Longitudinal Well-Visit Attendance & Preventive Care Receipt: Links to Longitudinal Health Promotion & Risk Behaviors from Mid-Adolescence to Young Adulthood

Adolescents and young adults (AYAs) engage in preventable behaviors that impact their health. Recognizing adolescence is an important time to improve health across the lifespan professional medical organizations recommend annual well-visits. Despite the promise of well-visits we know little about AYAs' longitudinal well-visit attendance and preventive care receipt from mid-adolescence through young adulthood during this critical transition between developmental periods let alone how longitudinal well-visit attendance and preventive care receipt relate to AYAs' health promotion and risk behaviors over time. This study is aligned with MCHB Strategic Research Issues #1 #3 #5 and #6. Goals/objectives: By the end of project Year 1 the goal of this secondary data analysis is to describe longitudinal well-visit attendance and preventive care receipt patterns from mid-adolescence to young adulthood associated longitudinal health promotion and risk behaviors and key factors from AYAs' background social determinants and health needs for explaining disparities in these associations. Our study's objectives are to for the first time 1) describe AYAs' longitudinal well-visit attendance and preventive care receipt patterns from mid-adolescence (age 15) to young adulthood (age 23) 2) identify key factors from AYAs' background social determinants and health needs for explaining disparities in these longitudinal well-visits patterns and 3) examine the longitudinal relationships between AYAs' well-visit attendance and preventive care receipt with involvement in health promotion and risk behaviors over time and identify key factors from their background social determinants and health needs for explaining disparities in these associations.

Proposed data sets and target populations:

We will use the NIH/MCHB-funded NEXT Generation Health Study data a nationally representative longitudinal cohort of 10th grade adolescents that began in 2010 and collected data for seven rounds through 2017 (age 23). At baseline the study consisted of 2 874 adolescents who were 55% female 20% Hispanic 18% African American 22% from low-affluent families and 42% living in the South with remainder living in West (26%) Northeast (17%) and Midwest (16%).

Products:

We will produce two peer-reviewed publications: Paper #1 will summarize results from study objectives #1 and #2 and Paper #2 results from study objective #3. We will disseminate findings to a broad range of audiences at local regional and national levels via professional conferences invited talks and to primary care providers parents AYAs insurers health systems consisting of but not limited to email messages newsletter articles conference presentations webcasts fact sheets infographics policy briefs and website and social media posts.

Evaluation:

We will conduct analyses using Latent Growth Mixture Models as outlined by our study objectives. The proposed study builds upon our research team's collaborative work over the past 4 years prior research with NEXT data and a structured mentoring approach for one junior faculty and one pre-doctoral student. We will use a continuous quality improvement model approach that will allow us to be effective and efficient in attaining the study's goals and objectives.