Chernick Lauren S, Bugaighis Mona, Hochster Daniel, Daylor Victoria, Gorroochurn Prakash, Schnall Rebecca, Stockwell Melissa S, Bell David
Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Columbia University Medical Center, New York, New York; Department of Population and Family Health, Mailman School of Public Health, Columbia University Medical Center, New York, New York.
Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Columbia University Medical Center, New York, New York.
J Adolesc Health. 2025 Jan;76(1):140-147. doi: 10.1016/j.jadohealth.2024.08.020. Epub 2024 Oct 11.
To assess implementation outcomes and potential efficacy of a user-informed, theory-based digital health intervention developed to improve adolescent and young adult (AYA) male sexual health.
We conducted a pilot randomized controlled trial of sexually active male emergency department (ED) patients aged 14-21 years. Participants were randomized to the intervention (Dr. Eric, Emergency Room Interventions to improve Care) or usual care. Dr. Eric consists of an ED-based sexual health app followed by 3 months of interactive text messages. We assessed the feasibility, adoption, and fidelity among users. Condom use, defined as the number of sexual encounters with condoms divided by the total number of sexual encounters over the past 4 weeks, was the primary efficacy outcome.
We enrolled 119 patients; mean age was 17.9 years, 87% were Hispanic, and half used condoms at last intercourse. Dr. Eric demonstrated feasibility, with high rates of consent (86.2%) and follow-up (81.5%). Intervention participants found Dr. Eric acceptable, liking (86.2%) and recommending (87.9%) the program. 98% of intervention participants interacted with all five app modules; one-quarter opted out of text messaging. At 6-week follow-up, the intervention group more often used a condom compared to the control group [OR 3.57, 95% confidence interval (1.93, 6.60)], p < .001]; however, this significant difference did not sustain at 13 weeks.
Dr. Eric was feasible to deliver and acceptable to male AYA patients. To our knowledge, Dr. Eric is the first intervention to demonstrate evidence of short-term efficacy for improving condom use among male AYA in the ED.
评估一种基于理论且由用户参与设计的数字健康干预措施的实施效果及潜在疗效，该干预措施旨在改善青少年及青年男性（AYA）的性健康状况。
我们对年龄在14至21岁之间、有性行为的男性急诊科（ED）患者进行了一项试点随机对照试验。参与者被随机分为干预组（埃里克医生，即急诊科改善护理干预措施）或常规护理组。埃里克医生包括一款基于急诊科的性健康应用程序，随后会有为期3个月的互动短信。我们评估了用户的可行性、接受程度和依从性。避孕套使用情况定义为过去4周内使用避孕套的性接触次数除以性接触总次数，这是主要的疗效指标。
我们招募了119名患者；平均年龄为17.9岁，87%为西班牙裔，一半患者在最后一次性交时使用了避孕套。埃里克医生展示了可行性，同意参与率（86.2%）和随访率（81.5%）都很高。干预组参与者认为埃里克医生是可接受的，喜欢该项目的比例为86.2%，推荐该项目的比例为87.9%。98%的干预组参与者与所有五个应用程序模块进行了互动；四分之一的人选择退出短信服务。在6周的随访中，干预组比对照组更常使用避孕套[比值比（OR）3.57，95%置信区间（1.93，6.60）]，p <.001]；然而，这种显著差异在13周时并未持续。
埃里克医生实施起来是可行的，且为AYA男性患者所接受。据我们所知，埃里克医生是首个证明对改善急诊科AYA男性使用避孕套情况有短期疗效证据的干预措施。
