Sophia Yen | Stanford University (original) (raw)

Papers by Sophia Yen

Pediatric annals, 2013

CME EDUCATIONAL OBJECTIVES: 1.Identify and explain the four currently available methods of emerge... more CME EDUCATIONAL OBJECTIVES: 1.Identify and explain the four currently available methods of emergency contraception.2.Discuss the risk and benefits of intrauterine devices as a first-line option for contraception in adolescents.3.Review strategies for explaining the most common contraceptive methods to an adolescent. The US has the highest pregnancy rate of any industrialized nation, approximately twice that of Canada, four times that of France, and eight times that of Japan or Italy.1 In recent years, the rate has declined, partially due to delayed coitarche (age of onset of vaginal sexual intercourse) but mainly due to greater use of contraception.2 Per the 2011 Youth Risk Behavior Survey (a national survey of about 15,000 youth in schools), 33% of high school freshmen, 44% of sophomores, 53% of juniors, and 63% of seniors have had vaginal sexual intercourse. To prevent unplanned and unwanted teenage pregnancies, which have negative consequences on a teenager's health and futur...

Open Access Journal of Contraception, 2016

Globally, unintended adolescent pregnancies pose a significant burden. One of the most important ... more Globally, unintended adolescent pregnancies pose a significant burden. One of the most important tools that can help prevent unintended pregnancy is the timely use of emergency contraception (EC), which in turn will decrease the need for abortions and complications related to adolescent pregnancies. Indications for the use of EC include unprotected sexual intercourse, contraceptive failure, or sexual assault. Use of EC is recommended within 120 hours, though is most effective if used as soon as possible after unprotected sex. To use EC, adolescents need to be equipped with knowledge about the various EC methods, and how and where EC can be accessed. Great variability in the knowledge and use of EC around the world exists, which is a major barrier to its use. The aims of this paper were to 1) provide a brief overview of EC, 2) discuss key social determinants affecting knowledge and use of EC, and 3) explore best practices for overcoming the barriers of lack of knowledge, use, and access of EC.

Journal of Adolescent Health, 2009

intervention strategies were in-school education of young people, safety guidelines provided to p... more intervention strategies were in-school education of young people, safety guidelines provided to parents, and free filtering software. Conclusions: Concerns about online threats differed by geographic region. While physical threats were universal concerns, identity theft, addiction, social isolation, and drug use were serious concerns in specific regions. Respondents rated interventions that targeted schools, parents, and young people as the most effective and those that utilized government agencies or government regulation as less effective. Programs designed to encourage healthy internet use among children and adolescents should be designed to address locally relevant issues and utilize resources close to young people rather than governmental or national agencies. Source of Support: Funded in part by the Internet Keep Safe Coalition.

Contraception, 2012

The United States has high rates of unintended pregnancy, and many women report difficulties in o... more The United States has high rates of unintended pregnancy, and many women report difficulties in obtaining contraception. Pharmacy access would expand access to hormonal contraception. A qualitative study using a structured interview guide was conducted with 20 reproductive health practitioners including physicians and advanced practice clinicians in California in 2008-2009. Most respondents considered the current prescription-only model of access to hormonal contraception to be too restrictive. Some reported a preference for a pharmacy access model where women could obtain contraceptives directly from a pharmacist, bypassing the clinic visit. Many providers believed that method continuation and compliance would improve with pharmacy access to contraception. The most common concern reported was pharmacist refusal to provide services. Overall, providers viewed increased access to hormonal contraception as an important public health service and supported pharmacy access. They thought that pharmacy access can be accomplished through pharmacist education and training. Additional research is needed to test the hypothesis generated by this qualitative study that physicians and advanced practice clinicians would welcome an enhanced role of pharmacists in the provision of hormonal contraception.

Archives of Pediatrics & Adolescent Medicine, 2007

Page 1. THE PEDIATRIC FORUM Diphenhydramine in Infants The randomized controlled trial by Merenst... more Page 1. THE PEDIATRIC FORUM Diphenhydramine in Infants The randomized controlled trial by Merenstein et al1 demonstrating lack of an infant sleep re-sponse to diphenhydramine is a welcome addi-tion to the pediatric literature. ...

Contemporary Ob Gyn, 2007

PEDIATRICS, 2012

WHAT'S KNOWN ON THIS SUBJECT: Expedited partner therapy (EPT) is an effective method of partner t... more WHAT'S KNOWN ON THIS SUBJECT: Expedited partner therapy (EPT) is an effective method of partner treatment of sexually transmitted infections but is not used frequently. There are limited data on provider knowledge, practices, and comfort with EPT use in adolescents. WHAT THIS STUDY ADDS: California pediatric residents have knowledge gaps and discomfort providing EPT and presence of an adolescent medicine fellowship is associated with increased EPT knowledge, use, and comfort among residents. Our findings support the need to improve EPT education in pediatric residencies. abstract OBJECTIVE: We examined California pediatric residents' knowledge, practices, and comfort of providing expedited partner therapy (EPT) for sexually transmitted infections, by postgraduate year of training and presence of an adolescent medicine fellowship. We hypothesized that few residents are aware of EPT, and fewer are comfortable providing it; knowledge, practices, and comfort increase during residency; and presence of an adolescent medicine fellowship increases knowledge, practices, and comfort. METHODS: Online anonymous questionnaires were completed by pediatric residents from 14 California programs. RESULTS: Two hundred eighty-nine pediatric residents (41% response; mean age, 29.4 6 2.7 years; 78% female) responded. Twenty-two percent reported being moderately or very familiar with EPT. Most correctly identified several EPT methods. Incorrectly identified as EPT included patient (55%), health department (42%), and provider (37%) referrals. Only 8% were aware of California' s legal status regarding EPT. Sixty-nine percent knew that California law allows EPT for chlamydia and gonorrhea, but 38% incorrectly stated that EPT can be used to treat trichomoniasis. Fifty-two percent reported ever providing EPT, but 30% of them were uncomfortable doing so. Postgraduate year 1 residents were significantly more likely to report lack of experience as a barrier to prescribing EPT. Residents in programs with the presence of an adolescent medicine fellowship had significantly higher global knowledge scores and were more likely to practice EPT with fewer concerns. CONCLUSIONS: California pediatric residents have knowledge gaps and discomfort providing EPT, and the presence of adolescent medicine fellowship is associated with increased EPT knowledge, use, and comfort among residents. Our findings demonstrate a need to improve EPT education in pediatric residencies.

Arthritis Care & Research, 2014

Objective-To assess perception and behavior after reproductive health counseling among adolescent... more Objective-To assess perception and behavior after reproductive health counseling among adolescent patients in a tertiary care-based pediatric rheumatology clinic. Methods-Adolescent females seen at Stanford pediatric rheumatology clinic were prospectively enrolled during routine visits. At study start, standard clinic procedures for the following were reviewed with providers: 1) HEADSS (home, education, activities, drugs, sexual activity, and suicide/depression) assessment; 2) reproductive health counseling; and 3) medical record documentation. Patients were enrolled if providers indicated that they performed HEADSS assessment and reproductive health counseling. At enrollment, patients completed a survey to assess perceptions of reproductive health counseling. Chart review confirmed documented discussions. Follow-up survey 3-5 months after enrollment tracked reproductive health information seeking behavior. Results-Ninety females (ages 17 ± 2 years old) participated. Almost all patients (99%) agreed that reproductive health was discussed. Seventy-one percent reported that pregnancy risks were discussed, 42% had recent concerns about reproductive health, and 33% reported their provider recommended that they seek further reproductive health care. Eighty-four patients completed follow-up phone surveys, with 25% reporting seeking further information on reproductive health concerns but merely 9.5% actually sought further care. Only 18% reported having ever asked their rheumatology provider for guidance regarding reproductive health care concerns.

AM:STARs: Acute Emergencies in Adolescents, Vol. 26, No. 3, 2016

Adolescent females frequently present to the ED with complaints that may be caused by a gynecolog... more Adolescent females frequently present to the ED with complaints that may be caused by a gynecologic emergency. Differentiating and excluding some of the common and most serious gynecologic emergencies reviewed in this article are critical. Timely and effective treatment of these conditions, once diagnosed, can result in better health outcomes.

AM:STARs: Adolescent Contraception: Basics and Beyond

PLOS ONE, 2015

Most adolescents do not achieve the recommended levels of moderate-to-vigorous physical activity ... more Most adolescents do not achieve the recommended levels of moderate-to-vigorous physical activity (MVPA), placing them at increased risk for a diverse array of chronic diseases in adulthood. There is a great need for scalable and effective interventions that can increase MVPA in adolescents. Here we report the results of a measurement validation study and a preliminary proof-of-concept experiment testing the impact of Zamzee, an accelerometer-linked online intervention system that combines proximal performance feedback and incentive motivation features to promote MVPA. In a calibration study that parametrically varied levels of physical activity in 31 12-14 year-old children, the Zamzee activity meter was shown to provide a valid measure of MVPA (sensitivity in detecting MVPA = 85.9%, specificity = 97.5%, and r = .94 correspondence with the benchmark RT3 accelerometer system; all p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001). In a subsequent randomized controlled multi-site experiment involving 182 middle school-aged children assessed for MVPA over 6 wks, intent-to-treat analyses found that those who received access to the Zamzee intervention had average MVPA levels 54% greater than those of a passive control group (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and 68% greater than those of an active control group that received access to a commercially available active videogame (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .0001). Zamzee&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s effects on MVPA did not diminish significantly over the course of the 6-wk study period, and were statistically significant in both females and males, and in normal- vs. high-BMI subgroups. These results provide promising initial indications that combining the Zamzee activity meter with online proximal performance feedback and incentive motivation features can positively impact MVPA levels in adolescents.

Obstetrics and gynecology, 2003

To estimate the prevalence of bacterial vaginosis by Nugent Gram stain criteria in a nonclinic na... more To estimate the prevalence of bacterial vaginosis by Nugent Gram stain criteria in a nonclinic national sample of young women entering recruit training; to examine clinical associations with bacterial vaginosis; and to evaluate the performance of a pH test card and Papanicolaou smear against Gram stain as screening tools for bacterial vaginosis. A cross-sectional study of 1938 women was conducted. Self-collected vaginal swabs were applied to a colorimetric pH test card and a glass slide for Gram stain evaluation according to the Nugent criteria. Papanicolaou smears and samples for sexually transmitted diseases screening were collected during routine entry pelvic examinations. Bacterial vaginosis prevalence was 27%, with 28% in sexually experienced and 18% in non-sexually experienced women (P = .001). Bacterial vaginosis prevalence was 11% in Asian/Pacific Islanders, which was lower than in other nonwhite ethnic groups (P = .004). Clinically, bacterial vaginosis was directly related ...

Journal of Pediatric and Adolescent Gynecology, 2014

To determine the awareness of, access to, and knowledge of the proper use of emergency contracept... more To determine the awareness of, access to, and knowledge of the proper use of emergency contraception pills (ECPs) among uninsured adolescents. Anonymous surveys were used to assess awareness of, knowledge of, and access to ECPs. From 2010 to 2012 at mobile primary care clinic in the San Francisco Bay Area. Patients were uninsured adolescents aged 13 to 25; 40% of the participants were currently or had been homeless in the past year. Ethnicity was 50% Asian, 22% Hispanic, 17% Pacific Islanders, 5.5% white, and 5.5% other/mixed ethnicity. Post survey completion, patients received one-on-one 15-minute dedicated ECP education. Awareness of, knowledge of, and access to ECPs. Of the study population of 439, 30% of the participants were 13-16 years old and 70% were 17-25 years old (mean age 17.8 years); 66% were women. Young women (86%) reported higher rates of &amp;amp;amp;amp;amp;amp;amp;quot;hearing about emergency contraception&amp;amp;amp;amp;amp;amp;amp;quot; than did young men (70%) (P &amp;amp;amp;amp;amp;amp;amp;lt; .0001). Many incorrectly identified or were uncertain if ECPs were an abortion pill (40%) or could be used as regular birth control (40%) or to prevent sexually transmitted infections (19%). Only 40% of women and 43% of men aged 17 and older correctly answered that they could obtain EC over the counter; 72% did not know that males could receive EC for use by their partner; 12% incorrectly selected that infertility was a side effect; 44% were under the false impression that EC had to be taken within 1 day of unprotected sex. Uninsured adolescents have high rates of ECP awareness but low ECP knowledge. These adolescents need more ECP education to alleviate misconceptions and increase practical knowledge, specifically, education about male access, side effects, over-the-counter availability for young men and women, and the 120-hour window of use.

Pediatric Annals, 2013

The Lancet, 2002

An outstanding guide to adolescent health. By - Sophia Yen, Charles E Irwin.

Journal of Pediatric and Adolescent Gynecology, 2010

Most pregnancies in adolescents are unintended and preventable if contraception were utilized. IU... more Most pregnancies in adolescents are unintended and preventable if contraception were utilized. IUDs provide an under-utilized highly effective form of contraception. IUDs are appropriate for nulliparous women, including adolescents. IUDs do not increase: the incidence of Pelvic Inflammatory Disease after the 1st month of insertion, the odds of infertility, nor rate of ectopic pregnancy. Adolesecnts need more education about and increased access to IUDs. Practical points regarding IUD selection and insertion in adolescents are reviewed, including pain prophylaxis, anticipatory guidance, side effects and complications. In summary, IUDs are safe for contraception in most adolescents. IUDs are effective and eliminate the need for ongoing adherence and thus have the potential to decrease unplanned pregnancies.

Journal of Adolescent Health, 2013

Journal of Adolescent Health, 2010