Primary care providers' responsiveness to health-risk behaviors reported by adolescent patients.
OBJECTIVE
To assess clinicians' responsiveness to health-risk behaviors reported by adolescent patients during a comprehensive clinical preventive services visit.


METHODS
Nonprobability sample of adolescent patients scheduled for a routine physical examination.


METHODS
Seven clinical sites in the Chicago, Ill, area.


METHODS
Fifteen primary care providers and 95 adolescent patients between 11 and 18 years of age.


METHODS
Providers delivered comprehensive clinical preventive services to adolescent patients using the Guidelines for Adolescent Preventive Services model. This model includes screening, guidance, a physical examination, and immunizations. Prior to the visit, adolescent patients completed a screening questionnaire that included a 52-item health-risk behavior profile. Responses on the screening questionnaire were discussed during the visit.


METHODS
Each provider's responsiveness to reported health-risk behaviors was determined by comparing the adolescent patient's responses on the screening questionnaire with those reported during a debriefing interview with the adolescent about whether specific subjects were discussed. Responsiveness to highly sensitive behaviors was determined by comparing the screening questionnaire and the medical record.


RESULTS
On average, each adolescent patient reported 10 risk behaviors, of which 7 were discussed. The severity of the reported risk behavior, the number of reported biological health concerns, and the adolescent patient's sex were significant predictors of the provider's responsiveness. The number of reported health-risk behaviors, visit duration, provider's professional role and sex, whether the adolescent was a new patient, and the adolescent patient's age were unrelated to responsiveness.


CONCLUSIONS
Providers addressed most health-risk behaviors reported during a single visit, but responsiveness declined when 3 or more biological health concerns or relatively severe problems were reported. Steps can be taken to increase providers' responsiveness.
Group on Professional Standards, American Medical Association, Chicago, Ill 60610, USA.
J E
JE
Epner
P B
PB
Levenberg
M E
ME
Schoeny
D000293:Adolescent; D000294:Adolescent Behavior; D003695:Delivery of Health Care; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008487:Medical History Taking; D011314:Preventive Health Services; D011320:Primary Health Care; D012044:Regression Analysis; D012309:Risk-Taking