Departments of Pediatrics and
Departments of Pediatrics and.
Pediatrics. 2021 Apr;147(4). doi: 10.1542/peds.2020-020610. Epub 2021 Mar 30.
Risky behaviors are the main threats to adolescents' health; consequently, evidence-based guidelines recommend annual comprehensive risk behavior screening.
To review studies of adolescent risk behavior screening and interventions in urgent care, emergency department (ED), and hospital settings.
Our data sources included PubMed (1965-2019) and Embase (1947-2019).
Studies were included on the basis of population (adolescents aged 10-25 years), topic (risk behavior screening or intervention), and setting (urgent care, ED, or hospital). Studies were excluded if they involved younger children or adults or only included previously identified high-risk adolescents.
Data extracted were risk behavior screening rates, screening and intervention tools, and attitudes toward screening and intervention.
Forty-six studies were included; most (38 of 46) took place in the ED, and a single risk behavior domain was examined (sexual health [19 of 46], mood and suicidal ideation [12 of 46], substance use [7 of 46], and violence [2 of 46]). In 6 studies, authors examined comprehensive risk behavior screening, demonstrating low rates at baseline (∼10%) but significant increases with clinician reminder implementation. Adolescents and clinicians were highly accepting of risk behavior screening in all settings and preferred electronic screening over a face-to-face interview. Reported barriers were time constraints and limited resources.
Only 1 included study was a randomized controlled trial, and there was large heterogeneity of included studies, potentially limiting generalizability.
Rates of adolescent risk behavior screening are low in urgent care, ED, and hospital settings. Our findings outline promising tools for improving screening and intervention, highlighting the critical need for continued development and testing of interventions in these settings to improve adolescent care.
危险行为是青少年健康的主要威胁；因此，循证指南建议每年对青少年进行全面的危险行为筛查。
综述在急救、急诊和住院环境中对青少年危险行为进行筛查和干预的研究。
我们的数据来源包括 PubMed（1965-2019 年）和 Embase（1947-2019 年）。
研究入选标准为人群（10-25 岁的青少年）、主题（危险行为筛查或干预）和环境（急救、急诊或医院）。如果研究涉及年龄较小的儿童或成人，或者仅包括先前确定的高危青少年，则将其排除在外。
提取的数据包括危险行为筛查率、筛查和干预工具以及对筛查和干预的态度。
共纳入 46 项研究；其中大多数（46 项中的 38 项）在急诊室进行，且仅检查单一危险行为领域（性健康[46 项中的 19 项]、情绪和自杀意念[46 项中的 12 项]、物质使用[46 项中的 7 项]和暴力[46 项中的 2 项]）。在 6 项研究中，作者检查了全面的危险行为筛查，发现基线筛查率较低（约 10%），但通过实施临床医生提醒，筛查率显著增加。在所有环境中，青少年和临床医生都非常接受危险行为筛查，并更喜欢电子筛查而不是面对面访谈。报告的障碍是时间限制和资源有限。
仅有 1 项纳入研究为随机对照试验，且纳入研究的异质性较大，可能限制了研究结果的普遍性。
在急救、急诊和住院环境中，青少年危险行为筛查率较低。我们的研究结果概述了改善筛查和干预的有前途的工具，强调了在这些环境中持续开发和测试干预措施以改善青少年护理的迫切需要。
