title: Advance provision of emergency contraception in an urban pediatric emergency department.
abstract: OBJECTIVE
  To assess whether a policy and educational intervention in an urban, pediatric emergency department (ED) increases advance provision of emergency contraception (EC) to patients.
  
  
  METHODS
  A pre- and post-intervention, retrospective chart review was conducted in an urban, pediatric ED assessing provider care of sexually active female adolescents and young adults. INTERVENTION/MAIN OUTCOME MEASURES: A policy was instituted recommending that ED providers prescribe EC and provide an educational handout to all sexually active female adolescents and young adults. ED providers were educated about EC and this policy. Charts, subsequently reviewed, included sexually active female patients, age 13-21 years, presenting to the ED status post sexual assault, seeking EC, or with an abdominal, gynecologic, or urologic complaint. Student's t-tests, Pearson's chi-square and Fisher's Exact tests compared pre- and post-intervention provider and patient characteristics and outcomes.
  
  
  RESULTS
  The mean age of the patient sample was 18.8 years (SD=1.7), 83% were Black or Hispanic, 43% were previously pregnant, 25% reported not using birth control. Last unprotected sexual intercourse was not documented for 87% of patients presenting with medical complaints. There was no difference in the advance prescribing of EC or the provision of the educational handout to patients pre- (3.3%) or post- (5.6%) intervention (P = 0.73).
  
  
  CONCLUSIONS
  Despite a policy and an educational intervention for providers, little change occurred in advance EC prescribing in an urban, pediatric ED. Additionally, many providers were not documenting last unprotected sexual intercourse, potentially missing an opportunity to treat patients with EC at the time of their visit.
authors.affiliation: Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, Boston, Massachusetts, USA. Sarah.Pitts@childrens.harvard.edu
authors.forename: Sarah A B
authors.initials: SA
authors.lastname: Pitts
authors.forename: Heather L
authors.initials: HL
authors.lastname: Corliss
authors.forename: Sigmund J
authors.initials: SJ
authors.lastname: Kharasch
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Gordon
mesh_terms: D000293:Adolescent; D000328:Adult; D044363:Contraception, Postcoital; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016134:Organizational Policy; D010353:Patient Education as Topic; D010372:Pediatrics / Q000193:education / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D019037:Urban Health Services / Q000706:statistics & numerical data; D055815:Young Adult