By Michelle Rizzo

NEW YORK (Reuters Health) - Physicians are not engaging in conversations with adolescents about health behaviors as often as recommended, according to results of a study published online by the Journal of Adolescent Health.

"Preventive care is a crucial element of quality primary care for adolescents," Dr. Sally Adams, of the University of California, San Francisco, and colleagues. Most causes of sickness and death in adolescents can be prevented. Plus, "many of the health and lifestyle behaviors established during adolescence have long-standing health effects across the entire lifespan," the researchers point out.

Guidelines have been produced by national agencies and professional organizations that recommend "all adolescents have an annual, confidential visit during which primary care providers screen and counsel adolescent patients for multiple risk behaviors."

The researchers used the 2003 California Health Interview Survey to examine coverage of preventive health topics during routine medical care for 2,192 patients between the ages of 12 and 17 years who had a physical exam within the prior 6 months.

Adolescents reported if they discussed tobacco, alcohol, drugs, seatbelt use, helmet use, sexually transmitted diseases (STDs), violence, exercise, and nutrition.

Discussions about health topics ranged from 15 percent for violence to 76 percent for nutrition and exercise. Younger adolescents reported discussing safety more often and less likely to discuss violence and STDs compared with their older peers.

Girls reported discussing tobacco and helmets less than males, but exercise and STDs more.

Compared with white adolescents, Hispanic patients reported more discussion on most topics and black patients reported more discussion on nutrition and less of violence. Asian adolescents reported discussing seatbelts and helmets more than white adolescents.

Compared with higher-income and insured groups, lower-income and uninsured patients reported more discussion of most health topics.

Regular check-ups provide the opportunity to discuss high-risk health behaviors with adolescent patients, Adams commented to Reuters Health. "When that doesn't happen, it is a lost opportunity to help adolescents understand and manage important health factors."

She noted that pediatric clinicians "often report that they lack the skills needed to discuss sensitive health issues, so much of our work has focused on developing (training programs) that increase clinicians' confidence and skills in talking with adolescents in an open manner about sensitive health issues."

Adams concluded, "The ideal would be for teens to see their clinicians as sources of accurate and trusted health guidance and information."

SOURCE: Journal of Adolescent Health, December 1, 2008.

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