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Provider Use of Time Alone With Adolescents: Differences by Health Concern

      Abstract

      Purpose

      To examine associations between reports of sensitive health behaviors and the provision of time alone by a clinician during adolescent well visits.

      Methods

      Data were collected from 547 adolescents who completed a well visit at one of eight clinics. Adjusted mixed logistic regression was used to examine whether reports of sexual behavior, substance use, disordered eating, mental health concerns, and demographic characteristics were associated with time alone.

      Results

      Sexual behavior was found to be significantly associated with time alone, while substance use, disordered eating, a positive depression screen, and suicidal ideation were not. Older adolescents and males were more likely to report time alone, while race/ethnicity had no association with time alone.

      Discussion

      Clinicians may be prioritizing time alone for behavioral concerns differently than for other sensitive behaviors.

      Keywords

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      References

        • Hagan J.F.
        • Shaw J.S.
        • Duncan P.M.
        Bright futures: Guidelines for health supervision of infants, children, and adolescents.
        4 ed. American Academy of Pediatrics, Elk Grove, IL2017
        • Kann L.
        • McManus T.
        • Harris W.A.
        • et al.
        Youth risk behavior Surveillance — United States, 2017.
        MMWR Surveill Summ. 2018; 67: 1-114
        • Ford C.
        • English A.
        • Sigman G.
        Confidential health care for adolescents: Position paper of the society for adolescent medicine.
        J Adolesc Health. 2004; 35: 160-167
        • Brown J.D.
        • Wissow L.S.
        Discussion of sensitive health topics with youth during primary care visits: Relationship to youth perceptions of care.
        J Adolesc Health. 2009; 44: 48-54
        • Klein J.D.
        • Wilson K.M.
        Delivering quality care: Adolescents' discussion of health risks with their providers.
        J Adolesc Health. 2002; 30: 190-195
        • Grilo S.A.
        • Catallozzi M.
        • Santelli J.S.
        • et al.
        Confidentiality discussions and private time with a health-care provider for youth, United States, 2016.
        J Adolesc Health. 2019; 64: 311-318
        • Edman J.C.
        • Adams S.H.
        • Park M.J.
        • Irwin Jr., C.E.
        Who gets confidential care? Disparities in a national sample of adolescents.
        J Adolesc Health. 2010; 46: 393-395
        • Irwin Jr., C.E.
        • Adams S.H.
        • Park M.J.
        • Newacheck P.W.
        Preventive care for adolescents: Few get visits and fewer get services.
        Pediatrics. 2009; 123: e565-572
        • Irwin Jr., C.E.
        Time alone for adolescents with their providers during clinical encounters: It is not that simple.
        J Adolesc Health. 2018; 63: 265-266
        • McKee M.D.
        • Rubin S.E.
        • Campos G.
        • O'Sullivan L.F.
        Challenges of providing confidential care to adolescents in urban primary care: Clinician perspectives.
        Ann Fam Med. 2011; 9: 37-43
        • McCarty C.A.
        • Katzman K.
        • Parker E.O.
        • et al.
        Testing a clinic-based program to reduce risky behaviors among teens.
        Patient Centered Outcomes Research Institute (PCORI), Washington, DC2020
        • Richardson L.
        • Parker E.O.
        • Zhou C.
        • et al.
        Electronic health risk behavior screening with integrated feedback among adolescents in primary care: Randomized controlled trial.
        J Med Internet Res. 2021; 23: e24135
        • Richardson L.P.
        • Zhou C.
        • Gersh E.
        • et al.
        Effect of electronic screening with personalized feedback on adolescent health risk behaviors in a primary care setting: A randomized clinical trial.
        JAMA Netw Open. 2019; 2: e193581
        • Kroenke K.
        • Spitzer R.L.
        • Williams J.B.
        The PHQ-9: Validity of a brief depression severity measure.
        J Gen Intern Med. 2001; 16: 606-613
      1. IBM SPSS Statistics for Windows [computer program]. Version 25. IBM Corp., Armonk, NY2017
        • Radovic A.
        • Reynolds K.
        • McCauley H.L.
        • et al.
        Parents' role in adolescent depression care: Primary care provider perspectives.
        J Pediatr. 2015; 167: 911-918
        • Zuckerbrot R.A.
        • Cheung A.
        • Jensen P.S.
        • et al.
        • GLAD-PC Steering Group
        Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice preparation, identification, assessment, and initial management.
        Pediatrics. 2018; 141: e20174081
        • Gadomski A.M.
        • Wissow L.S.
        • Palinkas L.
        • et al.
        Encouraging and sustaining integration of child mental health into primary care: Interviews with primary care providers participating in project TEACH (CAPES and CAP PC) in NY.
        Gen Hosp Psychiatry. 2014; 36: 555-562
        • Miller V.A.
        • Friedrich E.
        • García-España J.F.
        • et al.
        Adolescents spending time alone with pediatricians during routine visits: Perspectives of parents in a primary care clinic.
        J Adolesc Health. 2018; 63: 280-285

      Linked Article

      • Opportunities to Improve Adolescent Health and Wellbeing Through Medical Education and Delivery of Quality Preventive Care
        Journal of Adolescent HealthVol. 71Issue 4
        • Preview
          In this issue of the journal, Al-Shimari et al. report on clinicians' time alone with adolescent patients during routine healthcare visits in 10 primary care clinics in Washington State [1]. Their secondary analysis of adolescent well visits from two randomized controlled trials of electronic health risk behavior screening feedback found a wide variation in whether young people had private, one-on-one time with their clinicians during visits. The percent of adolescents who reported having had time alone during their visit varied from 51.6% to 97.8% across their study sites.
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