Assessment of health issues and concerns of Israeli seventh graders during school physician examinations: a pilot study.
BACKGROUND
The AMA Guidelines for Adolescent Preventive Services (GAPS) recommends annual medical evaluations during adolescence, emphasizing screening and counseling regarding psychosocial issues. In Israel, seventh graders undergo medical examinations within the school health services, focusing on the detection of physical conditions. We addressed the psychosocial issues of these students by introducing an expanded school physician evaluation.


METHODS
Twelve school physicians performed structured expanded health evaluations for seventh graders in 11 schools. Each student completed a questionnaire (checklist) with 22 health topics "about which s/he may want to receive information." The physician then carried out a biomedical and psychosocial evaluation, physical examination, and offered counseling to the student.


RESULTS
Two hundred and seventy-eight students were examined. The questionnaire required 1-2 minutes, and the physician's evaluation 20-25 minutes. Health behaviors revealed included: currently dieting (28%), no physical activity after school (35%), ever smoked cigarettes (3%), ever smoked a water pipe (9%), used alcoholic beverages (6%), and does not always use front (22%) or rear (55%) seat belt. Nine percent rated their mood as being less than 7 (on a scale from 1 to 10). The leading topics about which the students requested information were height (50%), acne (42%), weight (38%), nutrition/diet (37%), physical activity (35%), and menstrual period (29% of the girls). The physicians counseled the students on an average of 3.6 topics per visit.


CONCLUSIONS
An expanded school physician examination identifies students with psychosocial problems otherwise undetected during standard physical examinations, and provides the opportunity to address their personal concerns.
Knishkowy
Barry
B
Department of Mother, Child and Adolescent Health, Israel Ministry of Health, 20 King David St, PO Box 1176, Jerusalem 91010, Israel. barry.k@moh.health.gov.il
Amitai
Yona
Y
Hardoff
Daniel
D
Levy
Yehoshua
Y
Kiro
Amnon
A
D000293:Adolescent; D016497:Adolescent Health Services; D005260:Female; D015438:Health Behavior; D006266:Health Education; D006305:Health Status Indicators; D006801:Humans; D007557:Israel; D008297:Male; D008403:Mass Screening; D010808:Physical Examination; D010865:Pilot Projects; D012572:School Health Services; D013315:Stress, Psychological; D011795:Surveys and Questionnaires