MCH Best. NPM 10: Adolescent Well-Visit
Strategy. Support Clinic Systems in Promoting Attendance of Well-Visits
Approach. Provide information and guidance to actively schedule, code, and remind patients about the adolescent well-visit.
Overview. There is emerging evidence that supporting clinic systems to actively promote and document attendance of a well visit is effective. Specific strategies may include:
- Scheduling future well-visit when adolescents are in for a sick visit.
- Converting sports physicals to a well-visit through provision and documentation of well-visit services.
- Sending system reminders (e.g., emails/texts when adolescents are overdue for an annual visit).
Evidence. Emerging Evidence/Expert Opinion. There is emerging evidence on the effectiveness of using patient reminders and invitations to increase access to and utilization of adolescent well-visits.1-4 This strategy has been tested more than once and results trend positive overall. More research is needed for conclusive results. Access the peer-reviewed evidence through the MCH Digital Library. In addition, experts in the field have noted that supporting clinic systems is an effective method of increasing attendence. See webinar on emerging evidence (Read more about understanding evidence ratings).
Target Audience. Provider/System.
Outcome. Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.
Examples from the Field. Access descriptions of ESMs from across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.
The Role of Title V. Title V agencies can support schools that offer comprehensive bullying prevention programming:
- Increase access to public education for adolescents and thier caregivers.
- Increase health literacy among adolescents and their caregivers with regards to the importance of an adolescent well-visit.
Four states participated in a CDC CoIIN engaged youth and parents to create well-visit marketing messages and materials. Iowa received a grant from the American Academy of Pediatrics to promote well-visits at atheletic events; while Mississippi partnered with a SBHC to educate teachers, coaches, studetns, and clinic staff about the importance of adolescent well-visits. In addition the Adolescent and Young Adult Health National Resource Center created a poster for parents to be used in clinics to increase awareness.
Sample ESMs. Using the approach “Provide information and guidance to actively schedule, code, and remind patients about the adolescent well-visit,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):
Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).
1 Szilagyi, P.G., Gallivan, S., Albertin, C., Sandler, M., & Blumkin, A. Effectiveness of a citywide patient immunization program on improving adolescent immuninizations and preventive care visit rates. Arch Pediatr Adolesc Med. 2011;165(6):547-553.
2 Szilagyi, P.G., Schaffer, S., Barth, R., et al. Effect of telephone reminder/recall on adolescent immunization and preventive visits: results from a randomized clinical trial. Arch Pediatr Adolesc Med. 2006;160(2):157-163.
3 Knishkowy, B., Palti, H., Schein, M., Yaphe, J., Edman., R., Baras, M. Adolescent preventive health visits: a comparison of two invitation protocols. J Am Board Fam Pract. 2000;13(1):11-16.
4 Szilagyi, P.G., Albertin, C., Humiston, S.G., et al. A randomized trial of the effect of centralized reminder/recall on immunizations and preventive care visits for adolescents. Acad Pediatr. 2013;13(3): 204-213.