Delivery of Smoking Prevention and Cessation Services to Adolescents

Klein, Jonathan D.; Levine, Leonard; Allan, Marjorie J.

doi:10.1001/archpedi.155.5.597

Cited by 48 publications

(26 citation statements)

References 20 publications

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“…In a large, multistate survey of adolescents, psychosocial surveillance was far more likely if either the clinician arranged to have at least part of the visit private or the adolescent knew how to confidentially arrange a visit with a clinician (5). Likewise, a survey of physicians in New York found that those who made more of their adolescent visits private also provided more tobacco surveillance and counseling (47). A nationally representative survey of family physicians and pediatricians, however, found that only 64% of physicians often or always saw adolescents without their parents present (11).…”

Section: Lack Of Privacy For Adolescentsmentioning

confidence: 99%

“…Large surveys suggest that longer visit times with both young children and adolescents are associated not only with increased developmental or psychosocial surveillance and anticipatory guidance, but also with parent satisfaction (31,40,47,65,86). Likewise, a panel of childhood injury-prevention experts concluded that time may be one of the most important requirements for providing guidance (19).…”

Section: Clinician and Patient Gender-related Barriersmentioning

confidence: 99%

“…At least two of the major barriers described above [language-related barriers (45,51) and lack of privacy for adolescents (5,47)] may be addressed by providing multilingual services for families and arranging privacy for a portion of most or all adolescent visits.…”

Section: Overcoming Barriers In the Officementioning

confidence: 99%

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PREVENTIVE CARE FOR CHILDREN IN THE UNITED STATES: Quality and Barriers

Chung

Lee

Morrison

et al. 2006

Annu. Rev. Public Health

142

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Key Words primary health care, well-child care, adolescent, child, infant ■ Abstract Our objective was to examine the academic literature covering quality of childhood preventive care in the United States and to identify barriers that contribute to poor or disparate quality. We systematically reviewed articles related to childhood preventive care published from 1994 through 2003, focusing on 58 large observational studies and interventions addressing well-child visit frequency, developmental and psychosocial surveillance, disease screening, and anticipatory guidance. Although many children attend recommended well-child visits and receive comprehensive preventive care at those visits, many do not attend such visits. Estimates of children who attend all recommended visits range widely (from 37%-81%). In most studies, less than half is the proportion of children who receive developmental or psychosocial surveillance, adolescents who are asked about various health risks, children at risk for lead exposure who are screened, adolescents at risk for Chlamydia who are tested, or children and adolescents who receive anticipatory guidance on various topics. Major barriers include lack of insurance, lack of continuity with a clinician or place of care, lack of privacy for adolescents, lack of clinician awareness or skill, racial/ethnic barriers, language-related barriers, clinician and patient gender-related barriers, and lack of time. In summary, childhood preventive care quality is mixed, with large disparities among populations. Recent research has identified barriers that might be overcome through practice and policy interventions.

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Section: Lack Of Privacy For Adolescentsmentioning

confidence: 99%

Section: Clinician and Patient Gender-related Barriersmentioning

confidence: 99%

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PREVENTIVE CARE FOR CHILDREN IN THE UNITED STATES: Quality and Barriers

Chung

Lee

Morrison

et al. 2006

Annu. Rev. Public Health

142

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“…In 2 studies that assessed counseling of adolescent patients, physicians reported screening 71.4% of younger adolescents and 84.8% of older adolescents about tobacco use in a California survey 25 and 91% of adolescents in an upstate New York survey. 26 In a study of Connecticut physicians and dentists, 65% of practitioners reported "frequently" or "always" counseling patients about tobacco between ages 16 and 18, 54% between ages 13 and 15, and 38% between ages 10 and 12. 27 With respect to parent counseling, a study in Vermont found that 94% of pediatricians surveyed reported that they advised at least 60% of their smoking parents to quit, 12 and a similar study in Maine found that 91% of pediatricians reported that they advised their smoking parents to quit.…”

mentioning

confidence: 99%

Tobacco Counseling at Well-Child and Tobacco-Influenced Illness Visits: Opportunities for Improvement

Tanski

Klein

Winickoff³

et al. 2003

Pediatrics

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ABSTRACT. Objective. To assess the frequency of clinician-reported delivery of counseling for avoidance of child environmental tobacco smoke (ETS) exposure and tobacco use at periodic well-child visits and at illness visits for asthma and otitis media (OM).Methods. Combined data from the National Ambulatory Medical Care Survey and the outpatient portion of the National Hospital Ambulatory Medical Care Survey from 1997 to 1999 were analyzed. The frequency of pediatric visits (<18 years) that included clinician-reported counseling for tobacco use/exposure prevention was assessed. Diagnosis-specific visits were determined by using International Classification of Diseases, Ninth Revision codes for asthma (493-), OM (381-, 382-), and wellchild visits. Bivariate and regression analyses were performed.Results. Of 33 823 ambulatory care visits by children, 1.5% were reported to include delivery of tobacco counseling. Only 4.1% of well-child visits, 4.4% of illness visits for asthma, and 0.3% of illness visits for OM included tobacco counseling. With the use of logistic regression models, adolescent patient visits (13-18 years) were more likely to include delivery of tobacco counseling than younger child visits [OR ‫؍‬ 15.8, 95% CI (7.5-33.5)]. Visits by children with Medicaid and those seen by a nurse practitioner or a physician's assistant were also more likely to include tobacco counseling (odds ratio: 1.6; 95% confidence interval: 1.002-2.50; and odds ratio: 3.0; 95% confidence interval: 1.5-6.0, respectively). There were no significant differences in counseling delivery by race, ethnicity, or clinician specialty.Conclusions. Rates of tobacco counseling at wellchild visits and at illness visits for diagnoses directly affected by tobacco use and ETS are extremely low. Significant opportunities exist to improve counseling rates for child ETS exposure and adolescent tobacco use in primary care. Pediatrics 2003;111:e162-e167. URL: http: //www.pediatrics.org/cgi/content/full/111/2/e162; environmental tobacco smoke, smoking, tobacco use, counseling, parental smoking, second-hand smoke, pediatrics, asthma, otitis media.

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“…7,8 In a study, information and education activities of health workers in health facilities were considered key contributors to the changes in reported behaviors of the adolescents. 9 Most studies suggest that access to all settings can be improved through youth-friendly interventions. [10][11][12] In the present study too, there was statistically significant (P<0.05) improvement in the knowledge of adolescents on different aspects of ARSH issues [except the knowledge on male reproductive organ among boys in clinic-based and school-based study (P > 0.05) and knowledge on oral pills among boys in school-based study (P > 0.05)] following sensitization programme in youth friendly manner maintaining privacy, confidentiality and non-judgmental approach.…”

Section: Discussionmentioning

confidence: 99%

Sensitization and its impact on Reproductive and sexual health issues of adolescents in clinics and schools - a comparative study.

De¹,

Mitra²,

Das³

et al. 2011

Asian J Med Sci

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Objective: Adolescent Reproductive and Sexual Health Issue is an important component of Youth Friendly Health Services. The objective of this study to compare the impact of sensitization on adolescent reproductive and sexual health issues of adolescent clients between clinic and school setting using the youth-friendly principles. Material & Methods:An urban-based prospective longitudinal study, conducted at adolescent health clinic and schools. The participants are adolescents in the age group of 14-18 years (both boys and girls). Intervention: Youthfriendly sensitization. Main outcome measures: Change in the knowledge on different ARSH issues among adolescent clients in both clinics and schools.Results: Statistically significant improvement (p values< 0.05) in knowledge on various aspects of ARSH issues among adolescent clients in both clinic and school setting. Conclusion:Youth-friendly sensitization makes positive change in the knowledge of adolescents on ARSH issues in both clinics and schools.

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Delivery of Smoking Prevention and Cessation Services to Adolescents

Abstract: Familiarity with smoking cessation guidelines and physician's specialty and practice style with adolescents are associated with better delivery of tobacco cessation counseling to adolescents.

Cited by 48 publications

References 20 publications

PREVENTIVE CARE FOR CHILDREN IN THE UNITED STATES: Quality and Barriers

PREVENTIVE CARE FOR CHILDREN IN THE UNITED STATES: Quality and Barriers

Tobacco Counseling at Well-Child and Tobacco-Influenced Illness Visits: Opportunities for Improvement

Sensitization and its impact on Reproductive and sexual health issues of adolescents in clinics and schools - a comparative study.

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