title: Adolescents' Self-Reported Recall of Anticipatory Guidance Provided During Well-Visits at Nine Medical Clinics in San Diego, California, 2009-2011.
abstract: OBJECTIVE
  Anticipatory guidance (AG) is recommended for adolescent well care. AG recall is important in the event sequence that might lead to behavioral change, reduced health risk, and improved health. We assessed factors influencing adolescents' self-reported recall of specific AG topics.
  
  
  METHODS
  Through convenience sampling of nine clinics in San Diego, California, 872 adolescents (429 aged 11-13 years; 443 aged 14-17 years) who had received well visits completed standardized surveys between 2009 and 2011. Adolescents were asked to report recall of either 17 or 23 age-appropriate AG topics that were analyzed in five categories (health maintenance; social/emotional, safety/violence; smoking/substance abuse, and puberty/sexual health); a summary score for all categories was developed. Summary scores' associations with demographic variables, visit characteristics (including having time without parents present [private time]), clinic procedures, and lead physician attitudes were assessed.
  
  
  RESULTS
  AG recall was independently associated with adolescents having private time with clinicians, completing previsit questionnaires, reporting the well visit was helpful, and the well visit lasting at least 10 minutes. Higher summary recall scores were observed among adolescents who received care in clinics providing AG at both sick and well visits and having policies encouraging private time. Clinic electronic medical record use for AG prompts was associated with recall of fewer topics.
  
  
  CONCLUSIONS
  To increase adolescents' AG recall and potentially foster behavior change, our results suggest medical providers should adopt procedures advocated by professional societies, including assuring adolescents receive private time during visits, increasing visit time during well visits, using patient-completed questionnaires, and providing AG during all visits.
authors.affiliation: Graduate School of Public Health, San Diego State University, San Diego, California. Electronic address: mpeddeco@mail.sdsu.edu.
authors.forename: K Michael
authors.initials: KM
authors.lastname: Peddecord
authors.affiliation: Divisions of Infectious Disease and Adolescent Medicine, Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California.
authors.forename: Wendy
authors.initials: W
authors.lastname: Wang
authors.affiliation: Divisions of Infectious Disease and Adolescent Medicine, Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Wang
authors.affiliation: Divisions of Infectious Disease and Adolescent Medicine, Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Ralston
authors.affiliation: Divisions of Infectious Disease and Adolescent Medicine, Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Ly
authors.affiliation: Divisions of Infectious Disease and Adolescent Medicine, Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Friedman
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: C Robinette
authors.initials: CR
authors.lastname: Curtis
authors.affiliation: Divisions of Infectious Disease and Adolescent Medicine, Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Sawyer
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D002140:California; D002648:Child; D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D010290:Parents; D011314:Preventive Health Services; D040242:Risk Reduction Behavior; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Adolescents; Anticipatory guidance; Clinic characteristics; Clinical preventive services; Community health centers; Electronic medical record; Evidence-based practices; Patient privacy; Primary medical care; Vaccine; Well visits