title: Relationship of training to self-reported competency and care of adolescents in an African health care setting.
abstract: OBJECTIVE
  Adolescent medicine is not a recognized specialty in most African countries and African healthcare providers receive little adolescent-specific training. We explored the association between training, self-reported competence, and clinical practice related to adolescent health in an African setting.
  
  
  METHODS
  A total of 119 healthcare providers of various disciplines who work with adolescent patients in Francistown, Botswana were surveyed regarding their adolescent-specific training, self-reported competence, and counseling practices. Self-reported competence and practices related to counseling adolescents about sexual activity, alcohol and/or drug use, human immunodeficiency virus (HIV)-specific issues, and mental health were explored.
  
  
  RESULTS
  In all, 50.4% of respondents had received HIV training with an adolescent-specific component. Fewer had received adolescent-specific training outside the context of HIV prevention and management. Respondents were significantly more likely to report higher competence for all items except for counseling adolescents about depression and anxiety if they had received any adolescent-specific training. Respondents who reported higher competence were significantly more likely to report more frequent counseling of their adolescent clients.
  
  
  CONCLUSIONS
  Our study suggests that adolescent-focused training is important for ensuring that adolescents receive counseling when presenting for routine healthcare in our setting. The mental health needs of adolescents do not seem to be adequately addressed by current training.
authors.affiliation: General Pediatrics and Global Health, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. lowenthale@email.chop.edu
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Lowenthal
authors.forename: Dava
authors.initials: D
authors.lastname: Szalda
authors.forename: Nurit
authors.initials: N
authors.lastname: Harari
authors.forename: Rodney
authors.initials: R
authors.lastname: Finalle
authors.forename: Loeto
authors.initials: L
authors.lastname: Mazhani
mesh_terms: D000293:Adolescent; D000295:Adolescent Medicine / Q000193:education / Q000592:standards; D000328:Adult; D000349:Africa; D000368:Aged; D001291:Attitude of Health Personnel; D001902:Botswana; D002983:Clinical Competence; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology / Q000592:standards; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology / Q000592:standards; D055815:Young Adult