Development of a Novel Computerized Clinical Decision Support System to Improve Adolescent Sexual Health Care...

Area of Science:

• Public Health
• Clinical Informatics
• Adolescent Medicine

Background:

• Emergency departments (EDs) face challenges in providing consistent, evidence-based sexual health care to adolescents.
• Adolescent sexual health requires tailored approaches addressing contraception, sexually transmitted infections (STIs), and related counseling.
• Clinical decision support (CDS) systems can potentially bridge the gap between evidence and clinical practice.

Purpose of the Study:

• To develop an acceptable and usable clinical decision support (CDS) system for delivering evidence-based sexual health care to adolescents in the ED.
• To assess the perspectives of both adolescents and clinicians on the system's acceptability and usefulness.

Main Methods:

• A multiphased, iterative process involving expert group synthesis of sexual health evidence.
• Development of a computerized questionnaire and decision tree for tailored, evidence-based recommendations, including emergency contraception (EC) resources.
• Mixed-methods evaluation with adolescents (14-19 years) and clinicians in four EDs, assessing system acceptability and usefulness via questionnaires and qualitative feedback.

Main Results:

• Clinicians rated the system's usefulness highly (mean 3.4/4.0), with no significant differences based on demographics or role.
• Adolescents found the computerized questionnaire easy to complete (95%) and understand, with most comprehending EC information.
• Both groups preferred computer-based interaction for future assessments, highlighting potential for efficient data collection and information delivery.

Conclusions:

• A user-friendly sexual health CDS system was successfully developed, demonstrating potential to improve evidence-based care and reduce health outcome disparities for adolescents.
• The system's ease of use and acceptability among both adolescents and clinicians suggest its feasibility for implementation in ED settings.
• Further research is necessary to evaluate the system's impact on service delivery and ultimate health outcomes.