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Improving Adolescent Health Risk Assessment

Title: Improving Adolescent Health Risk Assessment: A Multi-method Pilot Study.
Name(s): Thompson, Lindsay A, author
Wegman, Martin, author
Muller, Keith, author
Eddleton, Katie Z, author
Muszynski, Michael, author
Rathore, Mobeen, author
De Leon, Jessica, author
Shenkman, Elizabeth A, author
, author
Type of Resource: text
Genre: Journal Article
Date Issued: 2016-12-01
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description: Objectives Given poor compliance by providers with adolescent health risk assessment (HRA) in primary care, we describe the development and feasibility of using a health information technology (HIT)-enhanced HRA to improve the frequency of HRAs in diverse clinical settings, asking adolescents' recall of quality of care as a primary outcome. Methods We conducted focus groups and surveys with key stakeholders (Phase I) , including adolescents, clinic staff and providers to design and implement an intervention in a practice-based research network delivering private, comprehensive HRAs via tablet (Phase II). Providers and adolescents received geo-coded community resources according to individualized risks. Following the point-of-care implementation , we collected patient-reported outcomes using post-visit quality surveys (Phase III). Patient-reported outcomes from intervention and comparison clinics were analyzed using a mixed-model, fitted separately for each survey domain. Results Stakeholders agreed upon an HIT-enhanced HRA (Phase I). Twenty-two academic and community practices in north-central Florida then recruited 609 diverse adolescents (14-18 years) during primary care visits over 6 months; (mean patients enrolled = 28; median = 20; range 1-116; Phase II). Adolescents receiving the intervention later reported higher receipt of confidential/private care and counseling related to emotions and relationships (adjusted scores 0.42 vs 0.08 out of 1.0, p < .01; 0.85 vs 0.57, p < .001, respectively, Phase III) than those receiving usual care. Both are important quality indicators for adolescent well-child visits. Conclusions Stakeholder input was critical to the acceptability of the HIT-enhanced HRA. Patient recruitment data indicate that the intervention was feasible in a variety of clinical settings and the pilot evaluation data indicate that the intervention may improve adolescents' perceptions of high quality care.
Identifier: FSU_pmch_27406154 (IID), 10.1007/s10995-016-2070-5 (DOI), PMC5124035 (PMCID), 27406154 (RID), 27406154 (EID), 10.1007/s10995-016-2070-5 (PII)
Keywords: Adolescent health services, Counseling/standards, Health behavior, Health care surveys, Health information technology, Patient-reported outcomes, Practice-based research network, Preventive health services, Quality improvement
Grant Number: F30 MH105153, TL1 TR000066, UL1 TR000064, UL1 TR001427
Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at
Subject(s): Adolescent
Adolescent Health Services/standards
Focus Groups
Health Behavior
Health Care Surveys
Medical Informatics/methods
Middle Aged
Patient Reported Outcome Measures
Pilot Projects
Preventive Health Services/standards
Quality Improvement
Quality Indicators, Health Care
Risk Assessment/methods
Persistent Link to This Record:
Host Institution: FSU
Is Part Of: Maternal and child health journal.
Issue: iss. 12, vol. 20

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Thompson, L. A., Wegman, M., Muller, K., Eddleton, K. Z., Muszynski, M., Rathore, M., … Shenkman, E. A. (2016). Improving Adolescent Health Risk Assessment: A Multi-method Pilot Study. Maternal And Child Health Journal. Retrieved from