Health promotion for adolescents in primary care: randomised controlled trial

Objectives To evaluate the effectiveness of inviting teenagers to general practice consultations to discuss health behaviour concerns and appropriate follow up care. Design Randomised controlled trial,with participants randomised to a consultation (intervention) or usual care (control). Questionnaires completed at baseline, 3 months, and 12 months. Setting Eight general practices in Hertfordshire, England. Participants 1516 teenagers aged 14-15 years. Intervention Consultations with practice nurses to discuss health concerns and develop plans for healthier lifestyles. Main outcome measures Mental and physical health, stage of change for health related behaviour, and use of health services. Results At baseline 970 teenagers completed questionnaires; 23% smoked, 35% had been drunk in the previous three months, 64% considered they ate unhealthily, 39% took little exercise, and 36% had possible depression. 41% (304) of teenagers invited attended for a consultation; over one third (112) were offered follow up care. More intervention group teenagers reported positive movement in stage of change for diet and exercise and in at least one of four behaviours (diet, exercise, smoking, drinking alcohol) at 3 months (41% v 31%, P<0.01), but this did not persist at 12 months. There was marginally more positive change in actual behaviour by intervention teenagers at 3 months (16% v 121%, P=0.06). Recognition of possible depression resulted in improved mental health outcomes at 3 and 12 months. 97% of attenders said they would recommend the intervention to a friend. Conclusions Change in behaviour was slight but encouraging, and the intervention was well received and relatively cheap.