In the U.S, teen males, especially older and minority adolescent males, engage in sexual risk behaviors that result in reproductive problems among adolescents of both genders, including sexually transmitted infections and unintended pregnancy. Efforts to promote safe sexual behaviors have been shown to be effective to prevent such morbidity and should start ideally during adolescence. Practice guidelines recommend that clinicians promote reproductive health among all adolescents, such as screening and counseling about sex and its consequences. Current efforts however target primarily females. We know very little about how to effectively promote reproductive health for males or how males think about their reproductive health needs. This is especially relevant since boys' use of health care declines during adolescence, which can ultimately result in unmet health needs. The ultimate goal of this study is to better understand adolescent males' perceived reproductive health needs in context of their general needs and identify those factors that are amenable to change in order to inform the development of adolescent male reproductive health intervention programs. The candidate is a pediatrician and specialist in adolescent medicine at the University of Maryland, Baltimore (UMB) who has conducted preliminary research on adolescent males. The training phase of the award will include 5 activities: 1) to learn how to develop study measures for behavioral research, 2) to develop further skills in data collection, including semi-structured patient-oriented interviews, 3) to learn how to design and analyze longitudinal studies, 4) to develop skills in the responsible conduct of research, and 5) to refine skills in presenting, publishing and grant writing. These objectives will be accomplished through mentored research activities, and complemented by focused coursework available through an existing UMB K30 award for training of clinical investigators. The research phase of the award includes a description of adolescent males' (ages 12-19) actual and perceived reproductive health needs, reproductive health care use, predictors of care use, and reproductive health morbidity by using an existing dataset and primary data collection. Using data from the National Longitudinal Study on Adolescent Health, Aim 1 of this study is to determine the extent to which adolescent males have reproductive health needs and the factors that predict reproductive health care use. Using primary data collection and analysis among adolescent males, parents and clinical experts, Aim 2 of this study is to explore adolescent males' perceived general and reproductive health needs and experiences with the health care system. Upon completion of this award, the candidate will become a rigorous behavioral scientist informed by his clinical orientation and enrich our understanding of domestic adolescent males' reproductive health and mechanisms by which to increase their access to clinical reproductive services.
