1. Adolescent Well-Visit Strategies and Evidence-informed Strategy Measures Charles E. Irwin, Jr., M.D. AYAH-NRC Project Director University of California, San Francisco May 16, 2016

2. Introducing: The Adolescent and Young Adult Health National Resource Center Purpose: To improve adolescent and young adult health and address their health issues by strengthening the capacity of State Title V MCH Programs and their public health and clinical partners to better serve these populations (ages 10-25) Four-year cooperative agreement supported by MCHB (2014 - 2018) http://nahic.ucsf.edu/resources/resource_center/

3. University of California San Francisco University of Minnesota University of Vermont

4. The Center’s Approach to National Performance Measure #10 Three National Strategies 1. Improve access & uptake of preventive services 2. Improve the quality of preventive services 3. Improve state/systems-level policies & practices to assure access to high-quality preventive services Strategies 1 and 3 are directly related to NPM-10 List of possible strategies available here: http://nahic.ucsf.edu/ayah-coiin-nst/

5. National Strategy 1: Improve access & uptake of preventive services ActivityMeasure Improve education/marketing about the value of the preventive visit in partnership with stakeholders (e.g., schools; counties; professional or parent organizations) 1.# of public service advertisements/marketing campaigns disseminated 2.# stakeholders implementing campaigns 3.# of hits to campaign website or hotline calls for more information 4.Measure pre/post-implementation awareness of importance of annual visit Collaborate with Federally Qualified Health Centers, School-based Health Centers, and other clinical delivery systems to assure optimal utilization. 1.#/% of practices within each system that have implemented a practice-wide reminder system 2.#/% of clinical delivery systems that participate in programs to increase the rate of adolescent well-visits (e.g. movie ticket incentives, “back-to school” promotions) Each stakeholder may be able to monitor improvement in awareness and/or utilization over time (pre-post activity implementation) in PDSA cycles

6. National Strategy 2: Improve the quality of preventive services (may be secondary strategies/ESMs) ActivityMeasure Strengthen clinic policies & practices to support AYA- centered care 1.# of clinics assessing policies and practices related to AYA-centered care (examples: scheduling same-day appointments; provision of time alone during visit) 2.# of clinics changing policies and/or practices related to AYA-centered Care, based on assessment 3.# of clinics educating families and providers about changes in clinical policies and practices Train clinicians & staff to strengthen capacity to provide AYA-centered care 1.Develop and implement training on AYA-centered Care 2.# clinician trainings conducted 3.# trained clinicians reporting changing practice

7. National Strategy 3: Improve state/systems -level policies and practices ActivityMeasure Collaborate with state-level programs and professional clinical organizations to strengthen policies & practices to support receipt of AYA-centered preventive care 1.# of partnerships developed between state Title V Programs and state-level programs (e.g., Medicaid) and/or professional organizations (e.g., American Academy of Pediatrics), with specific activities (e.g., clinician training; promotion of well visit) 2.# activities implemented, as defined by partnership Collaborate with state agencies serving youth in foster care to increase receipt of preventive care among youth in foster care 1.Assist foster care agencies in developing systems to assist foster care families to schedule annual preventive visit for their youth in foster care 2.# agencies that implement monitoring systems for tracking preventive visits received by youth

8. Stay Tuned for Additional Strategies and Measures from Strengthen the Evidence for MCH Programs Initiative Johns Hopkins University See: http://semch.org/uploads/3/4/9/4/34942022/sample_strategies_and_esms_040116.pdf.