Use of Inexpensive Technology to Enhance Adolescent Health Screening and Counseling

Administering a health behavior questionnaire on a personal digital assistant (PDA) seems to be an effective method for primary care practices to screen teens for risky behaviors, as well as their willingness to change those behaviors. This helps doctors use the limited time of well visits to best address issues for each patient, according to this small exploratory study.

Despite the consequences of health habits developed during adolescence, in a national survey most teens reported their doctors did not discuss the risk behaviors the teens wanted to discuss during their annual exams. So, in this study, 1,052 kids, aged 11-19 years, were given screening questionnaires to fill out on PDAs at their well visits with five primary care practices in New England. Physicians reviewed the results before meeting with the patient so they could tailor counseling to each teen.

Key Findings:

  • Study participants, largely white, middle class adolescents, had a limited number of major risk behaviors; the most common were obesity-related. Teens aged 15 and older were more likely to have major and/or multiple risk behaviors than their younger counterparts.
  • There were big differences in how interested older teens were in changing different behaviors, with the most interest in improving nutrition and exercise; moderate interest in changing tobacco and drug use; and very little interest in changing alcohol consumption.
  • Exit surveying of a small sample of teens after PDA screening was implemented, compared to a similar survey before PDA use, showed adolescents had fewer unanswered concerns and were more satisfied overall with their doctor visit.
  • Physicians reported the PDA screening was easily implemented by staff, well received by teens and helped them adapt counseling to address each teen’s behaviors and motivation to change each behavior.

This may be the first study to examine whether providing assessments of adolescents’ motivation helps primary care physicians enhance counseling. The use of inexpensive PDA-based screening at well visits with teens does show promise, although further study needs to be done to see if these results can be extended to other adolescent populations and care settings.