Published online June 2, 2008
PEDIATRICS Vol. 121 No. 6 June 2008, pp. 1099-1105 (doi:10.1542/peds.2007-1878)
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ARTICLE

Trial of Computerized Screening for Adolescent Behavioral Concerns

Jack Stevens, PhD, Kelly J. Kelleher, MD, MPH, William Gardner, PhD, Deena Chisolm, PhD, Jennifer McGeehan, MPH, Kathleen Pajer, MD, MPH and Lindsay Buchanan, BA

Research Institute at Nationwide Children's Hospital, Columbus, Ohio and Department of Pediatrics, The Ohio State University, Columbus, Ohio

OBJECTIVE. Injury risk, depressive symptoms, and substance use are the leading causes of adolescent morbidity and death. The goal of this randomized, controlled trial was to determine whether computerized screening with real-time printing of results for pediatricians increased the identification of these adolescent behavioral concerns.

METHODS. A total of 878 primary care patients 11 to 20 years of age participated in computerized behavioral screening (the Health eTouch system) in waiting rooms of 9 urban clinics. These clinics all served predominantly low-income patients. The clinics were randomly assigned to have pediatricians receive screening results either just before face-to-face encounters with patients (immediate-results condition) or 2 to 3 business days later (delayed-results condition).

RESULTS. Fifty-nine percent of Health eTouch respondents had positive results for ≥1 of the following behavioral concerns: injury risk behaviors, significant depressive symptoms, or substance use. Sixty-eight percent of youths in the immediate-results condition who screened positive were identified as having a problem by their pediatrician. This was significantly higher than the recognition rate of 52% for youths in the delayed-results condition.

CONCLUSION. Immediate provision of an adolescent's self-report of behavioral concerns to a pediatrician increased recognition of those problems, compared with the delayed provision of results.

Key Words: behavior screening • information technology

Abbreviations: CES-DC—Center for Epidemiological Studies Depression Scale for Children • CASI-A—Comprehensive Addiction Severity Index for Adolescents • aOR—adjusted odds ratio • CI—confidence interval

Accepted Oct 4, 2007.




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Computer screening helps identify behavioral concerns
AAP News, September 1, 2008; 29(9): 2 - 2.
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