title: Youths' health-related social problems: concerns often overlooked during the medical visit.
abstract: OBJECTIVE
  The objectives of this study were to (1) measure the prevalence of health-related social problems among adolescent and young adult primary care patients; (2) estimate previous screening and referral experiences; and (3) examine participant attitudes toward screening and referral.
  
  
  METHODS
  Data were collected as part of a cross-sectional study conducted in an urban young adult clinic. Patients aged 15 to 25 years completed a computerized questionnaire screening for health-related social problems in nine social domains. In addition, participants answered questions about their previous screening experiences, need for referrals, and their experience using the system.
  
  
  RESULTS
  Seventy-six percent (304/401) of youth screened positive for at least one major problem, including healthcare access (37%), housing (34%), and food security (29%). Forty-seven percent (190/401) experienced major problems in two or more social domains. The prevalence of screening in the past year for each domain averaged 26%; 3% were screened in all nine domains in the previous 12 months and 33% were not screened in any domain. Overall, 75% needed a referral within the previous year, and 42% identified at least one unmet referral need. The majority (84%) of participants reported that it was acceptable to screen for these problems.
  
  
  CONCLUSIONS
  Prevalence of health-related social problems among youth is high. The majority needed at least one referral for a social need in the previous year. Primary care physicians would benefit from improved systems for screening and referral of health-related social problems in order to create a comprehensive medical home for their patients.
authors: Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA 02115, USA. areej.hassan@childrens.harvard.edu
authors: Areej
authors: A
authors: Hassan
authors: Emily A
authors: EA
authors: Blood
authors: Aaron
authors: A
authors: Pikcilingis
authors: Emily G
authors: EG
authors: Krull
authors: LaQuita
authors: L
authors: McNickles
authors: Glenn
authors: G
authors: Marmon
authors: Sarah
authors: S
authors: Wylie
authors: Elizabeth R
authors: ER
authors: Woods
authors: Eric W
authors: EW
authors: Fleegler
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D003430:Cross-Sectional Studies; D004522:Educational Status; D001068:Feeding and Eating Disorders / Q000453:epidemiology; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D015370:Infant Equipment / Q000706:statistics & numerical data; D008297:Male; D009819:Office Visits; D012017:Referral and Consultation; D012940:Social Problems; D019966:Substance-Related Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014754:Violence / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Adolescents; Patient-centered care; Screening; Social problems; Technology; Young adults