Back off: Parents impeding teens' healthcare independence?

December 14, 2015 Volume 25 Issue 2
  • Only about 15% of parents report their teen would discuss health problems independently at a routine check-up.
  • Two-thirds of parents complete health history forms without involving their teen.
  • Parents’ top reason that teens are not involved in discussing health problems is they are not comfortable in that role.

As teenagers transition to adulthood, they should gradually increase responsibility for their own health and healthcare. This includes understanding their family health history, discussing symptoms of health problems with the provider, and asking questions about medications or treatments. Routine check-ups offer an opportunity for teens to practice these skills.

In September 2015, the C.S. Mott Children’s Hospital National Poll on Children’s Health asked parents of teens age 13-18 to describe their involvement in their teens’ healthcare visits.

Parent vs Teen Roles

For a routine check-up, 96% of parents said their teen would go to their usual doctor or clinic; 89% said the parent would also attend the visit. Only 34% of parents said at their teen’s most recent healthcare visit, the provider talked privately with the teen, without a parent in the room.

Two-thirds of parents report that they would complete the health history form without involving their teen; parents indicated their primary reason was that they would rather complete the form themselves. Similarly, 70% of parents would make decisions about vaccines without any involvement of their teen; the primary reason was that vaccine decisions are the parent’s role.

Over half of parents report that both they and their teen would be involved in discussing physical, emotional, or behavioral problems, and asking questions about health issues. Only about 15% of parents indicated that their teen would discuss physical or emotional problems independently, and only 5% said their teen would ask questions independently. Parents who would discuss health issues without any involvement of their teen reported that their teen would not be comfortable talking about these things.

Implications

The teenage years are a time of emerging independence—from taking on more responsibility for schoolwork and household chores, to learning to drive, getting a job, and planning for college. Parents often play an important role in giving teens opportunities to become more independent.

Results of this national poll suggest that parents may not fully appreciate their role in promoting teens’ independence in the healthcare setting. From completing health history forms at registration, to describing symptoms of health problems, many parents report that they—not their teen—play a greater role in the healthcare interaction.

Parents’ top reason for not having their teen take the lead in talking with the healthcare provider about physical, emotional, or behavioral health problems is that the teen isn’t comfortable in that role. However, when parents step in to manage the healthcare interaction, teens do not have the opportunity to develop confidence and comfort in having discussions with the provider, asking questions about their condition or treatment, and taking responsibility for their own health.

In terms of filling out health history forms or other paperwork, parents’ top reason for not involving their teen is that they’d rather do it themselves. Though perhaps more efficient for parents, this potentially deprives teens a chance to become accustomed to the usual processes at a health care visit, and to gain important knowledge about their family health history.

Parents can follow several strategies to promote their teens’ healthcare independence. Before the appointment, parents can encourage their teen to write down any health problems or questions they have. Upon arrival, the teen can check in at the registration desk and complete any forms, with the parent available as a back-up if questions arise. During the visit, parents can wait to speak, giving space for the teen to describe any problems or questions. The early opportunities to gain skills and confidence, with a parent nearby for guidance, will pave the way for teens to navigate the health care system when they become adults.

Data Source

This report presents findings from a nationally representative household survey conducted exclusively by GfK Custom Research, LLC (GfK), for C.S. Mott Children’s Hospital via a method used in many published studies.  The survey was administered in September 2015 to a randomly selected, stratified group of parents age 18 and older with at least one child age 13-18 (n=1,517). Parents were selected from GfK’s web-enabled KnowledgePanel® that closely resembles the U.S. population. The sample was subsequently weighted to reflect population figures from the Census Bureau. The survey completion rate was 40% among panel members contacted to participate. The margin of error is ± 1 to 4 percentage points.

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amilcar Matos-Moreno, MPH
Web Editor: Anna Daly Kauffman, BA
Research Associate: Sara L. Schultz, BA

Findings from the C.S. Mott Children's Hospital National Poll on Children's Health do not represent the opinions of the investigators or the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.

Questions were answered by aprents of teens age 13-18.

Q1. Where would your teen go for their routine check-up?

  • Teen’s usual provider or clinic
  • School health clinic
  • Urgent care center
  • Other

Q2. Who would likely attend the check-up?

  • Teen only
  • Teen plus parent
  • Teen plus older sibling/other adult

Q3. At the check-up, who would do the following?

  Teen Only Parent Only Both Teen and Parent
Fill out teen's health history form      
Tell provider about any physical problems teen is having      
Tell provider about any emotional or behavioral problems teen is having      
Ask questions about health issues      
Make decisions about vaccines      
Talk with the provider confidentially      

If respondent answered "Parent Only" to any options in Q3, respondents answered the following question(s):

Q4. Why would your teen NOT fill out teen’s health history form?

  • Teen does not know this information
  • I would rather do this myself
  • Teen is not comfortable doing this
  • This is the parent’s role
  • Other

Q5. Why would your teen NOT tell provider about any physical problems teen is having?

  • Teen does not know this information
  • I would rather do this myself
  • Teen is not comfortable doing this
  • This is the parent’s role
  • Other

Q6. Why would your teen NOT tell provider about any emotional or behavioral problems teen is having?

  • Teen does not know this information
  • I would rather do this myself
  • Teen is not comfortable doing this
  • This is the parent’s role
  • Other

Q7. Why would your teen NOT ask questions about health issues?

  • Teen does not know this information
  • I would rather do this myself
  • Teen is not comfortable doing this
  • This is the parent’s role
  • Other

Q8. Why would your teen NOT make decisions about vaccines?

  • Teen does not know this information
  • I would rather do this myself
  • Teen is not comfortable doing this
  • This is the parent’s role
  • Other

Q9. Why would your teen NOT talk with the provider confidentially?

  • Teen does not know this information
  • I would rather do this myself
  • Teen is not comfortable doing this
  • This is the parent’s role
  • Other

Q10. At the most recent healthcare visit, did the provider talk privately with your teen without a parent in the room?

  • Yes
  • No
  • Not sure

Participants were also asked demographic questions on gender, race/ethnicity, annual household income, education and insurance status.

All information is the sole property of the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health.  It can only be used if there is an acknowledgment that "The information came from, is copyright by and is owned by and belongs to the Regents of the University of Michigan and their C.S. Mott Children's Hospital National Poll on Children's Health. It cannot be republished or used in any format without prior written permission from the University."

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amilcar Matos-Moreno, MPH
Web Editor: Anna Daly Kauffman, BA
Research Associate: Sara L. Schultz, BA

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Figure 1. Who handles aspects of teens' check-ups?