Improving Adolescent Friendly Healthcare Services: Implementing Comprehensive Psychosocial Histories into Practice
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Abstract
Adolescence is a unique period of rapid physical and psychosocial growth and development. Adolescents are most often physically healthy, but as a normal part of adolescent development the population commonly experiments with risky behaviors, which may lead to the development of unhealthy habits (National Research Council and Institute of Medicine [NRC/IOM], 2009). Additionally, risky behaviors are connected to the top three causes of potentially preventable adolescent death – accidents/unintentional injury, homicide, and suicide (Goldenring & Rosen, 2004; NRC/IOM, 2009).
Primary healthcare providers may have not received specialized training in providing healthcare to the adolescent population, or may feel uncomfortable engaging in communication about psychosocial risk factors with adolescents (NRC/IOM, 2009). One critical gap involves the fragmented healthcare services available to adolescents and the missed opportunities for health promotion and disease prevention when adolescents do seek healthcare. Incorporating comprehensive psychosocial adolescent histories into practice may help facilitate positive changes in adolescent healthcare delivery.
In response to the need for improved adolescent friendly healthcare services, an online continuing education module was created in collaboration with the American Association of Nurse Practitioners Continuing Education Center. The psychosocial assessment focused on utilizing the HEEADSSS assessment, as psychosocial risk factors contribute to the leading causes of adolescent morbidity and mortality (Goldenring & Rosen, 2004; NRC/IOM, 2009).
The module was evaluated through pretest, posttest, and evaluation questions. Data were collected for approximately two months, and there were 328 participants. Following completion of the module, over half (52.4%; n = 172) of the participants reported they will modify their practice, and nearly all of the participants (91.8%; n = 301) felt that the level of content was “just right” for nurse practitioners. Five pretest and posttest questions related to the module’s content demonstrated increased knowledge as a result of the module. Additionally, a majority of the written qualitative responses were in support of or praising the quality of the module. Overall, data indicate a positive impact from the continuing education module about conducting comprehensive psychosocial interviews with adolescent patients.