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Implementing GAPS increased the receipt of preventive services at these health centers. Adolescents received more comprehensive screening and counseling, more health education materials, and had greater access to care after implementation. GAPS implementation may help improve the quality of care for adolescents.

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The reliability of adolescent reporting was strongly influenced by question characteristics such as sentence complexity and time frame; these should be carefully considered in the construction of questionnaires for adolescents. Adolescents can be an accurate source of health-care service data.

At the time of this study, this hospital's medical students and residents from multiple specialties used inadequate Spanish language skills to provide direct medical care despite the availability of professional interpretation services. Most of these trainees were motivated to improve their Spanish and would welcome evaluation of their language skills.

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