title: Opportunistic adolescent health assessment in the child protection unit.
abstract: OBJECTIVE
  Adolescent health assessments are recommended to identify health-risk behaviours. Adolescents who experience maltreatment are more likely to engage in such behaviours. This study (i) describes the frequency of health-risk behaviours amongst adolescents attending a hospital-based child protection unit (CPU) and (ii) determines whether use of a health assessment questionnaire increases the identification of these behaviours.
  
  
  METHODS
  A retrospective audit was performed of case notes of adolescents (aged ≥ 12 years) presenting to the CPU over 5 years (2007-2011). Data regarding health-risk behaviours were extracted. In 2012, following the introduction of a standardised HEADSS-based four-page questionnaire, health-risk data were collected prospectively over 18 months. The proportion of subjects reporting health-risk behaviours, before and after questionnaire introduction, was analysed.
  
  
  RESULTS
  Two hundred fifty-eight subjects, median age 13 (range 12-18) years, 78% female, were included in the pre-questionnaire period; and 85 subjects, median age 14 (range 12-17) years, 86% female, were included following introduction of the questionnaire. Questionnaire use was associated with an increase in the frequency of health-risk behaviours identified in the following domains: Education (odds ratio 4.48 [confidence interval 2.56-7.96] P < 0.001), Activities (16.18 [6.70-42.74] P < 0.001), Drugs/alcohol (4.00 [2.23-7.16] P < 0.001) and Suicidality (8.27 [4.59-14.92] P < 0.001). Participants reported higher rates of health-risk behaviours than the national population.
  
  
  CONCLUSIONS
  Adolescents attending a hospital-based CPU report high rates of health-risk behaviours. A standardised questionnaire results in increased identification of such behaviours.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Fiona Stanley Hospital, Perth, Western Australia, Australia.|Child Protection Unit, Princess Margaret Hospital, Perth, Western Australia, Australia.|Department of Adolescent Medicine & Eating Disorders, Princess Margaret Hospital, Perth, Western Australia, Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Hawkrigg
authors.affiliation: Child Protection Unit, Princess Margaret Hospital, Perth, Western Australia, Australia.
authors.forename: LeAnne
authors.initials: L
authors.lastname: Smith
authors.affiliation: Child Protection Unit, Princess Margaret Hospital, Perth, Western Australia, Australia.
authors.forename: Alice
authors.initials: A
authors.lastname: Johnson
authors.affiliation: Department of Adolescent Medicine, Westmead Hospital, Westmead, New South Wales, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Kennedy
authors.affiliation: Department of Adolescent Medicine & Eating Disorders, Princess Margaret Hospital, Perth, Western Australia, Australia.|School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Donald
authors.initials: D
authors.lastname: Payne
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000067697:Adolescent Health; D002648:Child; D000068216:Child Protective Services; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014904:Western Australia
keywords: adolescent; child protection; health risks; screening