title: Confidentiality and adolescents' use of providers for health information and for pelvic examinations.
abstract: OBJECTIVE
  To examine the relationship between adolescents' perception of the confidentiality of care provided by their regular health care provider and their reported use of this provider for private health information and for pelvic examinations.
  
  
  METHODS
  Anonymous, self-report survey.
  
  
  METHODS
  Thirty-two randomly selected public high schools in Massachusetts.
  
  
  METHODS
  Of 2224 students in systematically selected 9th and 12th grade classrooms, 1715 (50% male) had a regular provider and a checkup within the last year.
  
  
  RESULTS
  Of teens surveyed, 76% wanted the ability to obtain confidential health care, but only 45% perceived their regular provider to provide this, and only 28% had discussed it explicitly. Logistic regression analyses revealed strong relationships between confidentiality and all outcomes studied. Among adolescents, the likelihood of having discussed sexually transmitted diseases, pregnancy prevention, and/or facts about sex with their provider was greater among teens who received a confidentiality assurance than that for teens who did not (odds ratio [OR] = 2.7; 95% confidence interval [CI], 2.2-3.4). A similar relationship for teens' likelihood of having discussed substance use with the provider was found (OR = 1.8; 95% CI, 1.4-2.3). Among sexually active females, the likelihood of a recent pelvic examination for those who received a confidentiality assurance was greater than for those who did not (OR = 3.3; 95% CI, 2.1-5.5).
  
  
  CONCLUSIONS
  This study furthers evidence of an important link between teens' perception of confidentiality and use of health care services and information. Because teens' health risks lie largely in potential risks from health-related behaviors, confidentiality in health care may be a critical factor in disclosure and discussion of risky behaviors, and ultimately in appropriate use of health care services. Efforts should be made to increase teens' access to confidential health care sources.
authors.affiliation: The Department of Maternal and Child Health, School of Public Health, Harvard Medical School, Boston, Mass., USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Thrall
authors.forename: L
authors.initials: L
authors.lastname: McCloskey
authors.forename: S L
authors.initials: SL
authors.lastname: Ettner
authors.forename: E
authors.initials: E
authors.lastname: Rothman
authors.forename: J E
authors.initials: JE
authors.lastname: Tighe
authors.forename: S J
authors.initials: SJ
authors.lastname: Emans
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D001294:Attitude to Health; D003219:Confidentiality / Q000523:psychology*; D005193:Family Planning Services; D005260:Female; D019538:Health Care Surveys; D006266:Health Education / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D010388:Pelvis; D010808:Physical Examination / Q000523:psychology* / Q000706:statistics & numerical data*; D011247:Pregnancy; D000297:Psychology, Adolescent; D012736:Sex Education; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires