Pre-Visit iPad Screener Shifts Teen Annual Health Visit Focus to Psychosocial Concerns


Taking 10 minutes to answer questions on an iPad before an annual visit may help adolescents and their pediatricians address sensitive mental health issues. A recent study published in the Journal of Adolescent Health looks at the use of a computerized screening program, DartScreen, and how it impacts what takes place during adolescents’ annual visit. Pediatricians are often pressed for time during the annual check-up because they are expected to screen for a wide range of medical and behavioral concerns. Inadequate time may contribute to the lack of screening and counseling regarding sensitive issues (e.g., depression) that has been shown for adolescents. A pre-visit screening questionnaire (or “screener”) may help primary care providers (PCPs) screen for a wide range of issues before the visit even begins, potentially freeing up time to focus on issues of particular concern. Studies have found that adolescents are more comfortable disclosing personal information to a computer than a person, indicating that a computerized screener may allow adolescents to more readily identify their physical and mental health concerns. 

In this study, the authors compared 37 standard annual visits to 35 annual visits wherein adolescents completed a screener in the exam room prior to the visit. Adolescents aged 15-19 years, from two pediatric primary care clinics, who were scheduled for an annual visit, were eligible to participate. DartScreen took teens an average of 9.5 minutes to complete on an iPad and included questions about nutrition, exercise, school, safety, reproductive health, alcohol and substance use, and mental health. The PCP viewed the results of the screener at the start of the visit.

The study results showed that in the visits wherein the adolescents completed the pre-visit screener, adolescents offered up more psychosocial information and mental health was discussed more. One participating PCP noted: “It helped to pull out the issues. When you ask in person, you get monotone answers, but the screener helps them open up.” PCPs found the screener helpful for visit organization and efficiency. The findings suggest that using a pre-visit screener may:

  • help PCPs complete a comprehensive annual visit,
  • reduce the need to ask about each risk behavior during the visit, and
  • free up time to allow adolescents to talk about mental health issues.

The authors’ conclude that “these findings suggest that use of a screener allows for a shift of focus to psychosocial topics, which are likely to be of more concern to teens given that adolescence is a time of significant social and emotional development.”