The Impact of Health Care Education on Utilization Among Adolescents Preparing for Emancipation From Foster Care.

purposeAs teens in foster care prepare for emancipation, health care navigation is often overlooked, as caseworkers address other social needs. This study examined the impact of health care education materials designed for foster youth, called ICare2CHECK. It was hypothesized that ICare2CHECK would increase nonurgent ambulatory health care use and decrease emergency/urgent care use.

methodsAdolescents (N = 151; aged 16-22 years) were enrolled in ICare2CHECK and received health education materials at their baseline study visit. Surveys were repeated every 3 months to assess health care utilization. After 12 months of enrollment, health care data for all eligible youth and matched comparison youth (N = 151) over the previous 24 months were extracted from the electronic health record (N = 302). Electronic health record data were coded as counts of completed nonurgent ambulatory care encounters (i.e., primary and preventative care and specialty care), completed urgent or emergency encounters (i.e., urgent and emergency department visits and hospitalizations), completed foster care clinic visits, and total completed visits.

resultsHealth care use significantly decreased over time for both enrolled and comparison youth. Females, youth engaging in health risk behaviors, and those with a mental health or chronic condition diagnosis used significantly more health care. Receipt of educational materials was associated with a smaller decline in health care use and nonurgent ambulatory care use, controlling for covariates. Self-reported use of educational materials was associated with increased utilization in the enrolled condition.

conclusionsResults suggest that ICare2CHECK is associated with increased engagement in health care generally and nonurgent ambulatory care specifically (e.g., outpatient primary and specialty care).