The American Academy of Pediatrics recommends that clinicians screen adolescents for substance use and, if applicable, provide a brief intervention, establish follow-up, and consider referral. All rights reserved. However, many barriers to screening in the ED setting were reported. No charts contained documentation on other important risk-stratifying details, such as contraception use other than condoms, the sex of partners, partners risk of STIs, anal sex practice, or partners drug use.27 None of these studies reported on whether privacy was ensured in sexual history taking, although they did mention the need for confidentiality as a possible barrier to higher rates of screening.2326, McFadden et al25 described sexual health services provided in the hospital setting and reported that STI testing was conducted in 12% of patients, that pregnancy testing was done in 60% of female patients, and that contraception was provided for 2% of patients. The shorter versions of AUDIT (AUDIT-C and AUDIT-PC) failed to identify a significant proportion of adolescents with a positive AUDIT-10 result. The ED-DRS, a nonvalidated screening tool to assess for health risk behaviors, was administered by physician trainees. Marc Olivier: Heads up on Twitter: "RT @nancydoylebrown: David A total of 862 charts of adolescents discharged from the ED with an STI diagnosis were reviewed. Twenty-five percent never conducted SBIRT (limited time and resources are barriers). Completely updated and revised for new diagnostic criteria, this toolkit provides practical guidance and fillable forms to help you turn your practice into a medical home for children with ADHD. Promising solutions include self-disclosure via electronic screening tools, educational sessions for clinicians, and clinician reminders to complete screening. The HEEADSSS interview is a practical, time-tested, complementary strategy that physicians can use to build on and incorporate the guidelines into their busy office practices. Only 1 included study was a randomized controlled trial, and there was large heterogeneity of included studies, potentially limiting generalizability. In their study, Erickson et al62 described screening and intervention regarding abuse or violence, specifically focusing on evaluating risk of intimate partner violence with an 8-item screening tool (the Conflict Tactics Survey). Paper questionnaire to assess sexual activity, pregnancy or desire for pregnancy, interest in receiving sexual health interventions in the ED, and use of health care, Thirteen percent of surveyed adolescents (. Many adolescents felt the ED should universally provide education on sexual and reproductive health practices and provide contraceptive services, especially for patients who may not have access to a primary provider.25,3032 Chernick et al33 found that one-fourth of the adolescent patients in their study were interested in receiving contraception in the ED. PDF Mental Health Tools for Pediatrics - AAP Most adolescents have few physical health problems, so their medical issues come from risky behaviors. The Sexual Health Screen reported on by Goyal et al35 presents a feasible and valid way to screen for sexual and reproductive health. Protecting Children and Adolescents From Tobacco and Nicotine Fein et al49 found that with the BHS-ED, mental health problem identification increased from 2.5% to 4.2% (OR 1.70; 95% CI 1.382.10), with higher rates of social work or psychiatry evaluation in the ED (2.5% vs 1.7%; OR 1.47 [95% CI 1.131.90]). In this scoping review, we aim to comprehensively describe the extent and nature of the current body of research on risk behavior screening and risk behavior interventions for adolescents in urgent care, ED, and hospital settings. Within each category, we grouped studies by subcategory: screening rates, screening and intervention tools, and attitudes toward screening and intervention. Yeo et al13 found that 10% of admitted patients at a tertiary childrens hospital had a comprehensive risk behavior assessment documented (defined as 5 of 7 domains: home, education, activities, tobacco use, drug and/or alcohol use, sexual activity, suicide and/or depression). PDF Oral Health Risk Assessment Tool - AAP Computerized survey to assess sexual history and interest in interventions in the ED. Assessment of Respiratory Function in Infants and Young Children Wearing Face Masks During the COVID-19 Pandemic | Pediatrics | JAMA Network Open | JAMA Network This cohort study examines whether the use of surgical face masks among children was associated with changes in respiratory function or signs of respiratory dis [Skip to Navigation] We report on a number of successful domain-specific screening tools validated in ED and hospital settings. .Z\S(?CvRx(6?X8TTnY-k!/.~zNV?-.,/O]b1:z>=Z. The Newton Screen may be a good brief screening tool for assessing alcohol and cannabis use. In the hospital setting, the top 3 barriers to sexual activity screening among clinicians included concerns about follow-up (63%), lack of knowledge regarding contraception (59%), and time constraints (53%). Computerized health survey and guided decision-making tool for physicians in intervention arm. Almost all adolescents agreed that nurses should screen for suicide risk in the ED. Pediatrics. Previous studies indicate low rates of risk behavior screening and interventions in ED and hospital settings. Semistructured interviews of clinicians to assess perceptions of depression in the adolescent population and thoughts about screening for depression in the ED. We developed the rapid screening tool home, education, activities/peers, drugs/alcohol, suicidality, emotions/behavior, discharge resources (HEADS-ED), which is a modification of "HEADS," a mnemonic widely used to obtain a psychosocial . Two-thirds of patients surveyed did not prefer EPT and cited reasons such as importance of determining partner STI status, partner safety, partner accountability, and importance of clinical interaction. Using methods from a study by Rea et al,18 we analyzed risk of bias for each of the included studies and found that only 2of 46 studies had a low risk of bias, 33 of 46 had moderate risk of bias, and 11 of 46 had a high risk of bias. In the Supplemental Information, we outline the details of our search strategy. EC knowledge was poor among clinicians surveyed. How Pediatricians Screen for Autism - HealthyChildren.org A significant percentage of sexually active adolescents surveyed were potential candidates for EC. The NIAAA 2-question screen is a valid and brief way to screen for alcohol use in pediatric EDs. Three ED studies described interventions to increase comprehensive risk behavior screening. H&P, history and physical; IUD, intrauterine device. For more educational content visitwww.pedialink.org. Patient-administered 22- to 27-item survey on attitudes toward inpatient reproductive health screening and interventions. ACA, adaptive conjoint analysis; ACASI, audio-enhanced computer-assisted self-interview; ARA, adolescent relationship abuse; AUDIT-C, Alcohol Use Disorders Identification TestConsumption; AUDIT-PC, Alcohol Use Disorders Identification Test-(Piccinelli) Consumption; AUDIT-3, 3-Item Alcohol Use Disorder Identification Test; AUDIT-10, 10-Item Alcohol Use Disorder Identification Test; BHS, Beck Hopelessness Scale; BIS-11, Barratt Impulsivity Scale; CAGE, Cut down, Annoyed, Guilty, Eye-opener; CDS, clinical decision support; CRAFFT, Car, Relax, Alone, Forget, Friends, Trouble; CSSRS, Columbia Suicide Severity Rating Scale; CT, Chlamydia trachomatis; CTS, Conflict Tactics Survey; DSM5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; EC, emergency contraception; ED-DRS, Emergency Department Distress Response Screener; EPT, expedited partner therapy; ER, emergency department; FAST, Fast Alcohol Screening Test; GC, Neisseria gonorrhoeae; HCP, health care provider; HEADS-ED, Home, Education, Activities and peers, Drugs and alcohol, Suicidality, Emotions and behaviors, Discharge resources; IPV, intimate partner violence; LARC, long-acting reversible contraception; LR+, positive likelihood ratio; NIAAA, National Institute of Alcohol Abuse and Alcoholism; NP, nurse practitioner; NPV, negative predictive value; POSIT, Problem Oriented Screening Instrument for Teenagers; PRI, pregnancy risk index; PTSD, posttraumatic stress disorder; RADS-2, Reynolds Adolescent Depression Screening, Second Edition; RAFFT, Relax, Alone, Friends, Family, Trouble; RAPS4-QF, Remorse, Amnesia/blackouts, Perform, Starter/eye-opener, Quantity, Frequency; RBQ, Reckless Behavior Questionnaire; RUFT-Cut, Riding with a drinking driver, Unable to stop, Family/Friends, Trouble, Cut down; SIQ, Suicidal Ideation Questionnaire; SIQ-JR, Suicidal Ideation Questionnaire Junior; STD, sexually transmitted disease; TWEAK, Tolerance, Worried, Eye-opener, Amnesia, Kut-down . Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, HEADSS, a psychosocial risk assessment instrument: implications for designing effective intervention programs for runaway youth, Effectiveness of SBIRT for alcohol use disorders in the emergency department: a systematic review, The role of motivational interviewing in children and adolescents in pediatric care.
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