PolicyLab

To meet youth where they seek medical attention while addressing the urgent need for increased HIV prevention and treatment services, two multi-site studies will implement HIV screening in pediatric emergency departments: (1) Screen Smart and (2) Screen to Prevent (S2P). The studies share similar protocols and project leads, but they are conducted by different research networks at different sites. A key intervention in both studies is ScreenWell, an application designed and developed by the multi-site research teams and the CHOP Research IS Application Services team.

ScreenWell will send text messages with information about HIV PrEP to Screen Smart and S2P participants who opt in. In addition, each study site will have a PrEP navigator who will use ScreenWell to personally contact those participants and offer help with linking them to services.

ScreenWell Workflow

The workflow for Screen Smart and S2P will begin in the emergency department, where eligible patients will take a screening survey with behavior-based questions related to HIV risk. Based on participants’ responses, the survey will calculate whether they are eligible for PrEP. Eligible participants will also be asked about receiving educational resources via text message. Those who are interested need to provide a confidential phone number and consent to receiving text messages, and then they are enrolled in ScreenWell. On the backend, ScreenWell accomplishes the following:

1. Engages a chat-bot to text each enrolled participant PrEP resources, which include trustworthy websites and contact information for the site PrEP navigator.

2. Sends a notification to the site PrEP navigator so they may reach out to the newly enrolled participant.

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Screen Smart

Screen Smart is funded by an R01 award from The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and is part of the Pediatric Emergency Care Applied Research Network (PECARN). The study will be conducted at three pediatric emergency department sites: Children’s Hospital of Philadelphia, Nationwide Children’s Hospital, and Children’s Wisconsin – Milwaukee.

Over a period of 30 months, emergency department staff will implement universal opt-out HIV screening to patients ages 14–21 who present in the emergency department. Screen Smart will feature clinical decision support in the electronic medical record and integration with ScreenWell. During the first six months, Screen Smart will take an implementation science-based approach to improve uptake of the screening strategy at each of the three emergency department sites.

Screen to Prevent (S2P)

S2P is supported by a cooperative agreement as part of an NICHD UM2 award to the University of South Florida for the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). The five S2P sites include the pediatric emergency departments at University of South Florida, Johns Hopkins University, St. Jude Children’s Hospital, Emory Healthcare and Texas Children’s.

Staff at these sites will provide HIV screening for patients ages 14–24 who present in the emergency department using three distinct screening approaches: universal opt-out, universal opt-in, and targeted. The study will also feature clinical decision support in the electronic medical record and integration with ScreenWell.

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