Enhancing Substance Abuse and Wellness Check-ups for Youth and Young Adults

Enhancing Substance Abuse and Wellness Check-ups for Youth and Young Adults

Wellness and Substance Use Check-ups

Wellness and substance use check-ups are critical to protecting and promoting the heath of all youth and adults.  They are typically scheduled with a primary care doctor or nurse on an annual basis from birth into young adulthood.   

Unfortunately, it is common for individuals to miss their annual wellness checks once they reach adolescence.  This is a serious problem because while most young people have received their needed immunizations, adolescence and young adulthood is a time of significantly heightened threat for experiencing multiple and sometimes co-existing health risks, such as alcohol, tobacco, marijuana or other drug use, physical inactivity, and developing unhealthy eating patterns.     

We propose three solutions to the problem of youth and young adults not receiving needed annual wellness and substance use check-ups.  In addition, we present a simple four-step evidence-based practices model for maximizing the benefits of wellness checks for adolescents and young adults by addressing both the prevention of health risk behaviors while promoting health enhancing habits using a brief, cost-effective integrative behavior strategy.   

Solution One: Linking Wellness Checks to Other Primary Care Services

One solution to the problem of young people not receiving regular wellness or health risk checks-ups is to link them to other common health services provided by primary care specialists.  For example, physical examinations required for participation in sports, summer camps, school, college and employment are an excellent opportunity to address the prevention of health risk habits and the promotion of healthy behaviors, as well as their connection for living a healthy, fit and substance abuse free lifestyle.   

Drug screens are another service provided by many primary care organizations which lend themselves to discussing both prevention and wellness issues.  Whether a parent or an employer requested the drug screen, it’s a great situation for the health care provider to discuss the relationship between alcohol and drug abuse and wellness habits like physical activity, healthy nutrition, getting adequate sleep, and controlling daily stress.  Expanding health behavior feedback beyond the narrow and negative topic of drug abuse harm and problems will increase the potential interest in and efficacy of the drug screen.   

Linking wellness check-ups to physical exams, drug screens, and other health services provided to youth and young adults will increase enjoyment, participation and effectiveness of existing health services.  Wellness checks can also be provided by primary care specialists as a stand-alone service within their clinics and community, which many parents and community organizations would gladly promote and support. 

Solution Two: Providing Wellness Checks During Youth and Young Adult Activities

A second solution to young people not receiving annual check-ups is to provide wellness and risk behavior checks during common youth and young adult enrichment activities, including sports, summer camps, and recreational activities.  Regardless of the focus of these extra-curricular or personal development activities, or the time of year they are offered, they are an ideal situation for providing young people with a wellness check-up. 

For example, adding wellness checks to sports leagues and activities will directly connect sports participation to avoiding risky behaviors like alcohol, tobacco, marijuana and other drug use, while promoting healthy habits necessary for success in sports and life, such as staying physical active, eating healthy foods, getting plenty of sleep, and controlling stress.  Including wellness checks during recreational activities and summer camps will also help youth make an explicit connection between being physical active and avoiding unhealthy habits, thereby enhancing these types of activities for youth and parents.    

Including wellness checks with other adolescent and young adult activities will increase the quality of the activities while improving positive youth development.  If wellness check-ups are brief and positive, as they should be, young adults, youth, parents and organizations will soon expect them to be included as a standard component of extra-curricular and personal development activities, allowing significantly greater numbers of young people to have an opportunity to regularly participate in essential health check-ups.    

Solution Three: Providing Wellness Checks at Home

The third and final solution to the lack of wellness check-ups among youth and young adults is to have parents and guardians provide them at home.  While most parents/guardians are not trained health specialists, if wellness checks are brief, positive and scripted so that parents could easily follow steps for providing them to their youth and young adults, this would greatly increase the likelihood of young people receiving wellness check-ups at home.  Given many if not all parents and guardians are concerned about their youth and young adult’s health and substance use risk habits and overall well-being, the home could be a new setting for conducting wellness checks with young people in the future.

Shortcomings Associated with Typical Wellness and Risk Behavior Check-ups

Typical wellness and risk habit check-ups suffer from a number of limitations.  One, they are often too lengthy and complicated to be provided during or with other health services and activities.  Two, common wellness checks do not highlight the relationships between health behaviors so young people can learn the importance of avoiding risk behaviors like substance use while at the same time engaging in wellness behaviors necessary to develop overall healthy lifestyles.   

Third, some health and medical professionals report feeling like they are admonishing youth and young adults and being unnecessarily negative when providing typical wellness and risk behavior check-ups.  Fourth, wellness checks do not include an opportunity for young people to develop self-regulation skills by setting and monitoring multiple health behavior goals to avoid or reduce substance use while also increasing health promoting behaviors.

A Four-Step Practices Model for Enhancing Wellness and Substance Use Check-ups

A solution to the problems with typical wellness and substance use check-ups for youth and young adults is to implement wellness checks using the proven SFGF model.  SFGF is a four-step evidence-based practices model for providing health behavior Screening, Feedback, Goal setting and Follow-up (SFGF) with young people. 

SFGF allows wellness and risk behavior checks to be provided in a quick and cost-effective single session.  In addition, the SFGF model emphasizes scripted content ensuring wellness check-ups are conducted with ease, accuracy and quality across setting and provider.  

Step One: Screening Current Health Behaviors

The first step of the SFGF model involves quickly assessing common current health risks and health promoting habits of young people using a brief screening instrument.  Unlike other screening tools, the purpose of screening in the SFGF model is to both increase awareness of the youth’s or young adult’s current health behaviors, and permit data for providing personalized health behavior feedback and goal setting. 

Step Two: Feedback and Positive Image Communication

The second step in the SFGF model is the motivational component.  It is designed to provide tailored feedback based on the responses of the young person to the health behavior screening questions.  In addition, positive images of young people are communicated to connect participating in healthy habits with avoiding alcohol and drug use risk behaviors.   

This approach helps youth and young adults see how seemingly unrelated health behaviors can either support or hinder each other and the achievement of positive behavior change.  Because the communication focuses on positive images of young people engaged in healthy behaviors, providers and parents need not feel uncomfortable being negative or paternalistic in talking with adolescents and young adults. 

Step Three: Goal-setting to Improve Multiple Behaviors

The third step in the SFGF model is the action component.  It is designed to give young people an opportunity to practice self-regulation skills to set and monitor multiple health behaviors.   

It also allows adolescents and young adults to make a public commitment to work toward achieving their goals to improve their lifestyle and self-image as an active, fit and healthy young person.  Recommendations are provided to young participants on concrete strategies for achieving positive behaviors and images.     

Step Four: Follow-up

The final step of the SFGF model is to follow-up with youth and young adults to reinforce the motivational messages and recommendations for achieving positive behaviors and images.  Follow-up strategies can include providing print materials for youth and young adults, tips for parents on how to provide positive communication with their youth, and yearly wellness checks to provide young people with an annual inoculation against common health risks.   


Wellness and substance use check-ups are critical to protecting and improving the health of young people.  Unfortunately, adolescents and young adults rarely receive annual wellness or risk behavior checks.   

We proposed three solutions to this problem.  The first is to link wellness checks to other common primary care services for youth and young adults.  The second is to provide wellness checks during common youth and young adult activities.  The third is for parents and guardians to provide wellness checks to their youth and young adults at home.  All three strategies will significantly increase the prevalence of adolescents and young adults receiving critical wellness/risk behavior check-ups in the future.  

Typical wellness and risk behavior checks have a number of important limitations.  Using the four-step SFGF practices model to provide wellness checks eliminates these limitations while maximizing the potential interest in and effectiveness of the wellness check-up for young people.  

The SFGF model has also been used in the successful provision of a number of evidence-based screening and brief interventions for youth and young adults which have been proven to change both wellness and substance use behaviors of young people.  These evidence-based programs which use a wellness check format include the SPORT Prevention Plus Wellness program for youth, and the InShape Prevention Plus Wellness program for young adults.  

Using the SFGF model to provide wellness checks-ups will ensure that all adolescents and young adults will receive wellness checks that not only emphasize avoiding substance use risk behaviors, but also encourage engaging in positive behaviors to promote the broader physical and mental health and well-being of young people.   

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