• Colleen K Gutman, Atsuko Koyama, Michelle Pickett, Sara Holmstrom, Fahd A Ahmad, Ariel Hoch, Elizabeth Lehto, Kari Schneider, Kristin S Stukus, Emily Weber, Cassandra Stich, and Lauren S Chernick.
• Department of Child Health, University of Arizona, College of Medicine, Phoenix, AZ.
• Pediatr Emerg Care. 2024 Jul 1; 40 (7): e94e104e94-e104.

ObjectivesMore than 19 million adolescents seek care in the emergency department (ED) annually. We aimed to describe the knowledge, attitudes, and behaviors related to confidential adolescent care among pediatric ED physicians.MethodsWe conducted a cross-sectional questionnaire of US physician members of the Pediatric Emergency Medicine Collaborative Research Committee survey listserv. The 24-item questionnaire assessed familiarity with adolescent confidentiality laws, attitudes toward providing confidential care, frequency of discussing behavioral health topics confidentially, and factors influencing the decision to provide confidential care. We dichotomized Likert responses and used χ 2 to compare subgroups.ResultsOf 476 eligible physicians, 151 (32%) participated. Most (91. 4%) had completed pediatric emergency medicine fellowship. More participants reported familiarity with all sexual health-related laws compared with all mental health-related laws (64% vs 49%, P < 0.001). The median age at which participants thought it was important to begin routinely providing confidential care was 12 years; 9% thought confidential interviews should not be routinely conducted until older adolescence or at all. Their decision to provide confidential care was influenced by the following: chief complaint (97%), time (43%), language (24%), presence of family (23%) or friends (14%), and space (22%).ConclusionsRespondents reported moderate familiarity with adolescent confidentiality laws. Although they viewed confidential care as something they were comfortable providing, the likelihood of doing so varied. Barriers to confidential care were influenced by their assessment of adolescents' behavioral health risk, which may contribute to health inequity. Future efforts are needed to develop strategies that augment confidential ED care for adolescents.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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