Changing Adolescent Health Behaviors: The Healthy Teens Counseling Approach
Background
Brief motivational interventions that have been provided in addition to routine primary care have changed adolescent health behaviors. Whether health screening and motivational-interviewing–based counseling provided by clinicians during routine care can change behaviors is unknown.
Methods
Healthy Teens was a primary care, office-system intervention to support efficient, patient-centered counseling at well visits. Healthy Teens utilized a personal digital assistant (PDA)–based screener that provided the clinician with information about a teen's health risks and motivation to change. Changes in adolescent self-report of diet and activity health behaviors 6 months later were assessed in two cross-sectional samples of teens from five rural practices in 2005 and 2006. Usual-care subjects (N=148) were recruited at well visits prior to the intervention, and the Healthy Teens subjects (N=136) were recruited at well visits after the Healthy Teens system was well established.
Results
At 6-month follow-up, the Healthy Teens group had significantly increased self-reported exercise levels and milk-product intake. In the models exploring covariates, the only significant predictors for improvement in exercise levels were intervention-group status (p=0.009) and post-visit interest in making a change (p=0.015). Interest in changing predicted increased milk intake (p=0.028) in both groups. When teens planned an action related to nutrition, physical activity, or both after a well visit, Healthy Teens participants were more likely to report multiple planned actions (68% Healthy Teens vs 32% usual care, p<0.05).
Conclusions
Changes in office systems using low-cost technology to screen adolescents and promote patient-centered counseling appear to influence teens to increase exercise and milk intake.
aDepartment of Pediatrics, Dartmouth Medical School, Lebanon, New Hampshire
bDepartment of Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire
Address correspondence and reprint requests to: Ardis L. Olson, MD, Professor of Pediatrics and Community and Family Medicine, Clinicians Enhancing Child Health Network, Dartmouth Hitchcock Medical Center, Department of Pediatrics HB 7450, Lebanon NH 03756-001
ABSTRACT