Expanding Contraceptive Access for Teens-Leveraging the Pediatric Emergency Department.

Autor: Mollen C; Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Electronic address: mollenc@chop.edu., Ketterer T; Roberts Center for Pediatric Research, Philadelphia, Pennsylvania., Min J; Roberts Center for Pediatric Research, Philadelphia, Pennsylvania., Barral RL; Division of Adolescent Medicine, Children's Mercy at the University of Kansas Hospital, Kansas City, Kansas., Akers A; Division of Adolescent Medicine, Specialty Care Center, Philadelphia, Pennsylvania., Adams A; Division of Emergency Medicine, Department of Pediatrics, Children's Mercy at the University of Kansas Hospital, Kansas City, Kansas., Miller E; University Center, Pittsburgh, Pennsylvania., Miller MK; Division of Emergency Medicine, Department of Pediatrics, Children's Mercy at the University of Kansas Hospital, Kansas City, Kansas.
Jazyk: angličtina
Zdroj: The Journal of adolescent health : official publication of the Society for Adolescent Medicine [J Adolesc Health] 2023 Jul; Vol. 73 (1), pp. 155-163. Date of Electronic Publication: 2023 Apr 18.
DOI: 10.1016/j.jadohealth.2023.02.024
Abstrakt: Purpose: Adolescents have limited access to sexual healthcare services, and the emergency department (ED) may be the only place some will seek care. We implemented an ED-based contraception counseling intervention to assess intervention feasibility, and adolescent intention to initiate contraception, contraception initiation, and follow-up visit completion.
Methods: This prospective cohort study trained advanced practice providers in the EDs of two pediatric urban academic medical centers to deliver brief contraception counseling. A convenience sample of patients enrolled from 2019 to 2021 included females aged 15-18 not pregnant/desiring pregnancy and/or using hormonal contraception/an intrauterine device. Participants completed surveys to assess demographics and intention to initiate contraception (yes/no). Sessions were audiotaped and reviewed for fidelity. We ascertained contraception initiation and follow-up visit completion via medical record review and participant survey at 8 weeks.
Results: Twenty-seven advanced practice providers were trained, and 96 adolescents were counseled/responded to surveys (mean age 16.7 years; 19% non-Hispanic White, 56% non-Hispanic Black; 18% Hispanic). Mean counseling duration was 12 minutes and >90% of reviewed sessions maintained fidelity to content/style. Most participants (61%) reported intention to initiate contraception, and these participants were older and more likely to report prior contraceptive use, compared to those without intention. One-third (33%) initiated contraception in the ED or after the follow-up visit.
Discussion: Contraceptive counseling was feasible to integrate in the ED visit. Intention to initiate contraception was common and many adolescents initiated contraception. Future work should increase the pool of trained providers and supports for same-day contraception initiation for those desiring in this novel setting.
(Copyright © 2023 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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