Division of Pediatric Endocrinology, The Warren Alpert School of Medicine of Brown University, Providence, Rhode Island.
Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
J Adolesc Health. 2023 Dec;73(6):1046-1052. doi: 10.1016/j.jadohealth.2023.06.029. Epub 2023 Sep 10.
To examine differences in screening and advising for modifiable risk behaviors during well-visits based on adolescents' body mass index categories.
Retrospective analyses were conducted with the National Institute of Health's NEXT Generation Health Study data, a nationally representative cohort of 10th graders. In wave 1 (2010), adolescents were classified as being underweight (<4.99th percentile), normal-weight (5-84.99th percentile), overweight (85-94.99th percentile), or with obesity (≥95th percentile) based on the body mass index categories described by the Centers for Disease Control and Prevention. In wave 2 (2011), adolescents were asked by their provider about smoking, alcohol use, use of other drugs, sexual activity, nutrition, and exercise, and whether they were advised about risks associated with these behaviors.
The sample consisted of 1,639 eligible participants as follows: 57.8% females, 63.3% 16-year-olds, 47.8% non-Hispanic Whites, 41.5% living in the South, 75.4% with health insurance, and 29.8% with low family affluence. Screening rates for overweight compared to normal-weight males were 51% reduced for smoking, 46% for alcohol use, 47% for other drug use, 57% for nutrition, and 47% for exercise. Screening rates were 40% reduced for other drug use for males with obesity, and 89% reduced for alcohol use for underweight males compared to normal-weight males. Advice receipt for females with obesity compared to normal-weight females was 90% increased for nutrition and 78% increased for exercise.
Overweight male adolescents reported being less likely to be screened across almost all preventive service topics representing missed opportunities for care delivery.
根据青少年的体重指数类别，检查在就诊时针对可改变的风险行为进行筛查和咨询方面的差异。
利用美国国立卫生研究院下一代健康研究的数据进行回顾性分析，这是一个具有全国代表性的 10 年级队列。在第 1 波（2010 年）中，根据疾病控制与预防中心描述的体重指数类别，将青少年分为体重不足（<4.99 百分位）、正常体重（5-84.99 百分位）、超重（85-94.99 百分位）或肥胖（≥95 百分位）。在第 2 波（2011 年）中，由提供者询问青少年有关吸烟、饮酒、使用其他药物、性行为、营养和运动的情况，以及是否对这些行为相关风险进行了咨询。
本研究纳入了 1639 名符合条件的参与者，其中女性占 57.8%，16 岁的占 63.3%，非西班牙裔白人占 47.8%，居住在南部的占 41.5%，有医疗保险的占 75.4%，家庭经济状况不佳的占 29.8%。与正常体重男性相比，超重男性吸烟的筛查率降低了 51%，饮酒降低了 46%，使用其他药物降低了 47%，营养降低了 57%，运动降低了 47%。肥胖男性使用其他药物的筛查率降低了 40%，而体重不足男性饮酒的筛查率与正常体重男性相比降低了 89%。与正常体重女性相比，肥胖女性在营养方面接受建议的比例增加了 90%，在运动方面接受建议的比例增加了 78%。
超重的男青少年报告说，他们在几乎所有代表错失护理机会的预防服务主题上的筛查可能性都较低。
