Online Program

290584
Barriers and facilitators to conducting adolescent health risk assessments in primary care


Tuesday, November 5, 2013

Jessica De Leon, PhD, Florida State University College of Medicine, Tallahassee, FL
Katie Eddleton, MPH, University of Florida, College of Medicine, Gainesville, FL
Michelle Vinson, MS RD LD/N, Florida State University College of Medicine, Orlando Regional Campus, Orlando, FL
Jevetta Stanford, EdD, University of Florida, Clinical & Translation Science Institute, Jacksonville, FL
Michael Muszynski, MD, Florida State University College of Medicine, Orlando Regional Campus, Orlando, FL
Elizabeth A. Shenkman, PhD, University of Florida, College of Medicine, Gainesville, FL
Adolescence represents an important time for prevention and early intervention of health issues, which if not addressed, could lead to chronic conditions in adulthood. Health risk assessments (HRAs) with adolescents improve health status, yet many barriers exist to conducting HRAs. This qualitative study examined factors that facilitate or hinder adolescent HRA administration. Focus groups with healthcare teams were audio-recorded, transcribed verbatim, and content analyzed with Atlas.ti. Sixty-five subjects participated in eight focus groups in four Florida cities. Provider, patient, parent, practice and process barriers and facilitators were found. Provider facilitators included communication style, comfort level discussing sensitive topics, and cultural competence. Patient characteristics that hinder HRAs included low literacy, low health literacy, constraints faced by younger adolescents, privacy concerns, and teen's general apathy towards health issues. Parental concerns about confidentiality and parents infringing on privacy were reported barriers. Process barriers included time constraints, slowed workflow, multiple or critical health issues, and conducting non-English HRAs. Process facilitators included reducing time constraints, information technology, culturally competent tools appropriate for teens, and billing systems to recoup costs. Practice barriers included clinic layout and pressure to return student patients to class. Practice characteristics that facilitate HRAs included experienced staff, longer appointment times, and access to appropriate resources. Long-term and close patient-provider relationships also facilitate HRAs. The use of HRAs in primary care can be expanded and improved by addressing barriers and facilitators to administration. Adolescent health interventions can potentially reduce risks for adult chronic diseases, thus improving health status and reducing healthcare costs.

Learning Areas:

Administer health education strategies, interventions and programs
Provision of health care to the public
Public health or related research
Social and behavioral sciences

Learning Objectives:
List and describe provider, patient, parent, practice and process barriers and facilitators to administering health risk assessments in primary care settings.

Keyword(s): Adolescent Health, Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have served various research roles (research coordinator, investigator) on multiple funded studies, including research with adolescents and young adults, and I have presented at multiple local, state and national public health, medical and anthropology conferences. As a cultural and medical anthropologist, I have expertise in qualitative methods and the application of qualitative methods in health research. My research interests include sociocultural aspects of health, minority health and health disparities, and health across the lifespan.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.