 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Wilhelmena I. Lee-Ougo, PhD, Department of Public and Community Health, University of Maryland at College Park, 2387 Valley Drive, Room 1242D, College Park, MD 20742, (301) 405-2550, wt33@umail.umd.edu and Bradley O. Boekeloo, MS, PhD, Department of Public and Community Health, University of Maryland, 1242H HHP Bldg., Valley Drive, College Park, MD 20742-2611.
Active adolescent communication in general medical encounters could improve effectiveness of the care received. In this exploratory study, we sought to identify factors that influence adolescent patients' verbal communication, i.e., question-asking and proactive talk, with the doctor during preventive healthcare visits. We hypothesized that adolescents' trust in the doctor's intention to maintain confidentiality would be associated with adolescents' question asking and proactive talking to the doctor, and that the association would remain after controlling for various environmental, behavioral and demographic variables. Using a cross-sectional, correlational approach, we analyzed questionnaire responses of 444 adolescents receiving general health check-ups in five managed care group practices in Washington, D.C. and Prince George's County Maryland over a ten month period in 2000. Among the adolescents, 45% were male and 55% were female. The vast majority (80%) was African-American/black. Regarding age, 37%, 33% and 30% of the sample were 12-13, 14-15 and 16-17 year olds, respectively. In bivariate tests of association, we observed a significant association between trust and proactive talk. Also, adolescents' comfort in talking to the provider, alcohol use frequency, pre-visit alcohol education, receipt of condom literature, age, ethnicity, provider gender and provider counseling about alcohol were significantly associated with proactive talk. When entered together in a logistic regression model to predict proactive talking, adolescent comfort (OR=.578, CI=.385,.866), ethnicity (OR=1.747, CI=.986, 3.097) and pre-visit alcohol education (OR=1.772, CI=1.127, 2.786) retained significance. We observed no significant association between trust and question asking. Among variables (i.e., adolescents' comfort, age, pre-visit alcohol education, receipt of alcohol literature, familiarity with the provider, provider gender and provider counseling about alcohol and sex) that were significantly associated with question asking in bivariate tests, only pre-visit alcohol education (OR=1.867, CI=1.050, 3.319), adolescent age (OR=1.864, CI=1.306, 2.659) and provider gender (OR=1.887, CI=1.013, 3.514) retained significance in the regression model of question-asking. Our findings suggest that adolescents' trust in the doctors' intention to maintain confidentiality may not be a consistent correlate of their verbal communication during health examinations. Instead, adolescents' sense of comfort with the provider, their age and ethnicity, receipt of alcohol education immediately prior to the visit and the provider's gender may be more strongly associated with adolescent communication. Implications of these findings for the delivery of health care to adolescents will be discussed.
Learning Objectives:
Keywords: Adolescent Health, Communication
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.