Implementation of Contraception Care for Psychiatrically Hospitalized Adolescents: A Hybrid Type 2 Effectiveness-Implementation Study.

IF 5.5 2区医学 Q1 PEDIATRICS Journal of Adolescent Health Pub Date : 2024-11-08 DOI:10.1016/j.jadohealth.2024.10.006

Elise D Berlan, Abigail L Underwood, Kathryn A Hyzak, Charles Hardy, Ryan S Bode, Samantha A Herrmann, Anna Kerlek, Stephanie Lauden, Samuel W Dudley, Christine A Schmerge, Michael F Perry, Alicia C Bunger

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Abstract

Purpose: To examine the implementation and effectiveness of a contraception care intervention for adolescents hospitalized with psychiatric disorders.

Methods: This prospective, observational, hybrid type 2 effectiveness-implementation study examined the effectiveness of the Contraception Care at the Behavioral Health Pavilion (CC@BHP) intervention in 4 inpatient psychiatric units at a quaternary children's hospital. A multifaceted implementation blueprint guided implementation. CC@BHP is a clinical pathway intervention designed to increase access to contraceptive counseling and initiation during hospitalization. Eligible patients were assigned female at birth, at least 14 years old, and admitted to one of four units between December 2021 and February 2023. Implementation outcomes were provider adoption (documentation of assessing interest in contraception care) and intervention reach (order placed for contraception consultation). Intervention effectiveness outcomes assessed downstream health service access, including patient receipt of contraception consultation and contraceptive prescription/initiation.

Results: Across 1,461 visits, the mean patient age was 15.9 years and 63.4% were White. Forty percent (n = 586) of visits included at least one intervention component. Overall, healthcare providers adopted CC@BHP in 29.0% (n = 424) of visits and ordered contraception consultations in 19.1% (n = 279) of visits (reach). Adolescents received contraception consultations in 16.7% (n = 244) of visits and 116 patients (7.9%) initiated a contraceptive (effectiveness). Later study waves demonstrated greater adoption and reach.

Discussion: Implementation improved over time and CC@BHP delivered contraceptive counseling and initiation, including implants and intrauterine devices, in a large quaternary hospital to interested adolescents. Inpatient psychiatry admissions offer a timely opportunity to address reproductive health needs of adolescents.

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对住院精神病青少年实施避孕护理：第二类效果-实施混合研究》。

目的：研究针对患有精神疾病住院青少年的避孕护理干预措施的实施情况和效果：这项前瞻性、观察性、混合型 2 效果-实施研究考察了行为健康馆避孕护理（CC@BHP）干预措施在一家四级儿童医院 4 个精神科住院病房的效果。多方面的实施蓝图指导了实施工作。CC@BHP 是一项临床路径干预措施，旨在增加住院期间获得避孕咨询和开始使用避孕药具的机会。符合条件的患者在出生时即被指定为女性，年龄至少为 14 岁，并在 2021 年 12 月至 2023 年 2 月期间入住四个病房之一。实施结果为提供者采纳（对避孕护理兴趣的评估记录）和干预覆盖率（避孕咨询订单）。干预效果结果评估了下游医疗服务的获取情况，包括患者接受避孕咨询和避孕处方/启动：在 1,461 次就诊中，患者平均年龄为 15.9 岁，63.4% 为白人。40%（n = 586）的就诊包括至少一项干预内容。总体而言，29.0%（n = 424）的就诊者采用了 CC@BHP，19.1%（n = 279）的就诊者接受了避孕咨询（达到）。16.7%（244 人）的青少年接受了避孕咨询，116 名患者（7.9%）开始使用避孕药具（有效性）。后来的研究表明，采用率和覆盖率都有所提高：讨论：随着时间的推移，CC@BHP 的实施情况有所改善，在一家大型四级医院为有兴趣的青少年提供了避孕咨询和初始避孕药具，包括皮下埋植剂和宫内节育器。精神科住院病人提供了一个及时满足青少年生殖健康需求的机会。

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来源期刊

Journal of Adolescent Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

10.40

自引率

3.90%

发文量

526

审稿时长

46 days

期刊介绍： The Journal of Adolescent Health is a scientific publication dedicated to enhancing the health and well-being of adolescents and young adults. Our Journal covers a broad range of research topics, spanning from the basic biological and behavioral sciences to public health and policy. We welcome a variety of contributions, including original research papers, concise reports, literature reviews, clinical case reports, opinion pieces, and letters to the editor. We encourage professionals from diverse disciplines such as Anthropology, Education, Ethics, Global Health, Health Services Research, Law, Medicine, Mental and Behavioral Health, Nursing, Nutrition, Psychology, Public Health and Policy, Social Work, Sociology, and Youth Development to share their expertise and contribute to our mission of promoting adolescent health. Moreover, we value the voices of young individuals, family and community members, and healthcare professionals, and encourage them to submit poetry, personal narratives, images, and other creative works that provide unique insights into the experiences of adolescents and young adults. By combining scientific peer-reviewed research with creative expressions, our Journal aims to create a comprehensive understanding of the challenges and opportunities in adolescent and young adult health.