Most adolescents visit a health care provider once a year, providing an ideal opportunity to integrate behavioral/emotional health screening into clinical care. Yet despite clinical guidelines, providers screen adolescents for risky health behaviors and depression at rates consistently lower than recommended. New strategies are needed to increase behavioral health screening in primary care. Health information technology, with clinical decision support (CDS) has tremendous potential to improve health care quality and subsequent behavioral health outcomes for adolescents. Although the majority of adolescent health problems are amenable to behavioral intervention, and most adolescents are comfortable using interactive computerized technology, few health information technology interventions have been integrated into adolescent care. The proposed project primarily addresses the research area of Health IT to improve health care decision-making, specifically the development and implementation of health information tools into the primary care setting. A secondary research area is focused on Health IT to support patient-centered care. The major goals of this exploratory project are 1) to develop a theoretically based interactive behavioral/emotional health module for adolescents that can be integrated into health care delivery, serving both as a risk assessment and an intervention tool to enhance adolescent behavior change;and 2) to pilot the implementation of the computerized module/screening system into adolescent primary care, assessing clinician, adolescent, and system outcomes. The study will be conducted within the San Francisco Bay Collaborative Research Network (CRN) through the University of California, S.F. (UCSF). From these ethnically and economically diverse clinics, a sample of adolescents, ages 12 to18 years, will be recruited to participate in all phases of the research. Phase 1 (Year 1) will focus on developing a computerized behavioral/emotional health module that is acceptable to teenagers and to health professionals who care for them in primary care settings. Phase 2 (Year 2) will focus on implementing the module into two primary care clinics serving large numbers of diverse adolescent patients. Multiple approaches and data sources will be utilized to conduct quantitative and qualitative analyses on each of the outcomes of interest. The exploratory R21 provides an ideal opportunity to understand how the proposed intervention addresses the diverse needs of teenagers, inform us about contextual factors that contribute to quality of implementation in varied clinic contexts, and inform strategies for adaptation and integration in larger scale IT implementation.

Public Health Relevance

New strategies are needed to increase the screening of adolescents for risky health behaviors and depression when they visit their primary care provider. Health information technology, with clinical decision support (CDS) has tremendous potential to improve health care quality and subsequent behavioral health outcomes for adolescents. The major goals of this exploratory project are 1) to develop a theoretically based interactive behavioral/emotional health module for adolescents that can be integrated into health care delivery, serving both as a risk assessment and an intervention tool to enhance adolescent behavior change;and 2) to pilot the implementation of the computerized module/screening system into adolescent primary care, assessing clinician, adolescent, and system outcomes.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21HS020997-02
Application #
8323058
Study Section
Health Care Technology and Decision Science (HTDS)
Program Officer
Nunley, Angela
Project Start
2011-09-01
Project End
2013-08-31
Budget Start
2012-09-01
Budget End
2013-08-31
Support Year
2
Fiscal Year
2012
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Pediatrics
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Lau, Josephine S; Adams, Sally H; Irwin Jr, Charles E et al. (2013) Receipt of preventive health services in young adults. J Adolesc Health 52:42-9