Comparison of Parental and Adolescent Views on the Confidential Interview and Adolescent Health Risk Behaviors within the Gynecologic Setting

Abstract

Study objective: To explore parental and adolescent views on the confidential interview in the gynecologic setting and compare adolescent reported risk-taking behaviors with parental perception.

Design: Anonymous surveys were administered separately to parents/guardians and adolescents between the ages of 11 and 17 years. Information pertaining to the patient's Tanner stage and reason for visit was obtained from the provider. This first phase served as the usual care group. In the second phase of the study, surveys were again distributed after a brief educational intervention. Linear regression analysis, Wilcoxon rank sum test, and Fisher exact test were used where appropriate.

Setting and participants: Pediatric and adolescent gynecology clinics in 2 tertiary hospitals.

Interventions: Brief educational handout on key concepts of the confidential interview.

Main outcome measures: Parental perception of the confidential interview and adolescent risk-taking behaviors.

Results: A total of 248 surveys were included in the final analysis, which accounts for 62 adolescent and parent/guardian pairs in each group. Most parents and adolescents reported perceived benefit to the confidential interview. However, parents were less likely to rate benefits of private time specifically for their own adolescent and less than half of the parents believed that adolescents should have access to private time in the gynecologic setting. Parents/guardians as well as adolescents feared that the confidential interview would limit the parent's ability to take part in decision-making. The low support for confidential time for their adolescent was not different in the usual care group compared with the intervention group, although there was a trend toward parental acceptance with increased adolescent age. Adolescents were consistently more likely to report more risk-taking behaviors than their parents perceived.

Conclusion: There is a discord between parental perception and adolescent reports of risk-taking behaviors. This is coupled with a lack of understanding or comfort regarding the benefits of the confidential interview among parents and adolescents who present for gynecologic care. A short educational intervention had only a modest effect on parental perceptions regarding the confidential interview.

Keywords: Adolescent confidential interview; Adolescent risk-taking behaviors; Parental perception of confidential interview.