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J Pediatr. 2019 Oct;213:196-202. doi: 10.1016/j.jpeds.2019.05.056. Epub 2019 Jun 21.

Confidentiality in the Doctor-Patient Relationship: Perspectives of Youth Ages 14-24 Years.

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University of Michigan Medical School, Ann Arbor, MI. Electronic address:
Georgetown University, Washington, DC.
Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI.
Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI.



To describe the experiences of youth regarding confidentiality with their healthcare provider and how confidentiality affects their interactions with the healthcare system.


Using MyVoice, a national mixed methods text message poll, 4 qualitative probes were asked to 1268 youth age 14-24 years from July 2017 through December 2017. Respondents were asked about their opinions and experiences with confidentiality in their healthcare. Data were analyzed using a modified grounded theory approach.


The overall response rate was 75% (n = 948) with a mean age of 18.6 years (SD = 3.2). Respondents were mostly female (56%) and white (70%) with 44% reporting some college education or greater. Qualitative analysis revealed that the majority of youth have not had a conversation with their provider about confidentiality; many youth think all care should be confidential; youth worry about privacy and future discrimination; and youth may lie about their risk behaviors or not seek healthcare when concerned about confidentiality.


Confidentiality in healthcare is concerning to many youth and affects how they interact with the healthcare system. It is imperative for healthcare providers to discuss confidentiality while building trusting relationships with each youth to provide the highest level of care for this vulnerable population.


confidentiality; healthcare behaviors; mixed methods; policy; text messaging; youth

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