TY  - JOUR
T1  - DIrect observation of health-habit counseling of adolescents
AU  - Goodwin MA, Flocke SA, Borawski EA, Zyzanski SJ, Stange KC
Y1  - 1999/04/01
N1  - 10.1001/archpedi.153.4.367
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 367
EP  - 373
VL  - 153
IS  - 4
N2  - Objectives 
    To determine the rate of health-habit counseling of adolescents seeing community family physicians and to identify the factors associated with the delivery of recommended preventive counseling services.Design 
    Cross-sectional multimethod study emphasizing direct observation of patient visits.Setting 
    Community family practices in northeast Ohio.Patients or Other Participants 
    Adolescents (n=445) aged 11 to 21 years who were being seen for outpatient visits to community family physicians (n=119) during 2 days of observation by trained research nurses.Main Outcome Measure 
    Direct observation of the delivery of clinical preventive counseling services recommended by the Guidelines for Adolescent Preventive Services.Results 
    During the 445 visits made by adolescents, the most frequently delivered counseling service was exercise advice (13%). At least 1 health-habit counseling service was delivered during 38% of visits. In multivariable analyses, older patient age was strongly associated with increased service delivery. Visits for well care, longer visits, and new patient visits were also associated with the provision of counseling. Visits including preventive counseling services were on average 2.5 minutes longer than visits without preventive counseling.Conclusions 
    The rates of delivery of preventive counseling services in clinical practice were low, raising concern about the feasibility of current recommendations. The practical implementation of prevention guidelines may require a greater use of well-care visits and longer patient visits than are currently used in community family practice.
SN  - 1072-4710
M3  - doi: 10.1001/archpedi.153.4.367
UR  - http://dx.doi.org/10.1001/archpedi.153.4.367
ER  -