Our study should be replicated and expanded in other institutions that provide health care to adolescents. Bethesda, MD 20894, Web Policies The need for confidential care in all health-related encounters with adolescents has been endorsed by numerous international and national societies [4] [7]. Overlooked, misunderstood and at-risk: Exploring the lives and HIV risk of ethnic minority male-to-female transgender youth. American Academy of Pediatrics. Special requirements for electronic medical records in adolescent medicine. (2009). (2007b). Obstetrician-gynecologists and other health care providers who care for minors should be aware of federal and state laws that affect confidentiality. Confidentiality in adolescent health care. Abstract Confidential care for adolescents is important because it encourages access to care and increases discussions about sensitive topics and behaviors that may substantially affect their health and well-being. Studies indicate that adolescents are more likely to access health care and disclose sensitive health information when confidentiality is assured [8] [9]. The distinction between paramedical psychosocial support and paramedical physical support was unclear at times, and there were some respondents roles that fit appropriately into both categories. This is particularly true when the needs and wishes of the adolescent conflict with the opinions and preferences of the parents/guardians [ 1 ]. Pediatrics, 131, 12061210. Foregone health care among adolescents. Clinical preventive services for adolescents: Position paper of the Society for Adolescent Medicine. Topics: adolescent health services, confidentiality, american college of obstetricians and gynecologists, nurses, neonatal, physicians, family This content is only available via PDF. It is not intended to substitute for the independent professional judgment of the treating clinician. 8600 Rockville Pike Adolescents perceptions of factors affecting their decisions to seek health care. [Research Support, U.S. Govt, P.H.S. Telemedicine can improve health care access and is likely to be an increasingly common option for medical interactions because it allows flexible scheduling. These include health issues related to sexual behaviors, substance use, and mental health. . A home for paediatricians. Visit our ABOG MOC II collection. Teare, C., & English, A. official website and that any information you provide is encrypted 2-4 Additionally, ensuring young people have access to . Staff may have been on more than one electronic mailing list, staff may not have checked their e-mail during the time the survey was available and it was not feasible to determining how many of the 1800 staff receiving the survey had the potential to engage in caregiving interactions with adolescents. Society for Adolescent Health and Medicine; Gray SH, Pasternak RH, et al. Standards for Health Services in Juvenile Detention and Confinement Facilities. In both provinces, parents continue to have access to their adolescents medical information before the ages specified by law. Confidentiality protections encourage adolescents to seek care and openly discuss issues related to sexuality, substance use, and mental health concernssometimes without parental consent or notificationallowing clinicians to fulfill their role in improving adolescent health. Unfortunately, complexities in the U.S. legal and health care systems have created a setting in which confidential care is inaccessible to many adolescent patients. Please try again soon. 21st Century Cures Act ONC Rule: Implications for Adolescent Care and doi: 10.1097/AOG.0000000000003770. Studies have shown that adolescent patients are interested in being screened and receiving information on safe sexual practices and other risky behaviours in both ED [36] [37]and inpatient wards [38], regardless of gender, sexual experience, or relationship with primary care providers [39]. 633: Alcohol Abuse and Other Substance Use Disorders: Ethical Issues in Obstetric and Gynecologic Practice, Practice Bulletin No. Rushenberg, T. J. Preliminary estimates for 2011 as of July 2012 (Vol. Ensuring the proper provision of confidential care is also critical to the adolescent developmental trajectory. American Medical Association . There was also a relationship between documentation of confidential information in the health record and experience. Adolescent confidentiality is related to consent to treatment, but they are essentially different constructs and must be understood apart from one another. (2012). The local research ethics board approved the study protocol. If its not absolutely confidential, will information be disclosed? Policy compendium on confidential health services for adolescents. Civil Code of Qubec, CCQ-1991: http://legisquebec.gouv.qc.ca/en/showdoc/cs/ccq-1991 (Accessed June 14, 2022). Ensuring privacy and maintaining confidentiality are critical for effective, sensitive management of potentially stigmatizing health issues and enhanced quality care [2]. As adolescents transition into adulthood, the opportunity to spend time alone with a health care provider fosters . Pediatr Rev 2009;30 (11):457-9. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. By ensuring appropriate quantity and quality of confidential care for adolescents, clinicians are better equipped to elicit a comprehensive history and physical examination, while empowering the adolescent involved to develop agency, autonomy, trust, and responsibility for their own health care decision-making and management. English, A., & Morreale, M. (2001). SNL 1995 Chapter A-4.1: An Act Respecting Advance Health Care Directives and the Appointment of Substitute Health Care Decision Makers: https://www.assembly.nl.ca/Legislation/sr/statutes/a04-1.htm. J Adolesc Health 2020;67(2):164-71. Confidential health care for adolescents: Position paper of the Society for Adolescent Medicine. Beauchamp, T., & Childress, J. Do you provide this information to the adolescent: Everything we discuss with you today is confidential with three exceptions: if you are at risk of immediate harm; if you are putting someone else at risk of immediate harm; if someone else is putting you in immediate harm? Sickmund, M. (2010, February). Pediatrics, 130(5), 987990. Both the adolescent and the parent, guardian, or caregiver should be made aware of these circumstances by the HCP involved. Retrieved July 9, 2013, from http://www.aclu.org/FilesPDFs/med_privacy_guide.pdf. In adolescent health care, confidentiality is particularly important (6,7,13,14). Consent and confidentiality for adolescents in health care are too often neglected topics. Adolescent consent and confidentiality is an area of concern in the delivery of health care to this patient population. Thrall, J., McCloskey, L., Ettner, S., Rothman, E., Tighe, J., & Emans, S. (2000). Two provinces diverge from the mature minor doctrine at the present time. Archives of Pediatrics and Adolescent Medicine, 154(9), 885892. Clinicians need to become familiar with federal and state laws that influence practice and policies in their specific setting, and how to provide health care within this context to adolescent patients during routine and acute care. Les auteurs recommandent des stratgies pour amliorer la comprhension et les pratiques en matire de respect de la confidentialit chez les adolescents, soit encourager les individus examiner leurs croyances et favoriser les tudes postsecondaires, les stratgies de transfert du savoir au sein des programmes et les directives et politiques tablies par ltablissement. Adolescents perception of factors affecting their decisions to seek health care. Adolescents interpretations of conditional confidentiality assurances. Confidentiality for adolescents accessing health care is complex, and concerns about lack of confidentiality can be a barrier to receiving appropriate care 2 3. PubMedGoogle Scholar. For example, the provision of private and confidential health care was evaluated in a study involving a large sample of high school students in New Zealand. There should be private conversation time between the health care provider and adolescent patient. Oakland, CA: National Center for Youth Law. Canadian Medical Association. In J. Farrow (Ed. doi:10.1001/archpediatrics.2011.1131. Provided by the Springer Nature SharedIt content-sharing initiative, Health Promotion for Children and Adolescents, https://doi.org/10.1007/978-1-4899-7711-3_17, http://www.cdc.gov/hiv/resources/factsheets/PDF/youth.pdf, http://www.cdc.gov/vitalsigns/hivamongyouth/, http://www.militaryonesource.mil/12038/MOS/Reports/2011_Demographics_Report.pdf, http://www.dtic.mil/whs/directives/corres/pdf/602518r.pdf, http://www.guttmacher.org/pubs/confidentiality-review.pdf, http://tricare.mil/tma/dhcape/program/evaluation.aspx, http://www.uspreventiveservicestaskforce.org/tfchildcat.htm, http://www.guttmacher.org/statecenter/spibs/spib_MASS.pdf, http://nahic.ucsf.edu/download/health-care-for-homeless-youth-policy-options-for-improving-access/, http://b.3cdn.net/naeh/1c46153d87d15eaaff9zm6i2af5.pdf, http://www.med.navy.mil/directives/Pages/NAVMEDP-MANMED.aspx, http://www.doncio.navy.mil/uploads/0601CZD27871.pdf, http://www.huduser.org/publications/pdf/p6.pdf, http://www.aclu.org/FilesPDFs/med_privacy_guide.pdf. Lgis Qubec. Specifically, when an HCP deems that an adolescent is at risk of seriously harming themselves or others, confidentiality must be breached [20]. American Academy of Pediatrics, Committee on Adolescence; Council on Clinical and Information Technology; Blythe MJ, Del Beccaro MA. Our findings are unlikely to be unique. Levenberg, P., & Elster, A. 2020 Oct;136(4):e70-e80. (2012). In Quebec, the Act Respecting the Health Services and Social Services [16]specifically states that adolescents 14 years of age or older have the right to control access to their medical record. Emerging technologies will impact privacy, and our educational approaches will, thus, require constant attention to ensure continued relevance (18). The American College of Obstetricians and Gynecologists offers the following recommendations and conclusions: Number 803 (Replaces Committee Opinion Number 599, May 2014). A parent or legal guardian must provide consent on behalf of a minor (under age 18) before health care services are provided, with several important exceptions. The provision includes reporting certain communicable diseases to public health, for example. (2010). Berlan ED, Bravender T. Confidentiality, consent, and caring for the adolescent patient. Campbell AT. Journal of Adolescent Health, 12, 225232. McKee MD, O'Sullivan LF, Weber CM. HCPs must be aware of, and conversant with, the federal and provincial/territorial legislation affecting health care privacy and confidentiality in their jurisdiction. The State Government has to steer most of the funding towards those areas where many disadvantaged families live. Official action: Practice parameter for the assessment and treatment of youth in juvenile detention and correctional facilities. related to adolescent health care that address confidentiality for particular health care settings, special populations, and specific services preventive health care, testing & treatment for STDs & HIV, contraception, pregnancy-related care, and other reproductive health services. Health risk behaviors in adolescents with chronic conditions. Curr Opin Pediatr 2009;21(4):450-56. Lenhart, A., Ling, R., Campbell, S., & Purcell, K. (2010). An official website of the United States government. Meaningful use of a confidential adolescent patient portal. Accessibility Confidentiality refers to protection of privileged and private information shared during a health care encounter and in medical records that document the encounter 1. J Adolesc Health 2004;35(2):160-67. There were 389 respondents from a potential sample of approximately 1800 employees. The American College of Obstetricians and Gynecologists has neither solicited nor accepted any commercial involvement in the development of the content of this published product. National Library of Medicine 14. Journal of Adolescent Health, 40: 199-200.Google Scholar. Confidential Care for Adolescents in the U.S. Health Care System Journal of Adolescent Health, 27(1), 2533. Ford, C., Best, D., & Miller, W. (2001). While confidentiality is a basic principle for all health care encounters regardless of age, the unique considerations for capable adolescent patients are not always realized or appreciated. Sharing adolescents information with parents/legal guardians; Opportunities for adolescents to meet with health care providers without parents/legal guardians present; Informing adolescents and parents/legal guardians about adolescents right to confidential health care and its limits; Sharing adolescents confidential information with other health care providers; Documentation of adolescents confidential information in the health record; and. Sigman G, Silber TJ, English A, Epner JE. Manual of the Medical Department of the Navy, NAVMED P-117. State-by-State Variability in Adolescent Privacy Laws 19). For more information, please refer to our Privacy Policy. Confidentiality protection is an essential compo- nent of health care for adolescents because it is consistent with their development of maturity and autonomy and without it, some adolescents will forgo care. joc90755 [pii]. Bourgeois FC, Taylor PL, Emans SJ, Nigrin DJ, Mandl KD. McKee MD, Rubin SE, Campos G, OSullivan LF. Obstetrics and Gynecology Clinics of North America, 27(1), 195211. Pediatrics, AAP Council on Community Pediatrics. Houston Journal of Health Law and Policy, 1(1), 63108. Respondents who had worked <5 years in paediatrics were significantly more likely to answer often or always to the question about communicating limits of confidentiality to adolescents compared with respondents who had worked in paediatrics for 25 years (50% versus 23%). These policies often speak to the 100-2305 St. Laurent Blvd Ottawa, ON Canada K1G 4J8, [emailprotected] (613) 526-9397 (613) 526-3332, 2023 Canadian Paediatric Society. In general, informed consent requires that a decision-maker has the capacity to make a decision, is given all relevant information, and is making a voluntary decision freely, without coercion [18]. This combined approach might involve discussion with adolescents about how they perceive a specific disclosure to parents, helping them to weigh the potential advantages of more open communication, and offering to facilitate communication with parents in ways that help the patient. (2010b). Ford, C. A., Bearman, P. S., & Moody, J. Consent and Confidentiality - SAHM - Adolescent Health CrossRef Boekeloo, B., Schamus, L., Cheng, T., & Simmens, S. (1996). Increasing education around privacy laws while reinforcing awareness of confidentiality concerns can improve knowledge gaps. Pittsburgh, PA: National Center for Juvenile Justice. Adolescent health services: Missing opportunities. Holder, A. Exploration for physicians of the mature minor doctrine. Confidential health care for adolescents: Position paper of the society for adolescent medicine. (1985). Qualitative data were analyzed using manifest thematic analysis (8,9). 12. Privacy for the Vulnerable: Confidentiality in Adolescent Care 762 Summary: Prepregnancy Counseling, Committee Opinion No. https://doi.org/10.1007/978-1-4899-7711-3_17, DOI: https://doi.org/10.1007/978-1-4899-7711-3_17. Teens and mobile phones. The maintenance of patient confidentiality may be affected by the widespread adoption and integration of electronic health records (EHRs) in clinical care, which may necessitate a closer evaluation of the unique challenge this presents for providers of adolescent health care. Retrieved 2013, from http://www.cdc.gov/vitalsigns/hivamongyouth/. Confidentiality protections are a vital aspect of adolescent healthcare because they encourage young people to seek care and disclose sensitive information that helps providers deliver appropriate clinical services. Moreover, without confidential care, adolescents may decline routine services, such as sexually transmitted infection (STI) testing, or not engage in follow-up care [11]. (2012). MeSH Puzzanchera, C., Adams, B., & Hockenberry, S. (2012). At the state level, they include laws that allow minors to consent to their own care, some of which also specify privacy protections, as well as an array of medical privacy and health records laws. This document has been updated to include information on patient portals, guidance on the release of medical records, examples of ways to safeguard adolescent patients confidentiality, and talking points to use with parents and guardians. Pediatr Emerg Care 2010;26(6):413-16. Developing protocols to optimize confidential care in various settings can mitigate obstacles such as time constraints, space limits, and insurance practices that may compromise confidentiality. Quantitative data were analyzed using descriptive statistics. Moreover, sensitive health issues that an adolescent is not ready to disclose to others may be documented and accessed all too easily by other health professionals without explicit consent being given. English, A., Ford, C. A., & Santelli, J. S. (2009). As a library, NLM provides access to scientific literature. Washington, DC. Obstetriciangynecologists and other health care providers who care for minors should be aware of federal and state laws that affect confidentiality. Confidentiality in Adolescent Health Care - LWW Adolescent Health Care, Confidentiality | AAFP At times, the best strategy may be to encourage the adolescent to find a secure location outside of the home (e.g., an office at school) to speak from. However, several barriers to privacy protection exist when telemedicine is compared with in-person visits. Would you like email updates of new search results?