Improving Adolescent Health Outcomes Through Preventive Care Transformation

NCT02244138 | Completed

• 2 other identifiers: 1308038999R01HS022681
• Study Type: observational
• Target: 2,831
• Locations: 1 country
• Sites: 1

Brief Summary

Preventive care for adolescents is vitally important for maximizing their health and well-being. Unfortunately, pediatric primary care frequently fails to meet the preventive needs of adolescents as demonstrated by poor health outcomes for this population. In this grant application, the investigators propose to expand an existing computer decision support system (CDSS) into the investigators adolescent primary care practices for the purpose of implementing a comprehensive, and developmentally appropriate, screening and physician decision support process. Prior work completed by the investigators research group has demonstrated the feasibility of using CDSS to implement and evaluate clinical guidelines. The investigators seek to positively impact the effectiveness of preventative primary care visits by applying this previous success to the investigators adolescent practice. The investigators hypothesize that the implementation of developmentally appropriate universal screening practices, using tablet technology, and enhanced physician decision support regarding clinically relevant guidelines for all annual adolescent preventive care visits will result in better health outcomes, including higher rates of adherence to physician recommendations and improved patient functioning. The specific research aims of this proposal are: Aim 1: Expand and modify an existing CDSS to include an Adolescent Preventive Care Module comprised of developmentally appropriate screening tools for adolescents aged 11 to 21 years and tailored evidence-based clinical decision support for physicians. Aim 2: Evaluate the impact of the Adolescent Preventive Care Module on the identification of specific mental and physical health problems and treatment outcomes in an adolescent primary health care setting. Adolescent primary care issues of interest for this project include sexually transmitted infection (STI), depression, substance use and Human Papillomavirus (HPV) immunization. The investigators expect this project to improve the health outcomes of adolescents, guide future efforts to implement universal screening and CDSS in a variety of primary care settings, and provide additional evidence to support broad-based electronic screening and computerized decision support for use in preventive care as a method for improving adolescent health.

Conditions

Sexually Transmitted Diseases; Depression Diagnosis; Substance Use Disorders

Keywords

Adolescent; Screening; Primary Care; Computer Decision Support Systems

Outcome Measures

Primary Outcomes (1)

• sexually transmitted infection

  diagnosis of sexually transmitted infection by physician as indicated in electronic health record for patient

  12 months

Secondary Outcomes (1)

• depression

  12 months

Other Outcomes (1)

• substance use

  12 months

Study Arms (1)

Adolescent CDSS

Implementation clinic site for CDDS

Behavioral: Adolescent CDSS

Interventions

Adolescent CDSS BEHAVIORAL

computer decision support system (CDSS) for health care providers of adolescents in primary care

Adolescent CDSS

Eligibility Criteria

• Age: 12 Years - 21 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Adolescent from primary care clinics will be studied

You may qualify if:

• years
• attending primary care clinic

You may not qualify if:

• none

Sponsors & Collaborators

• Indiana University: lead
• Agency for Healthcare Research and Quality (AHRQ): collaborator

Study Sites (1)

Eskenazi Medical Group

Indianapolis, Indiana, 46203, United States

Location

Related Publications (3)

• Aalsma M, Keys J, Ferrin S, Shan M, Garbuz T, Scott T, Adams Z, Hulvershorn L, Downs S. Adolescent suicide assessment and management in primary care. BMC Pediatr. 2022 Jul 2;22(1):389. doi: 10.1186/s12887-022-03454-4.

  PMID: 35780090 DERIVED

• Etter DJ, McCord A, Ouyang F, Gilbert AL, Williams RL, Hall JA, Tu W, Downs SM, Aalsma MC. Suicide Screening in Primary Care: Use of an Electronic Screener to Assess Suicidality and Improve Provider Follow-Up for Adolescents. J Adolesc Health. 2018 Feb;62(2):191-197. doi: 10.1016/j.jadohealth.2017.08.026. Epub 2017 Nov 28.

  PMID: 29195764 DERIVED

• Aalsma MC, Zerr AM, Etter DJ, Ouyang F, Gilbert AL, Williams RL, Hall JA, Downs SM. Physician Intervention to Positive Depression Screens Among Adolescents in Primary Care. J Adolesc Health. 2018 Feb;62(2):212-218. doi: 10.1016/j.jadohealth.2017.08.023. Epub 2017 Nov 23.

  PMID: 29174939 DERIVED

MeSH Terms

Conditions

Sexually Transmitted Diseases; Substance-Related Disorders

Condition Hierarchy (Ancestors)

Communicable Diseases; Infections; Genital Diseases; Urogenital Diseases; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Chemically-Induced Disorders; Mental Disorders

Study Officials

• matthew c aalsma, phd

  Indiana University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: September 12, 2014
• First Posted: September 18, 2014
• Study Start: September 1, 2014
• Primary Completion: September 30, 2017
• Study Completion: September 30, 2017
• Last Updated: August 9, 2018

Record last verified: 2018-08

Locations

US (1)