Objectives To evaluate the effectiveness of inviting teenagers to general practice consultations to discuss health behaviour concerns and appropriate follow up care. Design Randomised controlled trial, with participants randomised to a consultation (intervention) or usual care (control). Questionnaires completed at baseline, 3 months, and 12 months. Setting Eight general practices in Hertfordshire, England. Participants 1516 teenagers aged 14-15 years. Intervention Consultations with practice nurses to discuss health concerns and develop plans for healthier lifestyles. Main outcome measures Mental and physical health, "stage of change" for health related behaviour, and use of health services. Results At baseline 970 teenagers completed questionnaires; 23% smoked, 35% had been drunk in the previous three months, 64% considered they ate unhealthily, 39% took little exercise, and 36% had possible depression. 41% (304) of teenagers invited attended for a consultation; over one third (112) were offered follow up care. More intervention group teenagers reported positive movement in stage of change for diet and exercise and in at least one of four behaviours (diet, exercise, smoking, drinking alcohol) at 3 months (41% v 31%, P < 0.01), but this did not persist at 12 months. There was marginally more positive change in actual behaviour by intervention teenagers at 3 months (16% v 12%, P=0.06). Recognition of possible depression resulted in improved mental health outcomes at 3 and 12 months. 97% of attenders said they would recommend the intervention to a friend. Conclusions Change in behaviour was slight but encouraging, and the intervention was well received and relatively cheap.
Walker ZAK and Townsend J. The role of general practice in promoting teenage health: a review of the literature. Family Practice 1999; 16: 164-172. Background and methods. Teenagers are acknowledged to be at high risk of health-damaging behaviours including smoking, teenage pregnancy, and drug and alcohol use. Additionally, the recognition of high levels of psychological distress is cause for serious concern about teenage health. This paper reviews health promotion interventions for teenagers in general practice. Medline, BIDS, Psyclit and SIGLE databases for January 1990-February 1997 were systematically searched for English language studies on adolescent/teenage health and health promotion interventions in primary health care/general practice; reference sections of articles were checked for earlier work.
Conclusions.The literature indicates that teenagers rarely receive health promotion advice from their physicians. The impact on behaviour change, of screening and health promotion for teenagers in general practice requires further evaluation to asssess the potential effectiveness in preventing the onset or continuation of health-damaging behaviours.
Survey and group work was carried out to inform a trial of teenage health promotion consultations in general practice and identify current provision in general practice of health promotion for teenagers, and their needs and preferences. Although 83 per cent of general practitioners. thought primary care an appropriate setting for health promotion, only 17 per cent currently provided services specifically for teenagers. Ninety-five per cent of the teenagers reported that they would like to receive health behaviour advice from their general practice doctor or nurse, Results of teenage group meetings held to discuss how best to develop a consultation service are reported.
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