Preventive care for adolescents: few get visits and fewer get services

Professional guidelines for adolescents recommend annual preventive visits with screening and anticipatory guidance for health-related behaviors. The objective of this study was to examine receipt of preventive services, including disparities in services received, by using a nationally representativ...

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Bibliographic Details
Published in:Pediatrics (Evanston) Vol. 123; no. 4; p. e565
Main Authors: Irwin, Jr, Charles E, Adams, Sally H, Park, M Jane, Newacheck, Paul W
Format: Journal Article
Language:English
Published: United States 01.04.2009
Subjects:
Adolescent
Adolescent Health Services - statistics & numerical data
Caregivers - statistics & numerical data
Confidentiality
Health Care Surveys
Health Expenditures - statistics & numerical data
Health Promotion
Healthcare Disparities
Humans
Income
Logistic Models
Multivariate Analysis
Poverty - statistics & numerical data
Preventive Health Services - utilization
United States
United States
ISSN:1098-4275, 1098-4275
Online Access:Get more information
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Summary:Professional guidelines for adolescents recommend annual preventive visits with screening and anticipatory guidance for health-related behaviors. The objective of this study was to examine receipt of preventive services, including disparities in services received, by using a nationally representative sample of adolescents. Using data from the 2001-2004 Medical Expenditure Panel Survey (ages 10-17; N = 8464), we examined receipt of preventive care visits and several measures of the content of care, based on caregiver's reports, among adolescents who received a preventive care visit during the past 12 months. Content of care outcomes included physical parameters measurement (height, weight, and blood pressure); receipt of anticipatory guidance (dental care, seat belts, helmets, exercise, healthy eating, and secondhand smoke exposure); and, for 12- to 17-year-olds, whether adolescents had time alone with their provider during their most recent visit, a proxy for confidential services. We conducted logistic regression analyses to test for disparities in the outcomes on the basis of race/ethnicity, income, and insurance status. Thirty-eight percent of adolescents had a preventive care visit in the previous 12 months. Low-income and full-year uninsured status were associated with higher risk for not receiving this visit. Most adolescents had height (87%), weight (89%), and blood pressure (78%) assessed. Rates for height and weight were lower in poor and uninsured adolescents. Anticipatory guidance rates were much lower, ranging from 31% for seat belts, helmets, and secondhand smoke to 49% for healthy eating. Only 10% had all 6 areas addressed. Multivariate analyses yielded few disparities in receipt of anticipatory guidance. Forty percent had time alone with their providers. Hispanic and the lowest-income adolescents were the least likely to have time alone. Few adolescents received a preventive visit; among those who received this visit, provision of recommended anticipatory guidance was very low. Strategies are required to improve delivery of recommended preventive services to adolescents.
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ISSN:1098-4275
1098-4275
DOI:10.1542/peds.2008-2601