Sentinel cues

Sentinel Cue / Population / Contingencies / Objectives / Interventions
Pregnancy test request (clinic or nurse) / Girls under age 18 (“under-age”-for intercourse in Wisconsin)
When do we want to engage guardians of minor boys and girls? / Pregnancy desired –negative test / 1. Re-evaluate pregnancy as goal
2. Implement effective contraception if acceptable
3. Detect STDs
4. Treat STDs
5. Prevent STDs
6. Assess voluntary nature of sexual contact (do we want to specify actions for the following: girl under 16, partner 17 or over (felonious sexual assault); both partners under 16? These have special legal meaning, beyond the legal age for intercourse consent of age 18.)
7. Knowledge of emergency contraception options
Pregnancy not desired- negative test / 1. Implement effective contraception or abstinence
2. Detect STDs
3. Treat STDs
4. Prevent STDs
5. Assess voluntary nature of sexual contact (See underage pregnancy test)
6. Knowledge of emergency contraception options
Intended pregnancy – positive test / 1. Immediate enrollment in prenatal care and services
2. Initiate prenatal vitamins
3. STD measures if practical???
4. Assessment of voluntary nature of sexual contact (See underage pregnancy test)
Unintended pregnancy – positive test / 1. Counseling & referral for prenatal, abortion or adoption planning and care
2. STD measures if practical???
3. Assessment of voluntary nature of sexual contact (See underage pregnancy test)
Adult / Pregnancy desired – negative test / 1. Detect STDs
2. Treat STDs
3. Prevent STDs
Pregnancy not desired – negative test / 1. Implement effective contraception
2. Detect STDs
3. Treat STDs
4. Prevent STDs
5. Knowledge of emergency contraception options
Intended pregnancy – positive test / 1. Immediate enrollment in prenatal care and services
2. Initiate prenatal vitamins
3. STD measures if practical???
Unintended pregnancy – positive test / 1. Counseling & referral for prenatal, abortion or adoption planning and care
2. STD measures if practical???
Pregnancy test – store-bought / Girls and women / Unknown / 1. Learn of contraception availability
2. Learn of STD risks and prevention
3. Learn of STD testing and treatment options
4. Learn of options for abuse or rape
5. Knowledge of emergency contraception options
STD screening or diagnosis sought / Girls, boys under 18(“under-age”) / 1. Detect STDs
2. Treat STDs
3. Prevent STDs
4. Assess and reevaluate intention of pregnancy
5. Initiate abstinence or effective contraception as appropriate
5. Assess voluntary nature of sexual contact (See underage pregnancy test)
6. Knowledge of emergency contraception options
Adults / 1. Detect STDs
2. Treat STDs
3. Prevent STDs
4. Initiate abstinence or effective contraception as appropriate
5. Knowledge of emergency contraception options
Spontaneous or therapeutic abortion / Pregnant girls and women, sexual partners / Intended pregnancy / 1. Defer fertilization for XX months
2. Contraception if indicated
3. Detect STDs
4. Treat STDs
5. Prevent STDs
Pregnant girls and women, sexual partners / Unintended pregnancy / 1. Long-term prevention of unintended pregnancy
2. Detect STDs
3. Treat STDs
4. Prevent STDs
5. Knowledge of emergency contraception options
Suspected sexual abuse or rape / Girls or boys under 18 / 1. Establish safety
2. Detect pregnancy
3. Prevent pregnancy
3. Detect STDs
4. Treat STDs
5. Prevent STDs
6. Obtain legal evidence and notify authorities as appropriate
Suspected sexual abuse or rape / Adults / 1. Establish safety
2. Detect pregnancy
3. Prevent pregnancy
3. Detect STDs
4. Treat STDs
5. Prevent STDs
6. Obtain legal evidence and notify authorities as appropriate
Initiate prenatal care / All age women / 1. Diagnosis of STDs
2. Treatment of STDs
3. Prevention of STDs
4. Planning contraception after delivery
Post-partum hospitalization / All age women / 1. Prevention of STDs
2. Initiation of effective contraception
3. Knowledge of emergency contraception options
Post-partum clinic visit / 1. Diagnosis of STDs
2. Treatment of STDs
3. Prevention of STDs
4. Effective contraception
5. Knowledge of emergency contraception options
Diagnosis of STD / Girls or boys under 18 / 1. Treatment of STD
2. Diagnosis of other STDs
3. Partner identification and notification
4. Initiate abstinence or effective contraception as appropriate
5. Assess voluntary nature of sexual contact (See underage pregnancy test)
Adults / 1. Treatment of STD
2. Diagnosis of other STDs
3. Partner identification and notification
4. Effective contraception