Although barriers to preventive care still exist for women and adolescents, organizations are working to overcome these gaps through standardized recommendations and online tools for providers, according to an article published in Medical Clinics in North America.1
Evidence-based preventative care can improve overall health and reduce illness and death among women and adolescents. However, gaps in care caused by barriers still exist, according to Catherine Takacs Witkop, MD, PhD, MPH, associate dean of medical education at the School of Preventive Medicine and Biostatistics at the Uniformed Services University of the Sciences of Health in Bethesda, Maryland. , who wrote the article.
Barriers to preventive care
Many barriers prevent women and adolescents from receiving necessary preventive care, both at the patient and system level, according to Takacs Witkop. Patients may not know what preventive services they need or have family or work commitments that prevent them from seeking care.1 Providers may be unclear about which preventive services are covered by insurance, be pressed for time to provide care, and may not be clear on preventive clinical guidelines.1 Some providers may even have biases that result in discrimination that becomes an unfortunate barrier to accessing appropriate care.1
Women have different health care needs than men, including pregnancy and menopause, in addition to issues more common among women, such as depression or anxiety.1 Fewer medical studies include women, and “subgroup analyzes are not performed to determine whether certain preventive services and treatments are differentially effective in women and men,” noted Takacs Witkop.1 “As a result, evidence from rigorously conducted randomized controlled trials is often insufficient to make evidence-based recommendations for clinical prevention services for women, leaving gaps in optimal health care for women. »1
Overcoming Barriers: Organizations and the Affordable Health Care Act (ACA)
Several organizations are growing to address barriers to health care for women and adolescents, such as Bright Futures, the U.S. Preventive Services Task Force (USPSTF), the Advisory Committee on Immunization Practices (ACIP), and the Women’s Preventive Services Initiative (WPSI).
Additionally, ACA policy changes have increased access to preventive care coverage at no cost to the patient. However, gaps remain for women and adolescents, as they are often not included in standard recommendations. The Institute of Medicine, now known as the National Academy of Medicine (NAM), is working to identify missing prevention and screening services for women and adolescents to fill these gaps, and to determine how to identify areas that may be lacking in the future. The group used evidence-based techniques to determine what would be most beneficial, including “screening for gestational diabetes; human papillomavirus screening; advice on sexually transmitted infections and human immunodeficiency virus (HIV); contraceptive methods and advice; breastfeeding support, supplies and advice; screening and counseling for interpersonal and domestic violence; and visits from healthy women.1
Implement web tools to improve health
The WPSI drafts guidelines for ongoing review and update revisions, which “have worked and continue to identify gaps in recommended preventive services for women,” Takacs Witkop noted. Providers can integrate WPSI web tools to address gaps in prevention services and improve the health of women and adolescents to close knowledge gaps.
“The Well-Woman Chart and accompanying clinical summary tables, which are updated annually and available online, can be used at the point of care to ensure that women are offered and receive all preventive services recommended for their age and situation. » Witkop wrote.
In addition to charts and tables, the WPSI website provides additional resources for providers to improve health outcomes for women and adolescents, including patient education brochures. The website provides clear, standardized guidelines that providers can follow to improve preventive care for women and adolescents, helping them close the gap in preventive services for this population.
