Adolescent access to sexual health care in ED draws support

Health care providers were generally found to be supportive of an intervention to incorporate a health educator in the ED to improve adolescent access to sexual health care, according to findings presented during the 2013 Society for Adolescent Health and Medicine Meeting.

However, the providers remained largely divided on the provision of sexual care in the ED and identified several barriers to its institution.

Melissa K. Miller

“While other ED interventions to improve various aspects of care have been implemented, little is known about providers’ perceptions about ED-based interventions to improve adolescent access to sexual health care,” Melissa K. Miller, MD, of the department of pediatric emergency medicine at Children’s Mercy Hospital in Kansas City, Mo., and colleagues wrote.

To explore the attitudes and beliefs of health care providers about adolescent sexual health care and evaluate barriers to developing sexual health care access for this high-risk population, Miller and colleagues conducted in-depth, semistructured interviews of nurses, nurse practitioners, physicians and social workers from the ED and teen clinic of a Midwestern, urban, academic children’s hospital.

The researchers interviewed several ED providers, including 12 physicians, 12 nurses, three nurse practitioners and two social workers, most (83%) of whom were female.

Attitudes affecting intention included health care providers’ opinion of their professional role, the role of the ED, as well as the need for patient safety/health. In addition, health care providers identified three practice referents: patients/families, peers and administrators, and professional organizations.

The researchers reported that health care providers perceived limited behavioral control over sexual health care delivery because of time constraints, patient flow concerns, confidentiality issues and comfort level.

Health care providers overall supported the idea of a health educator, and many felt the health educator could help overcome barriers to care. Some of the surveyed participants did not support the intervention based on the view that the ED was not “the place for it,” or they expressed concerns that it would result in increasing the health care provider workload.

“While providers were divided on sexual care provision in the ED and could identify many barriers, they were generally supportive of a novel intervention to incorporate a health educator to improve adolescent access to sexual health care,” Miller and colleagues wrote. “These findings can inform intervention development to improve access to care while accommodating system limitations.”

For more information:

Miller MK. Abstract #65. Presented at: Society for Adolescent Health and Medicine 2013; March 13-16, 2013; Atlanta.

Disclosure: The researchers reported no relevant financial disclosures.