Adolescent health brief
Increasing Clinician Self-Efficacy for Screening and Counseling Adolescents for Risky Health Behaviors: Results of an Intervention

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Abstract

This study evaluates a training and tools intervention to increase provider self-efficacy to screen and counsel adolescents for risky behavior. Two clinics within a health maintenance organization served as intervention sites, and two as comparison sites. Self-efficacy to deliver adolescent services increased significantly in the intervention group relative to the comparison group.

Section snippets

Design

The study was conducted in four outpatient pediatric clinics within a large health maintenance organization (HMO) throughout Northern California: two clinics served as intervention sites, and two as comparison sites. Both pediatricians and nurse practitioners participated in the study. Participant data are available in Table 1.

The study consisted of a preintervention baseline period, Time 1 (T1), and a postintervention period following the training and the integration of tools, Time 2 (T2). T2

Measures

Clinicians completed an assessment of their self-efficacy to deliver preventive services to adolescent patients at both T1 and T2. Six efficacy scales were constructed [5], one for each of the target areas: tobacco use (four items, alpha reliability = .79), alcohol use (eight items, alpha reliability = .94), drug use (five items, alpha reliability = .90), sexual behavior (seven items, alpha reliability = .94), seatbelt use (two items, alpha reliability = .96), and helmet use (two items, alpha

Descriptive statistics

In the intervention group, self-efficacy for screening and counseling increased significantly in all six target areas from T1 to T2 (all significant a p < .001) (Table 2). There were no significant changes in self-efficacy in the comparison clinics (Table 2).

ANCOVA to compare changes in perceived self-efficacy between the intervention and control groups

We conducted an ANCOVA to test the differences in the change in self-efficacy from T1 to T2 between the intervention and comparison groups. To control for any differences in baseline levels of self-efficacy, we entered the T1 self-efficacy

Discussion

This is the first study to utilize an experimental design to demonstrate the effect of a training and tools intervention on primary care clinicians' self-efficacy to deliver adolescent preventive services. The intervention group demonstrated increased self-efficacy in all six target areas in relation to the comparison group.

Clinician self-efficacy increased as a result of the intervention, whereas there was a downward trend in self-efficacy among providers in the comparison group (although not

Acknowledgments

This research was supported primarily by grant U18 HS11095 from the Agency for Healthcare Research and Quality. Additional support was provided by a cooperative agreement from the Center for Disease Control and Prevention through the Association of American Medical Colleges (MM-0162-02/02); the Maternal Child Health Bureau (T71 MC00003, U45 MC00023, and MC00002); The Staglin Music Festival for Mental Health; Young Adult and Family Center, Department of Psychiatry, UCSF; and The Hellman Family

References (11)

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