# Improving Adolescent Sexual Health Outcomes using Health Information Technology

> **NIH NIH R01** · CHILDREN'S RESEARCH INSTITUTE · 2024 · $695,471

## Abstract

Project Abstract
Adolescents account for nearly half of all new sexually transmitted infection (STI) cases annually, and of those,
non-Hispanic Black and Hispanic youth are disproportionately affected. These disparities are attributed, in part,
to differential access to and routine use of quality health care, including STI prevention and treatment. The
overarching goal of our research efforts are to improve adolescent sexual health outcomes and mitigate
disparities in STI rates by leveraging health information technology (HIT) in the emergency department (ED) to
enable detection and treatment of STIs through shared decision making. The objective of this proposal is to
scale and optimize our successful process in improving STI testing rates by leveraging HIT to: 1) seamlessly
integrate broad-scale targeted STI screening through the provision of real-time, electronic health record
embedded, clinical decision support (CDS) based on patient-reported STI-risk assessment into the normal ED
workflow to improve STI detection and 2) use mobile Health (mHealth) to improve STI treatment rates. Building
on our preliminary work, the specific aims are to: 1) use a human factors engineering approach to implement
and optimize a broad-scale computer-facilitated STI screening process into the clinical workflow of the ED; 2)
compare differences in STI detection rates between a sexual health screening (SHS)-derived electronic CDS
strategy versus usual care (no provision of CDS); and 3) compare differences in treatment adherence between
patients receiving text messages versus those receiving usual care (no text messages). Within the first aim, we
will use a human factors engineering approach to conduct workflow analyses which will inform the refinement
of implementation of an STI screening process into the clinical workflow of the ED. In the second aim, we will
conduct a pragmatic trial using an interrupted time series design to measure the impact of SHS-derived
electronic CDS on STI detection rates. In the third aim, we will conduct a randomized clinical trial, nested within
the pragmatic trial, to measure the impact of a two-way text-messaging intervention to improve treatment rates
through identifying and addressing barriers to STI treatment adherence. This innovative approach leverages
HIT to electronically integrate patient-reported sexual risk data to guide CDS and mHealth to improve
treatment adherence. We expect our contribution to help improve sexual health outcomes and reduce
disparities in the burden of STIs among at-risk, vulnerable adolescents by increasing STI detection and
treatment adherence. The proposed work is significant because it has the potential to improve the health of the
millions of adolescents who access EDs as their only source of healthcare and impact national policies related
to STI detection and treatment. In addition, this work can provide proof of concept for leveraging HIT to deliver
patient-centered care with shared decision making...

## Key facts

- **NIH application ID:** 10778530
- **Project number:** 5R01AI163232-03
- **Recipient organization:** CHILDREN'S RESEARCH INSTITUTE
- **Principal Investigator:** Monika Kumari Goyal
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $695,471
- **Award type:** 5
- **Project period:** 2022-02-01 → 2027-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10778530

## Citation

> US National Institutes of Health, RePORTER application 10778530, Improving Adolescent Sexual Health Outcomes using Health Information Technology (5R01AI163232-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10778530. Licensed CC0.

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