Critical Access to Care: Bringing Contraception to Adolescents in Nontraditional Settings
Despite recent declines, the unintended pregnancy rate among US adolescents is among the highest for industrialized nations [1]. Many adolescents who seek care in emergency departments (EDs) are at high-risk of pregnancy, reporting early sexual debut, multiple partners, and infrequent condom use [[2], [3]]. For many, the ED may be their only contact with a health-care provider [4].
Therefore, this ED-based study by Chernick et al. is a welcome step toward the goal of reaching adolescents at risk of pregnancy in health-care settings where issues of sexual and reproductive health are not often addressed. Chernick et al. provide additional support to existing literature that cellular phone-based text messages are a feasible and acceptable format for providing adolescent females information on pregnancy prevention and contraception. Although other studies have used this technology with adolescents treated in EDs, the specific content was novel for this setting [[5], [6], [7]]. Of note, however, many participants did not complete clinic referral or initiate contraception—the desired outcomes of ED-based interventions in this area of work. Although the study was not powered to determine differences between treatment arms, it still provides some information about a long-standing question—is it possible to connect ED patients with clinic-based care?