The Adolescent Champion Model: Primary Care Becomes Adolescent-Centered via Targeted Quality Improvement

J Pediatr. 2018 Feb;193:229-236.e1. doi: 10.1016/j.jpeds.2017.09.084. Epub 2017 Nov 29.

Abstract

Objective: To evaluate the effects of implementing the Adolescent Champion model, a novel quality improvement program targeted at helping primary care sites become more adolescent-centered.

Study design: Nine primary care sites from pediatrics, family medicine, and medicine-pediatrics implemented the Adolescent Champion model. Each site identified a multidisciplinary champion team to undergo training on adolescent-centered care, deliver prepackaged trainings to other staff and providers, make youth-friendly site changes, implement a standardized flow to confidentially screen for risky behaviors, and complete a quality improvement project regarding confidentiality practices. Adolescent patients, staff, and providers were surveyed at baseline, year-end, and 1-year follow-up to assess changes.

Results: Adolescent patients' experiences with both their provider and the site overall significantly improved (P values from <.0001 to .004, N = 474 baseline, 386 year-end). Staff perceived an improvement in clinic practices relating to adolescents and in their ability to make institutional and personal change (P < .0001, N = 121 baseline, 109 year-end). The majority of changes were sustained 1-year postintervention. Frequently noted site improvements included: (1) initiating a method to gather feedback from adolescent patients; (2) adding trainings on confidentiality, cultural humility, and using a nonjudgmental approach; (3) updating immunizations at every visit; and (4) training providers in long acting reversible contraception via implant training.

Conclusions: Implementing the Adolescent Champion model successfully helped primary care sites become more adolescent-centered. Further studies are needed to evaluate the effects of this model on patient outcomes.

Keywords: adolescence; adolescent-friendly; confidentiality; primary care; quality improvement; youth-friendly.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Health Services / standards*
  • Attitude to Health
  • Child
  • Delivery of Health Care / standards
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Patient Satisfaction / statistics & numerical data
  • Patient-Centered Care / methods*
  • Patient-Centered Care / standards
  • Physician-Patient Relations
  • Primary Health Care / methods
  • Primary Health Care / standards*
  • Program Evaluation / methods
  • Quality Improvement / statistics & numerical data*
  • Surveys and Questionnaires
  • Young Adult