TY - JOUR
T1 - Disparities in Medical Assessment Practices for Adolescents at Risk for Eating Disorders
AU - Sim, Leslie
AU - Witte, Micaela A.
AU - Lebow, Jocelyn
AU - LeMahieu, Allison
AU - Geske, Jennifer
AU - Witte, Nathaniel
AU - Whiteside, Stephen
AU - Loth, Katie
AU - Harbeck Weber, Cynthia
N1 - Publisher Copyright:
© 2023 Society for Adolescent Health and Medicine
PY - 2024/3
Y1 - 2024/3
N2 - Purpose: The United States Preventative Services Task Force found insufficient evidence to support universal screening for eating disorders (EDs) but did recommend assessing high-risk adolescents through laboratory tests, close follow-up, and referrals to other specialties. Yet, it is unclear whether youth at high risk for EDs receive such assessment and whether patient characteristics influence such practices. Methods: Using the Rochester Epidemiological Project, we identified adolescents (13–18 years) at risk for EDs (i.e., weight loss, underweight, or loss of appetite not explained by a medical condition) who presented for a medical appointment between January 1, 2005 to December 31, 2017 (n = 662; M age = 15.8 years; 66% female; 76% white). Patient and visit characteristics, assessment practices (i.e., tests, referrals, and follow-up), and ED diagnoses within 5 years following index visit were extracted. Results: Adolescents who received referrals to other providers were 4 times more likely to be diagnosed with a future ED (p < .001) and were diagnosed 137.8 days sooner (Est = −137.8, p = .04) compared to those who did not receive referrals. Compared to males, females were 2.2 times more likely to receive referrals (p < .001). Compared to those presenting at a lower body mass index, adolescents with a higher body mass index were more likely to receive medical tests (HR = 1.0, p < .01) and less likely to receive recommendations to improve eating/weight (HR = 0.99, p < .01) or follow up visits (HR = 0.99, p < .01). Discussion: Disparities in assessment practices for adolescents at high-risk for EDs underscore the need for improved tools to enhance early detection and treatment.
AB - Purpose: The United States Preventative Services Task Force found insufficient evidence to support universal screening for eating disorders (EDs) but did recommend assessing high-risk adolescents through laboratory tests, close follow-up, and referrals to other specialties. Yet, it is unclear whether youth at high risk for EDs receive such assessment and whether patient characteristics influence such practices. Methods: Using the Rochester Epidemiological Project, we identified adolescents (13–18 years) at risk for EDs (i.e., weight loss, underweight, or loss of appetite not explained by a medical condition) who presented for a medical appointment between January 1, 2005 to December 31, 2017 (n = 662; M age = 15.8 years; 66% female; 76% white). Patient and visit characteristics, assessment practices (i.e., tests, referrals, and follow-up), and ED diagnoses within 5 years following index visit were extracted. Results: Adolescents who received referrals to other providers were 4 times more likely to be diagnosed with a future ED (p < .001) and were diagnosed 137.8 days sooner (Est = −137.8, p = .04) compared to those who did not receive referrals. Compared to males, females were 2.2 times more likely to receive referrals (p < .001). Compared to those presenting at a lower body mass index, adolescents with a higher body mass index were more likely to receive medical tests (HR = 1.0, p < .01) and less likely to receive recommendations to improve eating/weight (HR = 0.99, p < .01) or follow up visits (HR = 0.99, p < .01). Discussion: Disparities in assessment practices for adolescents at high-risk for EDs underscore the need for improved tools to enhance early detection and treatment.
KW - Adolescence
KW - Eating disorders
KW - Health-care disparities
KW - Medical assessment
KW - Screening
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U2 - 10.1016/j.jadohealth.2023.10.004
DO - 10.1016/j.jadohealth.2023.10.004
M3 - Article
C2 - 38069936
AN - SCOPUS:85179495834
SN - 1054-139X
VL - 74
SP - 591
EP - 596
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 3
ER -