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J Pediatr ; 193: 229-236.e1, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29198766

RESUMO

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.


Assuntos
Serviços de Saúde do Adolescente/normas , Assistência Centrada no Paciente/métodos , Atenção Primária à Saúde/normas , Melhoria de Qualidade/estatística & dados numéricos , Adolescente , Atitude Frente a Saúde , Criança , Atenção à Saúde/normas , Seguimentos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Satisfação do Paciente/estatística & dados numéricos , Assistência Centrada no Paciente/normas , Relações Médico-Paciente , Atenção Primária à Saúde/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Inquéritos e Questionários , Adulto Jovem
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