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Increase screening and preventive care among children and youth

Increase protective factors impacting youth

% of youth age 12 to 17 who received at least one preventive health care visit in the past 12 months

Current Value

55%

2021

Definition

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Story Behind the Curve

Updated: February, 2024

Author: Division of Family and Child Health, Vermont Department of Health


This indicator, or population measure, is part of our Healthy Vermonters 2030 data set. Read more about how this data helps us understand and improve the well-being of people in Vermont on the Healthy Vermonters 2030 webpage.

Because this data is meant to show how the health of our state changes during the decade from 2020-2030, some indicators may have very few data points for now. Keep checking back to see the progress our public health system and partners are making.

By 2030, we want the percent of youth who have annual preventive healthcare visits to be at least 59%.

There was improvement during the last decade (2010-2020), but there was a large drop from 64% to 55% during the 2020-21 school year. Access to preventive care during the COVID-19 pandemic is a likely factor in that decrease. The number of youth accessing preventive health care has been slowly increasing again.

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Why Is This Important?

Preventive care visits are sometimes called, “well care,” “well visits,” or even “check-ups”.  Whatever your medical provider calls these preventive care visits, well care helps to keep your youth well!

As Healthy People 2030 says, “during preventive health care visits, adolescents get important screenings, health counseling, and interventions. Preventive visits are especially important for this age group because behaviors that can affect health often start in adolescence.”

The Health Department promotes the American Academy of Pediatrics’, Bright Futures guidelines for these visits. Bright Futures recommends youth ages 12-17 receive an annual physical exam, health history, guidance about what to expect at different ages, measurements, screenings, immunizations, and more during these visits.  These are also the recommended preventive care guidelines used by Vermont’s Medicaid benefit for children.  We want to support efforts to ensure all youth, including those with Medicaid, get this recommended care.

The Health Department is a recipient of the HRSA Title V Maternal and Child Health Services Block Grant and regularly chooses National Performance Measure 10 (adolescent well visits), as part of the annual action plan to impact youth health and well-being in Vermont.  The action plan supports improving access and increasing awareness among youth and caregivers about the importance of annual preventive care visits for adolescents.

Well care visits are an important quality measure for Vermont’s All-Payer Accountable Care Organization Model. This is also a priority that the Department of Vermont Health Access measures for Medicaid reporting. Collaboration between partners is helped by understanding the data and having a shared priority to increase the rate of preventive care visits among youth in Vermont.

Equity and Impact

All children should access recommended annual preventive care, and many different ways to increase access or decrease barriers should be explored.  Preventive care visits can help identify issues as early as possible to achieve the best possible outcomes for youth and families.  Visits can help connect individuals and families to services for their special health needs. Beyond just healthcare, visits with providers can support families with other aspects of their well-being, because practices screen for other social determinants of health needs during these visits (such as food security).

Partnerships with schools can help identify gaps and areas of need for youth accessing care. Many school nurses have indicated a concern for youth in Vermont, especially in relation to mental health and other impacts from the COVID-19 pandemic.

It is important to ensure that those with Medicaid get all recommended preventive care. This includes helping families understand when to go to their provider for well care visits, and to increase access and decrease barriers to getting care.

How We Can Improve

The Health Department will continue to work with different partner organizations and individuals to improve access to medical care and specifically to increase the number of youth getting preventive care as described in Bright Futures. Some of our partners include:

  • Vermont's medical provider community
  • Other Agency of Human Services Departments
  • Vermont Child Health Improvement Program
  • Vermont Chapter of the American Academy of Pediatrics
  • Vermont Academy of Family Physicians
  • Agency of Education
  • Schools and School Nurses

We will continue to work with the Vermont Child Health Improvement Program on quality improvement projects to address barriers that providers may have, improve medical office systems, and make visits more adolescent-informed and youth-friendly.

We can increase the number of youth getting preventive visits by educating youth and families about the importance of adolescent well care visits and the differences between preventive care and acute visits (such as those for injury, illness, sports clearance, or other individual service needs). We can also encourage medical practices to incorporate parent and youth feedback about the visits and their experience in getting care. These are all important ways to improve access to care and the quality of these visits.

School nurses, working with families, can support increasing access to medical homes, and promoting annual adolescent well care visits.

Notes on Methodology

Before the COVID-19 pandemic, rates of adolescent well care visits for grades 7-12 were in the mid-60 percent range.  We chose the goal of 59% as a modest improvement over the current percent as students and medical practices get back to normal after the pandemic. We may adjust this target if our goal is met before 2030.

This data is from the annual Vermont School Nurse Report conducted by the Health Department. The survey period is November to January 1st each year. This survey is completed by School Nurses in Vermont public schools based on information collected from student caregivers. The data from grades K-12 is filtered to reflect only grades 7-12 for this indicator.

This is self-reported data from student caregivers. The caregiver may indicate on the form that the child has had a well exam in the last year (or provide a date within the last year), that they did not have a well exam in the last year (or provide a date that exceeds a year), or they may not respond to the question. The percentage for this indicator is calculated by dividing the total number of students indicating a well exam in the last year by the total number of students. Data is aggregated before it is received from each school (no individual student responses are reported).

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