Original articleDiscussion of Sensitive Health Topics with Youth During Primary Care Visits: Relationship to Youth Perceptions of Care
Section snippets
Methods
This is a cross-sectional analysis of data collected to evaluate a cluster-randomized trial of a training to improve the ability of PCPs to communicate about issues related to mental health [21]. Half of the PCPs were randomized to receive three didactic training sessions, followed by self-study and practice with simulated patients. Controls received a training manual and unstructured feedback on standardized patient interviews. Patients were unaware of whether the PCP received the training.
Youth mental health symptoms
Youth reported an average of 11.02 (SD = 6.3) mental health symptoms and 23% scored within the “high difficulties” range. This mean was slightly higher than among youth in nonclinic community settings [33], [34].
Discussion of sensitive health topics. Of the visits, 29% (n = 107) included the discussion of behavior, 43.3% (n = 155) mood, 46.4% (n = 166) getting along with others, 30.2% (n = 108) parent mood, 32.7% (n = 117) family problems, 29.1% (n = 104) sexuality or birth control, and 33.2%
Discussion
Youth had more positive perceptions of the PCP and reported taking a more active role in treatment when sensitive topics were discussed. These findings advance the literature by demonstrating that the discussion of sensitive topics during primary care visits had an independent and robust relationship with youth perceptions of care, which was not explained by other characteristics of the youth or PCP.
These findings have several implications for primary care practice. Although these data were
Uncited reference
[35].
Acknowledgments
The primary data collection and analysis was supported by National Institute of Mental Health (NIMH) grant RO1MH62469 (to L.S.W.). This work was also supported by NIMH grant F31MH75531 to (J.D.B.). We thank the families, providers, and staff of participating clinics. The research team included Carmen Ivette Diaz, Mark Celio, O'Neil Costley, Anne Gadomski, Xianghua Luo, Lucia Martinez, Alexandra Suchman, Nancy Tallman, Mei-Chen Wang, Nancy Weissflog, and Ciara Zachary.
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