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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Marilyn Bobbin, MS1, Bradley O. Boekeloo, MS, PhD1, Kevin Worrell, MD2, and Ellen Hamburger, MD3. (1) Department of Public and Community Health, University of Maryland, 1242E HHP Bldg, Valley Drive, College Park, MD 20742, 301 405 2551, bobbin@umd.edu, (2) Camp Springs Medical Center, Pediatrics Department, Kaiser Permanente, 6104 Old Branch Avenue, Temple Hills, MD 20748, (3) Dept of Health Care Sciences - Division of Pediatrics, George Washington University Medical Center, 2150 Pennsylvania Avenue, NW, Washington, DC 20037
Sexuality is an area of much confusion, sensitivity, and risk among adolescent patients. Little research has examined actual patient-provider communication to determine how primary health care providers might effectively communicate with adolescents about sexuality. We analyzed the dialogue in 38 audiotaped adolescent general health check-ups with their primary provider to examine language and assumptions related to intimacy, dating, and sexual activity. Four male and four female pediatricians, and one female nurse practitioner participated. The 23 male and 15 female study patients ranged from 12 to 17 years old. Parents, adolescents, and providers all consented to the taping. In 29 (76%) visits, adolescents gave no indication of their sexual orientation. In two of the nine visits in which the provider discussed confidentiality, the provider clearly defined the limits and scope of confidentiality during the visit. In 24 (63%) visits, the provider discussed sexual activity without clarifying what that actually encompassed. In 15 (39%) of the visits, the provider discussed delaying sexual activity until marriage although in only three of these visits did the adolescent indicate a heterosexual orientation. In ten (26%) of the visits, the provider made at least one statement that assumed male-female sexual activity even though in only two of those cases had the adolescent indicated a heterosexual orientation. This exploratory study shows how audiotapes can be used to identify how the use of language and assumptions by health care providers may impede adolescent disclosure and discussion about sexuality.
Learning Objectives: At the conclusion of the session the participants will be able to
Keywords: Adolescent Health, Sexuality
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.