Original articleForgone Health Care among U.S. Adolescents: Associations between Risk Characteristics and Confidentiality Concern
Section snippets
Study design
The study used Wave I home interview data from the National Longitudinal Study of Adolescent Health (Add Health). Details regarding the Add Health study design have been presented elsewhere [12]. In summary, a stratified random sample of 80 U.S. high schools was selected from a list of eligible high schools; high schools were stratified by factors including region, urbanicity, school size, school type, and race/ethnic composition. One feeder school for each high school was also randomly
Results
Descriptive statistics for the study sample are presented in Table 1. By construction of the sample, all subjects reported having forgone needed health care in the past year; 10.5% of boys and 14.3% of girls reported that this was due, in part or in whole, to confidentiality concern (Table 1). Girls were more likely than boys to report confidentiality concern as a reason for forgone health care (p < .01).
Discussion
This national study examined risk characteristics of adolescents for whom confidentiality concern prevented the seeking of health care. The study findings suggest that U.S. adolescents who forgo care due in whole or in part to confidentiality concern are a particularly high-risk population in need of health care services. Among boys, prevalence of mental health difficulties was significantly higher among those who cited confidentiality concern as a reason for forgone care, as compared with
Acknowledgments
This work was supported by a grant from the Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention, Bureau of Maternal and Child Health – Leadership and Education in Adolescent Health Training. This research used data from Add Health, a program project designed by J. Richard Udry, Ph.D., Peter S. Bearman Ph.D., and Kathleen Mullan Harris, Ph.D., and funded by Grant P01-HD31921from the National Institute of Child Health and Human Development, with cooperative
References (40)
- et al.
Access to medical care for adolescents: results from the 1997 Commonwealth Fund Survey of the Health of Adolescent Girls
J Adolesc Health
(1999) - et al.
Foregone health care among adolescents
JAMA
(1999) - et al.
Confidentiality in health care: a survey of knowledge, perceptions, and attitudes among high school students
JAMA
(1993) - et al.
Influence of physician confidentiality assurances on adolescents’ willingness to disclose information and seek future health careA randomized controlled trial
JAMA
(1997) The American Medical Association Guidelines for Adolescent Preventive Services
Arch Pediatr Adolesc Med
(1997)- et al.
Confidential health care for adolescents: position paper for the Society for Adolescent Medicine
J Adolesc Health
(2004) - et al.
State Minor Consent Laws: A Summary
(2003) - et al.
The HIPAA privacy rule and adolescents: legal questions and clinical challenges
Perspect Sex Reprod Health
(2004) - et al.
Effect of mandatory parental notification on adolescent girls’ use of sexual health care services
JAMA
(2002)
Adolescent girls’ and boys’ preferences for provider gender and confidentiality in their health care
J Adolesc Health
Collecting sensitive self-report data with laptop computers: impact on the response tendencies of adolescents in a home interview
J Res Adolesc
The National Longitudinal Study of Adolescent Health (Add Health), Waves I & II, 1994–1996; Wave III, 2001–2002
The CES-D scale: a self-report depression scale for research in the general population
Appl Psychol Meas
Screening for adolescent depression: a comparison of depression scales
J Am Acad Child Adolesc Psychiatry
Temporal associations between depressive symptoms and self-reported sexually transmitted disease among adolescents
Arch Pediatr Gen Psychiatry
Depressive symptoms and cigarette smoking in teens
Pediatrics
Analysis of Longitudinal Data
Youth Risk Behavior Surveillance—United States, 2003
MMWR Surveill Summ
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