Adolescent Perceptions of Technology-Based Sexual and Reproductive Health Services: A Systematic Review

Implementing digital sexual and reproductive health care services in youth clinics: a qualitative study on perceived barriers and facilitators among midwives in Stockholm, Sweden

“…Previous studies have identified safety concerns in digital health care services both from a health care provider and a youth perspective, either due to insecurities surrounding confidentiality or lack of privacy in the meeting [ 7 , 9 , 20 , 36 , 39 ]. The primary safety concerns for midwives in our study were the risk of meetings being overheard by a third person, and not having full control over the meeting environment.…”

“…The primary safety concerns for midwives in our study were the risk of meetings being overheard by a third person, and not having full control over the meeting environment. By contrast, a systematic review by Rea et al (2022) [ 7 ], showed that adolescents largely perceive digital sexual and reproductive health care services to be more private than face-to-face meetings given their anonymity. It is worth noting that among youth, privacy-concerns in digital sexual and reproductive health care have primarily focused on a fear of family/parents eavesdropping or reading notifications on a device, rather than direct conversational control [ 7 , 20 ].…”

“…Digital health care services, such as mobile or computer-based consultations with health care providers, offer novel modes of health care delivery with the potential to improve access to services as well as health outcomes [ 6 , 7 ]. Given the widespread adoption of digital technology and high level of digital literacy among young people, the use of digital tools and interventions in health care has been particularly popular to target the youth population [ 8 , 9 ].…”

Exploring the Complexity of Telehealth Privacy Through a Lens of Adolescent Development

“…Privacy is also integral to adolescent development, and therefore to increase privacy, HCPs must take into consideration the complexity of how privacy is organized for adolescents through a virtual setting. Strategies for HCPs to ensure privacy during adolescent telehealth visits have been summarized elsewhere (Allison et al, 2022; Rea et al, 2022), and these approaches include ensuring that the adolescent is alone and in a private space at the beginning of a visit, encouraging headphone usage and chat features to reduce eavesdropping by family members, and asking yes and no questions (Allison et al, 2022; Barney et al, 2020; Carlson & Goldstein, 2020; Evans et al, 2020; Michigan Medicine, 2020; North, 2020; Wilkinson 2020). This study suggests that when adolescent privacy in health care is prioritized, these goals of adolescent development can be preserved and supported, leading to successful “life-long developmental trajectory and health of individuals, including their decision-making capacity, academic achievement, life skills, civic engagement, social skills, opportunities for exploration, and resilience, as well as physical and emotional health” (Blum et al, 2014).…”

“…Despite its recognized importance, ensuring privacy has presented a number of challenges for both HCPs and adolescent patients. Health care providers, for example, report difficulties such as maintaining adolescents’ privacy through the process of billing and reimbursement (Ford et al, 2004), while adolescents express concerns about family or friends overhearing their healthcare conversations and endorse doubts about the privacy of electronic medical records (Allison et al, 2022; Beeson et al, 2016; Cheng et al, 1993; Corley et al, 2022; Daley et al, 2019; Diaz et al, 2022; Ford et al, 1997; Ginsburg et al, 1995; Mikesell et al, 2022; Rea et al, 2022; Reddy et al, 2002; Sharko et al, 2018). Such privacy concerns may serve as obstacles to building trust between adolescent patients and their HCPs, especially when discussing sensitive topics such as sexual and reproductive health, substance use, and mental health, which are essential components of comprehensive care for adolescents (Copen et al, 2016; Ford et al, 1997; Thrall et al, 2000).…”