BACKGROUND:Female adolescents at high pregnancy risk frequently visit the emergency department (ED) and lack primary providers. It is unclear if current methods of ED referral are successful. The objective of this pilot study was to assess the potential effect and feasibility of a standardized, enhanced method of referral of sexually active females from an ED for family planning (FP). METHODS: We conducted an ED-based intervention study using an enhanced referral process, which included a wallet card advertising a walk-in, adolescent-friendly FP clinic and a standardized ED physician monologue. ED physicians were instructed to disseminate the enhanced process to sexually active females ages 12-19 years (intervention group). Patients receiving the intervention were prospectively enrolled. The control group consisted of patients who, on retrospective review, came to the ED during the enrollment period and were eligible but were not enrolled. We used the electronic medical record (EMR) to identify and randomly select missed eligible patients (control group) and accumulated one control for each case. The primary outcome was FP follow-up within 2 months, measured by EMR review. RESULTS: The intervention (n=101) and control groups (n=101) were similar in age, prior ED visits (54% versus 56%), and previous FP visits (28% versus 28%). The absolute difference in follow-up to a FP clinic between the enhanced referral group (7%; 7/101) compared with the nonenhanced referral group (5%; 5/101) was only 2% (95% confidence interval -5% to 9%). Feasibility of the intervention was modest, with a best-case scenario of 59/160 (37%) of eligible patients captured. CONCLUSIONS: An enhanced referral initiative relying on physician participation did not substantially increase follow-up rates to a FP clinic and showed modest feasibility. More research is required to identify effective means of ED-based referral for preventive reproductive care.
RCT Entities:
BACKGROUND: Female adolescents at high pregnancy risk frequently visit the emergency department (ED) and lack primary providers. It is unclear if current methods of ED referral are successful. The objective of this pilot study was to assess the potential effect and feasibility of a standardized, enhanced method of referral of sexually active females from an ED for family planning (FP). METHODS: We conducted an ED-based intervention study using an enhanced referral process, which included a wallet card advertising a walk-in, adolescent-friendly FP clinic and a standardized ED physician monologue. ED physicians were instructed to disseminate the enhanced process to sexually active females ages 12-19 years (intervention group). Patients receiving the intervention were prospectively enrolled. The control group consisted of patients who, on retrospective review, came to the ED during the enrollment period and were eligible but were not enrolled. We used the electronic medical record (EMR) to identify and randomly select missed eligible patients (control group) and accumulated one control for each case. The primary outcome was FP follow-up within 2 months, measured by EMR review. RESULTS: The intervention (n=101) and control groups (n=101) were similar in age, prior ED visits (54% versus 56%), and previous FP visits (28% versus 28%). The absolute difference in follow-up to a FP clinic between the enhanced referral group (7%; 7/101) compared with the nonenhanced referral group (5%; 5/101) was only 2% (95% confidence interval -5% to 9%). Feasibility of the intervention was modest, with a best-case scenario of 59/160 (37%) of eligible patients captured. CONCLUSIONS: An enhanced referral initiative relying on physician participation did not substantially increase follow-up rates to a FP clinic and showed modest feasibility. More research is required to identify effective means of ED-based referral for preventive reproductive care.
Authors: Melissa K Miller; Lauren S Chernick; Monika K Goyal; Jennifer L Reed; Fahd A Ahmad; Erin F Hoehn; Michelle S Pickett; Kristin Stukus; Cynthia J Mollen Journal: Acad Emerg Med Date: 2019-07-26 Impact factor: 3.451
Authors: Lauren S Chernick; Thomas H Chun; Rachel Richards; Julie R Bromberg; Fahd A Ahmad; Brett McAninch; Colette Mull; Rohit Shenoi; Brian Suffoletto; Charlie Casper; James Linakis; Anthony Spirito Journal: Acad Emerg Med Date: 2019-11-22 Impact factor: 3.451
Authors: Lauren S Chernick; John Santelli; Melissa S Stockwell; Ariana Gonzalez; Anke Ehrhardt; John L P Thompson; Cheng-Shiun Leu; Susanne Bakken; Carolyn L Westhoff; Peter S Dayan Journal: Acad Emerg Med Date: 2021-12-07 Impact factor: 3.451
Authors: Melissa K Miller; Kimberly A Randell; Romina Barral; Ashley K Sherman; Elizabeth Miller Journal: J Adolesc Health Date: 2016-02 Impact factor: 5.012
Authors: Lauren S Chernick; Melissa S Stockwell; Mengfei Wu; Paula M Castaño; Rebecca Schnall; Carolyn L Westhoff; John Santelli; Peter S Dayan Journal: J Adolesc Health Date: 2017-10-19 Impact factor: 5.012
Authors: Lauren S Chernick; Melissa S Stockwell; Ariana Gonzalez; Jameson Mitchell; Anke Ehrhardt; Susanne Bakken; Carolyn L Westhoff; John Santelli; Peter S Dayan Journal: J Adolesc Health Date: 2020-09-15 Impact factor: 5.012
Authors: Fahd A Ahmad; Donna B Jeffe; Christopher R Carpenter; Lauren S Chernick; Kristin S Stukus; Michael Turco; Feliciano B Yu; Thomas C Bailey Journal: J Pediatr Adolesc Gynecol Date: 2018-10-17 Impact factor: 1.814
Authors: Lauren Stephanie Chernick; Rebecca Schnall; Melissa S Stockwell; Paula M Castaño; Tracy Higgins; Carolyn Westhoff; John Santelli; Peter S Dayan Journal: J Med Internet Res Date: 2016-09-29 Impact factor: 5.428