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

Z. A. K. Walker; L. L. Oakley; J. L. Townsend

doi:10.1055/s-0038-1634339

Methods of Information in Medicine, Table of Contents

Methods Inf Med 2000; 39(03): 260-266
DOI: 10.1055/s-0038-1634339

Original Article

Schattauer GmbH

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

Authors

Z. A. K. Walker

¹Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, Herts, UK
L. L. Oakley

¹Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, Herts, UK
J. L. Townsend

¹Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, Herts, UK

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

Full Text

References

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