Adolescent Preventive Services Visits

The Maternal and Child Health Bureau (MCHB) Title V Maternal and Child Health Services Block Grants to States Program has established 15 National Performance Measures for the 2015-2017 grant cycle. Performance Measure 10 is the percent of adolescents, ages 12-17, with a preventive services visit in the past year. This evidence brief points to a selection of resources for state MCH programs about adolescent well visits, with emphasis on evidence-based information.

Significance

The Title V Maternal and Child Health Services Block Grant to States Program guidance1 defines the significance of this goal as follows:
Adolescence is a period of major physical, psychological, and social development. As adolescents move from childhood to adulthood, they assume individual responsibility for health habits, and those who have chronic health problems take on a greater role in managing those conditions. Initiation of risky behaviors is a critical health issue during adolescence, as adolescents try on adult roles and behaviors. Risky behaviors often initiated in adolescence include unsafe sexual activity, unsafe driving, and use of substances, including tobacco, alcohol, and illegal drugs.
Receiving health care services, including annual adolescent preventive well visits, helps adolescents adopt or maintain healthy habits and behaviors, avoid health?damaging behaviors, manage chronic conditions, and prevent disease. Receipt of services can help prepare adolescents to manage their health and health care as adults.
The Bright Futures guidelines recommend that adolescents have an annual checkup starting at age 11. The visit should cover a comprehensive set of preventive services, such as a physical examination, discussion of health?related behaviors, and immunizations. It recommends that the annual checkup include discussion of several health?related topics, including healthy eating, physical activity, substance use, sexual behavior, violence, and motor vehicle safety.

Read More about Performance Measure 10

Performance Measure 10

Percent of adolescents with a preventive services visit in the last year

Goal

To increase the number of adolescents who have a preventive services visit

Definition

Numerator: Parent report of adolescents, ages 12-17, with a preventive services visit in the past year from the survey [National Survey of Children's Health]

Denominator: Number of adolescents, ages 12-17 years

Units: 100

Text: Percent

Healthy People 2020 Objectives

Related to Adolescent Health (AH) Objective 1: Increase the proportion of adolescents who have had a wellness checkup in the past 12 months. (Baseline: 68.7%, Target: 75.6%)

Data Sources and Data Issues

The revised National Survey of Children's Health (NSCH) beginning in 2017. States can use data from the 2011-2012 NSCH as a baseline.

Data and Statistics

  • Data Resource Center for Child and Adolescent Health. Easy-to-use tools for searching and comparing data from the National Survey of Children's Health and National Survey of Children with Special Health Care Needs. For the most recent data on Performance Measure 7, view this chart. To find earlier data, use the Keyword Search box.
    emotional health of children ages 0-17. The website provides descriptions of the survey, questionnaires used in the survey, and datasets. It has been conducted in 2003, 2007, and 2011-2012.
    National Survey of Children with Special Health Care Needs. This survey assesses the prevalence and impact of special health care needs among children in the United States and evaluates change over time. It has been conducted in 2001, 2005-2006, and 2009-2010. After 2014 this survey will be combined with the National Survey of Children's Health.
  • Healthy People 2020: Adolescent Health. Lists objectives for adolescent health, links to evidence based interventions and resources; and national data that tracks the progress in meeting the objectives. Goal AH-1 refers to adolescent wellness checkups.

Key Websites

  • Bright Futures. Bright Futures is a national health promotion initiative dedicated to the principle that every child deserves to be healthy and that optimal health involves a trusting relationship between the health professional, the child, the family, and the community as partners in health practice. Launched by HRSA's Maternal and Child Health Bureau in 1990, the Bright Futures initiative is focused at the American Academy of Pediatrics and a collaborative of other federally- and State-funded Bright Futures projects, including Georgetown University and Family Voices. Bright Futures for Women's Health and Wellness has resources for adolescent girls and young women. Well-Child Care: A Bright Futures Curriculum for Pediatric Providers has an on-line curriculum, toolkit, downloadable family materials and links to other resources.
  • Bright Futures at American Academy of Pediatrics. Guidelines for health visits by age range (infancy, early childhood, middle childhood, and adolescence), information on implementing the Affordable Care Act pediatrics preventive services provision, 2014 periodicity chart for the content of preventive visits, and family resources.
  • Medicaid.gov: Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Program. This federal program provides comprehensive and preventive health care services for children under the age of 21 who are enrolled in Medicaid. EPSDT focuses on ensuring that children and adolescents receive appropriate preventive, dental, mental health, and developmental, and specialty services.
  • National Alliance to Advance Adolescent Health. The National Alliance to Advance Adolescent Health provides education, research, policy analysis, and technical assistance to achieve fundamental improvements in the way that adolescent health care is structured and delivered in the United States, with a focus on low-income and minority adolescents. They provide publications and a list of model programs that serve adolescents in a variety of settings. Also see Strengthening Preventive Care to Better Address Multiple Health Risks Among Adolescents (2010).

Policy Recommendations

Interventions

Further Reading

  • Abdus S, Selden TM. 2013. Adherence with recommended well-child visits has grown, but large gaps persist among various socioeconomic groups. Health Affairs (Millwood) 2013 Mar;32(3):508-15. View abstract.
  • Lau JS, Adams SH, Park MJ, Boscardin WJ, Irwin CE Jr. 2014. Improvement in preventive care of young adults after the Affordable Care Act: The Affordable Care Act is helping. JAMA Pediatrics epub ahead of print. View abstract.
  • Park MJ, Brindis CD, Vaughn B, Barry M, Guzman L, Berger A. 2013. Health care services. (Adolescent health highlight). Bethesda, MD: Child Trends.
  • Rickert VI, Gilbert AL, Aalsma MC. 2014. Proactive parents are assets to the health and well-being of teens. Journal of Pediatrics 164(6):1390-5. View abstract.
  • Smith KD, Merchen E, Turner CD, Vaught C, Fritz T, Mold J. 2010. Improving the rate and quality of Medicaid well child care exams in primary care practices. Journal of the Oklahoma State Medical Assocciation 103(7):248-53. View abstract.
  • Tsai Y, Zhou F, Wortley P, Shefer A, Stokley S. 2014. Trends and characteristics of preventive care visits among commercially insured adolescents, 2003-2010. Journal of Pediatrics 164(3):625-30. View abstract.
  • For additional articles see this PubMed automated search.

Related NCEMCH Resources

  • Adolescent Health resource brief
  • Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services in Medicaid knowledge path
  • Health and Wellness for Adolescent Girls and Women with Mental and Behavioral Health Conditions knowledge path


1Health Resources and Services Administration. 2014. Title V Maternal and Child Health Services Block Grant to States Program: Guidance and Forms for the Title V Application/Annual Report, Appendix F, p. 83.


Adolescent Preventive Services: Evidence Brief, 1st ed. (November 2014).

Author: Olivia K. Pickett, M.A., M.L.S., NCEMCH.