Technology Enhanced Community Health Nursing (TECH-N) Study
Condition: Pelvic Inflammatory Disease (PID)
MeSH terms: Pelvic Inflammatory Disease; Pelvic Infection
Study type: Interventional

Summary: 
      The investigators are enrolling 350 young women 13-25 years old diagnosed with pelvic
      inflammatory disease (PID) in Baltimore and randomize them to receive community health nurse
      (CHN) clinical support using a single post-PID face-to-face clinical evaluation and short
      messaging system communication support during the 30. The investigators hypothesize that
      repackaging the recommended Centers for Disease Control and Prevention (CDC) follow-up visit
      using a technology-enhanced community health nursing intervention (TECH-N) with integration
      of an evidence-based sexually transmitted infection (STI) prevention curriculum will reduce
      rates of short-term repeat infection by improving adherence to PID treatment and reducing
      unprotected intercourse and be more cost-effective compared with outpatient standard of care
      (and hospitalization).
    

Detailed description: 
      Pelvic Inflammatory Disease (PID) remains a serious reproductive health disorder and disease
      rates remain unacceptably high among minority adolescent girls and young adult women. Each
      episode of this upper reproductive tract infection, usually caused by a sexually transmitted
      infection (STI), increases the risk for multiple sequelae including tubal infertility,
      ectopic pregnancy, and chronic pelvic pain (CPP). Previous research demonstrates that
      inpatient treatment for PID is expensive without incremental increases in effectiveness when
      compared with outpatient treatment. The investigators' work and that of others suggest that
      additional outpatient cost-effective PID health care supports are needed for this vulnerable
      population to improve short and long-term reproductive health outcomes, including recurrent
      sexually transmitted infection and PID.

      Prior research has also demonstrated that community health nurse (CHN) interventions can
      increase access to appropriate resources enhance health care utilization and promote
      risk-reducing behavior. The investigators propose that integrating a technology component
      conducted by the CHN will increase appeal to adolescent females. The investigators' pilot
      data of a text messaging intervention for reproductive health clinical reminders has
      demonstrated that use of cell phones to assist urban adolescents residing in high STI
      prevalent communities with self-care is both highly acceptable and feasible.

      The investigators hypothesize that repackaging the recommended CDC-follow-up visit using a
      technology-enhanced community health nursing intervention (TECH-N) with integration of an
      evidence-based STI prevention curriculum will reduce rates of short-term repeat infection by
      improving adherence to PID treatment and reducing unprotected intercourse and be more
      cost-effective compared with outpatient standard of care (and hospitalization). We are
      enrolling 350 young women 13-21years old diagnosed with PID in Baltimore and randomizing them
      to receive CHN clinical support using a single post-PID face-to-face clinical evaluation and
      SMS communication support during the 30-days following the PID diagnosis or optimized
      standard of care.
    

Intervention name(s): Technology Enhanced Community Health Nursing
Intervention type(s): Behavioral
Intervention description(s): Text-messaging (twice daily medication reminders w/ positive adherence messages, positive sexual health messages throughout the 30 day treatment period)
Enhanced community health nursing visit on day 3-5, includes evidence-based STI/HIV prevention component (Sister to Sister Teen)
Other intervention name(s): Sister to Sister Teen; Short Messaging System (SMS) communication (Text Messages)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Prevention
Keywords: Pelvic Inflammatory Disease (PID); Community Health Nursing; Text Messaging; mobile health (mhealth); Adolescents