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Adolescents underuse and receive little preventive health counseling during primary care visits

U.S. adolescents underuse primary care and, when they do seek care, few receive preventive counseling about healthy behaviors and risky behaviors. With support from the Agency for Healthcare Research and Quality (HS11313), researchers analyzed data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey to examine U.S. adolescents' use of outpatient care and the likelihood of receiving preventive counseling from 1993 through 2000.

Adolescents ages 13 to 18 had the lowest rates of outpatient visits among all age groups. For example, adolescent visits counted for 5.1 percent of the total outpatient visits made by the U.S. population in 2000, yet adolescents represent 8.6 percent of the population. Rates were particularly low among boys and ethnic minorities.

Researchers specifically examined counseling on three health topics: diet, exercise, and growth/development; and five risk reduction topics: tobacco use/exposure, skin cancer prevention, injury prevention, family planning/contraception, and sexually transmitted disease (STD) transmission. From 1997 to 2000, only 39 percent of visits for general medical/physical examinations included counseling of adolescents, with 26 percent receiving diet counseling and 22 percent receiving exercise counseling. Counseling rates for the other six topics ranged from as low as 3 to 20 percent, with skin cancer prevention, HIV/STD transmission, and family planning/contraception ranking the lowest.

See "U.S. adolescents receive suboptimal preventive counseling during ambulatory care," by Jun Ma, M.D., R.D., Ph.D., Yun Wang, M.S., and Randall S. Stafford, M.D., Ph.D., in the May 2005 Journal of Adolescent Health 36, pp. 441e1-441e7.

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