# Improving the Detection of STIs in the Pediatric Emergency Department: A Pragmatic Trial

> **NIH NIH R01** · CHILDREN'S RESEARCH INSTITUTE · 2021 · $614,068

## Abstract

Project Summary:
Sexually transmitted infections (STIs) are highly prevalent among adolescents. Despite established principles
for STI control, clinical practices related to screening and diagnosis, treatment, and prevention of STIs among
adolescents are suboptimal. There is an urgent need to expand our screening programs to nontraditional
healthcare settings such as emergency departments (ED) to reach those adolescents who would otherwise not
receive preventive healthcare, and to determine the most efficient and cost-effective method for providing this
screening. The goal of this application is to leverage our recent insights obtained from single center ED-based
adolescent gonorrhea and chlamydia screening research and apply them across a national pediatric ED
research network to determine the most clinically effective and cost-effective screening approach for
adolescents when implemented into a real-world clinical setting through a pragmatic trial. This will be
accomplished through a network of children’s hospital EDs with a track record of robust research collaboration
(Pediatric Emergency Care Applied Research Network or PECARN). This research will contribute to the
evidence base for creating clinically effective, cost-effective, and sustainable GC/CT screening programs that
can be successfully implemented into the clinical workflow of the ED. It will also improve diagnosis of
asymptomatic STIs and decrease the time interval to treatment, consequently decreasing reinfection rates of
transmission and the overall STI burden as well as decreasing healthcare costs. This intervention will rely on
an innovative approach that electronically integrates patient-reported data to guide clinical decision support.
This work is significant because it has the potential to shift current ED clinical practice paradigms from only
acute health encounters to participation in the broader management of public health, and it will fill gaps in the
literature needed to provide evidence for the best method of gonorrhea and chlamydia screening in an ED
setting. First, we will apply human factors modeling methods to perform ED workflow evaluations at each
participating pediatric ED to determine the most efficient way to integrate the screening process into everyday
clinical care. Following these analyses, we will conduct a comparative effectiveness pragmatic trial of targeted
STI screening (screening only those disclosing high risk sexual behavior) versus universally-offered STI
screening (offered to all, regardless of risk) through electronic integration of patient reported data for provision
of clinical decision support. We will then develop decision analytic models to evaluate the cost-effectiveness of
targeted screening compared to universally offered screening. This research is novel in that it shifts the usual
clinical practice paradigm in the ED from STI diagnosis in symptomatic adolescents to STI screening and
prevention, an approach that is critical to addressin...

## Key facts

- **NIH application ID:** 10242746
- **Project number:** 5R01HD094213-04
- **Recipient organization:** CHILDREN'S RESEARCH INSTITUTE
- **Principal Investigator:** Monika Kumari Goyal
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $614,068
- **Award type:** 5
- **Project period:** 2018-09-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10242746

## Citation

> US National Institutes of Health, RePORTER application 10242746, Improving the Detection of STIs in the Pediatric Emergency Department: A Pragmatic Trial (5R01HD094213-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10242746. Licensed CC0.

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