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Comprehensive health care for high-risk adolescents: an evaluation study.

F Earls, L N Robins, A R Stiffman and J Powell

Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110.

This study was designed to evaluate the effectiveness of a large scale program to improve health care for high-risk adolescents. Seven clinics, funded to provide comprehensive primary care to adolescents, were compared to three non-funded clinics. The majority of the 2,788 adolescent patients sampled in these clinics were female (78 percent) and Black (71 percent). Each patient was initially interviewed at the time of a clinic visit and reinterviewed 12 months later; their medical records were systematically reviewed. As expected, the funded clinics detected and treated a wider range of medical and behavioral problems than the comparison clinics, a finding that was based on the self-reports of patients and confirmed by documentation in the medical records. However, improvements in life-style and in specific medical outcomes were not observed. To build on the limited success of this program, efforts are needed to encourage more males to receive care and to develop more specific interventions for patients in this age group.

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