Survey: Preventive health counseling for adolescents isn't what it ought to be

Adolescents under-use primary care and, when they do seek care, rarely receive preventive counseling about healthy behaviors and risky behaviors. Those are two findings from the recently released National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey.

The two surveys examined US adolescents' use of outpatient care and their likelihood of receiving preventive counseling from their providers. Survey data were collected from 1993 through 2000.

Adolescents 13 to 18 years old had the lowest rates of outpatient visits among all age groups: In 2000, adolescent visits counted for only 5.1% of total outpatient visits made by the US population. The rate was particularly low among male adolescents and teen-aged members of ethnic minorities.

Researchers examined the survey results in regard to counseling of adolescents on three health topics--diet, exercise, and growth/development--and five risk reduction topics--tobacco use/exposure, skin cancer prevention, injury prevention, family planning/contraception, and sexually transmitted disease. A somewhat disappointing picture emerges: Between 1997 to 2000, only 39% of adolescents' visits for general medical concerns and physical exams included counseling, with 26% receiving diet counseling and 22% receiving exercise counseling. Skin cancer prevention, STD transmission (including HIV), and family planning/contraception ranked the lowest.