Research Associate Center for Promotion of Child Development through Primary Care University of Michigan Medical School Ann Arbor, Michigan, United States
Background: Bright Futures recommends a strength-based approach to adolescent well visits. Positive psychology inventories identify strengths and values using hundreds of items; impractical for primary care. However, data collected pre- well visit might inform strength-based discussions between primary care providers (PCPs) and youth. Pre-visit online structured questionnaires could efficiently both inform discussion and trigger decision support and resources.
Objective: To collect youth feedback on acceptability, content, and context of questions about strengths, values, goals for pre-visit completion.
Design/Methods: Candidate items were compiled from literature review including factor analysis-derived categories. Youth ages 12-18 with representative gender, race and income were recruited for online focus groups stratified by age (12-14, 15-18). Youth provided perspectives on potential questionnaire items assessing strengths, values, goals, leisure activities, dream job, and life wishes. Youth also completed draft surveys of candidate items and provided written feedback and ratings. Mixed methods using pre-group input, and in-group polling and discussion themes were used to make iterative changes.
Results: 91 youth enrolled in 13 focus groups of 6-10 participants each. Youth suggested adding options including “I can’t decide,” and allowing multiple responses to avoid feeling pinned down or judged, plus providing better explanation of the reasons and value to youth for completing tools. In general, youth found their personal strengths, values, and and goals among candidate items. Polling showed pre-visit surveying acceptable and youth (76%) agreed that “using a confidential questionnaire about a teen’s strengths and goals before checkup visits would be a good addition to healthcare for teens”. Conclusion(s): Collecting pre-visit data from youth in several asset categories, and including opt-outs and multiple choices for self-characterization was acceptable and helpful to identifying what matters to youth and what they are open to discussing during well visits. Structured pre-visit data could facilitate relationship building and be actionable for assigning strength and resiliency building resources. Future research is needed to determine whether pre-visit assessment of strengths, values, and goals improves clinical process of well visits and youth health outcomes.
Authors/Institutions: Yidan Cao, Center for Promotion of Child Development through Primary Care, Baltimore, Maryland, United States; Raymond A. Sturner, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States; Barbara J. Howard, Total Child Health, Baltimore, Maryland, United States; Sion Harris, Boston Children's Hospital, Boston Children's Hospital, Boston, MA, US, hospital/children, Boston, Massachusetts, United States; Genevieve C. Vullo, Total Child Health, Baltimore, Maryland, United States; Marianne Z. WAMBOLDT, University of Colorado, Denver, Colorado, United States; Lydia Shrier, Boston Children's Hospital, Boston, Massachusetts, United States; Kerry A. Bet, Center for Promotion of Child Development through Primary Care, Baltimore, Maryland, United States; Lewis Dawn, Center for Promotion of Child Development through Primary Care, Baltimore, Maryland, United States