Unique needs of the teen in the health care setting

Current Opinion in Pediatrics

Volumn 8, Issue 4, 1996, Pages 333-337

  Ginsburg, Kenneth R ^a   Slap, Gail B ^b  

^a UNIVERSITY OF PENNSYLVANIA   (United States)

^b HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; CHILD HEALTH CARE; COST BENEFIT ANALYSIS; DOCTOR PATIENT RELATION; HEALTH CARE ACCESS; HEALTH CARE NEED; HEALTH CARE UTILIZATION; HEALTH PROMOTION; HUMAN; PATIENT EDUCATION; PRACTICE GUIDELINE; PREVENTIVE MEDICINE; PRIORITY JOURNAL; PRIVACY; REVIEW; SCHOOL HEALTH SERVICE;

EID: 0029851487     PISSN: 10408703     EISSN: None     Source Type: Journal    
DOI: 10.1097/00008480-199608000-00006     Document Type: Review

References (29)

1. Adolescent Health: I. Summary and Policy Options. Washington, DC: US Congress Office of Technology Assessment; 1991. [OTA publication no. OTA-H-468.]
2. American Medical Association: Healthy Youth 2000: National Health Promotion and Disease Prevention Objectives for Adolescents. Chicago: American Medical Association; 1990.
3. Gans J, McManus MA, Newacheck PW: Profiles of Adolescent Health: II. Adolescent Health Care: Use, Costs, and Problems of Access. Chicago: American Medical Association; 1991.
4. American Medical Association: Guidelines for Adolescent Preventive Services. Chicago: American Medical Association; 1992.
5. Elster AE, Kuznets NJ: AMA Guidelines for Adolescent Preventive Services: Recommendations and Rationale. Baltimore: Williams & Wilkins; 1994.
6. Igra V, Millstein S: Current status and approaches to improving preventive services for adolescents. JAMA 1993, 269:1408-1412.
7. Gans JE, Alexander B, Chu RC, Elster AB: The cost of comprehensive preventive medical services for adolescents. Arch Pediatr Adolesc Med 1995, 149:1226-1234. This article addresses the rationale behind the Guidelines for Adolescent Preventive Services and then evaluates its cost-effectiveness. It concludes that preventive interventions need to eliminate 15% of adverse outcomes to break even economically. It calls for rigorous outcome-based program evaluation to demonstrate effectiveness.
8. Klein J, Slap GB, Elster A, Schonberg SK: Access to health care for adolescents: a position paper for the Society of Adolescent Medicine. J Adolesc Health 1992, 13:162-170.
9. Ginsburg KR, Slap GB, Cnaan A, Forke CM, Balsley CM, Rouselle DM: Adolescents' perceptions of factors affecting their decisions to seek health care. JAMA 1995, 273:1913-1918. This five-stage study used group techniques and surveys to assure that adolescents, rather than adults, generated, prioritized, and explained all ideas. The 6821 students who returned the final survey comprised the study sample that underwent statistical analysis. Youth in focus groups generated the items in the survey and later added qualitative depth to the results. This teen-centered design produced results different from what would have been predicted from the existing literature.
10. Promoting the Health of Adolescents: Proceedings From the 1990 State Adolescent Health Coordinators Conference. Washington, DC: National Center for Education in Maternal and Child Health; 1990.
11. Cheng T, Savageau J, Sattler A, Dewitt T: Confidentiality in health care: a survey of knowledge, perceptions and attitudes among high school students. JAMA 1993, 269:1404-1407.
12. Hodgson C, Feldman W, Corber S, Quinn A: Adolescent health needs: II. Utilization of health care by adolescents. Adolescence 1986, 21:383-390.
13. Greydanus D, Patel D: Consent and confidentiality in adolescent health care. Pediatr Ann 1991, 20:80-84.
14. AMA Council on Scientific Affairs: Confidential health services for adolescents. JAMA 1993, 269:1420-1423.
15. Brindis C, Lee P: Public policy issues affecting the health care delivery system of adolescents. J Adolesc Health 1990, 11:387-397.
16. Cheng TL, Klein JD: The adolescent viewpoint: implications for access and prevention. JAMA 1995, 273:1957-1958. In an editorial comment, the authors describe implications for the findings from the Ginsburg et al. study (JAMA 1995, 273:1913-1918). They discuss the importance of improving accessibility to services for teenagers and of tailoring those services to meet the needs and expectations of youth.
17. Millstein S, Irwin C, Adler N, Cohn L, Kegeles S, Dolcini M: Health-risk behaviors and health concerns among young adolescents. Pediatrics 1992, 3:422-428.
18. Manning DT, Balson PM: Teenagers' beliefs about AIDS education and physicians' perception about them. J Fam Pract 1989, 29:173-177.
19. Friedman L, Johnson B, Brett A: Evaluation of substance-abusing adolescents by primary care physicians. J Adolesc Health 1990, 11:227-230.
20. Litt I, Cuskey R: Satisfaction with health care: a predictor of adolescent appointment keeping. J Adolesc Health 1984, 5:196-200.
21. Clark LR, Ginsburg KR: How to talk to your teenaged patients. Contemp Adolesc Gynecol 1995, 1:23-27. This article offers a practical approach to communicating with the adolescent patient. First, it discusses styles that teenagers consider attractive. Then, it offers a comprehensive behavioral screen as well as a brief screen for when time is limited.
22. Jenkins RR, Saxena SB: Keeping adolescents healthy. Contemp Pediatr 1995, 12:76-89. This article reviews several guidelines for preventive services for teenagers. It then offers the provider a framework from which to approach both routine biomedical and behaviorally based preventive care.
23. Klein JD, Cox EM: School-based health clinics in the mid-1990s. Curr Opin Pediatr 1995, 7:353-359. This article is a thorough review of the current state of SBHCs. It discusses various clinic models and the health and educational impact of each. It also raises policy issues of concern to school-based clinics in the current era of health care reform.
24. Dryfoos J: Medical clinics in junior high school: changing the model to meet demands. J Adolesc Health 1994, 15:549-557.
25. Kaplan DW: School based health centers: primary care in high school. Pediatr Ann 1995, 24:192-200. The author shares his experience of school-based centers in Denver. The author proposes the SBHC as a means to offer primary care in schools, while lowering barriers adolescents face in seeking health care.
26. Turner GM: Peer counseling. Pediatr Ann 1995, 24:330-333. This article reviews the role of peer counselors in health care settings. Peers are noted to be an effective and generally accepted route through which to convey preventive messages. Different styles of counseling that peers can offer are presented. The author views peer counseling as being therapeutic to both the teenaged counselor and the teenaged patient.
27. Downs SM, Klein JD: Clinical preventive services efficacy and adolescents' risky behaviors. Arch Pediatr Adolesc Med 1995, 149:374-379. This article develops a cost-effectiveness model that compares standard practice with a more intensive program that includes behavioral screening visits for all adolescents, with further counseling visits for high-risk youth. Their analysis finds that a more intensive program would be cost-effective if it were 5.6% effective at preventing adverse outcomes. It discusses the difficulties inherent in outcome research when studying efficacy at this level. The authors conclude that programs should be implemented based on current knowledge and evaluated as part of widespread implementation.
28. Capelli M, Clulow MK, Goodman JT, Davidson SJ, Feder SH, Baron P, Marion IG, McGrath PJ: Identifying depressed and suicidal adolescents in a teen health clinic. J Adolesc Health 1995, 16:64-70. This study examined the prevalence of depression and suicidal probability among new referrals to an adolescent health clinic. In a sample of 104 who completed the Beck Depression Inventory and the Suicide Probability Scale, 21% fell within the range of severe depression. The authors call for comprehensive screening practices for depression in teen health clinics.
29. Schneider MB, Friedman SB, Fisher M: Stated and unstated reasons for visiting a high school nurse's office. J Adolesc Health 1995, 16:35-40. This study surveyed 186 students visiting a school nurse in a suburban high school. It explored associations between presenting complaints and psychosocial problems. The analysis revealed that somatic complaints with no specific symptoms should be used as markers for exploring psychosocial problems, including stress and depression.