Evaluating the Impact of Primary Care Consultations on Teenage Lifestyle: A Pilot Study

Abstract

This study piloted an evaluation of the effectiveness of inviting teenagers to UK general practice consultations with health behaviour advice and appropriate follow-up care. 132 teenagers aged 14/15 years were randomised: intervention teenagers were invited to attend a health consultation with a practice nurse, the control group received usual care. Teenagers in two practices were consulted by postal survey and in focus groups to ensure the intervention met their needs. 56% of the teenagers invited attended for a consultation. 55% of the intervention group and 45% of the controls reported some positive change in health related behaviour at one month.

Keywords

Family Practice - Health Promotion - Adolescent Health Services - Adolescence - Randomised Controlled Trial

• REFERENCES

• 1 Department of Health.. Our Healthier Nation. London: Department of Health; 1998
• 2 Department of Health.. Smoking among secondary children in 1996: England and Scotland. Smoking related behaviour and attitudes. London: HMSO; 1997
• 3 Townsend J, Wilkes H, Haines A, Jarvis M. Adolescent Smokers in General Practice: Health, lifestyle, physical measurements and response to anti smoking advice. BMJ 1991; 303: 947-50.
• 4 Austoker J, Sanders D, Fowler G. Smoking and cancer: smoking cessation. BMJ 1994; 308: 1478-82.
• 5 Department of Health.. Health Survey for England 1995. London: HMSO; 1997
• 6 Balding J. Young People in Exeter in 1996 – School Study Series. Exeter: Schools Health Education Unit, University of Exeter; 1996
• 7 Office for National Statistics.. Population Trends. Winter 1998. London: HMSO; 1998
• 8 Center for Population Options.. Adolescents and sexually transmitted diseases. Washington: Center for Population Options; 1990. 2
• 9 Aggleton P, Kapila M. Young people, HIV/AIDS and the promotion of sexual health. Health Prom Int 1992; 7: 45-51.
• 10 Armstrong N, Balding J, Gentle P, Kirby B. Patterns of physical activity among 11 to 6 year old British children. Br Med J 1990; 301 July 203-5.
• 11 Crisp A. Anorexia Nervosa: Let me be. London: Academic Press; 1980
• 12 Bryant Waugh R, Lask B. Anorexia nervosa in a group of Asian children living in Britain. Br J Psych 1991; 158: 229-33.
• 13 McCabe R. Psychiatric disturbance. Practitioner 1992; 236 (1521) 1150 1152-4.
• 14 McDermott RJ, Hawkins WE, Marty PJ, Littlefield EA, Murray S, Williams TK. Health behavior correlates of depression in a sample of high school students. J School Health 1990; 60: 414-7.
• 15 Leslie SA. Psychiatric disorder in the young adolescents of an industrial town. Br J Psych 1974; 125: 113-24.
• 16 Rutter M, Graham P, Chadwick OFD, Yule W. Adolescent turmoil: fact or fiction?. J Child Psychol Psychiat 1976; 17: 35-56.
• 17 Glassman AH. Cigarette smoking: implication for psychiatric illness. Am J Psych 1993; 150: 546-53.
• 18 Van Hasselt VB, Null JA, Kempton T, Bukstein OG. Social skills and depression in adolescent substance abusers. Addictive Behav 1993; 18: 9-18.
• 19 Kazdin AE. Developmental Psychopathology: Current Research, Issues and Directions. Am Psychol 1989; 44: 180-7.
• 20 Gorman D, Masterton G. General practice consultation patterns before and after intentional overdose: a matched control study. Br J Gen Pract 1990; 40: 102-5.
• 21 Ladame F. Suicide prevention in adolescence: an overview of current trends. J Adolescent Health 1992; 13: 406-8.
• 22 Kandel DB, Davies M. Adult sequelae of adolescent depressive symptomology in adolescents. Archiv Gen Psych 1986; 43: 255-65.
• 23 Walker Z. Promoting Teenage Health in Primary Care. Presented at The 6th Annual Public Health Forum 1998; Lancaster: Association for Public Health; 1998
• 24 Halsam M, Faulkner C, Murray D. Lifestyles. A study of the health and lifestyles of the 12 to 15 age group in N. W. Herts. St Albans: North West Hertfordshire Health Authority; 1993
• 25 Balding J. Young people in 1994. Exeter: Schools Health Education Unit, University of Exeter; 1995
• 26 Department of Health.. General Household Survey. London: HMSO; 1992
• 27 Cheng TL, Savageau JA, Sattler AL, DeWitt TG. Confidentiality in health care: a survey of knowledge, perception and attitudes among high school students. JAMA 1993; 269: 1404-7.
• 28 Maturing Dangers. Lancet 1995; 345: 997-8.
• 29 Walker Z, Townsend JL. The Role of Primary Care in Promoting Teenage Health. A review of the literature. Fam Pract 1999; 16: 2
• 30 Walker Z, Townsend J. Promoting adolescent mental health in primary care: a review of the literature. J Adolescence 1998; 21: 621-34.
• 31 Campbell A, Edgar S. Teenage screening in a general practice setting. Health Visitor 1993; 66: 365-6.
• 32 Donovan CF, McCarthy S. Is there a place for adolescent screening in general practice?. Health Trends 1988; 20: 64-6.
• 33 Hibble A, Elwood J. Health promotion for young people. Practitioner 1992; 236: 1140. 1142-3.
• 34 Smith A, Melville E. Targeting teenagers in the primary care setting. Health Visitor 1996; 69: 228-30.
• 35 Westman A, Elena Garralda M. Mental health promotion for young adolescents in primary care: a feasibility study. Br J Gen Pract 1996; 46: 317.
• 36 Strecher VJ, DeVellis BM, Becker MH, Rosenstock IM. The role of self-efficacy in achieving health behavior change. Health Educ Quart 1986; 13: 73-91.
• 37 Bandura A. Social Foundations of Thought and Action: social cognitive theory. Englewood Cliffs, NJ: Prentice Hall; 1986
• 38 Bandura J. Self-efficacy mechanism in human agency. Am Psychol 1982; 37: 122-47.
• 39 Ajzen I. The Theory of Planned Behavior. Organizational Behavior and Human Decision Processes 1991; 50: 179-211.
• 40 Schwarzer R. Self-efficacy in the adoption and maintenance of health behaviors: Theoretical approaches and a new model. In: Schwarzer R. editor. Self-efficacy: Though approaches and a new model. Washington DC: Hemisphere; 1992
• 41 Kelly RB, Zyzanski SJ, Alemagno SA. Prediction of motivation and behavior change following health promotion: role of health beliefs, social support, and self-efficacy. Social Sci Med 1991; 32: 311-20.
• 42 Schwarzer R, Fuchs R. Self-efficacy and health behaviours. In: Conner M, Norman P. editors. Predicting Health Behavior. Bristol: Open University Press; 1996: 163-96.
• 43 Gillis AJ. Determinants of a health-promoting lifestyle: an integrative reivew. J Adv Nurs 1993; 18: 345-53.
• 44 McIntyre KO, Lichtenstein E, Mermelstein RJ. Self-efficacy and relapse in smoking cessation: a replication and extension. J Cons Clin Psychol 1983; 51: 632-3.
• 45 Coelho RJ. Self-efficacy and cessation of smoking. Psychol Rep 1984; 54: 309-10.
• 46 Prochaska JO, DiClemente CC. Self change processes, self efficacy and decisional balance across five stages of smoking cessation. Prog Clin Biol Res 1984; 156: 131-40.
• 47 Jeffrey RW, Bjornson-Benson WM, Rosenthal BS, Lindquits RA, Kurth CL, Johnson SL. Correlates of weight loss and its maintenance over two years of follow-up among middle-aged men. Prev Med 1984; 13: 155-68.
• 48 Desharnais R, Bouillon J, Godin G. Self-efficacy and outcome expectations as determinants of exercise adherence. Psychol Rep 1986; 59: 1155-9.
• 49 Wallis J. Women’s knowledge of emergency contraception. Professional Nurse 1994; 10: 158-9.
• 50 Gollwitzer PM. Goal Achievement: The role of intentions. Eur Rev Soc Psych 1993; 4: 141-85.
• 51 Walker ZAK, Townsend J, Bell J, Marshall S. An opportunity for teenage health promotion in general practice. Health Educ J 1999; 58: 218-27.
• 52 Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measure 1977; 1: 385-401.
• 53 McDowell Newell. Center for Epidemiologic Studies Depression Scale (CES-DC). Measuring Health. Oxford: Oxford University Press; 1996
• 54 Weissman MM, Sholomskas D, Pottenger M. et al. Assessing depressive symptoms in five psychiatric populations: a validation study. Am J Epidemiol 1977; 106: 203-14.
• 55 Weissman MM, Prusoff B, Newberry PB. Comparisons of CES-D, Zung and Beck Self Report Depression Scales. M.D.: Center for Epidemiologic Studies, National Institute of Mental Health; 1975
• 56 Faulstich ME, Carey MP, Ruggiero L, Enyart P, Gresham F. Assessment of depression in childhood and adolescence: an evaluation of the Center for Epidemiological Studies Depression Scale for Children (CESDC). Am J Psych 1986; 143: 1024-7.
• 57 Fendrich M, Weissman MM, Warner V. Screening for depressive disorder in children and adolescents: validating the Center for Epidemiologic Studies Depression Scale for Children. Am J Epidemiol 1990; 131: 538-51.
• 58 American Medical Association.. AMA Guidelines for Adolescent Preventive Services (GAPS). Recommendations and Rationale. Baltimore: Williams and Wilkins; 1994