title: Development of a Sexual Health Screening Tool for Adolescent Emergency Department Patients.
abstract: The objective was to develop a content-valid audio computer-assisted self-interview (ACASI) sexual health survey (SHS) that is understandable and acceptable to adolescents and can be feasibly implemented in a pediatric emergency department (ED) for sexually transmitted infection (STI) risk assessment.
  
  
  
  Multistep iterative qualitative study utilizing a Delphi panel of key informants for survey development and content validity, cognitive interviews with end-users to evaluate understanding, and pilot testing with end-users to evaluate acceptability and feasibility.
  
  
  
  We developed a 20-item questionnaire through an iterative modified Delphi process with experts in adolescent and pediatric emergency medicine. All items were assessed as understandable by >90% of adolescents during the cognitive interviews. All respondents found the SHS easy to use. A total of 76.5% preferred answering questions related to sexual health through the SHS compared to face-to-face interviews. Mean (±SD) length of survey completion was 17.5 (±6.7) minutes and 88.6% of participants found survey length to be "just right." With respect to feasibility testing, there was no statistically significant difference in median ED LOS between those who piloted the SHS and those who did not (230.0 minutes vs. 219.0 minutes; p = 0.7).
  
  
  
  We developed a content-valid ACASI for the identification of adolescents at risk for STIs that was understandable, acceptable, and easy to use by adolescent patients and feasible for implementation in the pediatric ED. Future planned steps include the evaluation of the SHS in providing clinical decision support for targeted STI screening in the ED.
authors.affiliation: Children's National Health System, The George Washington University, Washington, DC.
authors.forename: Monika K
authors.initials: MK
authors.lastname: Goyal
authors.affiliation: The University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
authors.forename: Judy A
authors.initials: JA
authors.lastname: Shea
authors.affiliation: Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Katie L
authors.initials: KL
authors.lastname: Hayes
authors.affiliation: Children's National Health System, The George Washington University, Washington, DC.
authors.forename: Gia
authors.initials: G
authors.lastname: Badolato
authors.affiliation: Children's National Health System, The George Washington University, Washington, DC.
authors.forename: James M
authors.initials: JM
authors.lastname: Chamberlain
authors.affiliation: The University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.|Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Theoklis
authors.initials: T
authors.lastname: Zaoutis
authors.affiliation: The University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.|Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Joel
authors.initials: J
authors.lastname: Fein
mesh_terms: D000293:Adolescent; D003697:Delphi Technique; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys / Q000379:methods; D006801:Humans; D007407:Interviews as Topic; D008403:Mass Screening / Q000295:instrumentation*; D036301:Qualitative Research; D060728:Reproductive Health; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000175:diagnosis*