Provider self-efficacy and the screening of adolescents for risky health behaviors.
OBJECTIVE
To examine the extent to which providers' perceived self-efficacy to deliver adolescent preventive services relates to their screening practices.


METHODS
Screening rates were determined by both provider self-reported screening practices and the independent report of the adolescent patient. First, 66 pediatric providers (pediatricians and nurse-practitioners), working in three pediatric clinics within a managed care organization, completed surveys assessing: (a) self-efficacy for screening adolescent patients in the areas of tobacco use, alcohol use, sexual behavior, seat belt use, and helmet use; and (b) self-reported screening of adolescents during well-visits over the past month. Second, a sample of patients, aged 14 years to 16 years, reported on whether their clinicians screened them for these behaviors during a well-visit. Adolescents completed reports (N = 323) immediately following the well visit. Data were analyzed using Pearson product-moment correlation coefficients.


RESULTS
Provider self-efficacy to deliver preventive services was correlated with self-reported screening in each of the five content areas, ranging from r = .24 (p < .05) for seat belt use to r = .51 (p < .001) for helmet use. Provider self-efficacy was significantly related to adolescent reports of screening in three of the five content areas; r = .25 (p < .05) for sexual behavior and tobacco use; and r = .23 (p = .06) for alcohol use.


CONCLUSIONS
Providers' self-efficacy to screen adolescents for risky behaviors was significantly related to both clinician self-report and independent adolescent reports of screening during well-visits. These findings point to the importance of enhancing clinicians' sense of competence to deliver adolescent preventive services.
Ozer
Elizabeth M
EM
Division of Adolescent Medicine, Department of Pediatrics, and The Research and Policy Center for Childhood and Adolescence, University of California, San Francisco, San Francisco, California, USA. eozer@itsa.ucsf.edu
Adams
Sally H
SH
Gardner
Linda Rieder
LR
Mailloux
Denise E
DE
Wibbelsman
Charles J
CJ
Irwin
Charles E
CE
D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services / Q000592:standards*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D008403:Mass Screening; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000592:standards*; D018570:Risk Assessment; D020377:Self Efficacy