496 - A Multimodal Approach to Understanding the Barriers and Facilitators to Adolescent Menstrual Health Equity

Poster Number: 496
Publication Number: 496.100

Shelby Davies, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Kaja Darien, Childrens Hospital of Philadelphia, Hamilton, NJ, United States; Sarah M. Wood, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Deborah A. Thomas, University of Pennsylvania, Philadelphia, PA, United States; Nadia Dowshen, Children’s Hospital of Philadelphia, Philadelphia, PA, United States

Background: Access to affordable menstrual products for adolescents is among the health disparities highlighted by the pandemic, with lower income and students of color being particularly affected. However, few studies have explored the lived experiences of this population.

Objective: This qualitative, policy-oriented health services research proposes to study how social factors, organizational structures and processes, health systems, and personal behaviors affect the physical and emotional experiences of menstruation among adolescents and young adults.

Design/Methods: This qualitative research study consisted of individual interviews among adolescents and young adults ages 13-24, recruited from an academic medical center. We conducted in-depth semi-structured interviews that used video diaries made by the participants as the basis for a visual elicitation exercise. Data from the interviews and the video diaries were coded by 2 investigators employing modified grounded theory. We also utilized a brief survey and limited chart review to obtain relevant demographic data. The study was reviewed and approved by the Institutional Review Board at the Children’s Hospital of Philadelphia.

Results: Participants (N = 20) were a mean age of 19 years, 25% had previously endorsed period poverty and 90% were Medicaid insured. Twelve youth participated in video diary elicitation and all reported positive experiences. Emergent themes included the need to normalize menstruation, the myriad limitations imposed on menstruating youth, and gaps in education on menstruation and menstrual health. Study participants highlighted the financial burden of menstruation and identified schools and medical offices as sites where menstrual products should be freely accessible, though preferred methods of distribution varied.Conclusion(s): This innovative multimodal methodology provides data that reflects real world experiences and provides powerful first-person narratives that have potential to broaden the policy impact of our findings. Our qualitative findings show that youth want advocacy around menstrual equity. Schools were identified as a logical place for these efforts, but more interventions are needed to reduce systemic barriers and broaden the scope of health education. Participants highlighted that medical providers should screen for unmet menstrual hygiene needs and identified medical offices as sites where menstrual products should be available without cost. Our research team and youth advisors plan to share this data with key stakeholders via a youth-produced video from the video diaries to inform policy and best practice guidelines.