Adolescent Health Literacy: Improving Use of Preventive Health Services

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Adolescence is characterized by social, physical, cognitive and emotional transitions. Developmental goals for teens include their becoming responsible and independent. While adolescents have many health issues and programs addressing them, one area of that is of growing interest is how adolescents interface with the medical care system. Most adolescents have access to healthcare and healthcare insurance (88% of teens are insured), however, they may have little experience or skill using healthcare effectively, especially those from disadvantaged backgrounds. Preventing disease and promoting health are integral part of current clinical primary care practice. In the proposed study we will partner with Health Net of California, a large health insurance corporation, to develop, implement, and assess an intervention to increase their adolescent patients’ utilization of preventive care and decrease emergency services use. We will engage beneficiaries of public health insurance namely Medicaid (Medi-cal) and SCHIP (Healthy Families) clients whose health care is managed by Health Net. Our goal is to develop a health literacy training intervention to encourage adolescents aged 12 – 17 to utilize their health care plan more effectively, specifically to increase the rate at which they receive an annual Adolescent Well Care Visit. Additionally we will attempt to increase their level of engagement in their health care and their own health. We will use a randomized controlled trial to test the effectiveness of two different interventions, one a web based social media intervention and one that could be called ‘usual care’. We will recruit an initial volunteer sample of 8000 Health Net patients out of 155,000 Medi-cal and Healthy Families teens they serve. We will conduct a 2 wave repeated measures survey to assess intervention impact on utilization patterns, health care system knowledge, positive encounters with their primary care provider, health information seeking, attitudes towards health care, and health behaviors. Data will also be collected from Health Net administrative data bases. Based on response rates and attrition we anticipate a final sample of 3478 participants distributed across the two study conditions (n= 1739 each) which are the treatment condition (social media) and control condition (usual care). Our goal is to enhance adolescent health literacy, increasing teens’ capacity to access and use their insurance and the current health care system, so they can become empowered health consumers as they transition into adulthood.