Too little attention is paid to improving the delivery of clinical preventive services to adolescents by addressing problems unique to that population, says a new study commissioned by Partnership for Prevention.
Most of the clinical preventive services that are recommended for adolescents also don't have good evidence to support their effectiveness, say authors of the study, which appears in the current online edition and the November print edition of the American Journal of Preventive Medicine.
The review article, "Clinical Preventive Services for Adolescents," is freely available to the public electronically at www.ajpm-online.net/article/S0749-3797(09)00490-5/abstract. It sheds light on the lack of attention that's been given to preventive health and wellness recommendations for adolescents between the ages of 11 and 17.
"We need to encourage both more clinical effectiveness research on clinical preventive services for adolescents and changes in the ways medical practices serving adolescents approach improving delivery rates," said Leif I. Solberg, MD, the study's chief author who is Associate Medical Director for Care Improvement Research, HealthPartners Medical Group.
"It's important that healthcare providers use every medical encounter, not just 'well-child visits,' which not all adolescents receive regularly, to address their clinical preventive services needs," Solberg said.
The study reviewed 28 counseling services and 31 screening services recommended by at least one of five national groups that issue comprehensive preventive care recommendations for teens. Only seven non-immunization services were given A or B recommendations from the U.S. Preventive Services Task Force (USPSTF), which uses a rigorous approach to assess the effectiveness of both the service itself and the benefits of delivering the service in a clinical setting. Those seven included cervical cancer (Pap test), Chlamydia (girls), depression, tobacco, and for persons at increased risk of gonorrhea, syphilis, and HIV.
Of the seven effective recommended services, five involve sexual health, including STIs (sexually transmitted infections) and cervical cancer (Pap test). Of this limited set of services, only Chlamydia screening and Pap tests are recommended for all sexually active young women and also have been judged to also be high value, according to the National Commission on Prevention Priorities.