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Lise M. Youngblade, PhD and Elizabeth A. Shenkman, PhD. Dept. of Pediatrics and Institute for Child Health Policy, University of Florida, 1329 SW 16th St., Room 5130, Gainesville, FL 32608, (352) 265-7220 x 86269, lmy@ichp.edu
RESEARCH OBJECTIVE: Study goals were (1) to examine the contribution of provider counseling about risky behavior during a preventive care visit to the odds of risky behavior engagement in low-income adolescents; and (2) to compare the direction and effect of provider counseling on risky behavior to other sources of influence, namely counseling by parents, siblings, and peers. STUDY DESIGN: Telephone surveys including the Young Adult Health Care Survey (YAHCS) were conducted with 640 adolescents aged 11.5 to 19 who had been enrolled in Florida’s S-CHIP for 12 months. The YAHCS contains items about engaging in risky behavior, and about provider counseling about risky behavior. The YAHCS was modified to also include used parents, peers, and siblings as item referents for counseling (E.g., “Did you talk with [your provider, parent, friend, sibling] about smoking?”). Logistic regression was used to model the odds of engaging in risky behavior based on counseling from providers, peers, parents, and siblings, controlling for sociodemographics. POPULATION: The focal population was low-income adolescents enrolled in Florida’s S-CHIP. Families earned less than 200% FPL, but did not qualify for Medicaid. PRINCIPAL FINDINGS: Adolescents talked more about risky behavior with parents and friends, than they did with a sibling or healthcare provider. Conversations with providers, siblings, and friends were associated with higher odds of risky behavior, whereas conversations with parents were associated with lower odds of risky behavior. CONCLUSIONS: Adolescent guidelines call for preventive counseling for all adolescents, yet adolescents already engaging in risky behavior may be more likely to receive counseling. In addition, parent-youth conversation about risky behavior may have a preventive effect on risky behavior. However, this conclusion must be evaluated cautiously as parent-youth conversation may be a marker for other family processes (openness, supportiveness) that were not measured in this study, but that may account for the ameliorative effect of parent-youth discourse about risky behavior on the adolescent’s behavior. IMPLICATIONS FOR POLICY OR PRACTICE: This study underscores the need for provider-based guidance for all adolescents, not just those engaging in risky behavior, and for providers to support communication between parents and adolescents about risky behavior.
Learning Objectives: At the conclusion of this session the participant will
Keywords: Adolescent Health, Risk Taking Behavior
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.