Mixed-methods Evaluation of an Expedited Partner Therapy Take-home Medication Program: Pilot Emergency Department Intervention to Improve Sexual Health Equity.

Background: Treatment for partners of patients diagnosed with sexually transmitted infections (STI), referred to as expedited partner therapy (EPT), is infrequently used in the emergency department (ED). This was a pilot program to initiate and evaluate EPT through medication-in-hand ("take-home") kits or paper prescriptions. In this study we aimed to assess the frequency of EPT prescribing, the efficacy of a randomized best practice advisory (BPA) on the uptake, perceptions of emergency clinicians regarding the EPT pilot, and factors associated with EPT prescribing. Methods: We conducted this pilot study at an academic ED in the midwestern US between August-October 2021. The primary outcome of EPT prescription uptake and the BPA impact was measured via chart abstraction and analyzed through summary statistics and the Fisher exact test. We analyzed the secondary outcome of barriers and facilitators to program implementation through ED staff interviews (physicians, physician assistants, and nurses). We used a rapid qualitative assessment method for the analysis of the interviews. Results: During the study period, 52 ED patients were treated for chlamydia/gonorrhea, and EPT was offered to 25% (95% CI 15%-39%) of them. Expedited partner therapy was prescribed significantly more often (42% vs 8%; P < 0.01) when the interruptive pop-up alert BPA was shown compared to not shown. Barriers identified in the interviews included workflow constraints and knowledge of EPT availability. The BPA was viewed positively by the majority of participants. Conclusion: In this pilot EPT program, expedited partner therapy was provided to 25% of ED patients who appeared eligible to receive it. The interruptive pop-up alert BPA significantly increased EPT prescribing. Barriers identified to EPT prescribing should be the subject of future interventions to improve provision of EPT from the emergency department.

Exploring the Impact Factor: Medical Students Mentoring High School Students and Cultivating Cultural Humility.

Purpose: Diversity at all levels of medical training remains relatively stagnant, despite efforts to address equity in medical schools. Early career-specific mentoring may address barriers to the pursuit of medical education for students underrepresented in medicine (URiM). By surveying a program that engages medical students as drivers of career-specific mentorship for URiM high school students, this study evaluates medical student mentors' experiences mentoring and seeks to develop a mentorship curriculum. Methods: The authors describe a medical student-led pipeline program, which connects medical students with URiM high school students. Medical student mentors participated in focus groups and gave written responses evaluating reasons for involvement, sociocultural attitudes, and skills needed for mentoring. Thematic analysis was applied. Results: Themes that emerged in this analysis include motivation to mentor, skills used to approach the mentoring relationship, and benefits to the mentor. Mentors felt their experiences had a high impact factor, and they employed dynamic discovery. It provided personal reward and a deeper understanding of disparities. Conclusion: Bringing medical school mentors together for peer to peer idea sharing, creating communities of practice, will help these students develop effective mentorship skills. A curriculum based on appreciative inquiry of mentors' strengths will enrich idea sharing, fostering cultural humility and avoiding burnout. Medical students involved in this program believe they gained benefits, including improving their mentorship skills, expanding their cultural humility, increasing their comfort with caring for underserved populations, and improving their ability to recognize health disparities.