Adolescent girls' and boys' preferences for provider gender and confidentiality in their health care.
OBJECTIVE
To assess the influence of demographic variables and health risk status on adolescents' preferences and actual receipt of services regarding provider gender, sharing a physician with parents, and private examinations.


METHODS
Data from students participating in the Commonwealth Fund 1997 Survey of the Health of Adolescent Girls were analyzed. The weighted sample included 6748 students from grades 5-12. The influence of demographic variables and health risk status on preferences regarding physician gender, sharing a physician with parents, and parental presence during examinations and on actual physician gender, sharing a physician with parents, and receipt of confidential care was assessed for the 5067 students who indicated that they had a health check-up or physical examination within the past 2 years. Associations were examined using SAS to determine preliminary estimates of significance and correlation coefficients, and SUDAAN to generate proportions and Cochran Mantel-Haenszel Chi-squared values. A multiple logistic regression procedure in SUDAAN was used to assess interaction among demographic variables.


RESULTS
Gender, race/ethnicity, grade level, and risk status were associated with preferences regarding provider gender and sharing a physician with parents. 50% of girls preferred a female provider; 48% had no preference. 23% of boys preferred a male provider; 65% had no preference. Most adolescents had no preference regarding whether they shared a physician with parents. Gender, race/ethnicity, grade level, and risk status were associated with preference regarding parental presence during examinations. Most younger girls preferred to have a parent present; most younger boys had no preference. Most older girls and boys preferred private examinations. For actual care situation, most adolescents were cared for by male health providers and did not share a physician with parents. 57% of girls and 66% of boys spoke privately with their health provider. Girls who had a female physician were more likely to have private time than were girls receiving care from a male physician. Gender, grade level, and risk status were associated with having private time with a physician.


CONCLUSIONS
Gender was a significant variable in adolescents' preferences regarding health care. Preferences were also influenced by race/ethnicity, grade level, and risk status. A substantial proportion of adolescents, including those involved in health risk activities, report not having private time with their health provider.
Kapphahn
C J
CJ
Division of Adolescent Medicine, Stanford University School of Medicine, CA, USA.
Wilson
K M
KM
Klein
J D
JD
D000293:Adolescent; D000367:Age Factors; D002648:Child; D003219:Confidentiality; D005006:Ethnicity; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D010287:Parent-Child Relations; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011287:Prejudice; D012309:Risk-Taking; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States