Targeting high risk teens in the emergency department: A user-informed, theory-based intervention using text messaging to reduce teen pregnancy

针对急诊科的高危青少年：基于用户知情、基于理论的干预措施，使用短信来减少青少年怀孕

• 批准号: 10007637
• 负责人: Lauren Stephanie Chernick
• 金额: $ 16.64万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-13 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10007637
• 关键词: Academic Medical Centers; Accident and Emergency department; Adolescent; Advisory Committees; Affect; Age; Award; Behavioral; Caring; Centers for Disease Control and Prevention (U.S.); Clinical Trials; Clinical Trials Design; Complement; Contraceptive Agents; Contraceptive Usage; Contraceptive methods; Counseling; Data; Development; Development Plans; Effectiveness; Elements; Emergency Care; Emergency Department patient; Emergency Department-based Intervention; Emergency Medicine; Emergency department visit; Ethics; Evaluation; Exhibits; Feedback; Female; Female Adolescents; Focus Groups; Funding; Geography; Goals; Grant; Health; Health Promotion; Healthy People 2020; High-Risk Pregnancy; Instruction; Intervention; Interview; K-Series Research Career Programs; Knowledge; Learning; Learning Module; Measures; Medical; Mentors; Meta-Analysis; Methodology; Methods; Minority; Multi-Institutional Clinical Trial; Multicenter Trials; Outcome; Outpatients; Participant; Pediatrics; Persons; Physicians; Population; Pregnancy; Pregnancy in Adolescence; Preparation; Preventive; Preventive Intervention; Preventive care; Preventive service; Provider; Public Health; Randomized; Randomized Controlled Trials; Regulation; Reproducibility; Reproductive Health; Research; Research Personnel; Research Training; Resources; Risk; Risk Behaviors; Role; Self Efficacy; Sexual Health; Site; Source; Technology; Teenagers; Testing; Text Messaging; Time; Training Activity; United States; Universities; Woman; Work; adolescent health; adolescent health outcomes; base; behavior change; behavioral health; binge drinking; career development; clinically significant; control trial; design; digital; evidence base; follow-up; high risk; high risk sexual behavior; high-risk adolescents; improved; innovation; interest; mHealth; mobile computing; motivated behavior; multidisciplinary; novel; patient oriented; pediatric emergency; peer; pregnancy prevention; pregnant; primary outcome; professor; programs; public health intervention; reproductive; reproductive health intervention; reproductive health of adolescents; research data dissemination; role model; skills; theories; underserved minority; unintended pregnancy

ABSTRACT Emergency Departments (ED) care for 15 million adolescents each year, the majority being poor, minority, and participating in risky sexual behaviors.1–6 Despite a growing interest in expanding the role of the ED to provide preventive care, ED providers identify limited resources and time constraints as barriers to the implementation of public health interventions.7,8 Novel interventions are needed that fit efficiently within the ED workflow.9 Our prior work recently highlighted a significant public health problem—a particularly high risk of unintended pregnancy among our adolescent ED population.3 We demonstrated that 1 in 5 adolescent females who use our ED are expected to become pregnant in the following year, a risk five times the national average and primarily due to contraceptive non-use. These adolescents infrequently follow up for reproductive care when referred, yet are receptive to ED-based pregnancy prevention interventions, particularly using text messaging.10–13 To date, no intervention has successfully increased contraception use among this high risk, hard-to-reach ED population. Lauren S. Chernick, MD, MSc, is an Assistant Professor of Pediatrics in the Division of Pediatric Emergency Medicine at Columbia University Medical Center and is committed to improving the reproductive health outcomes of underserved adolescents using the ED for medical care. During the proposed 3-year Mentored Patient- Oriented Career Development Award (K23), Dr. Chernick’s knowledge and skills will be augmented through the guidance of an interdisciplinary team of mentors and advisors committed to her academic independence. Dr. Chernick’s multi-disciplinary career development plan will focus on the following four key modules: 1) the use of mobile technology for intervention delivery and evaluation; (2) advanced clinical trial design and methodology; (3) the ethics and regulations of researching adolescents; and (4) research dissemination skills and professional development. Dr. Chernick’s training activities will be complemented by an original project that will accelerate the application of these skills. In Aim #1, she will conduct a pilot randomized control trial of a user-informed, theory-based, personalized, interactive, pregnancy prevention text messaging intervention (entitled Dr. Erica) to determine its feasibility, acceptability and potential efficacy. We hypothesize that high risk adolescent female ED patients who receive Dr. Erica will more often initiate contraceptives than those females who receive standard outpatient referral alone. In Aim #2, she will conduct a qualitative analysis to identify barriers and enablers to the implementation of reproductive health interventions across four diverse EDs in the US. This data will inform a multi-center clinical trial with sufficient power to measure clinically significant changes in contraceptive initiation. Dr. Chernick’s K23 research and training will culminate in the preparation of a R01 application to fund this definitive trial. Ultimately, a text messaging intervention that is effective and automated can be utilized by other EDs as a reproducible and scalable means to promote reproductive preventive care, decrease unintended teen pregnancy, and improve adolescent health outcomes throughout the US.

摘要

项目成果

Adolescent Male Receptivity of and Preferences for Sexual Health Interventions in the Emergency Department.

• DOI: 10.1097/pec.0000000000002563
• 发表时间: 2022-05-01
• 期刊: PEDIATRIC EMERGENCY CARE
• 影响因子: 1.4
• 作者: Chernick, Lauren S.;Wallace, Brendan K.;Potkin, Maxmoore T.;Bell, David L.;Dayan, Peter S.
• 通讯作者: Dayan, Peter S.

Prediction of Suicide Attempts and Suicide-Related Events Among Adolescents Seen in Emergency Departments.

• DOI: 10.1001/jamanetworkopen.2022.55986
• 发表时间: 2023-02-01
• 期刊: JAMA NETWORK OPEN
• 影响因子: 13.8
• 作者: Brent, David A.;Horowitz, Lisa M.;Grupp-Phelan, Jacqueline;Bridge, Jeffrey A.;Gibbons, Robert;Chernick, Lauren S.;Rea, Margaret;Cwik, Mary F.;Shenoi, Rohit P.;Fein, Joel A.;Mahabee-Gittens, E. Melinda;Patel, Shilpa J.;Mistry, Rakesh D.;Duffy, Susan;Melzer-Lange, Marlene D.;Rogers, Alexander;Cohen, Daniel M.;Keller, Allison;Hickey, Robert W.;Page, Kent;Casper, T. Charles;King, Cheryl A.
• 通讯作者: King, Cheryl A.

Contraception Provision in the Emergency Department: Are We Ready to Overcome the Obstacles?

急诊科的避孕措施：我们准备好克服障碍了吗？

• DOI: 10.1089/jwh.2020.8294
• 发表时间: 2020
• 期刊: Journal of women's health (2002)
• 作者: Fischer,Kayleigh;Chernick,LaurenS
• 通讯作者: Chernick,LaurenS

Preferences for Expedited Partner Therapy Among Adolescents in an Urban Pediatric Emergency Department: A Mixed-Methods Study.

城市儿科急诊科青少年对快速伴侣治疗的偏好：一项混合方法研究。

• DOI: 10.1097/pec.0000000000001746
• 发表时间: 2021
• 期刊: Pediatric emergency care
• 影响因子: 1.4
• 作者: Shamash,Zohar;Catallozzi,Marina;Dayan,PeterS;Chernick,LaurenS
• 通讯作者: Chernick,LaurenS

A User-Informed, Theory-Based Pregnancy Prevention Intervention for Adolescents in the Emergency Department: A Prospective Cohort Study.

• DOI: 10.1016/j.jadohealth.2020.07.020
• 发表时间: 2021-04
• 期刊: The Journal of adolescent health : official publication of the Society for Adolescent Medicine
• 作者: Chernick LS;Stockwell MS;Gonzalez A;Mitchell J;Ehrhardt A;Bakken S;Westhoff CL;Santelli J;Dayan PS
• 通讯作者: Dayan PS