Health Care Service Network for Adolescents and Young Adults in the Unified Health System - SUS (LCA&J): building encounters between subjects and network articulation

• Grant number: 25/10310-4
• Support Opportunities: Regular Research Grants
• Start date: January 01, 2026
• End date: December 31, 2027
• Field of knowledge: Health Sciences - Collective Health - Public Health
• Principal Investigator: Mariana Arantes Nasser
• Grantee: Mariana Arantes Nasser
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• City of the host institution: São Paulo
• Associated researchers: Adalto Alfredo Pontes Filho ; Alejandra López Gómez ; Amanda Pedroso Gonçalves ; Ana Lucia Pereira ; André Luiz da Silva Sobrinho ; Andrea Paula Ferrara ; Aretusa de Oliveira Martins Bitencourt ; BARBARA VITORIA MENDES ; Carolina Simone Souza Adania ; Cecilia Correa ; Cleverton da Silva Santos ; Cristiane Gonçalves da Silva ; Daisy Maria Machado ; Elen Rose Lodeiro Castanheira ; Emanuella Gomes Maia ; Fernanda Lopes Regina ; Gabriel Magalhães Francisco ; Giovana Ribeiro de Souza Favaretto ; Jan Stanislas Joaquim Billand ; João Gabriel de Moraes Pinheiro ; jorge harada ; José Ricardo de Carvalho Mesquita Ayres ; Josiane Fernandes Lozigia Carrapato ; Júlia Amaral Camargo ; Júlia de Campos Cardoso Rocha ; JULIANA DOS SANTOS CORBETT ; Julliana Luiz Rodrigues ; Lissi Mendonça da Silva Moraes ; Magnus Régios Dias da Silva ; Marcelo Dayrell Vivas ; María Fernanda Miguel ; Maria Gabriella Simões Alves de Oliveira ; Miriam de Toledo Leitão Figueiró ; Mônica Vilchez da Silva ; Noelia Nazarena Vacaflor ; Olívia Félix Bizetto ; Patricia Ferreira de Andrade ; ricardo de castro e silva ; Rubens Kon ; Rui Massato Harayama ; Ruth Terezinha Kehrig ; Sandra Mara Garcia ; Vanessa Silva dos Santos

Abstract

The project aims to explore and analyse pathways for implementing the Health Care Service Network for Adolescents and Young Adults in the Unified Health System - SUS (LCA&J), focusing on care encounters and health networks in the state of São Paulo (SP) and other regions of Brazil. Health Care Service Network are programmatic guidelines that address regional health priorities, coordinated by primary care. The relevance of the LCA&J is based on public health criteria: the magnitude of health problems, their social impact, and the engagement of adolescents and youth (A&Y) in actions of health care.The project adopts comprehensiveness as its theoretical framework, both in care practices and in the articulation of health networks. Its operational framework-and also a product of the same research line-is the LCA&J, developed through studies conducted in SP with support from the SUS Research Program and PAHO/WHO. From 2016-18, research built the LCA&J, producing a technical document presented to the Bipartite Inter-Manager Commission of SP in 2018. From 2019-22, continuing education activities were carried out to support the implementation of the LCA&J, including the publication of an online book and a training course course that engaged health professionals in 65 % of SP municipalities.The LCA&J is aligned with the principles and guidelines of SUS and aims to ensure comprehensive care for A&Y in outpatient services (Primary Health Care Units, Psychosocial Care Centers, Specialized STI/AIDS Care Services, referral centers, and hospital outpatient clinics), in addition to guiding intersectoral coordination. The LCA&J can be considered a public policy and health program for A&Y within SUS, as it has developed a set of guidelines, implementation recommendations, and evaluation indicators.The project will use a participatory action research methodology, with action taking place through institutional support for regional management and continuing education for health professionals. Intersectoral coordination-particularly between education and health-will be guided by the School Health Program. Social participation by adolescents and youth will also be a key component.Knowledge generation will take place through health evaluation-focused on individuals, services, and networks-and public health policy analysis, based on the Policy Cycle Approach. The project phases are designed to meet specific objectives for SP, focusing on pilot regions: providing institutional support to regional management; developing continuing education processes for professionals and managers of health services; fostering experiences of intersectoral coordination; and promoting youth engagement in health through the LCA&J.Additionally, the project will seek to: disseminate the LCA&J framework and support its development in one health network in each Brazilian region beyond the Southeast; foster dialogue with the formulation of the National Policy for Heath Care Integrality for Adolescents and Youth; and enable exchanges of knowledge and experiences on policies and services for A&Y care with other Latin American countries.The project will be submitted for review by a Research Ethics Committee. The study aims to promote the construction of knowledge regarding the life and health needs of A&Y, as well as care and public health policies, in connection with everyday practices and health management processes. It is expected to contribute to the continuity and deepening of LCA&J implementation in São Paulo, as well as to the broader dissemination of knowledge for application in other contexts and by interested stakeholders.Expected outcomes include audiovisual/interactive tools for A&Y health professionals and intersectoral stakeholders; guides for the continuing education of professionals; a model for institutional support to management; an evaluation system for LCA&J implementation; and policy and program recommendations to improve A&Y health care. (AU)