2020 Plan: Adolescent Well Care
National Performance measure (#10):
Percent of adolescents with a preventative medical visit in the last year.
High quality, confidential, preventive health services for adolescents.
Planned strategies, ESMs, and activities for October 2019 – September 2020
A logic model containing the full menu of Oregon’s local level adolescent well-visit strategies, sample activities and measures can be found in Supporting Document #4. The logic model represents all the evidence based/informed strategies that Oregon’s Title V grantees may work on during the 2016-2020 Title V grant cycle. The plan that follows details strategies, activities and measures selected for implementation during the 2020 grant year at both the state and local levels. A table outlining which local grantees are implementing different well woman care strategies is included in Supporting Document 4.
ESM 10.1: Number of health professionals trained on adolescent well-visits, i.e. number of health professionals who attend trainings or informational presentations on the promotion of youth friendly services (through trainings on positive youth development, confidentiality and privacy, and population health data on youth.)
Activities – State Level
- Update the Adolescent Snapshot with data on positive youth development, adverse childhood experiences, and other measures of health and well-being from 2019 Oregon Health Teens Survey and tie data to the importance of the adolescent well-visit and programs that support youth resiliency such as youth participatory action research. Continue to use data presentations to highlight the importance of evidence-based well-visits in screening and providing strengths-based anticipatory guidance. Target: one presentation per month for a total of 12 presentations starting October 2019.
- Work with educators and the Oregon Department of Education to ensure that school districts and schools have the data, resources, and personnel they need to promote, refer, and/or deliver adolescent preventive care (including mental and reproductive health care). Ongoing throughout the grant cycle.
- Create a stakeholder advisory committee for the Oregon Adolescent and School Health Unit (including Title V Adolescent Health priority area). Use Title V Needs Assessment to identify members for said advisory committee by September 2020.
- Continue to gather information from youth and educators to inform youth health surveys, make them more relevant, and to improve surveillance of adolescent health issues--ongoing throughout grant period
- Support the seven local public health authorities (North Central Public Health District and Clackamas, Curry, Harney, Marion, Morrow, and Umatilla County) that selected Adolescent Well-Visit as their priority measure for coming year--ongoing throughout grant period.
- Promote adolescent well-visits using social media messages--ongoing throughout the grant period.
Activities – State Level
- Evaluate effectiveness of the Youth Participatory Action Research (YPAR), a youth engagement strategy in which youth lead an action-oriented research project. Oregon has five counties who are supporting youth advisory councils to do YPAR. Continue to provide technical assistance to these sites throughout the grant period.
- Encourage, promote, and provide technical assistance for the proliferation of youth advisory councils, including the seven local public health authorities. Ongoing throughout grant period.
Strategy: Promote practice of going beyond sports physicals. (State and local Level)
ESM 10.2: Train and inform health professionals to promote the practice of going beyond sports physical (Oregon Sports Pre-Participation Examination or PPE) and to complete or refer an adolescent well-visit.
Activities – State Level
- Oregon School Activities Association (OSAA), Public Health Division, Transformation Center, Health System partners will continue to distribute joint adolescent well-visit and PPE comparison document to School-Based Health Centers, athletic departments, CCOs, and local partners. Ongoing throughout grant period.
- Support five counties as they work to promote the adolescent well-visit over the sports physical. Provide well-visit/sports physical document. Ongoing throughout grant period.
Activities – Local Level
- Curry County will continue to offer sports physicals at the local school-based health center and then attempt to convert them to well-visits. Ongoing throughout the grant period.
- Harney County will partner with schools to provide four full days of adolescent wellness exams in August prior to school and fall sports starting – helping to catch athletes as they try to fulfill the sports physical requirement.
- Marion County will explore partnering with local school districts to develop messaging that can be shared with families at school sponsored events during Fall of 2019.
- Morrow County will continue to support change in community norms to obtain adolescent well-visits on a yearly basis, and to eliminate sports physicals in all county healthcare clinics regardless if the child is playing sports. The county will continue an advisory council aimed at providing community education to parents and caregivers. Ongoing throughout the grant period.
- Umatilla County will meet with school district staff to promote the well-visit in place of sports physicals. They will work with school staff to schedule well-visits before the deadline that athletes must complete sports visits. They will develop a well-visit campaign at the middle and high school in the spring of 2020 and they will develop policies to try to institutionalize the well-visit.
Strategy: Investigate barriers to adolescent well-visits.
Activities – Local Level
- Curry County will conduct 2-3 student lead focus groups and distribute a survey throughout the school year to better understand the challenges facing children. They will utilize their local youth advisory council and engage other student groups in other cities to work with students to understand their needs and barriers. Ongoing throughout the grant period.
Activities – Local Level
- Clackamas County will develop and implement a marketing plan to promote adolescent well-visits at their local SBHC. The marketing plan will leverage sports physicals and school immunization law requirements. Ongoing throughout the grant period.
- Harney County will work with community members to try to improve adolescent wellness exam rates in the Paiute tribe and among adolescents coming to the local health department for family planning visits, WIC, STD screening, and immunizations. Harney County will also do some education among junior high and high school health classes. Ongoing throughout the grant period.
Strategy: Strengthen health care privacy and confidentiality policies and practices.
Activities – Local Level
- Morrow County will continue to promote collaboration between the county’s primary care clinics in implementing policies that protect adolescents’ ability to self-consent to care and to eliminate barriers (like privacy) to health care services. This is the next step as they developed an access and consent policy in a previous grant year. Ongoing throughout the grant period.
Activities – Local Level
- Marion County will explore surveying provider offices to assess if there is a difference in completing a well-visit among adolescents with private versus Medicaid insurance. The county will also survey families to investigate reasons for non-completion.
- North Central Public Health District will convene local partners (including youth-serving orgs, CCO’s, community providers and school districts) to address access and education barriers for the well-visit and reproductive health.
- Oregon Health Authority – Transformation Center
- Coordinated Care Organizations
- School-Based Health Centers
- Oregon School Nurses Association
- Oregon School-Based Health Alliance
- Oregon Health Authority – Reproductive Health Program
- Oregon Pediatric Society
- Oregon Pediatric Improvement Partnership
- Confederation of Oregon School Administrators
- Oregon Department of Education
- Oregon school districts
- Oregon Student Voice
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