Adolescent Preventive Services: Rates and Disparities in Preventive Health Topics Covered during Routine Medical Care in a California Sample
Received 2 February 2008; accepted 27 August 2008. published online 08 December 2008.
Abstract
Purpose
The objective was to examine rates and disparities in preventive health topics covered during routine medical care for adolescents, using a California sample.
Methods
Utilizing 2003 California Health Interview Survey data, the sample included 2192 adolescents attending a physical exam within the past 6 months. Adolescents reported whether nine health topics: tobacco, alcohol, drugs, seatbelts, helmets, violence, exercise, nutrition, and sexually transmitted diseases (STDs) were discussed during their most recent physical exam. Outcomes were rates of health topics discussed and disparities in rates based on age, gender, race/ethnicity, income level, and insurance status.
Results
Rates ranged from 15% (violence) to 76% (nutrition, exercise). Compared to older teens, younger teens reported discussing safety more, but substances, nutrition, and STDs less. Compared to males, females reported discussing tobacco and helmets less, but exercise and STDs more. Compared to white youths, Hispanic youths reported more discussion of most topics, black youths reported more discussion of nutrition and less of violence, and Asian youths reported more discussion of seatbelts and helmets. Lower income and uninsured groups reported more discussion of health topics compared to higher income and insured groups.
Conclusions
Rates of coverage of health topics are below recommended levels. Contrary to expectations, minority, uninsured, and lower income groups reported higher rates of discussing health topics. Strategies to increase the coverage of preventive health topics during routine medical care should address these findings.
Address correspondence to: Sally Adams, R.N., Ph.D., Division of Adolescent Medicine, Department of Pediatrics, University of California–San Francisco, 3333 California Street, Suite 245, San Francisco, CA 94143-0503.
ABSTRACT