title: Cystic fibrosis program directors' attitudes toward sexual and reproductive health in young women with CF.
abstract: BACKGROUND
  Advancements in therapy have led to dramatic increases in the life expectancy of patients with cystic fibrosis (CF). As survival improves, young women with CF will have expectations for their sexual and reproductive health (SRH) futures similar to their counterparts without CF. As they face unique CF-specific SRH concerns, they may rely on CF care providers for disease-specific SRH care provision. The purpose of this study was to investigate the attitudes of CF providers toward female SRH and perceived barriers in the current CF care model.
  
  
  METHODS
  U.S. CF program directors (n = 16) participated in qualitative interviews investigating attitudes and barriers to female CF SRH care. Interviews were audio-recorded, transcribed, and coded using a thematic analysis approach.
  
  
  RESULTS
  Participants (nine pediatric, five adult, and two combined) all agreed CF providers have a fundamental role in CF female SRH care. Most respondents named lack of time and patient and provider discomfort as significant barriers to effective SRH communication. Other reported barriers included: lack of training in SRH, family members in the room, low priority of SRH in setting of other CF issues, and lack of adequate rapport with patients.
  
  
  CONCLUSIONS
  This is the first study to assess the attitudes and experiences of CF care providers toward SRH discussion and care among female CF patients. Despite their perceived fundamental role in CF female SRH care, CF providers face significant barriers. Investment in provider training is needed to better address the complex SRH needs of young female patients.
authors.affiliation: Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Traci M
authors.initials: TM
authors.lastname: Kazmerski
authors.affiliation: Division of Adolescent and Young Adult Medicine, Children's National Health System, Washington, DC.
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Tuchman
authors.affiliation: Department of Medicine, University of Pittsburgh and VA Pittsburgh Center for Health Equity Research and Promotion, Pittsburgh, Pennsylvania.
authors.forename: Sonya
authors.initials: S
authors.lastname: Borrero
authors.affiliation: Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weiner
authors.affiliation: Department of Medicine, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Pilewski
authors.affiliation: Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: David M
authors.initials: DM
authors.lastname: Orenstein
authors.affiliation: Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D003550:Cystic Fibrosis; D003695:Delivery of Health Care; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D060728:Reproductive Health; D016387:Women's Health; D055815:Young Adult
keywords: barriers to care delivery; cystic fibrosis; sexual and reproductive health; women's health