Adolescent health, vaccination and engagement strategies

With A/Prof Melissa Kang and Ms Cristyn Davies - Improving vaccination uptake and preventative health offering in clinical practice


Presenters:

Associate Professor Melissa Kang
Sydney Medical School
General Practice Clinical School
Faculty of Medicine and Health

Ms Cristyn Davies
Senior Research Associate
Discipline of Child and Adolescent Health
Sydney University Clinical School & Children's Hospital at Westmead

Overview:

This module discusses the key role of general practice in improving uptake of recommended adolescent vaccinations, the main adolescent preventative health topics to be addressed in general practice and provides tips on communication and engagement strategies with young patients.

Learning Outcomes:

1. Identify vaccinations recommended for adolescents in Australia and classify as NIP funded or not funded.
2. Discuss the key role of general practice in improving uptake of adolescent vaccinations.
3. Summarise main adolescent preventative health topics to be addressed in general practice.
4. Discuss tips for communicating and engaging with young patients.

Information:

Hear Adolescent Health experts Associate Professor Melissa Kang and Ms Cristyn Davies share their experience and suggestions to improve outcomes for adolescent patients.

Young people aged 15 to 25 years have the lowest proportion of face-to-face time spent with GPs in Australia¹. Therefore it is crucial to optimize health discussions with adolescents when they present to your practice.

This module begins by setting the scene on the current uptake rates in vaccination in adolescent patients, which can be as low as 70%² then lays out the role of general practice in improving uptake as well as some of the challenges you may face.

One way you can improve adolescent vaccine uptake is by recalling patients.
This video demonstrates how to easily run an AIR report to identify your patients who have missed school-based vaccinations.

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Two cases studies are presented to describe typical scenarios you may see in general practice and suggests ways to address any gaps in vaccine uptake.

HPV, dTpa and MenACWY are included in the recommendations for adolescents³ and details of reimbursement and eligibility are discussed together with current trends in epidemiology.

The second part of this module discusses general assessments and preventative health advice relevant for all adolescents that may be covered at any GP visit⁴. These topics include:

• Measure growth and BMI routinely
• Encourage healthy lifestyle, including healthy eating, drinking, exercise, adequate sleep and socialising, limiting screen time
• Smoking and vaping status and strong anti-smoking/vaping message
• Promote sun protection
• Encourage dental health, including annual dentist visit  
• Screen for sexually-transmitted diseases and encourage contraception and use of barriers (if sexually active)
• Enquire about safety and wellbeing, including feeling safe in the home, bullying and mental health

The final section of this module suggests ways to communicate and engage with adolescents and young adults which include:

• Speak directly to the young person and encourage them to answer questions on their own behalf⁵
• Establish trust and rapport by taking the time to engage young person and connect in a meaningful way⁶
• Explain confidentiality and its limits^5,6

What constitutes a mature minor and to recognise that some adolescents have sufficient understanding and intelligence to enable full comprehension of what is being proposed in a medical intervention⁷. Most adolescents aged 16–18 are presumed to be mature minors (legislation differs by State).

The HEEADSSS assessment is a practical, comprehensive and tested tool GPs can use for a psychosocial review of an adolescent patient⁴. A/Prof Kang talks through the application of this tool and suggests ways to implement a management plan and follow up where possible.

A/Prof Kang and Ms Davies finish the module by providing a summary with take-home messages and lists some useful resources for general practices with adolescent patients.

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References:

1. Davies C and Skinner R. Medicine Today 2021;22(102):57-61.

2. National Centre for Immunisation Research and Surveillance Australia. Annual Immunisation Coverage Report 2021. Available at: https://ncirs.org.au/sites/default/files/202212/NCIRS%20Annual% 20Immu nisation%20Coverage%20Report%202021_FINAL.pdf. Accessed May 2023

3. National Centre for Immunisation Research and Surveillance. Immunisation recommendations for Non-Indigenous Australians without risk factors for vaccine-preventable diseases. Available at: https://www.ncirs.org.au/sites/default/files/2021-08/NCIRS%20Immunisation%20schedule%20for%20non-Indigenous%20people_1%20July%202020-Final.pdf. Accessed August 2021

4. The Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice. 9th edn. East Melbourne, Vic: RACGP, 2016.

5. NSW Department of Health. Adolescent Health GP Resource Kit (2nd Ed). Available at: https://www.health.nsw.gov.au/kidsfamilies/youth/Pages/gp-resource-kit.aspx. Accessed July 2021. 2. Klein D et al. Contemporary Pediatrics 2014;31(1):16-28.

6. Klein D et al. Contemporary Pediatrics 2014;31(1):16-28.

7. The Royal Children’s Hospital Melbourne. Engaging with and assessing the adolescent patient. Available at: https://www.rch.org.au/clinicalguide/guideline_index/Engaging_with_and_assessing_the_adolescent_patient/ Accessed May 2021.

PP-NIM-AUS-0350. 06/23/ Pfizer Australia, Sydney.