Monitoring Adolescents' Receipt of Time Alone From Two National Surveys.

PURPOSE: Despite professional endorsement and research supporting time alone with a clinician for adolescents, low rates and disparities persist. The purpose of the present analysis was to provide detailed monitoring of time alone estimates in two national surveys that assess time alone for adolescents aged 12-17 years: the National Survey of Children's Health (NSCH) and the Medical Expenditure Panel Survey (MEPS). METHODS: Time alone assessments in the NSCH and the MEPS have different definitions. The NSCH assessed time alone within the most recent preventive visit, and the MEPS assessed it within the most recent health care visit. We analyzed these within the subsample of 12- to 17-year-olds who had any past-year preventive visit: MEPS 2016-2017, n = 2,689; and NSCH 2016-2017, n = 24,085. We developed time alone estimates for full and subgroup samples and conducted multivariable logistic regressions to determine differences by age, sex, race/ethnicity, income, insurance, and region. RESULTS: Overall time alone receipt was 49% (NSCH) and 29% (MEPS). Overall rates are not comparable because their definitions differ. Some subgroup differences were similar across datasets: younger adolescents (p < .01) and females (p < .05) had lower rates. CONCLUSIONS: Among adolescents with a past-year preventive visit, time alone rates are low. Lower rates for females versus males and younger versus older adolescents persist. Detailed monitoring results can help to shape promising strategies including clinic-based interventions, such as provider training and educating parents, in efforts to improve the provision of time alone in clinical practice.

Delivering Anticipatory Guidance About Technology Use to Adolescents in Primary Care: Rates in a Representative California Sample.

PURPOSE: This study aimed to investigate rates of anticipatory guidance about technology use in primary care, as recommended by the American Academy of Pediatrics Bright Futures Guidelines, in a representative sample of California adolescents. METHODS: Adolescents 12-17 years of age were interviewed as part of the California Health Interview Survey, the largest state health surveillance survey in the U.S. Participants who reported seeing a doctor for a physical examination or checkup in the prior year were asked if their doctor had talked to them about technology use. RESULTS: Overall, 29.7% of the 742 participants reported that their doctor talked to them about technology use. There were no statistically significant differences in rates by age, sex, race/ethnicity, household income, or family type. CONCLUSIONS: While the American Academy of Pediatrics recommends that providers deliver anticipatory guidance about technology use to adolescents in primary care, less than one-third of adolescents surveyed reported having conversations about this topic with their doctor. Given concerns about potential impacts of technology use on adolescent health, medical education should facilitate provider screening and counseling of adolescents about technology use in primary care settings.

What gets measured gets done: assessing data availability for adolescent populations.

OBJECTIVES: To identify specific adolescent sub-populations; to evaluate the health data available regarding these populations related to 21 key national adolescent health objectives from Healthy People 2010; and to make recommendations for improving data capacity to further efforts to reduce health disparities among adolescents. METHODS: Adolescent populations were identified through a consensus process. Academic and government literature was extensively reviewed using internet search techniques to identify available national data for each of these populations on each key national health objective. RESULTS: 18 adolescent subpopulations were identified. These populations fit into four overlapping categories defined by demography, legal status, chronic health condition, or other special characteristics. Overall, national, population-based data regarding these sub-populations were located for 36% of the 21 health objectives. Within the sub-populations, most data was available for ethnic/racial groups, with 57-81% of each of the objectives having data. Data regarding rural/urban groups were found for about one-half of the 21 objectives, and data were located on all other groups for one-fourth or fewer of the objectives. Within the objectives, substance abuse objectives were the most widely measured, with data available for 56-78% of the various populations. For some objectives, such as drug-or alcohol-related motor vehicle deaths depression among the developmentally disabled, no national data were found. CONCLUSIONS: There are still too little data available regarding the specific health status or health objectives for different adolescent populations. A national adolescent data-priority agenda is needed to develop strategies to improve health data regarding adolescent sub-populations. Federal and state health monitoring agencies could create national health profiles of different populations, include more population markers in health studies, and develop tools for population-specific health assessment, particularly for those within the government's care, including incarcerated and foster care youth.