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Pediatr Emerg Care. 2019 Oct 28. doi: 10.1097/PEC.0000000000001947. [Epub ahead of print]

Attitudes Toward Electronic Sexual Health Assessments Among Adolescents in the Emergency Department.

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From the School of Medicine and Health Sciences, The George Washington University.
Children's National Health System, Washington, DC.



Adolescents account for nearly half of all newly diagnosed sexually transmitted infection (STI) cases in the United States and frequently access health care via emergency departments (EDs). However, there are many barriers to ED-based STI screening. Electronic sexual health assessments may overcome some of these ED-specific barriers. Thus, the objective of this study was to assess adolescent attitudes toward electronic sexual health assessments to guide STI screening in the ED.


This was a secondary analysis of data from 2 cross-sectional studies evaluating acceptability of electronic sexual health assessments in the pediatric ED. Study participants completed an electronic questionnaire that elicited sexual behavior information and attitudes toward electronic sexual health assessments. We interrogated the electronic health record to determine if sexual histories were documented, and if so, we assessed patient preference for mode of assessment. We performed multivariable logistic regression to identify demographic factors associated with acceptance of electronic sexual health assessments.


Of the 1159 adolescents surveyed, 935 (80.7%; 95% confidence interval, 78.3-82.9) found electronic assessments an acceptable method by which to provide sexual health information. The majority (n = 874 [75.4%]; 72.8-77.9) reported a preference for electronic assessments over other modes of assessment. Acceptance of electronic assessments was associated with STI-related chief complaint (adjusted odds ratio, 1.7; 1.0-2.7) and private insurance (adjusted odds ratio, 1.8; 1.2-2.7).


Electronic sexual health assessments are acceptable to adolescents and are an efficient alternative to face-to-face sexual health assessments. Future studies should focus on how best to integrate electronic assessments into the ED workflow.

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