Adolescent Behavior Clinical Trial
Official title:
Evaluation of an Inpatient Sexual Risk Behavior Assessment Program
This is an exploratory pilot study to evaluate the feasibility and potential effects of an innovative, individualized electronic inpatient sexual health intervention (iRAP) for adolescent females. The central hypothesis is that the electronic intervention, a sexual health questionnaire with tailored feedback based on the Trans Theoretical Model (TTM) of behavior change, will significantly increase adolescent females' requests for sexually transmitted infection (STI) screening and sexual health management during their hospital admission.
Sexually transmitted infections (STIs) are disproportionately common among 15-24 year-old
females, and can have detrimental effects including pelvic inflammatory disease and
infertility. Most STI's are asymptomatic, especially for females, making screening programs
essential. Current guidelines recommend HIV screening for all adolescents, and yearly
chlamydia and gonorrhea screening for sexually active females under 25 years-old. Yet only
one-third of primary care physicians report screening asymptomatic adolescents. Most
adolescents report no sexual health discussion during preventative healthcare visits.
Furthermore the majority do not regularly attend preventative healthcare visits. Therefore,
urgent healthcare visits, often in emergency departments (ED) and inpatient settings, provide
an important point of contact.
Given adolescents infrequently obtain outpatient sexual health services, the inpatient stay
may serve as a critical intervention point. Other studies have found success with STI
screening programs in the ED; none to our knowledge examined the efficacy of an inpatient
sexual health screening protocol. Previous pilot data demonstrated, however, significant
interest in sexual health information and desire for STI testing among adolescents admitted
to a children's hospital.
Investigators conducted an exploratory study to evaluate the feasibility and potential
effects of an innovative, individualized electronic inpatient sexual health intervention
(iRAP) for adolescent females. The central hypothesis is that the electronic intervention,
based on the Trans Theoretical Model (TTM) of behavior change, will significantly increase
adolescent females' requests for STI screening and sexual health management.
Investigators enrolled 70 14-18 year-old, medically stable female inpatients admitted to the
hospitalist service at Hasbro Children's Hospital for a randomized control trial during a
one-year period. Participants were randomized to receive an electronic sexual risk assessment
with or without real-time tailored feedback. Feedback was based on the TTM, utilizing
readiness for change to determine appropriate messaging. Participants were then able to
electronically request sexual health management options, including STI testing, discussion
with their inpatient or outpatient physician, or technology-hosted information on
contraception. Investigators conducted a chart review of enrolled adolescents to determine if
sexual health topics were addressed.
The investigators are examining participation rates, length of time to perform all study
elements, and proportion of teens that obtain requested service. Additionally, the
investigators are comparing participants' perceived reproductive health risk and uptake of
offered services between the intervention and control groups.
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