Adolescent girls' and boys' preferences for provider gender and confidentiality in their health care

Purpose: To assess the influence of demographic variables and health risk s tatus on adolescents' preferences and actual receipt of services regarding provider gender, sharing a physician with parents, and private examinations . Methods: Data from students participating in the Commonwealth Fund 1997 Sur vey of the Health of Adolescent Girls were analyzed. The weighted sample in cluded 6748 students from grades 5-12. The influence of demographic variabl es and health risk status on preferences regarding physician gender, sharin g a physician with parents, and parental presence during examinations and o n actual physician gender, sharing a physician with parents, and receipt of confidential care was assessed for the 5067 students who indicated that th ey had a health check-up or physical examination within the past 2 years. A ssociations were examined using SAS to determine preliminary estimates of s ignificance and correlation coefficients, and SUDAAN to generate proportion s and Cochran Mantel-Haenszel Chi-squared values. A multiple logistic regre ssion procedure in SUDAAN was used to assess interaction among demographic variables. Results: Gender, race/ethnicity, grade level, and risk status were associat ed with preferences regarding provider gender and sharing a physician with parents. 50% of girls preferred a female provider; 48% had no preference. 2 3% of boys preferred a male provider; 65% had no preference. Most adolescen ts had no preference regarding whether they shared a physician with parents . Gender, race/ethnicity, grade level, and risk status were associated with preference regarding parental presence during examinations. Most younger g irls preferred to have a parent present; most younger boys had no preferenc e. Most older girls and boys preferred private examinations. For actual car e situation, most adolescents were cared for by male health providers and d id not share a physician with parents. 57% of girls and 66% of boys spoke p rivately with their health provider. Girls who had a female physician were more likely to have private time than were girls receiving care from a male physician. Gender, grade level, and risk status were associated with havin g private time with a physician. Conclusions: Gender was a significant variable in adolescents' preferences regarding health care. Preferences were also influenced by race/ethnicity, grade level, and risk status. A substantial proportion of adolescents, incl uding those involved in health risk activities, report not having private t ime with their health provider. (C) Society for Adolescent Medicine, 1999.