Well-Visit Attendance From Mid-Adolescence to Young Adulthood: Who Remains Engaged?

Despite US recommendations for annual well-visit attendance (WVA) for adolescents and young adults (AYAs) through age 21, WVA rates remain suboptimal. This study explored AYAs' longitudinal WVA patterns and associations with sample characteristics.

Data are from the NEXT Generation Health Study, a nationally representative longitudinal cohort (n = 2,766) followed annually for 7 years (ages 15-23). Simultaneous three-step Latent Class Growth Analysis identified distinct WVA patterns by sex and examined associations with background and health-related factors.

For males, three classes were identified: "Engaged" (66%, n = 818), "Engaged with Decline" (17.7%, n = 221), and "Persistently Disengaged" (17%, n = 208). Similarly for females, three classes were identified: "Engaged" (67%, n = 1,022), "Engaged with Decline" (19%, n = 295), and "Gradually Reengaged" (13%, n = 202). Males with chronic health conditions were significantly more likely to be "Engaged," while females with depressive symptoms were significantly less likely to be "Engaged" WVA class membership was also significantly associated with health and insurance status, family affluence, race/ethnicity, geographic region, and youth/parental nativity.

While many AYAs remained engaged in WVA over time, declines were observed for both sexes, particularly males. Health needs were strongly associated with WVA, extending our knowledge beyond existing literature, which has mainly explored background characteristics and social determinants. This study provides valuable insights into WVA through the critical transition from adolescent to young adult care and underscores the potential influence of health needs, social determinants, and background characteristics on WVA. Findings can inform policy and practice to support sustained health-care engagement during this crucial period.