Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Peggy El-Mallakh

Clinical Mentor

Dr. Ginny Sprang

Committee Member

Dr. Jan Findlay


Aim: Investigate provider patterns of risk behavior screening at an adolescent health clinic and describe findings from a study that investigated patterns of risk behavior screening in an adolescent health clinic.

Background: Adolescents who engage in risky behaviors are vulnerable to problems with current and future mental health issues such as depression, substance use, or other psychiatric disorders. Identifying the risky behaviors in adolescents that are associated with the potential presence of depressive symptoms can be helpful to the provider when deciding to refer an adolescent for further mental health assessment. Provider fidelity in risk behavior screening is central to identifying these risky behaviors in adolescents.

Design: Descriptive retrospective review.

Method: Random sample of 150 medical records were reviewed for inclusion criteria to achieve an end total of 84 medical records of patients seen at an adolescent health clinic in the urban area of a south-central state of the US. All adolescents age 12 to 18 years were eligible regardless of race, ethnicity, or gender. Data collection by principle investigator with demographic and study variables extracted. Rates of provider screening, differences in screening practices of providers, differences in provider screening patterns by gender and race, and significance in risk behavior and risk level was computed.

Results: Females made up 72.6% of adolescent patients; Caucasians (52.4%) and African Americans (33.3%) made up majority of races. Provider rate of annual screening according to recommended guidelines was 33.3%. Tobacco use was the most assessed for risk behavior. African Americans had the highest Sexual Activity risk level compared with other races at a statistically significant level. Females had higher risk level scores compared with males for all risk behavior variables except within the variable School Issues.

Implications: Patient-centered care is the current model for patient care and incorporating behavioral health is a natural integrative component and a priority to address service quality, service cost, and service availability. Strategies that focus on increasing clinician fidelity and consistency regarding depression screening among adolescents have been proposed.