Background Ensuring effective inclusion of adolescents in primary care remains a major challenge within health systems. Despite structural efforts, adolescents still face barriers like stigma, low health literacy and limited access to preventive care. Aim To assess the implementation of an initiative aimed at strengthening adolescent access to and use of primary care services. Methods We conducted a quality improvement (QI) study in a socioeconomically vulnerable community ( Paraisópolis , São Paulo, Brazil). The initiative was divided into three phases: preintervention (October 2022–March 2023), intervention (April 2023–March 2024) and postintervention (April 2024–September 2024). The Model for Improvement was used to build capability in healthcare teams, providing them with evidence-based QI strategies to improve adolescent care, and complemented by principles of implementation science to enhance the adoption and sustainability of QI interventions. Results The percentage of adolescents accessing primary care increased by 29.8% during the intervention period (10.4%–13.5%), sustaining this improvement in the postintervention period (13.8%). Human papillomavirus vaccine administration steadily improved (from 52.0% to 64.4% to 72.4%). Consultations with physicians (from 3.4% to 5.7% to 8.1%), nurses (from 3.2% to 8.2% to 11.0%), multidisciplinary professionals (from 0.6% to 0.8% to 0.7%) and odontologists (from 1.5% to 4.4% to 4.3%) increased across all participating health centres. Conclusion Applying systematic and structured QI methodologies and implementation science strategies can enhance adolescent engagement in primary healthcare in limited-resource urban settings in Brazil. Our initiative offers a scalable, evidence-based and sustainable approach to strengthening adolescent health access, aiming for equitable service delivery.
Neto et al. (Sun,) studied this question.