Improvement of STI Detection in Adolescent Emergency Department Patients

Study Overview
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Brief Summary
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The goal of this trial is to test a novel means of collecting patient-entered sexual health information for the provision of clinical decision support to increase the testing and detection of sexually transmitted infections (STI) in adolescent emergency department (ED) patients at high risk for STIs.

Detailed Description
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The investigators have developed a novel means of collecting sexual health information from adolescents in the emergency department (ED) through the use of an audio-computer assisted self-interview (ACASI). This information can then be used to provide clinical decision support to clinicians for targeted sexually transmitted infection (STI) screening in the ED for adolescents. This randomized trial randomizes patients to whether or not the clinician receives the decision support and tests whether provision of decision support results in increased STI screening for patients who report high risk sexual activity. Secondary outcomes include evaluation of whether the clinical decision support results in increased STI detection, and identifying factors associated with adapting the clinical decision support.

Official Title
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Improvement of STI Detection in Adolescent Emergency Department Patients

Conditions
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Sexually Transmitted Infections

Intervention / Treatment
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* Behavioral: Sexual health screen (SHS)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 14-19 presenting to the emergency department. Exclusion Criteria: history of developmental delay, medical instability, altered mental status, unable to understand English

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Decision Support Arm<br>Patients randomized to the intervention will complete a sexual health screen (SHS). The results of the SHS will provide decision support for STI testing by risk stratifying patients with screening recommendations to the clinician based on risk. | Behavioral: Sexual health screen (SHS)<br>* Decision support for STI screening through a novel sexual health screen<br>|
| No Intervention: Usual Care Arm<br>Patients randomized to the usual care arm will complete the sexual health screen (SHS). However these results and the STI testing decision support will not be shared with the clinician. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants with difference in frequency of STI testing between the ACASI-SHS group compared to the usual care group. |  | an expected average of 4-6 hours. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The proportion of adolescents who test positive for an STI in the intervention group in comparison to the usual care group. |  | Baseline |