Documentation of Sexual History in Hospitalized Adolescents on the General Pediatrics Service

Riese, Alison; Tarr, Elizabeth; Baird, Janette; Alverson, Brian

doi:10.1542/hpeds.2017-0044

Cited by 26 publications

(27 citation statements)

References 39 publications

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“…15 Further, despite recommendations to routinely perform a confidential sexual health history in adolescents, 2,3 pediatricians are not consistently providing this critical evidence-based care in the ambulatory or hospital-based setting. 4,16 A recent study in the pediatric hospital demonstrated only 62% of adolescents have a documented sexual history. 16 National guidelines recommend at a minimum: annual GC/CT screening for all sexually active females <25 years of age, HIV testing at least once for ages 13–64 in all health care settings, and additional risk-based screening for high risk populations such as patients with multiple partners, gay and bisexual patients, and men who have sex with men.…”

Section: Discussionmentioning

confidence: 99%

“…4,16 A recent study in the pediatric hospital demonstrated only 62% of adolescents have a documented sexual history. 16 National guidelines recommend at a minimum: annual GC/CT screening for all sexually active females <25 years of age, HIV testing at least once for ages 13–64 in all health care settings, and additional risk-based screening for high risk populations such as patients with multiple partners, gay and bisexual patients, and men who have sex with men. 1,17 We found females were more likely to be tested than males.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Sexually Transmitted Infection Testing in Adolescents: Current Practices in the Hospital Setting

Masonbrink

Richardson

McCulloh

et al. 2018

Journal of Adolescent Health

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sexually Transmitted Infection Testing in Adolescents: Current Practices in the Hospital Setting

Masonbrink

Richardson

McCulloh

et al. 2018

Journal of Adolescent Health

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show abstract

“…8,9 While social and sexual history taking is a cornerstone of the patient interview, providers often fail to adequately document their patient's self-reported SBDH. [10][11][12][13][14] In addition, low adoption rates for clinical screening tools for SBDH in EHRs exist as a barrier to the collection of this information in a usable format. 9,15 While the majority of documentation related to SBDH exists in free-text notes, information on SBDH is also manifest in the structured data elements such as diagnosis codes and laboratory tests.…”

Section: Background and Significancementioning

confidence: 99%

Detecting Social and Behavioral Determinants of Health with Structured and Free-Text Clinical Data

et al. 2020

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Background Social and behavioral determinants of health (SBDH) are environmental and behavioral factors that often impede disease management and result in sexually transmitted infections. Despite their importance, SBDH are inconsistently documented in electronic health records (EHRs) and typically collected only in an unstructured format. Evidence suggests that structured data elements present in EHRs can contribute further to identify SBDH in the patient record. Objective Explore the automated inference of both the presence of SBDH documentation and individual SBDH risk factors in patient records. Compare the relative ability of clinical notes and structured EHR data, such as laboratory measurements and diagnoses, to support inference. Methods We attempt to infer the presence of SBDH documentation in patient records, as well as patient status of 11 SBDH, including alcohol abuse, homelessness, and sexual orientation. We compare classification performance when considering clinical notes only, structured data only, and notes and structured data together. We perform an error analysis across several SBDH risk factors. Results Classification models inferring the presence of SBDH documentation achieved good performance (F1 score: 92.7–78.7; F1 considered as the primary evaluation metric). Performance was variable for models inferring patient SBDH risk status; results ranged from F1 = 82.7 for LGBT (lesbian, gay, bisexual, and transgender) status to F1 = 28.5 for intravenous drug use. Error analysis demonstrated that lexical diversity and documentation of historical SBDH status challenge inference of patient SBDH status. Three of five classifiers inferring topic-specific SBDH documentation and 10 of 11 patient SBDH status classifiers achieved highest performance when trained using both clinical notes and structured data. Conclusion Our findings suggest that combining clinical free-text notes and structured data provide the best approach in classifying patient SBDH status. Inferring patient SBDH status is most challenging among SBDH with low prevalence and high lexical diversity.

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“…14 Although many adolescents who are hospitalized are at an increased risk for pregnancy complications due to their underlying medical conditions or use of teratogenic medication, sexual risk assessment is not consistently performed in this setting. 15,16 Although adolescents and their parents are supportive of sexual health discussions, STI testing, and pregnancy prevention education in the inpatient setting, 17 a thorough understanding of factors that influence the provision of this care among pediatric hospital physicians is lacking. This formative information is needed to facilitate efforts to improve and standardize clinical care provision.…”

mentioning

confidence: 99%

Adolescent Reproductive Health Care: Views and Practices of Pediatric Hospitalists

Masonbrink

Stancil

Reid³

et al. 2019

Hospital Pediatrics

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A B S T R A C TBACKGROUND AND OBJECTIVES: Many hospitalized adolescents are at increased risk for pregnancy complications due to an underlying medical condition, however sexual risk assessment is not consistently performed in this setting. While adolescents and their parents are supportive of sexual health discussion in the inpatient setting, a thorough understanding of factors that influence provision of this care among pediatric hospital physicians is lacking. This formative information is needed to facilitate efforts to improve and standardize clinical care provision. Our objective is to assess the frequency and factors that influence the provision of adolescent sexual and reproductive care by pediatric hospitalists. METHODS:We performed a cross-sectional computerized survey of hospitalists at 5 pediatric hospitals who cared for $1 adolescent (14-21 years old) in the past year. Sexual and reproductive care practices were assessed by using a 76-item novel survey informed by the theory of planned behavior. We used descriptive statistics to summarize the data. RESULTS:Sixty-eight pediatric hospitalists participated (49% response rate): 78% were women and 65% were aged ,40 years. Most (69%) reported treating .46 adolescents annually, including many who are at an increased risk for pregnancy complications due to teratogenic medication use or a comorbid condition. A majority felt that sexual and reproductive services are appropriate, although many endorsed barriers, including concern about follow-up after emergency contraception (63%) and time constraints (53%). Most reported insufficient knowledge regarding contraception (59%), desired contraception education (57%), and were likely to increase contraceptive provision if provided education (63%). Hospitalists rarely provided condoms or referral for an intrauterine device.CONCLUSIONS: Pediatric hospitalists frequently care for adolescents who are at risk for pregnancy complications and generally agree that reproductive care is appropriate in the inpatient setting. With these findings, we highlight the critical need for effective comprehensive reproductive health service interventions that are tailored to address the numerous actionable barriers identified in this study. d Division of Health Services and OutcomesResearch and

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Documentation of Sexual History in Hospitalized Adolescents on the General Pediatrics Service

Cited by 26 publications

References 39 publications

Sexually Transmitted Infection Testing in Adolescents: Current Practices in the Hospital Setting

Sexually Transmitted Infection Testing in Adolescents: Current Practices in the Hospital Setting

Detecting Social and Behavioral Determinants of Health with Structured and Free-Text Clinical Data

Adolescent Reproductive Health Care: Views and Practices of Pediatric Hospitalists

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