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利用创新解决青少年和青年人群盆腔炎健康差异:技术增强社区卫生精准护理(TECH-PN)试验设计。

Using Innovation to Address Adolescent and Young Adult Health Disparities in Pelvic Inflammatory Disease: Design of the Technology Enhanced Community Health Precision Nursing (TECH-PN) Trial.

机构信息

Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.

Department of Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.

出版信息

J Infect Dis. 2021 Aug 16;224(12 Suppl 2):S145-S151. doi: 10.1093/infdis/jiab157.

Abstract

New approaches to pelvic inflammatory disease (PID) care among adolescents and young adults (AYAs) that optimize self-care and personalize treatment are warranted to address age and racial-ethnic PID-related health disparities. Here we describe the 13-month preliminary feasibility and acceptability outcomes of recruitment, retention, and intervention delivery for Technology Enhanced Community Health Precision Nursing (TECH-PN) randomized controlled trial. Urban AYAs 13-25 years assigned female sex at birth with acute mild-moderate PID provided baseline and follow-up interview data and vaginal specimens for sexually transmitted infection (STI), cytokine, and microbiota assessment. All participants received medications and text-messaging support. Participants were block randomized to either control or intervention. Control participants received 1 community nursing visit with self-management for interim care per national guidelines. Intervention participants received unlimited precision care services driven by interim STI and macrolide resistance testing results by an advanced practice provider. In the first 13 months, 75.2% patients were eligible, and 76.1% of eligible patients enrolled. Of the participants, 94% completed the intervention and 96%, 91%, and 89%, respectively, completed their 14-, 30-, and 90-day visits. Baseline laboratory results revealed infection rates that were highest for Mycoplasma genitalium (45%) followed by Chlamydia trachomatis (31%). Preliminary enrollment, STI, intervention delivery, and retention data demonstrate the feasibility and acceptability of the TECH-PN intervention and support rationale for precision care for PID among urban AYAs. ClinicalTrials.gov Identifier. NCT03828994.

摘要

新的盆腔炎(PID)治疗方法在青少年和年轻人(AYA)中得到了优化,以优化自我护理和个性化治疗,以解决年龄和种族相关的 PID 健康差距。在这里,我们描述了 Technology enhanced Community Health Precision Nursing(TECH-PN)随机对照试验的招募、保留和干预交付的 13 个月初步可行性和可接受性结果。13-25 岁的城市 AYA 出生时被分配为女性,患有急性轻度-中度 PID,提供基线和随访访谈数据以及阴道标本,用于性传播感染(STI)、细胞因子和微生物组评估。所有参与者均接受药物治疗和短信支持。参与者被分为对照组或干预组。对照组接受 1 次社区护理访问,并根据国家指南进行自我管理以进行中期护理。干预组接受由高级执业护士根据中期 STI 和大环内酯类药物耐药检测结果提供的无限精准护理服务。在最初的 13 个月中,75.2%的患者符合条件,76.1%的符合条件的患者入组。在这些参与者中,94%完成了干预,分别有 96%、91%和 89%完成了他们的 14 天、30 天和 90 天的访问。基线实验室结果显示,感染率最高的是支原体(45%),其次是沙眼衣原体(31%)。初步入组、STI、干预交付和保留数据表明,TECH-PN 干预措施具有可行性和可接受性,并支持针对城市 AYA 中 PID 进行精准护理的理由。ClinicalTrials.gov 标识符。NCT03828994。

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Infect Drug Resist. 2016 Aug 19;9:191-7. doi: 10.2147/IDR.S91260. eCollection 2016.

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