Improving adolescent health outcomes through preventive care transformation

项目摘要 对青少年的预防性护理对于最大限度地提高他们的健康和福祉至关重要[1]。 不幸的是，儿科初级保健经常不能满足青少年的预防需要，因为 这一人群糟糕的健康结果证明了这一点[2]。 在这次拨款申请中，我们建议将现有的CDSS扩展到我们的青少年初级保健实践中，以 实施全面的、适合发展的筛查和医生的目的 决策支持流程。我们课题组之前完成的工作已经证明了使用 CDSS实施和评估临床指南[5，6]。我们寻求积极影响 通过将这一先前的成功应用到我们的青少年实践中，预防性初级保健访问。我们假设 实施适合发育的普遍筛查做法，使用平板电脑技术， 和增强的医生决策支持，为所有年度青少年提供临床相关指南 预防性护理访问将带来更好的健康结果，包括更高的医生依从率 建议和改善患者的功能。 这一建议的具体研究目标是： 目标1：扩展和修改现有的CDSS，以包括青少年预防护理模块 包括适合11至21岁青少年的适合发育的筛查工具 以及为医生量身定做的循证临床决策支持。 目的2：评估青少年预防护理模块对识别青少年的影响 青少年初诊患者的特定心理和身体健康问题及治疗结果 医疗保健环境。 该项目关注的青少年初级保健问题包括性传播感染(STI)、 抑郁、药物使用和人乳头瘤病毒(HPV)免疫。我们希望这个项目能有所改进。 青少年的健康结果，指导未来在一个国家实施普遍筛查和CDSS 各种初级保健设置，并提供更多证据支持广泛的电子筛查 以及用于预防保健的计算机化决策支持，作为改善青少年健康的一种方法。 关键词：青少年；筛查；初级保健；计算机决策支持系统

Project Abstract Preventive care for adolescents is vitally important for maximizing their health and well-being[1]. Unfortunately, pediatric primary care frequently fails to meet the preventive needs of adolescents as demonstrated by poor health outcomes for this population [2]. In this grant application, we propose to expand an existing CDSS into our adolescent primary care practices for the purpose of implementing a comprehensive, and developmentally appropriate, screening and physician decision support process. Prior work completed by our research group has demonstrated the feasibility of using CDSS to implement and evaluate clinical guidelines [5, 6]. We seek to positively impact the effectiveness of preventative primary care visits by applying this previous success to our adolescent practice. We 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. We 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. Keywords: Adolescent; Screening; Primary Care; Computer Decision Support Systems