SBHC staff, and use of performance improvement tools led by an Implementation Coach) and staff-level initiatives (trainings, technical assistance and incentives). Three matched-pairs of SBHCs were assigned to two cohorts to receive the same intervention: Cohort 1 initiated in Fall 2016, Cohort 2 in Fall 2017. All patients seen at least once in baseline and intervention years were included for analysis. Outcomes were the offer of an annual HIV test by the clinical staff and the acceptance of testing by the adolescents. Predictors examined included the intervention year, age > 16 years, gender, and ever having been sexually active. For each outcome, we fitted a logistic mixed effects model separately for each cohort. Odds ratios for each variable were calculated, p values set at < .01. Results: Combining both cohorts, there were 5504 unique patients in the baseline year and 5925 in the intervention year, of which the mean age was 15.9 (SD ¼ 1.43), 58.3% were female, 49.1% Hispanic, 26.5% Black and 36.3% had ever been sexually active. The odds of an HIV test offer for Cohort 1 increased by 14% (p ¼ 0.0043) from baseline (14.1%) to intervention (16.8%), and for Cohort 2 by 40% (p < 0.0001) from baseline (8.8%) to intervention (11.6%). Among those offered HIV testing, the odds of test acceptance increased in Cohort 1 by 81% (p < 0.0001) from baseline (34.6%) to intervention (47.8%) and in Cohort 2 by 59% (p < 0.0001) from baseline (59.0%) to intervention (67.7%). Both analyses were adjusted for age, gender, and sexual activity. Females tended to have lower odds of being offered testing within both Cohort 1 (OR ¼ 0.75) and Cohort 2 (OR ¼ 0.67), (p < 0.0001). Ever having been sexually active was associated with increased odds of an HIV test offer (Cohort 1 OR ¼ 1.56, p < 0.0001; Cohort 2 OR ¼ 1.99, p < 0.0001), as well as HIV test acceptance (Cohort 1 OR¼4.45, p<0.0001; Cohort 2 OR¼3.78, p<0.0001). Conclusions: To date, the implementation intervention increased both the offer and acceptance of HIV testing, with males more likely to be offered testing and with sexually active students more likely to be offered and to accept testing. Implementation activities will continue for one more year for each Cohort as we explore further innovations to increase universal testing and efforts to sustain these improvements.

Background Postpartum depression (PPD) is prevalent among adolescent mothers and is associated with negative maternal and infant outcomes. Peer support can improve health outcomes among adult and adolescent populations and involves the provision of informational, emotional, and appraisal support delivered by a peer. Purpose To describe adolescent mothers’ perceptions of a mobile phone-based peer support (MPPS) intervention designed to prevent PPD. Methods This analysis draws on data from the MPPS intervention group of a pilot randomized controlled trial of pregnant adolescents 17 to 24 years old ( n = 16). Maternal perceptions of the intervention were measured using the validated Peer Support Evaluation Inventory at 12 weeks postpartum. Results Participants acknowledged receiving supportive actions including emotional (91%), informational (66%), and appraisal (64%) support. Participants perceived positive relationship qualities with their peer mentor such as trustworthiness (94%), acceptance (75%), empathy (81%), and commitment (81%) and felt their peer mentor possessed social competence (91%) and social skills (91%). Overall, 100% of participants were satisfied with their peer support experience and would recommend this type of support to a friend. Conclusion Participants perceived their experience with the MPPS intervention positively, which lends support to MPPS as an acceptable way to provide support to adolescent mothers.

Introduction Breastfeeding rates among young mothers are low and do not meet recommendations from health authorities, putting the health of young mothers and their infants at risk. Young mothers require breastfeeding support that meets their learning needs and preferred mode for accessing information. The objective of this study was to work collaboratively with young mothers in order to cocreate an eHealth breastfeeding resource. Methodology A three-phase exploratory study was conducted in Ontario, Canada. In Phases I and II, young mothers and health care providers (HCPs) were recruited and preferences for an eHealth breastfeeding resource were explored. In Phase III, feedback from young mothers and HCPs about the new resource was collected. Results Participants found the breastfeeding eHealth resource visually appealing, engaging, and informative. Discussion Cocreating a tailored breastfeeding eHealth resource with young mothers and HCPs using a participatory approach ensured that the resource design and content met the learning needs of young mothers.

Objectives: This systematic review of the literature was conducted to determine the best way to design mindfulness interventions for perinatal adolescent mothers to support mental health during the transition to parenthood and beyond.  Perinatal adolescents face unique challenges compared to adults due to their developmental stage and difficulties accessing social determinants of health. Mindfulness educational interventions may be an ideal addition to perinatal supports to foster resilience and teach skills to reduce stress, anxiety, and depression. Methods:  A search strategy was developed to identify articles from 6 electronic databases including PsycInfo, ProQuest, PubMed, Cochrane Library, Ovid, and CINAHL. Qualitative analysis was done to identify mindfulness interventions which significantly decrease anxiety, depression or stress and to determine the components and designs of these interventions. Participants’ satisfaction with the interventions were analyzed, when available. Best practices for designing interventions for adolescents were used to recommend adaptations to the mindfulness interventions to tailor them to the perinatal adolescent population. Results: Of the 561 studies retrieved from the search, 16 met the inclusion criteria. All included studies found at last one significant decrease in mental health outcomes (stress 9 of 13, anxiety 9 of 9; depression 9 of 14). The majority of the interventions began in the perinatal period, were delivered face-to-face, included homework, multiple sessions and by a trained professional. Conclusion:  Mindfulness interventions are feasible, acceptable and effective in adult perinatal populations. Components and design of these interventions could be adapted for perinatal adolescents to increase resilience to cope with unique parenthood challenges.  

Introduction: Breastfeeding rates in Canada are suboptimal, putting mothers and their infants’ health at risk. Understanding breastfeeding knowledge and attitudes in the university student population is important as many are likely to become parents in the future. University students’ knowledge and attitudes regarding infant feeding has been studied internationally; however, no studies including both female and male students have been conducted in Canada. The purpose of this study was to determine breastfeeding experiences, education, knowledge, infant feeding attitude and perceptions of the difference in mode of infant feeding among university students which can be used to inform future health promotion campaigns and school curriculum. Methods: A non-experimental, descriptive cross-sectional study was conducted in which data from university students was collected to to identify knowledge and attitude toward breastfeeding identify differences in knowledge of breast and bottle feeding. Results: Findings suggest 65% (n=117) of university students had no previous knowledge of breastfeeding practices.  Conclusion: Breastfeeding information within the high school curriculum is needed to support evidence-informed preconception infant feeding choices and increase future parents' understanding of how breastfeeding works to assist them in meeting their future infant feeding goals and increase breastfeeding rates.