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Multi-level Emergency Department Intervention to Reduce Pregnancy Risk Among Adolescents

Award Number: R21HD098086
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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PROJECT SUMMARY The burden of adolescent unintended pregnancy in the US is substantial, despite declines in pregnancy rates in recent years. Although highly effective contraceptive methods exist, adolescents face multi-level barriers to contraceptive access and use. Research focused on increasing contraception initiation among adolescents is crucial. The emergency department (ED) is a non-traditional setting that is well-positioned to provide reproductive care, as almost 19 million adolescents seek care in EDs each year, many are amenable to receiving care in this setting, and the ED is often the only or primary contact with the health care system for the highest-risk youth. We propose a novel contraceptive counseling intervention for the ED setting that address barriers at the patient, provider, and system levels. Building on previous work and drawing on proven strategies from traditional settings, we will train ED advanced practice nurses to provide counseling utilizing Motivational Interviewing strategies to facilitate uptake of ED-based contraception or clinic referral among sexually active females aged 15-18 years. We will conduct a small randomized trial to evaluate these feasibility constructs using mixed methodology: acceptability, demand, implementation, practicality, adaptation, integration, expansion, and limited-efficacy. We compare two arms (intervention vs. enhanced standard of care) to determine size of effect rates on contraception initiation. We gather data to inform a future study to evaluate individual components and identify the most parsimonious combination of active components using an adaptive design. We expect these data to inform a trial with adequate sample to evaluate efficacy among contraceptive subtypes and to identify characteristics that enhance or inhibit contraception use. This project is significant because the national burden of adolescent childbearing ($9.4 billion for one year alone) is so great, even a small reduction in incidence should lead to significant cost reductions and reduce generational cycles of poverty and poor health outcomes.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2021	CHILDRENS MERCY HOSPITAL	2401 GILLHAM RD	KANSAS CITY	MO	64108	JACKSON	USA	Child Health and Human Development Extramural Research	000	2	4/4/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $0 )
2022	2021	CHILDREN'S MERCY HOSPITAL, THE	2401 GILLHAM RD	KANSAS CITY	MO	64108	JACKSON	USA	Child Health and Human Development Extramural Research	000	2	10/13/2021	SUPPLEMENT FOR EXPANSION	$0
2022	2021	CHILDREN'S MERCY HOSPITAL, THE	2401 GILLHAM RD	KANSAS CITY	MO	64108	JACKSON	USA	Child Health and Human Development Extramural Research	001	2	1/5/2022	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $598,270 )
2021	2021	CHILDREN'S MERCY HOSPITAL, THE	2401 GILLHAM RD	KANSAS CITY	MO	64108	JACKSON	USA	Child Health and Human Development Extramural Research	000	2	5/3/2021	NON-COMPETING CONTINUATION	$208,442
2021	2021	CHILDREN'S MERCY HOSPITAL, THE	2401 GILLHAM RD	KANSAS CITY	MO	64108	JACKSON	USA	Child Health and Human Development Extramural Research	001	2	9/16/2021	SUPPLEMENT FOR EXPANSION	$389,828
														Subtotal = $598,270

Issue Date FY: 2020 ( Subtotal = $259,749 )
2020	2020	CHILDREN'S MERCY HOSPITAL, THE	2401 GILLHAM RD	KANSAS CITY	MO	64108	JACKSON	USA	Child Health and Human Development Extramural Research	000	1	5/21/2020	NEW	$259,749
														Subtotal = $259,749

Grand Total All Awards = $858,019

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Multi-level Emergency Department Intervention to Reduce Pregnancy Risk Among Adolescents

Award Number: R21HD098086

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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