This project intends to answer the following questions: (1) how knowledgeable are teens and young adults on how they can maintain confidentiality when seeking sensitive health care services while under their parent or guardian’s health insurance, and (2) what is the most effective tool to disseminate this kind of information? Although health care confidentiality is protected by law, there still remains the possibility that health information may be disclosed when documents such as the Explanation of Benefits (EOBs) and invoices are sent home. For adolescents and young adults insured under their parent or guardian’s health insurance plan, the potential breach of confidentiality may deter them from seeking appropriate health care. We hypothesize that teens and young adults have little knowledge about how to protect to their health care confidentiality and that a pamphlet is the most effective tool to educate them. To test this hypothesis, we created a pamphlet that provides options on how to maintain confidentiality when seeking sensitive services while on their parent or guardian’s health insurance. We will survey 20 adolescents, aged 13-25, on the pamphlet information, including the content and lay-out. Additionally, respondents are asked about other tools that would be effective in disseminating this information. Survey responses will be analyzed for themes. Thus far, we have interviewed 9 persons between ages 13 and 25. Each respondent stated that he/she was unaware of some information provided in the pamphlet. For example, one young adult stated, “I didn’t know that insurance or laboratory testing could accidentally make it easier for privacy to be lost in the billing process.” Respondents stated that tools such as a website or videos may be more effective to publicize this information. This project highlights the need to inform adolescents and young adults about their rights to maintain confidentiality when under their parents’ health insurance plans.

The levenogestrel intrauterine system (LNG-IUS) is a progestin-containing hormonal IUD and an increasingly popular, effective method of contraception. The majority of women who discontinue this method do so in the first 6 months due to unpredicted side effects, such as bleeding and cramping. Anticipatory counseling about the side effects of other progestin-containing birth control methods is correlated with reduced removal rates and increased satisfaction with the method. This study examined information LNG-IUS users want to receive about the 6-month adjustment period in a counseling video. We conducted 7 focus groups, totaling 49 women (age 18 and over) that had a LNG-IUS placed in the last 6 months. We asked LNG-IUS users about their experiences with the LNG-IUS and what kind of information would be helpful to manage and understand side effects in the adjustment period. We performed thematic content analysis using a modified grounded theory approach. Starting with an a-priori code list, we added codes and revised the coding hierarchy based on themes that emerged. Women wanted counseling that acknowledged a range of experiences with the LNG-IUS and normalized the option to contact their doctor with concerns. Desired topics of counseling were risks and benefits of the LNG IUS, changes in bleeding and cramping, and explanation of how hormones worked in the body. Women preferred counseling that used statistics, visual aids, and personal stories from other LNG-IUS users. Participants wanted more specific information about what to expect in the first 6 months of LNG-IUS use, delivered in a way that normalized their experience in the context of other LNG-IUS users.