Delivery of confidential care to adolescent males

Susan E. Rubin, Diane McKee, Giselle Campos, Lucia F. O'Sullivan

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Purpose: Primary care providers' (PCPs') provision of time alone with an adolescent without the parents present (henceforth referred to as "confidential care") has a significant impact on adolescents' disclosure of risk behavior. To inform the development of interventions to improve PCPs' delivery of confidential care, we obtained the perspectives of adolescent males and their mothers about the health care concerns of adolescent males and the provision of confidential care. Methods: This focus-group study (5 groups: 2 with adolescent males and 2 with mothers) used standard qualitative methods for analysis. We recruited mother/son dyads who had been seen at urban primary care practices. Results: Adolescents' health concerns focused on pregnancy and sexually transmitted infections; mothers took a broader view. Many adolescents felt that PCPs often delivered safe sex counseling in a superficial, impersonal manner that did not add much value to what they already knew, and that their PCP's principal role was limited to performing sexually transmitted infection testing. Though adolescents cited a number of advantages of confidential care and disclosure, they expressed some general mistrust in PCPs and concerns about limits of confidentiality. Rapport and relationship building with their PCP are key elements to adolescents' comfort and increased disclosure. Overall, mothers viewed confidential care positively, especially in the context of continuity of care, but many felt excluded. Conclusions: To increase adolescents' perception of the relevance of primary care and to foster disclosure during health encounters, our participants described the critical nature of a strong doctor-patient relationship and positive physician demeanor and personalized messages, especially in the context of a continuity relationship. Regular, routine inclusion of confidential care time starting early in adolescence, as well as discussion of the purpose and limitations of confidentiality with parents and adolescents, could lead to greater parental comfort with confidential care and increased disclosure by the adolescent.

Original languageEnglish (US)
Pages (from-to)728-735
Number of pages8
JournalJournal of the American Board of Family Medicine
Volume23
Issue number6
DOIs
StatePublished - Nov 2010

Keywords

  • Adolescents
  • Confidentiality
  • Focus groups
  • Primary care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice

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