Abstract
The AMA Guidelines for Adolescent Preventive Services (GAPS) has been the cornerstone of preventive care for teenagers since its publication in 1994. Despite this, there has been little documentation of their implementation in the family medicine literature. This article gives an overview of a family practice–based adolescent preventive health program based on GAPS recommendations, and reports on compliance, feasibility and health issues. A Community-Oriented Primary Care (COPC) program targeted all adolescent patients aged 12—18 years in two Israeli family practices. 321 teenagers were invited to participate. Every 7th and 10th grader was invited for a preventive health visit with the family physician and nurse. The visits included a medical evaluation, screening and counseling regarding health issues recommended by GAPS, and counseling regarding personal health concerns. Parents were also invited to meet with the staff. 184 (57%) of the adolescents invited for health visits attended. The overall visit time was 47 minutes, including 12 minutes for a questionnaire and 35 minutes with providers. Common biomedical problems included overweight, acne and dysmenorrhea. Health risk behaviors and psychosocial problems included cigarette or alcohol use, dieting, infrequent/never seat belt use, and feeling depressed. 78% wanted to discuss at least one personal health issue. 27% were invited for follow-up visits. Only 3% of the parents came for visits. A community-oriented approach facilitates bringing adolescents for preventive health visits. Many previously undetected health issues, particularly psychosocial and behavioral, are revealed during these visits. A concerns checklist aids in addressing personal health concerns.
Highlights
The American Medical Association Guidelines for Adolescent Preventive Services (GAPS)[1] has been the cornerstone of preventive care for teenagers since its publication in 1994
We developed and implemented the first adolescent preventive health program in an Israeli primary health care setting
In order to establish a “case for action” for a preventive adolescent health program, focus groups and individual discussions were held with the family physicians and nurses, teenage patients, parents, and a boarding school’s staff and students who received their care in the family practice clinic
Summary
The American Medical Association Guidelines for Adolescent Preventive Services (GAPS)[1] has been the cornerstone of preventive care for teenagers since its publication in 1994. Knishkowy et al.: Preventive Adolescent Health Care. There has been minimal documentation of their implementation in the family medicine literature, and little has been written about confidentiality and other issues that are of particular importance for family physicians providing care to both teenagers and their parents. Against this background, we developed and implemented the first adolescent preventive health program in an Israeli primary health care setting. We give an overview of the program’s development and structure, the major findings, and the implications for adolescent health care in family practice
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