Abstract
Study Objective
Nearly 20 million adolescents receive emergency department (ED) care each year, many
of whom have untreated reproductive health issues. ED visits represent an opportunity
to provide appropriate care, however, ED physician reproductive health care practices
and capabilities in the United States have not been described. We sought to characterize
pediatric ED director's individual practice and ED system resources for providing
adolescent reproductive health care.
Design, Setting, Participants, and Interventions
We invited pediatric ED division and/or medical directors nationally to participate
in an anonymous, online survey.
Main Outcome Measures
Outcomes included ED directors' personal practice regarding providing adolescent patients
reproductive health care, and their ED's resources and standard practice regarding
screening adolescents for sexually transmitted infections (STIs) and other reproductive
health concerns.
Results
One hundred thirty-five of 442 (30.5%) ED directors responded. Respondents were 73%
(90/124) male, with a median of 18 (interquartile range, 13-23) years of experience
and 63% (84/134) working in urban EDs. Seventy-one percent (90/130) preferred face-to-face
interviews for obtaining a sexual history, but only 59% (77/130) of participants “always
ask parents to leave the room for sensitive questions.” Eighty-four percent (106/127)
were receptive to pregnancy prevention interventions being initiated in the ED, with
75% (80/106) of those willing to provide an intervention. Only 16% (21/128) indicated
their ED has a universal STI screening program, and only 18% (23/126) “always” successfully
notify patients of a positive STI test.
Conclusion
ED directors are comfortable providing adolescent reproductive health care, and many
individual- and ED-level opportunities exist to provide improved reproductive health
care for adolescents in the ED.
Key Words
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Article info
Publication history
Published online: October 16, 2018
Footnotes
The authors indicate no conflicts of interest.
Preliminary data from this study were presented as a poster at the 2017 Pediatric Academic Society Meeting in San Francisco, California.
Identification
Copyright
© 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
