Changing parental opinions about teen privacy through education

Jeffrey W Hutchinson, Elisabeth M Stafford
Pediatrics 2005, 116 (4): 966-71

OBJECTIVE: Confidentiality for adolescent patients is the standard of care. However, some parents object to this practice. We determined the prevalence of parents who have negative opinions regarding adolescent privacy policies and education's effect on that prevalence.

METHODS: All parents who sought care for their teen at 2 adolescent medicine clinics were asked to complete a computer survey about teen privacy and risk-taking behavior. Parents who did not know the clinic's privacy policy or had never been to the clinic were asked to participate in an educational study. Study participants were randomly selected to receive education by a handout or a scripted face-to-face encounter. They were surveyed again the same day. For evaluating long-term retention, a follow-up survey was conducted at least 30 days after the education.

RESULTS: A total of 563 parents were surveyed. Of 281 eligible parents, 130 (46%) completed the postintervention survey and 52 (19%) completed the follow-up survey. Repeated measures analysis of variance showed that both education types were equally effective in teaching parents chosen privacy facts. The average number of correct test questions increased from 58.6% to 89.1%. More than 30 days later, the parents' score was 86.9%. Before education, 35% disagreed or strongly disagreed with teens' having private information, compared with 13.8% immediately after education and 15.4% at follow-up. The percentage of parents who disagreed or strongly disagreed with providers' seeing the patient alone was 30.5%, which decreased to 14.5% after education and 17.3% with the follow-up survey. Chi2 tests showed no statistically significant differences between face-to-face and written education in changing parental opinions regarding privacy. When an adolescent wanted to speak with a provider alone, 93% of the parents agreed with that choice, regardless of intervention.

CONCLUSIONS: This study identifies that almost one third of the parents who presented to these adolescent medicine clinics had negative opinions about some privacy practices. The 2 main issues were teens' seeing a provider alone and providers' keeping information confidential. Education was effective in teaching parents about privacy issues and produced a significant improvement in parental opinion about confidentiality. Simultaneously, an overwhelming majority of parents support the idea that teens should speak with a provider alone if the teen so desires, suggesting that parents acknowledge a need for independence. Providing confidential services is an essential part of adolescent health care that works best with the alliance of parents. This study supports the continued need to assess parental attitudes about privacy issues and to provide parents with education.

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