Vu Steven, Zepeda Alex, Metzger Tai, Tebb Kathleen P
Joe C. Wen School of Population and Public Health, University of California, Irvine, Irvine, CA 92697, USA.
The Los Angeles Trust for Children's Health, Los Angeles, CA 90017, USA.
Healthcare (Basel). 2025 Jul 29;13(15):1839. doi: 10.3390/healthcare13151839.
: Adolescents and young adults (AYAs), especially those from underserved communities, often face barriers to sexual and reproductive health (SRH). This pilot study evaluated the implementation of mobile health technologies to promote SRH care, including the integration of the Rapid Adolescent Prevention Screening (RAAPS) and the Health-E You/Salud iTu (Health-E You) app at a School-Based Health Center (SBHC) in Los Angeles using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. : This multi-method pilot study included the implementation of an integrated tool with two components, the RAAPS electronic health screening tool and the Health-E You app, which delivers tailored SRH education and contraceptive decision support to patients (who were sex-assigned as female at birth) and provides an electronic summary to clinicians to better prepare them for the visit with their patient. Quantitative data on tool usage were collected directly from the back-end data storage for the apps, and qualitative data were obtained through semi-structured interviews and in-clinic observations. Thematic analysis was conducted to identify implementation barriers and facilitators. : Between April 2024 and June 2024, 60 unique patients (14-19 years of age) had a healthcare visit. Of these, 35.00% used the integrated RAAPS/Health-E You app, and 88.33% completed the Health-E You app only. All five clinic staff were interviewed and expressed that they valued the tools for their educational impact, noting that they enhanced SRH discussions and helped uncover sensitive information that students might not disclose face-to-face. However, the tools affected clinic workflows and caused rooming delays due to the time-intensive setup process and lack of integration with the clinic's primary electronic medical record system. In addition, they also reported that the time to complete the screener and app within the context of a 30-min appointment limited the time available for direct patient care. Additionally, staff reported that some students struggled with the two-step process and did not complete all components of the tool. Despite these challenges, clinic staff strongly supported renewing the RAAPS license and continued use of the Health-E You app, emphasizing the platform's potential for improving SRH care and its educational value. : The integrated RAAPS and Health-E You app platform demonstrated educational value and improved SRH care but faced operational and technical barriers in implementing the tool. These findings emphasize the potential of such tools to address SRH disparities among vulnerable AYAs while providing a framework for future implementations in SBHCs.
青少年和青年（AYAs），尤其是那些来自服务不足社区的人群，在性与生殖健康（SRH）方面常常面临障碍。这项试点研究评估了移动健康技术在促进SRH护理方面的实施情况，包括在洛杉矶的一家学校健康中心（SBHC）将快速青少年预防筛查（RAAPS）与“健康伴你行/ Salud iTu”（Health-E You）应用程序进行整合，采用了RE-AIM（覆盖范围、有效性、采用率、实施情况、维持情况）框架。
这项多方法试点研究包括实施一个具有两个组成部分的综合工具，即RAAPS电子健康筛查工具和Health-E You应用程序，该应用程序为患者（出生时被指定为女性）提供量身定制的SRH教育和避孕决策支持，并向临床医生提供电子摘要，以便他们更好地为与患者的就诊做准备。关于工具使用情况的定量数据直接从应用程序的后端数据存储中收集，定性数据通过半结构化访谈和临床观察获得。进行了主题分析以确定实施障碍和促进因素。
在2024年4月至2024年6月期间，60名独特的患者（14 - 19岁）进行了医疗就诊。其中，35.00%使用了综合的RAAPS/Health-E You应用程序，88.33%仅完成了Health-E You应用程序。所有五名诊所工作人员都接受了访谈，并表示他们重视这些工具的教育影响，指出这些工具加强了SRH讨论，并有助于发现学生可能不会面对面透露的敏感信息。然而，由于设置过程耗时且与诊所的主要电子病历系统缺乏整合，这些工具影响了诊所的工作流程并导致候诊延迟。此外，他们还报告说，在30分钟的预约时间内完成筛查器和应用程序的时间限制了直接护理患者的可用时间。此外工作人员报告说，一些学生在两步流程中遇到困难，没有完成工具的所有组件。尽管存在这些挑战，诊所工作人员强烈支持续签RAAPS许可证并继续使用Health-E You应用程序，强调该平台在改善SRH护理方面的潜力及其教育价值。
综合的RAAPS和Health-E You应用程序平台展示了教育价值并改善了SRH护理，但在实施该工具时面临操作和技术障碍。这些发现强调了此类工具在解决弱势AYAs中的SRH差异方面的潜力，同时为SBHCs未来的实施提供了一个框架。
