Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York.
Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, New York; Department of Pediatrics, Columbia University Medical Center, New York, New York; Morgan Stanley Children's Hospital, New York-Presbyterian Hospital, New York, New York.
J Adolesc Health. 2019 Mar;64(3):311-318. doi: 10.1016/j.jadohealth.2018.10.301. Epub 2019 Jan 9.
The objective of the study was to define factors associated with adolescent and young adult (AYA) experiences with private time and having discussed confidentiality and the impact of these experiences on improving delivery of clinical preventive services.
In 2016, a nationally representative sample of 1,918 US AYAs (13- to 26-year-olds) was surveyed. Survey questionnaire domains were based on prior research and Fishers' information-motivation-behavior skills conceptual model. Data were weighted to represent US households with AYA and analyzed to identify factors independently associated with ever experiencing private time and discussions of confidentiality with a regular health-care provider (HCP). We examined the association of these experiences on AYA attitudes about health care.
Fifty-five percent of female and 49% of male AYA reported ever having had private time with an HCP and 55% of female and 44% of male AYA had spoken to an HCP about confidentiality. Independent predictors of having experienced private time and confidentiality included older age, race, higher household income, gender of the provider, amount of years with the provider, and involvement in risk behaviors. AYA who had experienced private time and confidentiality discussions had more positive attitudes about their providers, were more willing and comfortable discussing sensitive topics, and thought that these discussions should happen at younger ages.
Although confidentiality and private time are important to AYA, many are not experiencing these components of care. Providing private time and discussions of confidentiality can improve the delivery of health care for young people by enhancing positive youth attitudes about preventive care.
本研究旨在确定与青少年和年轻成年人（AYA）私人时间体验以及讨论保密性相关的因素，以及这些体验对改善临床预防服务提供的影响。
2016 年，对美国具有代表性的 1918 名 AYA（13 至 26 岁）进行了调查。调查问卷的设计基于先前的研究和 Fishers 的信息-动机-行为技能概念模型。对数据进行加权处理，以代表有 AYA 的美国家庭，并进行分析，以确定与曾经与常规医疗保健提供者（HCP）有私人时间和讨论保密性相关的因素。我们研究了这些体验对 AYA 对医疗保健态度的影响。
55%的女性和 49%的男性 AYA 报告曾经与 HCP 有过私人时间，55%的女性和 44%的男性 AYA 与 HCP 讨论过保密性。有过私人时间和保密性讨论经历的独立预测因素包括年龄较大、种族、较高的家庭收入、提供者的性别、与提供者的合作年限以及参与风险行为。有过私人时间和保密性讨论经历的 AYA 对他们的提供者有更积极的态度，更愿意和舒适地讨论敏感话题，并认为这些讨论应该在更年轻时进行。
尽管保密性和私人时间对 AYA 很重要，但许多人并没有体验到这些护理的组成部分。提供私人时间和讨论保密性可以通过增强年轻人对预防保健的积极态度来改善年轻人的医疗保健提供。
