Primary care physicians’ screening of adolescent patients: a survey of California physicians

doi:10.1016/S1054-139X(97)00276-0

Journal of Adolescent Health

Volume 22, Issue 6, June 1998, Pages 433-438

https://doi.org/10.1016/S1054-139X(97)00276-0 Get rights and content

Abstract

Purpose: To determine how often primary care physicians screen adolescents for important risk factors and to determine how rates of screening vary by physicians’ specialty and practice setting, patients’ age, and type of risk factor.

Methods: A stratified random sample of 343 California physicians who are Board certified in pediatrics, family practice, or internal medicine, and physicians in these specialties who specialized in adolescent medicine were surveyed about their screening practices using a mailed questionnaire. Subjects were asked the percentage of routine comprehensive physical examination during which they personally queried or screened each age group of adolescents (11–14 years old and 15–18 years old) for each of the following risk factors: high blood pressure, alcohol use, cigarette use, sexual activity, and drug use.

Results: The frequency with which primary care physicians reported actually screening younger and older adolescents for the various risks were approximately: 93% and 96% for high blood pressure, 70% and 84% for alcohol use, 74% and 82% for drug use, 67% and 83% for sexual activity, and 76% and 86% for smoking, respectively. For all risk factors, providers screened older adolescents more frequently than younger adolescents (p < 0.01). Finally, screening rates varied by specialty (p < 0.01) but not by practice setting.

Conclusions: This study found that California physicians frequently screen adolescents for a variety of risk factors. However, the reported rates may not be consistent with published guidelines. Interventions may need to be developed which focus on improving primary care physicians’ adolescent-specific screening practices.

Section snippets

Subject selection

This study was conducted between October 1992 and February 1993, with the approval of our institution’s human subjects committee. The study surveyed a stratified (based on specialty, geography, and gender) random sample of California community-based, Board-certified specialists in pediatrics, family practice, and internal medicine, or physicians who specialize in adolescent medicine (84% of whom were Board certified in pediatrics). Subjects who met study criteria were chosen randomly from the

Results

Table 1 displays the weighted characteristics of the physicians responding to the questionnaire. The average age was 39.5 years old, and the mean year of graduation was 1980. The median number of younger adolescents seen per week was 7 (range 0–130), and the median number of older adolescents seen per week was 6 (range 0–150).

As shown in Table 2, Table 3, screening of younger and older adolescents varied significantly by risk factor (F = 55.12; p < 0.01, and F = 42.28; p < 0.01, respectively).

Discussion

This study found that California physicians frequently screen adolescents for risk factors associated with preventable health problems. Although differences in study design make comparison with other studies difficult, our data suggest that California physicians do as well or better at screening adolescents than other physicians. In 1990, Bradford and Lyons 8 found that the percentage of Pittsburgh pediatricians who frequently or always offered health education for the following topics were:

Acknowledgements

This research was supported, in part, by the Tobacco Related Disease Research Program (Grant 2FT0063), the Maternal and Child Health Bureau Training (Grant MCJ000978A), National Institutes of Allergy and Infectious Diseases (Grant AI36986), and Centers for Disease Control and Prevention (Grant R30/CCR903352).

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Original ArticlesPrimary care physicians’ screening of adolescent patients: a survey of California physicians

Abstract

Section snippets

Subject selection

Results

Discussion

Acknowledgements

J Adolesc Health Care

J Adolesc Health Care

J Adolesc Health Care

Am J Prev Med

AMA Guidelines for Adolescent Preventive Services (GAPS)Recommendations and Rationale

Comprehensive health screening in adolescentsMedical screening

J Adolesc Health

Firearm injury prevention counseling by pediatricians and family physiciansPractices and beliefs

Arch Pediatr Adolesc Med

Differences in the obstetric practices of obstetricians and family physicians in Washington state

J Fam Pract

Cancer prevention practices among Texas primary care physicians

J Cancer Educ

Original Articles
Primary care physicians’ screening of adolescent patients: a survey of California physicians