title: Adolescent views on comprehensive health risk assessment and counseling: assessing gender differences.
abstract: OBJECTIVE
  Adolescence is an important time for the detection of health risk behaviors and factors with subsequent counseling and intervention. Limited research has examined adolescent perceptions of comprehensive health risk assessments (HRAs) and counseling with an assessment of gender differences.
  
  
  METHODS
  Participants were identified using Florida's Medicaid and State Children's Health Insurance Program databases. A total of 35 low-income, racially/ethnically diverse adolescents (ages 14-18 years) participated in eight focus groups stratified by gender. Adolescents completed an internet-based, tablet-administered, comprehensive HRA and then participated in a semi-structured interview. Discussions were recorded, transcribed, and analyzed using a multi-step, team-based approach applying grounded theory to determine major themes.
  
  
  RESULTS
  Male adolescents desired less parental involvement, had less understanding of the protections of clinical confidentiality and the need for comprehensive HRA, and placed greater emphasis on the importance of professional appearance. In contrast, more females valued face-to-face interactions and stressed the importance of concern from the health risk assessor. Overall, adolescents placed importance on their relationship with the health risk assessor, and on valuing trust, confidentiality, and nonjudgmental care. Adolescents preferred to complete HRAs in clinical, private, and professional settings, and reported that tablet technology supported their confidentially in completing the HRA. Furthermore, they stressed the importance of autonomy and learning about the health risk outcomes for risk reduction.
  
  
  CONCLUSIONS
  Gender differences exist in adolescent perceptions of comprehensive HRAs. Adolescent perceptions of HRAs support their use in confidential primary care settings using modalities that emphasize nonjudgmental, private care, and the use of communication techniques that respect adolescents' autonomy to change health risks.
authors.affiliation: Department of Health Outcomes and Policy, University of Florida College of Medicine, Gainesville, Florida. Electronic address: kadivar@ufl.edu.
authors.forename: Hajar
authors.initials: H
authors.lastname: Kadivar
authors.affiliation: Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Thompson
authors.affiliation: Department of Health Outcomes and Policy, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: Martin
authors.initials: M
authors.lastname: Wegman
authors.affiliation: Department of Health Outcomes and Policy, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: TaJuana
authors.initials: T
authors.lastname: Chisholm
authors.affiliation: Department of Health Outcomes and Policy, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: Maryum
authors.initials: M
authors.lastname: Khan
authors.affiliation: Department of Health Outcomes and Policy, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: Katie
authors.initials: K
authors.lastname: Eddleton
authors.affiliation: Department of Clinical Sciences, Florida State University College of Medicine, Orlando, Florida.
authors.forename: Michael
authors.initials: M
authors.lastname: Muszynski
authors.affiliation: Department of Health Outcomes and Policy, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Shenkman
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D016497:Adolescent Health Services / Q000191:economics / Q000592:standards*; D001294:Attitude to Health; D003219:Confidentiality; D003376:Counseling; D005260:Female; D005431:Florida; D017144:Focus Groups; D006801:Humans; D020407:Internet; D007407:Interviews as Topic; D008297:Male; D008484:Medicaid; D054525:Minority Health; D010287:Parent-Child Relations; D011203:Poverty; D011369:Professional-Patient Relations; D018570:Risk Assessment / Q000379:methods; D012309:Risk-Taking; D012737:Sex Factors; D035502:Trust; D014481:United States
keywords: Adolescent health services; Ambulatory care; Health risk assessment; Preventive health services