When asked, patients tell - Disclosure of sensitive health-risk behaviors

OBJECTIVES. National health care organizations recommend routinely screenin g patients for behavioral health risks, the effectiveness of which depends on patients' willingness to disclose risky behaviors. This study aimed to d etermine if primary care patients' disclosures of potentially stigmatizing behaviors would be affected by (1) their expectation about whether or not t heir physician would see their disclosures and (2) the assessment method. METHODS. One thousand nine hundred fifty-two primary care patients complete d a questionnaire assessing human immunodeficiency virus (HIV), alcohol, dr ug, domestic violence, tobacco, oral health, and seat bell risks; half were told their responses would be seen by the researcher and their physician a nd half were told that their responses would be seen by the researcher only . Patients were randomly assigned to one of five assessment methods: writte n, face-to-face, audio-based, computer-based, or video-based. RESULTS. Across all risk areas, patients did not disclose differently wheth er or not they believed their physician would see their disclosures. Techno logically advanced assessment methods (audio, computer, and video) produced greater risk disclosure (4%-8% greater) than traditional methods in three of seven risk areas. CONCLUSIONS. These findings suggest patients are not less willing to disclo se health risks to a research assistant knowing that this information would be shared with their physician and that a number of assessment methods can effectively elicit patient disclosure. Potentially small increases in risk disclosure must be weighed against other factors, such as cost and conveni ence, in determining which method(s) to use in different health care settin gs.