May 24, 2017

Toolkit: Youth-Centered Care

About Youth-Centered Care

What are Strategies for improving the provision of quality youth-centered care?

Additional Resources

 

Youth-Centered Care

Youth-centered careUpdated July 5, 2016. Check back soon for updates.


About Youth-Centered Care

Youth-Centered Care, also known as “adolescent-friendly health services,” is an approach to providing high quality health care that meets the needs of young people. There are several definitions and frameworks, including one from the World Health Organization (WHO, 2002) in which WHO established five objectives of youth-centered care.

  • Accessible: Policies and procedures ensure that services are broadly accessible
  • Acceptable: Policies and procedures consider culture and relationships and the climate of engagement
  • Appropriate: Health services fulfill the needs of all young people
  • Effective: Health services reflect evidence-based standards of care and professional guidelines
  • Equitable: Policies and procedures do not restrict the provision of and eligibility for services

Other leading health organizations have also released policy statements and position papers on youth-centered care, including the American Academy of Pediatrics and the Society for Adolescent Health and Medicine.


What are the Strategies for improving the provision of quality youth-centered care?

In 2015, WHO published Global Strategies for Quality Youth-Centered Care, which provides guidance in implementing eight global standards to assure receipt of quality youth-centered care. Click here for the full document.

Click on each standard below for descriptions and strategies for implementation from WHO, plus resources and selected examples related to the annual well-visit. For an infographic based on these standards, click here

Standard 1: Adolescents’ Health Literacy

Standard 2: Community Support

Standard 3: Appropriate Package of Clinical Services

Standard 4: Providers’ Competencies

Standard 5: Facility Characteristics (with a special focus on confidentiality)

Standard 6: Equity and Non-Discrimination

Standard 7: Data and Quality Improvement

Standard 8: Adolescents’ Participation


Standard 1: Adolescents’ Health Literacy

Description: Systems are implemented to ensure adolescents are knowledgeable about their health and how to access and obtain health services.

Strategies: Health facility has a signboard that mentions operating hours, provide youth with age- and developmentally- appropriate health education and available services (e.g., drug and alcohol counseling, legal and social support).

Resources:

  • The New Mexico Department of Health created a toolkit with activities to improve adolescent health literacy.
  • The U.S. Department of Health and Human Services developed a National Action Plan to Improve Health Literacy with achievable objectives to create and sustain health literacy.


Standard 2: Community Support

Description: Parents, guardians, and other community members recognize the value of adolescent health services.

Strategies: Providers educate parents, teachers, and other community organizations about the value of adolescent health services.

Resources:

  1. AAP/Bright Futures developed a Family Pocket Guide to educate parents on the clinical services recommended for adolescents.
  2. The State Adolescent Health Resource Center (SAHRC) conducted a webinar series on ‘marketing the well-visit.’ Click here for more information and links to view the webinars.


Standard 3: Appropriate Package of Clinical Services

Description: The health facility provides a package of information, counseling, diagnostic, treatment and care services that fulfills the needs of all adolescents. Services are provided in the facility and through referral linkages and outreach.

Strategies: Policies are in place that define the required package of evidence-based clinical preventive services.

Resources: Click here for a 1-page fact sheer on the evidence base for AYA clinical preventive services.


Standard 4: Providers’ Competencies

Description: Providers demonstrate the technical competence required to provide effective health services to adolescents (e.g., confidentiality, respect, and non-discrimination).

StrategiesProviders and staff have been trained on providing sensitive health services to adolescents, current support tools (e.g., protocols, guidelines) are in place for providers; providers’ obligations and adolescents’ rights are clearly communicated to adolescent patients.

Resources:

  1. For a summary of recommended guidelines for clinical preventive services for adolescents up to age 18, click here.
  2. Texas Health Steps offers over 50 free online Continuing Medical Education modules on pediatric and adolescent health-care topics for providers and the general public. The adolescent modules cover health screening, substance use, behavioral health, and much more!


Standard 5: Facility Characteristics

Description: The health facility has convenient operating hours and an adolescent-friendly environment that maintains privacy and confidentiality.

Strategies: Extend operating hours, allow walk-in appointments, youth-friendly amenities in waiting room (e.g., magazines, internet access, brochures)

Example: Maryland and California require health plans to honor requests for confidential communications of sensitive services to go directly to the individual seeking care.

Resources:

1.) This report developed by UCSF researchers highlights key issues with Explanation of Benefits (EOBs) and sensitive health services, and discusses how these issues are impacted by the ACA.

2.) The National Institute for Health Care Management developed a brief titled “Protecting Confidential Health Services for Adolescents and Young Adults: Strategies and Consideration for Health Plans.”

3.) The Colorado Department of Public Health & Environment conducted a Youth-Friendly Clinic Makeover Project with two Title V Family Planning Clinics. Click here for more information and lessons learned from clinic sites.

4.) The Centers for Disease Control and Prevention created an infographic of a step-by-step teen-friendly reproductive health visit and what it would include from start to finish.

5.) The California School-Based Health Alliance developed a guide for school-based health centers with strategies and policy advocacy opportunities for creating a youth-friendly clinic.

6.) The U.S. Department of Health and Human Services created a tip sheet with information and resources to help programs design, implement, and maintain an effective sexual health services referral system.

For more information, please visit our Confidentiality page.


Standard 6: Equity and Non-Discrimination

Description: Adolescents are provided quality services regardless of income, age, sex, marital status, education, race/ethnicity, sexual orientation, or other characteristics.

Strategies: Policies and procedures are in place to ensure equitable care for all young people, services are offered at more affordable rates, providers and staff are trained on providing sensitive services to vulnerable groups of adolescents.

Resources:

1.) HHS Office of Minority Health offers free online continuing education programs related to providing culturally competent care for adolescents.

2.) The National Alliance to Advance Adolescent Health conducted focus groups with low-income adolescents to gather their experiences and recommendations for improving access to youth-centered care.


Standard 7: Data and Quality Improvement

Description: Data on service utilization and quality of care is collected, analyzed, and used to support quality improvement.

Strategies: Systems are in place to collect relevant data, staff is trained to collect and analyze data.

Resources:

  1. The Programme of Action for Children developed a tool for providers and planners to assess the quality of youth-friendly health services, and identify key areas in reviewing services and encourage achievable standards.
  2. The National Improvement Partnership Network at the University of Vermont developed a set of quality improvement measures that can be used to assess and track improvement within and among pediatric and family practices. Click here to view this tool.


Standard 8: Adolescents’ Participation

Description: Youth are involved in the planning, monitoring and evaluation of health services.

Strategies: Policies are in place to engage adolescents in service planning, monitoring and evaluation

Selected resources with Adolescent Voices:

Adolescents Experiences and Views on Health Care (National Alliance to Advance Adolescent Health, 2010)

  • Report provides findings from focus groups with low-income adolescents across 4 major U.S. metropolitian cities and their experiences and suggestions for a health care setting that would provide greater access, deliver comprehensive teen-specific services, and help them play a greater role in their own health care.

Voices of Latino Adolescents in Rural California: Health Care Access (Adolescent Health Collaborative, 2012)

  • Report provides findings from four focus groups conducted with rural, Latino adolescents in California on barriers to obtaining care, and suggestions for making care more accessible and youth-friendly.


Additional Resources

For more resources on youth-centered care please click here for a list of resources prepared by Center partner, SAHRC for The National Network of State Adolescent Health Coordinators.