Effect of patient priming and primary care provider prompting on adolescent-provider communication about alcohol

Arch Pediatr Adolesc Med. 2003 May;157(5):433-9. doi: 10.1001/archpedi.157.5.433.


Objective: To determine whether priming adolescent patients to discuss alcohol with their primary care providers and prompting providers to discuss alcohol increases adolescent-provider communication about alcohol.

Design: Randomized controlled trial.

Setting: Five managed care group practices in Washington, DC.

Participants: Consecutive patients aged 12 to 17 years who were seeing primary care providers (n = 26) for health checkups. Of 892 eligible adolescents, 444 (50%) were randomized and completed data collection. Most adolescents (80%) were African American, 55% were male, and 17% currently drank alcohol.

Intervention: Usual care (group 1) vs adolescent priming with alcohol self-assessment and education just before their health checkups (group 2) vs adolescent priming and provider prompting with the adolescent's self-assessment and a patient education brochure (group 3).

Main outcome measures: This exploratory substudy of a longitudinal study on adolescent alcohol behaviors examined adolescent-provider communication by adolescent exit survey, researcher observation, and audiotapes of a subsample of visits.

Results: More adolescents in group 3 (96%) than group 1 (87%) reported that their provider talked about alcohol (adjusted odds ratio [OR], 1.10; 95% confidence interval [CI], 1.04-1.17). More adolescents in group 3 (18%) than group 1 (10%) reported asking about alcohol (adjusted OR, 1.08; 95% CI, 1.00-1.16). The mean +/- SD number of minutes adolescents were with their providers without parents being present was greater for group 3 (10.8 +/- 7.6) than group 1 (8.8 +/- 8.0). Adolescents in group 2 spent more time with their provider and reported initiating more discussion not specific to alcohol than did group 1 adolescents.

Conclusion: Adolescent priming and provider prompting increases adolescent-provider communication about alcohol.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Adolescent Health Services*
  • Alcohol Drinking / epidemiology*
  • Alcohol Drinking / prevention & control
  • Child
  • Communication*
  • Confidence Intervals
  • Counseling
  • District of Columbia / epidemiology
  • Female
  • Humans
  • Male
  • Managed Care Programs
  • Physical Examination*
  • Physician-Patient Relations*