Developmental & Relationship Contexts of Adolescent Sexual Behavior and Sexually Transmitted Infections
Mary Ott’s research examines adolescent health and development with a focus on sexual behavior, unintended pregnancy and sexually transmitted infections (STIs).
Dr. Ott started with a rigorous scientific examination of sexual abstinence as a health decision. Abstinence had become a highly politicized primary approach to reducing adolescent pregnancy, yet our scientific understanding of how adolescents made decisions about abstinence was limited. Dr. Ott’s interdisciplinary research program advances our understanding of how development, relationships and social contexts influence adolescent abstinence decisions. Four linked studies use a mix of qualitative and quantitative research methods that are drawn from psychology, sociology, anthropology, and medicine. Her research findings have been translated into practice on several levels: (1) a developmental framework for office-based counseling; (2) evaluation and improvement of Indiana RESPECT, an abstinence-focused public health education program; and (3) research findings have been directly incorporated into Society for Adolescent Medicine policy statements.
Dr. Ott’s current research is a developmental examination of how adolescent boys’ make decisions about romantic and sexual relationships, and the impact of those decisions on STIs. Results suggest important roles for families in STI prevention, and identify patterns of communication that can inform both office-based STD prevention counseling and STD prevention programs.
She has provided technical assistance and consultation in adolescent health for several community organizations. For example, focus groups with Indiana youth across the state on their health related priorities provided important youth input to the Indiana Coalition to Improve Adolescent Health for the first Indiana state health plan for adolescents.
Professor Ott’s long-term goal is to inform and improve interventions that promote healthy sexual development and prevent adolescent unintended pregnancy and STIs.
Dr. Ott’s contributions to better understanding adolescent health and decision-making is an example of how IUPUI's faculty members are TRANSLATING their RESEARCH INTO PRACTICE.
(Elsevier, 2021-09-12) Hernandez-Nino, Jackeline; Thomas, Mary; Alexander, Andreia B.; Ott, Mary A.; Kline, Jeffrey A.; Emergency Medicine, School of Medicine
Introduction: Qualitative research has been increasingly used in health care research to allow in-depth insights and understanding of patients' lived experiences for poorly understood phenomena. The psychological stress mechanisms underlying fear, dyspnea, and pain after venous thromboembolism (VTE) remain poorly understood. However, novice VTE researchers may not be familiar with the process of undertaking qualitative research.
Objective: The aim of this article is to describe the planning, methodology and execution of qualitative methods, using the example of patients' lived experiences during and after the diagnosis of VTE. We discuss challenges and solutions in implementing qualitative research methods in health care research.
Methods: Patients were recruited from the emergency department and clinic using in-person and phone contact. We used both in-person and video format to interview 24 patients. Interviews were guided by a set of questions to be explored but conducted to elucidate unique thoughts and opinions from patients.
Results: For recruitment, "cold-calling" was found to be largely unsuccessful. Many patients have preexisting diagnoses of anxiety and depression. Video interviews were found to be at least as effective as in-person interviews. Interviews revealed unique post-VTE experiences from all participants, with a wide range of impact on quality of life. Themes that were most common included perceptions of physician communication, fear of recurrence, and concerns of death.
Conclusion: A qualitative research approach can reveal individual experiences and psychosocial impact in patients diagnosed with VTE, which allow the researchers to better comprehend the complexity of this phenomenon and its impact in health care.
(Sage, 2021-10) Meredith, Ashley H.; Wilkinson, Tracey A.; Campi, Jennifer A.; Meagher, Carolyn G.; Ott, Mary A.; Pediatrics, School of Medicine
Background: Many states have pharmacist contraceptive prescribing laws with several others in the process of enacting similar legislation. Little continuity or standardization exists across these programs, including development of counseling materials. Although the risk of unplanned pregnancy is greatest among adolescents and young adults, developed materials are not always sensitive to youth.
Objective: To use a modified Delphi method to develop standardized youth-friendly counseling tools that are sensitive to pharmacy workflow during pharmacist contraceptive prescribing.
Methods: A multidisciplinary expert panel of women's health pharmacists, community pharmacists, adolescent medicine pediatricians, obstetrician-gynecologists, and public health advocates was assembled and reviewed materials over 3 iterations. Comments were anonymized, summarized, and addressed with each iteration. A graphic designer assisted with visual representation of panel suggestions. Reviewer feedback was qualitatively analyzed for emergent themes.
Results: The Delphi method produced 5 main themes of feedback integrated into the final materials including attention to work flow, visual appeal, digestible medical information, universal use of materials, and incorporating new evidence-based best practices. Final materials were scored at a Flesch-Kincaid grade of 5.1 for readability.
Conclusions: The use of the Delphi method allowed for the efficient production of materials that are medically accurate, patient-centered, and reflect multiple disciplinary perspectives. Final materials were more robust and sensitive to the unique needs of youth.
(Oxford University Press, 2021-05-28) Spinola, Stanley M.; Zimet, Gregory D.; Ott, Mary A.; Katz, Barry P.; Microbiology and Immunology, School of Medicine
This corrects the article "Human Challenge Studies Are Unlikely to Accelerate Coronavirus Vaccine Licensure Due to Ethical and Practical Issues" in volume 222 on page 1572; https://doi.org/10.1093/infdis/jiaa457
(BMC, 2021-04-01) Raciti, Catherine G.; Enane, Leslie A.; MacDonald, Katherine R.; Whipple, Elizabeth C.; Ott, Mary A.; McHenry, Megan S.; Pediatrics, School of Medicine
Background: The proper and ethical inclusion of PWLHIV and their young children in research is paramount to ensure valid evidence is generated to optimize treatment and care. Little empirical data exists to inform ethical considerations deemed most critical to these populations. Our study aimed to systematically review the empiric literature regarding ethical considerations for research participation of PWLHIV and their young children.
Methods: We conducted this systematic review in partnership with a medical librarian. A search strategy was designed and performed within the following electronic databases: Ovid MEDLINE, Embase and CINAHL. We screened titles and abstracts using the following inclusion criteria: (1) a study population of PWLHIV or children under 5 years of age; and (2) collection of qualitative or quantitative data regarding ethics of research participation. Excluded were reviews, commentaries, policy statements, clinical care-related ethics concerns, abstracts, case studies, or studies unrelated to HIV research. Studies were appraised for quality, data were extracted, and studies were qualitatively analyzed using a principle-based ethical framework within the Belmont Report.
Results: Of the 7470 titles identified, 538 full-text articles were reviewed for eligibility and only three articles met full criteria for inclusion within this review. While we allowed for inclusion of studies involving young children born to mothers with HIV, only articles focused on PWLHIV were identified. Within the results of these studies, four themes emerged: (1) adequacy of informed consent; (2) consideration of paternal involvement; (3) balancing risks; and (4) access to research and treatment. A strength of this review is that it included perspectives of international research investigators, community leaders, and male partners. However, only two studies collected empiric data from PWLHIV regarding their experiences participating in research CONCLUSION: Researchers and funding agencies should be aware of these considerations and appreciate the value of and critical need for formative research to ensure clinical trials involving PWLHIV promote ethical, well-informed research participation and, ultimately, improve care outcomes. More research is needed to create a comprehensive ethical framework for researchers when conducting studies with PWLHIV.
(AAP, 2020-08) Robbins, Cynthia; Ott, Mary A.; Pediatrics, School of Medicine
Intrauterine devices (IUDs) are safe, highly effective, and recommended by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists as a first-line contraceptive option for adolescents.1,2 In this month’s Pediatrics, Schwartz et al3 examine the use of IUDs among adolescents with disabilities, providing further evidence that IUDs are safe for menstrual management and contraception in this population. In their work, Schwartz et al3 raise 3 important issues in IUD use and contraceptive decisions among adolescents with disabilities: recognition of the adolescent’s sexuality and rights to sexual and reproductive health; the need to incorporate quality of life into risk/benefit decisions; and the use of shared and supported decision-making approaches to maximize autonomy and dignity.