Theme: Improving Access to Adolescent Health Care
Need
According to the National Alliance to Advance Adolescent Health, teens face serious, unaddressed health risks with lifelong consequences[1]. More than 70 percent of adolescent morbidity and mortality is associated with such behaviors as unsafe sex, violence, substance use, tobacco use, poor nutritional habits, inadequate physical activity, and injuries.[2] Rates of sexually transmitted infections (STIs) and unintended pregnancies among teens remain high, particularly among minority youth. Yet, despite these risks, adolescents tend to slip through the cracks of the health care delivery system. Gaps in adolescent health care are related to lack of access and appropriateness of services available in most communities.
Teens 12-18 years old are less likely to be insured than their younger counterparts. One-fifth of visits by teens to the ER in the Northeast Florida region from 2007-2009 were self-pay. Even within the current teen population on Florida KidCare, only 55.8 percent of adolescents 12 years and older had a comprehensive well-care visit over a year period[3]. Fear of disclosure may further discourage teens from seeking particular services, such as birth control, pregnancy testing and STI screening and treatment. Lack of transportation is also a barrier.
Research has shown that teens are more likely to use, and do better in, clinics that offer a comprehensive, interdisciplinary model of physical, behavioral, and reproductive health care that is explicitly designed to welcome adolescents and respond to their particular needs.[4]
Regional Scan
Health services specifically designed for teens are limited in Northeast Florida. The Nassau County Health Department offers one of the few teen health clinics in the region. Teen health services are available at PACE Center for Girls to program participants through the Duval County Health Department. The JASMYN clinic also offers STI screening and treatment for teens; efforts to establish a teen-focused clinic at the Magnolia Project on the schools’ early release day has met with limited success. There are no school-based health clinics in the region.
Best Practices
Mount Sinai Adolescent Health Center (NY), Wake Teen Medical Services (NC) and the Erie Teen Health Center (Chicago) offer best practice models of adolescent health care, according to the National Alliance. These clinics share the following characteristics: a comprehensive range of services under a single roof, many of which can be accessed in a single visit; a team approach to care; sensitive staff who enjoy and care about youth; a “teen friendly” environment; and, a focus on positive youth development.
Teen Xpress is a mobile health unit that provides free medical and mental health care for at-risk youth in select locations throughout Orange County, Florida. A team of specialized healthcare professionals provide help to uninsured and at-risk adolescents who might otherwise go without treatment. The van provides care at schools and community sites. It is restricted from providing contraception services on school grounds, however.[5]
Implementation Strategies
1. Develop at least one Adolescent Health clinic in each county.
2. Explore opportunities to develop mobile Teen Clinic.
3. Organize and implement targeted KidCare enrollment activities for teens.
4. Educate health professionals on handling adolescent health issues
5.
Potential Partners for Implementation
· Job Corps
· Area health departments and FQHCs
· Wolfson Children’s Hospital
· The Way Clinic
· The Bridge of NEF
· Other?
· Other?
· Other?
[1] Sandmaier, M., Bell, A., Fox, H. et al (2007). Under One Roof: Primary Care Models that Work for Adolescents. The National Alliance to Advance Adolescent Health Report No. 7. Accessed online at http://www.thenationalalliance.org/jan07/Report1.pdf.
[2] Ibid.
[3] Institute for Child Health Policy, September 2010 “Quality of Care: Health and Dental Plan Performance Measures, Health Plan Contract Year 2008-2009, Prepared for the Florida Healthy Kids Corporation.”
[4] Sandmaier, M. et al. op cit.
