This study aims to adapt an electronic sexually transmitted infections (STIs) risk assessment tool for implementation during pediatric primary care visits.
Study Overview
Problem: Adolescents have high rates of STIs, including gonorrhea, chlamydia, and HIV. Unfortunately, they often do not receive STI screening during pediatric primary care visits, increasing the risk of undiagnosed STIs. This leads both to significant spread in the population and avoidable medical complications.
Main Objective: To identify adolescents at risk for STIs and provide testing by implementing electronic STI risk assessment in pediatric primary care settings.
Approach: This study will implement a STI risk assessment tool in three pediatric primary care clinics in the St. Louis metropolitan area, which has a high incidence of STIs. The assessment tool, which was initially developed for use in the emergency department, is completed by the patient and includes a branch-logic questionnaire along with a clinical decision support tool. Once completed, the patient’s responses and STI testing recommendations are integrated into the electronic health record, allowing the clinical team to easily identify patients at risk for STIs and arrange for testing and follow-up.
For this study, the research team is:
- Adapting the electronic STI risk assessment tool and clinical workflows to support successful implementation in pediatric clinics.
- Implementing use of the tool in three pediatric clinics.
- Assessing changes in STI testing and treatment in the three pediatric clinics after implementation.
Results: Identified barriers to STI screening and testing adolescents included clinicians’ perception of STI risk, time constraints during visits, and lack of clinic capacity to conduct testing.1 In initial testing of the electronic risk assessment tool, the research team found that primary care physicians and clinical staff as well as adolescents liked the tool and found it easy to use.2 Qualitative interviews revealed that physicians and clinic staff thought the tool would fit well into their existing primary care workflows.2 Patients, physicians, and clinical staff also believed the private nature of the tool would help adolescents share sensitive information with their physician, particularly when a parent is present.2
Additional findings are forthcoming. Publications can be found here.
Primary Care Relevance
Adapting an electronic STI risk assessment tool for use in a primary care setting has the potential to significantly improve STI care for adolescents.
AHRQ Primary Care Priority Area
Research to improve primary care, including regarding quality, access and affordability, the workforce, care delivery models, financing, digital healthcare, person-centeredness, and health equity.
Notes
1. Ahmad FA, Dickey V, Tetteh EK, Foraker R, McKay VR. The Use of the Consolidated Framework for Implementation Research to Understand Facilitators and Barriers to Sexually Transmitted Infection Screening in Primary Care. Sex Transm Dis 2022 Sep 1;49(9):610-615. doi: 10.1097/OLQ.0000000000001656. Epub 2022 Jun 2. PMID: 35649512.
2. Ahmad FA, Chan P, McGovern C, Dickey V, Foraker R, McKay V. Adapting an Electronic STI Risk Assessment Program for Use in Pediatric Primary Care. J Prim Care Community Health 2023 Jan-Dec;14:21501319231172900. doi: 10.1177/21501319231172900. PMID: 37199386; PMCID: PMC10201180.
