Doctors Often Skip Health Behavior Conversations With Teens

Newswise — Although national health guidelines call for physicians to discuss topics such as substance use, safety and nutrition with adolescents, new research suggests that these talks do not occur as often as they should.

"The guidelines say that adolescents should have an annual visit that provides screening and guidance about high-risk health behaviors," said lead study author Sally Adams, R.N., Ph.D. "If teens can get preventive care to avoid risky behavior, it may impact their health not only in adolescence, but also throughout their lifetime."

The study appears online in the Journal of Adolescent Health.

Adams, of the pediatrics department at the University of California, San Francisco, and colleagues looked at 2,192 adolescents 12 to 17 years old who had received a physical exam within the last six months.

The teens answered survey items about which of nine health-related topics physicians had discussed with them during an exam: tobacco, alcohol and drug use, seatbelts, helmets, violence, exercise, nutrition and sexually transmitted diseases.

Violence was the least-discussed topic, brought up only 15 percent of the time. At the other extreme, 76 percent of the teens had talks with their doctor about nutrition and exercise. Minority, low income and uninsured adolescents had talks with their physicians just as often, contrary to what the authors had expected.

"More that 80 percent of teens did not discuss safety issues like seatbelts and helmets, and at least 70 percent did not discuss substance use," Adams said.

"Pediatricians are well-positioned to identify risk factors and to provide either prevention or early intervention," said Irwin Benuck, M.D., attending pediatrician at Children's Memorial Hospital in Evanston, Ill. "The question brought up by this study is: Were the questions not asked or were they just not remembered?"

Benuck, who was not involved in the study, noted a lag time of up to six months between the visit to the doctor and the survey. During this time, memories might have faded, he said. Adams however, noted that the surveys did include "I don't remember" as a choice to control for this concern. She said research has shown adolescent recall of topics covered in medical visits is valid and accurate for one year, when compared to recordings of the visits.

Journal of Adolescent Health: Contact Tor Berg at (415) 502-1373 or [email protected] or visit http://www.jahonline.org

Adams SH, et al. Adolescent preventive services: rates and disparities in preventive health topics covered during routine medical care in a California sample. J Adolesc Health online, 2008.