You won't know unless you ask: the biopsychosocial interview for adolescents

Validation of the Perkins Adolescent Risk Screen (PARS)

PURPOSE

To examine the initial psychometric properties for the PARS, a brief interview used to screen for 16 items of adolescent risk and protective factors.

METHODS

Participants included 193 adolescents, attending public middle and high schools or a university-based Adolescent Clinic. Participants completed a PARS interview, as well as a battery of questionnaires. Approximately 31% of participants received a second PARS interview from an independent rater to assess inter-rater consistency.

RESULTS

Descriptive statistics revealed that participants, on average, were rated as low to moderate risk for health-related difficulties across all PARS items. Descriptive statistics also showed important risk patterns in this sample of adolescents (e.g., 1/5 of sample not exercising at all). Factor analysis yielded a total of five factors (Risk Factors, Protection Factors, Relationships/Mood, Motivation Issues, Weight Issues), accounting for 58% of the variance in PARS item scores. Satisfactory levels of internal consistency and inter-rater agreement for the PARS score were found. Convergent and divergent validity of PARS scores were supported by correlations obtained with similar and dissimilar measures, respectively. A significant age group difference was obtained in the total PARS score, with adolescents aged 17-19 years obtaining higher scores than did adolescents aged 14-16 years. No significant gender differences were found.

CONCLUSIONS

Our results support the initial psychometric properties (i.e., reliability, validity) of the PARS as a measure of health risk and protective factors in adolescents. The PARS is a brief, efficient means of obtaining important health risk information from adolescents throughout periodic routine health care visits.

The Juvenile Wellness and Health Survey (JWHS-76): a school based screening instrument for general and mental health in high school students

Existing screening instruments address adolescent health from a pediatric/public health perspective. We developed a school based screening instrument (the JWHS-76) for high schools measuring multiple health related domains from a child psychiatric viewpoint. We studied 1769 students in two suburban high schools (48% girls, mean age 16, predominantly white). Factor analyses revealed five coherent factors: general risk taking, mental health problems, sex related risks, eating and dietary problems, and general health problems. Analyses by gender, age and coping style revealed significant and consistent associations. The JWHS-76 is supported by preliminary evidence as a valid screening instrument in high school.

A computerized school-based health assessment with rapid feedback to improve adolescent health

Adolescent health problems are often undetected in physicians' offices. The Dartmouth Primary Care Cooperative Information Project has developed a validated and reliable approach to identify adolescent health problems and initiate education in a school setting. A self-administered, anonymous, 26-item questionnaire was given to 204 students in a rural high school. Responses were scanned into PC-based software. Within one working day students were given individualized letters identifying their problem health issues as detected by the questionnaire and recommendations for education. Ninety-nine percent of students participated. Six weeks later 49% of a sample of 41 students reported reading the information and 50% planned to change behavior. This standardized, validated strategy of adolescent health assessment, feedback, and education was feasible for use in schools. The school responded to the data by employing a psychologist to address mental health needs.