Communities of color do not have equal access to the same high-quality health care as communities that are predominantly white.3 Through the needs assessment, stakeholders including youth-supporting professionals, youth, and researchers emphasized a need for resources that acknowledge the effects of structural racism and trauma caused by systems of oppression in communities of color.

Elevate resources that address the sexual and reproductive health needs of youth who identify as LGBTQ+ and young men. Activate develops resources for youth-supporting professionals to fill a critical gap in research-informed resources that focus on the sexual and reproductive health of LGBTQ+ youth and young men, including fathers.

Professionals who support Activate’s focal populations of youth may not be equipped to address sexual and reproductive health among youth who identify as LGBTQ+ and/or young men. The needs assessment identified only a few studies and resources that specifically address the sexual and reproductive health of young people who identify as LGBTQ+ and/or young men. Research literature that includes males is primarily based on mixed-gender study samples (i.e., combine males and females).* Sexual and reproductive health resources for professionals are often designed to support youth who identify as heterosexual and cisgender (i.e., whose gender corresponds with their sex at birth). Given the dearth of sexual and reproductive health-related research about young people who identify as LGBTQ+ and/or young men who are involved in the child welfare or justice systems, experiencing homelessness, or opportunity youth, Activate’s resources will be informed by the broader research literature on adolescent sexual and reproductive health.

Create resources that are rooted in research, including trauma and medically-informed research. Activate draws upon research to adapt existing and create new resources using a systematic research-to-practice translation process for identifying and translating rigorous research, designing resources, and reviewing end products for accuracy.

The needs assessment found the body of research associated with the sexual and reproductive health of Activate’s focal youth populations is small but growing in ways that can be useful for youth-supporting professionals. For example, research clearly indicates that Activate’s focal youth populations are likely to have experienced trauma, so youth-supporting professionals need trauma-informed resources that realize and integrate the impact of trauma, symptoms of trauma, paths for recovery, and do not retraumatize youth. Professionals and researchers agree all resources must also be informed by medically accurate research and resources.

Increase youth-supporting professionals’ access to research and resources. Activate enhances access to research through curated descriptions of research, provides access to available resources through a web-based Resource Finder, creates research-informed content in easily accessible formats, distributes products widely to diverse audiences, and provides technical assistance to enhance the way information is used.

The needs assessment revealed that research is not typically disseminated in ways youth-supporting professionals prefer and that can be used with youth. Youth-supporting professionals also face barriers to accessing and using research (e.g., limited or no access to peer-reviewed journals). Meanwhile, researchers often do not have funding to disseminate their research to youth-supporting professionals.

Access to resources may vary among youth-supporting professionals. Most resources are developed for professionals who work on behalf of youth, rather than directly with youth. Unlike youth-supporting professionals who say addressing sexual and reproductive health is a part of their job description, youth-supporting professionals who do not identify addressing sexual and reproductive health as a part of their job say they are unable to find needed resources on a broad array of sexual and reproductive health topics.

Activate’s Initial Research-to-Practice Translation Goals

In Activate’s first year, the team developed Research-to-Practice Goals to inform the selection and development of research-to-practice resources. The goals are guided by priorities for research translation, available research, needs and gaps in resources, and project capacity. While honoring key priorities for resource development throughout the process, the Activate research-to-practice agenda identified the following goals:

  1. Increase access to relevant sexual and reproductive health resources
  2. Enhance relevance of resources about teen pregnancy and STI prevention
  3. Address a broader set of sexual and reproductive health topics
  4. Include resources for professionals who support youth with diverse experiences and characteristics
  5. Provide guidance on communicating with youth about sexual and reproductive health

To fulfill this agenda, Activate develops sexual and reproductive health resources for youth-supporting professionals who work on behalf of youth involved in the child welfare and/or justice systems, youth who experience homelessness, and/or opportunity youth and ongoing technical assistance about how to use resources.


Suggested Citation:

Decoursey, J., Scott, M., Desiderio, G. (2021). Activate’s agenda for developing research-based sexual and reproductive health resources. https://activatecenter.org/agenda/

Notes:

1. Artiga, S., & Hinton, E. (2018). Beyond health care: the role of social determinants in promoting health and health equity. Henry J. Kaiser Family Foundation.

2. Committee on Health Care for Underserved Women. (2018). ACOG Committee Opinion No. 729: Importance of Social Determinants of Health and Cultural Awareness in the Delivery of Reproductive Health Care. Obstetrics and gynecology, 131(1), e43–e48. https://doi.org/10.1097/AOG.0000000000002459

Committee on Health Care for Underserved Women. (2015). ACOG Committee Opinion No. 649: Racial and Ethnic Disparities in Obstetrics and Gynecology. Obstetrics and gynecology, 126(6), e130–e134. https://doi.org/10.1097/AOG.0000000000001213

Maness, S. B., & Buhi, E. R. (2016). Associations Between Social Determinants of Health and Pregnancy Among Young People: A Systematic Review of Research Published During the Past 25 Years. Public health reports, 131(1), 86–99. https://doi.org/10.1177/003335491613100115

National Academies of Sciences, Engineering, and Medicine. (2016). A framework for educating health professionals to address the social determinants of health. National Academies Press. doi: 10.17226/21923.

2. Dragomir, R.R. & Tadros, E. (2020). Exploring the impacts of racial disparity within the American juvenile justice system. Juvenile and Family Court Journal, 71(2), 61-73.
Eastman, A.L., Palmer, L., & Ahn, E. (2019). Pregnant and Parenting Youth in Care and Their Children: A Literature Review. Child and Adolescent Social Work Journal, 36(6), 571-581. https://doi.org/10.1007/s10560-019-00598-8.
Page, M. (2017). Forgotten Youth: Homeless LGBT Youth of Color and the Runaway and Homeless Youth Act. Northwestern Journal of Law & Social Policy, 12(2).

3. Mahajan, S., Caraballo, C., Lu, Y., Valero-Elizondo, J., Massey D., Annapureddy, A.R., Roy, B., Riley, C., Murugiah, K., Onuma, O., Nunez-Smith, M., Forman, H.P., Nasir, K., Herrin, J., & Krumholz, H.M. (2021). Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999-2018. Jama, 326(7), 637–648. doi:10.1001/jama.2021.9907.
Richardson, L. D., & Norris, M. (2010). Access to Health and Health Care: How Race and Ethnicity Matter. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 77(2), 166–177. doi:10.1002/msj.20174

*When describing research and resources, we use the language in the publications to accurately represent the publications. We acknowledge that this language is not always inclusive.