Assessing and referring adolescents' health-related social problems: qualitative evaluation of a novel web-based approach

We conducted a qualitative study to examine users' perceptions of a web-based screening and referral system for young adults with health-related social problems. The first 50 patients who used the system also took part in semi-structured interviews. There were 20 patients aged 15–17 years and 30 aged 18–25 years. Completing the web-based screening process took an average of 25 min. Ninety percent of participants reported at least one major health-related social problem and a total of 134 referrals were selected for further assistance. Ninety-six percent of participants said they would recommend the system to a friend or peer, and 80% supported its use for annual screening. Perceived strengths of the system were novelty, privacy, ease of use, relevance, motivation, variety and proximity of referrals, and clinic staff support. Perceived shortcomings were length, sensitivity, navigation challenges and agency availability. The system complemented provider visits and preserved privacy while improving attention to patient needs. Computerized screening and referral tools have potential to improve the quality of care in vulnerable young adults.

[1]  G. R. Gladstone,et al.  Use of inexpensive technology to enhance adolescent health screening and counseling. , 2009, Archives of pediatrics & adolescent medicine.

[2]  B. Grant,et al.  Controlled Trial of a Patient-Completed History Questionnaire: Effects on Quality of Documentation and Patient and Physician Satisfaction , 2002, American journal of medical quality : the official journal of the American College of Medical Quality.

[3]  W. Stanton,et al.  Development of an instrument for monitoring adolescent health issues. , 2000, Health education research.

[4]  T. Lieu,et al.  Families' Health-Related Social Problems and Missed Referral Opportunities , 2007, Pediatrics.

[5]  D. Paperny Office-based computerized risk-assessment and health-education systems. , 2007, Adolescent medicine: state of the art reviews.

[6]  L. A. Riesenberg,et al.  Systemic Barriers to Diabetes Management in Primary Care: A Qualitative Analysis of Delaware Physicians , 2011, American journal of medical quality : the official journal of the American College of Medical Quality.

[7]  J. Fortenberry,et al.  Patient and staff perspectives on the use of a computer counseling tool for HIV and sexually transmitted infection risk reduction. , 2007, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[8]  Markku Timonen,et al.  The compatibility of telehealth with health-care delivery , 2011, Journal of telemedicine and telecare.

[9]  E. Fleegler,et al.  Using technology to improve adolescent healthcare , 2010, Current opinion in pediatrics.

[10]  Judith M. Tanur,et al.  Questions About Questions: Inquiries into the Cognitive Bases of Surveys. , 1993 .

[11]  W. Gardner,et al.  Trial of Computerized Screening for Adolescent Behavioral Concerns , 2008, Pediatrics.

[12]  S. M. Rogers,et al.  Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology. , 1998, Science.

[13]  Matthew B. Miles,et al.  Qualitative Data Analysis: An Expanded Sourcebook , 1994 .