Sensitive topic? Teens will talk to you

Including counseling on at least one sensitive health subject in an adolescent's visit with a primary care physician makes the teenager more likely to feel the doctor understands his or her problems and has eased his or her worries. These patients also felt more in control and had an increased sense of responsibility for their treatment, according to a study in the January Journal of Adolescent Health (link).

"In large part, adolescents do feel comfortable discussing these sorts of health issues, and this should alleviate some physician fears about bringing up these types of topics during visits," said Jonathan D. Brown, PhD, lead author and an investigator with the research firm Mathematica Policy Research Inc. "Even brief discussions seem to be enough to improve kids' perceptions of care and feeling as if doctors understand their concerns."

Researchers interviewed 358 patients 11 to 16 years old immediately after appointments with primary care physicians from one of 13 urban and rural medical practices. Discussions about getting along with others, their mental state, behavioral issues, relationships with parents, sexuality, birth control, drugs, alcohol or tobacco had a positive effect. The greater the number of sensitive topics brought up, the greater the benefit.

How to provide relevant medical care for adolescents is a concern because many of these health issues need to be handled delicately. Several studies have reported that these types of discussions don't often happen.

"Past research has found that physicians often do feel as if they have a lack of training and a lack of time to deal with the nonmedical health issues of adolescents," Brown said. "But I think what physicians can do is try to create an environment in which they can encourage the discussion of these topics."

This recent data were collected as part of a trial to measure the effect of physician training to communicate more effectively with the age group about mental health. The authors would like to see the development of strategies that would allow primary care physicians to discuss a range of subjects in a brief time.

The American Medical Association published its Guidelines for Adolescent Preventive Services to help physicians deal with many of these issues. It is available online (link).