Evidence map›Paper›PMID 38881403›Full record

Trial reportAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2024

Feasibility of adolescent contraceptive care in the pediatric emergency department: A pilot randomized controlled trial.

Melissa K Miller, Kathy Goggin, Stephani L Stancil, Elizabeth Miller, Tara Ketterer, Vince Staggs, April D McNeill-Johnson, Amber Adams, Cynthia J Mollen

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Melissa K MillerDepartment of Pediatrics, Division of Emergency Medicine, Children's Mercy Hospital and Clinics, Kansas City, Missouri, USA.ORCID 0000-0002-8672-4944
Kathy GogginDepartment of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
Stephani L StancilDepartment of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
Elizabeth MillerDepartment of Pediatrics, Division of Adolescent and Young Adult Medicine, University of Pittsburgh Medical Center-Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Tara KettererPolicy Lab, Roberts Center for Pediatric Research-Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Vince StaggsDepartment of Pediatrics, Division of Health Services of Outcomes Research Medicine, Children's Mercy Hospital and Clinics, Kansas City, Missouri, USA.
April D McNeill-JohnsonDepartment of Pediatrics, Division of Emergency Medicine, Children's Mercy Hospital and Clinics, Kansas City, Missouri, USA.ORCID 0000-0001-8618-5090
Amber AdamsDepartment of Pediatrics, Division of Emergency Medicine, Children's Mercy Hospital and Clinics, Kansas City, Missouri, USA.
Cynthia J MollenDepartment of Pediatrics, Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Funding

Childrens Mercy Hospital Fellowship Program in Pediatric PharmacologyT32HD069038 · NICHD · CHILDREN'S MERCY HOSP (KANSAS CITY, MO) · PI Laura B Ramsey, Jonathan Wagner · 2011 to 2026
$3.1M
Multi-level Emergency Department Intervention to Reduce Pregnancy Risk Among AdolescentsR21HD098086 · NICHD · CHILDREN'S MERCY HOSP (KANSAS CITY, MO) · PI MILLER, MELISSA KRISTINE · 2020 to 2021
$858k
Eunice Kennedy Shriver National Institute of Child Health and Human Development R21HD098086Eunice Kennedy Shriver National Institute of Child Health and Human Development T32HD069038NICHD NIH HHS R21 HD098086NICHD NIH HHS T32 HD069038Organon BioSciences Investigator-Initiated Studies Program
6 · The paper itself

Abstract

backgroundThis study assessed feasibility constructs of adolescent contraceptive care in the pediatric emergency department (PED), including contraception initiation.

methodsWe conducted a randomized trial in two PEDs with pregnancy-capable adolescents aged 15-18 years who were assigned to enhanced usual care (usual) or same-day initiation (same day). All received counseling and clinic referral, but same-day participants could also receive contraception in the PED. We trained PED clinicians in counseling and prescribing. Adolescents and clinicians rated feasibility using five Likert-type items (1 = strongly disagree to 5 = strongly agree) after the session. We assessed PED medication initiation and appropriateness via medical record review and contraception use and side effects at 30 days via adolescent survey. To further explore feasibility, we conducted clinician interviews at study completion; these were audio-recorded, transcribed, and analyzed. We hypothesized contraceptive care would be feasible (defined as average score ≥ 4 across five survey items).

resultsWe enrolled 37 adolescents (12 in usual and 25 in same-day), mean age was 16.6 years, 73% were Black, and 19% were Hispanic. We trained 27 clinicians. Average feasibility scores were 4.6 ± 0.4 (adolescents) and 4.1 ± 0.8 (clinicians). Eleven (44%) same-day participants initiated contraception in the PED. One adolescent with migraines initially received estrogen-containing pills; this was corrected after discharge. At 30 days, same-day participants were more likely to report contraception use (78% vs. 13%; p = 0.007). One adolescent reported bloating as a side effect. Clinicians enjoyed delivering contraceptive care, found study resource materials useful, and identified staffing shortages as a barrier to care delivery.

conclusionsWe are among the first to report on PED-based adolescent contraception initiation to prevent unintended pregnancy. Adolescents and clinicians reported that contraceptive care was feasible. Initiation was common and medications were largely appropriate and tolerated. Future efforts should explore integrating contraceptive care into routine PED care.

Indexed as

Emergency Service, HospitalFeasibility StudiesAdolescentContraceptionCounselingFemaleHumansMalePilot ProjectsPregnancyPregnancy in Adolescenceadolescenthealth services researchpediatric emergency departmentsexual and reproductive health

Identifiers

PMID38881403
PMCPMC11560636

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.