Associations Between Health Screening Rates and Visits to Their Primary Care Provider in Young Adults Transitioning...

This study examines associations between a young adult's visit to a designated primary care physician (PCP) in the 18 months after transitioning from pediatrics and their completion of preventive healthcare screenings. The period from 18 to 25 years is marked by transition and continued brain development, making it an ideal period for impactful intervention on healthy behaviors and outcomes.

Completion of screening for alcohol use, mental health issues, exercise habits, and tobacco use was measured in members upon turning 18 during 2020-2021. These members had transitioned from pediatrics to adult medicine at an integrated healthcare system at Kaiser Permanente Northern California. Associations of sex, race and ethnicity, need of interpreter, insurance type, neighborhood deprivation, pediatric PCP visit, and chronic conditions were compared for members with or without a visit with their new PCP during the 18 months of transition.

A multivariate model showed that young adults with a visit to their PCP had increased likelihood of completion of screening: 21% for alcohol use, 12% for mental health issues, 18% for exercise, and 16% for tobacco use. Several characteristics were associated with a reduced likelihood of a visit with a PCP: 15% reduced likelihood for residence in more deprived neighborhoods (incidence rate ratio=0.85, 95% CI=0.82, 0.88); between a 6% and 3% reduced likelihood for individuals who were Asian, Black or Hispanic (incidence rate ratio=0.96, 95% CI=0.93, 0.99), (incidence rate ratio=0.94, 95% CI=0.90, 0.98), (incidence rate ratio=0.97, 95% CI=0.94, 0.99) respectively; 55% reduced likelihood for those requiring an interpreter (incidence rate ratio=0.45, 95% CI=0.37, 0.53); and 16% reduced likelihood for males (incidence rate ratio=0.84, 95% CI=0.82, 0.86). Individuals who had a visit to their pediatric PCP, and individuals with chronic conditions, were 20% and 29% more likely, respectively, to have had a visit with their adult PCP (incidence rate ratio=1.20, 95% CI=1.18, 1.23) and (incidence rate ratio=1.29, 95% CI=1.27, 1.32).

Promotion of PCP visits and outreach to individuals with a reduced likelihood of visiting their PCP during this transition could provide opportunities for preventive health interventions among young adults.