Identifying and Closing Gaps in Preventive Care for Women and Adolescents


Evidence-based preventive care can improve overall health and decreases illness and death for women and adolescents, but gaps in care caused by barriers still exist.

While barriers in preventive care still exist for women and adolescents, organizations are working towards overcoming these gaps through standardized recommendations and web-based tools for providers, according to an article published in Medical Clinics in North America.1

Evidence-based preventive care can improve overall health and decreases illness and death for 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 in the school of medicine’s preventive medicine and biostatistics at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, who wrote the article.

Barriers to Preventive Care

Many barriers prevent women and adolescents from receiving necessary preventive care, both on the patient level and on the 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 unsure what preventive services are covered by insurance, may be pressed for time to perform care, and may be unclear about preventive clinical guidelines.1 Some providers may even have biases that result in discrimination that becomes an unfortunate barrier to appropriate care.1

Women have different healthcare needs than men, including pregnancy and menopause, in addition to conditions more common in women, such as depression or anxiety.1 Fewer medical studies include women, and “subgroup analyses are not performed to determine if certain preventive services and treatments are differentially effective in women and men,” Takacs Witkop noted.1 “As a result, there is often insufficient evidence from rigorously conducted randomized controlled trials to make evidence-based recommendations for women’s clinical preventive services, leaving gaps in optimal health care for women.”1

Overcoming Barriers: Organizations and the Affordable Healthcare Act (ACA)

Several organizations are expanding to address barriers to healthcare for women and adolescents, such as Bright Futures, the US Preventive Services Task Force (USPSTF), the Advisory Committee on Immunization Practices (ACIP), and the Women’s Preventive Services Initiative (WPSI).

In addition, ACA policy changes have increased access to preventive care coverage at no cost to the patient. However, gaps still remain for women and adolescents as they are often not included in standard recommendations. The Institute of Medicine, now known as National Academy of Medicine (NAM), works to identify missing preventive services and screenings for woman and adolescent girls to close these gaps, and determine how to find what areas may be lacking in the future. The group used evidence-based techniques for what would be most beneficial including “screening for gestational diabetes; human papillomavirus screening; counseling for sexually transmitted infections and human immunodeficiency virus (HIV); contraceptive methods and counseling; breastfeeding support, supplies, and counseling; screening and counseling for interpersonal and domestic violence; and well-woman visits.”1

Implementing Web-Based Tools to Improve Health

The WPSI writes guidelines for an ongoing review and revisions of updates, which “has worked to and continues to identify gaps in recommended preventive services for women,” Takacs Witkop noted. Providers can incorporate WPSI web-based tools to close preventive services gaps and improve woman and adolescent health to close gaps in knowledge.

“The Well-Woman Chart and the accompanying Clinical Summary Tables, which are updated annually and available online, can be used at the point of care to ensure women are offered and receive all the preventive services recommended for their age and circumstance.” Witkop wrote.

In addition to the charts and tables, the WPSI website provides additional resources for providers to improve health outcomes for women and adolescents, including patient education pamphlets. The website provides clear and standardized guidelines that providers can follow to improve preventive care for women and adolescents, helping them close the preventive services gap for this population.

1. Takacs Witkop C. Women’s clinical preventative services: closing the gaps and implementing in practice. Med Clin N Am. July 21, 2023. doi 10.1016/j.mcna.2023.06.004.
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