Expanding Contraceptive Access for Teens-Leveraging the Pediatric Emergency Department

Area of Science:

• Adolescent sexual health
• Public health interventions
• Emergency medicine

Background:

• Adolescents face significant barriers to accessing sexual healthcare.
• The emergency department (ED) represents a critical, often sole, point of care for some adolescents.
• Integrating reproductive health services into ED settings is crucial for this population.

Purpose of the Study:

• To assess the feasibility of an ED-based contraception counseling intervention.
• To evaluate adolescent intention to initiate contraception.
• To determine contraception initiation and follow-up visit completion rates.

Main Methods:

• Prospective cohort study in two urban pediatric academic medical centers.
• Training of advanced practice providers to deliver brief contraception counseling.
• Enrollment of females aged 15-18, assessing intention via surveys and initiation/completion via records and surveys at 8 weeks.

Main Results:

• 96 adolescents were counseled; 61% intended to initiate contraception.
• Participants intending to initiate were older and more likely to have prior contraceptive use.
• One-third (33%) initiated contraception either in the ED or post-visit.

Conclusions:

• ED-based contraception counseling is feasible and can be integrated into routine visits.
• A significant proportion of adolescents express intent to use contraception, and many initiate use.
• Expanding trained providers and same-day initiation support is recommended for this novel setting.