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A Digital Referral Tool to Link Adolescent Females from the Emergency Department to Sexual and Reproductive
Talia Adler1, Lisa-Pierre Tchoungui1, Janet Garth2
1Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY.
Purpose:
Emergency departments (EDs) provide a critical access point for adolescents with unmet sexual and reproductive health (SRH) needs; yet, effective connection to follow-up care remains limited. This study aimed to develop and pilot test the Dr. Erica Digital Referral Tool (Dr. E-DRT), a patient-facing tool designed to educate adolescent females and facilitate linkage to person-centered sexual healthcare after ED discharge.
Methods:
We conducted a prospective cohort study from July 2023 to February 2024 in an urban pediatric ED. Biologically female, English-speaking adolescents aged 14-19 years were screened for eligibility. Enrolled participants completed a baseline survey, interacted with the Dr.E-DRT and were offered the option to schedule a follow-up appointment for SRH care. Two-month follow-up was completed via survey and electronic medical record (EMR) review. Outcomes included feasibility, acceptability, and potential efficacy to increase outpatient follow-up.
Results:
Of 223 adolescents screened, 31 met eligibility criteria and 25 enrolled. All participants completed the tool and 16 participants (64%) scheduled a follow-up visit at our local family planning practice. Acceptability of Dr. E-DRT was high across multiple dimensions, with mean Likert scores ranging from 4.2 to 4.4 out of 5 for satisfaction, appeal, and likelihood of recommending the tool. At 2-month follow-up, survey completion was 40% (10/25). Only 3 participants attended the follow-up visit.
Discussion:
Dr.E-DRT was feasible to implement and well accepted by adolescents in the ED. While appointment scheduling was high, visit completion remained low, highlighting the need for additional strategies to support linkage to SRH care after ED visit.
