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Parent and adolescent attitudes towards preventive care and confidentiality

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journal contribution
posted on 01.06.2019, 00:00 by Xiaoyu Song, Jonathan D. Klein, Hanying Yan, Marina Catallozzi, Xianling Wang, Jenifer Heitel, Kristen Kaseeska, Julie Gorzkowski, John S. Santelli
Objective Little is known about whether parents and adolescents agree in their attitudes towards preventive care, private time and confidentiality for adolescent care. Methods We surveyed a nationally representative sample of 1,209 13¬-18 year-old U.S. adolescents and their parents. Parent and adolescents attitudes towards preventive services, private time and confidentiality were compared. Parent-youth dyad agreement was measured using Cohen's kappa and Spearman coefficients and modeled for association with demographic variables. Results Parents are more likely than adolescents to think preventive services are important (71% vs 48%; p<0.001). Parent-youth attitudes were weakly to moderately correlated (Cohen's kappa coefficient = 0.22; p<0.001). Parents and adolescents report similar ages for when teens should start having private time (median 16 years for both) and many think this age should be at 18, the legal age of adulthood). Fewer than half believe confidentiality should be provided for 10 services, ranging from routine care to abortion care (parents range: 12.8-52.3%; adolescents: 24.0%-58.8%). While most adolescents agreed with their parents, teens were more likely to report wanting confidential access than parents. Older age, Hispanic ethnicity, having divorced parents and higher family income were associated with both adolescent/parent and adolescent endorsement of confidentiality. Conclusion Adolescents and parents generally agree about the importance of preventive services, private time, confidentiality, and what should and should not be confidential. On average, parents value clinical preventive services more than youth, and youth value confidentiality more than parents. Both believe private time should start at ages older than those recommended in clinical guidelines.


This work was supported by a grant from the Merck Foundation to the American Academy of Pediatrics. We thank the members of the Adolescent Health Consortium National Research Advisory Committee for their advice on research design and questionnaire construction.



Song, X. Y., Klein, J. D., Yan, H. Y., Catallozzi, M., Wang, X. L., Heitel, J., . . . Santelli, J. S. (2019). Parent and Adolescent Attitudes Towards Preventive Care and Confidentiality. Journal of Adolescent Health, 64(2), 235-241. doi:10.1016/j.jadohealth.2018.08.015







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