This type of screening can identify children with significant developmental and behavioral challenges early, when they may benefit most from intervention, as . l+PxF.wYh|:7#jvUF\A_Xr9Gs#C:Ynu,-,-AFk[,b5+"*,gbJW*;A[PA[r}Xq~jy!.N(7kF f Risky behaviors present a great threat to adolescent health and safety and are associated with morbidity into adulthood.1,2 Unintended pregnancy, sexually transmitted infections (STIs), substance use, suicide, and injury are the primary causes of morbidity and mortality in those aged 10 to 24 years.3 Risky behaviors are prevalent among US high school students, with 35% reporting alcohol use, 23% reporting marijuana use, and 47% reporting sexual activity (but only 59% reporting using a condom during their last sexual encounter).1 Consequently, the American Academy of Pediatrics recommends comprehensive risk behavior screening at annual preventive care visits during adolescence,4 with the goal of identifying risk behaviors and providing risk behaviorrelated interventions (eg, STI testing).5. HEADS UP to Healthcare Providers is a free online training developed by CDC and the American Academy of Pediatrics. Our data sources included PubMed (19652019) and Embase (19472019). .Z\S(?CvRx(6?X8TTnY-k!/.~zNV?-.,/O]b1:z>=Z. Adolescents and clinicians were highly accepting of risk behavior screening in all settings and preferred electronic screening over a face-to-face interview. When implementing an alcohol use screening and/or intervention program for adolescents in the ED, it is important to minimize workflow disruption caused by the program and provide adequate education to achieve staff participation. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines flowchart of study selection. Documentation of sexual activity screening of adolescents was low in both ED and hospital settings. Oral health risk assessment timing and establishment of the dental home. The CSSRS has been validated in multiple settings (including the ED and inpatient setting in patients with mental health problems). Adolescents have suboptimal rates of preventive visits, so emergency department (ED) and hospital visits represent an important avenue for achieving recommended comprehensive risk behavior screening annually. Reported barriers were time constraints and limited resources. Four screening questions can capture patients at risk for IPV: Have you felt unsafe in past relationships? Is there a partner from a previous relationship that is making you feel unsafe now? Have you been physically hit, kicked, shoved, slapped, pushed, scratched, bitten, or otherwise hurt by your boyfriend or dating partner when they were angry? Have you ever been hurt by a dating partner to the point where it left a mark or bruise?, Narrative review to explore ARA identification and intervention in the ED. After a title and abstract screen, 75 studies remained. Learn Steps to Improve the Care of Your Pediatric Patients with mTBI. Patient-administered 22- to 27-item survey on attitudes toward inpatient reproductive health screening and interventions. In the full-text screen, both reviewers included 43 studies and excluded 25 studies; 7 studies were in conflict. For COVID related questions, please emailcovid-19@aap.org.For Mental Health related questions, please emailmentalhealth@aap.org.Brought to you by AAP Education. The ED visit may provide an opportunity to meet the contraceptive needs of adolescents, particularly for those who do not receive regular well care. Preventive oral health intervention for pediatricians. We report on evaluation of the network after 10 years of operation by reviewing program context, input, processes, and products to measure its progress in performing educational research that advances . We excluded studies that involved outpatient follow-up of patients to evaluate interventions that could be completed in the ED or hospital setting, but this may have limited our review of more longitudinal effects. Early childhood is a pivotal period of child development that begins before birth through age 8. 28 Apr 2023 20:21:28 Study design and risk of bias are presented in Table 1. Adolescents in the intervention group were more likely to receive STI testing compared with those in the control arm (52.3% vs 42%; odds ratio [OR] 2.0 [95% confidence interval (CI) 1.13.8]). Newton Screen: 3 questions on substance use based on DSM5 aimed at adolescents (self-administered tablet tool with follow-up phone calls), Alcohol use disorder: sensitivity = 78.3%, specificity = 93%; cannabis use disorder: sensitivity = 93.1%, specificity = 93.5%. Guidance for authors when choosing between a systematic or scoping review approach, PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation, Rayyan-a web and mobile app for systematic reviews, Families experiences with pediatric family-centered rounds: a systematic review, Opportunistic adolescent health screening of surgical inpatients, Reaching adolescents for prevention: the role of pediatric emergency department health promotion advocates, Raising our HEADSS: adolescent psychosocial documentation in the emergency department, Mental health screening among adolescents and young adults in the emergency department. Documentation of reproductive health and inpatient delivery of reproductive health services (STI testing and/or treatment, HPV vaccination, and contraceptive provision), Documentation: Fifty-five percent of patients had sexual history documentation. The majority of ED physicians felt that the ED was an appropriate venue for screening and intervention on alcohol use disorders. *0zx4-BZ8Nv4K,M(WqhQD:4P H!=sb&ua),/(4fn7L b^'Y):(&q$aM83a hdQT Nj'8PHla8K^8nLBs7ltJ2umZi96^p&)PZ?]3^$Zc`O;|462 L-{:ZA:JmGv?Hw(ibKWyK2>{)K_P/)g?\(E~&=wAez8nsM7bvE^#FUTd1"$73;ST\ao=7S[ddf(K$7v |(|w .AFX With the heterogeneity of studies included, we could only summarize findings but could not perform a meta-analysis. Tools to aid. The assessment starts with simple and easy questions about life to allow a . ED clinicians acknowledged the importance of depression screening. These brief validated tools within single risk behavior domains could potentially be combined into a single comprehensive screen (with consideration that these screening tools may have been validated for specific populations and plans to assess feasibility and time burdens). Fifty-seven percent of female adolescents answered that adolescents should be offered contraception in the inpatient setting (no significant difference in response between self-reported sexually active and nonactive patients). Review of instruments used to assess alcohol and other drug use in pediatric patients in the ED (published in 2011; included studies published in 20002009). Survey of hospitalists to assess beliefs and practices surrounding sexual and reproductive health screening and interventions. When patients screen positive for risky behaviors, it is imperative to have strategies and resources in place to address these behaviors. The ED-DRS, a nonvalidated screening tool to assess for health risk behaviors, was administered by physician trainees. Nineteen studies on sexual activity screening and/or intervention were included in our review: 5 in the hospital setting (Table 3) and 14 in the ED (Table 4). A 2-question SI screen was piloted by Patel et al50 in an urgent care setting to identify adolescents at risk for SI. 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 . In 75% of cases in which risk behaviors were identified, interventions were provided. Semistructured interviews of clinicians to assess perceptions of depression in the adolescent population and thoughts about screening for depression in the ED. Documentation of sexual history in hospitalized adolescents on the general pediatrics service, Addressing reproductive health in hospitalized adolescents-a missed opportunity, Documentation of sexual and menstrual histories for adolescent patients in the inpatient setting, Sexual-history taking in the pediatric emergency department, A computerized sexual health survey improves testing for sexually transmitted infection in a pediatric emergency department, Brief behavioral intervention to improve adolescent sexual health: a feasibility study in the emergency department, Examining the role of the pediatric emergency department in reducing unintended adolescent pregnancy, A pilot study to assess candidacy for emergency contraception and interest in sexual health education in a pediatric emergency department population, Factors associated with interest in same-day contraception initiation among females in the pediatric emergency department, Identifying adolescent females at high risk of pregnancy in a pediatric emergency department, Characteristics of youth agreeing to electronic sexually transmitted infection risk assessment in the emergency department, Development of a sexual health screening tool for adolescent emergency department patients, Preferences for expedited partner therapy among adolescents in an urban pediatric emergency department: a mixed-methods study [published online ahead of print March 14, 2019], Developing emergency department-based education about emergency contraception: adolescent preferences, Using the hospital as a venue for reproductive health interventions: a survey of hospitalized adolescents, Acceptability of sexual health discussion and testing in the pediatric acute care setting, Adolescent reproductive health care: views and practices of pediatric hospitalists, Pediatric emergency health care providers knowledge, attitudes, and experiences regarding emergency contraception, Development of a novel computerized clinical decision support system to improve adolescent sexual health care provision, Utility of the no response option in detecting youth suicide risk in the pediatric emergency department, Ask Suicide-Screening Questions (ASQ): a brief instrument for the pediatric emergency department, Adolescent suicide risk screening in the emergency department. Abstract. Falcn et al61 found that, during implementation of a standardized screening program, it was important to minimize workflow disruption and provide adequate education to achieve participant buy-in. Parents and adolescents were highly accepting of sexual health discussion, STD testing, and pregnancy testing in the acute care setting. Self-administered BHS-ED: computerized survey to assess substance use, PTSD, exposure to violence, SI, and depression, During the implementation period, BHS-ED was offered to 33% of patients by clinical staff. Adolescents preference for technology-based emergency department behavioral interventions: does it depend on risky behaviors? American Academy of Pediatrics Offers Guidance for Caring and Treatment of Long-Term Cancer Survivors Childhood Cancer Survivors: What to Expect After Treatment News Releases Policy Collections Advocacy The State of Children in 2020 Healthy Children Secure Families Strong Communities In retrospective cohort studies by Riese et al,24 McFadden et al,25 and Stowers and Teelin,26 sexual activity screening rates in the hospital setting are described.