Available online 21 January 2026

To explore primary care providers’ confidence delivering sexual and reproductive health (SRH) education and services to adolescents.

A cross-sectional survey measured United States based primary care providers’ confidence delivering SRH care to adolescents. Confidence was measured on a 4-point Likert scale. Providers were asked to estimate the time burden of including sex education in appointments and to describe their perceived barriers to including SRH in routine care and to select their preferred education modalities to increase confidence. Median confidence scores were calculated. Mann-Whitney U-tests compared confidence by providers with a pediatric specialty to those without.

Confidence levels were mixed. Provider confidence was highest discussing pregnancy or sexually transmitted infection prevention. Compared to those without a pediatric specialty, pediatric providers reported lower confidence in most areas, with the greatest differences reported in abortion-inclusive options counseling, pregnancy planning, and hand to genital sexual activity. Time was the most frequently cited barrier. The estimated time burden of including SRH in care varied widely, ranging from 5 to over 60 minutes. Preferred education modalities varied, but most providers preferred online education in one or more formats.

Providers report uneven confidence when delivering SRH to adolescents. Additional research and targeted training are needed to better understand this issue and increase confidence.

adolescent

sexual health

reproductive health

primary care providers

© 2026 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.