title: Measuring Unmet Needs for Anticipatory Guidance Among Adolescents at School-Based Health Centers.
abstract: OBJECTIVE
  Our previously validated Youth Engagement with Health Services survey measures adolescent health care quality. The survey response format allows adolescents to indicate whether their needs for anticipatory guidance were met. Here, we describe the unmet needs for anticipatory guidance reported by adolescents and identify adolescent characteristics related to unmet needs for guidance.
  
  
  METHODS
  We administered the survey in 2013-2014 to 540 adolescents who used school-based health centers in Colorado and New Mexico. A participant was considered to have unmet needs for anticipatory guidance if they indicated that guidance was needed on a given topic but not received or guidance was received that did not meet their needs. We calculated proportions of students with unmet needs for guidance and examined associations between unmet needs for guidance and participant characteristics using the chi-square test and logistic regression.
  
  
  RESULTS
  Among participants, 47.4% reported at least one unmet need for guidance from a health care provider in the past year. Topics with the highest proportions of adolescents reporting unmet needs included healthy diet (19.5%), stress (18.0%), and body image (17.0%). In logistic regression modeling, adolescents at risk for depression and those with minority or immigrant status had increased unmet needs for guidance. Adolescents reporting receipt of patient-centered care were less likely to report unmet needs for guidance.
  
  
  CONCLUSIONS
  The Youth Engagement with Health Services survey provides needs-based measurement of anticipatory guidance received that may support targeted improvements in the delivery of adolescent preventive counseling. Interventions to improve patient-centered care and preventive counseling for vulnerable youth populations may be warranted.
authors.affiliation: Department of Pediatrics, Envision New Mexico, University of New Mexico School of Medicine, Albuquerque, New Mexico. Electronic address: mramos@salud.unm.edu.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Ramos
authors.affiliation: Child Policy and Population Health, James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Sebastian
authors.affiliation: Department of Population, Family, and Reproductive Health, Child and Adolescent Health Measurement Initiative, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Scott P
authors.initials: SP
authors.lastname: Stumbo
authors.affiliation: Department of Pediatrics, Envision New Mexico, University of New Mexico School of Medicine, Albuquerque, New Mexico.
authors.forename: Jane
authors.initials: J
authors.lastname: McGrath
authors.affiliation: AcademyHealth, Washington, D.C.
authors.forename: Gerry
authors.initials: G
authors.lastname: Fairbrother
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D003120:Colorado; D003376:Counseling; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D009516:New Mexico; D012572:School Health Services / Q000706:statistics & numerical data*
keywords: Adolescent health care; Anticipatory guidance; Depression; Immigrant; Minority; Preventive counseling; Quality