Does delivering preventive services in primary care reduce adolescent risky behavior?
OBJECTIVE
To determine whether the delivery of preventive services changes adolescent behavior. This exploratory study examined the trajectory of risk behavior among adolescents receiving care in three pediatric clinics, in which a preventive services intervention was delivered during well visits.


METHODS
The intervention consisted of screening and brief counseling from a provider, followed by a health educator visit. At age 14 (year 1), 904 adolescents had a risk assessment and intervention, followed by a risk assessment 1 year later at age 15 (year 2). Outcomes were changes in adolescent behavior related to seat belt and helmet use; tobacco, alcohol, and drug use; and sexual behavior. Analysis involved age-related comparisons between the intervention and several cross-sectional comparison samples from the age of 14-15 years.


RESULTS
The change in helmet use in the intervention sample was 100% higher (p < .05), and the change in seat belt use among males was 50% higher (p = .14); the change in smoking among males was 54% lower (p < .10), in alcohol use was no different, and in drug use was 10% higher (not significant [NS]); and the change in rate of sexual intercourse was 18% and 22% lower than cohort comparison samples (NS).


CONCLUSIONS
The intervention had the strongest effect in the area of helmet use, shows promise for increasing seat belt use and reducing smoking among male adolescents, and indicates a nonsignificant trend toward delaying the onset of sexual activity. Participation in the intervention seemed to have no effect on the rates of experimentation with alcohol and drugs between the ages of 14 and 15 years.
Division of Adolescent Medicine, Department of Pediatrics, University of California, San Francisco, California 94118, USA. elizabeth.ozer@ucsf.edu
Elizabeth M
EM
Ozer
Sally H
SH
Adams
Joan K
JK
Orrell-Valente
Charles J
CJ
Wibbelsman
Julie L
JL
Lustig
Susan G
SG
Millstein
Andrea K
AK
Garber
Charles E
CE
Irwin
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D016497:Adolescent Health Services / Q000458:organization & administration*; D000428:Alcohol Drinking / Q000517:prevention & control; D015331:Cohort Studies; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D008297:Male; D010379:Peer Group; D011314:Preventive Health Services / Q000458:organization & administration*; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012649:Self Concept; D000074606:Smoking Prevention; D019966:Substance-Related Disorders / Q000517:prevention & control; D047568:Unsafe Sex / Q000517:prevention & control