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一项针对青少年盆腔炎的简短行为干预随机对照试验的结果

Results of a randomized controlled trial of a brief behavioral intervention for pelvic inflammatory disease in adolescents.

作者信息

Trent Maria, Chung Shang-en, Burke Michael, Walker Allen, Ellen Jonathan M

机构信息

Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.

出版信息

J Pediatr Adolesc Gynecol. 2010 Apr;23(2):96-101. doi: 10.1016/j.jpag.2009.06.005. Epub 2009 Sep 3.

Abstract

OBJECTIVE

The objective of this research was to examine the effectiveness of a brief behavioral intervention, provided at the time of diagnosis of pelvic inflammatory disease, on subsequent behaviors by patients who were urban adolescents in a community in which sexually transmitted infection was prevalent.

METHODS

121 adolescents aged 15 to 21 years with mild to moderate pelvic inflammatory disease were enrolled in a randomized trial. All participants received standardized care, completed baseline audio computerized self-interviews, received full courses of medication at discharge, and were interviewed after the 2-week treatment course. The intervention group also watched a 6-minute intervention video.

MAIN OUTCOME MEASURES

Medication completion, temporary sexual abstinence during the 14-day treatment period, partner notification, partner treatment, and return for 72-hour follow-up were studied. Data were evaluated using multivariate regression analysis.

RESULTS

Of the participants, 61% were located and could participate in the 2-week interview by the disease intervention specialist. The intervention participants had higher rates of 72-hour follow-up (32% vs. 16%) and partner treatment (71% vs. 53%) in bivariate analyses at a P = 0.1 level. There were no differences in medication completion (66% vs. 66%), sexual abstinence (78% vs. 89%), or partner notification (88% vs. 92%). Only the partner-treatment finding persisted in multivariate models (AOR = 3.10; 95% CI, 1.03-9.39, P = .045).

CONCLUSIONS

Adolescent girls randomized to a community-specific video intervention at diagnosis of pelvic inflammatory disease were three times more likely to have their partners treated than those in the control group. Given the value of partner treatment in secondary prevention of sexually transmitted diseases, this video may be an essential component of discharge programming in urgent care settings. Additional structural supports may be necessary to facilitate improved adherence to other key adherence behaviors.

摘要

目的

本研究的目的是检验在盆腔炎诊断时提供的一种简短行为干预措施,对性传播感染流行社区中的城市青少年患者后续行为的有效性。

方法

121名年龄在15至21岁之间患有轻度至中度盆腔炎的青少年被纳入一项随机试验。所有参与者均接受标准化护理,完成基线音频计算机化自我访谈,出院时接受完整疗程的药物治疗,并在2周治疗疗程后接受访谈。干预组还观看了一段6分钟的干预视频。

主要结局指标

研究了药物治疗完成情况、14天治疗期内的暂时性性禁欲、性伴通知、性伴治疗以及72小时随访的返回情况。使用多变量回归分析对数据进行评估。

结果

在参与者中,61%被找到并能够由疾病干预专家参与2周访谈。在P = 0.1水平的双变量分析中,干预组参与者的72小时随访率(32%对16%)和性伴治疗率(71%对53%)更高。在药物治疗完成情况(66%对66%)、性禁欲(78%对89%)或性伴通知(88%对92%)方面没有差异。只有性伴治疗结果在多变量模型中仍然显著(调整后比值比 = 3.10;95%置信区间,1.03 - 9.39,P = 0.045)。

结论

在盆腔炎诊断时随机接受社区特定视频干预的青春期女孩,其性伴接受治疗的可能性是对照组的三倍。鉴于性伴治疗在性传播疾病二级预防中的价值,该视频可能是紧急护理环境中出院计划的重要组成部分。可能需要额外的结构支持来促进对其他关键依从行为的更好依从。

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