Background and objectives: This study describes variation in reproductive health preventive services delivery to adolescents by family physicians in Upstate New York.
Methods: We surveyed a stratified random sample of 354 family physicians from three New York State metropolitan statistical areas about the proportion of their adolescent patients (ages 15-18) to whom they deliver preventive reproductive health interventions. Responses were averaged to create a preventive care practice score.
Results: Of 295 eligible respondents, 179 returned completed surveys (61%). Eighty-one percent were male. Respondents did not vary by geographical area. However, female family physicians were less likely to respond than males, and olderfamily physicians were less likely to respond than more-recent graduates. On average, family physicians reported asking 79% of their adolescent patients about contraceptive use, 73% about condom use, 72% about sexual relationships, and 61% about sexual behaviors. Only 36% reported asking teens when they thought sex was appropriate, and 30% had discussed sexual orientation. Seventy-six percent of physicians discussed adolescents' risks of HIV with adolescent patients, 78% advised adolescent patients to use condoms, 21% gave handouts about HIV, and 9% gave condoms to adolescent patients. Factors associated with provision of more preventive reproductive services included regularly discussing confidentiality, more-recent medical school graduation, placing a high value on the American Academy of Family Physicians recommendations, having read Centers for Disease Control immunization guidelines, having read American Academy of Pediatrics guidelines, and female gender Overall, these factors explained 26% of the variance in provision of preventive reproductive services.
Conclusions: Family physicians report providing most reproductive preventive services to more than half of their patients. Female physicians, older physicians, physicians who regularly discuss confidentiality, and physicians who have a more-positive attitude toward andfamiliarity with preventive care guidelines are more likely to provide reproductive health screening and counseling during adolescent visits.