Factors that influence adolescent reports of counseling by physicians on risky behavior

Fairbrother, Gerry; Scheinmann, Roberta; Osthimer, Beth; Dutton, Melinda J.; Newell, Kerry-Ann; Fuld, Jennifer; Klein, Jonathan D.

doi:10.1016/j.jadohealth.2004.11.001

« Previous Next »Journal of Adolescent Health
Volume 37, Issue 6 , Pages 467-476, December 2005

Factors that influence adolescent reports of counseling by physicians on risky behavior

Gerry Fairbrother, Ph.D.
- Division of Health and Science Policy, New York Academy of Medicine, New York, New York, USA
- Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
- Address correspondence to: Dr. Gerry Fairbrother, New York Academy of Medicine, Division of Health and Science Policy, 1216 Fifth Avenue, New York, NY 10029-5283.
Roberta Scheinmann, M.P.H.
- Center for Drug Use and HIV Research, National Development and Research Institutes, Inc., New York, New York, USA
Beth Osthimer, J.D.
- Children’s Defense Fund, Los Angeles, California, USA
Melinda J. Dutton, J.D.
- Children’s Defense Fund, New York, New York, USA
Kerry-Ann Newell, M.S.
- Division of Health and Science Policy, New York Academy of Medicine, New York, New York, USA
Jennifer Fuld, M.A.
- Division of Health and Science Policy, New York Academy of Medicine, New York, New York, USA
Jonathan D. Klein, M.D., M.P.H.
- Division of Adolescent Medicine, Department of Pediatrics, University of Rochester, Rochester, New York, USA

Received 2 June 2004; received in revised form 1 November 2004

Abstract

Purpose

To determine factors that affect whether low-income adolescents report that their doctor talked with them about risky behavior.

Methods

Random digit-dial survey of low-income adolescents in New York City asking about depression, smoking, alcohol use, and sexual activity and the screening and counseling they received on these risk factors and risks during health visits.

Results

Prevalence of counseling by physicians was low, according to adolescent reports, ranging from 17% of adolescents counseled about depression to 52% about sexually transmitted diseases. Older adolescents were more likely than younger to receive counseling about all topics. In bivariate and multivariate models, having the risk factor was strongly associated with physicians counseling for depression (adjusted [adj.] OR = 4.42; p < 0.001); for sexual activity and counseling about condom use (adj. OR = 4.06; p < 0.01), and birth control (adj. OR = 2.76; p < 0.03). Still, many adolescents at risk had not received counseling. Many adolescents have not had a private and confidential visit with their provider. Having a private and confidential visit was also associated with receipt of counseling.

Conclusions

Adolescents are not receiving sufficient counseling about risks and risky behavior, according to their own reports. There is need to improve delivery of counseling and ensure that private and confidential visits are provided to youth.

Keywords: Adolescents , Risky behavior , Counseling