title: Acceptability of sexual health discussion and testing in the pediatric acute care setting.
abstract: OBJECTIVE
  The objective of this study was to determine acceptability of sexual health discussion and testing among adolescents, parents, and health care providers (HCPs).
  
  
  METHODS
  We conducted a cross-sectional study of acute care patients (aged 14-19 years), parents, nurses, and physicians/nurse practitioners. Subjects rated sexual health discussion, sexually transmitted disease and pregnancy testing as acceptable/unacceptable and verbally explained their reasoning. Reasons were transcribed verbatim, coded, and analyzed. Agreement with individual adolescent responses was determined. Controlling for visit type, logistic regression was used to evaluate association between location and acceptance with odds ratios (ORs). Visits were categorized as reproductive/nonreproductive.
  
  
  RESULTS
  Subjects included 127 adolescents, 90 parents, and 190 HCP responses. Mean adolescent age was 15.5 years; 57% were female; 43% reported previous intercourse; 43% were black, and 39% were white. Most visits (76%) were nonreproductive. Adolescents and parents were highly accepting of discussion and testing and were more accepting than HCPs. Acceptance was more likely for reproductive versus nonreproductive visits (P ≤ 0.05). Emergency department HCPs were more likely to accept discussion (OR, 2.8) and sexually transmitted disease testing (OR, 3.1) than urgent care HCPs. Acceptance themes among adolescents were comfort with system/HCP, confidentiality concerns, and desire for good health; among parents, acceptance themes were identification as a safe place for disclosure and desire for adolescent good health and information; and among HCPs, these were relevance to chief complaint and perception of appropriate care.
  
  
  CONCLUSIONS
  In contrast to HCPs, adolescents and parents expressed broad support for sexual health discussion and testing, which may inform HCP practice to improve access to care.
authors.affiliation: Division of Emergency Medical Services, Children's Mercy Hospital, Kansas City, MO 64108, USA. mmiller@cmh.edu
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Miller
authors.forename: Laurie
authors.initials: L
authors.lastname: Hornberger
authors.forename: Ashley K
authors.initials: AK
authors.lastname: Sherman
authors.forename: M Denise
authors.initials: MD
authors.lastname: Dowd
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003219:Confidentiality; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009722:Nurse Practitioners / Q000523:psychology*; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D010372:Pediatrics; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011258:Pregnancy Tests / Q000523:psychology; D011368:Professional-Family Relations; D060728:Reproductive Health; D012650:Self Disclosure; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology; D014193:Trauma Centers / Q000458:organization & administration*; D055815:Young Adult