A Social Emergency Medicine Approach to the Implementation of Sexual and Reproductive Health Interventions in the Emergency Department

Alexander, Andreia B.; Ott, Mary A.

doi:10.1111/acem.13616

Cited by 3 publications

(5 citation statements)

References 7 publications

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“…Of participants who were able to but did not want to get pregnant in the next year, 32.6% of them were not using any form of contraception, with another 26.5% relying on condoms only or the withdrawal method. To reduce unintended pregnancy in the US we need to increase access to contraception by identifying alternative settings for its provision 13 , 26 , 27 because the traditional settings are insufficient to meet the needs of the most vulnerable populations. The need identified by this study supports the notion that the ED may be an important setting to reach some of our patients who are at high risk for unintended pregnancy and its complications.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The emergency department (ED) is a promising alternative setting to increase access to sexual and reproductive health (SRH) services including contraception, especially among marginalized populations. [13][14][15][16][17][18] Emerging evidence has suggested it is feasible to provide SRH services in the ED. 19 A mandatory aspect of translating medical services from theory into practice (so-called implementation science, or T2 to T3 translation) requires input from patients.…”

Section: Introductionmentioning

confidence: 99%

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Acceptability of Contraceptive Services in the Emergency Department: A Cross-sectional Survey

Alexander¹,

Chernoby²,

VanderVinne³

et al. 2021

WJEM

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Introduction Unintended pregnancy disproportionately affects marginalized populations and has significant negative health and financial impacts on women, their families, and society. The emergency department (ED) is a promising alternative setting to increase access to sexual and reproductive health (SRH) services including contraception, especially among marginalized populations. The primary objective of this study was to determine the extent to which adult women of childbearing age who present to the ED would be receptive to receiving contraception and/or information about contraception in the ED. As a secondary objective, we sought to identify the barriers faced in attempting to obtain SRH care in the past. Methods We conducted a quantitative, cross-sectional, assisted, in-person survey of women aged 18–50 in the ED setting at two large, urban, academic EDs between June 2018–September 2019. The survey was approved by the institutional review board. Survey items included demographics, interest in contraception initiation and/or receiving information about contraception in the ED, desire to conceive, prior SRH care utilization, and barriers to SRH. Results A total of 505 patients participated in the survey. Participants were predominantly single and Black, with a mean age of 31 years, and reporting not wanting to become pregnant in the next year. Of those participants, 55.2% (n = 279) stated they would be interested in receiving information about birth control AND receiving birth control in the ED if it were available. Of those who reported the ability to get pregnant, and not desiring pregnancy in the next year (n = 279, 55.2%), 32.6% were not currently using anything to prevent pregnancy (n = 91). Only 10.5% of participants stated they had experienced barriers to SRH care in the past (n = 53). Participants who experienced barriers to SRH reported higher interest in receiving information and birth control in the ED (74%, n = 39) compared to those who had not experienced barriers (53%, n = 240); (P = 0.004, 95% confidence interval, 1.30–4.66). Conclusion The majority of women of childbearing age indicated the desire to access contraception services in the ED setting. This finding suggests favorable patient acceptability for an implementation study of contraception services in emergency care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acceptability of Contraceptive Services in the Emergency Department: A Cross-sectional Survey

Alexander¹,

Chernoby²,

VanderVinne³

et al. 2021

WJEM

View full text Add to dashboard Cite

show abstract

“…Social EM is an approach to care that recognizes the ED's unique position within the community and strives to address the social determinants driving medical illness, in addition to providing illness‐related care . Because there is growing support for a broader, ecologic perspective to amplify and extend efficacy of sexual risk reduction interventions, we should consider how to partner with community‐based organizations when developing or implementing ED‐based interventions.…”

Section: Discussionmentioning

confidence: 99%

“…The Society for Academic Medicine recognizes the ED as an “effective site for preventive care,” evidenced by organizational conferences, consensus statements, and specialized training opportunities to reduce disparities stemming from social determinants of health . Further, national organizations recommend that all clinicians capitalize on any health visits to provide key preventive sexual health services .…”

Section: Goals Of This Workmentioning

confidence: 99%

A Research Agenda for Emergency Medicine–based Adolescent Sexual and Reproductive Health

Miller

Chernick

Goyal

et al. 2019

Academic Emergency Medicine

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Objective: The objective was to identify key questions for emergency medicine (EM)-based adolescent sexual and reproductive health and to develop an evidence-based research agenda. Methods:We recruited national content experts to serve as advisory group members and used a modified Delphi technique to develop consensus around actionable research questions related to EM-based adolescent reproductive and sexual health care. Author subgroups conducted literature reviews and developed the initial list of research questions, which were iteratively refined with advisory members. External stakeholders then independently rated each item for its importance in expanding the evidence base (1 = not important to 5 = very important) via electronic survey.Results: Our final list of 24 research questions included items that intersected all sexual and reproductive health topics as well as questions specific to human immunodeficiency virus/sexually transmitted infections (HIV/STIs), pregnancy prevention, confidentiality/consent, public health, and barriers and facilitators to care. External stakeholders rated items related to HIV/STI, cost-effectiveness, brief intervention for sexual risk reduction, and implementation and dissemination as most important. Conclusions:We identified critical questions to inform EM-based adolescent sexual and reproductive health research. Because evidence-based care has potential to improve health outcomes while reducing costs associated with HIV/STI and unintended pregnancy, funders and researchers should consider increasing attention to these key questions.A lthough preventable, sexually transmitted infections (STIs), human immunodeficiency virus (HIV) infection, and unintended pregnancy are significant and costly public health problems in the United States that disproportionately impact adolescents, especially racial and ethnic minorities and those From the

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Evaluation of an emergency department opt-out provider-driven HIV and syphilis screening and linkage-to-care program

Scott,

Faryar,

Patil

et al. 2024

The American Journal of Emergency Medicine

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A Social Emergency Medicine Approach to the Implementation of Sexual and Reproductive Health Interventions in the Emergency Department

Cited by 3 publications

References 7 publications

Acceptability of Contraceptive Services in the Emergency Department: A Cross-sectional Survey

Acceptability of Contraceptive Services in the Emergency Department: A Cross-sectional Survey

A Research Agenda for Emergency Medicine–based Adolescent Sexual and Reproductive Health

Evaluation of an emergency department opt-out provider-driven HIV and syphilis screening and linkage-to-care program

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