Improving adolescent health: Health care professionals' views of parental involvement in adolescent health care

BACKGROUND: The Healthy People 2010 initiative proposed the creation of working partnerships among health care professionals (HCPs) and families as a strategy to achieve the 21 Critical Health Objectives for Adolescents and Young Adults. However, little is known about how HCPs work with the parents of adolescent patients.

OBJECTIVE: This study's aim is to explore how HCPs involve parents in adolescent health care.

METHODS: Participants in five communities across North Carolina were recruited through school-based and school-linked health centers. We conducted 21 interviews and seven focus groups with HCPs (N=51). Discussion questions elicited information about their philosophy, policies, and protocols regarding parental involvement in teen health care, and their successes and challenges with trying to engage parents. Qualitative data were coded to identify emerging themes.

RESULTS: HCPs in this sample endorsed developmentally- appropriate parental involvement. They reported a range of involvement among their patients' parents and described encouraging communication betweens teens and parents as one way to facilitate involvement in health care and to promote adolescent health. Participants also cited challenges including: 1) patient confidentiality, 2) parental availability and capacity to be involved, 3) level of parental trust in the HCP, 4) potential detrimental effects of involvement, and 5) parent-teen relationship dynamics.

CONCLUSIONS: Understanding HCP experiences with parental involvement may inform efforts to improve adolescent health and health care. Future research should examine how providers choose strategies for working with parents, develop interventions to encourage appropriate parental involvement, and assess their impact on teen health outcomes.