Adolescent Health Maintenance, Preventive Care, and Screening
The annual visit is the intervention
Adolescents should have a preventive visit every year from 11 through 21. Its core is a confidential, structured psychosocial interview (HEEADSSS: Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicide/depression, Safety) conducted with the parent out of the room. Explain confidentiality and its limits (imminent danger, abuse) at the start to both teen and parent; this habit produces more honest disclosure than any questionnaire.
Immunizations at a glance
Tdap and MenACWY at 11-12, with a MenACWY booster at 16; HPV series at 11-12 (two doses if begun before 15, three if 15 or older); annual influenza; MenB by shared clinical decision at 16-23; catch up MMR, varicella, and hepatitis B. Review the record every visit - the 16-year visit is the classic place to miss the meningococcal booster.
Screening that earns its place
Universal depression and suicide-risk screening yearly from age 12; CRAFFT for substance use yearly from 12; blood pressure, BMI percentile, and vision/hearing annually; a lipid panel once at 9-11 and again at 17-21; chlamydia and gonorrhea annually in sexually active females 24 or younger (and in males with risk); HIV at least once by age 15. Cervical cancer screening does not begin before 21. Scoliosis screening is recommended for girls at 10 and 12 and boys at 13 and 14. Anemia and tuberculosis screening are risk-based, not universal.
Traps
A sports physical is not a well visit and rarely covers psychosocial screening; do not let a parent answer for the teen; and do not place confidential content where a parent can read it without discussing it first.
Rule of thumb
A positive screening score does not end the visit - it obligates one follow-up question and a documented plan.