A recent issue of the Journal of Adolescent Health (October 2006) included an article entitled "Vaccination: An Opportunity to Enhance Early Adolescent Preventive Services," by Rupp, Rosenthal, & Middleman. This aricle provided some great suggestions for how clinicians can use the new vaccines (HPV and meningitis) as opportunities to provide preventive services to a population that traditionally has received little preventive care.
There are many reasons why teens do not seem to get the preventive care they need during adolescence. Some lack insurance or transportation, and others just do not come in for annual exams, electing only for acute care or required physicals for sports or summer camp.
Any chance to screen a teen for health risks should be taken by clinicians, but some clinicians do not feel they have the time, are uncomfortable bringing up health issues with teens, or are not prepared to talk with parents about the need for preventive screening and time alone with the teen to ask the more "sensitive" questions about alcohol or drug use and sexual involvement.
It is clear that teens need more effective preventive services given that the major morbidities/mortalities of adolescence are psychosocial in nature, and thus, likely to be preventable. Unintentional injuries (including sports), violence and suicide are the major causes of death among this age group. Substance use, sexual behaviors, and dieting are behaviors with which adolescents being to experiment and can be associated with significant morbidity and mortality.
10% of teens had taken some sort of diet pill, powder or liquid;
and 6% had used vomiting or laxatives to control their weight.
The new immunization recommendations will hopefully motivate parents to get teens in to see their provider and motivate clinicians to screen teens for risky behavior, discuss confidentiality as well as physical, emotional, and cognitive changes associated with adolescence, and encourage teens to come in every year to discuss any health concerns they may have.