Increasing the Screening and Counseling of Adolescents for Risky Health Behaviors: A Primary Care Intervention

This United States-based study seeks to determine whether a systems intervention for primary care providers resulted in increased preventive screening and counseling of adolescent patients, compared with the usual standard of care. According to the findings, screening and counseling rates increased significantly in each of the 6 areas in the intervention sites compared with rates of delivery using the usual standard of care. Findings offer strong support for an intervention to increase clinicians' delivery of preventive services to a wide age range of adolescent patients.

The method used for this study was an intervention conducted in 2 outpatient pediatric clinics while two different pediatric clinics in the same health
maintenance organisation served as comparison sites. The intervention was implemented in 2 phases: first, pediatric primary care providers attended a
training workshop to increase screening and counseling of adolescents in the areas of tobacco, alcohol, drugs, sexual behavior, and safety (seatbelt and helmet use). Second, screening and charting tools were integrated into the intervention clinics. Providers in the comparison sites continued to provide the
usual standard of care to their adolescent patients. Adolescent reports were used to assess changes in provider behavior.

Results from the intervention indicate that screening and counseling rates increased significantly in each of the 6 areas in the intervention sites, compared
with rates of delivery using the usual standard of care. Across the 6 areas combined, the average screening rate increased from 58% to 83%; counseling rates

increased from 52% to 78%. There were no significant increases in the comparison sites during the same period. The training component seems to account for most of this increase, with the tools sustaining the effects of the training.

The study concludes that there is "strong support" for an intervention to increase clinicians' delivery of preventive services to a wide age range of
adolescent patients.