Provider self-efficacy and the screening of adolescents for risky health behaviors

Abstract

Purpose To examine the extent to which providers' perceived self-efficacy to deliver adolescent preventive services relates to their screening practices. Methods Screening rates were determined by both provider self-reported screening practices and the independent report of the adolescent patient. First, 66 pediatric providers (pediatricians and nurse-practitioners), working in three pediatric clinics within a managed care organization, completed surveys assessing: (a) self-efficacy for screening adolescent patients in the areas of tobacco use, alcohol use, sexual behavior, seat belt use, and helmet use; and (b) self-reported screening of adolescents during well-visits over the past month. Second, a sample of patients, aged 14 years to 16 years, reported on whether their clinicians screened them for these behaviors during a well-visit. Adolescents completed reports (N = 323) immediately following the well visit. Data were analyzed using Pearson product-moment correlation coefficients. Results Provider self-efficacy to deliver preventive services was correlated with self-reported screening in each of the five content areas, ranging from r = .24 (p < .05) for seat belt use to r = .51 (p < .001) for helmet use. Provider self-efficacy was significantly related to adolescent reports of screening in three of the five content areas; r = .25 (p < .05) for sexual behavior and tobacco use; and r = .23 (p = .06) for alcohol use. Conclusions Providers' self-efficacy to screen adolescents for risky behaviors was significantly related to both clinician self-report and independent adolescent reports of screening during well-visits. These findings point to the importance of enhancing clinicians' sense of competence to deliver adolescent preventive services.