An unprecedented study
Health experts and advocates worldwide are increasingly recognizing that conventional health care focuses on childhood and adulthood, virtually neglecting the years in between—with clear and long-term implications both for young people and society.
“The U.S. health care system today is not designed to help young people develop healthy routines, behaviors, and relationships to prepare them for adulthood,” the Institute of Medicine of the National Academies of Science, one of this country’s most influential health policy organizations, said in a landmark 2009 report titled Adolescent Health Services: Missing Opportunities
In calling on the nation’s health system to provide care to adolescents that focuses on their distinct needs, the report noted something that caught our attention: Nobody’s ever produced hard data establishing what makes an effective and successful adolescent health program.
We decided to respond to the challenge. As the largest and most comprehensive center of its kind in the country, and a leading advocate of adolescent health care, we felt an obligation to subject our methods and results to serious assessment by an outside evaluator. In late 2009, we hired the consulting firm ICF International to conduct an independent five-year examination of everything we do and to assess whether adolescents who receive care from us have better outcomes than those who don’t. And we brought in the Philip R. Lee Institute for Health Policy Studies at the University of California San Francisco to explore the public policy implications of the eventual findings.
The evaluation, to be completed in 2016, is unprecedented in both purpose and scope. ICF and MSAHC spent more than a year designing an exhaustive and scientifically rigorous study and another two years recruiting two large groups of participants. Half the 1,402 adolescents in the study are our patients. The other half are similar adolescents from the community who do not receive care from the Center. All the participants were first interviewed for baseline information about their health, health-related behaviors and well-being, and the health care they receive. They agreed to be interviewed every six months for three years.
The goal of the ICF study is to provide us—and health care professionals and policy makers across the country and around the world—with much-needed evidence of how best to deliver high-quality care to young people.
THE BIG QUESTIONS
Aims of the five-year ICF study
We’re looking for hard evidence that the care we deliver to our patients results in better health.
- Do we manage patients’ chronic illnesses better than providers elsewhere?
- Are we reducing sexually transmitted infection, substance abuse, pregnancy and risky behaviors?
- Are we improving our patients’ own sense of overall well-being?
- Can we quantify an association between the health care we deliver to our patients and their success in school?
A vital element of our holistic approach to adolescent health is the active but nonjudgmental questioning of young people about the health-related issues in their lives.
- Are we doing a better job of intervening in issues and dangers our teens may face than providers who typically don’t probe for information with adolescents?
- Are we reducing conflicts, violence and risky behaviors?
- Do our patients seek help—from us or others—when they’re in trouble?
Access and Engagement
We want to know how well we’re delivering on our promise of removing barriers to health-care access for adolescents in the community we serve. And how effectively our teen-friendly design engages young people in their own health.
- Are we meeting all the health care needs of our patients? If not, what are we missing?
- How good are we at serving as a medical “home” for our patients–the place they rely on for high-quality, sustained health services?
- How well are we delivering developmentally and culturally appropriate services?
- How well do we convey our confidential, nonjudgmental and embracing environment to our patients? Do they have positive relationships with their providers, the kind that might have long-term impact?
- Do our patients become better health care consumers?