PRIMARY-CARE PHYSICIANS SCREENING OF ADOLESCENT PATIENTS - A SURVEY OF CALIFORNIA PHYSICIANS

Purpose: To determine how often primary care physicians screen adolesc ents for important risk factors and to determine how rates of screenin g vary by physicians' specialty and practice setting, patients' age, a nd type of risk factor. Methods: A stratified random sample of 343 Cal ifornia physicians who are Board certified in pediatrics, family pract ice, or internal medicine, and physicians in these specialties who spe cialized in adolescent medicine were surveyed about their screening pr actices using a mailed questionnaire. Subjects were asked the percenta ge of routine comprehensive physical examination during which they per sonally queried or screened each age group of adolescents (11-14 years old and 15-18 years old) for each of the following risk factors: high blood pressure, alcohol use, cigarette use, sexual activity, and drug use. Results: The frequency with which primary care physicians report ed actually screening younger and older adolescents for the various ri sks were approximately: 93% and 96% for high blood pressure, 70% and 8 4% for alcohol use, 74% and 82% for drug use, 67% and 83% for sexual a ctivity, and 76% and 86% for smoking, respectively. For all risk facto rs, providers screened older adolescents more frequently than younger adolescents (p < 0.01). Finally, screening rates varied by specialty ( p < 0.01) but not by practice setting. Conclusions: This study found t hat California physicians frequently screen adolescents for a variety of risk factors. However, the reported rates may not be consistent wit h published guidelines. Interventions may need to be developed which f ocus on improving primary care physicians' adolescent-specific screeni ng practices. (C) Society for Adolescent Medicine, 1998.