NY Manual
SHP Manual

New York Provider Manual
VII-B Child/Teen Health Plan (C/THP) Guidelines and Immunization Schedule | VII-D Primary Care Provider Behavioral Health Screening Tool

Appendix VII-C — Guidelines for Adolescent Preventive Services (GAPS)

The recommendations for GAPS emphasize annual clinical preventive services visits that address both the developmental and psychosocial aspects of adolescent health, in addition to traditional biomedical conditions. These recommendations were developed by the AMA, with contributions from a Scientific Advisory Panel comprising national experts, as well as representatives of primary care medical organizations and the health insurance industry. The body of scientific evidence indicated that the periodicity and content of preventive services can be important in promoting the health and well-being of adolescents.

Preventive Health Service by Age and Procedure

Age of Adolescent
Early
Middle
Late
Procedure
11     12        13     14
15          16          17
18      19       20      21
Health guidance
 
 
 
Parenting****
----------------*-----------------
----------------*-------------------
 
Development
*         *         *        *
*              *           *
*         *          *        * 
Diet and physical activity
*         *         *        *
*              *           *
*         *          *        * 
Healthy lifestyles**
*         *         *        *
*              *           *
*         *          *        * 
Injury prevention
*         *         *        *
*              *           *
*         *          *        * 
Screening history
 
 
 
Eating disorders
*         *         *        *
*              *           *
*         *          *        * 
Sexual activity***
*         *         *        *
*              *           *
*         *           *        * 
Alcohol & other drug use
*         *         *        *
*              *           *
*         *          *        * 
Tobacco use
*         *         *        *
*              *           *
*         *          *        * 
Abuse
*         *         *        *
*              *           *
*         *          *        * 
School performance
*         *         *        *
*              *           *
*         *          *        * 
Depression
*         *         *        *
*              *           *
*         *          *        * 
Risk for suicide
*         *         *        *
*              *           *
*         *          *        * 
Physical Assessment
 
 
 
Blood pressure
*         *         *        *
*              *           *
*         *          *        * 
BMI
*         *         *        *
*              *           *
*         *          *        * 
Comprehensive exam
----------------*-----------------
-----------------*------------------
-----------------*----------------
Tests
 
 
 
Cholesterol
---------------1----------------
----------------1-----------------
----------------1-----------------
TB
---------------2----------------
----------------2-----------------
----------------2-----------------
GC, Chlamydia, Syphilis and HPV
---------------3----------------
----------------3-----------------
----------------3-----------------
HIV
---------------4----------------
----------------4-----------------
----------------4-----------------
Pap smear
---------------5----------------
----------------5-----------------
----------------5-----------------
Immunizations
 
 
 
MMR
----*---- 
 
 
Td
----*----
----------------+------------------
 
Hep B
----*----
----------------6-----------------
----------------6-----------------
Hep A
---------------7----------------
----------------7-----------------
----------------7-----------------
Varicella
---------------8---------------
----------------8----------------
----------------8-----------------
1.  Screening test performed once if family history is positive for early cardiovascular disease or hyperlipidemia
2.  Screen if positive for exposure to active TB or lives/works in high-risk situation; e.g., homeless shelter, healthcare facility
3.  Screen at least annually if sexually active
4.  Screen if high risk for infection
5.  Screen annually if sexually active or if 18 years or older.
6.  Vaccinate if high risk for hepatitis B infection.
7.  Vaccinate if at risk for hepatitis A infection.
8.  Vaccinate if no reliable history of chicken pox.
9.  * Adolescents should have a complete physical examination during three of these preventive services visits. One should be performed during early adolescence (age 11-14), one during middle adolescence (age 15-17), and one during late adolescence (age 18-21), unless more frequent examinations are warranted by clinical signs or symptoms.
10. ** Includes counseling regarding sexual behavior and avoidance of tobacco, alcohol, and other drug use.
11. *** Includes history of unintended pregnancy and STD.
12. **** A parent health guidance visit is recommended during early and middle adolescence.
13. -+- Do not give if administered in last five years.