Reducing Adolescent Pregnancy

Study Overview
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Brief Summary
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This multi-site study is employing a brief contraception counseling intervention in the Emergency Department (ED) to shed light on factors that affect decision making as well as barriers and facilitators to conception initiation in the Emergency Department (ED) setting. The overarching goal of the study is to reduce unintended pregnancy among females ages 15 to 18 who present to the Emergency Department (ED).

Detailed Description
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This study is a prospective cohort study involving females who present to one of two emergency departments (ED) between the ages of 16 and 18, who are at risk of unintended pregnancy. Our primary objective is to assess intention to initiate contraception (high=very/somewhat likely vs low=unsure/not likely/definitely not on Likert scale survey) among females aged 15 to 18 years who receive emergency department-based contraceptive counseling. Our secondary objectives are as follows: Among the same population, assess completion of a referral for any contraceptive care, defined as attendance at a referral site within 4 weeks after the index ED visit. Assess the proportion who ultimately initiate contraception through electronic medical record documentation (i.e., visit note, procedure note, medication review) and participant report (follow-up calls). Use qualitative interview methodology to explore attitudes, barriers, and facilitators that affect decisions to A) express intention to initiate contraception, B) complete a referral for contraceptive care, and C) ultimately initiate contraception among this unique group of high-risk adolescents.

Official Title
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An Emergency Department-Based Study to Reduce Adolescent Pregnancy

Conditions
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Pregnancy in Adolescence, Counseling, Contraception Behavior

Intervention / Treatment
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* Behavioral: Contraception Counseling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Females aged 15-18 years who are at high-risk of pregnancy, defined as sexual activity within the last 6 months or likely future sexual activity. Females who do not desire to become pregnant within the next year. Eligible individuals must be proficient in speaking and reading in English. Consent of the adolescent. Exclusion Criteria: Females who are currently using hormonal contraception or an intrauterine device. Females who are pregnant. Patient has a developmental delay limiting participation. Patient is presenting in the ED after sexual assault. Patient is too ill to be screened. APPs: [no age limit]] Have been working in ED 6 months

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Interventional Model Description: Contraception counseling will occur for all adolescent participants and APPs will be enrolled to conduct counseling. The number of participants enrolled includes the final number of participants including adolescent and APPs.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Counseling Intervention<br>All participants will receive contraception counseling by study Advanced Practice Providers (APPs) | Behavioral: Contraception Counseling<br>* Each participant will receive a 10 minute confidential contraception counseling session with an APP in the Emergency Department<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intention to Initiate Contraception | Intention to initiate contraception at Emergency Department (ED) or follow-up visit from survey responses | up to 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Contraceptive Care Referral Completion | Participants completed a referral visit for any contraception care | up to 8 weeks | 
| Initiation of Contraception | Participant has started contraception as evidenced by electronic medical record view and follow-up phone calls or surveys | up to 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Contraception counseling, Adolescent pregnancy, Contraception initiation