Adolescence is characterized by social, physical, cognitive and emotional transitions. Developmental goals for teens include their becoming responsible and independent. While adolescents have many health issues and programs addressing them, one area of that is of growing interest is how adolescents interface with the medical care system. Most adolescents have access to healthcare and healthcare insurance (88% of teens are insured), however, they may have little experience or skill using healthcare effectively, especially those from disadvantaged backgrounds. Preventing disease and promoting health are integral part of current clinical primary care practice. In the proposed study we will partner with Health Net of California, a large health insurance corporation, to develop, implement, and assess an intervention to increase their adolescent patients'utilization of preventive care and decrease emergency services use. We will engage beneficiaries of public health insurance namely Medicaid (Medi-cal) and SCHIP (Healthy Families) clients whose health care is managed by Health Net. Our goal is to develop a health literacy training intervention to encourage adolescents aged 12 - 17 to utilize their health care plan more effectively, specifically to increase the rate at which they receive an annual Adolescent Well Care Visit. Additionally we will attempt to increase their level of engagement in their health care and their own health. We will use a randomized controlled trial to test the effectiveness of two different interventions, one a web based social media intervention and one that could be called 'usual care'. We will recruit an initial volunteer sample of 8000 Health Net patients out of 155,000 Medi-cal and Healthy Families teens they serve. We will conduct a 2 wave repeated measures survey to assess intervention impact on utilization patterns, health care system knowledge, positive encounters with their primary care provider, health information seeking, attitudes towards health care, and health behaviors. Data will also be collected from Health Net administrative data bases. Based on response rates and attrition we anticipate a final sample of 3478 participants distributed across the two study conditions (n= 1739 each) which are the treatment condition (social media) and control condition (usual care). Our goal is to enhance adolescent health literacy, increasing teens'capacity to access and use their insurance and the current health care system, so they can become empowered health consumers as they transition into adulthood.

Public Health Relevance

The goal of this study is to create and test innovative educational outreach materials using internet, social media and narrative story telling formats for adolescents aged 12-17 who are Medicaid (Medi-Cal) and SCHIP (Healthy Families) beneficiaries living in California whose care is managed by Health Net of California, to encourage their use of preventive care, decreased their use of emergency care, increase the quality of their healthcare encounters and increase their overall health literacy. This project builds on the finding that teens have many health issues;however, teens often lack experience using health insurance benefits appropriately. A secondary issue addressed is how to communicate with teens about these issues. In this project we will explore how newer digital media platforms popular with teens can be utilized for health promotion and at the same time testing their effectiveness.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
1R01HD059756-01
Application #
7559463
Study Section
Special Emphasis Panel (ZRG1-RPHB-B (50))
Program Officer
Haverkos, Lynne
Project Start
2009-09-20
Project End
2011-08-31
Budget Start
2009-09-20
Budget End
2010-08-31
Support Year
1
Fiscal Year
2009
Total Cost
$645,565
Indirect Cost
Name
University of California Los Angeles
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Massey, Philip; Prelip, Michael; Calimlim, Brian et al. (2013) Findings toward a multidimensional measure of adolescent health literacy. Am J Health Behav 37:342-50
Massey, Philip M; Prelip, Michael; Calimlim, Brian M et al. (2012) Contextualizing an expanded definition of health literacy among adolescents in the health care setting. Health Educ Res 27:961-74