{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T14:08:16Z","timestamp":1789222096052,"version":"build-2803163510"},"reference-count":34,"publisher":"Elsevier BV","issue":"5","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100007305","name":"Maternal and Child Health Bureau","doi-asserted-by":"publisher","award":["T71MC00009"],"award-info":[{"award-number":["T71MC00009"]}],"id":[{"id":"10.13039\/100007305","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jpagonline.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pediatric and Adolescent Gynecology"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.jpag.2026.03.007","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:21:45Z","timestamp":1774398105000},"page":"632-638","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cHey Guys, How Are Your Vaginas Doing?\u201d Exploring Adolescents\u2019 and Young Adult Women Attitudes and Practices Toward Vulvovaginal Health: A Qualitative Study"],"prefix":"10.1016","volume":"39","author":[{"given":"Roxanne","family":"Rengifo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David N.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"D\u2019Ambrosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Leahy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Addison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areej","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.jpag.2026.03.007_bib0001","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jpag.2023.09.005","article-title":"Qualitative assessment of vulvovaginal health information on social Media","volume":"37","author":"Bhuiyan","year":"2024","journal-title":"J Pediatr Adolesc Gynecol"},{"issue":"3","key":"10.1016\/j.jpag.2026.03.007_bib0002","doi-asserted-by":"crossref","first-page":"A70","DOI":"10.1289\/ehp.122-A70","article-title":"A question for women\u2019s health: chemicals in feminine hygiene products and personal lubricants","volume":"122","author":"Nicole","year":"2014","journal-title":"Environ Health Perspect"},{"key":"10.1016\/j.jpag.2026.03.007_bib0003","year":"2025"},{"key":"10.1016\/j.jpag.2026.03.007_bib0004","doi-asserted-by":"crossref","first-page":"E49","DOI":"10.5888\/pcd18.200550","article-title":"Association between social Media use and vaping among Florida adolescents","volume":"18","author":"Lee","year":"2021","journal-title":"Prev Chronic Dis"},{"issue":"5","key":"10.1016\/j.jpag.2026.03.007_bib0005","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.jpag.2016.04.003","article-title":"Qualitative analysis of sexually experienced adolescents females: attitudes about vaginal health","volume":"29","author":"Francis","year":"2016","journal-title":"J Pediatr Adolesc Gynecol"},{"issue":"1","key":"10.1016\/j.jpag.2026.03.007_bib0006","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s12905-018-0543-y","article-title":"Vaginal health and hygiene practices and product use in Canada: a national cross-sectional survey","volume":"18","author":"Crann","year":"2018","journal-title":"BMC Womens Health"},{"issue":"2","key":"10.1016\/j.jpag.2026.03.007_bib0007","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.jpag.2024.12.008","article-title":"The vaginal microbiome and reproductive health in adolescents and adults","volume":"38","author":"Malave-Ortiz","year":"2025","journal-title":"J Pediatr Adolesc Gynecol"},{"issue":"5","key":"10.1016\/j.jpag.2026.03.007_bib0008","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1111\/j.1743-6109.2008.01152.x","article-title":"Beyond douching: use of feminine hygiene products and STI risk among young women","volume":"6","author":"Ott","year":"2009","journal-title":"J Sex Med"},{"key":"10.1016\/j.jpag.2026.03.007_bib0009","doi-asserted-by":"crossref","DOI":"10.1016\/j.ssmqr.2022.100133","article-title":"\u201cIt was always just a sacrifice I was willing to make\u201d: understanding women's use of vaginal cleansing products in spite of adverse health effects","volume":"2","author":"Jenkins","year":"2022","journal-title":"SSM Qual Res Health"},{"issue":"5","key":"10.1016\/j.jpag.2026.03.007_bib0010","first-page":"396","article-title":"Guidelines for Adolescent Health Research. A position paper of the society for Adolescent Medicine","volume":"33","author":"Santelli","year":"2003","journal-title":"J Adolesc Health"},{"key":"10.1016\/j.jpag.2026.03.007_bib0011","series-title":"cloud application for managing, analyzing, and presenting qualitative and mixed method research data","year":"2025"},{"issue":"5","key":"10.1016\/j.jpag.2026.03.007_bib0012","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.jpag.2016.04.003","article-title":"Qualitative analysis of sexually experienced female adolescents: attitudes about vaginal health","volume":"29","author":"Francis","year":"2016","journal-title":"J Pediatr Adolesc Gynecol"},{"issue":"2","key":"10.1016\/j.jpag.2026.03.007_bib0013","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/S1083-3188(01)00148-6","article-title":"Douching behavior in high-risk adolescents. What do they use, when and why do they douche?","volume":"15","author":"Oh","year":"2002","journal-title":"J Pediatr Adolesc Gynecol"},{"issue":"2","key":"10.1016\/j.jpag.2026.03.007_bib0014","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.jpag.2015.09.006","article-title":"Pelvic health curriculum in school settings: the effect on adolescent females\u2019 Knowledge","volume":"30","author":"Hebert-Beirne","year":"2017","journal-title":"J Pediatr Adolesc Gynecol"},{"issue":"2","key":"10.1016\/j.jpag.2026.03.007_bib0015","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-1348","article-title":"Sexuality education for children and adolescents","volume":"138","author":"Breuner","year":"2016","journal-title":"Pediatrics"},{"issue":"5","key":"10.1016\/j.jpag.2026.03.007_bib0016","doi-asserted-by":"crossref","first-page":"e227","DOI":"10.1097\/AOG.0000000000001769","article-title":"Committee opinion no. 678: comprehensive sexuality education","volume":"128","year":"2016","journal-title":"Obstet Gynecol"},{"issue":"3","key":"10.1016\/j.jpag.2026.03.007_bib0017","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jadohealth.2017.06.001","article-title":"Abstinence-only-until-marriage policies and programs: an updated position paper of the society for adolescent health and medicine","volume":"61","year":"2017","journal-title":"J Adolesc Health"},{"issue":"2","key":"10.1016\/j.jpag.2026.03.007_bib0018","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.jadohealth.2021.08.027","article-title":"Adolescents\u2019 Receipt of sex education in a nationally representative sample, 2011\u20132019","volume":"70","author":"Lindberg","year":"2022","journal-title":"J Adolesc Health"},{"issue":"6","key":"10.1016\/j.jpag.2026.03.007_bib0019","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.jadohealth.2016.03.032","article-title":"The State of sex education in the United States","volume":"58","author":"Hall","year":"2016","journal-title":"J Adolesc Health"},{"key":"10.1016\/j.jpag.2026.03.007_bib0020","series-title":"Sex education and HIV education [Internet]","year":"2024"},{"issue":"1","key":"10.1016\/j.jpag.2026.03.007_bib0021","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1001\/jamapediatrics.2015.2731","article-title":"Parent-adolescent sexual communication and adolescent safer sex behavior: a meta-analysis","volume":"170","author":"Widman","year":"2016","journal-title":"JAMA Pediatr"},{"issue":"5","key":"10.1016\/j.jpag.2026.03.007_bib0022","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2017-2858","article-title":"Sexual and reproductive Health care services in the pediatric setting","volume":"140","author":"Marcell","year":"2017","journal-title":"Pediatrics"},{"issue":"2","key":"10.1016\/j.jpag.2026.03.007_bib0023","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2020-049411","article-title":"Sexual and reproductive health discussions during preventive visits","volume":"148","author":"Sieving","year":"2021","journal-title":"Pediatrics"},{"issue":"4","key":"10.1016\/j.jpag.2026.03.007_bib0024","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1177\/2150131917730210","article-title":"Adolescent perspectives on patient-provider sexual health communication: a qualitative study","volume":"8","author":"Hoopes","year":"2017","journal-title":"J Prim Care Community Health"},{"key":"10.1016\/j.jpag.2026.03.007_bib0025","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2022-073552","article-title":"Social media use and health risk behaviours in young people: systematic review and meta-analysis","volume":"383","author":"Purba","year":"2023","journal-title":"BMJ"},{"key":"10.1016\/j.jpag.2026.03.007_bib0026","doi-asserted-by":"crossref","DOI":"10.1016\/j.appet.2021.105765","article-title":"Social media's influence on adolescents' food choices: a mixed studies systematic literature review","volume":"168","author":"Kucharczuk","year":"2022","journal-title":"Appetite"},{"issue":"9","key":"10.1016\/j.jpag.2026.03.007_bib0027","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1093\/infdis\/jiw388","article-title":"Association between vaginal douching and genital human papillomavirus infection among women in the United States","volume":"214","author":"Bui","year":"2016","journal-title":"J Infect Dis"},{"issue":"2","key":"10.1016\/j.jpag.2026.03.007_bib0028","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/NMC.0b013e3181cae9da","article-title":"An updated review of evidence to discourage douching","volume":"35","author":"Cottrell","year":"2010","journal-title":"MCN Am J Matern Child Nurs"},{"issue":"2","key":"10.1016\/j.jpag.2026.03.007_bib0029","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1093\/epirev\/mxf004","article-title":"Vaginal douching: evidence for risks or benefits to women\u2019s health","volume":"24","author":"Martino","year":"2002","journal-title":"Epidemiol Rev"},{"issue":"4","key":"10.1016\/j.jpag.2026.03.007_bib0030","first-page":"387","article-title":"Vaginal douching practice: frequency, associated factors and relationship with vulvovaginal symptoms","volume":"66","author":"Yanikkerem","year":"2016","journal-title":"J Pak Med Assoc"},{"issue":"7","key":"10.1016\/j.jpag.2026.03.007_bib0031","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.2105\/AJPH.87.7.1207","article-title":"Vaginal douching and adverse health effects: a meta-analysis","volume":"87","author":"Zhang","year":"1997","journal-title":"Am J Public Health"},{"issue":"8","key":"10.1016\/j.jpag.2026.03.007_bib0032","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1001\/archpedi.153.8.834","article-title":"Douching: a problem for adolescent girls and young women","volume":"153","author":"Merchant","year":"1999","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"5","key":"10.1016\/j.jpag.2026.03.007_bib0033","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1067\/mob.2001.113848","article-title":"Predictors of the vaginal microflora","volume":"184","author":"Newton","year":"2001","journal-title":"Am J Obstet Gynecol"},{"issue":"6","key":"10.1016\/j.jpag.2026.03.007_bib0034","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/j.jogc.2018.07.013","article-title":"Second-degree burn sustained after vaginal steaming","volume":"41","author":"Robert","year":"2019","journal-title":"J Obstet Gynaecol Can"}],"container-title":["Journal of Pediatric and Adolescent Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1083318826003566?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1083318826003566?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T14:03:21Z","timestamp":1789221801000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1083318826003566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["S1083318826003566"],"URL":"https:\/\/doi.org\/10.1016\/j.jpag.2026.03.007","relation":{},"ISSN":["1083-3188"],"issn-type":[{"value":"1083-3188","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"\u201cHey Guys, How Are Your Vaginas Doing?\u201d Exploring Adolescents\u2019 and Young Adult Women Attitudes and Practices Toward Vulvovaginal Health: A Qualitative Study","name":"articletitle","label":"Article Title"},{"value":"Journal of Pediatric and Adolescent Gynecology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jpag.2026.03.007","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}