@article{2f470476531d4b5390ffd3912a99ed63,
title = "A Pediatric Emergency Department Intervention to Increase Contraception Initiation Among Adolescents",
abstract = "Background: The pediatric emergency department (PED) provides care for adolescents at high risk of unintended pregnancy, but little is known regarding the efficacy of PED-based pregnancy prevention interventions. The objectives of this PED-based pilot intervention study were to 1) assess the rate of contraception initiation after contraceptive counseling and appointment facilitation in the PED during the study period, 2) identify barriers to successful contraception initiation, and 3) determine adolescent acceptability of the intervention. Methods: This pilot intervention study included females 14 to 19 years of age at risk for unintended pregnancy. Participants received standardized contraceptive counseling and were offered an appointment with gynecology. Participants were followed via electronic medical record and phone to assess contraception initiation and barriers. Chi-square tests were used to examine the association between contraception initiation and participant characteristics. Results: A total of 144 patients were eligible, and 100 were enrolled. In the PED, 68% (68/100) expressed interest in initiating hormonal contraception, with 70% (48/68) of interested participants indicating that long-acting reversible contraception (LARC) was their preferred method. Twenty-five percent (25/100) of participants initiated contraception during the study period, with 19 participants starting LARC. Thirty-nine percent (22/57) of participants who accepted a gynecology appointment attended that appointment. Barriers to follow-up include transportation and inconvenient follow-up times. Participants were accepting of the intervention with 93% agreeing that the PED is an appropriate place for contraceptive counseling. Conclusions: PED contraceptive counseling is acceptable among adolescents and led to successful contraception initiation in 25% of participants. The main barrier to contraception initiation was participant follow-up with the gynecology appointment.",
author = "Hoehn, {Erin F.} and Holly Hoefgen and Chernick, {Lauren S.} and Jenna Dyas and Landon Krantz and Nanhua Zhang and Reed, {Jennifer L.}",
note = "Funding Information: From the Division of Emergency Medicine (EFH, JD, LK, JLR), the Division of Pediatric and Adolescent Gynecology (HH), and the Division of Biostatistics and Epidemiology (NZ), Cincinnati Children{\textquoteright}s Hospital Medical Center, Cincinnati, OH; the Department of Pediatrics, University of Cincinnati College of Medicine (EFH, JLR), Cincinnati, Ohio; and the Department of Pediatrics, Columbia University Medical Center (LSC), New York, New York. Received June 28, 2018; revision received August 18, 2018; accepted September 4, 2018. Presented at Pediatric Academic Society Annual Meeting, San Francisco, CA, May 2017. Funded by an internal funding source, Cincinnati Children{\textquoteright}s Hospital Medical Center, Division of Emergency Medicine, Small Grant Award, $5,000. No external funding was received for this article. Dr. Chernick was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant KLSTR001874. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The authors have no potential conflicts to disclose. Author contributions: EFH conceptualized and designed the study, acquired data, participated in study intervention, analyzed and interpreted data, drafted and revised the manuscript, and approved the final manuscript as submitted; HH conceptualized and designed the study, participated in study intervention, drafted and revised the manuscript, and approved the final manuscript as submitted; LSC conceptualized and designed the study, revised the manuscript, and approved the final manuscript as submitted; JD aided in study design, assisted with data acquisition, revised the manuscript, and approved the final manuscript as submitted; LK acquired data, participated in study intervention, revised the manuscript, and approved the final manuscript as submitted; NZ analyzed and interpreted the data, provided statistical expertise, revised the manuscript, and approved the final manuscript as submitted; JLR conceptualized and designed the study, analyzed and interpreted data, drafted and revised the manuscript, and approved the final manuscript as submitted; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. Supervising Editor: Mark R. Zonfrillo, MD. Address for correspondence and reprints: Erin Hoehn, MD; e-mail: erin.hoehn@cchmc.org. ACADEMIC EMERGENCY MEDICINE 2019;26:761–769. Publisher Copyright: {\textcopyright} 2018 by the Society for Academic Emergency Medicine",
year = "2019",
month = jul,
doi = "10.1111/acem.13565",
language = "English",
volume = "26",
pages = "761--769",
journal = "Academic Emergency Medicine",
issn = "1069-6563",
number = "7",
}