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J Fam Pract. 1994 May;38(5):489-94.

A short survey for assessing health and social problems of adolescents. Dartmouth Primary Care Cooperative Information Project (The COOP).

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Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH 03755-3862.



Many significant problems of adolescents are undetected and untreated. To aid in the discovery of these problems, we have developed and tested picture-and-word charts for use in the classroom or the physician's office. This report presents the results of these tests and describes how the charts may be used.


We assessed test-retest reliability of the picture-and-word charts. We also compared picture-and-word chart scores with corresponding multi-item questionnaires. Six charts were determined to be the most effective in measuring mutually exclusive dimensions of health and social problems. We used these six charts to examine factors that might affect the distribution of chart scores.


We administered the picture-and-word charts to a diverse population of 658 adolescents whose median age was 15 years. Compared with multi-item questionnaires, respondents found the charts easier to understand and less likely to induce dishonest replies. Girls scored significantly worse (P < .001) than boys on the Physical Fitness and Emotional Feelings charts but better on the (at-risk) Health Habits chart (P < .001). The scores of teenagers known to have behavioral problems were worse on the Health Habits chart than were those of other adolescents (P < .001).


The charts are an efficient and acceptable method for detecting health and social problems of adolescents.

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