(132) Video-Assisted Strategy for Reducing Adolescent Anxiety in Gynecologic Care: A Quality Improvement Initiative

Background: Many pediatric and adolescent patients have anxiety about their experience and privacy prior to visiting the gynecologist for the first time, with previous studies identifying that these concerns may even prevent or delay care in adolescent patients. In recent years social media has also been shown to have significant negative influences on this population. The aim of this study is to develop an informational video to reduce patient anxiety, improve patient education, and improve outcomes for patients.

Methods: To date, the sample population consists of 12 patients ages 12-18 scheduled for new-patient appointments at Prisma Health’s pediatric gynecology office. In the exam room, subjects were consented and given a survey scoring baseline anxiety levels and social media usage before their appointment via tablet storing directly to RedCap and is IRB exempt. The subjects were then directed to watch a video, which provides a tour of the facility and an explanation of what to expect. After the video, the subjects once again filled out the survey. Outcome measures include anxiety levels before and after the video as well as specific concerns such as pelvic exams, male providers, and privacy. All responses were collected with a modified Wong-Baker scale using emojis with depictions of “not worried at all” to “totally freaking out.” The overall impact on subject anxiety was gauged by the average anxiety level measured across all questions. Detailed comparative and statistical analyses are to be performed using paired and unpaired t-tests.

Results: Of 21 subjects, 12 submitted valid responses to the survey, with 5 subject responses being incomplete. A dependent t-test for paired samples was then used to compare the average level of anxiety between pre and post video survey results. Preliminary results show a statistically significant difference between the pre- and post-survey anxiety levels with an overall reduction in anxiety from a mean of 2.6 ±0.9 to a mean of 2.1 ±0.7 respectively, a 19% drop in anxiety level (p value= 0.0346). Based on responses, patients were most concerned about a male provider (mean=3.2 ±1.2) and having a pelvic exam (mean=3.1±1.4). 42% of patients reported social media use in preparing for the appointment.
Data is anticipated to be collected through December 31, and final data analysis will be conducted.

Conclusions: A multifaceted approach is needed to ensure patient comfort at their first appointment. Early results indicate that addressing common concerns before the first appointment leads to a decrease in patient anxiety. Future studies are needed on this intervention’s impact on health outcomes.