24: A Qualitative Study Examining the Health Care Experience of Pregnancy and Parenting Youth in a Community Sample
Bibliographic record
Abstract
The importance of positive healthcare interactions, including labour and delivery experiences, has been well documented. Positively engaging with care providers is perhaps even more important for adolescents, who tend to avoid seeking health care for a number of reasons. Pregnant and parenting youth (PPY) are a subgroup of adolescents whose health care access has historically been suboptimal. As a group, teen mothers and their children are at increased risk for poor medical and mental health outcomes and therefore require health care engagement for both their children and themselves. Negative health care interactions may lead to disengagement of this already vulnerable group. The purpose of this qualitative study was to explore influences that shaped PPY's views about health and well-being, and whether their perceptions informed their social and health behaviours. Five semi-structured focus groups were conducted at two urban community centres known to service PPY. A convenience sample of 26 participants was recruited across both sites. Focus groups were audio recorded and transcribed verbatim; transcripts were analyzed thematically. Participants were a mean age of 18.7 years. While many PPY described positive healthcare encounters, almost every participant could recount at least one healthcare event they perceived as negative and detrimental. Positive health care encounters tended to feature mutual respect, support, open dialogue, and non-judgmental attitudes. Descriptions of negative encounters featured a fear of judgment; the presence of remarks that questioned the capacity and ability to raise a child; the expression of assumptions about drug abuse and the teen parent lifestyle; and the use of language implying that early childbearing was necessarily a mistake. Many of the young parents expressed a sense of heightened surveillance by healthcare providers when attending appointments for their children; others felt their responses to routine questions were faced with skepticism. For some, perceptions of negative interactions contributed to a general sense of mistrust and hesitance to access health care, and several reported delaying care because of fear of judgment by their providers. Participants felt strongly that physicians should provide unbiased, supportive, and non-judgmental care. Engaging PPY as partners in their care and introducing discussions about their prior health care experiences could help identify potential issues with mistrust or fear that may have developed. Establishing this dialogue could also clarify their expectations and goals of the health care relationship. Learning from their experiences will help inform youth friendly and patient-centered health care practices.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.013 | 0.007 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".