October 1, 2020

Improving Young Adult Health: Methods

Where did the Strategies from this Report come from?

This section discusses in greater detail the sources used to develop the five strategies in this report and to identify the resources used as examples.

Review of State-Level Policies & Programs

With input from young adult health experts, policies and programs were searched through: 1) keyword search of publicly available information on Google’s search engine, 2) snowball sampling of activities found online, and 3) keyword search on state/territory health agency websites with accessible search function. Queries such as “[state/territory] young adult health” were repeated for all 59 US states and territories to ensure adequate coverage of all regions.

Policies and programs were organized by state, activity type and up to two focus areas each. Activity types included Education, Partnerships and Legislation, while focus areas included topics such as Mental Health, Sexual Health, Transition and Health Insurance. 

Additionally, policies and programs were given a categorical rating from 1-3, with 1 indicating lower focus on the young adult population, 2 indicating moderate focus and 3 indicating an activity that is highly targeted to young adults. These ratings were then validated by a young adult health professional through independent rating of a simple random sample of activities. 

Title V Agency Interviews

Using information from 2018 MCH block grant reports, the AYAH-NRC identified states and territories that have explicitly highlighted the young adult population in a state performance or outcome measure (SPM/SOM). The selection of these young adult measures was used as a proxy to identify agencies with a demonstrated interest, and potentially innovative programming, in young adult health.

The following five states selected a young adult SPM or SOM:

  • Illinois: Rate of chlamydia infections in women ages 15-24
  • Iowa: % of adults 18-24 years old who report being physically active
  • Maine: % of new mothers ages 18-24 years whose most recent pregnancy was unintended
  • Rhode Island: Youth suicide rate ages 10-24
  • Texas: % of young adults ages 18-24 who visited a doctor for a routine checkup in the past year

A standardized interview tool was used to understand factors and activities that influenced each state’s focus on young adults, discuss barriers to the implementation of programming for young adults and garner advice for other states interested in YA health. Additional questions were then adapted for each state in order to learn more about specific initiatives found through the programs and policies review.

To better identify overarching changes that influenced adoption of a young adult measure, state Title V leadership were prioritized as potential interviewees. In total, the AYAH-NRC held 7 interviews with Maternal and Child Health directors, state adolescent health coordinators, family planning managers and mental/ behavioral health officers. All interviewees were verbally consented and the project was deemed exempt by University of California, San Francisco’s Institutional Review Board.

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