Does screening for and intervening with multiple health compromising behaviours and mental health disorders amongst young people attending primary care improve health outcomes? A systematic review

BMC Family Practice

Research Article

Sylvia D. Kauer¹  Marianne J. Webb¹  Lena A. Sanci¹  Dagmar M. Haller²  Elizabeth M. Ozer³ 

[1] Department of General Practice, University of Melbourne, 200 Berkeley Street, 3053, Carlton, Australia;Department of General Practice, University of Melbourne, 200 Berkeley Street, 3053, Carlton, Australia;Primary Care Unit, Faculty of Medicine, University of Geneva, 9 av de Champel, 1211, Geneva 4, Switzerland;Adolescent and Young Adult Program, Department of Community, Primary Care and Emergency Medicine and Department of Pediatrics, Geneva University Hospitals, 87 bvd de la Cluse, 1205, Geneva, Switzerland;Division of Adolescent & Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children’s Hospital, University of California San Francisco, 94118, San Francisco, USA;UCSF Office of Diversity and Outreach, University of California San Francisco, 94118, San Francisco, USA;

关键词: Adolescent;    Screening;    Primary care;    Health compromising behaviour;    Mental health;    Prevention;   

DOI  :  10.1186/s12875-016-0504-1

 received in 2016-01-22, accepted in 2016-07-28,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAdolescence and young adulthood are important developmental periods. Screening for health compromising behaviours and mental health disorders during routine primary care visits has the potential to assist clinicians to identify areas of concern and provide appropriate interventions. The objective of this systematic review is to investigate whether screening and subsequent interventions for multiple health compromising behaviours and mental health disorders in primary care settings improves the health outcomes of young people.MethodsUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, literature searches were conducted in Medline, PsycINFO, Scopus and Cochrane Library databases (Prospero registration number CRD42013005828) using search terms representing four thematic concepts: primary care, young people, screening, and mental health and health compromising behaviour. To be eligible for inclusion, studies had to: include a measure of health outcome; include at least 75 % of participants aged under 25 years; use a screening tool that assessed more than one health domain; and be conducted within a primary care setting. Risk of bias was assessed using the Quality Rating Scale.ResultsFrom 5051 articles identified, nine studies fulfilled the inclusion criteria and were reviewed: two randomised controlled trials (RCTs), one pilot RCT, two clustered RCTs, one randomised study with multiple intervention groups and no control group, one cluster RCT with two active arms, one longitudinal study and one pre-post study. Seven studies, including two RCTs and one clustered RCT, found positive changes in substance use, diet, sexual health or risky sexual behaviour, alcohol-related risky behaviour, social stress, stress management, helmet use, sleep and exercise. Of only two studies reporting on harms, one reported a negative health outcome of increased alcohol use.ConclusionsThere is some evidence that the use of screening and intervention with young people for mental health disorder or health compromising behaviours in clinical settings improves health outcomes. Along with other evidence that young people value discussions of health risks with their providers, these discussions should be part of the routine primary care of young people. Further quality studies are needed to strengthen this evidence.

【 授权许可】

CC BY   
© The Author(s). 2016