Enhanced SexHealth Intervention to Improve Adolescent Outcomes

Enhanced SexHealth Intervention to Improve Adolescent Outcomes: A Clinical Trial

This is an adaptive trial with an initial Formative Revision Process followed by a Randomized Controlled Trial (RCT). Up to 500 adolescents will be consented into this study to achieve 6 completed subjects for the formative process and 86 completed subjects for the RCT.

In a randomized controlled trial at a pediatric emergency department, sexually active adolescents will receive the control (i.e., printed materials) or intervention (i.e., motivationally-guided facilitation) arm delivered by a health educator. The tablet-based, interactive intervention includes motivational techniques to promote risk reduction, condom skills training, and tailored service recommendations. The primary outcome is uptake of ≥1 service at the index visit (i.e., counseling, condoms, emergency contraception for immediate or future use, pregnancy/sexually transmitted infection (STI)/HIV testing, STI treatment, and clinic referral). We assess feasibility (i.e., intervention completion, recommendations discussed, and satisfaction). Participants report sexual risk and care-seeking behaviors at 2, 4, and 6 months. We compare uptake between arms using Fisher exact tests.

Inclusion Criteria:

• Aged 14-19 years old
• Reside within 30 minutes travel time
• Report previous sexual activity

Exclusion Criteria:

• Subjects who are unable to provide consent (i.e., determined to be too ill by the ED team, have cognitive impairment due to chronic condition or acute medical concern)
• Subjects in police custody
• Subjects seeking care due to sexual assault or psychiatric emergency
• Subjects who do not speak English
• Subjects who are patients under the clinical care of a study investigator working in the ED