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Health Brief: Factors associated with adolescents remembering anticipatory guidance :

March 4, 2016

Adolescents were more likely to remember anticipatory guidance if they had private time with a clinician, filled out a questionnaire before the visit or if the visit lasted longer than 10 minutes, according to a study of 872 youths ages 11-17.

Guidelines, including those from the Academy, recommend counseling adolescent patients on myriad issues to reduce risky behaviors and increase healthy ones. This study assessed whether adolescents ages 11-13 and 14-17 years remembered what topics were discussed during well visits and factors associated with recalling anticipatory guidance.

Adolescents seen at nine clinics in San Diego completed surveys an average of 12 days after their well visit asking if they recalled a doctor or nurse discussing topics related to health maintenance; social-emotional issues; smoking and substance abuse; safety and violence; and sexual health.

Researchers also interviewed a physician at each clinic to find out how long well visits typically last, whether they use patient questionnaires, and if checklists or electronic medical records (EMRs) are used to prompt clinicians on anticipatory guidance topics.

About 75% of adolescents said discussions with clinicians were helpful or very helpful, and all recalled some health maintenance topics being discussed.

Among 11- to 13-year-olds, only about one-third recalled discussions about substance abuse, and females were more likely to remember sexual issues being discussed than males (81% vs. 62%).

Topics that 14- to 17-year-olds were least likely to recall being discussed were substance abuse (55%) and safety (52%).

Those who completed a questionnaire before the visit remembered significantly more items than those who did not fill out a questionnaire or if their parent filled it out (8.6 vs. 6.3 for younger patients and 10.4 vs. 8.3 for older patients). In addition, teens who had private time with the clinician remembered discussing more topics (9.9 vs. 6.1 for younger patients and 11.3 vs. 6.7 for older patients).

Clinic characteristics associated with greater adolescent recall of topics discussed included providing anticipatory guidance at sick visits, using handwritten records instead of EMRs to document anticipatory guidance and using a paper or electronic system to prompt discussions.

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