Find Established Evidence

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): Health Insurance Coverage
Intervention Description: We performed a secondary data set analysis of the 2014 Medical Expenditure Panel Survey. Data are collected through interviews of caregivers of a nationally representative sample of the noninstitutionalized US population. We used descriptive analyses to examine use of health care according to age and gender, and visit types at which vaccines were given according to age.
Primary Outcomes: N/A
Conclusion: Fewer than half of adolescents receive preventive care, and many have no PCP visits. This reinforces the need to offer outreach to adolescents to improve rates of preventive visits, and to take advantage of all primary care visits for vaccinations. Because pediatricians and family practice/general practice physicians vaccinate most adolescents, these providers should remain the target audience for vaccine education and quality improvement activities.
Study Design: secondary data set analysis
Significant Findings: N/A
Setting: N/A
Data Source: 2014 Medical Expenditure Panel Survey
Sample Size: N/A
Age Range: Adolescents

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): Expanded Insurance Coverage, Collaboration with Local Agencies (Health Care Provider/Practice)
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): Assessment
Intervention Description: N/A
Primary Outcomes: This review has two aims: (1) to examine trends in key indicators in outcomes, behaviors, and health care over the past decade for U.S. adolescents and young adults; and (2) to compare U.S. adolescents and young adults on these indicators. The review also assesses sociodemographic differences in trends and current indicators. Guided by our aims, previous reviews, and national priorities, the present review identified 21 sources of nationally representative data to examine trends in 53 areas and comparisons of adolescents and young adults in 42 areas.
Conclusion: Most health and health care indicators have changed little over the past decade. Encouraging exceptions were found for adolescents and young adults in unintentional injury, assault, and tobacco use, and, for adolescents, in sexual/reproductive health. Trends in violence and chronic disease and related behaviors were mixed. Review of current indicators demonstrates that young adulthood continues to entail greater risk and worse outcomes than adolescence. Young adults fared worse on about two-thirds of the indicators examined. Differences among sociodemographic subgroups persisted for both trends and current indicators.
Study Design: Review
Significant Findings: N/A
Setting: N/A
Data Source: 21 sources of nationally representative data to examine trends in 53 areas and comparisons of adolescents and young adults in 42 areas
Sample Size: Review included 21 sources
Age Range: N/A

NPM: 10: Adolescent Well-Visit
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: The Life Course Health Development (LCHD) framework offers a new approach to health measurement, health system design, and long-term investment in health development and also suggests new directions for research. Perhaps the most important implication of the LCHD framework is the need to treat health development as a long-term investment. By underscoring the investment opportunity of early childhood, the LCHD framework shows how the health of the elderly is connected to the health of the young. Accordingly, rather than simply treating the consequences of decline in old age, promoting health from the beginning of life should improve health and well-being both at midlife and in later years while at the same time reducing the cost of treating degenerative diseases. As the genomics revolution begins, the LCHD model provides a developmentally oriented guide to health investment, health policy, and health research.
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 10: Adolescent Well-Visit
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): Access, Educational Material
Intervention Description: We review existing data on the effects of social determinants on health in adolescence, and present findings from country-level ecological analyses on the health of young people aged 10-24 years.
Primary Outcomes: N/A
Conclusion: The strongest determinants of adolescent health worldwide are structural factors such as national wealth, income inequality, and access to education. Furthermore, safe and supportive families, safe and supportive schools, together with positive and supportive peers are crucial to helping young people develop to their full potential and attain the best health in the transition to adulthood. Improving adolescent health worldwide requires improving young people's daily life with families and peers and in schools, addressing risk and protective factors in the social environment at a population level, and focusing on factors that are protective across various health outcomes. The most effective interventions are probably structural changes to improve access to education and employment for young people and to reduce the risk of transport-related injury.
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 10: Adolescent Well-Visit
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): Assessment, Data Collection System
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): Outreach (Provider), Policy/Guideline (State)
Intervention Description: Provisions of the Patient Protection and Affordable Care Act (ACA) of 2010 hold promise for improving access to and receipt of preventive services for adolescents and young adults (AYAs). The Title V Block Grant transformation also includes a focus on improving adolescent preventive care. This brief report describes and discusses an inquiry of promising strategies for improving access and preventive care delivery identified in selected high-performing states.
Primary Outcomes: N/A
Conclusion: This commentary identifies strategies and recommends areas for future action, as Title V programs and their partners focus on improving healthcare for AYAs as ACA implementation and the Title V transformation continues.
Study Design: Report
Significant Findings: N/A
Setting: California, Colorado, Illinois, Iowa, Oregon, Vermont, and Texas
Data Source: Two data sources were used to identify top-performing states in insurance enrollment and preventive care delivery: National Survey of Children's Health for adolescents (ages 12-17 years) and Behavioral Risk Factors Surveillance System for young adults (ages 18-25 years)
Sample Size: N/A
Age Range: 12-17 and 18-25

NPM: 10: Adolescent Well-Visit
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: Key trends include a decrease of white youth as a proportion of the adolescent population; a shift from African American to Hispanic /Latino youth as the most populous ethnic /racial group; and more ethnic /racial diversity among the adolescent population as compared to the US population.1'2 These changes have implications for training health care providers and for developing responsive systems of care. Ensuring adolescents' access to comprehensive health care is imperative, not only because it directly affects health but also because health behaviors adopted during adolescence are ultimately responsible for the leading causes of adult morbidity and mortality. In this article, we review what is known about the need to ensure access to clinical preventive services, the barriers to care for adolescents, and potential solutions.
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 10: Adolescent Well-Visit
Intervention Description: In this article, we review (1) opportunities for improving young adult preventive health care as a result of the Affordable Care Act; (2) findings from a recent article that identified and synthesized preventive service guidelines relevant to the young adult age group3 ; (3) a new young adult tool for clinicians developed by University of California, San Francisco’s (UCSF) National Adolescent & Young Adult Information Center (NAHIC) to facilitate the delivery of preventive services to young adults; and (4) lessons learned in implementing adolescent clinical preventive services that can inform improving young adult preventive care.
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): Reporting & Response System, Other Media
Intervention Description: We reviewed research regarding system- and visit-level strategies to enhance clinical preventive service delivery and quality for adolescents and young adults.
Primary Outcomes: N/A
Conclusion: Although results have been mixed, interventions have moved beyond increasing service delivery to demonstrating behavior change. Research on emerging technology-such as gaming platforms, mobile phone applications, and wearable devices-suggests opportunities to expand clinicians' reach; however, existing research is based on limited clinical settings and populations. Improved monitoring systems and further research are needed to examine preventive services facilitators and ensure that interventions are effective across the range of clinical settings where youth receive preventive care, across multiple populations, including young adults, and for more vulnerable populations with less access to quality care.
Study Design: Review
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 10: Adolescent Well-Visit
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Parent Engagement, PROVIDER/PRACTICE, Maintenance of Certification Credits, Provider Training/Education, Patient-Centered Medical Home, Quality Improvement/Practice-Wide Intervention
Study Design: Not specified
Setting: Not specified
Target Audience: Not specified
Data Source: Not specified
Sample Size: Not specified
Age Range: Not specified

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): Expanded Insurance Coverage, PAYER
Study Design: QE: non-equivalent control group
Significant Findings: Yes
Setting: Ten states: Alabama, California, Florida, Louisiana, Michigan, New York, Ohio, Texas, Utah, and Virginia
Target Audience: Youth ages 13 and older enrolled in CHIP for at least 12 consecutive months
Data Source: 2012 Congressionally Mandated Survey of CHIP and Medicaid Enrollees and Disenrollees
Sample Size: Established enrollees (n≈2345) Uninsured children (n≈381) N=children >13 years
Age Range: Not specified

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PAYER, Expanded Insurance Coverage
Study Design: QE: non-equivalent control group
Significant Findings: Yes
Setting: Ten states: Alabama, California, Florida, Louisiana, Michigan, New York, Ohio, Texas, Utah, and Virginia
Target Audience: Youth ages 13 and older enrolled in CHIP for at least 12 consecutive months
Data Source: 2013 Congressionally Mandated Survey of CHIP and Medicaid Enrollees and Disenrollees
Sample Size: Established enrollees (n≈2345) Uninsured children (n≈381) N=children >13 years
Age Range: Not specified

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PAYER, Expanded Insurance Coverage
Intervention Description: Objectives: To use Medical Expenditure Panel Survey data to determine (1) whether adolescent well visit rates increased from the pre-ACA period to post-ACA period, and (2) whether caregivers' reports of past-year preventive services delivery increased from the pre- to post-ACA period among adolescents with any past-year health care visit.
Conclusion: Despite modest to moderate increases, with greatest gains for underserved youth, adolescent preventive care rates remain low, highlighting the need for increased efforts to bring adolescents into well care and improve clinician delivery of preventive care within their practices.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: U.S.
Target Audience: Adolescents ages 10-17
Data Source: Medical Expenditure Panel Survey
Sample Size: Total (N=25,695)
Age Range: Not specified

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): Expanded Insurance Coverage, PAYER
Conclusion: We highlight some areas to target for future improvement, such as reducing the high levels of unmet needs among special-needs children and increasing preventive care, especially for Hispanic children.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: Florida, New York, Kansas
Target Audience: Children and adolescents ages 1-18 who had enrolled in CHIP between July 2000 and March 2001
Data Source: Interviews
Sample Size: Florida (n=918)4 N=adolescent ages 12-18 New York (n=2,290) N=all children ages 1-18 Kansas (n=434) N=all children ages 1-18
Age Range: Not specified

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Patient-Centered Medical Home
Intervention Description: To determine the association between enrollment in patient-centered medical homes (PCMHs) and the receipt of preventive services among adolescents and young adults.
Conclusion: Overall, patients enrolled in PCMHs had higher odds of receiving multiple preventive services.
Study Design: Retrospective cohort design
Significant Findings: Yes
Setting: Clinics in the Hennepin County Medical Center network in Minneapolis, Minnesota
Target Audience: Young adults ages 10-24
Data Source: Medical record review
Sample Size: Intervention (n=729) Control (n=20,975)
Age Range: Not specified

NPM: 10: Adolescent Well-Visit
Intervention Components (click on component to see a list of all articles that use that intervention): Assessment
Intervention Description: To measure the impact of the New York State (NYS) SCHIP on access, utilization, and quality of health services for enrolled children.
Primary Outcomes: Demographic and health measures (child and family characteristics, health status, presence of a special health care need, and prior health insurance), access (usual source of care [USC] and unmet needs for health care), utilization (visits for specific health services), and quality (continuity with USC and measures of primary care interactions). Analyses included bivariate tests, comparing the pre-SCHIP period to the 1-year period after enrollment in SCHIP. Multivariate models were computed to generate standardized populations comprised of key characteristics of the sample to test for differences in measures (after SCHIP versus before SCHIP), controlling for demographic characteristics.
Conclusion: Enrollment in the NYS SCHIP was associated with 1) improved access, continuity, and quality of care and 2) a change in the pattern of health care, with a greater proportion of care taking place within the usual source of primary care.
Study Design: For the study group, the design used pre/poststudy telephone interviews of parents of children enrolling in the NYS SCHIP, with baseline interviews soon after enrollment and follow-up interviews 1 year after enrollment. Baseline interviews reflected the child's experience during the 1-year period before enrollment in SCHIP. The follow-up interviews reflected the 1-year period after enrollment in SCHIP. For the comparison group, the design used baseline interviews of a comparison group enrolled 1 year after the study group to test for secular trends; these interviews reflected the 1-year period before enrollment in SCHIP.
Significant Findings: Yes
Setting: NYS, stratified into 4 regions. The NYS SCHIP is modeled on commercial insurance (32 managed care plans) and at the time of the study had 18% of SCHIP enrollees nationwide.
Data Source: N/A
Sample Size: 2644
Age Range: Children (n = 2644) 0 to 18 years of age who enrolled in the NYS SCHIP for the first time (November 2000 to March 2001), stratified by age (0-5, 6-11, and 12-18 years), race/ethnicity (white non-Hispanic, black non-Hispanic, and Hispanic; others excluded), and region of NYS. The comparison group consisted of 400 children. Telephone interviews were conducted in English or Spanish throughout the day and evening, 7 days per week, to obtain measures.