别问了，他们不会说的：五种医疗机构环境下青少年健康筛查的质量。
Don't ask, they won't tell: the quality of adolescent health screening in five practice settings.
作者信息
Blum R W, Beuhring T, Wunderlich M, Resnick M D
机构信息
Division of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis 55455, USA.
出版信息
Am J Public Health. 1996 Dec;86(12):1767-72. doi: 10.2105/ajph.86.12.1767.
OBJECTIVES
This study examined the extent to which comprehensive, age-appropriate adolescent health screening is undertaken in the clinical setting and whether the extent of such screening varies by setting.
METHODS
Charts of adolescents 13 to 17 years old (n = 788) were randomly selected from five practice settings in Minneapolis, Minn. Each was assessed for the number of biomedical and sociobehavioral health risks screened.
RESULTS
In no practice setting was there screening to the level recommended. The two teen clinics screened more extensively for behavioral, psychosocial, substance use and sexual behavior risks than the community family practice setting, which, in turn, screened more extensively than either the private family practice or private pediatric practice settings, which did not differ from each other. Age differences and gender accounted for only small amounts of variance in total number of health risks screened, whereas differences among practice settings accounted for a larger amount.
CONCLUSIONS
Results suggest substantive deficiencies in private practice settings' implementation of preventive care screening protocols for adolescents.
目的
本研究调查了在临床环境中进行全面、适合青少年年龄的健康筛查的程度，以及这种筛查的程度是否因环境而异。
方法
从明尼苏达州明尼阿波利斯的五个医疗机构中随机抽取13至17岁青少年的病历（n = 788）。对每份病历进行生物医学和社会行为健康风险筛查数量的评估。
结果
在任何医疗机构中，筛查都未达到推荐水平。两家青少年诊所对行为、心理社会、物质使用和性行为风险的筛查比社区家庭医疗机构更广泛，而社区家庭医疗机构又比私立家庭医疗机构或私立儿科医疗机构筛查更广泛，私立家庭医疗机构和私立儿科医疗机构之间没有差异。年龄差异和性别在筛查的健康风险总数中仅占少量变异，而医疗机构之间的差异占更大比例。
结论
结果表明私立医疗机构在实施青少年预防性保健筛查方案方面存在实质性缺陷。
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