Objective: To examine the extent to which pediatricians are adhering to clinical preventive service guidelines that have been developed to assist clinicians in screening adolescents for health risks.

Method: 134 pediatricians within a managed care organization in California completed a survey assessing the extent to which they screen for biomedical and sociobehavioral health risks as recommended by guidelines for adolescent preventive services. First, on 41 items reflecting a broad range of recommended services, pediatricians indicated their screening practices with adolescent patients regardless of risk status. Second, pediatricians were asked a series of questions about their practices with patients who are engaging in risky behavior. This included patients who 1) are sexually active, 2) use alcohol, 3) use tobacco, and 4) do not always use a seatbelt or helmet.

Results: First, pediatricians deliver a broad range of recommended preventive services to 52% of their adolescent patients. Among all adolescent patients, they screen (assess and educate) 38% for sexual activity, 47% for alcohol use, 53% for tobacco use, and 64% for seatbelt and helmet use. Second, pediatricians are inconsistent in responding to adolescents who are engaging in risky behavior. On average, they educate 46% of sexually active teens, 45% of teens who use alcohol, 81% of teens who use tobacco, and 86% of teens who do not use a helmet or seatbelt about the health risks associated with these behaviors.

Conclusions: This study indicates that pediatricians within this managed care setting are not consistently delivering recommended preventive services to adolescents. Funded by The California Wellness Foundation and the Bureau of Maternal and Child Health