Promoting Adolescent Health: Partnerships between Health Care Providers, Parents & Adolescents
Guidelines from professional organizations highlight provision of confidential care and time alone between adolescents and their health care providers as critical elements of adolescent preventive services.1 Time alone gives adolescents opportunities to learn to interact independently with their provider and to discuss sensitive issues. While there are clear benefits to time alone and confidential services for adolescents, there are also potential benefits of strengthening relationships between providers and parents.
Research highlights a gap between professional guidelines around confidential services and practice. A nationwide study found that only 30% of adolescents who had a clinic visit in the past year reported time alone with their provider.2 In another study, adolescents, parents, and providers all expressed strong support for confidential preventive services but also voiced ambivalence about these services. All three groups spoke of the need to balance adolescents’ needs for privacy with efforts to involve parents as a key support in teens’ health and health care.3 Current research led by Renee Sieving, Chris Mehus, and Annie-Laurie McRee--involving Minnesota-based primary care providers, parents and teens—explores the balance between confidential services and parent engagement.
Considering relationships between providers, adolescents, and parents, multiple strategies emerge for developmentally appropriate partnerships to promote adolescent health.4 A strategy endorsed by many parents involves encouraging communication between adolescent patients and their parents. Teen-parent communication is protective for adolescent health and can decrease risk-taking behaviors. For providers, time alone with adolescent patients provides an opportunity to build relationships, and an occasion to discuss the value of teen-parent communication. Within the context of confidential care, providers’ discussions with parents can inform the care provided to adolescent patients; reinforce parents’ roles as partners in their adolescent’s health care; and provide support for parents in raising healthy adolescents.
Providers can use the following strategies to engage adolescents and their parents around confidential services and teen-parent communication:
- Normalize (with both parents and teens) time alone and confidentiality as a part of routine, quality health care for all adolescents.
- Discuss relationships between the provider, teen, and parent, and their respective roles in the adolescent’s health. (e.g. with teens, "This is a fun age because you have more independence each year and so have to be thoughtful about the decisions you make. Your parents support you in that, by knowing who your friends are, where you're going, and being a resource for any questions you have; and I get to be a resource for you for questions or concerns you'd rather ask me than your parents.")
- Start conversations with parents around sensitive subjects by validating their experiences. Provide general guidance about topics that may actually be tailored to an adolescent patient’s needs, but without specifically disclosing the adolescent’s confidential information.
- Encourage supportive teen-parent communication.
Providers should feel reassured that most parents support time alone with adolescent patients and confidential services, and that these services are supported by professional organizations and state laws. Within the context of confidential care, providers can support parent-adolescent relationships, facilitate teen-parent communication, and function as a partner with parents, even while seeing adolescent patients privately for developmentally appropriate care.
- Hagan J, Shaw J, Duncan P, eds. (2017). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents: Pocket Guide. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics.
- Adams S, Park MJ, Tweitmeyer L, Brindis C, Irwin C. (2018). Association Between Adolescent Preventive Care and the Role of the Affordable Care Act. JAMA Pediatrics, 172, 43-48.
- Catallozzi M, Humphrey J, Boyle MC, Kaseeska J, Gorzkowski J, Heitel J, Klein J, Santelli J (2017). Confidentiality and Clinical Preventive Services: Perspectives of Youth, Parents, and Clinicians. Journal of Adolescent Health, 60, S60-61.
- Ford C, Davenport A, Meier A, McRee AL. (2011). Partnerships between parents and health care professionals to improve adolescent health. Journal of Adolescent Health, 49, 53-57.