The ASQ, RSQ, CSSRS, and HEADS-ED have been all been validated in the ED setting. Our initial search yielded 1336 studies in PubMed and 656 studies in Embase. The Newton Screen had better sensitivity for cannabis use and good specificity for both. Fifty-seven percent of female adolescents answered that adolescents should be offered contraception in the inpatient setting (no significant difference in response between self-reported sexually active and nonactive patients). A sexual health screening electronic tool was acceptable to patients and feasible in terms of workflow in the ED. Documentation of sexual activity screening of adolescents was low in both ED and hospital settings. A significant percentage of sexually active adolescents surveyed were potential candidates for EC. To help identify such patients, a cross-sectional study done to validate the RSQ in patients presenting to the ED revealed a clinically significant prevalence (5.7%) of SI in patients with nonpsychiatric chief complaints.46 However, another validation study revealed that in a low-risk, nonsymptomatic patient population, the RSQ had high false-positive rates. All rights reserved. Interview, primary question of interest (asked after standardized suicide screening): Do you think ER nurses should ask kids about suicide/thoughts about hurting themselveswhy or why not?. Adolescents reported interest in receiving education about sexual health topics, such as STIs, contraception, and HIV, in the ED. A significant proportion of adolescents who screened positive for elevated suicide risk in the ED were presenting for nonpsychiatric reasons. Similarly, in 2 qualitative studies by Ballard et al,52,53 90% to 96% of interviewed adolescents responded positively to SI screening in the ED. EC knowledge was poor among clinicians surveyed. Copyright 2023 American Academy of Pediatrics. PDF Getting into adolescent heads: An essential update - University of Arizona We acknowledge Evans Whitaker, MD, MLIS, for his assistance with the literature search. We found that although clinicians and patients are receptive to risk behavior screening and interventions in these settings, they also report several barriers.54 Clinicians are concerned that parents may object to screening; however, parents favor screening and intervention as long as their child is not in too much pain or distress.46 Clinicians additionally identify obstacles such as time constraints, lack of education or knowledge on the topic, and concerns about adolescent patients reactions.40,60,61 Additionally, adolescent patients report concerns around privacy and confidentiality of disclosed information.51. PDF The SSHADESS Screening: A Strength-Based Psychosocial Assessment The AAP has developed and published position statements with recommended public policy and clinical approaches to reduce the incidence of firearm injuries in children and adolescents and to reduce the effects of gun violence. PDF Oral Health Risk Assessment Tool - AAP Previous studies indicate low rates of risk behavior screening and interventions in ED and hospital settings. With the COVID-19 pandemic, this activity . No charts contained documentation on other important risk-stratifying details, such as contraception use other than condoms, the sex of partners, partners risk of STIs, anal sex practice, or partners drug use.27 None of these studies reported on whether privacy was ensured in sexual history taking, although they did mention the need for confidentiality as a possible barrier to higher rates of screening.2326, McFadden et al25 described sexual health services provided in the hospital setting and reported that STI testing was conducted in 12% of patients, that pregnancy testing was done in 60% of female patients, and that contraception was provided for 2% of patients. Youth who select no response are at elevated risk of SI and may warrant further screening and/or evaluation. However, lack of initial physician buy-in and administrative hurdles, such as funding for HPAs, training, and competition with other medical professionals (ie, social workers), made it difficult to transition this intervention into sustainable clinical practice.20 In 2 studies, researchers evaluated physician reminders to screen, including a home, education, activities, drugs, sexual activity, suicide and/or mood (HEADSS) stamp on paper medical charts and a distress response survey in the electronic health record (EHR). More prospective controlled studies are needed to evaluate such interventions in ED and hospital settings. Adolescents prefer in-person counseling and target education (related to their chief complaint). E-mail: Search for other works by this author on: Achieving quality health services for adolescents, Centers for Disease Control and Prevention, Opportunistic adolescent health assessment in the child protection unit, Does screening for and intervening with multiple health compromising behaviours and mental health disorders amongst young people attending primary care improve health outcomes? Dr Pfaff conceptualized and designed the study, conducted the literature search, screened literature for inclusion, extracted data from included studies, and drafted and edited the manuscript; Dr DaSilva helped in study design, conducted the literature search, screened literature for inclusion, extracted data, and helped with drafting the original manuscript; Dr Ozer helped in study design, editing and revising the manuscript, and critically appraising the manuscript content; Dr Kaiser supervised the conceptualization and design of the study, supervised the data extraction from the included literature, and helped in revising and editing the manuscript; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. h222W0Pw/+Q0,H/-K-0 = It's caused by a bump, blow or jolt to the head or by a hit to the body that causes the head and brain to move quickly back and forth inside the skull. 10.1542/peds.2020-020610. Although comprehensive risk behavior screens (eg, the American Academy of Pediatrics Bright Futures64 and HEADSS3,65) remain the gold standard, they have not been validated in the ED or hospital setting. To review studies of adolescent risk behavior screening and interventions in urgent care, emergency department (ED), and hospital settings. If your child is alert and responds to you, the head injury is mild and usually no tests or X-rays are needed. Details on risk level were frequently left out. Also, most studies had limited durations of follow-up, so we cannot comment on long-term effects. Similarly, in a hospital study of surgical adolescent patients by Wilson et al,19 the authors found that only 16% of patients were offered screening, and of these, 30% required interventions. Approximately 4% of younger adolescents (aged 1315; The AUDIT-10 may be a less useful tool in the younger adolescent population (1315) compared with the older adolescent population (1617) given the low rate of positive screen results in the younger group.
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