Chernick Lauren S, Adler Talia, De Souza Jaciara N, Franqui Christina N, Tchoungui Lisa-Pierre, Caselli Anna, Tyndell Ariel, Castilho Renato, Probst Marc A, Castor Delivette, Zucker Jason
From the Departments of Emergency Medicine.
Modus Agency, Purchase, New York.
Sex Transm Dis. 2025 Aug 1;52(8):462-469. doi: 10.1097/OLQ.0000000000002166. Epub 2025 Jun 4.
Adolescents and young adults (AYA) frequently use the emergency department (ED) and admit to infrequent contraceptive use, increasing their risk of sexually transmitted infections (STIs). This study aimed to design STI Check in the Emergency Room (STIckER), a user-informed digital patient decision aid aiming to increase shared decision making around genitourinary and extragenital STIs testing among AYA ED patients.
This 2-center study followed a multiphase approach. In phase 1, we defined our health condition, target audience, and health decision, and organized a multidisciplinary steering group. Through a series of design workshops, we created a low-fidelity prototype. In phase 2, we conducted semistructured interviews with AYA ED patients and ED health care providers to understand values and preferences around STI testing and decision-aid implementation. Interviews were recorded and analyzed using rapid qualitative analysis techniques. Data from interviews led to a final high-fidelity prototype.
Interviews with 19 AYA ED patients suggested interest in participating in the decision for STI testing and have emotions about getting results. Interviews with 15 ED health care providers highlighted that shared decision making matches clinical practice, interventions should not increase cognitive load, and sexual health interventions are more complex when parents are involved. Both groups were receptive to nonjudgmental sexual health interventions that promote privacy and eliminate testing stigma.
The STIckER decision aid was designed using an iterative process that involved user testing and integrating feedback, leading to a digital tool that could promote equitable STI testing built specifically for the complex ED setting.
青少年和青年(AYA)经常使用急诊科(ED),且承认避孕措施使用频率低,这增加了他们感染性传播感染(STI)的风险。本研究旨在设计“急诊室性传播感染检查”(STIckER),这是一种基于用户需求的数字患者决策辅助工具,旨在增强AYA急诊科患者在泌尿生殖系统和生殖器外性传播感染检测方面的共同决策。
这项双中心研究采用多阶段方法。在第一阶段,我们明确了健康状况、目标受众和健康决策,并组建了一个多学科指导小组。通过一系列设计研讨会,我们创建了一个低保真原型。在第二阶段,我们对AYA急诊科患者和急诊科医护人员进行了半结构化访谈,以了解他们在性传播感染检测和决策辅助工具实施方面的价值观和偏好。访谈进行了录音,并使用快速定性分析技术进行分析。访谈数据促成了最终的高保真原型。
对19名AYA急诊科患者的访谈表明,他们有兴趣参与性传播感染检测的决策,并对获取检测结果有情绪反应。对15名急诊科医护人员的访谈强调,共同决策与临床实践相匹配,干预措施不应增加认知负担,且当父母参与时,性健康干预会更加复杂。两组都接受促进隐私并消除检测污名的无歧视性健康干预措施。
STIckER决策辅助工具是通过一个迭代过程设计的,该过程包括用户测试和整合反馈,从而产生了一种数字工具,该工具可以促进专门为复杂的急诊科环境构建的公平性性传播感染检测。