Increasing Delivery of Preventive Services to Adolescents and Young Adults: Does the Preventive Visit Help?

Abstract

Purpose: Despite decades of emphasizing the delivery of adolescent preventive care visits and evidence that many preventive services reduce risk, little evidence links preventive visits to increased preventive service delivery. This study examined whether a preventive healthcare visit versus any nonpreventive healthcare visit was associated with higher rates of adolescent and young adult preventive services.

Methods: Analyzed Medical Expenditure Panel Survey data (2013-2015) to determine whether those with a preventive versus nonpreventive healthcare visit had higher rates of past-year preventive services receipt; adolescents (N = 8,474, ages 10-17) and young adults (N = 5,732, ages 18-25). Bivariable and multivariable analyses adjusting for personal/sociodemographic covariates tested for differences in preventive services rates between preventive versus nonpreventive care groups. Adolescent services were blood pressure, height and weight measured, and all three measured; and guidance given regarding healthy eating, physical activity, seatbelts and helmets, secondhand smoke, dental care, all six topics received, and time alone with provider. Young adult services were blood pressure and cholesterol checked, received influenza immunization, and all three services received.

Results: All preventive services rates were significantly higher in those attending preventive visits versus those with nonpreventive visits. Adolescent services increase ranged from 7% to 19% and young adults increase from 9% to 14% (all bivariable and multivariable analyses, p < .001). However, most rates were low overall.

Conclusions: Higher rates of preventive services associated with preventive visits support its clinical care value. However, low preventive services rates overall highlight necessary increased efforts to promote preventive care and improve the provider delivery of prevention for both age groups.

Keywords: Adolescents; Preventive services; Preventive visit; Young adults.