Clinical trial NCT02244138: Improving Adolescent Health Outcomes Through Preventive Care Transformation
Official title: Improving Adolescent Health Outcomes Through Preventive Care Transformation
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Sexually Transmitted Diseases
Depression Diagnosis
Substance Use Disorders
Keywords: Adolescent
Screening
Primary Care
Computer Decision Support Systems
Lead sponsor: Indiana University
Sponsor class: OTHER
Collaborators: name: Agency for Healthcare Research and Quality (AHRQ)
First posted: 2014-09-18
Enrollment: 2831
Sex: ALL
Minimum age (years): 12
Maximum age (years): 21
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Adolescent from primary care clinics will be studied

Brief summary: 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.


Eligibility criteria: Inclusion Criteria:

* 11-21 years
* attending primary care clinic

Exclusion Criteria:

* none

Primary outcomes:
measure: sexually transmitted infection
timeFrame: 12 months
Secondary outcomes:
measure: depression
timeFrame: 12 months
Other outcomes:
measure: substance use
timeFrame: 12 months
Locations:
city: Indianapolis
country: United States
facility: Eskenazi Medical Group
state: Indiana
Study officials:
affiliation: Indiana University
name: matthew c aalsma, phd
role: PRINCIPAL_INVESTIGATOR
References:
citation: Aalsma M, Keys J, Ferrin S, Shan M, Garbuz T, Scott T, Adams Z, Hulvershorn L, Downs S. Adolescent suicide assessment and management in primary care. BMC Pediatr. 2022 Jul 2;22(1):389. doi: 10.1186/s12887-022-03454-4.
citation: Etter DJ, McCord A, Ouyang F, Gilbert AL, Williams RL, Hall JA, Tu W, Downs SM, Aalsma MC. Suicide Screening in Primary Care: Use of an Electronic Screener to Assess Suicidality and Improve Provider Follow-Up for Adolescents. J Adolesc Health. 2018 Feb;62(2):191-197. doi: 10.1016/j.jadohealth.2017.08.026. Epub 2017 Nov 28.
citation: Aalsma MC, Zerr AM, Etter DJ, Ouyang F, Gilbert AL, Williams RL, Hall JA, Downs SM. Physician Intervention to Positive Depression Screens Among Adolescents in Primary Care. J Adolesc Health. 2018 Feb;62(2):212-218. doi: 10.1016/j.jadohealth.2017.08.023. Epub 2017 Nov 23.