Arik Marcell, MD, MPH, discusses well visit attendance declines for adolescents and young adults

Preventive care engagement declines for many adolescents as they transition into young adulthood, with a subset of male patients showing persistent disengagement from annual well visits, according to findings discussed by Arik Marcell, MD, MPH, professor of pediatrics and adolescent medicine at Johns Hopkins University.

“While most people, regardless of their sex, were engaged in well visit attendance,” Marcell said, “we showed significant declines in well visit attendance trajectory patterns for both males and females.” He added that the study also identified “a unique subset of male adolescents [who] had persistent disengagement in well visits across this period, from age 15 to 23.”

Distinct preventive care trajectories emerge over time

The findings highlight that adolescents and young adults follow different paths in preventive care engagement. According to Marcell, understanding these trajectories may help clinicians identify patients at risk of becoming disconnected from preventive care and tailor strategies accordingly.

“This study really shows how young people follow different paths of preventive care engagement across the middle adolescent to young adulthood period,” he said. “It can really help primary care providers create more targeted strategies to prevent adolescents who are at risk of becoming disconnected from preventive care during this period.”

Marcell noted that some young people may still access care through other visit types but not annual well visits. “It may be that some of these young people are making other visit types, but just not well visits,” he said, emphasizing the need to “use any opportunity to bundle preventive care as part of these other visit types.”

Sex-based differences mirror earlier childhood patterns

Lower well visit attendance among males was consistent with the research team’s prior work. Marcell explained that earlier studies tracking patients from age 5 through age 17 identified a similar proportion of boys who were persistently disengaged from well visits.

“Half of all boys’ wellness visits significantly dropped off after they turned five,” he said, noting that “one third continue to be disconnected from preventive care through age 17.”

Several factors may contribute, including parental perceptions of health and differences in opportunities to build health care skills. “Females have many more opportunities to practice healthcare,” Marcell said, while “males have [fewer] opportunities to do so and to build these skills.”

Opportunities to strengthen preventive care delivery

The dataset focused on annual well visits and did not capture other visit types, such as problem-based or follow-up visits. Marcell emphasized that these encounters may represent missed opportunities to deliver preventive services.

“We may forget to schedule that annual well visit,” he said, adding that clinicians may need reminders within the medical record and flexibility in clinical scheduling to integrate preventive care during other visits.

He also highlighted the importance of early transition planning to adult care. “It’s recommended to start at age 16,” Marcell said, which should include discussions with families, identifying adult providers, and making a “soft handoff” to ensure continuity of care.

For clinicians seeking structured tools, Marcell pointed to Got Transition, which offers resources to support transition planning for adolescents and young adults.

Disclosure

Marcell reports no relevant disclosures

Reference

Akande M, Eck KV, Wu X, et al. Well-Visit Attendance From Mid-Adolescence to Young Adulthood: Who Remains Engaged? Journal of Adolescent Health. Published online December 1, 2025. doi:https://doi.org/10.1016/j.jadohealth.2025.10.007