Adolescents in particular are much less likely to have an annual well-visit as recommended by the American Academy of Pediatrics' Bright Futures Guidelines, the American Medical Association's Guidelines for Adolescent Preventative Services, and the US Office of Disease Prevention and Health Promotion's Healthy People 2020 goals. Barriers to increasing the rate and effectiveness of adolescent well-visits are complex. Contributing factors range from the attitudes of the patient, to parents, to providers, as well as institutional biases of the medical profession. The majority of teens feel no need to see the doctor as long as they feel healthy.
Goal 1: Improve participation in adolescent well-care visits to 78 percent in order to meet the HP2020 goal. Objective 1.1: Select participating Community Health Centers. Objective 1.2: Form advisory board to include state agencies and CHC representatives. Objective 1.3: Create an outreach plan to increase participation in well-care visits by adolescents. Objective 1.4: Assess gaps in provision of teen-centered care at each participating CHC and re-design workflow to integrate best practices for teen-centered care. Objective 1.5: In project years two through five, continually re-measure attendance at adolescent well-care visits and modify interventions to maintain improvement. Goal 2: During the project period, improve the quality of the adolescent well-care visit using care team education, screening tools, and practice transformation. Objective 2.1: Engage the CHCs' care teams in using the Bright Futures protocols. Objective 2.2: Utilize CQI principles and incentives for improvements. Objective 2.3: Through Years 2 -- 5, continue to increase the number of CHC clinical sites that have implemented Bright Futures Guidelines.
The Nevada Primary Care Association (NVPCA) will provide training and technical assistance to Nevada's Community Health Centers (CHC), also known as FQHCs, with the goal of preparing these primary care clinics to implement comprehensive protocols for adolescent well-care visits, improve attendance at adolescent well-care visits, increase the health literacy of adolescents and their families, and support a healthy transition to adulthood.
Partners include NV State Title V, the NV American Academy of Pediatrics state chapter, and the NV Division of Health Care Financing and Policy.
The project will gather feedback from community education efforts, outreach activities, workflow optimization, and staff surveys. NVPCA will collect quantitative data from partner organizations through questionnaires and surveys. Qualitative data will include observations of service delivery activities and semi-structured interviews or focus groups with staff, adolescents, and/or families about outreach and care delivery. Qualitative data will also help identify perceptions and attitudes of patients and families about outreach, education, marketing, and the well-care visit process. Any youth participant asked to participate in planning, outreach or feedback, who is also a patient of the Health Center, will be asked to sign a release of information form. Thus, their patient health record data will be utilized anonymously to validate data collected during the course of intervention activities of the Community Health Center. Parental consent forms will be obtained, and the youth assent to the consent of the parent.