RESUMO
OBJECTIVE: To test the hypothesis that our motivational sexual health intervention (SexHealth) would increase health service uptake when compared with control. STUDY DESIGN: In a randomized controlled trial at a pediatric emergency department, sexually active adolescents received either the SexHealth intervention or printed materials (control). SexHealth, delivered by a health educator, was a tablet-based, interactive intervention that included motivational techniques to promote sexual health, condom skills training, and tailored service recommendations. We assessed feasibility (eg, intervention completion, recommendations discussed, intervention duration), acceptability (ie, proportion enrolled and rating intervention as satisfactory), and efficacy; secondary outcomes were sexual and care-seeking behaviors at 6 months. The efficacy outcome was completion of ≥1 service at the index visit (ie, counseling, condoms, emergency contraception for immediate or future use, pregnancy/sexually transmitted infection/HIV testing, sexually transmitted infection treatment, and clinic referral). RESULTS: We enrolled 91 participants (intervention = 44; control = 47). The intervention demonstrated high feasibility: 98% completed the intervention; 98% of recommendations were discussed; duration was 24.6 minutes, and acceptability: 87% of eligible adolescents enrolled and 93% rated the intervention as fairly to very satisfactory. Compared with controls, intervention participants were more likely to complete ≥1 service (98% vs 70%, P < .001) including HIV testing (33% vs 6%, P = .02) and emergency contraception (80% vs 0%, P = .01). There were no meaningful differences between arms in behaviors at follow-up. CONCLUSIONS: SexHealth was feasible to implement, acceptable to youth, and resulted in increased uptake of health services during the emergency department visit. Additional strategies may be needed to extend intervention effects over time. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov; NCT03341975.
Assuntos
Comportamento do Adolescente , Serviços de Saúde do Adolescente , Serviço Hospitalar de Emergência , Entrevista Motivacional , Aceitação pelo Paciente de Cuidados de Saúde , Comportamento Sexual , Adolescente , Estudos de Viabilidade , Feminino , Humanos , Masculino , Projetos PilotoRESUMO
Objective: Assess the feasibility and acceptability of a culturally- and linguistically-adapted smoking cessation text messaging intervention for Latino smokers. Methods: Using a community-based strategy, 50 Latino smokers were recruited to participate in a smoking cessation pilot study. Participants received a 12-week text messaging intervention and were offered Nicotine Replacement Therapy (NRT) at no cost. We assessed biochemically verified abstinence at 12 weeks, text messaging interactivity with the program, NRT utilization, self-efficacy, therapeutic alliance, and satisfaction. Results: Participants were 44.8 years old on average (SD 9.80), and they were primarily male (66%) and had no health insurance (78%). Most of the participants were born in Mexico (82%) and were light smokers (1-10 CPD) (68%). All participants requested the first order of NRT, and 66% requested a refill. Participants sent an average of 39.7 text messages during the 12-week intervention (SD 82.70). At 12 weeks, 30% of participants were biochemically verified abstinent (88% follow-up rate) and working alliance mean value was 79.2 (SD 9.04). Self-efficacy mean score increased from 33.98 (SD 10.36) at baseline to 40.05 (SD 17.65) at follow-up (p = 0.04). The majority of participants (90.9%, 40/44) reported being very or extremely satisfied with the program. Conclusion: A culturally- and linguistically-adapted smoking cessation text messaging intervention for Latinos offers a promising strategy to increase the use of NRT, generated high satisfaction and frequent interactivity, significantly increased self-efficacy, produced high therapeutic alliance, and resulted in noteworthy cessation rates at the end of treatment. Additional testing as a formal randomized clinical trial is warranted.