Eisner-Fellay Taslina, Akre Christina, Auderset Diane, Barrense-Dias Yara, Suris Joan-Carles
Research Group on Adolescent Health, Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Fam Pract. 2020 Nov 28;37(6):759-765. doi: 10.1093/fampra/cmaa068.
Adolescence and early adulthood are periods of experimentation during which health detrimental behaviours might be acquired.
This study's purpose is to evaluate physicians' likelihood of addressing health risk behaviours with youths depending on the youths' wishes, risk behaviours and personal characteristics.
Data were drawn from the third wave (2017-18) of the GenerationFRee longitudinal study carried out on a sample of 1970 youths aged 17-26 in Switzerland. Analysed risk behaviours were: eating disorders, substance use, emotional wellbeing, problematic Internet use and gambling. Bivariate and multivariate analyses were performed, results are presented as adjusted odds ratios (aORs).
Physicians discussed most risk behaviours with less than half of the youths. The odds of addressing risk behaviours were seldom raised when the risk behaviour was present, or when the youth wished to discuss it. Emotional wellbeing was addressed with half as many males as females (aOR 0.47), and drugs were found to be addressed more frequently with youths reporting a low family socio-economic status (aOR 6.18). When a risk behaviour is addressed it is mostly alongside an extended screening.
This study confirmed the low levels of health risk behaviours screening, regardless of the youths' wish to discuss the topic with their physician. Despite the low levels, physicians do tend to screen systematically, especially when discussing substance use. There is a need to improve physicians training in risk behaviour screening and counselling in order to increase this practice.
青少年期和成年早期是进行各种尝试的阶段，在此期间可能会养成对健康有害的行为。
本研究旨在评估医生根据青少年的意愿、风险行为和个人特征来探讨青少年健康风险行为的可能性。
数据取自瑞士对1970名年龄在17 - 26岁的青少年进行的GenerationFRee纵向研究的第三波（2017 - 2018年）。分析的风险行为包括：饮食失调、物质使用、情绪健康、网络使用问题和赌博。进行了双变量和多变量分析，结果以调整后的优势比（aORs）呈现。
医生与不到一半的青少年讨论了大多数风险行为。当存在风险行为或青少年希望讨论时，探讨风险行为的几率很少提高。针对情绪健康问题，与男性讨论的人数只有女性的一半（aOR 0.47），发现与家庭社会经济地位低的青少年讨论药物问题的频率更高（aOR 6.18）。当讨论一种风险行为时，大多会同时进行扩展筛查。
本研究证实，无论青少年是否希望与医生讨论该话题，健康风险行为筛查的水平都较低。尽管水平较低，但医生确实倾向于进行系统筛查，尤其是在讨论物质使用问题时。有必要改进医生在风险行为筛查和咨询方面的培训，以增加这种做法。
