Adolescent Views on Comprehensive Health Risk Assessment and Counseling: Assessing Gender Differences

• Published in: Journal of adolescent health Vol. 55; no. 1; pp. 24 - 32
• Main Authors: Kadivar, Hajar, M.D., M.P.H, Thompson, Lindsay, M.D., M.S, Wegman, Martin, Chisholm, TaJuana, Ed.S, Khan, Maryum, M.P.H, Eddleton, Katie, M.P.H, Muszynski, Michael, M.D, Shenkman, Elizabeth, Ph.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-07-2014; Elsevier
• Subjects: Adolescent; Adolescent Behavior - psychology; Adolescent health services; Adolescent Health Services - economics; Adolescent Health Services - standards; Adolescents; Ambulatory care; Attitude to Health; Autonomy; Biological and medical sciences; Child Care Services; Confidentiality; Counseling; Counselling; Female; Florida; Focus Groups; Gender differences; Health; Health Care Services; Health risk assessment; Health risks; Humans; Internet; Interviews as Topic; Male; Medicaid; Medical sciences; Mental health; Minority Health; Organization of mental health. Health systems; Parent-Child Relations; Pediatrics; Perceptions; Poverty; Preventive health services; Professional-Patient Relations; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk; Risk Assessment; Risk Assessment - methods; Risk-Taking; Sex Differences; Sex Factors; Social psychiatry. Ethnopsychiatry; Trust; United States; United States; North America; America; Florida; USA, Florida; Health risk assessment; Adolescent health services; Preventive health services; Ambulatory care; Human; Sex; Health service; Gender; Council; Prevention; Adolescent; Health hazards; Ambulatory; Service quality; Public health
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2013.12.002

Abstract Purpose Adolescence is an important time for the detection of health risk behaviors and factors with subsequent counseling and intervention. Limited research has examined adolescent perceptions of comprehensive health risk assessments (HRAs) and counseling with an assessment of gender differences. Methods Participants were identified using Florida's Medicaid and State Children's Health Insurance Program databases. A total of 35 low-income, racially/ethnically diverse adolescents (ages 14–18 years) participated in eight focus groups stratified by gender. Adolescents completed an internet-based, tablet-administered, comprehensive HRA and then participated in a semi-structured interview. Discussions were recorded, transcribed, and analyzed using a multi-step, team-based approach applying grounded theory to determine major themes. Results Male adolescents desired less parental involvement, had less understanding of the protections of clinical confidentiality and the need for comprehensive HRA, and placed greater emphasis on the importance of professional appearance. In contrast, more females valued face-to-face interactions and stressed the importance of concern from the health risk assessor. Overall, adolescents placed importance on their relationship with the health risk assessor, and on valuing trust, confidentiality, and nonjudgmental care. Adolescents preferred to complete HRAs in clinical, private, and professional settings, and reported that tablet technology supported their confidentially in completing the HRA. Furthermore, they stressed the importance of autonomy and learning about the health risk outcomes for risk reduction. Conclusions Gender differences exist in adolescent perceptions of comprehensive HRAs. Adolescent perceptions of HRAs support their use in confidential primary care settings using modalities that emphasize nonjudgmental, private care, and the use of communication techniques that respect adolescents' autonomy to change health risks.