Adolescent Characteristics, Health Risk Factors and Physician Training Associated with Provision of Confidential Consultation in Primary Care

An abstract of a study by Gilbert et al examining relationships between physician endorsement of confidential consultation; physician training; adolescent characteristics; and adolescent reports of sexual activity, substance use and depressive symptoms is presented. Of 1,233 adolescents, 18% reported sexual activity, 9% reported substance use and 25% reported depressive symptoms. When compared to those seen by general pediatricians (Peds), adolescents seen by adolescent medicines (AMs) reported sexual activity, depressive symptoms and substance abuse significantly more often. Physicians answered the confidential consultation question for 95% of all visits. Among adolescents seen by AMs, confidential consultation was provided to 90%. For those seen by Peds, confidential consultation was provided to 53%. Among adolescents seen by Peds, all three categories of health risk factors were positively associated with confidential consultation in univariate analyses. In the multivariate analysis, however, no significant associations remained for health risk factors. Female gender, middle and late adolescence, and clinic were significantly associated with confidential consultation.