745 - Implementation of a Contraception Care Intervention in Pediatric Hospital-Based Psychiatry Settings

Poster Number: 745
Publication Number: 745.414

Samantha A. Herrmann, Nationwide Children's Hospital, Columbus, OH, United States; Elise Berlan, Nationwide Children's Hospital, Columbus, OH, United States; Charles Hardy, Nationwide Children's Hospital, Grove City, OH, United States; Kathryn Hyzak, The Ohio State University, Columbus, OH, United States; Anna J.. Kerlek, Nationwide Children's Hospital, Columbus, OH, United States; Ryan Bode, Nationwide Children's Hospital, Columbus, OH, United States; Stephanie M. Lauden, Children's Hospital Colorado, Denver, CO, United States; Christine A. Schmerge, Nationwide Children's Hospital, Columbus, OH, United States; Samuel W. Dudley, Ohio State University College of Medicine, Columbus, OH, United States; Michael F. Perry, Nationwide Children's Hospital, Pataskala, OH, United States; Alicia C. Bunger, The Ohio State University, Columbus, OH, United States

Background: Improving access to contraception care for adolescents with psychiatric disorders has potential to improve health outcomes, but interventions are underutilized.

Objective: Examine implementation (adoption, reach, and fidelity) of the Contraception Care at Behavioral Health Pavilion (CC@BHP) intervention for adolescents hospitalized with psychiatric disorders. 

Design/Methods: This prospective, observational study examined implementation of the CC@BHP intervention on four inpatient units (adolescent psychiatric unit, psychiatry boarders, Youth Crisis Stabilization Unit, and Psychiatric Crisis Department Extended Observation Suite). Pediatric hospital medicine and psychiatry providers were trained to deliver CC@BHP which included: assessing interest in contraception care, placing orders for contraception consultation, completing consultation, and ensuring follow up care. We examined implementation of CC@BHP between 12/1/2021 to 11/30/2022 among patients ≥14 years assigned female at birth admitted with psychiatric conditions. Data extracted from electronic health records were used to track adoption (% of eligible patients assessed for interest in contraception care), reach (% of eligible patients with consult ordered and % of eligible patients who received a consult), and fidelity to CC@BHP through direct observation. Barriers to incomplete consultations were assessed and used to identify solutions in real-time.

Results: 1375 patients were eligible for CC@BHP. Providers adopted the intervention with 320 (23%) eligible patients (i.e., documentation of screening for interest in contraception consultation, Fig. 1). In terms of reach, 237 (17%) eligible patients had a contraception consultation ordered and 203 (15%) received a contraception consultation. Adoption and reach increased during implementation (Fig. 2) and 86% of ordered consults were completed. Main reasons for incomplete consultations were lack of patient availability or discharged. All 25 fidelity observation sessions were assessed as satisfactory or excellent.

Conclusion(s): We successfully implemented CC@BHP on four pediatric hospital-based psychiatry units, demonstrating potential to improve access to contraception care for adolescents. Our results suggest a strong demand for contraception care among youth in this population. Newly trained providers can deliver high quality contraception care within this setting. Future research should identify specific implementation strategies that target gaps in the adoption and reach of CC@BHP and then scale to other hospital settings.