Influence of mental health and alcohol or other drug use risk on adolescent reported care received in primary care settings

Abstract

BackgroundTo describe patterns of alcohol and other drug (AOD) use risk and adolescent reported primary care (PC) screening and intervention, and examine associations of AOD risk and mental health with reported care received.MethodsWe analyzed data from cross-sectional surveys collected from April 3, 2013 to November 24, 2015 from 1279 diverse adolescents ages 12–18 who reported visiting a doctor at least once in the past year. Key measures were AOD risk using the Personal Experience Screening Questionnaire; mental health using the 5-item Mental Health Inventory; binary measures of adolescent-reported screening and intervention.ResultsHalf (49.2%) of the adolescents reported past year AOD use. Of the 769 (60.1%) of adolescents that reported being asked by a medical provider in PC about AOD use, only 37.2% reported receiving screening/intervention. The odds of reported screening/intervention were significantly higher for adolescents with higher AOD risk and lower mental health scores.ConclusionsAdolescents at risk for AOD use and poor mental health are most likely to benefit from brief intervention. These findings suggest that strategies are needed to facilitate medical providers identification of need for counseling of both AOD and mental health care for at risk youth.Trials registrationclinicaltrials.gov, Identifier: NCT01797835, March 2013.

Validation of the Spanish Healthy Lifestyle Questionnaire

“…Specifically, the results of the CFA revealed that the structure was adequate, as shown by acceptable fit indices and McDonald's omega coefficients showed high levels of internal consistency. Such findings confirm that a questionnaire has been developed for the Spanish population that includes all the essential dimensions that make up a healthy lifestyle ( Aparicio-Ugarriza et al, 2019 , Jakicic et al, 2018 , Meredith et al, 2018 ; Onambele-Pearson et al, 2019 ).…”

“…It is a well-established fact that living a healthy lifestyle (HLS) is important from an early age ( Arriscado et al, 2017 ). This includes engaging in habits related to balanced nutrition (balanced diet and respect for meal schedules) ( Aparicio-Ugarriza et al, 2019 ), practice of physical exercise ( Jakicic et al, 2018 ), and optimal rest ( Onambele-Pearson et al, 2019 ) and, in contrast, avoiding a sedentary lifestyle, lack of rest, smoking, drug use and excessive alcohol intake ( Meredith et al, 2018 ). Harmful lifestyle habits such as a sedentary lifestyle, unbalanced diet, lack of rest, and the use of harmful substances are, in the long term, associated with diseases such as obesity, type II diabetes, hypercholesterol, and even cancer, thus leading to a premature increase in morbidity ( Dunton, 2018 , Ezzati and Riboli, 2013 ).…”

Adolescents with better mental health have less problem alcohol use six months later

“…Previous work with the current sample indicated that although screening rates for alcohol use have been shown to be low for adolescents, those at highest risk for alcohol use were significantly more likely to be screened and referred to a mental health intervention (Meredith et al, 2018). This suggests that screening for alcohol use may identify those also needing help with mental health problems given high rates of comorbidity of alcohol problems with mental health problems common among adolescents, such as depression and anxiety conditions (Kushner, Krueger, Frye, & Peterson, 2008).…”

Substance Use Among Adolescents and Young Adults With Type 1 Diabetes: Discussions in Routine Diabetes Care

“…In studies examining patient recall of substance use–related discussions, only 50% to 60% of adolescents reported discussing substance use with a primary care provider in the past year. 14,15 A recent study of youth aged 14 to 18 years with chronic conditions found that 70% of youth reported being asked about alcohol use in the past year. 16 Common barriers include lack of time to screen for substance use and the presence of parents during the medical visit.…”