A User-Informed, Theory-Based Pregnancy Prevention Intervention for Adolescents in the Emergency Department: A Prospective Cohort Study.
A User-Informed, Theory-Based Pregnancy Prevention Intervention for Adolescents in the Emergency Department: A Prospective Cohort Study.
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DOI：
10.1016/j.jadohealth.2020.07.020
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Dayan PS
中科院分区：
文献类型：
--
作者：
Chernick LS;Stockwell MS;Gonzalez A;Mitchell J;Ehrhardt A;Bakken S;Westhoff CL;Santelli J;Dayan PS
寻求急诊科(ED)护理的女性青少年意外怀孕的风险很高，主要是因为没有使用避孕药；然而，很少有ED患者在转诊时跟进生殖保健。这项队列研究的目的是确定一种基于ED的个性化和互动式怀孕预防移动健康干预(急诊室干预以改善青少年护理(Erica博士))的可行性、可接受性、采用率、保真度和潜在疗效。我们对14-19岁性行为活跃的女性ED患者进行了一项前瞻性队列研究，她们没有使用高效避孕药。埃里卡博士在循证的性健康课程、社会认知理论和动机访谈技术的基础上，进行了为期10周的自动化双向短信干预。在12周时，我们通过在线调查和电话进行随访，以衡量可行性、可接受性、收养、保真度和初步疗效数据(避孕开始)。我们筛选了209名女性勃起功能障碍患者，纳入42名。平均年龄为17.5岁(SD+/−1.4)；大多数是西班牙裔(37；88%)，有主要供养者(40；95%)。1名参与者选择退出(1/42；2%)，共有35人(83%)完成了随访。尽管互动性随着时间的推移而减少，83%(35/42)的人回复了一条或多条短信。94%(29/31)的人喜欢这些信息，83%(25/30)的人会推荐这个节目。使用激素避孕药的比例为46%(16/35)。埃里卡博士在女性青春期ED患者中是可行和可接受的，并表现出高度的忠诚度和认可度。这项干预措施还显示了在高危女性中增加高效避孕用具的潜力。
Female adolescents seeking emergency department (ED) care are at high risk of unintended pregnancy, primarily due to contraceptive nonuse; yet, few ED patients follow up for reproductive care when referred. The objective of this cohort study was to determine the feasibility, acceptability, adoption, fidelity, and potential efficacy of a personalized and interactive ED-based pregnancy prevention mobile health intervention (Emergency Room Interventions to improve the Care of Adolescents (Dr. Erica)). We conducted a prospective cohort study with sexually active female ED patients age 14–19 who were not using highly effective contraceptives. Dr. Erica consists of a 10-week, automated, two-way texting intervention based on an evidence-based sexual health curriculum, the Social Cognitive Theory, and motivational interviewing techniques. At 12 weeks, we conducted follow-up via online survey and phone call to measure feasibility, acceptability, adoption, fidelity and preliminary efficacy data (contraception initiation). We screened 209 female ED patients to enroll 42. The average age was 17.5 years (SD+/−1.4); the majority were Hispanic (37; 88%) and had a primary provider (40; 95%). One participant opted out (1/42; 2%), and a total of 35 (83%) completed follow-up. Although interactivity diminished with time, 83% (35/42) replied to 1 or more text. 94% (29/31) liked the messages and 83% (25/30) would recommend the program. Hormonal contraceptives were initiated by 46% (16/35). Dr. Erica was feasible and acceptable among female adolescent ED patients and demonstrated high fidelity and adoption. The intervention also showed potential to increase highly effective contraceptive use among high-risk females.
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