A New System for Determining Teens' Health Needs
Embargoed for Release: Monday August 3, 1998
Contact: Lisbeth Pettengill; (410)-955-6878; [email protected]
Researchers at the Johns Hopkins School of Public Health have developed and tested a practical new way of grouping populations of adolescents into distinct health "profiles"--unique combinations of mental, physical, and behavioral problems--so that health care workers can plan for the health needs of a population of teenagers. The study appeared in the August issue of Medical Care.
The new system, called "profile typing," could distinguish a youth, for example, who was doing poorly because of physical discomfort and dissatisfaction about her bodily health from one who was emotionally dissatisfied with himself and so was engaged in high-risk behaviors. Lead author Anne W. Riley, PhD, assistant professor, Health Policy and Management at the Johns Hopkins School of Public Health, said, "Youth with these two profiles could easily have had the same total score on a traditional health inventory, despite their distinctly different needs for health services and their potentially different health trajectories as they become adults."
Although profile typing has been used for many years by mental health practitioners to evaluate the mental health and personalities of their clients, the technique has never been used by physicians or public health workers to get a handle on the general health status of individuals. The authors' system clustered teenagers together by taking into consideration such things as a young person's self-perceptions about health, physical and emotional symptoms, barriers to the normal life activities, behaviors that either risk or protect the health, and level of social functioning.
"Accurately characterizing the health of the individual is the key to health planning," Dr. Riley noted. "We used profile types because they reflect underlying and complex patterns of health and functioning not typically available in reports of health status. These profiles do not merely group behaviors, but instead paint a more true-to-life picture by grouping together individuals with sets of specifically inter-related behaviors."
The authors administered the Child Health and Illness Profile-Adolescent Edition (CHIP-AE) health status questionnaire to adolescents ages 11 to 17 in both clinical settings and public schools. Thirteen distinct profiles were defined that described observed patterns of health and health needs across four primary areas of health--Satisfaction, Discomfort, Risks, and Resilience. The scientists then assigned each youth in the study to one of the 13 patterns, and found that individuals within the same profile-type did indeed have similar combinations of physical, emotional, and behavioral disorders. The system consistently clustered teenagers on the basis of poor rather than good health, a result the researchers said might be explained by the fact that there are more ways of being in poor health than in good health.
The profiles that depicted the best and worst pictures of health both contained more people than had originally been predicted, with twice as many people as expected ending up in the worst, or lowest, profile. All the youths in the two lowest profiles had more emotional disorders and lower achievement rates than average.
Dr. Riley speculated that physicians and public health workers had never gotten around to developing a profiling system because of public health's past heavy reliance on such things as mortality and morbidity statistics, and physicians' necessarily narrow focus on specific physical disorders.
The authors warned that, while their profile typing system has shown promise as a tool for health planning, its accuracy and usefulness must still be proven across a broader range of ethnically and geographically diverse young people.
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This work was supported in part by grants from the Bureau of Maternal and Child Health, the Agency for Health Care Policy and Research, and the National Institute of Mental Health.
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