title: Preventive care for adolescents: few get visits and fewer get services.
abstract: OBJECTIVE
  Professional guidelines for adolescents recommend annual preventive visits with screening and anticipatory guidance for health-related behaviors. The objective of this study was to examine receipt of preventive services, including disparities in services received, by using a nationally representative sample of adolescents.
  
  
  METHODS
  Using data from the 2001-2004 Medical Expenditure Panel Survey (ages 10-17; N = 8464), we examined receipt of preventive care visits and several measures of the content of care, based on caregiver's reports, among adolescents who received a preventive care visit during the past 12 months. Content of care outcomes included physical parameters measurement (height, weight, and blood pressure); receipt of anticipatory guidance (dental care, seat belts, helmets, exercise, healthy eating, and secondhand smoke exposure); and, for 12- to 17-year-olds, whether adolescents had time alone with their provider during their most recent visit, a proxy for confidential services. We conducted logistic regression analyses to test for disparities in the outcomes on the basis of race/ethnicity, income, and insurance status.
  
  
  RESULTS
  Thirty-eight percent of adolescents had a preventive care visit in the previous 12 months. Low-income and full-year uninsured status were associated with higher risk for not receiving this visit. Most adolescents had height (87%), weight (89%), and blood pressure (78%) assessed. Rates for height and weight were lower in poor and uninsured adolescents. Anticipatory guidance rates were much lower, ranging from 31% for seat belts, helmets, and secondhand smoke to 49% for healthy eating. Only 10% had all 6 areas addressed. Multivariate analyses yielded few disparities in receipt of anticipatory guidance. Forty percent had time alone with their providers. Hispanic and the lowest-income adolescents were the least likely to have time alone.
  
  
  CONCLUSIONS
  Few adolescents received a preventive visit; among those who received this visit, provision of recommended anticipatory guidance was very low. Strategies are required to improve delivery of recommended preventive services to adolescents.
authors.affiliation: Department of Pediatrics, University of California, San Francisco, 3333 California St, Suite 245 San Francisco, CA 94143-0503, USA.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Irwin
authors.forename: Sally H
authors.initials: SH
authors.lastname: Adams
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Park
authors.forename: Paul W
authors.initials: PW
authors.lastname: Newacheck