Little is known about the health concerns adolescents bring to preventive visits, or what health counseling adolescents find important. We used pre- and postvisit structured interviews of 11-21-year-olds seen for preventive visits at two health centers to: 1) describe the adolescents' health concerns; 2) identify the counseling that adolescents perceive to be most important; and 3) assess how preventive visits affect adolescents' intentions to modify their health behaviors.

Sixty-three of 70 (90%) eligible adolescents were enrolled; 29 (46%) were female and 20 (32%) were non-white. Of 127 total concerns, most common were about fitness, weight or nutrition (FWN) 28%; general health 16%; reproductive health (RH) 12%; and orthopedic issues 9%. The remaining other concerns fell into 18 separate categories, each accounting for ≤ 4% of the total. No differences in the number or type of concerns were observed by gender or race except females had more RH concerns.

Forty (63%) adolescents identified a specific discussion as “most valuable”; most commonly FWN 23%; RH 20%; or alcohol, tobacco or other drugs (ATOD) 15%. Although 58% of “most valuable” discussions related to preexisting concerns, this was true for none of the ATOD counseling. Twenty-five (37%) adolescents planned changes in health behaviors after their visits, most commonly related to FWN 56%, RH 24%, or injury prevention 12%. Sixty percent of intentions to change related to preexisting concerns, but this was true for half or fewer of those that would reduce risks for pregnancy, STDs, AIDS and injuries.

Adolescents seen for preventive visits have a wide range of health concerns. Most counseling that adolescents perceive to be valuable, or that leads to intentions for health behavior change, relates to preexisting concerns. However, health care providers identify and provide counseling about additional topics that adolescents value highly and that may influence adolescents to modify critical health behaviors.