Sally H Adams1, Justine Po2, M Jane Park2, Charles E Irwin2. 1. Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, California. Electronic address: Sally.Adams@ucsf.edu. 2. Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, San Francisco, California.
Abstract
PURPOSE: Despite professional endorsement and research supporting time alone with a clinician for adolescents, low rates and disparities persist. The purpose of the present analysis was to provide detailed monitoring of time alone estimates in two national surveys that assess time alone for adolescents aged 12-17 years: the National Survey of Children's Health (NSCH) and the Medical Expenditure Panel Survey (MEPS). METHODS: Time alone assessments in the NSCH and the MEPS have different definitions. The NSCH assessed time alone within the most recent preventive visit, and the MEPS assessed it within the most recent health care visit. We analyzed these within the subsample of 12- to 17-year-olds who had any past-year preventive visit: MEPS 2016-2017, n = 2,689; and NSCH 2016-2017, n = 24,085. We developed time alone estimates for full and subgroup samples and conducted multivariable logistic regressions to determine differences by age, sex, race/ethnicity, income, insurance, and region. RESULTS: Overall time alone receipt was 49% (NSCH) and 29% (MEPS). Overall rates are not comparable because their definitions differ. Some subgroup differences were similar across datasets: younger adolescents (p < .01) and females (p < .05) had lower rates. CONCLUSIONS: Among adolescents with a past-year preventive visit, time alone rates are low. Lower rates for females versus males and younger versus older adolescents persist. Detailed monitoring results can help to shape promising strategies including clinic-based interventions, such as provider training and educating parents, in efforts to improve the provision of time alone in clinical practice.
PURPOSE: Despite professional endorsement and research supporting time alone with a clinician for adolescents, low rates and disparities persist. The purpose of the present analysis was to provide detailed monitoring of time alone estimates in two national surveys that assess time alone for adolescents aged 12-17 years: the National Survey of Children's Health (NSCH) and the Medical Expenditure Panel Survey (MEPS). METHODS: Time alone assessments in the NSCH and the MEPS have different definitions. The NSCH assessed time alone within the most recent preventive visit, and the MEPS assessed it within the most recent health care visit. We analyzed these within the subsample of 12- to 17-year-olds who had any past-year preventive visit: MEPS 2016-2017, n = 2,689; and NSCH 2016-2017, n = 24,085. We developed time alone estimates for full and subgroup samples and conducted multivariable logistic regressions to determine differences by age, sex, race/ethnicity, income, insurance, and region. RESULTS: Overall time alone receipt was 49% (NSCH) and 29% (MEPS). Overall rates are not comparable because their definitions differ. Some subgroup differences were similar across datasets: younger adolescents (p < .01) and females (p < .05) had lower rates. CONCLUSIONS: Among adolescents with a past-year preventive visit, time alone rates are low. Lower rates for females versus males and younger versus older adolescents persist. Detailed monitoring results can help to shape promising strategies including clinic-based interventions, such as provider training and educating parents, in efforts to improve the provision of time alone in clinical practice.
Authors: Renee E Sieving; Christopher Mehus; Janna R Gewirtz O'Brien; Riley J Steiner; Shuo Wang; Marina Catallozzi; Julie Gorzkowski; Stephanie A Grilo; Kristen Kaseeska; Annie-Laurie McRee; John Santelli; Jonathan D Klein Journal: J Adolesc Health Date: 2021-11-24 Impact factor: 7.830