Division of Adolescent Medicine, Department of Pediatrics, University of California, San Francisco, California 94118, USA.
J Adolesc Health. 2011 Nov;49(5):476-82. doi: 10.1016/j.jadohealth.2011.02.011. Epub 2011 Jun 8.
To determine whether the delivery of preventive services changes adolescent behavior. This exploratory study examined the trajectory of risk behavior among adolescents receiving care in three pediatric clinics, in which a preventive services intervention was delivered during well visits.
The intervention consisted of screening and brief counseling from a provider, followed by a health educator visit. At age 14 (year 1), 904 adolescents had a risk assessment and intervention, followed by a risk assessment 1 year later at age 15 (year 2). Outcomes were changes in adolescent behavior related to seat belt and helmet use; tobacco, alcohol, and drug use; and sexual behavior. Analysis involved age-related comparisons between the intervention and several cross-sectional comparison samples from the age of 14-15 years.
The change in helmet use in the intervention sample was 100% higher (p < .05), and the change in seat belt use among males was 50% higher (p = .14); the change in smoking among males was 54% lower (p < .10), in alcohol use was no different, and in drug use was 10% higher (not significant [NS]); and the change in rate of sexual intercourse was 18% and 22% lower than cohort comparison samples (NS).
The intervention had the strongest effect in the area of helmet use, shows promise for increasing seat belt use and reducing smoking among male adolescents, and indicates a nonsignificant trend toward delaying the onset of sexual activity. Participation in the intervention seemed to have no effect on the rates of experimentation with alcohol and drugs between the ages of 14 and 15 years.
确定预防服务的提供是否会改变青少年的行为。本探索性研究调查了在三个儿科诊所接受护理的青少年的风险行为轨迹，其中在常规就诊期间提供了预防服务干预。
干预措施包括由提供者进行筛查和简短咨询，然后由健康教育者进行访问。在 14 岁（第 1 年）时，904 名青少年接受了风险评估和干预，然后在 15 岁（第 2 年）时再次进行风险评估。结果是与安全带和头盔使用、烟草、酒精和药物使用以及性行为相关的青少年行为变化。分析涉及干预组与 14-15 岁年龄组的几个横断面比较样本之间的年龄相关比较。
干预组中头盔使用率的变化高出 100%（p<.05），男性安全带使用率的变化高出 50%（p=0.14）；男性吸烟的变化低 54%（p<.10），饮酒无差异，药物使用增加 10%（无统计学意义[NS]）；性交率的变化比队列比较样本低 18%和 22%（NS）。
干预在头盔使用方面效果最强，有希望增加男性青少年安全带的使用并减少吸烟，表明性行为开始的时间延迟有非显著趋势。参与干预似乎对 14 至 15 岁之间酒精和药物使用的实验率没有影响。
