New Directions to Improve Preventive Care Discussions for Adolescents and Young Adults.

Abstract

The passage of the Affordable Care Act reduced financial barriers to preventive care,1 and the development of adolescent vaccines prompts patients to visit their primary care providers more frequently.2 This provides a rich opportunity to improve the delivery of adolescent preventive services. In this month’s Pediatrics , Santelli et al3 report findings from a national survey of adolescents and young adults about discussing potentially sensitive topics with medical providers during primary care visits. Notably, private time with providers, explanation of confidentiality, and risk-factor screening were associated with discussing more topics during these visits. Collectively, these findings provide important direction for efforts to improve the delivery of adolescent preventive care. Advances in primary care management of chronic conditions, preventive care for young children, and quality improvement science over the past 2 decades inform how best to implement these elements of primary care. Changing office systems to promote consistent screening, private time with providers, and confidentiality policies can be done through changing office culture, assigning new roles to office staff, working in teams, and measuring performance. … Address correspondence to Jeanne Van Cleave, MD, Department of Pediatrics, University of Colorado, 13199 E. Montview Blvd, Suite 300, Aurora, CO 80045. E-mail: jeannemarie.vancleave{at}childrenscolorado.org