Factors that influence adolescent reports of counseling by physicians on risky behavior.
OBJECTIVE
To determine factors that affect whether low-income adolescents report that their doctor talked with them about risky behavior.


METHODS
Random digit-dial survey of low-income adolescents in New York City asking about depression, smoking, alcohol use, and sexual activity and the screening and counseling they received on these risk factors and risks during health visits.


RESULTS
Prevalence of counseling by physicians was low, according to adolescent reports, ranging from 17% of adolescents counseled about depression to 52% about sexually transmitted diseases. Older adolescents were more likely than younger to receive counseling about all topics. In bivariate and multivariate models, having the risk factor was strongly associated with physicians counseling for depression (adjusted [adj.] OR = 4.42; p < 0.001); for sexual activity and counseling about condom use (adj. OR = 4.06; p < 0.01), and birth control (adj. OR = 2.76; p < 0.03). Still, many adolescents at risk had not received counseling. Many adolescents have not had a private and confidential visit with their provider. Having a private and confidential visit was also associated with receipt of counseling.


CONCLUSIONS
Adolescents are not receiving sufficient counseling about risks and risky behavior, according to their own reports. There is need to improve delivery of counseling and ensure that private and confidential visits are provided to youth.
Fairbrother
Gerry
G
Division of Health and Science Policy, New York Academy of Medicine, New York, New York 10029-5283, USA. gfairbro@nyam.org
Scheinmann
Roberta
R
Osthimer
Beth
B
Dutton
Melinda J
MJ
Newell
Kerry-Ann
KA
Fuld
Jennifer
J
Klein
Jonathan D
JD
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D003376:Counseling; D003863:Depression; D005260:Female; D019538:Health Care Surveys; D006293:Health Promotion; D006801:Humans; D008297:Male; D009519:New York City; D016017:Odds Ratio; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D012309:Risk-Taking; D012725:Sexual Behavior; D012907:Smoking; D019966:Substance-Related Disorders; D014505:Urban Population