PM2103: Preventive Care and Medical Homes for Black Youth: A Qualitative Interview Study

Background: Adolescents do not routinely complete preventive care visits, have one-on-one conversations with providers, or have a medical home. Black youth are less likely to access these services. This study aimed to identify Black adolescents’ experiences with and desires for preventive healthcare, confidential conversations, parental involvement, and the medical home model.

Methods: Semi-structured qualitative interviews were completed with Black adolescents ages 14-18 living in Chicago. Conversations were audio-recorded and transcribed. Themes were identified using content analysis.

Results: Nine adolescents were interviewed. Despite all participants reporting a preventive care visit in the last two years, most adolescents did not report a recent one-on-one conversation with their provider. For preventive care priorities, they perceived physical health and social and emotional needs as most important. In terms of confidentiality, participants felt talking to a provider alone would be comfortable and private, viewing trust and rapport as mediators for disclosure. Regarding parental involvement, they did not express a strong preference for talking with a provider alone, especially when they reported close relationships with their parents. However, they felt sensitive topics would be better suited for one-on-one conversations while medical topics should include their parents. They were unaware but supportive of the medical home model, highlighting family-centeredness and cultural-effectiveness as notable qualities that would benefit adolescents.

Conclusion: Black adolescents in the sample overall did not experience professional standards of confidentiality and anticipatory guidance. Education is needed for providers, adolescents, and parents about confidential psychosocial screening. Cultural effectiveness of medical homes may support the unique needs of this population.