Impact of the COVID-19 pandemic on the sexual and reproductive health of adolescents in Alberta, Canada.

PURPOSE: The COVID-19 pandemic led to major service disruptions in the healthcare sector, especially regarding sexual and reproductive health services. However, the impact of the pandemic on Canadian adolescents is relatively unknown. This study aimed to investigate the impacts of the COVID-19 pandemic and associated public health measures on the sexual and reproductive health (SRH) of adolescents in Alberta, Canada. METHODS: A qualitative study using an interpretive description (ID) approach and community-based participatory research principles was conducted to capture the subjective experience and perceptions of adolescents and service providers. With the collaboration of the Adolescent Advisory Group and community partners, 18 adolescents and 15 service providers were recruited for the study through purposive sampling. Findings from the qualitative interviews were analyzed using thematic analysis. RESULTS: Three major themes emerged from the analysis: (1) COVID-19 SRH experience, (2) barriers to SRH, and (3) adolescent SRH strategies. Our findings highlight numerous barriers and challenges that prevented adolescents from accessing SRH education, products, and services. CONCLUSION: The COVID-19 pandemic had a profound impact on the SRH and the well-being of adolescents. Our study reflects the need for diverse SRH strategies to maintain continued access to SRH resources during disruptive events, such as the pandemic.

Access to sexual and reproductive health (SRH) services is a basic human right. All individuals require access to appropriate SRH services to maintain their optimal sexual and reproductive health. Adolescents require special guidance, support, and youth-friendly services in matters of SRH as they enter puberty and explore their sexual identity. However, during the COVID-19 pandemic, many health and SRH services were suspended. Access to SRH products and services became difficult due to public health restrictions, which has possible negative consequences for adolescents' SRH. The experiences of adolescents during the COVID-19 pandemic regarding their SRH are not reported in Alberta, Canada. Therefore, we explored the impacts of these public health restrictions on adolescents' SRH. We performed qualitative interviews with adolescents and SRH service providers to know their perspectives on how the pandemic influenced the SRH of adolescents. This paper provides insights into the barriers faced by adolescents while accessing SRH services during the pandemic, as well as their perceptions of digital strategies, such as mobile applications, and other recommendations for supporting SRH education and services. Based on the study findings, an adolescent-friendly mobile application will be developed to provide a virtual platform connecting adolescents to SRH educational resources, services, and support.

Environmental scan of mobile apps for promoting sexual and reproductive health of adolescents in low- and middle-income countries.

Background: Adolescence is a period of emotional, mental, and physical change. To increase health seeking behaviors, reduce risky sexual behavior, and improve sexual and reproductive health (SRH) knowledge, adolescents require support and access to SRH services. Providing evidence-informed SRH knowledge to adolescents in low- and middle-income countries (LMICs) can be a challenge as they face unique barriers such as lack of confidentiality, fear of refusal, and stigma from cultural norms. Increasing availability of mobile apps necessitates a comprehensive evaluation of the quality and classification of these SRH mobile applications so that accurate and evidence-based information is reaching its users. Failure to provide SRH services can have damaging effects throughout their development. Objective: Provide an overview of current adolescent SRH (ASRH) mobile applications targeting adolescents in LMICs by evaluating their quality and classifying their characteristics. Methods: 21 search terms related to ASRH mobile apps was developed. These terms were searched in the Apple IOS store and Google Play stores. Inclusion and exclusion criteria were used to screen these apps. Resulting apps were assessed using the Mobile App Rating Scale (MARS) tool. Data extracted was used to rank order each app and identify any gaps in quality. Results: Search strategy yielded 2,165 mobile apps. Of these, only 8 were assessed using the MARS tool. Functionality subdomain scored highest at 4.6, while Information scored lowest at 2.5. None of the assessed apps contained information on the MARS items: Evidence base and Goals. Too Shy to Ask had the highest individual app mean score of 4.1, while e-SRHR scored lowest at 2.3. Conclusions: The goal of this study is to classify and rate the quality of mobile apps designed to promote ASRH behaviors and knowledge in LMICs. Numerous apps were reviewed and all of them failed to provide evidence-based and goal oriented SRH information. Strengths include ease of use, navigation, and gestural designs. Weaknesses include evidence base, goals, willingness to pay, customization, and interactivity. These findings can be potentially used to guide future app development and educate decision makers responsible for policy changes.

Promoting Adolescent Sexual and Reproductive Health in North America Using Free Mobile Apps: Environmental Scan.

BACKGROUND: Neglecting adolescents' sexual and reproductive health (SRH) can affect multiple domains of development. Promoting healthy adolescent SRH is increasingly done using mobile phone apps. Providing SRH information via mobile phones can positively influence SRH outcomes including improving knowledge, reducing sexual risk behavior, and increasing the use of health services. A systematic approach to establishing and evaluating the quality of adolescent SRH mobile apps is urgently needed to rigorously evaluate whether they are a viable and effective strategy for reaching adolescents and improving adolescent SRH knowledge and behaviors in particular. OBJECTIVE: This study aimed to conduct an environmental scan to produce an inventory of adolescent SRH-specific mobile apps with descriptions of their purpose, structure, operations, and quality of evidence. METHODS: We used a literature review to develop 15 search terms for adolescent SRH-related apps in the Canadian and US Apple and Google app stores. After generating the search results, inclusion and exclusion criteria were applied. Using the remaining apps, we built an evidence table of app information, and app reviewers assessed each included app using the Mobile App Rating Scale. App assessments were then used to highlight trends between apps and identify gaps in app quality. RESULTS: In total, 2761 apps were identified by our searches, of which 1515 were duplicates. Of the 1246 remaining apps, 15 met the criteria for further assessment. Across all subdomains, on a scale of 1-5, the mean app score was 3.4/5. The Functionality subdomain had the highest mean score of 4.1/5, whereas the Engagement subdomain had the lowest score of 2.9/5. The top 4 apps were Tia: Female Health Advisor (4.7/5), Under the Stethoscope (4.2/5), Condom Credit Card (4.1/5), and Shnet (3.7/5). CONCLUSIONS: This environmental scan aimed to provide a comprehensive overview of the mobile apps developed to promote adolescent SRH knowledge and outcomes. Of the 15 mobile apps available to provide information related to adolescent SRH, few provided comprehensive, reliable, and evidence-based SRH information. Areas of strength included the apps' gestural design, performance, ease of use, and navigation. Areas of weakness included app goals, evidence base, and app customization options. These results can be used to conduct future studies evaluating the use and efficacy of mobile apps on health knowledge and behaviors and promote adolescent SRH.

Understanding the sexual and reproductive health needs of immigrant adolescents in Canada: A qualitative study.

Background: Literature suggests that immigrant adolescents receive limited sexual and reproductive health (SRH) education and rarely utilize SRH services in Canada. This study sought to explore the SRH information needs of immigrant adolescents in the province of Alberta. Methods: A qualitative descriptive methodology was undertaken to conduct 21 individual interviews with immigrant adolescents in Alberta. Results: A total of four themes emerged from the interviews: (1) Barriers to SRH; (2) needs of adolescents regarding SRH; (3) sources of knowledge; and (4) strategies to improve SRH. Our findings document the conflicting needs and preferences between adolescents and their parents regarding access to SRH resources and services. Discussion: Adolescents often felt unprepared to deal with their SRH issues due to socio-cultural barriers and conflicts with their parents' conservative attitude toward SRH concerns. Structural barriers to accessing SRH resources and services were also reported, including the location and cost of services. As a result, the majority of adolescents relied on digital methods to receive SRH information. Conclusion: This study highlights that future research and SRH service provider efforts need to remain cognizant of the positionality of immigrant adolescents and explore innovative ways to deliver SRH resources and services that meet their unique needs.