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. Author manuscript; available in PMC: 2018 Mar 1.
Published in final edited form as: J Adolesc Health. 2016 Dec 20;60(3):249–260. doi: 10.1016/j.jadohealth.2016.10.005

Table 2.

Summary of recommendations for future research in adolescent and young adult clinical preventive services

Broad recommendations

  1. Examine clinical preventive services delivery and effectiveness among young adults as a population distinct from adolescents and other adults.

  2. Apply advances in developmental science (including understanding of key developmental windows for optimal service effectiveness) to improve models of care and brief interventions for adolescents, young adults, and parents.

  3. Clarify the role of the health care system, and of parents, in supporting healthy developmental transitions for adolescents and young adults.

  4. Improve monitoring and tracking of the delivery of clinical preventive services, including:
    1. Develop standardized measures
    2. Urge federal agencies responsible for public health monitoring systems to align data collection with preventive services recommended in the Affordable Care Act, particularly those that are evidence-based.
    3. Identify continuously collected data sources, including EMRs, that can be leveraged to inform clinical preventive services for adolescent and young adult health promotion.
Systems-focused recommendations

  1. Examine the extended effects of shifts in health insurance policy (e.g., the Affordable Care Act) on adolescent and young adult clinical preventive services access, utilization, and health outcomes.

  2. Respond to shifts in the healthcare system and service delivery contexts (e.g., vaccinations and other preventive health offered outside clinic offices) to inform the development of a more nimble clinical model and innovative preventive care strategies.

  3. Examine strategies to reduce disparities, particularly promoting linkages between traditional health care facilities and adolescents and young adults (AYA)–serving community-based agencies such as schools, juvenile justice settings, and community-based youth services organizations.

Recommendations on optimizing the clinical encounter
Clinician-targeted strategies

  1. Implement and evaluate larger, practice-based, multisite research trials of promising clinician-focused interventions such as those that incorporate training and screening tools and clinical decision support systems in electronic medical record systems.

  2. Continue to evaluate the effects and potential of electronic medical record systems to improve preventive services delivery and quality in pediatric health settings.

Parent engagement
 Implement developmentally and culturally appropriate strategies to engage parents in the clinical encounters of AYAs and evaluate their effects on the receipt of clinical preventive services and health outcomes.
Recommendations on optimizing the clinical encounter (continued)
Improving AYA behavior/health: efficacy of clinical preventive interventions

  1. Prioritize more rigorous, outcomes-focused research that studies the effect of AYA-targeted clinical preventive services on behavior change or health outcomes, both short and long term.

  2. Implement and evaluate the interventions’ effectiveness in different settings and on a broader scale.

  3. Identify effective, brief, practical generalized (i.e., nonsilo) interventions within developmental windows of opportunities.

  4. Deepen our understanding of behavior change interventions, including the framing and timing of health information and messages, and what components are most effective.

  5. Develop criteria for publishing/reporting on intervention outcomes and how evidence-based principles are applied (e.g., what are the intervention’s “active ingredients” and mechanisms of action).

Using technology to extend clinicians’ preventive reach
 Leverage new technological tools (e.g., computer programs, mobile devices, wearable sensors) to enhance/improve AYA health services
 (e.g., for clinicians, youth, parents, and integrated systems) with attention to privacy and confidentiality concerns.

  1. Develop interventions that provide adolescents/young adults with guidance in navigating complex systems that are providing health information and develop and health and media safety literacy (e.g., online sites, social networks, etc.)

  2. Prioritize rigorous and timely outcomes-focused research on use of “clinician extenders”

  3. Identify safety and quality criteria for health technology platforms with a focus on youth needs.