title: Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?
abstract: We reviewed research regarding system- and visit-level strategies to enhance clinical preventive service delivery and quality for adolescents and young adults. Despite professional consensus on recommended services for adolescents, a strong evidence base for services for young adults, and improved financial access to services with the Affordable Care Act's provisions, receipt of preventive services remains suboptimal. Further research that builds off successful models of linking traditional and community clinics is needed to improve access to care for all youth. To optimize the clinical encounter, promising clinician-focused strategies to improve delivery of preventive services include screening and decision support tools, particularly when integrated into electronic medical record systems and supported by training and feedback. Although results have been mixed, interventions have moved beyond increasing service delivery to demonstrating behavior change. Research on emerging technology-such as gaming platforms, mobile phone applications, and wearable devices-suggests opportunities to expand clinicians' reach; however, existing research is based on limited clinical settings and populations. Improved monitoring systems and further research are needed to examine preventive services facilitators and ensure that interventions are effective across the range of clinical settings where youth receive preventive care, across multiple populations, including young adults, and for more vulnerable populations with less access to quality care.
authors.affiliation: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Sion K
authors.initials: SK
authors.lastname: Harris
authors.affiliation: Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Aalsma
authors.affiliation: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Elissa R
authors.initials: ER
authors.lastname: Weitzman
authors.affiliation: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Department of Family Medicine, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Diego
authors.initials: D
authors.lastname: Garcia-Huidobro
authors.affiliation: Division of Adolescent Medicine, University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Charlene
authors.initials: C
authors.lastname: Wong
authors.affiliation: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Hadland
authors.affiliation: Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York.
authors.forename: John
authors.initials: J
authors.lastname: Santelli
authors.affiliation: Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California.
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Park
authors.affiliation: Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California; Office of Diversity and Outreach, University of California, San Francisco, San Francisco, California. Electronic address: elizabeth.ozer@ucsf.edu.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Ozer
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D011314:Preventive Health Services / Q000379:methods*; D011320:Primary Health Care / Q000379:methods*; D012106:Research; D055815:Young Adult
keywords: Adolescents; Preventive services; Young adults