Dual Psychosocial Screening of the Adolescent Patient by Implementing the Safe Environment for Every Kid Teen Questionnaire

Objective: This study introduces the SEEK Teen Questionnaire, expanding the Safe Environment for Every Kid (SEEK) approach to include adolescent perspectives alongside caregiver responses for dual psychosocial screening. The objective of this study was to triangulate adolescent responses with those of their caregivers to demonstrate the benefits of dual psychosocial screening. Methods: The SEEK Teen Questionnaire was developed by integrating input from primary care and adolescent medicine professionals, national experts, and adolescent stakeholders. The resulting 32-item psychosocial screening tool was administered to adolescent patients aged 11–18 during well visits simultaneously with caregiver completion of the SEEK Parent Questionnaire from August to October, 2022 with interventions offered for identified problems. Responses were compared using McNemar's and Fisher's exact tests. Results: Four hundred and eighty caregivers and adolescents consented to the study. Participants were generally white (64%), non-Hispanic (81%), and privately insured (62%). Adolescents had a high completion rate (97%) with concordant responses among matched caregivers between 83% and 96%. Among discordant dyads, adolescents disclosed concerns for their caregivers more commonly than caregivers expressed for themselves: discipline (83% vs. 17%, P < 0.001), food insecurity (71% vs. 29%, P = 0.09), intimate partner violence (78% vs. 22%, P < 0.018), stress (81% vs. 19%, P < 0.001), depression (64% vs. 36%, P = 0.12), and substance misuse (91% vs. 9%, P < 0.001). Conclusions: This study demonstrates adolescents' willingness to provide insights into their caregivers' well-being and their high awareness of stressors affecting them. Incorporating adolescent perspectives enhances the identification of issues that may otherwise go unnoticed, underscoring the importance of dual psychosocial screening during adolescence.