The Adolescent Health Review: Test of a computerized screening tool in school-based clinics

This study tested the viability of a stand-alone screening process in school-based health centers, and gauged its acceptance by patients and providers. The study also examined the prevalence of a variety of health risks disclosed in response to a new screening instrument and the relationship between these health risks and the stated purpose for the clinic visit. Seven school-based clinics located in six high schools and one alternative school in an urban school district participated in the study; 692 patients (83% female, 67% minority) completed the Adolescent Health Review (AHR), a multidimensional screening instrument that addressed 14 risk domains. The AHR was computerized for administration, scoring, and report generation. Females reported risk in significantly more domains than males (4.2 vs. 3.2; t = 4.5, p < .0001), including higher risk in family interaction problems, a history of physical or sexual abuse, emotional distress, suicidal behavior, marijuana use, and sexual activity. Significantly more males than females reported violent behavior. Risk rates were high regardless of stated purpose for the clinic visit. According to clinic staff, use of the AHR increased routine screening and the process was well accepted by patients and providers. Providers benefited from the opportunity to discuss risks with patients by using the printed reports to facilitate conversation and develop health care plans.