Increasing Adolescent Sexual Activity Screening Through a Provider-Based Intervention

Abstract

Screening for adolescent sexual activity is a vital aspect of comprehensive pediatric care. Adolescents engage in risky sexual behaviors. Thus, a complete and accurate sexual health history can assist in the prevention and treatment of disease, prevention of unwanted pregnancy, treatment of existing diseases, and optimal planning of future healthcare for adolescents. Current evidence shows that provider-focused strategies improve the delivery of preventive services, including sexual health screenings. In this initiative, we assessed and examined pre- and post-screening rates for sexual activity among adolescents by advanced practice providers. This multi-site initiative was implemented in four school-based health centers and a school-linked center that included 2,102 unique patients ages 9 to 24 years. Our biphasic intervention included education for advanced practice providers and electronic health record modifications. Pre- and post-data collection was conducted to determine changes in the rate of screening for sexual activity during a primary care adolescent health visit over a 3-year period. Data were collected via retrospective medical chart review and analyzed in three time periods for comparison from 2018 to 2021. Screening rates for sexual activity increased significantly after the intervention (all p < .001) with the likelihood more than double that of the year before it was implemented. The intervention was deemed to be a feasible and cost-effective strategy to improve the provider’s willingness and ability to provide more adolescent sexual health screenings.