Improving Teen Care With Health IT (Washington)

Project Details - Ongoing

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Most of the causes of adolescent morbidity and mortality result from participation in health risk behaviors such as alcohol and other drug use, smoking, sexual activity without use of protection against pregnancy or sexually transmitted diseases, unhealthy eating patterns, and physical inactivity. These behaviors frequently begin during adolescence and then persist into adulthood, thereby also influencing adult health, disease, disability, health care burden, and premature death. In recognition of the impact of these behaviors on adolescent and adult health, professional practice guidelines from multiple organizations recommend that primary care providers (PCPs) screen for these behaviors and provide counseling aimed at prevention and risk reduction. Despite these recommendations, adolescents with health risk behaviors are under-identified in primary care settings and are seldom provided with risk reduction counseling or followup interventions.

To address this gap in recommended care, this project will develop and test a Web-based interactive Health Assessment (iHA) for implementation in primary care settings prior to adolescent health care visits. The iHA will be designed to: 1) conduct multi-risk screening; 2) provide personalized youth-focused prevention and risk reduction feedback; 3) summarize results, including youth-reported risk behaviors, goals, and consequences for PCPs, to stimulate patient-provider discussions; and 4) provide decision support for PCPs in determining the next appropriate steps in care. Personalized feedback, an innovative feature of this intervention, has demonstrated robust effectiveness in reducing risky drinking among young adults but has not yet been tested with adolescents or used in health care settings. Health areas covered by the iHA include alcohol, tobacco, and drug use; physical activity; diet; sexual health; and safety.

The specific aims of the project are as follows:

  • To optimize the iHA design and content for adolescents and PCPs. 
  • To develop implementation processes and training materials to facilitate the use of iHA. 
  • To examine the impact of iHA on primary care services. 
  • To examine the efficacy of iHA in reducing adolescent health risk behaviors. 

Development of an interactive health assessment can improve adolescent health care by assuring that the delivery of preventive feedback and early intervention strategies are employed following screening. This innovative approach will provide an essential foundation for broader dissemination of behavioral risk screening, brief interventions, and linkage to treatments when indicated.

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