52. Health Risk Screening Practices by Providers and Associated Factors Among University Students in Hong Kong

Abstract

Purpose: The prevalence of health issues such as depression, eating disorders and internet addiction has increased significantly among teens in Hong Kong. Despite the importance of targeted health risk behaviour screening and counselling for adolescents on issues such asmental health, body image, drug and alcohol use and sexual activity, there is very limited information regarding actual screening practices by health providers in Hong Kong. This study was conducted to determine the frequency of specific screening and counselling practices by providers as well as the associated barriers to screening during health visits among university students in Hong Kong. Methods: In 2011, a cross sectional studywas conducted among469 randomly selected incoming medical, nursing, public health and pharmacy students to a public university in Hong Kong using a self-administered questionnaire. Questionnaires were collected while students attended a required health check-up in the university health service. Descriptive statistics were generated by SPSS 16.0. Results: The mean age of students was 19 years and 66% were female. The majority of students received care in the private system (64%) and saw a traditional Western practitioner (75.9%). Only 1⁄2 (49.5%) reported that the visit was conducted in a confidential manner. Themain reasons for visitswere for acute visits (44.8%), followed by routine health checks (14.7%) Students reported having problems in the last five years with school issues (18.6%), depression (17.1%), body image (16.8%), and internet overuse (11.3%). However, providers only infrequently asked about school issues (3.2%) depression (4.3%), body image (.9%), and internet overuse (2.8%) during encounters. In addition, providers rarely asked about sexual activity (.6%), condomuse (.4%) and drug/ alcohol use (1.3%). Only 2.1% of providers used a written or electronic screening questionnaire to ask about health behaviours. The majority of students cited that they were comfortable and honest in discussing personal information related to dietary habits (80.6%), sleep (77.8%), and depression and stress (59.7%) but less so for drug use (39.9%), sexual activity (34.1%) and sexual identity (35.8%). Some participants responded (40.9%) that they would feel shocked if their provider asked about personal behaviours such as drug use or sexual activity when the student visited for a routine URI and nearly 1⁄2 (53.7%) did not consider it part of the physician’s job to ask about such issues. Main barriers reported by students to disclosing personal information included feeling ashamed (71%) and fear of disclosure to parents (19%). Conclusions:Depression, body image concerns, and internet addiction are important health problems among adolescents in Hong Kong. However, students in this study were infrequently screened or counselled about these issues during visits. Health providers are missing important opportunities to provide preventive care. The use of a standardizedwritten or electronic screening questionnaire could be a useful adjunct to current care. In addition, a more comprehensive approachwhich is confidential and culturally appropriate should be adopted to improve the health of adolescents and young adults in Hong Kong. Sources of Support: None SESSION I: SEXUAL HEALTH