To describe the health issues reported using a personal digital assistant (PDA) to conduct screening at adolescent well visits, and to determine the effect of a PDA screening tool on the content and quality of the clinical interaction. Design: The PDA screening tool was used to record adolescent health risk behaviors, and cross-sectional exit surveys were administered before and after PDA introduction. Setting: Five primary care practices in New England. Participants: The PDA screening was completed by 1052 youth aged 11 to 19 years. In addition, youth seen before (n=65) and after (n=98) PDA screening implementation completed exit surveys. Intervention: Adolescents completed the PDA screening immediately before the well visit. Branching questions explored risk behaviors in more depth, including motivation to change. Physicians viewed the summarized findings before the adolescent health visit. Main Outcome Measures: Health risk behaviors based on PDA data. Exit surveys assessed the quality of the visit and of any discussion of nutrition, exercise, screen time, tobacco use, alcohol and other drug use, and mood. Results: Multiple risk behaviors (n = 3-9) were reported by 30% of 11-to 14-year-olds and 45% of 15-to 19-year-olds. Exit surveys showed that, with PDA use, the proportion of visits that included discussions of health risk behaviors increased for fruit/vegetable intake (60.4% vs 41.7% without PDA use; P=.03), tobacco use (54.9% vs 40.0%; P = .07), and alcohol use (53.9% vs 38.0%; P =.05). With PDA use, more adolescents rated the visit as confidential (83.7% vs 61.5%; P=.002), more thought they were listened to carefully (87.8% vs 64.6%; PϽ.001), and more were very satisfied (87.8% vs 63.1%; PϽ.001). Conclusion: Use of a PDA-based screening tool enhances physician counseling and improves adolescents' perceptions of the well visit.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.