Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Research

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

Authors: Linn Zettergren, Elin C. Larsson, Lovisa Hellsten, Kyriaki Kosidou, Anna Maria Nielsen

Published in: BMC Health Services Research | Issue 1/2024

Login to get access

Abstract

Background

Digital health care services have the potential to improve access to sexual and reproductive health care for youth but require substantial implementation efforts to translate into individual and public health gains. Health care providers are influential both regarding implementation and utilization of the services, and hence, their perceptions of digital health care services and the implementation process are essential to identify and address. The aim of this study was to explore midwives’ perception of digital sexual and reproductive health care services for youth, and to identify perceived barriers and facilitators of the implementation of digital health care provision in youth clinics.

Methods

We performed semi-structured interviews with midwives (n = 16) working at youth clinics providing both on-site and digital sexual and reproductive health care services to youth in Stockholm, Sweden. Interview data were analyzed using a content analysis approach guided by the Consolidated Framework for Implementation Research (CFIR).

Results

Midwives acknowledged that the implementation of digital health care improved the overall access and timeliness of the services at youth clinics. The ability to accommodate the needs of youth regarding their preferred meeting environment (digital or on-site) and easy access to follow-up consultations were identified as benefits of digital health care. Challenges to provide digital health care included communication barriers, privacy and confidentiality concerns, time constraints, inability to offer digital appointments for social counselling, and midwives’ preference for in person consultations. Experiencing organizational support during the implementation was appreciated but varied between the respondents.

Conclusion

Digital sexual and reproductive health care services could increase access and are valuable complements to on-site services in youth clinics. Sufficient training for midwives and organizational support are crucial to ensure high quality health care. Privacy and safety concerns for the youth might aggravate implementation of digital health care. Future research could focus on equitable access and youth’ perceptions of digital health care services for sexual and reproductive health.
Appendix
Available only for authorised users
Literature
1.
Starrs AM, Ezeh AC, Barker G, Basu A, Bertrand JT, Blum R, et al. Accelerate progress-sexual and reproductive health and rights for all: report of the Guttmacher-Lancet Commission. Lancet. 2018;391(10140):2642–92.CrossRefPubMed
2.
The Public Health Agency of Sweden. National Strategy for Sexual and Reproductive Health and Rights (SRHR)– Good, fair, and equal sexual and reproductive health throughout the population. 2020.
3.
Braeken D, Rondinelli I. Sexual and reproductive health needs of young people: matching needs with systems. Int J Gynaecol Obstet. 2012;119(Suppl 1):S60–3.PubMed
4.
Shaw D. Access to sexual and reproductive health for young people: bridging the disconnect between rights and reality. Int J Gynaecol Obstet. 2009;106(2):132–6.CrossRefPubMed
5.
Thomson A, Christensen E, Wiklund M, Christianson M. A safe place - adolescents’ and young adults’ perceptions of youth clinics in northern Sweden. Sex Reprod Healthc. 2022;33:100752.CrossRefPubMed
6.
7.
Rea S, Zynda A, Allison B, Tolleson-Rinehart S. Adolescent perceptions of Technology-Based Sexual and Reproductive Health Services: a systematic review. J Adolesc Health. 2022;71(5):533–44.CrossRefPubMed
8.
9.
Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, et al. Our future: a Lancet commission on adolescent health and wellbeing. Lancet. 2016;387(10036):2423–78.CrossRefPubMedPubMedCentral
10.
Orton M, Agarwal S, Muhoza P, Vasudevan L, Vu A. Strengthening Delivery of Health Services Using Digital Devices. Glob Health Sci Pract. 2018;6(Suppl 1):S61–71.CrossRefPubMedPubMedCentral
11.
12.
12.The Public Health Agency of Sweden & The National Board of Health and Wellfare. Basis for a National Strategy for Sexual and Reproductive Health and Rights. 2014.
13.
The Swedish Association of Midwives. Description of Required Competences for Registered Midwives. 2018. Description-of-Required-Competences-for-Registered-Midwives_The-Swedish-Association-of-Midwives-2019.pdf (storage.googleapis.com).
14.
15.
Almathami HKY, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence Telemedicine-Based, Real-Time, Online Consultation at patients’ homes: systematic literature review. J Med Internet Res. 2020;22(2):e16407.CrossRefPubMedPubMedCentral
16.
Smith PB, Buzi RS. Reproductive health professionals’ adoption of emerging technologies for health promotion. Health Inf J. 2014;20(4):250–60.CrossRef
17.
Jacob C, Sanchez-Vazquez A, Ivory C. Social, Organizational, and Technological factors impacting clinicians’ adoption of Mobile Health tools: systematic literature review. JMIR Mhealth Uhealth. 2020;8(2):e15935.CrossRefPubMedPubMedCentral
18.
Laar AS, Harris ML, Shifti DM, Loxton D. Perspectives of health care professionals’ on delivering mHealth sexual and reproductive health services in rural settings in low-and-middle-income countries: a qualitative systematic review. BMC Health Serv Res. 2022;22(1):1141.CrossRefPubMedPubMedCentral
19.
Granja C, Janssen W, Johansen MA. Factors determining the success and failure of eHealth interventions: systematic review of the literature. J Med Internet Res. 2018;20(5):e10235.CrossRefPubMedPubMedCentral
20.
Diaz MF, Colleen G, Gruver R, Gold MA, Maier M, Usseglio J, et al. Providing Contraceptive Health Services to adolescents and young adults by Telemedicine: a scoping review of patient and provider perspectives. J Pediatr Adolesc Gynecol. 2022;35(5):575–84.CrossRefPubMed
21.
Henry BW, Block DE, Ciesla JR, McGowan BA, Vozenilek JA. Clinician behaviors in telehealth care delivery: a systematic review. Adv Health Sci Educ Theory Pract. 2017;22(4):869–88.CrossRefPubMed
22.
Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011;38(2):65–76.CrossRefPubMed
23.
Damschroder LJ, Reardon CM, Opra Widerquist MA, Lowery J. Conceptualizing outcomes for use with the Consolidated Framework for Implementation Research (CFIR): the CFIR outcomes Addendum. Implement Sci. 2022;17(1):7.CrossRefPubMedPubMedCentral
24.
25.
Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful sampling for Qualitative Data Collection and Analysis in mixed method implementation research. Adm Policy Ment Health. 2015;42(5):533–44.CrossRefPubMedPubMedCentral
26.
Kallio H, Pietila AM, Johnson M, Kangasniemi M. Systematic methodological review: developing a framework for a qualitative semi-structured interview guide. J Adv Nurs. 2016;72(12):2954–65.CrossRefPubMed
27.
DeJonckheere M, Vaughn LM. Semistructured interviewing in primary care research: a balance of relationship and rigour. Fam Med Community Health. 2019;7(2):e000057.CrossRefPubMedPubMedCentral
28.
Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs H. Qualitative content analysis: a focus on trustworthiness. SAGE Open. 2014;4(1):2158244014522633.CrossRef
29.
Walker JL. The use of saturation in qualitative research. Can J Cardiovasc Nurs. 2012 Spring;22(2):37–46.
30.
Elo S, Kyngas H. The qualitative content analysis process.JAdv Nurs.2008;62(1)107– 15.
31.
32.
Kirk MA, Kelley C, Yankey N, Birken SA, Abadie B, Damschroder L. A systematic review of the use of the Consolidated Framework for Implementation Research. Implement Sci. 2016;11:72.CrossRefPubMedPubMedCentral
33.
CFIR Research Team-Center for Clinical Management Research. The Consolidated Framework for Implementation Research– Technical Assistance for users of the CFIR framework. https://​cfirguide.​org/​.
34.
Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.CrossRefPubMed
35.
Barney A, Buckelew S, Mesheriakova V, Raymond-Flesch M. The COVID-19 pandemic and Rapid implementation of adolescent and young adult telemedicine: challenges and opportunities for Innovation. J Adolesc Health. 2020;67(2):164–71.CrossRefPubMedPubMedCentral
36.
Schlief M, Saunders KRK, Appleton R, Barnett P, Vera San Juan N, Foye U, et al. Synthesis of the evidence on what works for whom in Telemental Health: Rapid Realist Review. Interact J Med Res. 2022;11(2):e38239.CrossRefPubMedPubMedCentral
37.
Alami H, Lehoux P, Shaw SE, Papoutsi C, Rybczynska-Bunt S, Fortin JP. Virtual care and the Inverse Care Law: implications for policy, practice, Research, Public and patients. Int J Environ Res Public Health. 2022;19(17).
38.
Meherali S, Rehmani AI, Ahmad M, Adewale B, Kauser S, Lebeuf S, et al. Impact of the COVID-19 pandemic on the sexual and reproductive health of adolescents in Alberta, Canada. Reprod Health. 2023;20(1):172.CrossRefPubMedPubMedCentral
39.
Jonasdottir SK, Thordardottir I, Jonsdottir T. Health professionals’ perspective towards challenges and opportunities of telehealth service provision: a scoping review. Int J Med Inf. 2022;167:104862.CrossRef
40.
Steiner RJ, Zapata LB, Curtis KM, Whiteman MK, Brittain AW, Tromble E, et al. COVID-19 and sexual and Reproductive Health Care: findings from primary care providers who serve adolescents. J Adolesc Health. 2021;69(3):375–82.CrossRefPubMedPubMedCentral
41.
Rangachari P, Mushiana SS, Herbert K. A scoping review of applications of the Consolidated Framework for Implementation Research (CFIR) to telehealth service implementation initiatives. BMC Health Serv Res. 2022;22(1):1450.CrossRefPubMedPubMedCentral
42.
Traube DE, Cederbaum JA, Taylor A, Naish L, Rau A. Telehealth Training and Provider Experience of Delivering Behavioral Health Services. J Behav Health Serv Res. 2021;48(1):93–102.CrossRefPubMed
43.
Keith RE, Crosson JC, O’Malley AS, Cromp D, Taylor EF. Using the Consolidated Framework for Implementation Research (CFIR) to produce actionable findings: a rapid-cycle evaluation approach to improving implementation. Implement Sci. 2017;12(1):15.CrossRefPubMedPubMedCentral
44.
Ross J, Stevenson F, Lau R, Murray E. Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update). Implement Sci. 2016;11(1):146.CrossRefPubMedPubMedCentral
Metadata
Title
Implementing digital sexual and reproductive health care services in youth clinics: a qualitative study on perceived barriers and facilitators among midwives in Stockholm, Sweden
Authors
Linn Zettergren
Elin C. Larsson
Lovisa Hellsten
Kyriaki Kosidou
Anna Maria Nielsen
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-10932-1

Other articles of this Issue 1/2024

BMC Health Services Research 1/2024 Go to the issue

Research

Assessing nurses’ knowledge and attitudes towards promoting female condom use in South African primary healthcare clinics

Research

Healthcare social network research and the ECHO model™: Exploring a community of practice to support cultural brokers and transfer cultural knowledge

Research

Nurturing transformative local structures of multisectoral collaboration for primary health care: qualitative insights from select states in India

Research

Risk management and empirical study of the doctor-patient relationship: based on 1790 litigation cases of medical damage liability disputes in China

Research

Infection prevention practice in home healthcare: a mixed-method study in two Swiss home healthcare organisations

Research

Building climate resilience: awareness of climate change adaptation in German outpatient medical practices