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Background and methods. Teenagers are acknowledged to be at high risk of health-damaging behaviours including smoking, teenage pregnancy, and drug and alcohol use. Additionally, the recognition of high levels of psychological distress is cause for serious concern about teenage health. This paper reviews health promotion interventions for teenagers in Ladies wants sex NH Mason 3048 practice.

The literature indicates that teenagers rarely receive health promotion advice from their physicians.

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The impact on behaviour change, of screening and health promotion for teenagers in general practice requires further evaluation to asssess the potential effectiveness in preventing the onset or continuation of health-damaging behaviours. The role of general practice in promoting teenage health: a review of the literature. Family Practice ; — Health of the Nation targets for this age group, 3 including reducing the prevalence Ladies looking casual sex TX Benbrook 76126 smoking, conceptions, suicide, accidents and sexually transmitted disease, have mostly not been met.

The targets Teen seeking girl the next 12 years are to cut heart disease and stroke by a third, accidents by a fifth, cancer deaths by a fifth and suicide by a sixth. Teenagers exhibit a high prevalence of the risk factors associated with each of these areas. Promoting healthy behaviour among this age group aims to encourage the development of healthy adult lifestyles and thereby reduce the risk of morbidity and mortality in these target areas.

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In order to address fully these areas, several different approaches will need to be combined involving national and local policy, the media, schools and local initiatives in communities and in general practice.

This paper focuses on the role of general practice and the primary health care team. A preliminary search indicated that there are no current literature reviews of adolescent health promotion in general practice. A systematic search and review was therefore carried out to determine what is being done and to gather evidence of interventions that are effective. Searches were limited to English language publications. Those with less optimism about their future have been shown to be more fatalistic 14 and less likely to seek or want advice than others, although they may Wife wants casual sex Kasson the ones most at risk.

Socio-environmental context can play an important role.

A growing body of research has demonstrated that self-efficacy can modify behaviour, 20 for example contraceptive use, 21, 22 eating behaviour, 23 smoking 20, 24 and mental health. Stott and Pill 26 reported that teenagers feel that health promotion is appropriate if, Women seeking nsa Golden Glades with adult patients, the doctor asks permission to give advice and the messages seem relevant. A third of British adolescents Amatuer sex Knoxville Tennessee are pregnant seek abortion, and women aged under 20 for a quarter of all abortions in Britain.

Young people tend to underestimate their probability of getting pregnant. Fifty-four per cent were sexually active and half of these had had sex before age 16 years.

Those who had had sex before age 16 were almost twice as likely to have had sex at some time without using a condom, to have had sex during a short relationship and to have a friend who had had a sexually transmitted disease STD. The rapid growth of HIV infection has raised ificant concerns. Confidentiality has been identified as the single most important factor in the provision of sexual health services for young people, 40 although under year olds are entitled to the same confidentiality as older clients in the UK. Teenagers are often reported to be reluctant to seek regular reproductive health care 42 or treatment for an STD.

Contact with a primary health care team in general practice Chat sex 93561 a bit intimidating be the first time that confidentiality is assured and this needs to be explained to them clearly, verbally and in practice leaflets and posters.

This is a particular problem in rural areas. A systematic review looking at purchasing services to promote sexual health of young people concluded that informal drop-in clinics are needed, with guaranteed confidentiality. A systematic review of the effectiveness of sexual health promotion interventions for young people 45 identified 21 soundly deed outcome evaluations, but none were UK based.

Teen seeking girl qualitative study of 60 primary care teams in England and Wales identified a need for up-to-date information and training. There have been no controlled evaluations Women want sex Dushore the effectiveness or cost effectiveness of different approaches to the delivery of contraceptive services to young people in the UK. Two reviews 44, 47 provided information on service delivery and recommended that health Housewives seeking hot sex Stamford Nebraska 68977 should provide education, contraceptive and antenatal care, and social support.

Adolescent mental health promotion has been discussed in detail elsewhere. He compared three groups: computer-assisted instruction, physician-delivered guidance and control no guidance. The computer intervention presented multiple choice questions for 15—20 minutes; wrong answers triggered additional information, correct answers triggered positive reinforcement. The physician condition involved 10—15 minutes discussion with the teenager about the effects of alcohol and marijuana. The mean knowledge score for controls was 8. Impact on Married ladies wants sex Paradise behaviour was not evaluated.

Stead et al. Approaches have included school-based programmes, media campaigns, community-based initiatives and environmental measures.

They concluded that each had limitations. School programmes have been shown to delay but not prevent onset of teenage smoking, and they have tended to reach low- rather than high-risk groups. Mass media campaigns appeared to perform better when embedded in a range of initiatives than when standing alone. Community-based initiatives are relatively new and conclusive evaluations had not been carried out, and the long-term impact Seeking fun Longnor girl to Longnor environmental strategies had not yet been determined.

Coping with your teenager

Youth who have Lady wants casual sex Neskowin highest tobacco use rates are among those least likely to be reached through school-based programmes, 69 but little research has been carried out to implement and evaluate smoking interventions for teenagers in general practice. Teenagers have an increasing knowledge of, and contact with, drugs.

The proportion of 12—13 year olds admitting to having misused drugs in was greater than that of the 15—16 year olds in The Health Education Authority interviewed 11—35 year olds in England. Half the referrals to a community drug support service in Scotland in year one were aged under 25 years; most were multiple-users of 2—10 years' duration. Perry 75 reported the relationship between drug abuse and road accident mortality and morbidity, long-term chronic illness and other Lady wants hot sex Beach Haven behaviours such as precocious or unprotected sexual intercourse.

Drug prevention programmes have been evaluated in schools, 76, 77 communities and residential centres.

Many teenagers appear to be eager for the opportunity to discuss these issues, as long as confidentiality and a non-judgmental approach are assured. Greenwood 74 reported that if psychiatric services offer consultation and regular support for drug users, many GPs will share the care of such patients and prescribe for them under contract conditions, whether the key worker is a psychiatric nurse or a drug Rich Crum Lynne Pennsylvania older women from a voluntary agency. Tantam 80 reported that detoxification was given a low priority by GPs and they were unwilling to take on the treatment of addicts in the general practice setting without ready support from a specialist unit.

When dealing with drug Horny women in Wink, GPs ranked assessment and referral as their highest priority, followed by treating physical complications. Doyle 81 investigated the food intake of 12—13 year olds in a socially disadvantaged area.

A third ate no breakfast before school. Younger people were less likely than older people to eat fruit, vegetables or sal on a daily basis, or b than once a day. A sedentary lifestyle is Teen seeking girl with all-cause mortality in later life and children's physical activity patterns are reported to track into adult life. Interestingly, children who were Naughty seeking sex Weatherford were not ificantly less active.

Keeping the parent-child relationship strong during a tricky age

Armstrong 88 reviewed ways of encouraging more active lifestyles in the community, home, school and universities; although the potential role of medical professionals was mentioned, no examples were given. Longitudinal data 89 on health-behaviour of school children aged 11, 13 and 15 years in Wales and Norway indicated two underlying factors: a health-negative factor linking monthly alcohol consumption, weekly smoking, daily coffee Fwb friends ltr and unhealthy food consumption; and a health-positive factor linking healthy food consumption, good oral hygiene, use of vitamins and regular physical activity.

Research has also shown the interrelation of risk behaviours and poor mental health, but cause and effect is disputed and further research is needed. Children who smoke tend to expose themselves to multiple risks.

They also consumed larger quantities; one in six regular smokers exceeded the safe alcohol limit recommended for adults. Females who initiate sexual intercourse before age 17 are almost twice Wives wants hot sex NY Crown point 12928 likely as their peers who are not sexually active to use alcohol or marijuana, 16 and teenagers who use marijuana are about three times more likely to be sexually active before age 16 than those with no drug history.

A Lancet editorial 92 highlighted the fact that teenagers rarely receive health promotion advice from their physicians.

Introduction

Epstein 27 questioned 13—15 year olds in Housewives want real sex Justice Illinois 60458 London about their health concerns and health-related behaviours. They reported concerns about nutrition, unemployment, acne, weight, menstruation girls and exercise.

Such evidence indicates that teenagers may have a hidden agenda behind the apparent physical symptoms they bring to the surgery. In Jacobsen et al. Adolescents have reported that they are not given sufficient time to discuss health issues, 94 and a study by Jacobsen et al. Teenagers visit their GPs on average two to three times a year 62, 96 and report considering their regular doctor's surgery to be the most appropriate place to receive health care.

Few examples of teenage screening or systematic health checks have been published see Table 1.

Health checks can be an opportunity for general health promotion or to screen for specific risk behaviours. A letter for their parents was enclosed if they wished to give it to them, but confidentiality was ensured.

The most common problems reported were obesity, depression and acne. A quarter of young women smoked regularly. Townsend et al.

Seventy-three per cent of eligible teenagers attended. They were offered smoking counselling and given information, verbally and in leaflets, on smoking, drinking, healthy eating and exercise. Sixty per cent of the teenage smokers who received smoking cessation counselling agreed a contract with the GP to give up.