Prompting Discussions of Youth Violence Using Electronic Previsit Questionnaires in Primary Care: A Cluster Randomized Trial

Riese, Alison; Mello, Michael J.; Baird, Janette; Steele, Dale W.; Ranney, Megan L.

doi:10.1016/j.acap.2015.01.005

Cited by 12 publications

(21 citation statements)

References 26 publications

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“…An intervention that included a primary care previsit computerized substance use screening system, which produced a clinician report and guidance for brief counseling, led to significant increases in clinician advice and counseling about the health risks of alcohol and drug use [87]. A violence screening module intervention found that youth were 2.6 times more likely to discuss youth violence with their providers compared to controls [88]. In the area of emotional health, a computer self-administered previsit health screener significantly increased clinician mental health–related counseling and adolescent patient disclosure of mental health issues [89].…”

Section: Resultsmentioning

confidence: 99%

Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

Harris

Aalsma

Weitzman

et al. 2017

Journal of Adolescent Health

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We reviewed research regarding system- and visit-level strategies to enhance clinical preventive service delivery and quality for adolescents and young adults. Despite professional consensus on recommended services for adolescents, a strong evidence base for services for young adults, and improved financial access to services with the Affordable Care Act’s provisions, receipt of preventive services remains suboptimal. Further research that builds off successful models of linking traditional and community clinics is needed to improve access to care for all youth. To optimize the clinical encounter, promising clinician-focused strategies to improve delivery of preventive services include screening and decision support tools, particularly when integrated into electronic medical record systems and supported by training and feedback. Although results have been mixed, interventions have moved beyond increasing service delivery to demonstrating behavior change. Research on emerging technology—such as gaming platforms, mobile phone applications, and wearable devices—suggests opportunities to expand clinicians’ reach; however, existing research is based on limited clinical settings and populations. Improved monitoring systems and further research are needed to examine preventive services facilitators and ensure that interventions are effective across the range of clinical settings where youth receive preventive care, across multiple populations, including young adults, and for more vulnerable populations with less access to quality care.

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Section: Resultsmentioning

confidence: 99%

Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

Harris

Aalsma

Weitzman

et al. 2017

Journal of Adolescent Health

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“…Why no parental involvement? From a developmental perspective, adolescent-focused interventions are most appropriate for this age group (13-17 year olds); our prior work supports parental acceptance of in-ED interventions for at-risk youth when content focuses on teens alone [33,58,77,78,161].…”

Section: Design Considerationsmentioning

confidence: 74%

“…Emergency departments (ED) are often the only source of healthcare for these at-risk teens [28][29][30][31][32]. Higher rates of peer violence (40-50%), depressive symptoms (20-40%), and other mental health issues are reported among youth in the ED, regardless of the reason for their ED visit, compared to youth in schools or pediatric clinics [5,26,[33][34][35][36][37]. Youth with a history of peer violence and depressive symptoms are also more likely to have future ED visits for assault injuries [21,22,38].…”

Section: Introductionmentioning

confidence: 99%

A technology-augmented intervention to prevent peer violence and depressive symptoms among at-risk emergency department adolescents: Protocol for a randomized control trial

Ranney

Pateña

Dunsiger

et al. 2019

Contemporary Clinical Trials

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Background: Peer violence and depressive symptoms are increasingly prevalent among adolescents, and for many, use the emergency department (ED) as their primary source of healthcare. Brief in-person interventions and longitudinal text-message-based interventions are feasible, acceptable, and may be effective in reducing peer violence and depressive symptoms when delivered in the ED setting. This paper presents the study design and protocol for an in-ED brief intervention (BI) and text messaging program (Text). Methods: This study will be conducted in a pediatric ED which serves over 50,000 pediatric patients per year. Recruitment of study participants began in August 2018 and anticipated to continue until October 2021. The study will enroll 800 adolescents (ages13-17) presenting to the ED for any reason who self-report past-year physical peer violence and past-two week mild-tomoderate depressive symptoms. The study will use a factorial randomized trial to test both overall intervention efficacy and determine the optimal combination of intervention components. A full

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“…Importantly, and also consistent with prior research on electronic screening, participants perceived the tool as a way to enhance—but not replace—interactions with providers by helping them to identify questions and concerns before an appointment [ 41 , 42 ]. To date, studies regarding screening instruments have focused primarily on the frequency of provider counseling and referral [ 8 - 12 ]. However, our data suggest that electronic screening with feedback could be used to impact adolescent behavior during the appointment.…”

Section: Discussionmentioning

confidence: 99%

“…One strategy for increasing the frequency of screening and follow-up counseling for adolescent health risk behaviors in primary care is the use of electronic screening tools [ 8 - 13 ]. The benefits of electronic screening tools include their ability to streamline the screening process through branching logic and to generate reports to inform follow-up counseling by providers [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Adolescents’ Perspectives on Personalized E-Feedback in the Context of Health Risk Behavior Screening for Primary Care: Qualitative Study

et al. 2017

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BackgroundElectronic health screening tools for primary care present an opportunity to go beyond data collection to provide education and feedback to adolescents in order to motivate behavior change. However, there is limited research to guide feedback message development.ObjectiveThe aim of this study was to explore youth perceptions of and preferences for receiving personalized feedback for multiple health risk behaviors and reinforcement for health promoting behaviors from an electronic health screening tool for primary care settings, using qualitative methodology.MethodsIn total, 31 adolescents aged 13-18 years completed the screening tool, received the electronic feedback, and subsequently participated in individual, semistructured, qualitative interviews lasting approximately 60 min. Participants were queried about their overall impressions of the tool, perceptions regarding various types of feedback messages, and additional features that would help motivate health behavior change. Using thematic analysis, interview transcripts were coded to identify common themes expressed across participants.ResultsOverall, the tool was well-received by participants who perceived it as a way to enhance—but not replace—their interactions with providers. They appreciated receiving nonjudgmental feedback from the tool and responded positively to information regarding the consequences of behaviors, comparisons with peer norms and health guidelines, tips for behavior change, and reinforcement of healthy choices. A small but noteworthy minority of participants dismissed the peer norms as not real or relevant and national guidelines as not valid or reasonable. When prompted for possible adaptations to the tool, adolescents expressed interest in receiving follow-up information, setting health-related goals, tracking their behaviors over time, and communicating with providers electronically between appointments.ConclusionsAdolescents in this qualitative study desired feedback that validates their healthy behavior choices and supports them as independent decision makers by neutrally presenting health information, facilitating goal setting, and offering ongoing technological supports.

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Prompting Discussions of Youth Violence Using Electronic Previsit Questionnaires in Primary Care: A Cluster Randomized Trial

Cited by 12 publications

References 26 publications

Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

A technology-augmented intervention to prevent peer violence and depressive symptoms among at-risk emergency department adolescents: Protocol for a randomized control trial

Adolescents’ Perspectives on Personalized E-Feedback in the Context of Health Risk Behavior Screening for Primary Care: Qualitative Study

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