Using the distress thermometer to guide electronic referrals to psychosocial services.

Purpose: Evaluate a new administration protocol of the distress thermometer (DT) and assess its use in guiding electronic referrals within the medical record.Design: Data were gathered as part of a quality improvement project.Sample: Any patient within Saint Luke's Cancer Institute from March of 2016 to December of 2017.Methods: The DT was administered at every appointment with surgical and medical oncology and on Mondays while completing radiation. A referral to supportive services was offered to any patient scoring a 4 or above.Findings: Referrals to all supportive services increased by 69%. Staff adherence to distress screening guidelines increased to 95.42% and patient refusal to accept referrals fell to 2.72%.Conclusion: Administering the DT on a more regular basis and utilizing the DT to guide electronic referrals is achievable and results in increased referrals to supportive services.Implications for psychosocial providers or policy: Utilizing the DT in this manner can increase the number of patients identified and treated for distress.

Comparisons of Contraceptive Use between Rural and Urban Teens.

STUDY OBJECTIVE: The purpose of the study was to determine if barriers in rural areas might decrease an adolescent's likelihood of obtaining effective contraception. Previous studies have reported mixed results in comparisons of rural and urban contraception use. DESIGN: Electronic survey. SETTING: Midwestern Public University. PARTICIPANTS: Undergraduate and graduate women. INTERVENTIONS: Questionnaire. MAIN OUTCOME MEASURES: Participants retrospectively recalled their contraceptive use and barriers to contraceptive use between the 9th and 12th grades. RESULTS: A Barriers to Contraception Use Scale was created using exploratory factor analysis and yielded 31 questions with 1 underlying factor: barriers. Participants were identified as rural or urban using the Office of Management and Budget (OMB) definition and the participant's self-identification. Overall, rural participants endorsed more barriers to accessing contraceptives than urban participants using the OMB definition (χ(2) (2; n = 388) = 2.04; P < .05), and self-identification (χ(2) (2; n = 398) = 2.37; P < .05). However, no differences were found in contraception use according to the OMB definition, t (380) = -1.90; P = .06, or self-identification, t (380) = -2.11; P > .05. The Barriers to Contraception Use Scale total score predicted whether an individual would have a prescription for contraceptives 70.5% of the time compared to the base rate of 54.1%. CONCLUSION: Although no rural-urban differences in actual contraception use were found, rural participants reported more barriers to accessing contraception, and those who endorsed more barriers were less likely to obtain contraceptives while in high school. Pregnancy prevention programs should thus take these barriers into account when developing future interventions.