Improving Adolescent Health Outcomes Through Preventive Care Transformation

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.