Optimus Health Care is a Joint Commission accredited and a federally qualified health center (FQHC) in Southern Connecticut, which serves thousands of male transition-age-youth per year. Attrition among males moving from pediatric to adult primary care is a nationally recognized issue.
Literature suggests that there are three key barriers to young men seeking care: (1) concerns about confidentiality; (2) embarrassment and discomfort about disclosing their concerns; and (3) concerns about cost and accessibility (location, limited open hours). Studies highlight the importance of examining demographic trends and establishing consensus among transition protocols.
This study seeks to assess the prevalence and magnitude of the young male attrition problem and evaluate transition services available to Optimus patients. This project will focus on the population of male transition age youth (TAY, 18-21 years old) who live within the Southern Connecticut areas (Bridgeport and Stamford) who move from pediatric to adult primary care at any one of Optimus Health Care’s locations.
used de-identified electronic medical records (EMRs) (n= 874) of male patients ages 16-23 at Optimus Health Care. Chi-square analyses were conducted to analyze the relationship between particular demographic factors and attrition.
Qualitative: in-depth interviews were conducted with community health workers employed by Optimus Health Care (n=4). These interviews utilized a guide that reflected initial quantitative analyses and the preliminary literature review findings.
I have people come in and [the insurance paperwork is] due tomorrow, and I’m like – how long do you have this? [They say,] Oh I didn’t realize how important it was. [I say,] Really? Because by tomorrow you won’t have insurance. [a lot of] our patients don’t have transportation or they don’t have money to take the bus. Now you see if you’re not working, where are you getting that money from?
We would like to thank Dr. Alix Pose, Justin Markowski, Nelly Angah, the Optimus Community Health Workers, the transition age youth patient population, and all other contributing members of the Optimus community for their assistance.
Betz, Cecily L., Gay Redcay, and Sylvia Tan. “Self-Reported Health Care Self-Care Needs of Transition-Age Youth: A Pilot Study.” Issues in Comprehensive Pediatric Nursing 26, no. 3 (January 1, 2003): 159–81. https://www.tandfonline.com/action/cookieAbsent.
Noone, Jack H., and Christine Stephens. “Men, Masculine Identities, and Health Care Utilisation.” Sociology of Health & Illness 30, no. 5 (July 1, 2008): 711–25. https://doi.org/10.1111/j.1467-9566.2008.01095.x. Walker, Zoe, et al. "Health promotion for adolescents in primary care: randomised controlled trial." BMJ 325.7363 (2002): 524.