Female adolescents\u27 educational choices about reproductive health modules

Purpose: To assess girls\u27 reproductive educational choices, satisfaction with choice, and relationship between demographics, module choice, and satisfaction. Methods: We recruited 286 girls, aged 13 to 21 years, from a hospital-based adolescent clinic, from advertisements, and by word of mouth. At enrollment, participants completed a 60-minute computerized assessment. Those who were randomized to receive didactic counseling were asked to select which module they preferred to receive (abstinence, STD prevention or contraception) at enrollment. After the first counseling visit, participants rated their satisfaction with the counseling session on the computer. Results: At enrollment, 40.5% of the entire sample chose the contraception module, 34.3% chose the STD prevention module and 25.2% chose the abstinence module for their first counseling module. There were differences in module choice by age, STD and sexual history, but not by race or pregnancy history. Most were satisfied with the module; there were no differences in satisfaction by module choice. Conclusions: When allowed to choose the order of reproductive health modules, the majority of girls chose the contraception module first, followed by the STD prevention and abstinence modules. Age, sexual and STD history were associated with the module adolescents chose first. However, satisfaction was high regardless of which module was chosen. Given time limitations for counseling, health care providers and educators may consider age, sexual and STD history when choosing together with adolescents which reproductive health topics they wish to discuss first

Cognitive testing in older primary care patients: A cluster-randomized trial

INTRODUCTION: This study investigated whether neuropsychological testing in primary care (PC) offices altered physician-initiated interventions related to cognitive impairment (CI) or slowed the rate of CI progression. METHODS: This 24-month, cluster-randomized study included 11 community-based PC practices randomized to either treatment as usual (5 practices) or cognitive report (CR; 6 practices) arms. From 2005 to 2008, 533 patients aged ≥65 years and without a diagnosis of CI were recruited; 423 were retested 24 months after baseline. RESULTS: CR physicians were significantly more likely to order cognitive-related interventions (P = .02), document discussions about cognition (P = .003), and order blood tests to rule out reversible CI (P = .002). At follow-up, significantly more CR patients had a medication for cognition listed in their chart (P = .02). There was no difference in the rate of cognitive decline between the groups. DISCUSSION: Providing cognitive information to physicians resulted in higher rates of physician-initiated interventions for patients with CI